1,721,211 research outputs found
Lessons from placebo effects in migraine treatment.
Full text linkIn medical research, the placebo effect is an important methodological tool. Placebo is given to participants in clinical trials, with the intention of mimicking an experimental intervention. The "nocebo" effect, on the other hand, is the phenomenon whereby a patient who believes that a treatment will cause harm actually does experience adverse effects. The placebo effect strongly influences the way the results of clinical trials are interpreted. Placebo responses vary with the choice of study design, the choice of primary outcome measure, the characteristics of the patients and the cultural setting in which the trial is conducted. In migraine trials, the placebo response is high, in terms of both efficacy and side effects. Although medical ethics committees are becoming increasingly resistant to the use of placebo in acute migraine trials, placebo nevertheless remains the pivotal comparator in trials of migraine medications
Results of Membrane-Activated Chelator Stroke Intervention randomized trial of DP-b99 in acute ischemic stroke.
No full text
Association of improved outcome in acute ischemic stroke patients with atrial fibrillation who receive early antithrombotic therapy: analysis from VISTA
No full textBackground and purpose: Ischaemic stroke patients with atrial fibrillation
(AF) are at risk of early recurrent stroke (RS). However, antithrombotics
commenced at the acute stage may exacerbate haemorrhagic transformation,
provoking symptomatic intracerebral haemorrhage (SICH). The relevance of
antithrombotics on the patterns and outcome of the cohort was investigated.
Methods: A non-randomized cohort analysis was conducted using data
obtained from VISTA (Virtual International Stroke Trials Archive). The associations
of antithrombotics with the modified Rankin Scale (mRS) outcome
and the occurrence of RS and SICH (each as a combined end-point of fatal
and non-fatal events) at 90 days for post-stroke patients with AF were
described. Dichotomized outcomes were also considered as a secondary
end-point (i.e. mortality and good outcome measure at 90 days).
Results: In all, 1644 patients were identified; 1462 (89%) received antithrombotics,
157 (10%) had RS and 50 (3%) sustained SICH by day 90. Combined
antithrombotic therapy (i.e. anticoagulants and antiplatelets), 782 (48%), was
associated with favourable outcome on ordinal mRS and a significantly lower
risk of RS, SICH and mortality by day 90, compared with the no antithrombotics
group. The relative risk of RS and SICH appeared highest in the first
2 days post-stroke before attenuating to become constant over time.
Conclusions: The risks and benefits of antithrombotics in recent stroke
patients with AF appear to track together. Early introduction of anticoagulants
(2–3 days post-stroke), and to a lesser extent antiplatelet agents, was
associated with substantially fewer RS events over the following weeks but
with no excess risk of SICH. More evidence is required to guide clinicians on
this issue.Background and purposeIschaemic stroke patients with atrial fibrillation (AF) are at risk of early recurrent stroke (RS). However, antithrombotics commenced at the acute stage may exacerbate haemorrhagic transformation, provoking symptomatic intracerebral haemorrhage (SICH). The relevance of antithrombotics on the patterns and outcome of the cohort was investigated.MethodsA non-randomized cohort analysis was conducted using data obtained from VISTA (Virtual International Stroke Trials Archive). The associations of antithrombotics with the modified Rankin Scale (mRS) outcome and the occurrence of RS and SICH (each as a combined end-point of fatal and non-fatal events) at 90days for post-stroke patients with AF were described. Dichotomized outcomes were also considered as a secondary end-point (i.e. mortality and good outcome measure at 90days).ResultsIn all, 1644 patients were identified; 1462 (89%) received antithrombotics, 157 (10%) had RS and 50 (3%) sustained SICH by day 90. Combine..
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