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stroke randomized controlled trials

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https://www.readbyqxmd.com/read/29667175/first-line-drugs-for-hypertension
#1
REVIEW
James M Wright, Vijaya M Musini, Rupam Gill
BACKGROUND: This is the first update of a review published in 2009. Sustained moderate to severe elevations in resting blood pressure leads to a critically important clinical question: What class of drug to use first-line? This review attempted to answer that question. OBJECTIVES: To quantify the mortality and morbidity effects from different first-line antihypertensive drug classes: thiazides (low-dose and high-dose), beta-blockers, calcium channel blockers, ACE inhibitors, angiotensin II receptor blockers (ARB), and alpha-blockers, compared to placebo or no treatment...
April 18, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29665842/sensory-re-learning-of-the-upper-limb-after-stroke-sensupp-study-protocol-for-a-pilot-randomized-controlled-trial
#2
Håkan Carlsson, Birgitta Rosén, Hélène Pessah-Rasmussen, Anders Björkman, Christina Brogårdh
BACKGROUND: Many stroke survivors suffer from sensory impairments of their affected upper limb (UL). Although such impairments can affect the ability to use the UL in everyday activities, very little attention is paid to sensory impairments in stroke rehabilitation. The purpose of this trial is to investigate if sensory re-learning in combination with task-specific training may prove to be more effective than task-specific training alone to improve sensory function of the hand, dexterity, the ability to use the hand in daily activities, perceived participation, and life satisfaction...
April 17, 2018: Trials
https://www.readbyqxmd.com/read/29664857/restrictive-versus-liberal-strategy-for-red-blood-cell-transfusion-a-systematic-review-and-meta-analysis-in-orthopaedic-patients
#3
Wan-Jie Gu, Xiao-Ping Gu, Xiang-Dong Wu, Hao Chen, Joey S W Kwong, Lu-Yang Zhou, Shuo Chen, Zheng-Liang Ma
BACKGROUND: Current guidelines recommend restrictive criteria for red blood-cell transfusion in most clinical settings. However, patients undergoing orthopaedic surgery may require distinct transfusion criteria since benefits and potential harm often vary considerably based on patient characteristics and surgical procedures. We aimed to assess the efficacy and safety of restrictive transfusion in patients undergoing orthopaedic surgery, especially in important subgroups. METHODS: Electronic databases were searched to identify randomized controlled trials investigating restrictive (mostly a hemoglobin level of 8...
April 18, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29664057/remote-ischemic-postconditioning-for-ischemic-stroke-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#4
Jing-Jing Zhao, Hui Xiao, Wen-Bo Zhao, Xiao-Pei Zhang, Yu Xiang, Zeng-Jie Ye, Miao-Miao Mo, Xue-Ting Peng, Lin Wei
Background: Remote ischemic postconditioning (RIPostC) appears to protect distant organs from ischemia-reperfusion injury (IRI). However, cerebral protection results have remained inconclusive. In the present study, a meta-analysis was performed to compare stroke patients with and without RIPostC. Methods: CNKI, WanFang, VIP, CBM, PubMed, and Cochrane Library databases were searched up to July 2016. Data were analyzed using both fixed-effects and random-effects models by Review Manager...
April 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29664001/-protective-effect-of-mild-hypothermia-at-different-starting-times-on-organ-function-in-patient-with-exertional-heat-stroke
#5
Qinghua Li, Rongqing Sun, Hongdi Lyu, Dexin Shen, Qing Hu, Haiwei Wang, Nannan Wang, Jin Yan, Jing Wang
OBJECTIVE: To investigate the protective effect of mild hypothermia at different starting times on the physiological functions of the viscera of exertional heat stroke (EHS). METHODS: A prospective randomized controlled trial was conducted. EHS patients admitted to intensive care unit of the 159th Hospital of People's Liberation Army and the First Affiliated Hospital of Zhengzhou University from June 2015 to June 2017 were enrolled. The patients were divided into 2, 4, 6 hours start hypothermia treatment groups according to the random number table method, the mild hypothermia was initiated at 2, 4 and 6 hours after the disease onset respectively, and the methods were the same in each group...
April 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29663857/adherence-of-stroke-patients-with-an-online-brain-training-program-the-role-of-health-professionals-support
#6
M M Wentink, J Meesters, M A M Berger, A J de Kloet, E Stevens, G P H Band, C H Kromme, R Wolterbeek, P H Goossens, T P M Vliet Vlieland
Background Computer-based cognitive rehabilitation is used to improve cognitive functioning after stroke. However, knowledge on adherence rates of stroke patients is limited. Objective To describe stroke patients' adherence with a brain training program using two frequencies of health professionals' supervision. Methods This study is part of a randomized controlled trial comparing the effect of the brain training program (600 min playtime with weekly supervision) with a passive intervention in patients with self-perceived cognitive impairments after stroke...
April 17, 2018: Topics in Stroke Rehabilitation
https://www.readbyqxmd.com/read/29663464/uninterrupted-administration-of-edoxaban-vs-vitamin-k-antagonists-in-patients-undergoing-atrial-fibrillation-catheter-ablation-rationale-and-design-of-the-eliminate-af-study
#7
Stefan H Hohnloser, John Camm, Riccardo Cappato, Hans-Christoph Diener, Hein Heidbuchel, Hans-Joachim Lanz, Lluís Mont, Carlos A Morillo, Rüdiger Smolnik, Ophelia Q P Yin, Josef Kautzner
Patients with atrial fibrillation (AF) are at an approximately 0.5% to 3% increased risk of thromboembolism during and immediately after catheter ablation. Treatment guidelines recommend periprocedural oral anticoagulation plus unfractionated heparin during ablation. Rivaroxaban and dabigatran are the only non-vitamin K oral anticoagulants for which there are randomized controlled trials assessing uninterrupted anticoagulation in patients undergoing catheter ablation of AF. Edoxaban, a direct factor Xa inhibitor, is noninferior vs warfarin for the prevention of stroke or systemic embolism with less major bleeding in patients with nonvalvular AF...
April 17, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29662510/long-term-outcomes-of-drug-eluting-stent-versus-coronary-artery-bypass-grafting-for-left-main-coronary-artery-disease-a-meta-analysis
#8
Kong-Yong Cui, Shu-Zheng Lyu, Xian-Tao Song, Fei Yuan, Feng Xu, Min Zhang, Ming-Duo Zhang, Wei Wang, Dong-Feng Zhang, Jing Dai, Jin-Fan Tian, Yun-Lu Wang
Background: It is still controversial whether percutaneous coronary intervention with drug-eluting stent (DES) is safe and effective compared to coronary artery bypass graft surgery (CABG) for unprotected left main coronary artery (ULMCA) disease at long-term follow up (≥ 3 years). Methods: Eligible studies were selected by searching PubMed, EMBASE, and Cochrane Library up to December 6, 2016. The primary endpoint was a composite of death, myocardial infarction (MI) or stroke during the longest follow-up...
February 2018: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29656857/legacy-effect-of-intensive-blood-glucose-control-on-cardiovascular-outcomes-in-patients-with-type-2-diabetes-and-very-high-risk-or-secondary-prevention-of-cardiovascular-disease-a-meta-analysis-of-randomized-controlled-trials
#9
REVIEW
Xinyue Zhang, Yuqi Liu, Fang Zhang, Juan Li, Nanwei Tong
PURPOSE: We performed a meta-analysis to investigate the legacy effect of >5 years of intensive blood glucose lowering on cardiovascular outcomes in patients with type 2 diabetes and very high risk or secondary prevention of cardiovascular disease (CVD). METHODS: We mainly searched PubMed, Embase, and the Cochrane Library for relevant randomized controlled trials. Patients in the included studies had intensive glucose lowering for >5 years and posttrial follow-up for at least 5 years...
April 12, 2018: Clinical Therapeutics
https://www.readbyqxmd.com/read/29656002/dangers-of-outpatient-nimodipine-use-after-spontaneous-subarachnoid-hemorrhage-in-accordance-with-the-comprehensive-stroke-center-guidelines
#10
Ching-Jen Chen, Cassie Turnage, Jennifer D Sokolowski, Jeyan S Kumar, M Yashar Kalani, Min S Park
Despite the adverse effects and unclear benefit of the complete 21-day course of nimodipine therapy, The Joint Commission mandates adherence to nimodipine treatment for 21 days after hemorrhage or after hospital discharge if discharged within 21 days for Comprehensive Stroke Center (CSC) certification. We hereby present a 67 year-old male patient with Hunt-Hess grade 2 and Fisher grade 3 non-aneurysmal spontaneous subarachnoid hemorrhage who was discharged with oral nimodipine as stipulated by the CSC guidelines, and subsequently developed symptomatic hypotension...
April 11, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29655505/midterm-outcome-of-transcatheter-versus-surgical-aortic-valve-replacement-in-low-to-intermediate-risk-patients-a-meta-analysis-of-randomized-controlled-trials
#11
Yanwei Wang, Yijiang Zhou, Li Zhang, Jianhua Zhu
BACKGROUND: Current guidelines recommend transcatheter aortic valve replacement (TAVR) in patients with severe symptomatic aortic stenosis (AS) who are not suitable for conventional surgical aortic valve replacement (SAVR). In light of the recent trend in performing TAVR in patients with lower risk profile, we assessed the midterm outcome comparing TAVR and SAVR for the treatment of patients with severe AS at low to intermediate risk. METHODS: PubMed, EBSCO, and Cochrane CENTRAL were systematically searched for randomized controlled trials that reported the clinical outcomes of TAVR versus SAVR in patients at low to intermediate surgical risk with at least 2 years of follow-up...
June 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29652078/total-cardiovascular-events-analysis-of-the-examine-trial-in-patients-with-type-2-diabetes-and-recent-acute-coronary-syndrome
#12
Matthew A Cavender, William B White, Yuyin Liu, Joseph M Massaro, Richard M Bergenstal, Cyrus R Mehta, Faiez Zannad, Simon Heller, William C Cushman, Christopher P Cannon
BACKGROUND: Alogliptin, a dipeptidyl-peptidase 4 inhibitor, is approved for the treatment of patients with type 2 diabetes. EXAMINE was a randomized-controlled clinical trial designed to demonstrate the cardiovascular safety of alogliptin. In the trial, 5380 patients with established T2DM who had a recent ACS event (between 15-90 days) were randomized to treatment with either alogliptin or placebo. HYPOTHESIS: To better understand and describe the cardiovascular (CV) safety of alogliptin, we analyzed data from the EXAMINE randomized clinical trial to determine whether treatment with alogliptin affected recurrent and total CV events...
April 13, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29651563/predictors-of-decompressive-hemicraniectomy-in-malignant-middle-cerebral-artery-stroke
#13
Saadat Kamran, Abdul Salam, Naveed Akhtar, Atlantic D'soza, Ashfaq Shuaib
Identification of factors in malignant middle cerebral artery (MMCA) stroke patients that may be useful in selecting patients for DHC. This study was a retrospective multicenter study of patients referred for DHC based on the criteria of the randomized control trials of DHC in MMCA stroke. Demographic, clinical, and radiology data were analyzed. Patients who underwent DHC were compared to those who survived without surgery. Two hundred three patients with MMCA strokes were identified: 137 underwent DHC, 47 survived without DHC, and 19 refused surgery and died...
April 12, 2018: Neurosurgical Review
https://www.readbyqxmd.com/read/29650408/normothermic-ex-vivo-preservation-with-the-portable-organ-care-system-lung-device-for-bilateral-lung-transplantation-inspire-a-randomised-open-label-non-inferiority-phase-3-study
#14
Gregor Warnecke, Dirk Van Raemdonck, Michael A Smith, Gilbert Massard, Jasleen Kukreja, Federico Rea, Gabriel Loor, Fabio De Robertis, Jayan Nagendran, Kumud K Dhital, Francisco Javier Moradiellos Díez, Christoph Knosalla, Christian A Bermudez, Steven Tsui, Kenneth McCurry, I-Wen Wang, Tobias Deuse, Guy Lesèche, Pascal Thomas, Igor Tudorache, Christian Kühn, Murat Avsar, Bettina Wiegmann, Wiebke Sommer, Arne Neyrinck, Marco Schiavon, Fiorella Calebrese, Nichola Santelmo, Anne Olland, Pierre-Emanuel Falcoz, Andre R Simon, Andres Varela, Joren C Madsen, Marshall Hertz, Axel Haverich, Abbas Ardehali
BACKGROUND: Severe primary graft dysfunction (PGD) of grade 3 (PGD3) is a common serious complication following lung transplantation. We aimed to assess physiological donor lung preservation using the Organ Care System (OCS) Lung device compared with cold static storage. METHODS: In this non-inferiority, randomised, controlled, open-label, phase 3 trial (INSPIRE) recipients were aged 18 years or older and were registered as standard criteria primary double lung transplant candidates...
April 9, 2018: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29649992/protocol-for-promoting-recovery-optimization-of-walking-activity-in-stroke-prowalks-a-randomized-controlled-trial
#15
Henry Wright, Tamara Wright, Ryan T Pohlig, Scott E Kasner, Jonathan Raser-Schramm, Darcy Reisman
BACKGROUND: Stroke survivors are more physically inactive than even the most sedentary older adults, and low activity is associated with increased risk of recurrent stroke, medical complications, and mortality. We hypothesize that the combination of a fast walking intervention that improves walking capacity, with a step activity monitoring program that facilitates translation of gains from the clinic to the "real-world", would generate greater improvements in real world walking activity than with either intervention alone...
April 12, 2018: BMC Neurology
https://www.readbyqxmd.com/read/29649819/patent-foramen-ovale-and-cryptogenic-stroke-or-transient-ischemic-attack-to-close-or-not-to-close-a-systematic-review-and-meta-analysis
#16
Simona Lattanzi, Francesco Brigo, Claudia Cagnetti, Mario Di Napoli, Mauro Silvestrini
BACKGROUND: The optimal strategy of secondary stroke prevention in patients with patent foramen ovale (PFO) is controversial. This study was performed to evaluate the efficacy and safety of the device closure (DC) versus the medical therapy (MT) in patients with cryptogenic stroke or transient ischemic attack (TIA) and PFO. SUMMARY: Randomized controlled trials with active and control groups receiving the DC plus MT and MT alone in patients with history of cryptogenic stroke/TIA and diagnosis of PFO were systematically searched...
April 12, 2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29645285/cardiovascular-safety-of-the-%C3%AE-3-adrenoceptor-agonist-mirabegron-and-the-antimuscarinic-agent-solifenacin-in-the-synergy-trial
#17
William B White, Christopher Chapple, Christian Gratzke, Sender Herschorn, Dudley Robinson, Jeffrey Frankel, Arwin Ridder, Matthias Stoelzel, Asha Paireddy, Robert van Maanen, Michael A Weber
There have been concerns that treatment of overactive bladder with β3 -adrenoceptor agonists may potentially have detrimental cardiovascular (CV) side effects. We evaluated the CV safety of mirabegron, a β3 -adrenoceptor agonist, alone and in combination therapy with the antimuscarinic agent solifenacin. The SYNERGY trial was a multinational, multicenter, randomized, double-blind, parallel-group, placebo and active-controlled phase 3 trial. Patients were randomized to receive solifenacin 5 mg + mirabegron 50 mg (combination 5 + 50 mg), solifenacin 5 mg + mirabegron 25 mg (combination 5 + 25 mg), solifenacin 5 mg monotherapy, mirabegron 25 mg monotherapy, mirabegron 50 mg monotherapy, or placebo for a 12-week double-blind treatment period...
April 12, 2018: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29644880/effects-of-mirror-therapy-on-walking-ability-balance-and-lower-limb-motor-recovery-after-stroke-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#18
Yi Li, Qingchuan Wei, Wei Gou, Chengqi He
OBJECTIVE: To investigate the effects of mirror therapy on walking ability, balance and lower limb motor recovery in patients with stroke. METHOD: MEDLINE, EMBASE, Web of Science, CENTRAL, PEDro Database, CNKI, VIP, Wan Fang, ClinicalTrials.gov, Current controlled trials and Open Grey were searched for randomized controlled trials that investigated the effects of mirror therapy on lower limb function through January 2018. The primary outcomes included were walking speed, mobility and balance function...
April 1, 2018: Clinical Rehabilitation
https://www.readbyqxmd.com/read/29644412/patent-foramen-ovale-closure-versus-medical-therapy-for-prevention-of-recurrent-cryptogenic-embolism-updated-meta-analysis-of-randomized-clinical-trials
#19
Brunilda Alushi, Alexander Lauten, Salvatore Cassese, Roisin Colleran, Stefanie Schüpke, Himanshu Rai, Heribert Schunkert, Bernhard Meier, Ulf Landmesser, Adnan Kastrati
BACKGROUND: We performed an updated meta-analysis of all randomized-controlled trials (RCTs) comparing patent foramen ovale (PFO) closure with medical therapy for prevention of recurrent ischemic stroke. METHODS AND RESULTS: We searched Medline, EMBASE, and Cochrane databases, and proceedings of international meetings for RCTs of patients with cryptogenic stroke and PFO comparing percutaneous PFO closure versus medical therapy for prevention of recurrent ischemic stroke...
April 11, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29643598/effects-of-gait-training-on-sand-on-improving-the-walking-ability-of-patients-with-chronic-stroke-a-randomized-controlled-trial
#20
Tae-Ho Kim, Byoung-Ha Hwang
[Purpose] This study examines how difference in sandy ground between firm ground influences the effects of gait training in patients with chronic stroke. [Subjects and Methods] A total of 28 patients with chronic stroke were evenly divided into experimental and control groups. Initial evaluation of the subjects was conducted by Timed Up & Go (TUG) and 6-Minute Walking Test (6MWT). Each patient in both groups received daily, 30-minute gait training on sandy ground and firm ground, five times each week, for a total of six weeks, after which reevaluation was conducted...
December 2017: Journal of Physical Therapy Science
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