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Stroke trials

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https://www.readbyqxmd.com/read/29240976/clopidogrel-plus-aspirin-versus-aspirin-alone-for-preventing-cardiovascular-events
#1
REVIEW
Alessandro Squizzato, Marta Bellesini, Andrea Takeda, Saskia Middeldorp, Marco Paolo Donadini
BACKGROUND: Aspirin is the prophylactic antiplatelet drug of choice for people with cardiovascular disease. Adding a second antiplatelet drug to aspirin may produce additional benefit for people at high risk and people with established cardiovascular disease. This is an update to a previously published review from 2011. OBJECTIVES: To review the benefit and harm of adding clopidogrel to aspirin therapy for preventing cardiovascular events in people who have coronary disease, ischaemic cerebrovascular disease, peripheral arterial disease, or were at high risk of atherothrombotic disease, but did not have a coronary stent...
December 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29240784/effects-of-calcium-channel-blockers-comparing-to-angiotensin-converting-enzyme-inhibitors-and-angiotensin-receptor-blockers-in-patients-with-hypertension-and-chronic-kidney-disease-stage-3-to-5-and-dialysis-a-systematic-review-and-meta-analysis
#2
Yen-Chung Lin, Jheng-Wei Lin, Mai-Szu Wu, Kuan-Chou Chen, Chiung-Chi Peng, Yi-No Kang
BACKGROUND: Calcium channel blocker (CCB) or two renin angiotensin aldosterone system blockades (RAAS), angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), are major potent and prevalently used as initial antihypertensive agents for mild to moderate hypertension, but no uniform agreement as to which antihypertensive drugs should be given for initial therapy, especially among chronic kidney disease (CKD) patients. DESIGN: A systematic review and meta-analysis comparing CCBs and the two RAAS blockades for hypertensive patients with CKD stage 3 to 5D...
2017: PloS One
https://www.readbyqxmd.com/read/29239808/drug-class-renal-elimination-and-outcomes-of-direct-oral-anticoagulants-in-asian-patients-a-meta-analysis
#3
Kang-Ling Wang, Chun-Chih Chiu, Robert P Giugliano, Doreen Su-Yin Tan, Chun-Yi Lin, En-Yu Lai, Shinya Goto, Chern-En Chiang
BACKGROUND: Direct oral anticoagulants (DOACs) have a better risk benefit profile in Asian patients with atrial fibrillation (AF). Whether treatment effects could be modified by drug class and dependency on renal elimination of studied agents has not yet been explored. METHODS: We searched PubMed, CENTRAL, and CINAHL databases through November 2016 for phase III randomized controlled trials comparing DOACs with warfarin in patients with AF. Efficacy and safety outcomes were pooled according to drug class and dependency on renal elimination of DOACs and were compared with the Mantel-Haenszel fixed-effects model...
November 24, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29239328/leap-motion-based-virtual-reality-training-for-improving-motor-functional-recovery-of-upper-limbs-and-neural-reorganization-in-subacute-stroke-patients
#4
Zun-Rong Wang, Ping Wang, Liang Xing, Li-Ping Mei, Jun Zhao, Tong Zhang
Virtual reality is nowadays used to facilitate motor recovery in stroke patients. Most virtual reality studies have involved chronic stroke patients; however, brain plasticity remains good in acute and subacute patients. Most virtual reality systems are only applicable to the proximal upper limbs (arms) because of the limitations of their capture systems. Nevertheless, the functional recovery of an affected hand is most difficult in the case of hemiparesis rehabilitation after a stroke. The recently developed Leap Motion controller can track the fine movements of both hands and fingers...
November 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/29239134/recent-advances-in-managing-atherosclerosis-via-nanomedicine
#5
REVIEW
Cecilia Ka Wing Chan, Lei Zhang, Chak Kwong Cheng, Hongrong Yang, Yu Huang, Xiao Yu Tian, Chung Hang Jonathan Choi
Atherosclerosis, driven by chronic inflammation of the arteries and lipid accumulation on the blood vessel wall, underpins many cardiovascular diseases with high mortality rates globally, such as stroke and ischemic heart disease. Engineered bio-nanomaterials are now under active investigation as carriers of therapeutic and/or imaging agents to atherosclerotic plaques. This Review summarizes the latest bio-nanomaterial-based strategies for managing atherosclerosis published over the past five years, a period marked by a rapid surge in preclinical applications of bio-nanomaterials for imaging and/or treating atherosclerosis...
December 14, 2017: Small
https://www.readbyqxmd.com/read/29237411/periprocedural-heparin-bridging-in-patients-receiving-oral-anticoagulation-a-systematic-review-and-meta-analysis
#6
Jing Wen Yong, Li Xia Yang, Bright Eric Ohene, Yu Jie Zhou, Zhi Jian Wang
BACKGROUND: Periprocedural heparin bridging therapy aims to reduce the risk of thromboembolic events in patients requiring an interruption in their anticoagulation therapy for the purpose of an elective procedure. The efficacy and safety of heparin bridging therapy has not been well established. OBJECTIVES: To compare through meta-analysis the effects of heparin bridging therapy on the risk of major bleeding and thromboembolic events of clinical significance among patients taking oral anticoagulants...
December 13, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29237339/multimodal-rehabilitation-in-the-late-phase-after-stroke-enhances-the-life-situation-of-informal-caregivers
#7
Lina Bunketorp-Käll, Åsa Lundgren-Nilsson, Michael Nilsson, Christian Blomstrand
Purpose The burden of caregiving for stroke survivors is well known, but the effect of late stroke rehabilitation on the life situation of informal caregivers is unknown. Here, we assessed changes in the life situation of informal caregivers of stroke survivors enrolled in a multimodal intervention trial. Methods This controlled study was a questionnaire-based survey accompanying a three-armed randomized controlled trial of 123 stroke survivors. The care recipients of 106 caregivers who chose to participate were assigned to rhythm-and-music-based therapy (R-MT; n = 37), horse-riding therapy (H-RT; n = 37), or delayed intervention (control group, n = 32)...
December 13, 2017: Topics in Stroke Rehabilitation
https://www.readbyqxmd.com/read/29236892/joinville-stroke-biobank-study-protocol-and-first-year-s-results
#8
Leslie Ecker Ferreira, Paulo Henrique Condeixa de França, Vivian Nagel, Vanessa Venancio, Juliana Safanelli, Felipe Ibiapina Dos Reis, Luis Furtado, Rui Kleber Martins, Gustavo Weiss, Elder Oda, Iscia Lopes-Cendes, Octavio Pontes-Neto, Norberto Luiz Cabral
Aiming to contribute to studies that use detailed clinical and genomic information of biobanks, we present the initial results of the first Latin American Stroke Biobank. METHODS: Blood samples were collected from patients included in the Joinville Stroke Registry and four Brazilian cities. Demographic socio-economic data, cardiovascular risk factors, Causative Classification System for Ischemic Stroke, Trial of Org 10172 in Acute Stroke Treatment and National Institutes of Health scores, functional stroke status (modified Rankin) and brain images were recorded...
December 2017: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/29236075/risks-and-benefits-of-increased-nut-consumption-cardiovascular-health-benefits-outweigh-the-burden-of-carcinogenic-effects-attributed-to-aflatoxin-b%C3%A2-exposure
#9
Hanna Eneroth, Stina Wallin, Karin Leander, Johan Nilsson Sommar, Agneta Åkesson
Nuts are rich in nutrients and mounting evidence shows that consumption reduces cardiovascular disease (CVD) incidence. Nuts may also be a major source of aflatoxin B₁, a potent liver carcinogen and the risk/benefit balance is unknown. Based on national statistics and data from the PREDIMED intervention trial, we estimated the potential CVD-reduction if Swedes aged 55-79 consumed 30 g nuts/day, instead of the current national average of five grams per day. We also assessed the reduction in disability-adjusted life years (DALYs) due to myocardial infarction (MI) and stroke...
December 13, 2017: Nutrients
https://www.readbyqxmd.com/read/29234813/hormone-therapy-for-the-primary-prevention-of-chronic-conditions-in-postmenopausal-women-evidence-report-and-systematic-review-for-the-us-preventive-services-task-force
#10
Gerald Gartlehner, Sheila V Patel, Cynthia Feltner, Rachel Palmieri Weber, Rachel Long, Kelly Mullican, Erin Boland, Linda Lux, Meera Viswanathan
Importance: Postmenopausal status coincides with increased risks for chronic conditions such as heart disease, osteoporosis, cognitive impairment, or some types of cancers. Previously, hormone therapy was used for the primary prevention of these chronic conditions. Objective: To update evidence for the US Preventive Services Task Force on the benefits and harms of hormone therapy in reducing risks for chronic conditions. Data Sources: MEDLINE, Cochrane Library, EMBASE, and trial registries from June 1, 2011, through August 1, 2016...
December 12, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29234571/measurement-of-elevated-il-37-levels-in-acute-ischemic-brain-injury-a-cross-sectional-pilot-study
#11
Atif Zafar, Asad Ikram, Dinesh V Jillella, Duraisamy Kempuraj, Mohammad Moshahid Khan, Saif Bushnaq, Harold Adam, Santiago Ortega-Gutierrez, Syed A Quadri, Mudassir Farooqui, Asgar Zaheer, Enrique C Leira
Interleukin (IL)-37 is a new member of the IL-1 cytokine family with a defined role as a negative feedback inhibitor of proinflammatory responses. IL-37 has yet to be evaluated in non-immune-mediated neurological diseases, such as ischemic or hemorrhagic strokes. This study aimed to measure urine and serum IL-37 levels in patients with ischemic stroke. Twelve patients consented for our study. Two sets of serum and urine samples were obtained and analyzed, one upon admission to the hospital and the second the next morning...
October 11, 2017: Curēus
https://www.readbyqxmd.com/read/29233831/the-efficacy-of-the-proprioceptive-neuromuscular-facilitation-pnf-approach-in-stroke-rehabilitation-to-improve-basic-activities-of-daily-living-and-quality-of-life-a-systematic-review-and-meta-analysis-protocol
#12
Francesc Xavier Guiu-Tula, Rosa Cabanas-Valdés, Mercè Sitjà-Rabert, Gerard Urrútia, Natàlia Gómara-Toldrà
INTRODUCTION: Proprioceptive neuromuscular facilitation (PNF) is a widely used rehabilitation concept, although its efficacy has not yet been demonstrated in stroke survivors. The aim of this systematic review is to identify, assess and synthesise the potential benefits of using PNF to improve the activities of daily living (ADL) and quality of life (QoL) of individuals with stroke. METHODS AND ANALYSIS: A systematic electronic search will be conducted in MEDLINE, Embase, CENTRAL and PEDro...
December 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29233189/head-to-head-comparison-of-prasugrel-versus-ticagrelor-in-patients-with-acute-coronary-syndrome-a-systematic-review-and-meta-analysis-of-randomized-trials
#13
Pravesh Kumar Bundhun, Jia-Xin Shi, Feng Huang
BACKGROUND: Prasugrel and Ticagrelor are emerging antiplatelet drugs that might have the potential to replace currently used antiplatelet agents. Previous analyses comparing prasugrel with ticagrelor mainly focused on an indirect comparison whereas direct comparison was reported only in a few recently published trials. We aimed to systematically carry out a head to head comparison of the adverse clinical outcomes which were associated with prasugrel versus ticagrelor in patients with acute coronary syndrome (ACS)...
December 12, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29233087/stroke-prevention-rehabilitation-intervention-trial-of-exercise-sprite-a-randomised-feasibility-study
#14
Neil Heron, Frank Kee, Jonathan Mant, Philip M Reilly, Margaret Cupples, Mark Tully, Michael Donnelly
BACKGROUND: The value of cardiac rehabilitation (CR) after a transient ischaemic attack (TIA) or minor stroke is untested despite these conditions sharing similar pathology and risk factors to coronary heart disease. We aimed to evaluate the feasibility of conducting a trial of an adapted home-based CR programme, 'The Healthy Brain Rehabilitation Manual', for patients following a TIA/minor stroke, participants' views on the intervention and, to identify the behaviour change techniques (BCTs) used...
December 12, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29233072/improving-the-development-monitoring-and-reporting-of-stroke-rehabilitation-research-consensus-based-core-recommendations-from-the-stroke-recovery-and-rehabilitation-roundtable
#15
Marion F Walker, Tammy C Hoffmann, Marian C Brady, Catherine M Dean, Janice J Eng, Amanda J Farrin, Cynthia Felix, Anne Forster, Peter Langhorne, Elizabeth A Lynch, Kathryn A Radford, Katharina S Sunnerhagen, Caroline L Watkins
Recent reviews have demonstrated that the quality of stroke rehabilitation research has continued to improve over the last four decades but despite this progress, there are still many barriers in moving the field forward. Rigorous development, monitoring and complete reporting of interventions in stroke trials are essential in providing rehabilitation evidence that is robust, meaningful and implementable. An international partnership of stroke rehabilitation experts committed to develop consensus-based core recommendations with a remit of addressing the issues identified as limiting stroke rehabilitation research in the areas of developing, monitoring and reporting stroke rehabilitation interventions...
October 2017: Neurorehabilitation and Neural Repair
https://www.readbyqxmd.com/read/29233071/biomarkers-of-stroke-recovery-consensus-based-core-recommendations-from-the-stroke-recovery-and-rehabilitation-roundtable
#16
Lara A Boyd, Kathryn S Hayward, Nick S Ward, Cathy M Stinear, Charlotte Rosso, Rebecca J Fisher, Alexandre R Carter, Alex P Leff, David A Copland, Leeanne M Carey, Leonardo G Cohen, D Michele Basso, Jane M Maguire, Steven C Cramer
The most difficult clinical questions in stroke rehabilitation are "What is this patient's potential for recovery?" and "What is the best rehabilitation strategy for this person, given her/his clinical profile?" Without answers to these questions, clinicians struggle to make decisions regarding the content and focus of therapy, and researchers design studies that inadvertently mix participants who have a high likelihood of responding with those who do not. Developing and implementing biomarkers that distinguish patient subgroups will help address these issues and unravel the factors important to the recovery process...
October 2017: Neurorehabilitation and Neural Repair
https://www.readbyqxmd.com/read/29232981/transcutaneous-electrical-nerve-stimulation-improves-walking-capacity-and-reduces-spasticity-in-stroke-survivors-a-systematic-review-and-meta-analysis
#17
Patrick Wh Kwong, Gabriel Yf Ng, Raymond Ck Chung, Shamay Sm Ng
OBJECTIVE: To evaluate (1) the effectiveness of transcutaneous electrical nerve stimulation (TENS) at improving lower extremity motor recovery in stroke survivors and (2) the optimal stimulation parameters for TENS. REVIEW METHODS: A systematic search was conducted for studies published up to October 2017 using eight electronic databases (CINAHL, ClinicalTrials.gov, the Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, PEDro, PubMed and Web of Science)...
December 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/29232836/spasticity-management-in-disorders-of-consciousness
#18
REVIEW
Géraldine Martens, Steven Laureys, Aurore Thibaut
Background: Spasticity is a motor disorder frequently encountered after a lesion involving the central nervous system. It is hypothesized to arise from an anarchic reorganization of the pyramidal and parapyramidal fibers and leads to hypertonia and hyperreflexia of the affected muscular groups. While this symptom and its management is well-known in patients suffering from stroke, multiple sclerosis or spinal cord lesion, little is known regarding its appropriate management in patients presenting disorders of consciousness after brain damage...
December 9, 2017: Brain Sciences
https://www.readbyqxmd.com/read/29232308/a-backward-walking-training-program-to-improve-balance-and-mobility-in-acute-stroke-a-pilot-randomized-controlled-trial
#19
Dorian K Rose, Lou DeMark, Emily J Fox, David J Clark, Peter Wludyka
BACKGROUND AND PURPOSE: Strategies to address gait and balance deficits early poststroke are minimal. The postural and motor control requirements of Backward Walking Training (BWT) may provide benefits to improve balance and walking speed in this population. This pilot study (1) determined the feasibility of administering BWT during inpatient rehabilitation and (2) compared the effectiveness of BWT to Standing Balance Training (SBT) on walking speed, balance, and balance-related efficacy in acute stroke...
January 2018: Journal of Neurologic Physical Therapy: JNPT
https://www.readbyqxmd.com/read/29231792/patient-selection-for-mechanical-thrombectomy-in-posterior-circulation-emergent-large-vessel-occlusion
#20
Scott Raymond, Natalia Sana Rost, Pamela Whitney Schaefer, Thabele Leslie-Mazwi, Joshua A Hirsch, Ramon Gilberto Gonzalez, James Rabinov
Triage of posterior circulation stroke from emergent large-vessel occlusion (pc-ELVO) is challenging owing to the stuttering clinical course and potential for rapid decline. Growing clinical data support the use of mechanical thrombectomy in pc-ELVO, but there are limited data addressing the clinical and imaging criteria for patient selection. We present our triage algorithm used to select patients for endovascular therapy (EVT) in the setting of pc-ELVOS. We use a consecutive retrospective database from 2004 to 2016 to describe the practice patterns and prognostic factors for pc-ELVO patients treated using both medical and EVT...
January 1, 2017: Interventional Neuroradiology
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