The third Intensive Care Bundle with Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT3): an international, stepped wedge cluster randomised controlled trial

Early control of elevated blood pressure is the most promising treatment for acute intracerebral haemorrhage. We aimed to establish whether implementing a goal-directed care bundle incorporating protocols for early intensive blood pressure lowering and management algorithms for hyperglycaemia, pyrexia, and abnormal anticoagulation, implemented in a hospital setting, could improve outcomes for patients with acute spontaneous …

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Isosorbide Mononitrate and Cilostazol Treatment in Patients With Symptomatic Cerebral Small Vessel Disease

Cerebral small vessel disease (cSVD) is a common cause of stroke (lacunar stroke), is the most common cause of vascular cognitive impairment, and impairs mobility and mood but has no specific treatment.ObjectiveΒ Β To test the feasibility, drug tolerability, safety, and effects of 1-year isosorbide mononitrate (ISMN) and cilostazol treatment on vascular, functional, and cognitive outcomes in …

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Early versus Later Anticoagulation for Stroke with Atrial Fibrillation

The effect of early as compared with later initiation of direct oral anticoagulants (DOACs) in persons with atrial fibrillation who have had an acute ischemic stroke is unclear.METHODSWe performed an investigator-initiated, open-label trial at 103 sites in 15 countries. Participants were randomly assigned in a 1:1 ratio to early anticoagulation (within 48 hours after a …

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Dietary sugar consumption and health: umbrella review

Objective To evaluate the quality of evidence, potential biases, and validity of all available studies on dietary sugar consumption and health outcomes.Design Umbrella review of existing meta-analyses.Data sources PubMed, Embase, Web of Science, Cochrane Database of Systematic Reviews, and hand searching of reference lists.Inclusion criteria Systematic reviews and meta-analyses of randomised controlled trials, cohort studies, …

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Sleep Patterns and the Risk of Acute Stroke: Results from the INTERSTROKE International Case-Control Study

Background and Objectives: Symptoms of sleep disturbance are common, and may represent important modifiable risk factors for stroke. We evaluated the association between a spectrum of sleep disturbance symptoms and risk of acute stroke in an international setting.Methods: INTERSTROKE is an international case-control study of patients presenting with first acute stroke and controls matched by …

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