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Pracoviště: Semmelweis University Budapest Hungary

52 záznamů v BMČ Filtry

Článek

Apixaban for Stroke Prevention in Subclinical Atrial Fibrillation

Healey, Jeff S
Autor Healey, Jeff S ORCID From the Population Health Research Institute, McMaster University, Hamilton, ON (J.S.H., W.F.M., D.C., J.A.W., L.X., K.S., S.N., R.M., S.J.C.), the Montreal Heart Institute, University of Montreal, Montreal (L.R.), the University of Ottawa Heart Institute, Ottawa (D.H.B.), Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec, QC (F.P.), the Department of Clinical Neurosciences, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB (S.B.C.), and the Université de Sherbrooke, Sherbrooke, QC (F.A.-P.) - all in Canada the Duke Clinical Research Institute, Duke University, Durham, NC (R.D.L., C.B.G.) Amphia Ziekenhuis, Breda, the Netherlands (M.A.) Oslo University Hospital and the University of Oslo, Oslo (D.A.) the University of Modena and Reggio Emilia, Modena (G.B.), and the Department of Clinical Sciences and Community Health, University of Milan, and the Division of Subacute Care, IRCCS Istituti Clinici Scientifici Maugeri, Milan (M. Proietti) - all in Italy St. George's, University of London, London (A.J.C.), and Liverpool Heart and Chest Hospital, Liverpool (D.J.W.) - both in the United Kingdom J.W. Goethe University, University Hospital Department of Cardiology, Frankfurt, Germany (J.W.E., S.H.H.) the Medical University of South Carolina, Charleston (M.R.G.) Michigan State University, Lansing (J.I.) the Institute for Clinical and Experimental Medicine, Prague, Czech Republic (J.K.) the University of Rochester, Rochester, NY (V.K.) Semmelweis University, Budapest, Hungary (V.K.) Karolinska Institutet and the Heart, Vascular, and Neurology Theme, Karolinska University Hospital, Stockholm (C.L.) the University of Rennes, Rennes, France (P.M.) Cliniques du Sud-Luxembourg, Arlon, Belgium (G.M.) Hospital Universitario La Luz, Madrid (J.B.M.), and Hospital Costa del Sol, Marbella (M. Pombo) - both in Spain Aarhus University Hospital and Aarhus University, Aarhus, Denmark (J.C.N.) University Hospital Basel, University of Basel, Basel, Switzerland (C.S.) the Veterans Affairs Portland Health Care System, Portland, OR (I.G.Z.) and Abrazo Arrowhead Hospital, Glendale, AZ (A.K.)
Lopes, Renato D
Autor Lopes, Renato D From the Population Health Research Institute, McMaster University, Hamilton, ON (J.S.H., W.F.M., D.C., J.A.W., L.X., K.S., S.N., R.M., S.J.C.), the Montreal Heart Institute, University of Montreal, Montreal (L.R.), the University of Ottawa Heart Institute, Ottawa (D.H.B.), Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec, QC (F.P.), the Department of Clinical Neurosciences, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB (S.B.C.), and the Université de Sherbrooke, Sherbrooke, QC (F.A.-P.) - all in Canada the Duke Clinical Research Institute, Duke University, Durham, NC (R.D.L., C.B.G.) Amphia Ziekenhuis, Breda, the Netherlands (M.A.) Oslo University Hospital and the University of Oslo, Oslo (D.A.) the University of Modena and Reggio Emilia, Modena (G.B.), and the Department of Clinical Sciences and Community Health, University of Milan, and the Division of Subacute Care, IRCCS Istituti Clinici Scientifici Maugeri, Milan (M. Proietti) - all in Italy St. George's, University of London, London (A.J.C.), and Liverpool Heart and Chest Hospital, Liverpool (D.J.W.) - both in the United Kingdom J.W. Goethe University, University Hospital Department of Cardiology, Frankfurt, Germany (J.W.E., S.H.H.) the Medical University of South Carolina, Charleston (M.R.G.) Michigan State University, Lansing (J.I.) the Institute for Clinical and Experimental Medicine, Prague, Czech Republic (J.K.) the University of Rochester, Rochester, NY (V.K.) Semmelweis University, Budapest, Hungary (V.K.) Karolinska Institutet and the Heart, Vascular, and Neurology Theme, Karolinska University Hospital, Stockholm (C.L.) the University of Rennes, Rennes, France (P.M.) Cliniques du Sud-Luxembourg, Arlon, Belgium (G.M.) Hospital Universitario La Luz, Madrid (J.B.M.), and Hospital Costa del Sol, Marbella (M. Pombo) - both in Spain Aarhus University Hospital and Aarhus University, Aarhus, Denmark (J.C.N.) University Hospital Basel, University of Basel, Basel, Switzerland (C.S.) the Veterans Affairs Portland Health Care System, Portland, OR (I.G.Z.) and Abrazo Arrowhead Hospital, Glendale, AZ (A.K.)
Granger, Christopher B
Autor Granger, Christopher B From the Population Health Research Institute, McMaster University, Hamilton, ON (J.S.H., W.F.M., D.C., J.A.W., L.X., K.S., S.N., R.M., S.J.C.), the Montreal Heart Institute, University of Montreal, Montreal (L.R.), the University of Ottawa Heart Institute, Ottawa (D.H.B.), Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec, QC (F.P.), the Department of Clinical Neurosciences, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB (S.B.C.), and the Université de Sherbrooke, Sherbrooke, QC (F.A.-P.) - all in Canada the Duke Clinical Research Institute, Duke University, Durham, NC (R.D.L., C.B.G.) Amphia Ziekenhuis, Breda, the Netherlands (M.A.) Oslo University Hospital and the University of Oslo, Oslo (D.A.) the University of Modena and Reggio Emilia, Modena (G.B.), and the Department of Clinical Sciences and Community Health, University of Milan, and the Division of Subacute Care, IRCCS Istituti Clinici Scientifici Maugeri, Milan (M. Proietti) - all in Italy St. George's, University of London, London (A.J.C.), and Liverpool Heart and Chest Hospital, Liverpool (D.J.W.) - both in the United Kingdom J.W. Goethe University, University Hospital Department of Cardiology, Frankfurt, Germany (J.W.E., S.H.H.) the Medical University of South Carolina, Charleston (M.R.G.) Michigan State University, Lansing (J.I.) the Institute for Clinical and Experimental Medicine, Prague, Czech Republic (J.K.) the University of Rochester, Rochester, NY (V.K.) Semmelweis University, Budapest, Hungary (V.K.) Karolinska Institutet and the Heart, Vascular, and Neurology Theme, Karolinska University Hospital, Stockholm (C.L.) the University of Rennes, Rennes, France (P.M.) Cliniques du Sud-Luxembourg, Arlon, Belgium (G.M.) Hospital Universitario La Luz, Madrid (J.B.M.), and Hospital Costa del Sol, Marbella (M. Pombo) - both in Spain Aarhus University Hospital and Aarhus University, Aarhus, Denmark (J.C.N.) University Hospital Basel, University of Basel, Basel, Switzerland (C.S.) the Veterans Affairs Portland Health Care System, Portland, OR (I.G.Z.) and Abrazo Arrowhead Hospital, Glendale, AZ (A.K.)
Alings, Marco
Autor Alings, Marco From the Population Health Research Institute, McMaster University, Hamilton, ON (J.S.H., W.F.M., D.C., J.A.W., L.X., K.S., S.N., R.M., S.J.C.), the Montreal Heart Institute, University of Montreal, Montreal (L.R.), the University of Ottawa Heart Institute, Ottawa (D.H.B.), Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec, QC (F.P.), the Department of Clinical Neurosciences, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB (S.B.C.), and the Université de Sherbrooke, Sherbrooke, QC (F.A.-P.) - all in Canada the Duke Clinical Research Institute, Duke University, Durham, NC (R.D.L., C.B.G.) Amphia Ziekenhuis, Breda, the Netherlands (M.A.) Oslo University Hospital and the University of Oslo, Oslo (D.A.) the University of Modena and Reggio Emilia, Modena (G.B.), and the Department of Clinical Sciences and Community Health, University of Milan, and the Division of Subacute Care, IRCCS Istituti Clinici Scientifici Maugeri, Milan (M. Proietti) - all in Italy St. George's, University of London, London (A.J.C.), and Liverpool Heart and Chest Hospital, Liverpool (D.J.W.) - both in the United Kingdom J.W. Goethe University, University Hospital Department of Cardiology, Frankfurt, Germany (J.W.E., S.H.H.) the Medical University of South Carolina, Charleston (M.R.G.) Michigan State University, Lansing (J.I.) the Institute for Clinical and Experimental Medicine, Prague, Czech Republic (J.K.) the University of Rochester, Rochester, NY (V.K.) Semmelweis University, Budapest, Hungary (V.K.) Karolinska Institutet and the Heart, Vascular, and Neurology Theme, Karolinska University Hospital, Stockholm (C.L.) the University of Rennes, Rennes, France (P.M.) Cliniques du Sud-Luxembourg, Arlon, Belgium (G.M.) Hospital Universitario La Luz, Madrid (J.B.M.), and Hospital Costa del Sol, Marbella (M. Pombo) - both in Spain Aarhus University Hospital and Aarhus University, Aarhus, Denmark (J.C.N.) University Hospital Basel, University of Basel, Basel, Switzerland (C.S.) the Veterans Affairs Portland Health Care System, Portland, OR (I.G.Z.) and Abrazo Arrowhead Hospital, Glendale, AZ (A.K.)
Rivard, Lena
Autor Rivard, Lena From the Population Health Research Institute, McMaster University, Hamilton, ON (J.S.H., W.F.M., D.C., J.A.W., L.X., K.S., S.N., R.M., S.J.C.), the Montreal Heart Institute, University of Montreal, Montreal (L.R.), the University of Ottawa Heart Institute, Ottawa (D.H.B.), Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec, QC (F.P.), the Department of Clinical Neurosciences, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB (S.B.C.), and the Université de Sherbrooke, Sherbrooke, QC (F.A.-P.) - all in Canada the Duke Clinical Research Institute, Duke University, Durham, NC (R.D.L., C.B.G.) Amphia Ziekenhuis, Breda, the Netherlands (M.A.) Oslo University Hospital and the University of Oslo, Oslo (D.A.) the University of Modena and Reggio Emilia, Modena (G.B.), and the Department of Clinical Sciences and Community Health, University of Milan, and the Division of Subacute Care, IRCCS Istituti Clinici Scientifici Maugeri, Milan (M. Proietti) - all in Italy St. George's, University of London, London (A.J.C.), and Liverpool Heart and Chest Hospital, Liverpool (D.J.W.) - both in the United Kingdom J.W. Goethe University, University Hospital Department of Cardiology, Frankfurt, Germany (J.W.E., S.H.H.) the Medical University of South Carolina, Charleston (M.R.G.) Michigan State University, Lansing (J.I.) the Institute for Clinical and Experimental Medicine, Prague, Czech Republic (J.K.) the University of Rochester, Rochester, NY (V.K.) Semmelweis University, Budapest, Hungary (V.K.) Karolinska Institutet and the Heart, Vascular, and Neurology Theme, Karolinska University Hospital, Stockholm (C.L.) the University of Rennes, Rennes, France (P.M.) Cliniques du Sud-Luxembourg, Arlon, Belgium (G.M.) Hospital Universitario La Luz, Madrid (J.B.M.), and Hospital Costa del Sol, Marbella (M. Pombo) - both in Spain Aarhus University Hospital and Aarhus University, Aarhus, Denmark (J.C.N.) University Hospital Basel, University of Basel, Basel, Switzerland (C.S.) the Veterans Affairs Portland Health Care System, Portland, OR (I.G.Z.) and Abrazo Arrowhead Hospital, Glendale, AZ (A.K.)
McIntyre, William F
Autor McIntyre, William F From the Population Health Research Institute, McMaster University, Hamilton, ON (J.S.H., W.F.M., D.C., J.A.W., L.X., K.S., S.N., R.M., S.J.C.), the Montreal Heart Institute, University of Montreal, Montreal (L.R.), the University of Ottawa Heart Institute, Ottawa (D.H.B.), Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec, QC (F.P.), the Department of Clinical Neurosciences, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB (S.B.C.), and the Université de Sherbrooke, Sherbrooke, QC (F.A.-P.) - all in Canada the Duke Clinical Research Institute, Duke University, Durham, NC (R.D.L., C.B.G.) Amphia Ziekenhuis, Breda, the Netherlands (M.A.) Oslo University Hospital and the University of Oslo, Oslo (D.A.) the University of Modena and Reggio Emilia, Modena (G.B.), and the Department of Clinical Sciences and Community Health, University of Milan, and the Division of Subacute Care, IRCCS Istituti Clinici Scientifici Maugeri, Milan (M. Proietti) - all in Italy St. George's, University of London, London (A.J.C.), and Liverpool Heart and Chest Hospital, Liverpool (D.J.W.) - both in the United Kingdom J.W. Goethe University, University Hospital Department of Cardiology, Frankfurt, Germany (J.W.E., S.H.H.) the Medical University of South Carolina, Charleston (M.R.G.) Michigan State University, Lansing (J.I.) the Institute for Clinical and Experimental Medicine, Prague, Czech Republic (J.K.) the University of Rochester, Rochester, NY (V.K.) Semmelweis University, Budapest, Hungary (V.K.) Karolinska Institutet and the Heart, Vascular, and Neurology Theme, Karolinska University Hospital, Stockholm (C.L.) the University of Rennes, Rennes, France (P.M.) Cliniques du Sud-Luxembourg, Arlon, Belgium (G.M.) Hospital Universitario La Luz, Madrid (J.B.M.), and Hospital Costa del Sol, Marbella (M. Pombo) - both in Spain Aarhus University Hospital and Aarhus University, Aarhus, Denmark (J.C.N.) University Hospital Basel, University of Basel, Basel, Switzerland (C.S.) the Veterans Affairs Portland Health Care System, Portland, OR (I.G.Z.) and Abrazo Arrowhead Hospital, Glendale, AZ (A.K.)
Atar, Dan
Autor Atar, Dan From the Population Health Research Institute, McMaster University, Hamilton, ON (J.S.H., W.F.M., D.C., J.A.W., L.X., K.S., S.N., R.M., S.J.C.), the Montreal Heart Institute, University of Montreal, Montreal (L.R.), the University of Ottawa Heart Institute, Ottawa (D.H.B.), Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec, QC (F.P.), the Department of Clinical Neurosciences, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB (S.B.C.), and the Université de Sherbrooke, Sherbrooke, QC (F.A.-P.) - all in Canada the Duke Clinical Research Institute, Duke University, Durham, NC (R.D.L., C.B.G.) Amphia Ziekenhuis, Breda, the Netherlands (M.A.) Oslo University Hospital and the University of Oslo, Oslo (D.A.) the University of Modena and Reggio Emilia, Modena (G.B.), and the Department of Clinical Sciences and Community Health, University of Milan, and the Division of Subacute Care, IRCCS Istituti Clinici Scientifici Maugeri, Milan (M. Proietti) - all in Italy St. George's, University of London, London (A.J.C.), and Liverpool Heart and Chest Hospital, Liverpool (D.J.W.) - both in the United Kingdom J.W. Goethe University, University Hospital Department of Cardiology, Frankfurt, Germany (J.W.E., S.H.H.) the Medical University of South Carolina, Charleston (M.R.G.) Michigan State University, Lansing (J.I.) the Institute for Clinical and Experimental Medicine, Prague, Czech Republic (J.K.) the University of Rochester, Rochester, NY (V.K.) Semmelweis University, Budapest, Hungary (V.K.) Karolinska Institutet and the Heart, Vascular, and Neurology Theme, Karolinska University Hospital, Stockholm (C.L.) the University of Rennes, Rennes, France (P.M.) Cliniques du Sud-Luxembourg, Arlon, Belgium (G.M.) Hospital Universitario La Luz, Madrid (J.B.M.), and Hospital Costa del Sol, Marbella (M. Pombo) - both in Spain Aarhus University Hospital and Aarhus University, Aarhus, Denmark (J.C.N.) University Hospital Basel, University of Basel, Basel, Switzerland (C.S.) the Veterans Affairs Portland Health Care System, Portland, OR (I.G.Z.) and Abrazo Arrowhead Hospital, Glendale, AZ (A.K.)
Birnie, David H
Autor Birnie, David H From the Population Health Research Institute, McMaster University, Hamilton, ON (J.S.H., W.F.M., D.C., J.A.W., L.X., K.S., S.N., R.M., S.J.C.), the Montreal Heart Institute, University of Montreal, Montreal (L.R.), the University of Ottawa Heart Institute, Ottawa (D.H.B.), Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec, QC (F.P.), the Department of Clinical Neurosciences, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB (S.B.C.), and the Université de Sherbrooke, Sherbrooke, QC (F.A.-P.) - all in Canada the Duke Clinical Research Institute, Duke University, Durham, NC (R.D.L., C.B.G.) Amphia Ziekenhuis, Breda, the Netherlands (M.A.) Oslo University Hospital and the University of Oslo, Oslo (D.A.) the University of Modena and Reggio Emilia, Modena (G.B.), and the Department of Clinical Sciences and Community Health, University of Milan, and the Division of Subacute Care, IRCCS Istituti Clinici Scientifici Maugeri, Milan (M. Proietti) - all in Italy St. George's, University of London, London (A.J.C.), and Liverpool Heart and Chest Hospital, Liverpool (D.J.W.) - both in the United Kingdom J.W. Goethe University, University Hospital Department of Cardiology, Frankfurt, Germany (J.W.E., S.H.H.) the Medical University of South Carolina, Charleston (M.R.G.) Michigan State University, Lansing (J.I.) the Institute for Clinical and Experimental Medicine, Prague, Czech Republic (J.K.) the University of Rochester, Rochester, NY (V.K.) Semmelweis University, Budapest, Hungary (V.K.) Karolinska Institutet and the Heart, Vascular, and Neurology Theme, Karolinska University Hospital, Stockholm (C.L.) the University of Rennes, Rennes, France (P.M.) Cliniques du Sud-Luxembourg, Arlon, Belgium (G.M.) Hospital Universitario La Luz, Madrid (J.B.M.), and Hospital Costa del Sol, Marbella (M. Pombo) - both in Spain Aarhus University Hospital and Aarhus University, Aarhus, Denmark (J.C.N.) University Hospital Basel, University of Basel, Basel, Switzerland (C.S.) the Veterans Affairs Portland Health Care System, Portland, OR (I.G.Z.) and Abrazo Arrowhead Hospital, Glendale, AZ (A.K.)
Boriani, Giuseppe
Autor Boriani, Giuseppe From the Population Health Research Institute, McMaster University, Hamilton, ON (J.S.H., W.F.M., D.C., J.A.W., L.X., K.S., S.N., R.M., S.J.C.), the Montreal Heart Institute, University of Montreal, Montreal (L.R.), the University of Ottawa Heart Institute, Ottawa (D.H.B.), Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec, QC (F.P.), the Department of Clinical Neurosciences, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB (S.B.C.), and the Université de Sherbrooke, Sherbrooke, QC (F.A.-P.) - all in Canada the Duke Clinical Research Institute, Duke University, Durham, NC (R.D.L., C.B.G.) Amphia Ziekenhuis, Breda, the Netherlands (M.A.) Oslo University Hospital and the University of Oslo, Oslo (D.A.) the University of Modena and Reggio Emilia, Modena (G.B.), and the Department of Clinical Sciences and Community Health, University of Milan, and the Division of Subacute Care, IRCCS Istituti Clinici Scientifici Maugeri, Milan (M. Proietti) - all in Italy St. George's, University of London, London (A.J.C.), and Liverpool Heart and Chest Hospital, Liverpool (D.J.W.) - both in the United Kingdom J.W. Goethe University, University Hospital Department of Cardiology, Frankfurt, Germany (J.W.E., S.H.H.) the Medical University of South Carolina, Charleston (M.R.G.) Michigan State University, Lansing (J.I.) the Institute for Clinical and Experimental Medicine, Prague, Czech Republic (J.K.) the University of Rochester, Rochester, NY (V.K.) Semmelweis University, Budapest, Hungary (V.K.) Karolinska Institutet and the Heart, Vascular, and Neurology Theme, Karolinska University Hospital, Stockholm (C.L.) the University of Rennes, Rennes, France (P.M.) Cliniques du Sud-Luxembourg, Arlon, Belgium (G.M.) Hospital Universitario La Luz, Madrid (J.B.M.), and Hospital Costa del Sol, Marbella (M. Pombo) - both in Spain Aarhus University Hospital and Aarhus University, Aarhus, Denmark (J.C.N.) University Hospital Basel, University of Basel, Basel, Switzerland (C.S.) the Veterans Affairs Portland Health Care System, Portland, OR (I.G.Z.) and Abrazo Arrowhead Hospital, Glendale, AZ (A.K.)
Camm, A John
Autor Camm, A John From the Population Health Research Institute, McMaster University, Hamilton, ON (J.S.H., W.F.M., D.C., J.A.W., L.X., K.S., S.N., R.M., S.J.C.), the Montreal Heart Institute, University of Montreal, Montreal (L.R.), the University of Ottawa Heart Institute, Ottawa (D.H.B.), Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec, QC (F.P.), the Department of Clinical Neurosciences, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB (S.B.C.), and the Université de Sherbrooke, Sherbrooke, QC (F.A.-P.) - all in Canada the Duke Clinical Research Institute, Duke University, Durham, NC (R.D.L., C.B.G.) Amphia Ziekenhuis, Breda, the Netherlands (M.A.) Oslo University Hospital and the University of Oslo, Oslo (D.A.) the University of Modena and Reggio Emilia, Modena (G.B.), and the Department of Clinical Sciences and Community Health, University of Milan, and the Division of Subacute Care, IRCCS Istituti Clinici Scientifici Maugeri, Milan (M. Proietti) - all in Italy St. George's, University of London, London (A.J.C.), and Liverpool Heart and Chest Hospital, Liverpool (D.J.W.) - both in the United Kingdom J.W. Goethe University, University Hospital Department of Cardiology, Frankfurt, Germany (J.W.E., S.H.H.) the Medical University of South Carolina, Charleston (M.R.G.) Michigan State University, Lansing (J.I.) the Institute for Clinical and Experimental Medicine, Prague, Czech Republic (J.K.) the University of Rochester, Rochester, NY (V.K.) Semmelweis University, Budapest, Hungary (V.K.) Karolinska Institutet and the Heart, Vascular, and Neurology Theme, Karolinska University Hospital, Stockholm (C.L.) the University of Rennes, Rennes, France (P.M.) Cliniques du Sud-Luxembourg, Arlon, Belgium (G.M.) Hospital Universitario La Luz, Madrid (J.B.M.), and Hospital Costa del Sol, Marbella (M. Pombo) - both in Spain Aarhus University Hospital and Aarhus University, Aarhus, Denmark (J.C.N.) University Hospital Basel, University of Basel, Basel, Switzerland (C.S.) the Veterans Affairs Portland Health Care System, Portland, OR (I.G.Z.) and Abrazo Arrowhead Hospital, Glendale, AZ (A.K.)

The New England journal of medicine. 2024 ; 390 (2) : 107-117. [pub] 20231112

N Engl J Med
ISSN 1533-4406
Medvik
Zdroj

BACKGROUND: Subclinical atrial fibrillation is short-lasting and asymptomatic and can usually be detected only by long-term continuous monitoring with pacemakers or defibrillators. Subclinical atrial fibrillation is associated with an increased risk of stroke by a factor of 2.5; however, treatment with oral anticoagulation is of uncertain benefit. METHODS: We conducted a trial involving patients with subclinical atrial fibrillation lasting 6 minutes to 24 hours. Patients were randomly assigned in a double-blind, double-dummy design to receive apixaban at a dose of 5 mg twice daily (2.5 mg twice daily when indicated) or aspirin at a dose of 81 mg daily. The trial medication was discontinued and anticoagulation started if subclinical atrial fibrillation lasting more than 24 hours or clinical atrial fibrillation developed. The primary efficacy outcome, stroke or systemic embolism, was assessed in the intention-to-treat population (all the patients who had undergone randomization); the primary safety outcome, major bleeding, was assessed in the on-treatment population (all the patients who had undergone randomization and received at least one dose of the assigned trial drug, with follow-up censored 5 days after permanent discontinuation of trial medication for any reason). RESULTS: We included 4012 patients with a mean (±SD) age of 76.8±7.6 years and a mean CHA2DS2-VASc score of 3.9±1.1 (scores range from 0 to 9, with higher scores indicating a higher risk of stroke); 36.1% of the patients were women. After a mean follow-up of 3.5±1.8 years, stroke or systemic embolism occurred in 55 patients in the apixaban group (0.78% per patient-year) and in 86 patients in the aspirin group (1.24% per patient-year) (hazard ratio, 0.63; 95% confidence interval [CI], 0.45 to 0.88; P = 0.007). In the on-treatment population, the rate of major bleeding was 1.71% per patient-year in the apixaban group and 0.94% per patient-year in the aspirin group (hazard ratio, 1.80; 95% CI, 1.26 to 2.57; P = 0.001). Fatal bleeding occurred in 5 patients in the apixaban group and 8 patients in the aspirin group. CONCLUSIONS: Among patients with subclinical atrial fibrillation, apixaban resulted in a lower risk of stroke or systemic embolism than aspirin but a higher risk of major bleeding. (Funded by the Canadian Institutes of Health Research and others; ARTESIA ClinicalTrials.gov number, NCT01938248.).

MeSH
antikoagulancia * škodlivé účinky terapeutické užití MeSH
Aspirin * škodlivé účinky terapeutické užití MeSH
cévní mozková příhoda * etiologie prevence a kontrola MeSH
dvojitá slepá metoda MeSH
embolie * etiologie prevence a kontrola MeSH
fibrilace síní * komplikace diagnóza MeSH
inhibitory faktoru Xa škodlivé účinky terapeutické užití MeSH
krvácení chemicky indukované MeSH
lidé MeSH
pyridony škodlivé účinky MeSH
senioři nad 80 let MeSH
senioři MeSH
výsledek terapie MeSH
Check Tag
lidé MeSH
mužské pohlaví MeSH
senioři nad 80 let MeSH
senioři MeSH
ženské pohlaví MeSH
Publikační typ
časopisecké články MeSH
randomizované kontrolované studie MeSH
srovnávací studie MeSH
Geografické názvy
Kanada MeSH

Článek

Factors Influencing Health Care Providers Payment Reforms in Central and Eastern European Countries

Inquiry : a journal of medical care organization, provision and financing. 2024 ; 61 (-) : 469580241287626. [pub] -

Inquiry
ISSN 1945-7243
Medvik
Zdroj

Central and Eastern European (CEE) countries have recently implemented reforms to health care provider payment systems, which include changing payment methods and related systems such as contracting, management information systems, and accountability mechanisms. This study examines factors influencing provider payment reforms implemented since 2010 in Bulgaria, Croatia, Czechia, Estonia, Latvia, Lithuania, Hungary, Poland, and Romania. A four-stage mixed methods approach was used: developing a theoretical framework and data collection form using existing literature, mapping payment reforms, consulting with national health policy experts, and conducting a comparative analysis. Qualitative analysis included inductive thematic analysis and deductive approaches based on an existing health policy model, distinguishing context, content, process, and actors. We analyzed 27 payment reforms that focus mainly on hospitals and primary health care. We identified 14 major factor themes influencing those reforms. These factors primarily related to the policy process (pilot study, coordination of implementation systems, availability of funds, IT systems, training for providers, reform management) and content (availability of performance indicators, use of clinical guidelines, favorability of the payment system for providers, tariff valuation). Two factors concerned the reform context (political willingness or support, regulatory framework, and bureaucracy) and two were in the actors' dimension (engagement of stakeholders, capacity of stakeholders). This study highlights that the content and manner of implementation (process) of a reform are crucial. Stakeholder involvement and their capacities could influence every dimension of the reform cycle. The nine countries analyzed share similarities in barriers and facilitators, suggesting the potential for cross-country learning.

Článek

Andexanet for Factor Xa Inhibitor-Associated Acute Intracerebral Hemorrhage

The New England journal of medicine. 2024 ; 390 (19) : 1745-1755. [pub] 20240516

N Engl J Med
ISSN 1533-4406
Medvik
Zdroj

BACKGROUND: Patients with acute intracerebral hemorrhage who are receiving factor Xa inhibitors have a risk of hematoma expansion. The effect of andexanet alfa, an agent that reverses the effects of factor Xa inhibitors, on hematoma volume expansion has not been well studied. METHODS: We randomly assigned, in a 1:1 ratio, patients who had taken factor Xa inhibitors within 15 hours before having an acute intracerebral hemorrhage to receive andexanet or usual care. The primary end point was hemostatic efficacy, defined by expansion of the hematoma volume by 35% or less at 12 hours after baseline, an increase in the score on the National Institutes of Health Stroke Scale of less than 7 points (scores range from 0 to 42, with higher scores indicating worse neurologic deficit) at 12 hours, and no receipt of rescue therapy between 3 hours and 12 hours. Safety end points were thrombotic events and death. RESULTS: A total of 263 patients were assigned to receive andexanet, and 267 to receive usual care. Efficacy was assessed in an interim analysis that included 452 patients, and safety was analyzed in all 530 enrolled patients. Atrial fibrillation was the most common indication for factor Xa inhibitors. Of the patients receiving usual care, 85.5% received prothrombin complex concentrate. Hemostatic efficacy was achieved in 150 of 224 patients (67.0%) receiving andexanet and in 121 of 228 (53.1%) receiving usual care (adjusted difference, 13.4 percentage points; 95% confidence interval [CI], 4.6 to 22.2; P = 0.003). The median reduction from baseline to the 1-to-2-hour nadir in anti-factor Xa activity was 94.5% with andexanet and 26.9% with usual care (P<0.001). Thrombotic events occurred in 27 of 263 patients (10.3%) receiving andexanet and in 15 of 267 (5.6%) receiving usual care (difference, 4.6 percentage points; 95% CI, 0.1 to 9.2; P = 0.048); ischemic stroke occurred in 17 patients (6.5%) and 4 patients (1.5%), respectively. There were no appreciable differences between the groups in the score on the modified Rankin scale or in death within 30 days. CONCLUSIONS: Among patients with intracerebral hemorrhage who were receiving factor Xa inhibitors, andexanet resulted in better control of hematoma expansion than usual care but was associated with thrombotic events, including ischemic stroke. (Funded by Alexion AstraZeneca Rare Disease and others; ANNEXA-I ClinicalTrials.gov number, NCT03661528.).

Článek

Sodium Zirconium Cyclosilicate in HFrEF and Hyperkalemia: REALIZE-K Design and Baseline Characteristics

JACC. Heart failure. 2024 ; 12 (10) : 1707-1716. [pub] 20240513

JACC Heart Fail
ISSN 2213-1787
Medvik
Zdroj

BACKGROUND: Mineralocorticoid receptor antagonists (MRAs) improve outcomes in patients with heart failure and reduced ejection fraction (HFrEF). However, MRAs are often underused because of hyperkalemia concerns. OBJECTIVES: The purpose of this study was to assess whether sodium zirconium cyclosilicate (SZC), a nonabsorbed crystal that traps and rapidly lowers potassium, enables MRA use in patients with HFrEF and prevalent hyperkalemia (or at high risk). METHODS: REALIZE-K is a prospective, double-blind, placebo-controlled trial in patients with HFrEF (NYHA functional class II-IV; left ventricular ejection fraction ≤40%), optimal therapy (except MRA), and prevalent hyperkalemia (or at high risk). During the open-label run-in, all participants underwent protocol-mandated spironolactone titration (target: 50 mg daily); those with prevalent (cohort 1) or incident (cohort 2) hyperkalemia during titration started SZC. Participants achieving normokalemia while on spironolactone ≥25 mg daily were randomized to continuing SZC or matching placebo for 6 months. The primary composite endpoint was proportion of participants with optimal response (normokalemia, on spironolactone ≥25 mg daily, no rescue for hyperkalemia [months 1-6]). RESULTS: Of 365 patients (run-in), 202 were randomized. Baseline characteristics included mean age 70 years, prevalent comorbidities (78% estimated glomerular filtration rate <60 mL/min/1.73 m2, 38% atrial fibrillation/flutter), high N-terminal pro B-type natriuretic peptide (median 1,136 pg/mL), and high HFrEF therapy use (64% sacubitril/valsartan, 96% beta-blocker, 42% sodium glucose co-transporter 2 inhibitor). At randomization, 78% were receiving spironolactone 50 mg daily. CONCLUSIONS: REALIZE-K is the first trial to evaluate whether SZC can enable rapid and safe MRA optimization and long-term continuation in patients with HFrEF and prevalent/high risk of hyperkalemia. (Study to Assess Efficacy and Safety of SZC for the Management of High Potassium in Patients with Symptomatic HFrEF Receiving Spironolactone [REALIZE-K]; NCT04676646).

Článek

Clinician treatment choices for post-traumatic stress disorder: ambassadors survey of psychiatrists in 39 European countries

European psychiatry. 2024 ; 67 (1) : e24. [pub] 20240307

Eur Psychiatry
ISSN 1778-3585
Medvik
Zdroj

BACKGROUND: Considering the recently growing number of potentially traumatic events in Europe, the European Psychiatric Association undertook a study to investigate clinicians' treatment choices for post-traumatic stress disorder (PTSD). METHODS: The case-based analysis included 611 participants, who correctly classified the vignette as a case of PTSD, from Central/ Eastern Europe (CEE) (n = 279), Southern Europe (SE) (n = 92), Northern Europe (NE) (n = 92), and Western Europe (WE) (N = 148). RESULTS: About 82% woulduse antidepressants (sertraline being the most preferred one). Benzodiazepines and antipsychotics were significantly more frequently recommended by participants from CEE (33 and 4%, respectively), compared to participants from NE (11 and 0%) and SE (9% and 3%). About 52% of clinicians recommended trauma-focused cognitive behavior therapy and 35% psychoeducation, irrespective of their origin. In the latent class analysis, we identified four distinct "profiles" of clinicians. In Class 1 (N = 367), psychiatrists would less often recommend any antidepressants. In Class 2 (N = 51), clinicians would recommend trazodone and prolonged exposure therapy. In Class 3 (N = 65), they propose mirtazapine and eye movement desensitization reprocessing therapy. In Class 4 (N = 128), clinicians propose different types of medications and cognitive processing therapy. About 50.1% of participants in each region stated they do not adhere to recognized treatment guidelines. CONCLUSIONS: Clinicians' decisions for PTSD are broadly similar among European psychiatrists, but regional differences suggest the need for more dialogue and education to harmonize practice across Europe and promote the use of guidelines.

MeSH
antidepresiva terapeutické užití MeSH
kognitivně behaviorální terapie * MeSH
lidé MeSH
posttraumatická stresová porucha * farmakoterapie psychologie MeSH
psychiatři MeSH
Check Tag
lidé MeSH
Publikační typ
časopisecké články MeSH
kazuistiky MeSH
přehledy MeSH
Geografické názvy
Evropa MeSH

Článek

Durvalumab ± Tremelimumab + Platinum-Etoposide in Extensive-Stage Small Cell Lung Cancer (CASPIAN): Outcomes by PD-L1 Expression and Tissue Tumor Mutational Burden

Clinical cancer research. 2024 ; 30 (4) : 824-835. [pub] 20240216

Clin Cancer Res
ISSN 1557-3265
Medvik
Zdroj

PURPOSE: In the CASPIAN trial, first-line durvalumab plus platinum-etoposide (EP) significantly improved overall survival (OS) versus EP alone in extensive-stage small cell lung cancer (ES-SCLC). We report exploratory analyses of CASPIAN outcomes by programmed cell death ligand-1 (PD-L1) expression and tissue tumor mutational burden (tTMB). EXPERIMENTAL DESIGN: Patients were randomized (1:1:1) to durvalumab (1,500 mg) plus EP, durvalumab plus tremelimumab (75 mg) plus EP, or EP alone. Treatment effects in PD-L1 and tTMB subgroups were estimated using an unstratified Cox proportional hazards model. RESULTS: The PD-L1 and tTMB biomarker-evaluable populations (BEP) comprised 54.4% (438/805) and 35.2% (283/805) of the intention-to-treat population, respectively. PD-L1 prevalence was low: 5.7%, 25.8%, and 28.3% had PD-L1 expression on ≥1% tumor cells (TC), ≥1% immune cells (IC), and ≥1% TCs or ICs, respectively. OS benefit with durvalumab plus EP versus EP was similar across PD-L1 subgroups, with HRs all falling within the 95% confidence interval (CI) for the PD-L1 BEP (0.47‒0.79). OS benefit with durvalumab plus tremelimumab plus EP versus EP was greater in PD-L1 ≥1% versus <1% subgroups, although CIs overlapped. There was no evidence of an interaction between tTMB and treatment effect on OS (durvalumab plus EP vs. EP, P = 0.916; durvalumab plus tremelimumab plus EP vs. EP, P = 0.672). CONCLUSIONS: OS benefit with first-line durvalumab plus EP in patients with ES-SCLC was observed regardless of PD-L1 or tTMB status. PD-L1 expression may prove to be a useful biomarker for combined treatment with PD-(L)1 and CTLA-4 inhibition, although this requires confirmation with an independent dataset. See related commentary by Rolfo and Russo, p. 652.

MeSH
antigeny CD274 genetika MeSH
etoposid MeSH
humanizované monoklonální protilátky * MeSH
lidé MeSH
malobuněčný karcinom plic * farmakoterapie genetika MeSH
monoklonální protilátky * MeSH
nádory plic * farmakoterapie genetika MeSH
platina MeSH
protokoly protinádorové kombinované chemoterapie terapeutické užití MeSH
Check Tag
lidé MeSH
Publikační typ
časopisecké články MeSH
práce podpořená grantem MeSH
randomizované kontrolované studie MeSH

Článek

The Mutographs biorepository: A unique genomic resource to study cancer around the world

Cell genomics. 2024 ; 4 (3) : 100500. [pub] 20240206

Cell Genom
ISSN 2666-979X
Medvik
Zdroj

Large-scale biorepositories and databases are essential to generate equitable, effective, and sustainable advances in cancer prevention, early detection, cancer therapy, cancer care, and surveillance. The Mutographs project has created a large genomic dataset and biorepository of over 7,800 cancer cases from 30 countries across five continents with extensive demographic, lifestyle, environmental, and clinical information. Whole-genome sequencing is being finalized for over 4,000 cases, with the primary goal of understanding the causes of cancer at eight anatomic sites. Genomic, exposure, and clinical data will be publicly available through the International Cancer Genome Consortium Accelerating Research in Genomic Oncology platform. The Mutographs sample and metadata biorepository constitutes a legacy resource for new projects and collaborations aiming to increase our current research efforts in cancer genomic epidemiology globally.

Článek

Use of eculizumab in children with allogeneic haematopoietic stem cell transplantation associated thrombotic microangiopathy - a multicentre retrospective PDWP and IEWP EBMT study

Bone marrow transplantation. 2023 ; 58 (2) : 129-141. [pub] 20221104

Bone Marrow Transplant
ISSN 1476-5365
Medvik
Zdroj

Terminal complement blockade by humanised monoclonal antibody eculizumab has been used to treat transplantation-associated thrombotic microangiopathy (TA-TMA) in recent years. This retrospective international study conducted by the Paediatric Diseases (PDWP) and Inborn Error Working Party (IEWP) of the European Society for Blood and Marrow Transplantation (EBMT) describes outcome and response of 82 paediatric patients from 29 centres who developed TA-TMA and were treated with eculizumab between January 2014 and May 2019. The median time from hematopoietic stem cell transplantation (HSCT) to TA-TMA manifestation was 92 days (range: 7-606) and from TA-TMA diagnosis to the start of eculizumab treatment 6 days (range: 0-135). Most patients received eculizumab weekly (72%, n = 55) with a standard weight (kg)-based dose (78%, n = 64). Six months from beginning of eculizumab therapy, the cumulative incidence of TA-TMA resolution was 36.6% (95% CI: 26.2-47) and the overall survival (OS) was 47.1% (95% CI: 35.9-57.5). All 43 patients with unresolved TA-TMA died. The cause of death was HSCT-related in 41 patients. This study also documents poor outcome of patients without aGvHD and their frequent concomitant viral infections. Considering recent publications, intensified eculizumab dosing and complement monitoring could potentially improve upon outcomes observed in this study.

MeSH
dítě MeSH
humanizované monoklonální protilátky MeSH
lidé MeSH
retrospektivní studie MeSH
transplantace hematopoetických kmenových buněk * škodlivé účinky MeSH
trombotické mikroangiopatie * farmakoterapie etiologie diagnóza MeSH
Check Tag
dítě MeSH
lidé MeSH
Publikační typ
časopisecké články MeSH
multicentrická studie MeSH

Článek

ASAS-EULAR recommendations for the management of axial spondyloarthritis: 2022 update

Annals of the rheumatic diseases. 2023 ; 82 (1) : 19-34. [pub] 20221021

Ann Rheum Dis
ISSN 1468-2060
Medvik
Zdroj

OBJECTIVES: To update the Assessment of SpondyloArthritis international Society (ASAS)-EULAR recommendations for the management of axial spondyloarthritis (axSpA). METHODS: Following the EULAR Standardised Operating Procedures, two systematic literature reviews were conducted on non-pharmacological and pharmacological treatment of axSpA. In a task force meeting, the evidence was presented, discussed, and overarching principles and recommendations were updated, followed by voting. RESULTS: Five overarching principles and 15 recommendations with a focus on personalised medicine were agreed: eight remained unchanged from the previous recommendations; three with minor edits on nomenclature; two with relevant updates (#9, 12); two newly formulated (#10, 11). The first five recommendations focus on treatment target and monitoring, non-pharmacological management and non-steroidal anti-inflammatory drugs (NSAIDs) as first-choice pharmacological treatment. Recommendations 6-8 deal with analgesics and discourage long-term glucocorticoids and conventional synthetic disease-modifying antirheumatic drugs (DMARDs) for pure axial involvement. Recommendation 9 describes the indication of biological DMARDs (bDMARDs, that is, tumour necrosis factor inhibitors (TNFi), interleukin-17 inhibitors (IL-17i)) and targeted synthetic DMARDs (tsDMARDs, ie, Janus kinase inhibitors) for patients who have Ankylosing Spondylitis Disease Activity Score ≥2.1 and failed ≥2 NSAIDs and also have either elevated C reactive protein, MRI inflammation of sacroiliac joints or radiographic sacroiliitis. Current practice is to start a TNFi or IL-17i. Recommendation 10 addresses extramusculoskeletal manifestations with TNF monoclonal antibodies preferred for recurrent uveitis or inflammatory bowel disease, and IL-17i for significant psoriasis. Treatment failure should prompt re-evaluation of the diagnosis and consideration of the presence of comorbidities (#11). If active axSpA is confirmed, switching to another b/tsDMARD is recommended (#12). Tapering, rather than immediate discontinuation of a bDMARD, can be considered in patients in sustained remission (#13). The last recommendations (#14, 15) deal with surgery and spinal fractures. CONCLUSIONS: The 2022 ASAS-EULAR recommendations provide up-to-date guidance on the management of patients with axSpA.

MeSH
analgetika terapeutické užití MeSH
ankylózující spondylitida * farmakoterapie MeSH
antiflogistika nesteroidní terapeutické užití MeSH
antirevmatika * terapeutické užití MeSH
lidé MeSH
spondylartritida * farmakoterapie MeSH
Check Tag
lidé MeSH
Publikační typ
časopisecké články MeSH
práce podpořená grantem MeSH

Článek

Proposed Response Parameters for Twelve-Month Drug Trial in Juvenile Systemic Sclerosis: Results of the Hamburg International Consensus Meetings

Arthritis care & research. 2023 ; 75 (12) : 2453-2462. [pub] 20230912

Arthritis Care Res
ISSN 2151-4658
Medvik
Zdroj

OBJECTIVE: Juvenile systemic sclerosis (SSc) is an orphan disease, associated with high morbidity and mortality. New treatment strategies are much needed, but clearly defining appropriate outcomes is necessary if successful therapies are to be developed. Our objective here was to propose such outcomes. METHODS: This proposal is the result of 4 face-to-face consensus meetings with a 27-member multidisciplinary team of pediatric rheumatologists, adult rheumatologists, dermatologists, pediatric cardiologists, pulmonologists, gastroenterologists, a statistician, and patients. Throughout the process, we reviewed the existing adult data in this field, the more limited pediatric literature for juvenile SSc outcomes, and data from 2 juvenile SSc patient cohorts to assist in making informed, data-driven decisions. The use of items for each domain as an outcome measure in an open label 12-month clinical trial of juvenile SSc was voted and agreed upon using a nominal group technique. RESULTS: After voting, the domains agreed on were global disease activity, skin, Raynaud's phenomenon, digital ulcers, musculoskeletal, cardiac, pulmonary, renal, and gastrointestinal involvement, and quality of life. Fourteen outcome measures had 100% agreement, 1 item had 91% agreement, and 1 item had 86% agreement. The domains of biomarkers and growth/development were moved to the research agenda. CONCLUSION: We reached consensus on multiple domains and items that should be assessed in an open label, 12-month clinical juvenile SSc trial as well as a research agenda for future development.

MeSH
dítě MeSH
dospělí MeSH
konsensus MeSH
kvalita života MeSH
lidé MeSH
Raynaudova nemoc * farmakoterapie MeSH
systémová sklerodermie * diagnóza farmakoterapie komplikace MeSH
Check Tag
dítě MeSH
dospělí MeSH
lidé MeSH
Publikační typ
časopisecké články MeSH
přehledy MeSH

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