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  • Stroke Death Rate Plateaus

    Abstract Full Text
    JAMA. 2017; 318(18):1751-1751. doi: 10.1001/jama.2017.15453
  • JAMA September 27, 2017

    Figure 3: Kaplan-Meier Estimates of the Probability of Postoperative Organ Dysfunction by Day 30 After Surgery

    Organ dysfunction was assessed for renal (risk, injury, failure, loss, and end-stage kidney injury [RIFLE] stage of risk or higher), respiratory (need for invasive or noninvasive ventilation), cardiovascular (acute cardiac failure or myocardial ischemia or infarction), neurologic (stroke or altered consciousness), and coagulation (Sequential Organ Failure Assessment subscore ≥2 points in the coagulation component) systems. Data for patients who did not develop organ dysfunction were censored at 30 days after surgery. The adjusted hazard ratio (HR) for postoperative organ dysfunction in the individualized treatment group, as compared with the standard treatment group, was 0.66 (95% CI, 0.52-0.84; P = .001). The median follow-up duration was 30 days (interquartile range, 30-30 days) in the 2 treatment groups.
  • Effect of Routine Low-Dose Oxygen Supplementation on Death and Disability in Adults With Acute Stroke: The Stroke Oxygen Study Randomized Clinical Trial

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    JAMA. 2017; 318(12):1125-1135. doi: 10.1001/jama.2017.11463

    Three months after acute stroke, this randomized clinical trial compares rates of death and disability among adult patients receiving continuous or nocturnal low-dose oxygen supplementation or control intervention (oxygen only if clinically indicated.

  • JAMA September 19, 2017

    Figure 3: Mean Difference in the Changes of Systolic and Diastolic Blood Pressure Among Patients With Hypertension by Subgroups

    Mean differences in systolic and diastolic blood pressure changes from baseline to the 18-month follow-up between the intervention and control groups. Data markers indicate mean difference in the changes; error bars, 95% CIs. aHigh cardiovascular risk subgroup includes participants with a history of coronary heart disease, heart failure, stroke, hypercholesterolemia, or diabetes. Those without these risk factors are considered not at high risk.
  • Lightweight Exosuit Could Help Patients Walk After Stroke

    Abstract Full Text
    JAMA. 2017; 318(10):898-898. doi: 10.1001/jama.2017.13165
  • JAMA September 12, 2017

    Figure 2: Mortality Outcomes in the Women’s Health Initiative Hormone Therapy Trials During the 18-Year Cumulative Follow-up

    The 18-year follow-up is cumulative, indicating the intervention plus extended postintervention phases of the 2 trials (median, 17.7 [interquartile range {IQR}, 16.6-18.6] years in the conjugated equine estrogens [CEE] plus medroxyprogesterone acetate [MPA] trial; median, 17.7 [IQR, 16.5-18.7] years in the CEE-alone trial; and median,17.7 [IQR,16.6-18.6] years in the pooled analysis).aCardiovascular disease (CVD) mortality includes deaths due to myocardial infarction, coronary heart disease, stroke, heart failure, peripheral vascular disease, venous thromboembolism, and other major causes of CVD death.bThe P value corresponding with a test of heterogeneity between trial-specific hazard ratios (HRs) was .05 or less; therefore, the pooled estimate and HR (95% CI) are not reported.cIndicates other mortality outcomes that were known but were not due to Alzheimer disease or other dementia, chronic obstructive pulmonary disease (COPD), or accident or injury.
  • JAMA September 12, 2017

    Figure 3: Mortality Outcomes During the Intervention Phase According to 10-Year Age Groups at Randomization

    Reported values indicate the duration of follow-up for the intervention phase (median, 5.6 [interquartile range {IQR}, 4.9-6.5] years in the conjugated equine estrogens [CEE] plus medroxyprogesterone acetate [MPA] trial; median, 7.2 [IQR, 6.5-8.2] years in the CEE-alone trial; and median, 6.3 [IQR, 5.3-7.3] years in the pooled analysis). Age groups indicate participant ages at randomization. HR indicates hazard ratio.aP values based on a test for trend of interaction between the randomization group and the age group.bCardiovascular disease (CVD) mortality includes deaths due to myocardial infarction, coronary heart disease, stroke, heart failure, peripheral vascular disease, venous thromboembolism, and other major causes of CVD death.cIndicates mortality outcomes not due to CVD or cancer.
  • JAMA September 12, 2017

    Figure 4: Mortality Outcomes During the 18-Year Cumulative Follow-Up According to 10-Year Age Groups at Randomization

    The 18-year follow-up is cumulative, indicating the intervention plus extended postintervention phases of the 2 trials (median, 17.7 [interquartile range {IQR}, 16.6-18.6] years in the conjugated equine estrogens [CEE] plus medroxyprogesterone acetate [MPA] trial; median, 17.7 [IQR, 16.5-18.7] years in the CEE-alone trial; and median,17.7 [IQR,16.6-18.6] years in the pooled analysis). HR indicates hazard ratio.aP values based on a test for trend of interaction between the randomization group and the age group.bCardiovascular disease (CVD) mortality includes deaths due to myocardial infarction, coronary heart disease (CHD), stroke, heart failure, peripheral vascular disease, venous thromboembolism, and other major causes of CVD death.cIndicates mortality outcomes not due to CVD or cancer.
  • Effect of Cerebral Embolic Protection Devices on CNS Infarction in Surgical Aortic Valve Replacement: A Randomized Clinical Trial

    Abstract Full Text
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    JAMA. 2017; 318(6):536-547. doi: 10.1001/jama.2017.9479

    This randomized clinical trial compares the efficacy and adverse effects of 2 cerebral embolic protection devices vs a shared control group in reducing ischemic central nervous system injury during surgical aortic valve replacement.

  • Socially Assistive Robots Help Patients Make Behavioral Changes

    Abstract Full Text
    JAMA. 2017; 317(24):2472-2474. doi: 10.1001/jama.2017.5682

    This Medical News article is a Q&A with University of Southern California robotics expert Maja Matarić.

  • JAMA May 2, 2017

    Figure: Spider Venom Peptide May Protect Neurons Following Stroke

    Spider venom may reveal insights on promising avenues for stroke treatment.
  • Spider Venom Peptide May Protect Neurons Following Stroke

    Abstract Full Text
    JAMA. 2017; 317(17):1715-1715. doi: 10.1001/jama.2017.4450
  • Association of Preceding Antithrombotic Treatment With Acute Ischemic Stroke Severity and In-Hospital Outcomes Among Patients With Atrial Fibrillation

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    JAMA. 2017; 317(10):1057-1067. doi: 10.1001/jama.2017.1371

    This cohort study of patients with atrial fibrillation and acute ischemic stroke examines the prevalence of preceding antithrombotic treatment and its association with stroke severity and in-hospital outcomes.

  • Association Between Dietary Factors and Mortality From Heart Disease, Stroke, and Type 2 Diabetes in the United States

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    JAMA. 2017; 317(9):912-924. doi: 10.1001/jama.2017.0947

    This nutritional epidemiology study uses NHANES data to estimate associations between dietary components and mortality due to heart disease, stroke, and type 2 diabetes among US adults between 2002 and 2012.

  • Recovery After Stroke

    Abstract Full Text
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    JAMA. 2016; 316(22):2440-2440. doi: 10.1001/jama.2016.16901
  • JAMA November 22, 2016

    Figure 6: Meta-analysis of Randomized Clinical Trials on the Association Between Palliative Care and Survival

    For all trials, the P value for the pooled hazard ratio (HR) was .44; τ2, 0.08; and Q, 24.29. For trials at low risk of bias, the P value for the pooled the HR was .14; τ2, <0.0001; and for Q, <0.0001. For high risk of bias, the P value for the pooled HR was .99; τ2, <0.59; and Q, 7.03. For unclear risk of risk of bias the P value for the pooled HR was .74; τ2, 0.06; and Q, 10.98. Sample sizes in the figure are the number of patients analyzed at the specific time points.Error bars represent 95% CIs. The size of the shaded squares indicates study weight. Diamonds represent pooled HRs and 95% CIs. The vertical dashed line indicates the pooled effect estimate, and the solid vertical line depicts a null effect (ie, HR, 1).aNon–small cell lung cancer. bGastrointestinal, lung, genitourinary, and breast cancers. cCancer, heart failure, chronic obstructive pulmonary disease, end-stage renal disease, stroke, and dementia. dBreast, colon, lung, and other cancers. eGastrointestinal, lung, breast, gynecological, genitourinary, kidney, lymphoma, skin, and other cancers.
  • Clinical Practice Guidelines From the AABB: Red Blood Cell Transfusion Thresholds and Storage

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    JAMA. 2016; 316(19):2025-2035. doi: 10.1001/jama.2016.9185

    This study summarizes transfusion recommendations from the AABB (formerly known as the American Association of Blood Banks) based on randomized clinical trials.

  • JAMA November 15, 2016

    Figure 1: Flow of Participation in the SIESTA Trial of Conscious Sedation vs General Anesthesia During Thrombectomy

    tPA indicates tissue-type plasminogen activator.aScreening criteria for inclusion were severe acute ischemic anterior circulation stroke, as defined by the National Institutes of Health Stroke Scale score (>10 on a 0- to 42-point scale); decision for thrombectomy at the discretion of the physician in charge; nonintubation on admission; and noncandidacy for other intervention trial.bOne patient was randomized to the general anesthesia group, and 1 was randomized to the conscious sedation group. Both patients received the intervention.cIndicates the only major protocol violation.
  • JAMA November 15, 2016

    Figure 2: Primary Outcome as the Improvement of NIHSS Score in Prespecified Subgroupsa

    Size of the data markers is proportional to the precision of the estimates (ie, the area is proportional to the inverse of the squared standard errors).aFor the detailed analysis of the prespecified subgroups see eTable 11 in Supplement 2.bThe National Institutes of Health Stroke Scale (NIHSS) ranges from 0 to 42 with higher scores indicating more severe neurological deficits.cASPECTS (Alberta Stroke Program Early CT [computed tomographic] Score) is a measure of the extension of stroke. Scores range from 0 to 10 with higher scores indicating fewer early ischemic changes.dThe TICI (Thrombolysis in Cerebral Infarction) scale ranges from 0 to 3 (0 indicates no antegrade flow beyond the occlusion; 1, minimal perfusion; 2a, perfusion of less than 50% of the vascular distribution of the occluded artery; 2b, perfusion of at least 50% of the vascular distribution of the occluded artery; 3, complete perfusion).
  • Reducing Stroke Disability

    Abstract Full Text
    JAMA. 2016; 316(15):1538-1538. doi: 10.1001/jama.2016.14561