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Ischemic stroke randomized

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https://www.readbyqxmd.com/read/27903389/-dabigatran-versus-warfarin-for-the-prevention-of-stroke-in-chinese-patients-with-nonvalvular-atrial-fibrillation-chinese-subpopulation-analysis-of-re-ly
#1
X Gao, Y M Yang, J Zhu, Y Dai, H Q Tan
Objective: This analysis was performed to evaluate the efficacy in stroke prevention and safety of dabigatran in Chinese nonvalvular atrial fibrillation(NVAF) patients enrolled in RE-LY trial. Methods: RE-LY was an prospective, open-label, randomized, multicenter study. From March 2006 to March 2009, 541 atrial fibrillation patients at risk of stroke were recruited from 13 medical centers in China. Patients randomly received, in a blinded fashion, fixed doses of dabigatran-110 mg or 150 mg twice daily or, in an unblinded fashion, adjusted-dose warfarin...
November 24, 2016: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/27900231/efficacy-and-safety-of-direct-oral-anticoagulants-compared-to-warfarin-in-prevention-of-thromboembolic-events-among-elderly-patients-with-atrial-fibrillation
#2
REVIEW
Shilpa D Kailas, Sirisha Reddy Thambuluru
Direct oral anticoagulants (DOACs), previously also known as novel oral anticoagulants (NOACs), have increased the therapeutic options for stroke prevention in atrial fibrillation (AF). Previous studies comparing their relative efficacy and safety do not address age-related differences, such as comorbidities and physical and social boundaries. This review aimed to summarize and compare the clinical and safety outcomes of DOACs and warfarin for stroke prevention in AF in the elderly population (≥ 65 years)...
October 18, 2016: Curēus
https://www.readbyqxmd.com/read/27899742/acute-endovascular-treatment-delivery-to-ischemic-stroke-patients-transferred-within-a-telestroke-network-a-retrospective-observational-study
#3
Jessica Barlinn, Johannes Gerber, Kristian Barlinn, Lars-Peder Pallesen, Timo Siepmann, Charlotte Zerna, Claudia Wojciechowski, Volker Puetz, Rüdiger von Kummer, Heinz Reichmann, Jennifer Linn, Ulf Bodechtel
BACKGROUND: Five randomized controlled trials recently demonstrated efficacy of endovascular treatment in acute ischemic stroke. Telestroke networks can improve stroke care in rural areas but their role in patients undergoing endovascular treatment is unknown. AIM: We compared clinical outcomes of endovascular treatment between anterior circulation stroke patients transferred after teleconsultation and those directly admitted to a tertiary stroke center. METHODS: Data derived from consecutive patients with intracranial large vessel occlusion who underwent endovascular treatment from January 2010 to December 2014 at our tertiary stroke center...
November 29, 2016: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/27898402/recent-update-on-carotid-endarterectomy-versus-carotid-artery-stenting
#4
Raywat Noiphithak, Anusak Liengudom
Carotid artery stenosis (CS) is a major cause of ischemic stroke. Treatment of CS consists of best medical treatment and carotid revascularization (CR), including carotid endarterectomy (CEA) and carotid artery stenting (CAS). Both CR techniques have their own procedural risks. Therefore, selection of the appropriate treatment for patients with CS is relatively complicated. Many studies and guidelines have reported the efficacy of each treatment for both symptomatic and asymptomatic patients. However, the results are still controversial, especially concerning the efficacy and safety of CEA and CAS...
November 30, 2016: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/27895298/effect-of-right-insular-involvement-on-death-and-functional-outcome-after-acute-ischemic-stroke-in-the-ist-3-trial-third-international-stroke-trial
#5
Luciano A Sposato, Geoffrey Cohen, Joanna M Wardlaw, Peter Sandercock, Richard I Lindley, Vladimir Hachinski
BACKGROUND AND PURPOSE: In patients with acute ischemic stroke, whether involvement of the insular cortex influences outcome is controversial. Much of the apparent adverse outcome may relate to such strokes usually being severe. We examined the influence of right and left insular involvement on stroke outcomes among patients from the IST-3 study (Third International Stroke Trial) who had visible ischemic stroke on neuroimaging. METHODS: We used multiple logistic regression to compare outcomes of left versus right insular and noninsular strokes across strata of stroke severity, on death, proportion dead or dependent, and level of disability (ordinalized Oxford Handicap Score) at 6 months, with adjustment for the effects of age, lesion size, and presence of atrial fibrillation...
December 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27892885/vitamin-k-antagonists-for-stroke-prevention-in-hemodialysis-patients-with-atrial-fibrillation-a-systematic-review-and-meta-analysis
#6
Hans Van Der Meersch, Dirk De Bacquer, An S De Vriese
BACKGROUND: The use of vitamin K antagonists (VKAs) in hemodialysis patients with atrial fibrillation (AF) is controversial. No randomized trials are available and observational studies have yielded conflicting results, engendering a large clinical practice variability and physician uncertainty. An unresolved but highly relevant question is whether AF poses a true risk of ischemic stroke in hemodialysis and whether any form of oral anticoagulation is therefore warranted. METHODS: We conducted a systematic review of studies that compared the incidence of ischemic stroke and bleeding in hemodialysis patients with AF taking VKA and those not taking VKA...
October 4, 2016: American Heart Journal
https://www.readbyqxmd.com/read/27891238/the-effect-of-long-working-hours-on-10-year-risk-of-coronary-heart-disease-and-stroke-in-the-korean-population-the-korea-national-health-and-nutrition-examination-survey-knhanes-2007-to-2013
#7
Dong-Wook Lee, Yun-Chul Hong, Kyoung-Bok Min, Tae-Shik Kim, Min-Seok Kim, Mo-Yeol Kang
BACKGROUND: Recently, the emergence of long working hours and the associated conditions such as coronary heart disease (CHD) and stroke have gained attention. The aim of this study was to investigate the association between long working hours and the 10-year-risk of CHD and stroke, estimated by Jee's health risk-appraisal model for ischemic heart disease. METHODS: We analyzed data from Koreans who randomly enrolled in Korean National Health and Nutrition Examination Survey 2008-2012 and finally included 13,799 participants...
2016: Annals of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/27889229/brown-propolis-attenuates-cerebral-ischemia-induced-oxidative-damage-via-affecting-antioxidant-enzyme-system-in-mice
#8
Gholamreza Bazmandegan, Mohammad Taher Boroushaki, Ali Shamsizadeh, Fatemeh Ayoobi, Elham Hakimizadeh, Mohammad Allahtavakoli
Oxidative stress plays a critical role in ischemic brain injury. Superoxide dismutase (SOD) and glutathione peroxidase (GPx) are the enzymes underlying the endogenous antioxidant mechanisms affected by stroke and are considered as oxidative stress biomarkers. Brown propolis (BP) is a bioactive natural product with a set of biological activities that in turn may differ depending on the area from which the substance is originated. The aim of this study was to investigate the effect of water-extracted brown propolis (WEBPs), from two regions of Iran, against cerebral ischemia-induced oxidative injury in a mouse model of stroke...
November 23, 2016: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/27886815/antiplatelet-therapy-for-secondary-prevention-after-acute-myocardial-infarction
#9
REVIEW
Ilaria Cavallari, Marc P Bonaca
Patients with prior myocardial infarction (MI) are at long-term heightened risk for recurrent ischemic events. Several large randomized controlled trials have demonstrated the benefit of more intensive antiplatelet strategies for long-term secondary prevention of cardiovascular death, recurrent MI, and stroke in patients with a history of MI at a cost of increased bleeding. The bleeding risk associated with long-term intensive antiplatelet strategies requires careful patient selection and involvement of patients in shared decision making regarding risks and benefits of therapy...
January 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27881833/apixaban-for-treatment-of-embolic-stroke-of-undetermined-source-atticus-randomized-trial-rationale-and-study-design
#10
Tobias Geisler, Sven Poli, Christoph Meisner, Juergen Schreieck, Christine S Zuern, Thomas Nägele, Johannes Brachmann, Werner Jung, Georg Gahn, Elisabeth Schmid, Hansjörg Bäezner, Timea Keller, Gabor C Petzold, Jan-Wilko Schrickel, Jan Liman, Rolf Wachter, Frauke Schön, Martin Schabet, Alfred Lindner, Albert C Ludolph, Hubert Kimmig, Sebastian Jander, Uwe Schlegel, Meinrad Gawaz, Ulf Ziemann
RATIONALE: Optimal secondary prevention of embolic stroke of undetermined source is not established. The current standard in these patients is acetylsalicylic acid, despite high prevalence of yet undetected paroxysmal atrial fibrillation. AIM: The ATTICUS randomized trial is designed to determine whether the factor Xa inhibitor apixaban administered within 7 days after embolic stroke of undetermined source, is superior to acetylsalicylic acid for prevention of new ischemic lesions documented by brain magnetic resonance imaging within 12 months after index stroke...
November 23, 2016: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/27881569/extended-duration-betrixaban-reduces-the-risk-of-stroke-versus-standard-dose-enoxaparin-among-hospitalized-medically-ill-patients-an-apex-trial-substudy-acute-medically-ill-venous-thromboembolism-prevention-with-extended-duration-betrixaban
#11
C Michael Gibson, Gerald Chi, Rim Halaby, Serge Korjian, Yazan Daaboul, Purva Jain, Douglas Arbetter, Samuel Z Goldhaber, Russell Hull, Adrian F Hernandez, Alex Gold, Olga Bandman, Robert A Harrington, Alexander T Cohen
BACKGROUND: -Stroke is a morbid and potentially mortal complication among patients hospitalized with acute medical illness. The potential of extended-duration thromboprophylaxis with the factor Xa inhibitor betrixaban to reduce the risk of stroke compared with standard-dose enoxaparin in this population was assessed in this retrospective APEX trial substudy (Acute Medically Ill Venous Thromboembolism Prevention With Extended Duration Betrixaban). METHODS: -Hospitalized acutely medically ill subjects (n=7513) were randomized in a double-dummy double-blind fashion to either extended-duration oral betrixaban (80 mg once daily for 35-42 days) or standard-dose subcutaneous enoxaparin (40 mg once daily for 10±4 days) for venous thromboprophylaxis...
November 14, 2016: Circulation
https://www.readbyqxmd.com/read/27881167/differing-association-of-alcohol-consumption-with-different-stroke-types-a-systematic-review-and-meta-analysis
#12
Susanna C Larsson, Alice Wallin, Alicja Wolk, Hugh S Markus
BACKGROUND: Whether light-to-moderate alcohol consumption is protective against stroke, and whether any association differs by stroke type, is controversial. We conducted a meta-analysis to summarize the evidence from prospective studies on alcohol drinking and stroke types. METHODS: Studies were identified by searching PubMed to September 1, 2016, and reference lists of retrieved articles. Additional data from 73,587 Swedish adults in two prospective studies were included...
November 24, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27879970/mortality-hospital-days-and-expenditures-attributable-to-ambient-air-pollution-from-particulate-matter-in-israel
#13
Gary M Ginsberg, Ehud Kaliner, Itamar Grotto
BACKGROUND: Worldwide, ambient air pollution accounts for around 3.7 million deaths annually. Measuring the burden of disease is important not just for advocacy but also is a first step towards carrying out a full cost-utility analysis in order to prioritise technological interventions that are available to reduce air pollution (and subsequent morbidity and mortality) from industrial, power generating and vehicular sources. METHODS: We calculated the average national exposure to particulate matter particles less than 2...
2016: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/27876083/two-year-clinical-follow-up-of-the-multicenter-randomized-clinical-trial-of-endovascular-treatment-for-acute-ischemic-stroke-in-the-netherlands-mr-clean-design-and-statistical-analysis-plan-of-the-extended-follow-up-study
#14
Lucie A van den Berg, Marcel G W Dijkgraaf, Olvert A Berkhemer, Puck S S Fransen, Debbie Beumer, Hester Lingsma, Charles B M Majoie, Diederik W J Dippel, Aad J van der Lugt, Robert J van Oostenbrugge, Wim H van Zwam, Yvo B W E M Roos
BACKGROUND: MR CLEAN was the first randomized trial to demonstrate the short-term clinical effectiveness of endovascular treatment in patients with acute ischemic stroke caused by large vessel occlusion in the anterior circulation. Several other trials confirmed that endovascular treatment improves clinical outcome at three months. However, limited data are available on long-term clinical outcome. We aimed to estimate the effect of endovascular treatment on functional outcome at two-year follow-up in patients with acute ischemic stroke...
November 22, 2016: Trials
https://www.readbyqxmd.com/read/27873238/cardiovascular-safety-of-dipeptidyl-peptidase-iv-inhibitors-a-meta-analysis-of-placebo-controlled-randomized-trials
#15
Islam Y Elgendy, Ahmed N Mahmoud, Amr F Barakat, Akram Y Elgendy, Marwan Saad, Ahmed Abuzaid, Siddarth A Wayangankar, Anthony A Bavry
BACKGROUND: Large randomized trials have shown conflicting evidence regarding the cardiovascular safety of dipeptidyl-peptidase 4 (DPP-4) inhibitors. Systematic reviews have been limited by incomplete data and inclusion of observational studies. This study aimed to systematically evaluate the cardiovascular safety of DPP-4 inhibitors in patients with type 2 diabetes. METHODS: Electronic databases were searched for randomized trials that compared DPP-4 inhibitors versus placebo and reported cardiovascular outcomes...
November 21, 2016: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/27871433/regional-variation-in-acute-stroke-care-organisation
#16
Paula Muñoz Venturelli, Thompson Robinson, Pablo M Lavados, Verónica V Olavarría, Hisatomi Arima, Laurent Billot, Maree L Hackett, Joyce Y Lim, Sandy Middleton, Octavio Pontes-Neto, Bin Peng, Liying Cui, Lily Song, Gillian Mead, Caroline Watkins, Ruey-Tay Lin, Tsong-Hai Lee, Jeyaraj Pandian, H Asita de Silva, Craig S Anderson
BACKGROUND: Few studies have assessed regional variation in the organisation of stroke services, particularly health care resourcing, presence of protocols and discharge planning. Our aim was to compare stroke care organisation within middle- (MIC) and high-income country (HIC) hospitals participating in the Head Position in Stroke Trial (HeadPoST). METHODS: HeadPoST is an on-going international multicenter crossover cluster-randomized trial of 'sitting-up' versus 'lying-flat' head positioning in acute stroke...
December 15, 2016: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/27867477/hyperbaric-oxygen-therapy-in-experimental-and-clinical-stroke
#17
REVIEW
Wei-Wei Zhai, Liang Sun, Zheng-Quan Yu, Gang Chen
Stroke, which is defined as a neurologic deficit caused by sudden impaired blood supply, has been considered as a common cause of death and disability for decades. The World Health Organization has declared that almost every 5 seconds a new stroke occurs, placing immense socioeconomic burdens. However, the effective and available treatment strategies are still limited. Additionally, the most effective therapy, such as thrombolysis and stenting for ischemic stroke, generally requires a narrow therapeutic time window after the event...
April 2016: Medical Gas Research
https://www.readbyqxmd.com/read/27866027/cardiovascular-outcomes-with-sodium-glucose-cotransporter-2-inhibitors-in-patients-with-type-ii-diabetes-mellitus-a-meta-analysis-of-placebo-controlled-randomized-trials
#18
Marwan Saad, Ahmed N Mahmoud, Islam Y Elgendy, Ahmed Abuzaid, Amr F Barakat, Akram Y Elgendy, Mohammad Al-Ani, Amgad Mentias, Ramez Nairooz, Anthony A Bavry, Debabrata Mukherjee
BACKGROUND: The impact of sodium-glucose cotransporter-2 (SGLT-2) inhibitors on cardiovascular outcomes in patients with type II diabetes mellitus (DM) is not well established. METHODS: We searched electronic databases from inception through July 2016 for randomized, placebo-controlled trials, involving SGLT-2 inhibitors. Fixed-effects summary odds ratios (OR) were constructed using Peto model. RESULTS: Eighty-one trials with a total of 37,195 patients were included...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27865732/prevention-of-heartmate-ii-pump-thrombosis-through-clinical-management-the-prevent-multi-center-study
#19
Simon Maltais, Ahmet Kilic, Sriram Nathan, Mary Keebler, Sitaramesh Emani, John Ransom, Jason N Katz, Brett Sheridan, Andreas Brieke, Gregory Egnaczyk, John W Entwistle, Robert Adamson, John Stulak, Nir Uriel, John B O'Connell, David J Farrar, Kartik S Sundareswaran, Igor Gregoric
BACKGROUND: Recommended structured clinical practices including implant technique, anti-coagulation strategy, and pump speed management (PREVENT [PREVENtion of HeartMate II Pump Thrombosis Through Clinical Management] recommendations) were developed to address risk of early (<3 months) pump thrombosis (PT) risk with HeartMate II (HMII; St. Jude Medical, Inc. [Thoratec Corporation], Pleasanton, CA). We prospectively assessed the HMII PT rate in the current era when participating centers adhered to the PREVENT recommendations...
November 16, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27865153/efficient-multi-scale-3d-cnn-with-fully-connected-crf-for-accurate-brain-lesion-segmentation
#20
Konstantinos Kamnitsas, Christian Ledig, Virginia F J Newcombe, Joanna P Simpson, Andrew D Kane, David K Menon, Daniel Rueckert, Ben Glocker
We propose a dual pathway, 11-layers deep, three-dimensional Convolutional Neural Network for the challenging task of brain lesion segmentation. The devised architecture is the result of an in-depth analysis of the limitations of current networks proposed for similar applications. To overcome the computational burden of processing 3D medical scans, we have devised an efficient and effective dense training scheme which joins the processing of adjacent image patches into one pass through the network while automatically adapting to the inherent class imbalance present in the data...
October 29, 2016: Medical Image Analysis
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