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Interventions for dysphagia and nutritional support in acute and subacute stroke.
- C. Geeganage, J. Beavan, Sharon J. Ellender, P. Bath
- MedicineThe Cochrane database of systematic reviews
- 17 October 2012
Dysphagia at end-of-trial was reduced by acupuncture and behavioural interventions, and percutaneous endoscopic gastrostomy and nasogastric tube (NGT) feeding did not differ for case fatality or the composite outcome of death or dependency, but PEG was associated with fewer treatment failures as compared to late feeding.
Dual or Mono Antiplatelet Therapy for Patients With Acute Ischemic Stroke or Transient Ischemic Attack: Systematic Review and Meta-Analysis of Randomized Controlled Trials
Dual antiplatelet therapy appears to be safe and effective in reducing stroke recurrence and combined vascular events in patients with acute isChemic stroke or transient ischemic attack as compared with mono therapy.
Interventions for deliberately altering blood pressure in acute stroke.
There is insufficient evidence to evaluate the effect of altering blood pressure on outcome during the acute phase of stroke, and in patients with acute stroke, CCBs, ACEI, ARA and GTN each lower blood pressure while phenylephrine probably increases blood pressure.
Relationship Between Therapeutic Changes in Blood Pressure and Outcomes in Acute Stroke: A Metaregression
Although large falls or increases in BP are associated with a worse outcome, modest reductions may reduce death and combine death or dependency, although the CIs are wide and compatible with an overall benefit or hazard.
Clinical trials for preventing post stroke cognitive impairment
- Sandeep Ankolekar, C. Geeganage, P. Anderton, C. Hogg, P. Bath
- MedicineJournal of the Neurological Sciences
- 15 December 2010
Prepping cognitive decline and dementia post stroke is critical and large definitive trials are now needed, although whether this relates to the magnitude of BP reduction or specific drug classes remains unclear.
Vasoactive drugs for acute stroke.
There is not enough evidence reliably to evaluate the effect of altering blood pressure on outcome after acute stroke, and CCBs, beta blockers, and probably ACE-inhibitors, prostacyclin and nitric oxide, each lowered BP during the acute phase of stroke.
Use of Ordinal Outcomes in Vascular Prevention Trials: Comparison With Binary Outcomes in Published Trials
When analyzing vascular events from prevention trials, statistical tests which use ordered categorical data are more efficient and are more likely to yield reliable results than binary tests.
Balance of symptomatic pulmonary embolism and symptomatic intracerebral hemorrhage with low-dose anticoagulation in recent ischemic stroke: a systematic review and meta-analysis of randomized…
- C. Geeganage, N. Sprigg, Matthew W Bath, P. Bath
- MedicineJournal of stroke and cerebrovascular diseases…
- 1 October 2013
Prophylactic/low-dose heparin increased sICH by more than they reduced sPE in patients with recent ischemic stroke, and their routine acute use cannot be recommended but they may still be relevant in patients at very high risk of PE.
Relationship Between Baseline Blood Pressure Parameters (Including Mean Pressure, Pulse Pressure, and Variability) and Early Outcome After Stroke: Data From the Tinzaparin in Acute Ischaemic Stroke…
Early death or neurologic deterioration, deterioration, and recurrent stroke are associated independently with high systolic BP, mean arterial pressure, pulse pressure, and BP variability, which offer potential therapeutic targets for improving early outcome after acute ischemic stroke.
Asymptomatic Hemorrhagic Transformation of Infarction and Its Relationship With Functional Outcome and Stroke Subtype: Assessment From the Tinzaparin in Acute Ischaemic Stroke Trial
AHTI is increased in ischemic stroke with cortical syndromes and of large vessel or cardioembolic etiology and after adjustment for infarct volume, the presence of AHTI was not associated with outcome at 3 or 6 months as measured by the modified Rankin Scale and Barthel Index.