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stroke randomized controlled trials

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https://www.readbyqxmd.com/read/29227525/functional-electrical-stimulation-and-ankle-foot-orthoses-provide-equivalent-therapeutic-effects-on-foot-drop-a-meta-analysis-providing-direction-for-future-research
#1
Sarah Prenton, Kristen L Hollands, Laurence P J Kenney, Pornsuree Onmanee
OBJECTIVE: To compare the randomized controlled trial evidence for therapeutic effects on walking of functional electrical stimulation and ankle foot orthoses for foot drop caused by central nervous system conditions. DATA SOURCES: MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials, REHABDATA, PEDro, NIHR Centre for Reviews and Dissemination, Scopus and clinicaltrials.gov. STUDY SELECTION: One reviewer screened titles/abstracts...
November 17, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/29224649/efficacy-and-safety-of-potent-platelet-p2y12-receptor-inhibitors-in-elderly-versus-nonelderly-patients-with-acute-coronary-syndrome-a-systematic-review-and-meta-analysis
#2
Giuseppe Tarantini, Daisuke Ueshima, Gianpiero D'Amico, Giulia Masiero, Giuseppe Musumeci, Gregg W Stone, Sorin J Brener
BACKGROUND: The use of the potent oral P2Y12 inhibitors prasugrel and ticagrelor in patients with acute coronary syndromes (ACS) has a favorable net clinical effect compared with clopidogrel and is recommended as first-line therapy. However, the impact of these agents on ischemic and bleeding events in elderly ACS patients is not well defined. METHODS: We performed a systematic review of articles comparing potent P2Y12 inhibitors to clopidogrel in elderly and nonelderly patients (defined according to each study) with ACS in terms of efficacy (composite of cardiovascular death, myocardial infarction, or stroke) and safety (major bleeding) end points...
January 2018: American Heart Journal
https://www.readbyqxmd.com/read/29223954/effect-of-pcsk9-inhibitors-on-clinical-outcomes-in-patients-with-hypercholesterolemia-a-meta-analysis-of-35-randomized-controlled-trials
#3
REVIEW
Aris Karatasakis, Barbara A Danek, Judit Karacsonyi, Bavana V Rangan, Michele K Roesle, Thomas Knickelbine, Michael D Miedema, Houman Khalili, Zahid Ahmad, Shuaib Abdullah, Subhash Banerjee, Emmanouil S Brilakis
BACKGROUND: We sought to examine the efficacy and safety of 2 PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors: alirocumab and evolocumab. METHODS AND RESULTS: We performed a systematic review and meta-analysis of randomized controlled trials comparing treatment with and without PCSK9 inhibitors; 35 randomized controlled trials comprising 45 539 patients (mean follow-up: 85.5 weeks) were included. Mean age was 61.0±2.8 years, and mean baseline low-density lipoprotein cholesterol was 106±22 mg/dL...
December 9, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29223441/edoxaban-for-the-management-of-elderly-japanese-patients-with-atrial-fibrillation-ineligible-for-standard-oral-anticoagulant-therapies-rationale-and-design-of-the-eldercare-af-study
#4
Ken Okumura, Gregory Y H Lip, Masaharu Akao, Kimihiko Tanizawa, Masayuki Fukuzawa, Kenji Abe, Masahiro Akishita, Takeshi Yamashita
Edoxaban-a non-vitamin K antagonist oral anticoagulant (NOAC)- 60-mg and 30-mg once-daily dose regimens are noninferior versus well-managed warfarin for the prevention of stroke or systemic embolic events (SEE) with less major bleeding in patients with nonvalvular atrial fibrillation (NVAF). There are no published data from phase 3 clinical trials specifically evaluating the use of NOACs in elderly NVAF patients, especially those considered ineligible for available oral anticoagulants. The Edoxaban Low-Dose for EldeR CARE AF patients (ELDERCARE-AF) study is a phase 3, randomized, double-blind, placebo-controlled, parallel-group, multicenter study that will compare the safety and efficacy of once-daily edoxaban 15 mg versus placebo in Japanese patients with NVAF ≥80 years of age who are considered ineligible for standard oral anticoagulant therapy...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29223437/outcomes-in-elderly-and-young-patients-with-st-segment-elevation-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention-with-bivalirudin-versus-heparin-pooled-analysis-from-the-euromax-and-horizons-ami-trials
#5
Khalid Qaderdan, Gerrit-Jan A Vos, Thomas McAndrew, Philippe Gabriel Steg, Christian W Hamm, Arnoud Van't Hof, Roxana Mehran, Efthymios N Deliargyris, Debra Bernstein, Gregg W Stone, Jurriën M Ten Berg
BACKGROUND: Since older age is a strong predictor of not only bleeding but also of ischemic events, understanding the risk:benefit profile of bivalirudin in the elderly undergoing primary percutaneous coronary intervention (pPCI) for ST-segment elevation (STEMI) is important. For this, we aim to compare elderly with young patients, who all underwent pPCI for STEMI and randomly received either bivalirudin or heparin. METHODS: We performed a patient-level pooled analysis (n=5800) of two large randomized trials...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29222227/pings-phone-based-intervention-under-nurse-guidance-after-stroke-interim-results-of-a-pilot-randomized-controlled-trial
#6
Fred Sarfo, Frank Treiber, Mulugeta Gebregziabher, Sheila Adamu, Sachin Patel, Michelle Nichols, Dominic Awuah, Asumadu Sakyi, Nyantakyi Adu-Darko, Arti Singh, Raelle Tagge, Jenkins Carolyn, Bruce Ovbiagele
BACKGROUND AND PURPOSE: Stroke exacts an immense toll in sub-Saharan Africa where there are few resources, and stroke prevention research is limited. The aim of this study is to test the feasibility and preliminary efficacy of an m-Health technology-enabled, nurse-guided intervention in improving blood pressure (BP) control among Ghanaian stroke patients within 1 month of symptom onset. METHODS: We conducted a 2-arm cluster pilot randomized controlled trial involving 60 recent stroke survivors encountered within a single tertiary medical system in Ghana...
December 8, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29221272/goal-directed-fluid-restriction-using-stroke-volume-variation-and-cardiac-index-during-one-lung-ventilation-a-randomized-controlled-trial
#7
Hui Xu, Shu-Hua Shu, Di Wang, Xiao-Qing Chai, Yan-Hu Xie, Wei-De Zhou
Background: Goal-directed therapy confers a strong prognosis in patients undergoing major cardiac or noncardiac surgery. The present study investigated whether intraoperative goal-directed fluid restriction (GDFR) using stroke volume variation (SVV) and cardiac index could improve oxygenation and postoperative outcome in patients undergoing one-lung ventilation (OLV). Methods: A Total of 168 patients scheduled for elective thoracoscopic lobectomy under OLV were randomized into the GDFR protocol (group G) or conventional fluid therapy groups (group C)...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29219877/effectiveness-of-robotic-assisted-rehabilitation-for-mobility-and-functional-ability-in-adult-stroke-patients-a-systematic-review
#8
Kenneth Lo, Matthew Stephenson, Craig Lockwood
BACKGROUND: Stroke is a leading cause of long-term disability, and rehabilitation, involving repetitive, high intensity, task-specific exercises, is the pathway to restoring motor skills. Robotic assistive devices are increasingly being used and it is hoped that with robotic devices, rehabilitation progress can be achieved for patients. OBJECTIVES: To examine the effectiveness of robotic devices in the rehabilitation of stroke patients for upper limb mobility, lower limb mobility, and activities of daily living...
December 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29218822/european-academy-of-neurology-european-stroke-organisation-consensus-statement-and-practical-guidance-for-pre-hospital-management-of-stroke
#9
A Kobayashi, A Czlonkowska, G A Ford, A C Fonseca, G J Luijckx, J Korv, N Pérez de la Ossa, C Price, D Russell, A Tsiskaridze, M Messmer-Wullen, J De Keyser
Reduction of delay between onset and hospital arrival and adequate pre-hospital care of persons with acute stroke are important for improving chances of a favorable outcome. The objective is to recommend evidence-based practices for the management of patients with suspected stroke in the pre-hospital setting. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used to define the key clinical questions. An expert panel then reviewed the literature, established the quality of the evidence, and made recommendations...
December 7, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29216285/myocardial-adaption-to-hi-r-t-in-previously-untrained-men-with-a-randomized-longitudinal-cardiac-mr-imaging-study-physical-adaptions-in-untrained-on-strength-and-heart-trial-push-trial
#10
Michael Scharf, Derya Oezdemir, Axel Schmid, Wolfgang Kemmler, Simon von Stengel, Matthias S May, Michael Uder, Michael M Lell
OBJECTIVE: Although musculoskeletal effects in resistance training are well described, little is known about structural and functional cardiac adaption in formerly untrained subjects. We prospectively evaluated whether short term high intensity (resistance) training (HI(R)T) induces detectable morphologic cardiac changes in previously untrained men in a randomized controlled magnetic resonance imaging (MRI) study. MATERIALS AND METHODS: 80 untrained middle-aged men were randomly assigned to a HI(R)T-group (n = 40; 43...
2017: PloS One
https://www.readbyqxmd.com/read/29212825/intensive-blood-pressure-lowering-in-patients-with-and-patients-without-type-2-diabetes-a-pooled-analysis-from-two-randomized-trials
#11
Tom F Brouwer, Jim T Vehmeijer, Deborah N Kalkman, Wouter R Berger, Bert-Jan H van den Born, Ron J Peters, Reinoud E Knops
OBJECTIVE: The Action to Control Cardiovascular Risk in Diabetes Blood Pressure (ACCORD-BP) study did not find a significant beneficial effect of intensive systolic blood pressure (SBP) lowering on cardiovascular events in hypertensive patients with type 2 diabetes mellitus (T2DM), while the Systolic Blood Pressure Intervention Trial (SPRINT) did find a significant beneficial effect in patients without T2DM. The objective of this analysis was to assess the effect of both T2DM and baseline cardiovascular disease (CVD) risk on the treatment effect of intensive blood pressure lowering...
December 6, 2017: Diabetes Care
https://www.readbyqxmd.com/read/29212743/successful-reperfusion-with-intravenous-thrombolysis-preceding-mechanical-thrombectomy-in-large-vessel-occlusions
#12
Georgios Tsivgoulis, Aristeidis H Katsanos, Peter D Schellinger, Martin Köhrmann, Panayiotis Varelas, Georgios Magoufis, Maurizio Paciaroni, Valeria Caso, Anne W Alexandrov, Edip Gurol, Andrei V Alexandrov
BACKGROUND AND PURPOSE: Although current guidelines advocate pretreatment with intravenous thrombolysis (IVT) in all eligible patients with acute ischemic stroke with large-vessel occlusion before mechanical thrombectomy, there are observational data questioning the efficacy of this approach. One of the main arguments in favor of IVT pretreatment is the potential for tissue-type plasminogen activator-induced successful reperfusion (SR) before the onset of endovascular procedure. METHODS: We performed a systematic review and meta-analysis of randomized controlled clinical trials and observational cohorts providing rates of SR with IVT in patients with large-vessel occlusion before the initiation of mechanical thrombectomy...
December 6, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29212562/a-randomised-controlled-trial-of-the-monoaminergic-stabiliser-osu6162-in-treatment-of-myalgic-encephalomyelitis-chronic-fatigue-syndrome
#13
Marie Karin Lena Nilsson, Olof Zachrisson, Carl-Gerhard Gottfries, Michael Matousek, Birgitta Peilot, Sara Forsmark, Robert Christiaan Schuit, Maria Lizzie Carlsson, Angelica Kloberg, Arvid Carlsson
OBJECTIVE: The monoaminergic stabiliser (-)-OSU6162 has in previous studies shown promising effects on mental fatigue after stroke and traumatic brain injury. This study investigated the safety and effectiveness of (-)-OSU6162 in patients with myalgic encephalomyelitis/chronic fatigue syndrome. METHODS: A total of 62 patients were randomly assigned to placebo or (-)-OSU6162. Primary outcomes were assessment on the mental fatigue scale (MFS) and the clinical global impression of change (CGI-C) scale...
December 7, 2017: Acta Neuropsychiatrica
https://www.readbyqxmd.com/read/29212462/pharmacological-targeting-of-secondary-brain-damage-following-ischemic-or-hemorrhagic-stroke-traumatic-brain-injury-and-bacterial-meningitis-a-systematic-review-and-meta-analysis
#14
Thomas Beez, Hans-Jakob Steiger, Nima Etminan
BACKGROUND: The effectiveness of pharmacological strategies exclusively targeting secondary brain damage (SBD) following ischemic stroke, aneurysmal subarachnoid hemorrhage, aSAH, intracerebral hemorrhage (ICH), traumatic brain injury (TBI) and bacterial meningitis is unclear. This meta-analysis studied the effect of SBD targeted treatment on clinical outcome across the pathological entities. METHODS: Randomized, controlled, double-blinded trials on aforementioned entities with 'death' as endpoint were identified...
December 7, 2017: BMC Neurology
https://www.readbyqxmd.com/read/29211225/off-pump-versus-on-pump-coronary-artery-bypass-grafting-in-frail-patients-study-protocol-for-the-fragile-multicenter-randomized-controlled-trial
#15
Omar Asdrúbal Vilca Mejía, Michel Pompeu Barros Oliveira Sá, Maurilio Onofre Deininger, Luís Roberto Palma Dallan, Rodrigo Coelho Segalote, Marco Antonio Praça de Oliveira, Fernando Antibas Atik, Magaly Arrais Dos Santos, Pedro Gabriel Melo de Barros E Silva, Rodrigo Mussi Milani, Alexandre Ciappina Hueb, Rosangela Monteiro, Ricardo Carvalho Lima, Luiz Augusto Ferreira Lisboa, Luís Alberto Oliveira Dallan, John Puskas, Fabio Biscegli Jatene
INTRODUCTION: Advances in modern medicine have led to people living longer and healthier lives. Frailty is an emerging concept in medicine yet to be explored as a risk factor in cardiac surgery. When it comes to CABG surgery, randomized controlled clinical trials have primarily focused on low-risk (ROOBY, CORONARY), elevated-risk (GOPCABE) or high-risk patients (BBS), but not on frail patients. Therefore, we believe that off-pump CABG could be an important technique in patients with limited functional capacity to respond to surgical stress...
September 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29211222/cabg-surgery-remains-the-best-option-for-patients-with-left-main-coronary-disease-in-comparison-with-pci-des-meta-analysis-of-randomized-controlled-trials
#16
Michel Pompeu Barros Oliveira Sá, Artur Freire Soares, Rodrigo Gusmão Albuquerque Miranda, Mayara Lopes Araújo, Alexandre Motta Menezes, Frederico Pires Vasconcelos Silva, Ricardo Carvalho Lima
OBJECTIVE: To compare the safety and efficacy of coronary artery bypass grafting (CABG) with percutaneous coronary intervention (PCI) using drug-eluting stents (DES) in patients with unprotected left main coronary artery (ULMCA) disease. METHODS: MEDLINE, EMBASE, CENTRAL/CCTR, SciELO, LILACS, Google Scholar and reference lists of relevant articles were searched for clinical studies that reported outcomes at 1-year follow-up after PCI with DES and CABG for the treatment of ULMCA stenosis...
September 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29209731/kinaesthetic-ability-training-improves-unilateral-neglect-and-functional-outcome-in-patients-with-stroke-a-randomized-control-trial
#17
Sehim Kutlay, Aysun Genç, Haydar Gök, Derya Öztuna, Ayşe A Küçükdeveci
OBJECTIVE: To investigate the effects of kinaesthetic ability training with the Kinesthetic Ability Trainer (KAT) on unilateral neglect and functional outcomes in stroke patients. STUDY DESIGN: An assessor-blinded, randomized controlled, clinical trial. METHODS: A total of 64 stroke patients with unilateral neglect (mean age 61 (standard deviation (SD) 12) years, 60.4% male, mean time since stroke 6.4 (SD 10.4) months, left hemiplegia 92.5%) were randomly assigned to a conventional rehabilitation programme (control group, n = 32) or KAT plus a conventional rehabilitation programme (KAT group, n = 32) for 4 weeks...
December 5, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/29209183/cognitive-flexibility-training-a-large-scale-multimodal-adaptive-active-control-intervention-study-in-healthy-older-adults
#18
Jessika I V Buitenweg, Renate M van de Ven, Sam Prinssen, Jaap M J Murre, K Richard Ridderinkhof
As aging is associated with cognitive decline, particularly in the executive functions, it is essential to effectively improve cognition in older adults. Online cognitive training is currently a popular, though controversial method. Although some changes seem possible in older adults through training, far transfer, and longitudinal maintenance are rarely seen. Based on previous literature we created a unique, state-of-the-art intervention study by incorporating frequent sessions and flexible, novel, adaptive training tasks, along with an active control group...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/29208476/what-does-best-evidence-tell-us-about-robotic-gait-rehabilitation-in-stroke-patients-a-systematic-review-and-meta-analysis
#19
REVIEW
Maria Federica Bruni, Corrado Melegari, Maria Cristina De Cola, Alessia Bramanti, Placido Bramanti, Rocco Salvatore Calabrò
BACKGROUND: Studies about electromechanical-assisted devices proved the validity and effectiveness of these tools in gait rehabilitation, especially if used in association with conventional physiotherapy in stroke patients. OBJECTIVE: The aim of this study was to compare the effects of different robotic devices in improving post-stroke gait abnormalities. METHODS: A computerized literature research of articles was conducted in the databases MEDLINE, PEDro, COCHRANE, besides a search for the same items in the Library System of the University of Parma (Italy)...
December 2, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29207946/achieved-systolic-blood-pressure-in-older-people-a-systematic-review-and-meta-analysis
#20
Aline A I Moraes, Cristina P Baena, Taulant Muka, Arjola Bano, Adriana Buitrago-Lopez, Ana Zazula, Bruna O Erbano, Nicolle A Schio, Murilo H Guedes, Wichor M Bramer, Oscar H Franco, José Rocha Faria-Neto
BACKGROUND: It remains unclear into which level the systolic blood pressure (SBP) should be lowered in order to provide the best cardiovascular protection among older people. Hypertension guidelines recommendation on attaining SBP levels <150 mmHg in this population is currently based on experts' opinion. To clarify this issue, we systematically reviewed and quantified available evidence on the impact of achieving different SBP levels <150 mmHg on various adverse outcomes in subjects aged ≥60 years old receiving antihypertensive drug treatment...
December 5, 2017: BMC Geriatrics
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