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stroke randomized controlled trials

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https://www.readbyqxmd.com/read/29035430/the-use-pattern-and-clinical-impact-of-new-antiplatelet-agents-including-prasugrel-and-ticagrelor-on-30-day-outcomes-after-acute-myocardial-infarction-in-korea-korean-health-insurance-review-and-assessment-data
#1
Choongki Kim, Dong Ho Shin, Chul Min Ahn, Jung Sun Kim, Byeong Keuk Kim, Young Guk Ko, Donghoon Choi, Myeong Ki Hong, Juhee Park, Hyeyeong Lee, Yoon Jung Choi, Youn Song Choi, Sang Kwon Oh, Yangsoo Jang
BACKGROUND AND OBJECTIVES: Despite the favorable efficacy of new antiplatelet agents demonstrated in randomized controlled trials, their clinical implications in Korea are unclear. The purpose of this study was to investigate trends in antiplatelet agent use for acute myocardial infarction (AMI) and their impact on 30-day clinical outcomes. METHODS: AMI patients undergoing percutaneous coronary intervention between 2010 and 2015 were assessed using claim data from the Health Insurance Review and Assessment Service...
September 12, 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/29031023/whole-body-vibration-combined-with-treadmill-training-improves-walking-performance-in-post-stroke-patients-a-randomized-controlled-trial
#2
Wonjae Choi, Donghun Han, Junesun Kim, Seungwon Lee
BACKGROUND Stroke is characterized by an asymmetrical gait pattern that causes poor stability and reduces overall activity levels. The aim of this study was to investigate the effect of whole-body vibration combined with treadmill training (WBV-TT) on walking performance in patients with chronic stroke. MATERIAL AND METHODS Thirty ambulatory chronic stroke patients were randomly allocated to the WBV-TT group or the treadmill training (TT) group. The participants in the WBV-TT group performed 6 types of exercises on a vibrating platform for 4...
October 14, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29030478/randomized-controlled-trial-of-early-versus-delayed-statin-therapy-in-patients-with-acute-ischemic-stroke-assort-trial-administration-of-statin-on-acute-ischemic-stroke-patient
#3
Shinichi Yoshimura, Kazutaka Uchida, Takashi Daimon, Ryuzo Takashima, Kazuhiro Kimura, Takeshi Morimoto
BACKGROUND AND PURPOSE: Several studies suggested that statins during hospitalization were associated with better disability outcomes in patients with acute ischemic stroke, but only 1 small randomized trial is available. METHODS: We conducted a multicenter, open-label, randomized controlled trial in patients with acute ischemic strokes in 11 hospitals in Japan. Patients with acute ischemic stroke and dyslipidemia randomly received statins within 24 hours after admission in the early group or on the seventh day in the delayed group, in a 1:1 ratio...
October 13, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29028286/doppler-guided-goal-directed-fluid-therapy-does-not-affect-intestinal-cell-damage-but-increases-global-gastrointestinal-perfusion-in-colorectal-surgery-a-randomized-controlled-trial
#4
Kostan W Reisinger, Henriette M Willigers, Jochen Jansen, Wim A Buurman, Maarten F Von Meyenfeldt, Geerard L Beets, Martijn Poeze
Individualized, goal-directed fluid therapy (GDFT) based on Doppler measurements of stroke volume has been proposed as a treatment strategy in terms of reducing complications, mortality and length of hospital stay in major bowel surgery. We studied the effect of Doppler guided GDFT on intestinal damage as compared with standard post-operative fluid replacement. STUDY DESIGN: Patients undergoing elective colorectal resection for malignancy were randomized to standard intra- and postoperative fluid therapy or standard fluid therapy with additional Doppler guided GDFT...
October 13, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29027438/-meta-analysis-on-indirect-comparison-of-erigeron-breviscapus-injection-and-breviscapus-injection-in-treatment-of-acute-ischemic-stroke
#5
Yu-Fang Zhang, Xi-Tong Ke, Bao-Cai Li, Cheng Xiang, Song Zhao
Erigeron breviscapus injection(DZXI) and Breviscapus injection(DZSI) are two popular injections in treatment of acute ischemic stroke in China. Both of them are manufactured from a same herbal medicine, E. breviscapus, but DZXI is an herbal extract(mixture) preparation and DZSI is a pure compound injection. This article was aimed to systemically evaluate and compare their efficacy and safety in treatment of acute ischemic stroke. The randomized controlled trials(RCTs) were collected for comparing DZXI and DZSI with Salvia miltiorrhiza injection(FDI) as the medium, and they were compared with indirect Meta-analysis(ITC)...
March 2017: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
https://www.readbyqxmd.com/read/29024310/influence-of-metabolic-syndrome-and-race-on-the-relationship-between-intensive-blood-pressure-control-and-cardiovascular-outcomes-in-the-sprint-cohort
#6
Kathleen Dungan, Timothy E Craven, Kyaw Soe, Jackson T Wright, Jan Basile, William E Haley, Nancy R Kressin, Uzma Rani, Leonardo Tamariz, Jeff Whittle, Alan Wiggers, Kwame Osei
AIMS: To determine whether baseline metabolic syndrome (MetS) modifies the effect of intensive blood pressure control on cardiovascular (CV) outcomes, and whether effects varied by race/ethnicity. MATERIALS AND METHODS: We performed post-hoc analyses among Non-Hispanic Black (NHB), Non-Hispanic White (NHW), and Hispanic participants with and without MetS in the Systolic Blood Pressure Intervention Trial (SPRINT) randomized to a systolic blood pressure (SBP) target of less than 120 mm Hg (intensive group, N = 4544) or one less than 140 mm Hg (standard group, N = 4553)...
October 12, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29023249/priming-with-1-hz-rtms-over-contralesional-leg-motor-cortex-does-not-increase-the-rate-of-regaining-ambulation-within-3-months-of-stroke-a-randomized-controlled-trial
#7
Ying-Zu Huang, Li-Fong Lin, Kwang-Hwa Chang, Chaur-Jong Hu, Tsan-Hon Liou, Yen-Nung Lin
BACKGROUND: The potential benefits of repetitive transcranial magnetic stimulation (rTMS), applied either alone or as a combination treatment, on recovery of lower extremities after stroke have been insufficiently studied. OBJECTIVE: To evaluate the effect of priming with 1-Hz rTMS over contralesional leg motor area with a double cone coil prior physical therapy (PT) on regaining ambulation. METHODS: Thirty-eight subacute stroke patients with significant leg disabilities were randomly assigned into the experimental (E) group or control (C) group to receive a 15-min real or sham 1-Hz rTMS, respectively, over the contralesional motor cortex representing the quadriceps muscle followed by 45-min PT for 15 sessions over 3 weeks...
October 10, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/29020435/blood-pressure-targets-for-the-treatment-of-people-with-hypertension-and-cardiovascular-disease
#8
REVIEW
Luis Carlos Saiz, Javier Gorricho, Javier Garjón, Mª Concepción Celaya, Lourdes Muruzábal, Mª Del Mar Malón, Rodolfo Montoya, Antonio López
BACKGROUND: Hypertension is a prominent preventable cause of premature morbidity and mortality. People with hypertension and established cardiovascular disease are at particularly high risk, so reducing blood pressure below standard targets may be beneficial. This strategy could reduce cardiovascular mortality and morbidity but could also increase adverse events. The optimal blood pressure target in people with hypertension and established cardiovascular disease remains unknown. OBJECTIVES: To determine if 'lower' blood pressure targets (≤ 135/85 mmHg) are associated with reduction in mortality and morbidity as compared with 'standard' blood pressure targets (≤ 140 to 160/ 90 to 100 mmHg) in the treatment of people with hypertension and a history of cardiovascular disease (myocardial infarction, angina, stroke, peripheral vascular occlusive disease)...
October 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29020353/differential-effects-of-pcsk9-variants-on-risk-of-coronary-disease-and-ischaemic-stroke
#9
Jemma C Hopewell, Rainer Malik, Elsa Valdés-Márquez, Bradford B Worrall, Rory Collins
Aims: PCSK9 genetic variants that have large effects on low-density lipoprotein cholesterol (LDL-C) and coronary heart disease (CHD) have prompted the development of therapeutic PCSK9-inhibition. However, there is limited evidence that PCSK9 variants are associated with ischaemic stroke (IS). Methods and results: Associations of the loss-of-function PCSK9 genetic variant (rs11591147; R46L), and five additional PCSK9 variants, with IS and IS subtypes (cardioembolic, large vessel, and small vessel) were estimated in a meta-analysis involving 10 307 IS cases and 19 326 controls of European ancestry...
July 17, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29019319/the-asymptomatic-carotid-surgery-trial-2-acst-2-an-ongoing-randomised-controlled-trial-comparing-carotid-endarterectomy-with-carotid-artery-stenting-to-prevent-stroke
#10
Richard Bulbulia, Alison Halliday
BACKGROUND: A successful open surgical operation to remove atheromatous carotid artery narrowing that has not yet caused a stroke (asymptomatic carotid stenosis) carries some procedural risk but, if completed successfully, halves patients' future annual stroke risk for at least 10 years. A newer, less invasive alternative is carotid stenting, which also carries some procedural risk, especially if the carotid lesion has recently given rise to a stroke (symptomatic carotid stenosis). For both surgery and stenting, improvements in technique (and in medication) have reduced risk...
October 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29017589/randomized-trial-of-telephone-versus-in-person-delivery-of-a-brief-psychosocial-intervention-in-post-stroke-depression
#11
Catherine J Kirkness, Kevin C Cain, Kyra J Becker, David L Tirschwell, Ann M Buzaitis, Pamela L Weisman, Sylvia McKenzie, Linda Teri, Ruth Kohen, Richard C Veith, Pamela H Mitchell
BACKGROUND: A psychosocial behavioral intervention delivered in-person by advanced practice nurses has been shown effective in substantially reducing post-stroke depression (PSD). This follow-up trial compared the effectiveness of a shortened intervention delivered by either telephone or in-person to usual care. To our knowledge, this is the first of current behavioral therapy trials to expand the protocol in a new clinical sample. 100 people with Geriatric Depression Scores ≥ 11 were randomized within 4 months of stroke to usual care (N = 28), telephone intervention (N = 37), or in-person intervention (N = 35)...
October 10, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28985268/clinical-outcomes-by-race-and-ethnicity-in-the-systolic-blood-pressure-intervention-trial-sprint-a-randomized-clinical-trial
#12
Carolyn H Still, Carlos J Rodriguez, Jackson T Wright, Timothy E Craven, Adam P Bress, Glenn M Chertow, Paul K Whelton, Jeffrey C Whittle, Barry I Freedman, Karen C Johnson, Capri G Foy, Jiang He, John B Kostis, James P Lash, Carolyn F Pedley, Roberto Pisoni, James R Powell, Barry M Wall
BACKGROUND: The Systolic Blood Pressure Intervention Trial (SPRINT) showed that targeting a systolic blood pressure (SBP) of ≤ 120 mm Hg (intensive treatment) reduced cardiovascular disease (CVD) events compared to SBP of ≤ 140 mm Hg (standard treatment); however, it is unclear if this effect is similar in all racial/ethnic groups. METHODS: We analyzed SPRINT data within non-Hispanic White (NHW), non-Hispanic Black (NHB), and Hispanic subgroups to address this question...
August 23, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28982494/techniques-for-endovascular-treatment-of-acute-ischemic-stroke
#13
REVIEW
L Pierot, M Gawlitza, S Soize
Early recanalization of occluded vessels in patients with acute ischemic stroke (AIS) by either intravenous thrombolysis (IVT) or endovascular revascularization has been shown to be associated with improved clinical outcomes and reduced mortality. Since the initial report regarding endovascular treatment (EVT) of AIS in 1983, endovascular techniques have been tremendously improved, advancing from intra-arterial administration of thrombolytic drugs to stent retrievers. IVT has been evaluated in several large randomized trials and has been shown to improve clinical outcomes at 90 days if treatment was initiated within 3h of stroke onset, while its benefit at 3-4...
October 2, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28981592/comparison-of-two-stroke-volume-variation-based-goal-directed-fluid-therapies-for-supratentorial-brain-tumour-resection-a-randomized-controlled-trial
#14
C Y Wu, Y S Lin, H M Tseng, H L Cheng, T S Lee, P L Lin, W H Chou, Y J Cheng
Background: The optimal volume status for neurosurgery has yet to be determined. We compared two fluid protocols based on different stroke volume variation (SVV) cut-offs for goal-directed fluid therapy (GDFT) during supratentorial brain tumour resection. Methods: A randomized, single-blind, open-label trial was conducted. Eighty adult patients undergoing elective supratentorial brain tumour resection were randomly divided into a low SVV and a high SVV group. The SVV cut-offs were used to determine when to initiate colloid infusion...
July 17, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28978349/effects-of-action-observation-therapy-and-mirror-therapy-after-stroke-on-rehabilitation-outcomes-and-neural-mechanisms-by-meg-study-protocol-for-a-randomized-controlled-trial
#15
Tsai-Yu Shih, Ching-Yi Wu, Keh-Chung Lin, Chia-Hsiung Cheng, Yu-Wei Hsieh, Chia-Ling Chen, Chih-Jou Lai, Chih-Chi Chen
BACKGROUND: Loss of upper-extremity motor function is one of the most debilitating deficits following stroke. Two promising treatment approaches, action observation therapy (AOT) and mirror therapy (MT), aim to enhance motor learning and promote neural reorganization in patients through different afferent inputs and patterns of visual feedback. Both approaches involve different patterns of motor observation, imitation, and execution but share some similar neural bases of the mirror neuron system...
October 4, 2017: Trials
https://www.readbyqxmd.com/read/28977981/effects-of-liraglutide-on-hemodynamic-parameters-in-patients-with-heart-failure
#16
Jin Ying Zhang, Xin Yun Wang, Xiang Wang
Glucagon-like peptide-1 analogues improve left ventricular function in patients with acute myocardial infarction. This study aimed to evaluate the effects of liraglutide on hemodynamic parameters in patients with heart failure. A total of 78 patients with heart failure were enrolled in this study between August 2014 and November 2015. Of these, 52 patients were randomized 1:1 to receive either liraglutide or placebo for 7 days. Hemodynamic measurements were made using transpulmonary thermodilution and arterial pulse contour analysis...
September 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28973619/effect-of-routine-low-dose-oxygen-supplementation-on-death-and-disability-in-adults-with-acute-stroke-the-stroke-oxygen-study-randomized-clinical-trial
#17
Christine Roffe, Tracy Nevatte, Julius Sim, Jon Bishop, Natalie Ives, Phillip Ferdinand, Richard Gray
Importance: Hypoxia is common in the first few days after acute stroke, is frequently intermittent, and is often undetected. Oxygen supplementation could prevent hypoxia and secondary neurological deterioration and thus has the potential to improve recovery. Objective: To assess whether routine prophylactic low-dose oxygen therapy was more effective than control oxygen administration in reducing death and disability at 90 days, and if so, whether oxygen given at night only, when hypoxia is most frequent, and oxygen administration is least likely to interfere with rehabilitation, was more effective than continuous supplementation...
September 26, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28973527/a-direct-aspiration-first-pass-technique-vs-standard-endovascular-therapy-for-acute-stroke-a-systematic-review-and-meta-analysis
#18
Kevin Phan, Adam A Dmytriw, Ian Teng, Justin M Moore, Christoph Griessenauer, Christopher Ogilvy, Ajith Thomas
BACKGROUND: The direct aspiration first pass technique (ADAPT) is a recent endovascular treatment for ischemic stroke due to large vessel occlusion that has been gaining popularity due to the rapidity of the technique and the potential for cost savings in comparison to standard thrombectomy methods such as stent retrievers. However, few studies have directly compared these 2. OBJECTIVE: To compare ADAPT with stent retrievers for thrombectomy via systematic review and meta-analysis...
July 21, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28973174/low-dose-vs-standard-dose-alteplase-for-patients-with-acute-ischemic-stroke-secondary-analysis-of-the-enchanted-randomized-clinical-trial
#19
Xia Wang, Thompson G Robinson, Tsong-Hai Lee, Qiang Li, Hisatomi Arima, Philip M Bath, Laurent Billot, Joseph Broderick, Andrew M Demchuk, Geoffrey Donnan, Jong S Kim, Pablo Lavados, Richard I Lindley, Sheila O Martins, Veronica V Olavarria, Jeyaraj D Pandian, Mark W Parsons, Octavio M Pontes-Neto, Stefano Ricci, Vijay K Sharma, Nguyen H Thang, Ji-Guang Wang, Mark Woodward, Craig S Anderson, John Chalmers
Importance: A lower dose of intravenous alteplase appears to be a safer treatment option than the standard dose, reducing the risk of symptomatic intracerebral hemorrhage. There is uncertainty, however, over how this effect translates into an overall clinical benefit for patients with acute ischemic stroke (AIS). Objective: To assess whether older, Asian, or severely affected patients with AIS who are considered at high risk of thrombolysis may benefit more from low-dose rather than standard-dose alteplase treatment...
October 2, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28973024/is-two-better-than-one-muscle-vibration-plus-robotic-rehabilitation-to-improve-upper-limb-spasticity-and-function-a-pilot-randomized-controlled-trial
#20
Rocco Salvatore Calabrò, Antonino Naro, Margherita Russo, Demetrio Milardi, Antonino Leo, Serena Filoni, Antonia Trinchera, Placido Bramanti
Even though robotic rehabilitation is very useful to improve motor function, there is no conclusive evidence on its role in reducing post-stroke spasticity. Focal muscle vibration (MV) is instead very useful to reduce segmental spasticity, with a consequent positive effect on motor function. Therefore, it could be possible to strengthen the effects of robotic rehabilitation by coupling MV. To this end, we designed a pilot randomized controlled trial (Clinical Trial NCT03110718) that included twenty patients suffering from unilateral post-stroke upper limb spasticity...
2017: PloS One
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