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Ischemic stroke randomized

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https://www.readbyqxmd.com/read/28440589/prime-movers-advanced-practice-professionals-in-the-role-of-stroke-coordinator
#1
Nicholas A Rattray, Teresa M Damush, Cherie Luckhurst, Catherine J Bauer-Martinez, Barbara J Homoya, Edward J Miech
BACKGROUND AND PURPOSE: Following a stroke quality improvement clustered randomized trial and a national acute ischemic stroke (AIS) directive in the Veterans Health Administration in 2011, this comparative case study examined the role of advanced practice professionals (APPs) in quality improvement activities among stroke teams. METHODS: Semistructured interviews were conducted at 11 Veterans Affairs medical centers annually over a 3-year period. A multidisciplinary team analyzed interviews from clinical providers through a mixed-methods, data matrix approach linking APPs (nurse practitioners and physician assistants) with Consolidated Framework for Implementation Research constructs and a group organization measure...
April 25, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28440116/telemedical-strategies-for-the-improvement-of-secondary-prevention-in-patients-with-cerebrovascular-events-a-systematic-review-and-meta-analysis
#2
Peter Kraft, Steffi Hillmann, Viktoria Rücker, Peter U Heuschmann
Background Data from European countries consistently show that guideline-conform secondary prevention after stroke/transient ischemic attack is being realized in only 50-80% of patients. Use of telemedicine to support long-term secondary prevention has been effective in other cardiovascular diseases. Aims We reviewed current evidence for telemedical-supported strategies for the improvement of secondary prevention after stroke/transient ischemic attack. A systematic review was performed in accordance with the PRISMA statement searching MEDLINE, the Cochrane Central Register of Controlled Trials, and reference lists of articles published until 18 May 2016...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28439774/albumin-induced-neuroprotection-in-focal-cerebral-ischemia-in-the-alias-trial-does-severity-mechanism-and-time-of-infusion-matter
#3
Rakesh Khatri, Mohammad Rauf Afzal, Gustavo J Rodriguez, Alberto Maud, Muhammad Shah Miran, Mohtashim Arbaab Qureshi, Salvador Cruz-Flores, Adnan I Qureshi
OBJECTIVE: To determine whether there is any differential benefit of albumin administration within 2 h of onset of ischemia and in settings (severe ischemia with reperfusion in cardioembolic strokes with National Institutes of Health Stroke Scale [NIHSS] ≥15), most representative of experimental models of cerebral ischemia in which albumin was effective in reducing neurological injury. BACKGROUND: High-dose intravenous (IV) albumin treatment for acute ischemic stroke (ALIAS) trial did not show overall clinical benefit in ischemic stroke patients in contrast to preclinical studies; however, models of preclinical studies were not completely followed...
April 24, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28438739/reporting-clinical-end-points-and-safety-events-in-an-acute-coronary-syndrome-trial-results-with-integrated-collection
#4
Patrícia O Guimarães, Renato D Lopes, Susanna R Stevens, André Zimerman, Lisa Wruck, Stefan K James, Ghazala Haque, Roberto Rocha C V Giraldez, John H Alexander, Karen P Alexander
BACKGROUND: End points and adverse events (AEs) are collected separately in clinical trials, yet regulatory requirements for serious AE reporting vary across regions, so classifying end points according to seriousness criteria can be useful in global trials. METHODS AND RESULTS: In the Apixaban for Prevention of Acute Ischemic Events 2 (APPRAISE-2) trial, patients with a recent acute coronary syndrome were randomized to apixaban or placebo for the prevention of recurrent ischemic events...
April 24, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28436307/choice-of-anesthesia-for-endovascular-treatment-of-acute-ischemic-stroke-protocol-for-a-randomized-controlled-canvas-trial
#5
Yuming Peng, Yan Li, Minyu Jian, Xiaoyuan Liu, Jian Sun, Bo Jia, Jia Dong, Min Zeng, Nan Lin, Li Zhang, Adrian W Gelb, Matthew Tv Chan, Ruquan Han
Background Observational studies indicate that the type of anesthesia, local or general, may be associated with the post-procedural neurological function in patients with acute ischemic stroke undergoing endovascular treatment. However, these results need further confirmation, and the causal relationship has not yet been established. Methods This is a randomized controlled equivalence trial. Permuted block randomization stratified by culprit vessels will be used. Six hundred and forty patients with acute ischemic stroke undergoing endovascular recanalization will be randomized one to one to receive either general anesthesia or local anesthesia...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28436305/quality-of-life-after-intra-arterial-treatment-for-acute-ischemic-stroke-in-the-mr-clean-trial-update
#6
Jennifer Schreuders, Lucie A van den Berg, Puck Ss Fransen, Olvert A Berkhemer, Debbie Beumer, Hester F Lingsma, Robert J van Oostenbrugge, Wim H van Zwam, Charles Blm Majoie, Aad van der Lugt, Paul Lm de Kort, Yvo Bwem Roos, Diederik Wj Dippel
Background Health-related quality of life measured with the EuroQol Group 5-Dimension Self-Report Questionnaire was one of the secondary outcomes in the Multicenter Randomized Clinical trial of Endovascular treatment for Acute ischemic stroke in the Netherlands (MR CLEAN). We reported no statistically significant difference in EuroQol Group 5-Dimension Self-Report Questionnaire score between the intervention and control groups, but deaths were not included. Aims Reanalyze the effect of intra-arterial treatment for large vessel occlusion in acute ischemic stroke patients on health-related quality of life in more detail...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28433996/factor-xii-as-a-risk-marker-for-hemorrhagic-stroke-a-prospective-cohort-study
#7
Kristina Johansson, Jan-Håkan Jansson, Lars Johansson, Ingemar Bylesjö, Torbjörn K Nilsson, Mats Eliasson, Stefan Söderberg, Marcus Lind
BACKGROUND: Coagulation factor XII (FXII) is involved in pathological thrombus formation and is a suggested target of anticoagulants. It is unclear whether FXII levels are correlated with cardiovascular risk factors and whether they are associated with myocardial infarction or ischemic or hemorrhagic stroke. The aim of this study was to investigate the correlation between FXII and cardiovascular risk factors in the general population. We also aimed to study the associations between FXII levels and future myocardial infarction and ischemic and hemorrhagic stroke...
April 21, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28433215/meta-analysis-of-randomized-controlled-trials-of-percutaneous-coronary-intervention-with-drug-eluting-stents-versus-coronary-artery-bypass-grafting-in-left-main-coronary-artery-disease
#8
Aakash Garg, Sunil V Rao, Sahil Agrawal, Kleanthis Theodoropoulos, Marco Mennuni, Abhishek Sharma, Lohit Garg, Giuseppe Ferrante, Omar A Meelu, Davit Sargsyan, Bernhard Reimers, Marc Cohen, John B Kostis, Giulio G Stefanini
Few randomized controlled trials (RCTs) and observational studies had shown acceptable short-term efficacy and safety of percutaneous coronary intervention (PCI) with drug-eluting stents (DES) compared with coronary artery bypass grafting (CABG) in selected patients with left main coronary artery disease (LMCAD). We aimed to evaluate long-term outcomes of PCI using DES compared with CABG in patients with LMCAD. On November 1, 2016, we searched available databases for published RCTs directly comparing DES PCI with CABG in patients with LMCAD...
March 29, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28432266/baseline-blood-pressure-effect-on-the-benefit-and-safety-of-intra-arterial-treatment-in-mr-clean-multicenter-randomized-clinical-trial-of-endovascular-treatment-of-acute-ischemic-stroke-in-the-netherlands
#9
Maxim J H L Mulder, Saliha Ergezen, Hester F Lingsma, Olvert A Berkhemer, Puck S S Fransen, Debbie Beumer, Lucie A van den Berg, Geert Lycklama À Nijeholt, Bart J Emmer, H Bart van der Worp, Paul J Nederkoorn, Yvo B W E M Roos, Robert J van Oostenbrugge, Wim H van Zwam, Charles B L M Majoie, Aad van der Lugt, Diederik W J Dippel
BACKGROUND AND PURPOSE: High blood pressure (BP) is associated with poor outcome and the occurrence of symptomatic intracranial hemorrhage in acute ischemic stroke. Whether BP influences the benefit or safety of intra-arterial treatment (IAT) is not known. We aimed to assess the relation of BP with functional outcome, occurrence of symptomatic intracranial hemorrhage and effect of IAT. METHODS: This is a post hoc analysis of the MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands)...
April 21, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28432265/artemida-trial-a-randomized-trial-of-efficacy-12-months-international-double-blind-actovegin-a-randomized-controlled-trial-to-assess-the-efficacy-of-actovegin-in-poststroke-cognitive-impairment
#10
Alla Guekht, Ingmar Skoog, Sally Edmundson, Vladimir Zakharov, Amos D Korczyn
BACKGROUND AND PURPOSE: Poststroke cognitive impairment is a debilitating consequence of stroke. The aim of this study was to assess whether Actovegin confers cognitive benefit in patients who have had an ischemic stroke. METHODS: This was a 12-month, parallel-group, randomized, multicenter, double-blind, placebo-controlled study. Eligible patients were ≥60 years of age with a Montreal Cognitive Assessment test score of ≤25 points. Patients were randomized into 2 groups within 1 week of acute supratentorial ischemic stroke in a 1:1 ratio: Actovegin (a deproteinized hemoderivative of calf blood, 2000 mg/d for ≤20 intravenous infusions followed by 1200 mg/d orally) or placebo for 6 months...
April 21, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28427459/subjective-perceived-impact-of-tai-chi-training-on-physical-and-mental-health-among-community-older-adults-at-risk-for-ischemic-stroke-a-qualitative-study
#11
Guohua Zheng, Zhenyu Xiong, Xin Zheng, Junzhe Li, Tingjin Duan, Dalu Qi, Kun Ling, Lidian Chen
BACKGROUND: Evidence from quantitative studies suggest that Tai Chi produces a variety of health-related benefits, but few qualitative studies have investigated how older adults perceive the benefit of Tai Chi. The objective of the current study was to qualitatively evaluate the perceived benefits of Tai Chi practice among community older population. METHODS: This study was conducted with participants from a trial examining the effects of a 12-week Tai Chi training on ischemic stroke risk in community older adults (n = 170)...
April 20, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28427299/effects-of-low-frequency-repetitive-transcranial-magnetic-stimulation-on-upper-extremity-motor-recovery-and-functional-outcomes-in-chronic-stroke-patients-a-randomized-controlled-trial
#12
Ayhan Aşkın, Aliye Tosun, Ümit Seçil Demirdal
BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) was suggested as a preconditioning method that would increase brain plasticity and that it would be optimal to combine rTMS with intensive rehabilitation. OBJECTIVE: To assess the efficacy of inhibitory rTMS on upper extremity motor recovery and functional outcomes in chronic ischemic stroke patients. METHODS: In this randomized controlled trial, experimental group received low-frequency (LF) rTMS to the primary motor cortex of the unaffected side + physical therapy (PT), and control group received PT...
April 20, 2017: Somatosensory & Motor Research
https://www.readbyqxmd.com/read/28425349/clinical-characteristics-of-unknown-symptom-onset-stroke-patients-with-and-without-diffusion-weighted-imaging-and-fluid-attenuated-inversion-recovery-mismatch
#13
Götz Thomalla, Florent Boutitie, Jochen B Fiebach, Claus Z Simonsen, Salvador Pedraza, Robin Lemmens, Norbert Nighoghossian, Pascal Roy, Keith W Muir, Martin Ebinger, Ian Ford, Bastian Cheng, Ivana Galinovic, Tae-Hee Cho, Josep Puig, Vincent Thijs, Matthias Endres, Jens Fiehler, Christian Gerloff
Background Diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) mismatch was suggested to identify stroke patients with unknown time of symptom onset likely to be within the time window for thrombolysis. Aims We aimed to study clinical characteristics associated with DWI-FLAIR mismatch in patients with unknown onset stroke. Methods We analyzed baseline MRI and clinical data from patients with acute ischemic stroke proven by DWI from WAKE-UP, an investigator-initiated, randomized, placebo-controlled trial of MRI-based thrombolysis in stroke patients with unknown time of symptom onset...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28425296/medium-to-long-term-persistence-with-non-vitamin-k-oral-anticoagulants-in-patients-with-atrial-fibrillation-australian-experience
#14
Leon A Simons, Michael Ortiz, S Ben Freedman, Benjamin J Waterhouse, David Colquhoun
OBJECTIVE: Long-term anticoagulant therapy with non-valvular atrial fibrillation (AF) is essential to prevent thromboembolic complications, especially ischemic stroke. This study examines medium-term persistence in AF patients using a non-vitamin K antagonist oral anticoagulant drug (NOAC). RESEARCH DESIGN AND METHODS: We assessed national Pharmaceutical Benefit Scheme records December 2013 through September 2016 for initial prescription of a NOAC in a 10% random sample of concessional patients...
April 20, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28424039/endovascular-treatment-of-ischemic-stroke-an-updated-meta-analysis-of-efficacy-and-safety
#15
Simone Vidale, Elio Agostoni
BACKGROUND: Recent randomized trials demonstrated the superiority of the mechanical thrombectomy over the best medical treatment in patients with acute ischemic stroke due to an occlusion of arteries of proximal anterior circulation. In this updated meta-analysis, we aimed to summarize the total clinical effects of the treatment, including the last trials. METHODS: We performed literature search of Randomized Crontrolled Trials (RCTs) published between 2010 and October 2016, comparing endovenous thrombolysis plus mechanical thrombectomy (intervention group) with best medical care alone (control group)...
May 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28420648/association-of-magnet-status-with-hospitalization-outcomes-for-ischemic-stroke-patients
#16
Kimon Bekelis, Symeon Missios, Todd A MacKenzie
BACKGROUND: It is not clear whether Magnet recognition by the American Nurses Credentialing Center (nursing excellence program) is associated with improved patient outcomes. We investigated whether hospitalization in a Magnet hospital is associated with improved outcomes for patients with ischemic stroke. METHODS AND RESULTS: We performed a cohort study of patients with ischemic stroke from 2009 to 2013, who were registered in the New York Statewide Planning and Research Cooperative System database...
April 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28416405/development-validation-and-assessment-of-an-ischemic-stroke-or-transient-ischemic-attack-specific-prediction-tool-for-obstructive-sleep-apnea
#17
Jason J Sico, H Klar Yaggi, Susan Ofner, John Concato, Charles Austin, Jared Ferguson, Li Qin, Lauren Tobias, Stanley Taylor, Carlos A Vaz Fragoso, Vincent McLain, Linda S Williams, Dawn M Bravata
BACKGROUND: Screening instruments for obstructive sleep apnea (OSA), as used routinely to guide clinicians regarding patient referral for polysomnography (PSG), rely heavily on symptomatology. We sought to develop and validate a cerebrovascular disease-specific OSA prediction model less reliant on symptomatology, and to compare its performance with commonly used screening instruments within a population with ischemic stroke or transient ischemic attack (TIA). METHODS: Using data on demographic factors, anthropometric measurements, medical history, stroke severity, sleep questionnaires, and PSG from 2 independently derived, multisite, randomized trials that enrolled patients with stroke or TIA, we developed and validated a model to predict the presence of OSA (i...
April 14, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28411259/cerebral-embolic-protection-devices-during-transcatheter-aortic-valve-implantation-systematic-review-and-meta-analysis
#18
Rodrigo Bagur, Karla Solo, Saleh Alghofaili, Luis Nombela-Franco, Chun Shing Kwok, Samual Hayman, Reed A Siemieniuk, Farid Foroutan, Frederick A Spencer, Per O Vandvik, Tim G Schäufele, Mamas A Mamas
BACKGROUND AND PURPOSE: Silent ischemic embolic lesions are common after transcatheter aortic valve implantation (TAVI). The use of embolic protection devices (EPD) may reduce the occurrence of these embolic lesions. Thus, a quantitative overview and credibility assessment of the literature was necessary to draw a robust message about EPD. Therefore, the aim of this meta-analysis was to study whether the use of EPD reduces silent ischemic and clinically evident cerebrovascular events associated with TAVI...
April 14, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28409731/a-direct-aspiration-first-pass-technique-vs-stentriever-thrombectomy-in-emergent-large-vessel-intracranial-occlusions
#19
Christopher J Stapleton, Thabele M Leslie-Mazwi, Collin M Torok, Reza Hakimelahi, Joshua A Hirsch, Albert J Yoo, James D Rabinov, Aman B Patel
OBJECTIVE Endovascular thrombectomy in patients with acute ischemic stroke caused by occlusion of the proximal anterior circulation arteries is superior to standard medical therapy. Stentriever thrombectomy with or without aspiration assistance was the predominant technique used in the 5 randomized controlled trials that demonstrated the superiority of endovascular thrombectomy. Other studies have highlighted the efficacy of a direct aspiration first-pass technique (ADAPT). METHODS To compare the angiographic and clinical outcomes of ADAPT versus stentriever thrombectomy in patients with emergent large vessel occlusions (ELVO) of the anterior intracranial circulation, the records of 134 patients who were treated between June 2012 and October 2015 were reviewed...
April 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28406964/granulocyte-colony-stimulating-factor-therapy-for-stroke-a-pairwise-meta-analysis-of-randomized-controlled-trial
#20
Xin Huang, Yu Liu, Shuang Bai, Lidan Peng, Boai Zhang, Hong Lu
Granulocyte colony-stimulating factor (G-CSF) is atherapeutic candidate for stroke that has demonstrated anti-inflammatory and neuroprotective properties. Data from preclinical and clinical studies have suggested the safety and efficacy of G-CSF in stroke; however, the exact effects and utility of this cytokine in patients remain disputed. We performed a meta-analysis of randomized controlled trials of G-CSF in ischemic and hemorrhagic stroke to assess its clinical safety and efficacy. Electronic databases were searched for relevant publications in English and Chinese...
2017: PloS One
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