Adaptive enrichment designs for clinical trials

Biostatistics: March 21, 2013 Modern medicine has graduated from broad spectrum treatments to targeted therapeutics. New drugs recognize the recently discovered heterogeneity of many diseases previously considered to be fairly homogeneous. These treatments attack specific genetic pathways which are only dysregulated in some smaller subset of patients with the disease. Often this subset is only rudimentarily […]

Effect of longer term modest salt reduction on blood pressure: Cochrane systematic review and meta-analysis of randomised trials

BMJ: April 4, 2013 Objective To determine the effects of longer term modest salt reduction on blood pressure, hormones, and lipids. Design Systematic review and meta-analysis. Data sources Medline, Embase, Cochrane Hypertension Group Specialised Register, Cochrane Central Register of Controlled Trials, and reference list of relevant articles. Inclusion criteria Randomised trials with a modest reduction in salt intake and […]

Many U.S. Blacks Eager to Take Part in Medical Research

Health Day: April 12, 2013 THURSDAY, April 4 (HealthDay News) — Black Americans are more likely than other racial/ethnic groups to be interested in participating in medical research, including when it involves providing blood or genetic samples, a new study finds. Now the challenge is to better match that interest with greater inclusion in clinical trials, […]

Favorable Vascular Profile is an Independent Predictor of Outcome

STROKEAHA: April 2, 2013 Background and Purpose—We hypothesized that a favorable vascular profile (FVP) defined as anatomic intactness of the Circle of Willis combined with a stable cerebral perfusion pressure (mean arterial blood pressure>65 mm Hg) is a prerequisite for collateral recruitment and maintenance and may improve outcome. We performed post hoc analyses of a subset […]

Stroke After Primary Percutaneous Coronary Intervention in Patients With ST-Segment Elevation Myocardial Infarction

CIRCINTERVENTIONS: April 2, 2013 Background—Stroke is a rare but potentially devastating complication of acute myocardial infarction. Little is known about stroke timing, characteristics, and clinical outcomes in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention (PCI). Methods and Results—We studied 5372 patients enrolled in the Assessment of Pexelizumab in Acute Myocardial Infarction […]

Malignant Emboli on Transcranial Doppler During Carotid Stenting Predict Postprocedure Diffusion-Weighted Imaging Lesions

​STROKEAHA: March 26, 2013 Background and Purpose—Carotid angioplasty and stenting (CAS) has a higher incidence of periprocedural stroke compared with endarterectomy. Identifying CAS steps with the highest likelihood of embolization may have important implications. We evaluated CAS safety by correlating the findings of procedural transcranial Doppler with postprocedure diffusion-weighted imaging (DWI) lesions. Methods—In this prospective study, […]

Efficacy of Coupling Inhibitory and Facilitatory Repetitive Transcranial Magnetic Stimulation to Enhance Motor Recovery in Hemiplegic Stroke Patients

​STROKEAHA: March 26, 2013 Background and Purpose—Although there has been extensive research on the effectiveness of repetitive transcranial magnetic stimulation (rTMS) to improve patients’ motor performance after experiencing chronic stroke, explicit findings on the coupling of different rTMS protocols are meager. We designed this sham-controlled randomized study to investigate the potential for a consecutive suppressive-facilitatory TMS […]

More Inconclusive Results from PFO-Closure Trials

Journal Watch Cardiology:  March 20, 2013 Patent foramen ovale (PFO) is more prevalent in patients with cryptogenic stroke than in the general population, but can correction of the PFO reduce stroke incidence? Findings from the CLOSURE I trial of the STARFlex PFO-closure device after cryptogenic stroke showed no significant reduction in the rate of recurrent stroke […]

Betrixaban compared with warfarin in patients with atrial fibrillation: results of a phase 2, randomized, dose-ranging study (Explore-Xa)

Eur Heart J: March 13, 2013 Aims Patients with atrial fibrillation (AF) are at increased risk of stroke. Betrixaban is a novel oral factor Xa inhibitor administered once daily, mostly excreted unchanged in the bile and with low (17%) renal excretion. Methods and results Patients with AF and more than one risk factor for stroke were randomized […]

Cryoballoon Ablation of Pulmonary Veins for Paroxysmal Atrial Fibrillation

JACC: March 1, 2013 Objectives  This study sought to assess the safety and effectiveness of a novel cryoballoon ablation technology designed to achieve single-delivery pulmonary vein (PV) isolation. Background  Standard radiofrequency ablation is effective in eliminating atrial fibrillation (AF) but requires multiple lesion delivery at the risk of significant complications. Read more

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