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stroke randomized controlled trials

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https://www.readbyqxmd.com/read/28097882/antidiabetic-agents-and-cardiovascular-outcomes-in-patients-with-heart-diseases
#1
Judy W M Cheng, Hisham A Badreldin, Dhiren K Patel, Snehal H Bhatt
This article reviews evidence of benefits and risk of antidiabetic agents in cardiovascular (CV) outcomes, with a focus on medications approved by the FDA since 2008. Peer-reviewed articles were identified from MEDLINE and Current Content database (both 1966 to October 1, 2016) using the search terms insulin, metformin, rosiglitazone, pioglitazone, glyburide, glipizide, glimepiride, acarbose, miglitol, albiglutide, exenatide, liraglutide, lixisenatide, dulaglutide, pramlintide, meglitinide, alogliptin, linagliptin, saxagliptin, sitagliptin, canagliflozin, dapagliflozin, empagliflozin, colesevalam, bromocriptine, mortality, myocardial infarction (MI), heart failure, (HF) and stroke...
January 18, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28095924/sonolysis-in-prevention-of-brain-infarctions-during-internal-carotid-endarterectomy-sonobirdie-trial-study-protocol-for-a-randomized-controlled-trial
#2
Tomáš Hrbáč, David Netuka, Vladimír Beneš, Vladimír Nosáľ, Petra Kešnerová, Aleš Tomek, Táňa Fadrná, Vladimír Beneš, Jiří Fiedler, Vladimír Přibáň, Miroslav Brozman, Kateřina Langová, Roman Herzig, David Školoudík
BACKGROUND: Carotid endarterectomy (CEA) is a beneficial procedure for selected patients with an internal carotid artery (ICA) stenosis. Surgical risk of CEA varies from between 2 and 15%. The aim of the study is to demonstrate the safety and effectiveness of sonolysis (continual transcranial Doppler monitoring, TCD) using a 2-MHz diagnostic probe with maximal diagnostic energy on the reduction of the incidence of stroke, transient ischemic attack (TIA) and brain infarction detected using magnetic resonance imaging (MRI) by the activation of the endogenous fibrinolytic system during CEA...
January 17, 2017: Trials
https://www.readbyqxmd.com/read/28095412/intensive-versus-guideline-blood-pressure-and-lipid-lowering-in-patients-with-previous-stroke-main-results-from-the-pilot-prevention-of-decline-in-cognition-after-stroke-trial-podcast-randomised-controlled-trial
#3
Philip M Bath, Polly Scutt, Daniel J Blackburn, Sandeep Ankolekar, Kailash Krishnan, Clive Ballard, Alistair Burns, Jonathan Mant, Peter Passmore, Stuart Pocock, John Reckless, Nikola Sprigg, Rob Stewart, Joanna M Wardlaw, Gary A Ford
BACKGROUND: Stroke is associated with the development of cognitive impairment and dementia. We assessed the effect of intensive blood pressure (BP) and/or lipid lowering on cognitive outcomes in patients with recent stroke in a pilot trial. METHODS: In a multicentre, partial-factorial trial, patients with recent stroke, absence of dementia, and systolic BP (SBP) 125-170 mmHg were assigned randomly to at least 6 months of intensive (target SBP <125 mmHg) or guideline (target SBP <140 mmHg) BP lowering...
2017: PloS One
https://www.readbyqxmd.com/read/28093928/functional-electrical-stimulation-therapy-for-severe-hemiplegia-randomized-control-trial-revisited
#4
Cesar Marquez-Chin, Shaghayegh Bagher, Vera Zivanovic, Milos R Popovic
BACKGROUND: Stroke is the leading cause of long-term disability. Stroke survivors seldom improve their upper-limb function when their deficit is severe, despite recently developed therapies. PURPOSE: This study aims to assess the efficacy of functional electrical stimulation therapy in improving voluntary reaching and grasping after severe hemiplegia. METHOD: A post hoc analysis of a previously completed randomized control trial ( clinicaltrials...
January 1, 2017: Canadian Journal of Occupational Therapy. Revue Canadienne D'ergothérapie
https://www.readbyqxmd.com/read/28092847/repetitive-transcranial-magnetic-stimulation-for-the-treatment-of-post-stroke-depression-a-systematic-review-and-meta-analysis-of-randomized-controlled-clinical-trials
#5
REVIEW
XinYi Shen, MingYi Liu, Yu Cheng, Cui Jia, XinYue Pan, QingYun Gou, XinLian Liu, Hui Cao, LuShun Zhang
BACKGROUND: Every year, more than fifteen million people worldwide experience a stroke, nearly 30% of stroke survivors are likely to experience post-stroke depression (PSD). Repetitive transcranial magnetic stimulation (rTMS) is one of the emerging techniques which assist in targeting rehabilitation after stroke. Although deterioration of PSD greatly affects the recovery and quality of life of stroke sufferers, the effect of rTMS therapy has not been systematically studied. OBJECTIVE: A systematic review and meta-analysis was conducted to determine the effect of rTMS on PSD...
January 10, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28092139/content-of-conventional-therapy-for-the-severely-affected-arm-during-subacute-rehabilitation-after-stroke-an-analysis-of-physiotherapy-and-occupational-therapy-practice
#6
Lex D de Jong, Frederike van Wijck, Roy E Stewart, Alexander C H Geurts, Pieter U Dijkstra
BACKGROUND AND PURPOSE: Physiotherapy (PT) and occupational therapy (OT) are key professions providing treatment for the arm after stroke; however, knowledge about the content of these treatments is scant. Detailed data are needed to replicate interventions, evaluate their effective components, and evaluate PT and OT practice. This paper describes PT and OT treatment for the severely affected arm in terms of duration, content according to components and categories of the International Classification of Human Functioning, Disability and Health, and to analyze differences between professions...
January 16, 2017: Physiotherapy Research International: the Journal for Researchers and Clinicians in Physical Therapy
https://www.readbyqxmd.com/read/28090731/addition-of-ezetimibe-to-statins-for-patients-at-high-cardiovascular-risk-systematic-review-of-patient-important-outcomes
#7
REVIEW
Yutong Fei, Gordon Henry Guyatt, Paul Elias Alexander, Regina El Dib, Reed A C Siemieniuk, Per Olav Vandvik, Mark E Nunnally, Huda Gomaa, Rebecca L Morgan, Arnav Agarwal, Ying Zhang, Neera Bhatnagar, Frederick A Spencer
Ezetimibe is widely used in combination with statins to reduce low-density lipoprotein. We sought to examine the impact of ezetimibe when added to statins on patient-important outcomes. Medline, EMBASE, CINAHL, and CENTRAL were searched through July, 2016. Randomized controlled trials (RCTs) of ezetimibe combined with statins versus statins alone that followed patients for at least 6 months and reported on at least one of all-cause mortality, cardiovascular deaths, non-fatal myocardial infarctions (MI), and non-fatal strokes were included...
January 16, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28081585/drug-eluting-stent-placement-versus-coronary-artery-bypass-surgery-for-unprotected-left-main-coronary-artery-disease-a-meta-analysis-of-randomized-controlled-trials
#8
Sunil Upadhaya, Ramkaji Baniya, Seetharamprasad Madala, Suresh Kumar Subedi, Jahangir Khan, Ravi Kanth Velagapudi, Ghassan Bachuwa
BACKGROUND: Coronary artery bypass grafting (CABG) is the standard of care for treating left main coronary lesions. However, recently published randomized controlled trials (RCT) have shown conflicting results. We sought to compare clinical outcomes of percutaneous coronary intervention (PCI) with drug-eluting stent placement to CABG using a meta-analysis of randomized controlled trials. METHODS: A systemic search of Pubmed, Scopus, Cochrane library, and Clinicaltrials...
January 12, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28076634/immediate-versus-delayed-treatment-for-recently-symptomatic-carotid-artery-stenosis
#9
Vladimir Vasconcelos, Nicolle Cassola, Edina Mariko Koga da Silva, José Carlos Costa Baptista-Silva
BACKGROUND: The timing of surgery for recently symptomatic carotid artery stenosis remains controversial. Early cerebral revascularization may prevent a disabling or fatal ischemic recurrence, but it may also increase the risk of hemorrhagic transformation, or of dislodging a thrombus. This review examined the randomized controlled evidence that addressed whether the increased risk of recurrent events outweighed the increased benefit of an earlier intervention. OBJECTIVES: To assess the risks and benefits of performing very early cerebral revascularization (within two days) compared with delayed treatment (after two days) for people with recently symptomatic carotid artery stenosis...
November 2016: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28072733/efficacy-and-safety-of-puerarin-injection-in-curing-acute-ischemic-stroke-a-meta-analysis-of-randomized-controlled-trials
#10
Qing-Hua Zheng, Xiao-Li Li, Zhi-Gang Mei, Li Xiong, Qing-Xian Mei, Jin-Feng Wang, Ling-Jing Tan, Song-Bai Yang, Zhi-Tao Feng
BACKGROUND: Previous studies indicated that the puerarin injection has been widely employed in China for the treatment of acute ischemic stroke. We aim to evaluate the efficacy and safety of the puerarin injection for the treatment of acute ischemic stroke. METHODS: A systematic literature search was performed in PUBMED, EMBASE, SPRINGER LINK, Scopus, Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP Journals Database, Wanfang database and the China Biological Medicine database before November 2016, randomized controlled clinical trials (RCTs) of puerarin injection treating acute ischemic stroke were included...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28067616/management-of-acute-central-retinal-artery-occlusion-intravenous-thrombolysis-is-feasible-and-safe
#11
Cécile Préterre, Gaelle Godeneche, Xavier Vandamme, Thomas Ronzière, Matthias Lamy, Christophe Breuilly, Cédric Urbanczyk, Valérie Wolff, Pierre Lebranchu, Mathieu Sevin-Allouet, Benoit Guillon
Background Although acute central retinal artery occlusion is as a stroke in the carotid territory (retinal artery), its management remains controversial. The aim of this study was to assess the feasibility and safety of intravenous thrombolysis delivered within 6 h of central retinal artery occlusion in French stroke units. Methods We performed a retrospective analysis of patients treated with intravenous alteplase (recombinant tissue-plasminogen activator), based on stroke units thrombolysis registers from June 2005 to June 2015, and we selected those who had acute central retinal artery occlusion...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28065663/antithrombotic-treatment-in-anticoagulated-atrial-fibrillation-patients-undergoing-percutaneous-coronary-intervention
#12
REVIEW
Csaba András Dézsi, Balázs Bence Dézsi, Döme András Dézsi
: Coronary artery disease coexists in a clinically relevant number of patients with atrial fibrillation and it often requires percutaneous coronary intervention. These patients represent a particular challenge for clinicians in terms of antithrombotic management. They require combined antiplatelet-anticoagulant therapy to reduce the risk of recurrent ischemic cardiac events and stroke; however, this antithrombotic strategy is associated with an increased risk of bleeding complications...
January 5, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28062859/outcomes-after-direct-thrombectomy-or-combined-intravenous-and-endovascular-treatment-are-not-different
#13
Sònia Abilleira, Aida Ribera, Pedro Cardona, Marta Rubiera, Elena López-Cancio, Sergi Amaro, Ana Rodríguez-Campello, Pol Camps-Renom, David Cánovas, Maria Angels de Miquel, Alejandro Tomasello, Sebastian Remollo, Antonio López-Rueda, Elio Vivas, Joan Perendreu, Miquel Gallofré
BACKGROUND AND PURPOSE: Whether intravenous thrombolysis adds a further benefit when given before endovascular thrombectomy (EVT) is unknown. Furthermore, intravenous thrombolysis delays time to groin puncture, mainly among drip and ship patients. METHODS: Using region-wide registry data, we selected cases that received direct EVT or combined intravenous thrombolysis+EVT for anterior circulation strokes between January 2011 and October 2015. Treatment effect was estimated by stratification on a propensity score...
January 6, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28062249/extracranial-arterial-and-venous-thromboembolism-in-patients-with-atrial-fibrillation-a-meta-analysis-of-randomized-controlled-trials
#14
Kang-Ling Wang, Harry R Büller, Shinya Goto, Chun-Yi Lin, En-Yu Lai, Chun-Chih Chiu, Chern-En Chiang, Robert P Giugliano
BACKGROUND: Thromboembolism prevention is central to atrial fibrillation (AF) management. Randomized controlled trials (RCTs) have primarily focused on stroke prevention. Detailed analyses of extracranial thromboembolic events, particularly in patients with low dose non-vitamin K antagonist oral anticoagulants (NOACs), are scarce. OBJECTIVES: To assess efficacy of NOACs in prevention of extracranial arterial and venous thromboembolism. METHODS: We searched PubMed, CENTRAL, and CINAHL through April 2016 for phase III RCTs of NOACs in patients with AF...
January 3, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28060096/safety-of-extracranial-intracranial-arterial-bypass-in-the-treatment-of-moyamoya-disease
#15
Lian Liu, Song Wei Su, Hong Yan Sun
OBJECTIVE: The purpose of this study is to uncover the controversial problems and review the safety of extracranial-intracranial arterial bypass (EC-IC arterial bypass) in the treatment of moyamoya disease. METHODS: Published randomized controlled clinical trials were searched from PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Web of science without date or language limitations until September 2016. Meta-analysis was performed as recommended by the Cochrane Collaboration of trials...
January 5, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28057693/assessing-the-safety-of-sitagliptin-in-older-participants-in-the-trial-evaluating-cardiovascular-outcomes-with-sitagliptin-tecos
#16
M Angelyn Bethel, Samuel S Engel, Jennifer B Green, Zhen Huang, Robert G Josse, Keith D Kaufman, Eberhard Standl, Shailaja Suryawanshi, Frans Van de Werf, Darren K McGuire, Eric D Peterson, Rury R Holman
OBJECTIVE: Limited data exist regarding safety and efficacy of antihyperglycemic drugs in older patients with type 2 diabetes. The Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS) was a randomized, double-blind, placebo-controlled trial assessing the impact of sitagliptin on a primary composite outcome of cardiovascular death, nonfatal stroke, nonfatal myocardial infarction, or unstable angina hospitalizations in patients with type 2 diabetes (HbA1c ≥6.5% [48 mmol/mol] and ≤8...
January 5, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28057444/redefining-beta-blocker-use-in-hypertension-selecting-the-right-beta-blocker-and-the-right-patient
#17
REVIEW
Samuel J Mann
Randomized controlled trials have concluded that the cardiovascular outcome of first-step treatment of hypertension with traditional vasoconstricting beta-blockers is inferior to treatment with other antihypertensive drug classes. Beta-blocker use is also associated with undesirable side effects. Consequently, some recent guidelines consider beta-blockers an inferior option for first-step treatment of hypertension. Despite this, beta-blockers are still widely prescribed, and likely overused, in the management of hypertension...
December 5, 2016: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/28056795/bleeding-outcomes-associated-with-rivaroxaban-and-dabigatran-in-patients-treated-for-atrial-fibrillation-a-systematic-review-and-meta-analysis
#18
Pravesh Kumar Bundhun, Mohammad Zafooruddin Sani Soogund, Abhishek Rishikesh Teeluck, Manish Pursun, Akash Bhurtu, Wei-Qiang Huang
BACKGROUND: Warfarin is commonly used as a secondary prevention of stroke in patients with atrial fibrillation (AF). However, limitations have been observed even with the use of this medication. Recently, several newer direct oral anticoagulants (DOACs) have been approved for use by the food and drug administrations. Unfortunately, these newer drugs have seldom been compared directly with each other. Therefore, this study aimed to compare the bleeding events associated with rivaroxaban and dabigatran in patients treated for non-valvular AF...
January 6, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28050492/efficacy-of-modified-constraint-induced-movement-therapy-in-the-treatment-of-hemiparetic-upper-limb-in-stroke-patients-a-randomized-controlled-trial
#19
Raj Kumar Yadav, Rajendra Sharma, Diganta Borah, S Y Kothari
INTRODUCTION: Paretic upper limb in stroke patients has a significant impact on the quality of life. Modified Constraint Induced Movement Therapy (mCIMT) is one of the treatment options used for the improvement of the function of the paretic limb. AIM: To investigate the efficacy of four week duration mCIMT in the management of upper extremity weakness in hemiparetic patients due to stroke. MATERIALS AND METHODS: Prospective single blind, parallel randomized controlled trial in which 30 patients received conventional rehabilitation programme (control group) and 30 patients participated in a mCIMT programme in addition to the conventional rehabilitation programme (study group)...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28049699/on-treatment-blood-pressure-and-cardiovascular-outcomes-in-older-adults-with-isolated-systolic-hypertension
#20
Yuichiro Yano, Hiromi Rakugi, George L Bakris, Donald M Lloyd-Jones, Suzanne Oparil, Takao Saruta, Kazuyuki Shimada, Hiroaki Matsuoka, Yutaka Imai, Toshio Ogihara
: Our aim was to assess optimal on-treatment blood pressure (BP) at which cardiovascular disease (CVD) and all-cause mortality risks are minimized in Japanese older adults with isolated systolic hypertension. We used data from the VALISH study (Valsartan in Elderly Isolated Systolic Hypertension) that recruited older adults (n=3035; mean age, 76 years) with systolic BP (SBP) of ≥160 mm Hg and diastolic BP of <90 mm Hg. Patients were treated by valsartan. Patients were also categorized into 3 groups based on achieved on-treatment SBP of <130 mm Hg (n=317), 130 to <145 mm Hg (n=2025), or ≥145 mm Hg (n=693)...
January 3, 2017: Hypertension
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