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https://www.readbyqxmd.com/read/29150806/ticagrelor-a-review-in-long-term-secondary-prevention-of-cardiovascular-events
#1
Zaina T Al-Salama, Gillian M Keating, Susan J Keam
Ticagrelor (Brilique(®)) is an orally administered P2Y12 inhibitor. A long-term (maintenance) regimen of ticagrelor 60 mg twice daily is indicated in the EU for coadministration with low-dose aspirin 75-150 mg/day for the secondary prevention of atherothrombotic events in high-risk patients with a history of myocardial infarction (MI) of at least 1 year. Approval is based on the results of the PEGASUS-TIMI 54 trial that compared ticagrelor with placebo (in conjunction with low-dose aspirin) in stable patients who had had a spontaneous MI 1-3 years prior to enrolment and were at high risk of atherothrombotic events...
November 18, 2017: Drugs
https://www.readbyqxmd.com/read/29150464/testosterone-therapy-in-hypogonadal-men-a-systematic-review-and-network-meta-analysis
#2
Jesse Elliott, Shannon E Kelly, Adam C Millar, Joan Peterson, Li Chen, Amy Johnston, Ahmed Kotb, Becky Skidmore, Zemin Bai, Muhammad Mamdani, George A Wells
OBJECTIVE: To assess the relative effects of individual testosterone products among hypogonadal men. DESIGN: Systematic review and network meta-analysis. METHODS: We searched MEDLINE, Embase, Cochrane CENTRAL, and grey literature (25 May 2017) for randomised-controlled trials (RCTs) and non-randomised studies (NRS) that involved hypogonadal men given testosterone replacement therapy (TRT) for ≥3 months. Comparators were placebo, another TRT, or the same product at a different dose...
November 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29150164/testosterone-replacement-therapy-and-the-risk-of-stroke-in-men-a-systematic-review
#3
REVIEW
Simone Y Loo, Bing Yu Chen, Oriana Hoi Yun Yu, Laurent Azoulay, Christel Renoux
In recent years, questions have been raised regarding the cardiovascular safety of testosterone replacement therapy (TRT). The objective of this study was to systematically review the available evidence on TRT safety in men, specifically with respect to the risk of stroke. We identified publications from MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials up to May 2017. Articles eligible for review included observational studies evaluating TRT and the risk of stroke among men aged 18 or older...
December 2017: Maturitas
https://www.readbyqxmd.com/read/29149815/stroke-and-hypertension-an-appraisal-from-pathophysiology-to-clinical-practice
#4
Agata Buonacera, Benedetta Stancanelli, Lorenzo Malatino
Stroke as a cause of long-term disability is a growing public health burden. Therefore, focusing on prevention is important. The most prominent aim of this strategy is to treat modifiable risk factors, such as arterial hypertension, the leading modifiable contributor to stroke. Thus, efforts to adequately reduce blood pressure (BP) among hypertensives are mandatory. In this respect, although safety and benefits of BP control related to long-term outcome have been largely demonstrated, there are open questions that remain to be addressed, such as optimal timing to initiate BP reduction and BP goals to be targeted...
November 16, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29148963/clinical-stroke-research-in-resource-limited-settings-tips-and-hints
#5
Jeyaraj D Pandian, Hueiming Liu, Dorcas Bc Gandhi, Richard I Lindley
Background Most stroke research is conducted in high income countries, yet most stroke occurs in low- and middle-income countries. There is an urgent need to build stroke research capacity in low- and middle-income countries. Aims To review the global health literature on how to improve research capacity in low- and middle-income countries, provide additional data from the recently completed ATTEND Trial and provide examples from our own experience. Summary of review The main themes from our literature review were: manpower and workload, research training, research question and methodology and research funding...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29148960/how-to-do-a-systematic-review
#6
Alex Pollock, Eivind Berge
High quality up-to-date systematic reviews are essential in order to help healthcare practitioners and researchers keep up-to-date with a large and rapidly growing body of evidence. Systematic reviews answer pre-defined research questions using explicit, reproducible methods to identify, critically appraise and combine results of primary research studies. Key stages in the production of systematic reviews include clarification of aims and methods in a protocol, finding relevant research, collecting data, assessing study quality, synthesizing evidence, and interpreting findings...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29148635/admission-patterns-and-outcomes-in-the-medical-intensive-care-unit-of-st-paul%C3%A2-s-hospital-millennium-medical-college-addis-ababa-ethiopia
#7
Seman Kedir, Abreham Berhane, Tola Bayisa, Tewodros Wuletaw
Background: Knowledge of the characteristics and outcomes of critically ill patients admitted to Medical Intensive Care Unit (MICU) helps with identification of priorities and the resources required to improve care. The objective of this study was to examine admission patterns and outcomes in MICU at St. Paul’s Hospital Millennium Medical College. Materials: A retrospective review of 1256 patients’ case notes who were admitted to the MICU at St. Paul’s Hospital Millennium Medical College from 2007 to 2012 was carried out...
January 2017: Ethiopian Medical Journal
https://www.readbyqxmd.com/read/29147858/community-interventions-to-increase-stroke-preparedness-and-acute-stroke-treatment-rates
#8
REVIEW
Kathleen M Kelly, Kathryn T Holt, Gina M Neshewat, Lesli E Skolarus
PURPOSE OF REVIEW: Acute stroke treatments reduce the risk of post-stroke disability. These treatments, tissue plasminogen activator (tPA) and intra-arterial treatment, are highly time-dependent; thus, one of the main barriers to treatment is pre-hospital delay. Stroke preparedness is defined as the ability to recognize stroke symptoms and the intent to activate emergency medical services (EMS). This review describes types of acute stroke treatment and preparedness interventions, including recent mass media interventions to increase acute stroke treatment rates, and adult and youth community interventions to increase stroke preparedness...
November 16, 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29146668/percutaneous-left-atrial-appendage-closure-current-devices-and-clinical-outcomes
#9
REVIEW
Lluis Asmarats, Josep Rodés-Cabau
Chronic oral anticoagulation therapy is the standard therapy for preventing thromboembolic events in patients with atrial fibrillation. However, oral anticoagulation has been associated with an increased risk of bleeding events, and despite the improvements linked to the introduction of direct oral anticoagulants, more than one third of atrial fibrillation patients still remain untreated. Over the past decade, percutaneous left atrial appendage closure has emerged as a valid alternative to anticoagulation therapy for the prevention of stroke/systemic embolism in patients with atrial fibrillation...
November 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29146534/systematic-review-for-the-2017-acc-aha-aapa-abc-acpm-ags-apha-ash-aspc-nma-pcna-guideline-for-the-prevention-detection-evaluation-and-management-of-high-blood-pressure-in-adults-a-report-of-the-american-college-of-cardiology-american-heart-association-task
#10
David M Reboussin, Norrina B Allen, Michael E Griswold, Eliseo Guallar, Yuling Hong, Daniel T Lackland, Edgar Pete R Miller, Tamar Polonsky, Angela M Thompson-Paul, Suma Vupputuri
OBJECTIVE: To review the literature systematically and perform meta-analyses to address these questions: 1) Is there evidence that self-measured blood pressure (BP) without other augmentation is superior to office-based measurement of BP for achieving better BP control or for preventing adverse clinical outcomes that are related to elevated BP? 2) What is the optimal target for BP lowering during antihypertensive therapy in adults? 3) In adults with hypertension, how do various antihypertensive drug classes differ in their benefits and harms compared with each other as first-line therapy? METHODS: Electronic literature searches were performed by Doctor Evidence, a global medical evidence software and services company, across PubMed and EMBASE from 1966 to 2015 using key words and relevant subject headings for randomized controlled trials that met eligibility criteria defined for each question...
November 7, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29144166/imaging-assessment-of-acute-ischaemic-stroke-a-review-of-radiological-methods
#11
Aubrey Smith, Chris Rowland Hill
Acute ischaemic stroke is the second largest cause of death worldwide and a cause of major physical and psychological morbidity. Current evidence based treatment includes intravenous thrombolysis (IVT) and mechanical thrombectomy (MT), both requiring careful patient selection and to be administered as quickly as possible within a limited time window from symptom onset. Imaging plays a crucial role identifying patients who may benefit from MT or IVT whilst excluding those that maybe harmed. For IVT, imaging must as a minimum exclude haemorrhage, stroke mimics and provide an estimate of non-viable brain...
November 16, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/29143805/mechanisms-of-acupuncture-therapy-in-ischemic-stroke-rehabilitation-a-literature-review-of-basic-studies
#12
REVIEW
Lina M Chavez, Shiang-Suo Huang, Iona MacDonald, Jaung-Geng Lin, Yu-Chen Lee, Yi-Hung Chen
Acupuncture is recommended by the World Health Organization (WHO) as an alternative and complementary strategy for stroke treatment and for improving stroke care. Clinical trial and meta-analysis findings have demonstrated the efficacy of acupuncture in improving balance function, reducing spasticity, and increasing muscle strength and general well-being post-stroke. The mechanisms underlying the beneficial effects of acupuncture in stroke rehabilitation remain unclear. The aim of this study was to conduct a literature review, summarize the current known mechanisms in ischemic stroke rehabilitation through acupuncture and electroacupuncture (EA) therapy, and to detail the frequently used acupoints implicated in these effects...
October 28, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29143697/stroke-and-food-groups-an-overview-of-systematic-reviews-and-meta-analyses
#13
Cuiyu Deng, Qi Lu, Bingyan Gong, Liya Li, Lianxia Chang, Li Fu, Yue Zhao
OBJECTIVE: Numerous systematic reviews of prospective studies on the association of stroke risk with the consumption of various food groups have been published. A review of the evidence across the existing systematic reviews and meta-analyses of prospective studies was conducted to provide an overview of the range and validity of the reported associations of food groups with stroke risk. DESIGN: The PubMed, EMBASE and Cochrane Library databases were searched for articles published up to September 2015 to identify systematic reviews of prospective studies...
November 16, 2017: Public Health Nutrition
https://www.readbyqxmd.com/read/29143463/advances-in-chronic-cerebral-circulation-insufficiency
#14
REVIEW
Da Zhou, Ran Meng, Si-Jie Li, Jing-Yuan Ya, Jia-Yue Ding, Shu-Ling Shang, Yu-Chuan Ding, Xun-Ming Ji
Chronic cerebral circulation insufficiency (CCCI) may not be an independent disease; rather, it is a pervasive state of long-term cerebral blood flow insufficiency caused by a variety of etiologies, and considered to be associated with either occurrence or recurrence of ischemic stroke, vascular cognitive impairment, and development of vascular dementia, resulting in disability and mortality worldwide. This review summarizes the features and recent progress of CCCI, mainly focusing on epidemiology, experimental research, pathophysiology, etiology, clinical manifestations, imaging presentation, diagnosis, and potential therapeutic regimens...
November 15, 2017: CNS Neuroscience & Therapeutics
https://www.readbyqxmd.com/read/29143099/-left-atrial-appendage-clusure-in-nonvalvular-atrial-fibrillation-clinical-evidence-2017
#15
REVIEW
Steffen Gloekler, Bajram Hajredini, Simon Rycerz, Sebastian Jäckle, Werner Jung
Nonvalvular atrial fibrillation (AF) is the most common arrhythmia with a prevalence of 1-2% and affects approximately 15-20% of all octogenarians. Patients are at increased risk of thromboembolic stroke, with an overall risk of 5% per year. Thrombi form almost exclusively in the left atrial appendage (LAA), a blind sac-like heterogeneous structure trabeculated by pectinate muscles. In the past five decades, life-long oral anticoagulation (OAC) with vitamin K antagonists (VKA) has been the state-of-the art treatment to prevent stroke and systemic embolism from thrombi in AF...
November 15, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29142624/significances-and-outcomes-of-mechanical-thrombectomy-for-acute-infarction-in-very-elderly-patients-a-single-center-experience
#16
Dong Hun Kim, Sang Uk Kim, Jae Hoon Sung, Dong Hoon Lee, Ho Jun Yi, Sang Won Lee
Objective: Mechanical thrombectomy is increasingly being used for the treatment of acute ischemic stroke. The population over 80 years of age is growing, and many of these patients have acute infarction; however, these patients are often excluded from clinical trials, so the aim of this study was to compare the functional outcomes and complication rates in very elderly patients (age ≥80 years) and aged patients (60-79 years) treated with mechanical thrombectomy. Methods: Between January 2010 and June 2015, we retrospectively reviewed 113 senior patients (over 60 years old) treated at our institution for acute ischemic stroke with mechanical thrombectomy...
November 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29141890/british-thoracic-society-clinical-statement-on-pulmonary-arteriovenous-malformations
#17
Claire L Shovlin, Robin Condliffe, James W Donaldson, David G Kiely, Stephen J Wort
Pulmonary arteriovenous malformations (PAVMs) are structurally abnormal vascular communications that provide a continuous right-to-left shunt between pulmonary arteries and veins. Their importance stems from the risks they pose (>1 in 4 patients will have a paradoxical embolic stroke, abscess or myocardial infarction while life-threatening haemorrhage affects 1 in 100 women in pregnancy), opportunities for risk prevention, surprisingly high prevalence and under-appreciation, thus representing a challenging condition for practising healthcare professionals...
December 2017: Thorax
https://www.readbyqxmd.com/read/29141856/impact-of-diabetes-mellitus-on-outcomes-in-patients-supported-with-left-ventricular-assist-devices-a-single-institutional-9-year-experience
#18
Rabea Asleh, Alexandros Briasoulis, Sarah D Schettle, Vakhtang Tchantchaleishvili, Naveen L Pereira, Brooks S Edwards, Alfredo L Clavell, Simon Maltais, David L Joyce, Lyle D Joyce, Richard C Daly, Sudhir S Kushwaha, John M Stulak
BACKGROUND: Diabetes mellitus (DM) is a risk factor for morbidity and mortality in patients with heart failure. The effect of DM on post-left ventricular assist device (LVAD) implantation outcomes is unclear. This study sought to investigate whether patients with DM had worse outcomes than patients without DM after LVAD implantation and whether LVAD support resulted in a better control of DM. METHODS AND RESULTS: We retrospectively reviewed 341 consecutive adults who underwent implantation of LVAD from 2007 to 2016...
November 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29141027/the-efficacy-of-chimeric-antigen-receptor-car-immunotherapy-in-animal-models-for-solid-tumors-a-systematic-review-and-meta-analysis
#19
Yingcheng Wu, Ran Xu, Keren Jia, Hui Shi
BACKGROUND: Most recently, an emerging theme in the field of tumor immunology predominates: chimeric antigen receptor (CAR) therapy in treating solid tumors. The number of related preclinical trials was surging. However, an evaluation of the effects of preclinical studies remained absent. Hence, a meta-analysis was conducted on the efficacy of CAR in animal models for solid tumors. METHODS: The authors searched PubMed/Medline, Embase, and Google scholar up to April 2017...
2017: PloS One
https://www.readbyqxmd.com/read/29140557/withdrawn-pharmacological-cardioversion-for-atrial-fibrillation-and-flutter
#20
REVIEW
John Cordina, Gillian E Mead
BACKGROUND: Atrial fibrillation is the commonest cardiac dysrhythmia. It is associated with significant morbidity and mortality. There are two approaches to the management of atrial fibrillation: controlling the ventricular rate or converting to sinus rhythm in the expectation that this would abolish its adverse effects. OBJECTIVES: To assess the effects of pharmacological cardioversion of atrial fibrillation in adults on the annual risk of stroke, peripheral embolism, and mortality...
November 15, 2017: Cochrane Database of Systematic Reviews
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