Showing 1 – 20 of 457
Relevance | Newest | Oldest |
  • Global Burden of Hypertension and Systolic Blood Pressure of at Least 110 to 115 mm Hg, 1990-2015

    Abstract Full Text
    free access is active quiz
    JAMA. 2017; 317(2):165-182. doi: 10.1001/jama.2016.19043

    This population epidemiology study uses pooled global health evaluation surveys data to estimate trends in the association between elevated stystolic blood pressure and death and disability between 1990 and 2015.

  • JAMA July 5, 2016

    Figure 2: Cumulative Probability of Stroke, Composite Event, and Bleeding According to Loss-of-Function Allele Carrier Status

    Loss-of-function allele carriers were defined as patients with at least 1 loss-of-function allele (ie, *2 or *3): *1/*2, *1/*3, *2/*2, *2/*3, *3/*3, *2/*17, or *3/*17; loss-of-function allele noncarriers were defined as patients with no loss-of-function allele: *1/*1, *1/*17, or *17/*17. Composite event was defined as a new clinical vascular event, including ischemic stroke, hemorrhagic stroke, myocardial infarction, or vascular death.
  • JAMA July 5, 2016

    Figure 1: Clopidogrel-Aspirin vs Aspirin on Clinical Outcome Stratified by Metabolizer Phenotype

    NE indicates not estimable. Patients with two *2 or *3 alleles (ie, *2/*2, *2/*3, or *3/*3) were classified as having the poor metabolizer phenotype, those with one *2 or *3 allele (ie, *1/*2 or *1/*3) were classified as having the intermediate metabolizer phenotype, those without a *2, *3, or *17 allele (ie, *1/*1) were classified as having the extensive metabolizer phenotype, those with a single *17 allele (ie, *1/*17) and *17 homozygotes were classified as having the ultra metabolizer phenotype. Composite event was defined as a new clinical vascular event, including ischemic stroke, hemorrhagic stroke, myocardial infarction, or vascular death. The size of the data markers indicate the sample size of the subgroup.
  • JAMA November 3, 2015

    Figure 4: Subgroup and Sensitivity Analyses for Favorable Functional Outcome Reduced Disability at 90 Days

    Favorable functional outcome was defined as reduced disability at 90 days. Odds ratios and corresponding confidence intervals among patient subgroups from individual trials were pooled and interactions were evaluated by random-effects meta-analyses. aThe National Institutes of Health Stroke Scale (NIHSS) evaluates the clinical severity of stroke and ranges from 0 to 42, with higher values indicating more severe neurological deficit. An NIHSS score of 20 points was used as a cut-off because scores higher than 20 are considered severe impairment and correspond to a significantly greater risk of intracranial hemorrhage and unfavorable outcome.bThe Alberta Stroke Program Early Computed Tomography Score (ASPECTS) is a 10-point topographic score evaluating the presence and severity of early ischemic change on standard computed tomographic (CT) scan in patients with early acute ischemic stroke of the anterior circulation, with a normal CT scan receiving 10 points and a score of 0 indicating diffuse involvement throughout the middle cerebral artery (MCA) territory. An ASPECTS of 7 points was used as a cutoff because scores higher than 7 are associated with poorer functional outcomes and greater risk of intracranial hemorrhage.cConfirmed arterial occlusion refers to use of CT angiography or magnetic resonance angiograph (MRA) to confirm arterial occlusion prior to treatment. dProximal MCA occlusion refers to occlusion of the M1 MCA or 2 or more M2 MCA segments; data on outcomes of M1 vs M2 MCA occlusion were not available. eIntravenous tissue plasminogen activator (tPA) refers to use of combination therapy (endovascular intervention plus intravenous tPA).fMethod of thrombectomy was separated based on high (>80%) vs low (<20%) rate of use of retrievable stent devices.
  • Trends in Care Practices, Morbidity, and Mortality of Extremely Preterm Neonates, 1993-2012

    Abstract Full Text
    free access is active quiz
    JAMA. 2015; 314(10):1039-1051. doi: 10.1001/jama.2015.10244

    This population epidemiology study used neonatal registry data to characterize trends in maternal and neonatal care, and morbidity and mortality of extremely preterm infants between 1993 and 2012.

  • JAMA September 8, 2015

    Figure 2: Neonatal Morbidities for Infants Born at Gestational Ages 22 Through 28 Weeks

    Circles show the percent of infants born each year diagnosed with the morbidity and the smoothed curve shows the trend. Shading to indicate the 95% CI for each curve is not visible where CIs are close to values on the curve. Percentages shown in graphs are among infants of all gestational ages who survived more than 12 hours with additional restrictions as noted in the text and eTable 3 in the Supplement. Relative risks (RRs) are based on infants of all gestational ages and are shown for outcomes for which the year-gestational age interaction was not significant. When the year-gestational age interaction was significant, graphs and RRs are shown for each gestational age for late-onset sepsis, severe intracranial hemorrhage, periventricular leukomalacia, and bronchopulmonary dysplasia in eFigures 5-8 in the Supplement. RRs for the change per year were adjusted for study center, maternal race/ethnicity, infant gestational age, small size for gestational age, and sex. Total number of infants (mean [range] per year): 30 790 (1539 [1035-1809]) for necrotizing enterocolitis; 29 252 (1462 [980-1702]) for late-onset sepsis; 29 883 (1494 [1016-1741]) for severe intracranial hemorrhage (ICH); 28 498 (1424 [769-1744]) for periventricular leukomalacia (PVL); 24 951 (1247 [808-1509]) for retinopathy of prematurity (ROP) of stage 3 or greater; and 25 000 (1250 [746-1534]) for bronchopulmonary dysplasia (BPD).
  • JAMA September 8, 2015

    Figure 4: Infant Survival to Discharge Without Major Morbidity by Birth Year and Gestational Age

    Major morbidity was defined as one or more of necrotizing enterocolitis, infections (early-onset sepsis, late-onset sepsis, or meningitis), bronchopulmonary dysplasia (BPD), severe intracranial hemorrhage (ICH), periventricular leukomalacia (PVL), and retinopathy of prematurity (ROP) of stage 3 or greater. Circles show the percent of infants who survived without major morbidity each year, the smoothed curve shows the trend, and shading indicates a 95% CI for the curve. Percentages are among infants who survived to discharge, excluding those not adequately evaluated for major morbidity. Infants born at gestational age 22 weeks are not shown because only 99 of 1550 survived to discharge and only 5 survived without major morbidity. Relative risks (RRs) for the change per year were adjusted for study center, maternal race/ethnicity, infant gestational age, small size for gestational age, and sex. Trends varied by gestational age (year-gestational age interaction, P = .01). Total number of infants [mean (range) per year]: 877 (43 [33-69]) for 23 weeks; 2706 (135 [75-183]) for 24 weeks; 4007 (200 [119-249]) for 25 weeks; 4900 (245 [155-313]) for 26 weeks; 5902 (295 [184-350]) for 27 weeks; and 6808 (340 [256-405]) for 28 weeks.
  • Anticoagulant Reversal, Blood Pressure Levels, and Anticoagulant Resumption in Patients With Anticoagulation-Related Intracerebral Hemorrhage

    Abstract Full Text
    free access
    JAMA. 2015; 313(8):824-836. doi: 10.1001/jama.2015.0846

    This retrospective cohort study in Germany reports on analyses of the treatment of oral anticoagulation–associated intracerebral hemorrhage and its association with rates of hematoma enlargement, ischemic and hemorrhagic events with or without resumption of oral anticoagulation, and long-term functional outcome.

  • Oral Anticoagulants and the Risk of Intracranial Hemorrhage

    Abstract Full Text
    JAMA. 2014; 312(23):2562-2563. doi: 10.1001/jama.2014.12180
  • Thrombolysis for Pulmonary Embolism and Risk of All-Cause Mortality, Major Bleeding, and Intracranial Hemorrhage: A Meta-analysis

    Abstract Full Text
    free access
    JAMA. 2014; 311(23):2414-2421. doi: 10.1001/jama.2014.5990

    Chatterjee and coauthors performed a meta-analysis to determine benefits and risks associated with thrombolytic therapy vs anticoagulation in acute pulmonary embolism, including the subset of hemodynamically stable patients with right ventricular dysfunction. In an Editorial, Beckman discusses how to assess the net clinical benefit of thrombolysis for patients with pulmonary embolism.

  • JAMA April 23, 2014

    Figure 3: Progression to the Secondary Outcome During 12 Years of Prospective Follow-up

    The secondary outcome was first occurrence after inception of a nonfatal intracranial hemorrhage, cerebral infarction, or persistent/progressive nonhemorrhagic focal neurological deficit or death due to a brain arteriovenous malformation or intervention complication. Error bars indicate 95% CIs of the cumulative proportions at 4 and 12 years after inception.
  • Factor Xa Inhibitors vs Warfarin for Preventing Stroke and Thromboembolism in Patients With Atrial Fibrillation

    Abstract Full Text
    JAMA. 2014; 311(11):1150-1151. doi: 10.1001/jama.2014.1403
  • Risks of Intracranial Hemorrhage Among Patients With Acute Ischemic Stroke Receiving Warfarin and Treated With Intravenous Tissue Plasminogen Activator

    Abstract Full Text
    free access is expired quiz
    JAMA. 2012; 307(24):2600-2608. doi: 10.1001/jama.2012.6756
    To assess risk of intracranial hemorrhage among warfarin-treated patients with acute ischemic stroke treated with intravenous tissue plasminogen activator (tPA), Xian and coauthors observed 23 437 such patients (international normalized ratios ≤1.7). In the related Editorial, Alberts discusses the need for increased use of tPA in eligible patients with acute ischemic stroke.
  • Does This Patient Have a Hemorrhagic Stroke? Clinical Findings Distinguishing Hemorrhagic Stroke From Ischemic Stroke

    Abstract Full Text
    is expired quiz
    JAMA. 2010; 303(22):2280-2286. doi: 10.1001/jama.2010.754
  • JAMA June 9, 2010

    Figure: Explanation of Additional Symptoms of Intracerebral Hemorrhage

    In the top panel, a small hemorrhage in the right basal ganglia causes left hemiparesis and a clinical presentation indistinguishable from ischemic stroke. As intracerebral bleeding continues (middle panel), expansion of the hemorrhage exerts a mass effect on the brain, increasing intracranial pressure and causing a midline shift. Clinical findings characteristic of hemorrhagic stroke manifest, such as progressive neurological deficits, headache, and vomiting. Eventually, blood may dissect into the ventricles and extend into the subarachnoid space via the median and lateral apertures of the fourth ventricle (bottom panel), leading to neck stiffness. In severe hemorrhagic stroke, intracerebral expansion of the hemorrhage may result in coma from bilateral cerebral dysfunction or uncal herniation.
  • Hemorrhagic Stroke

    Abstract Full Text
    JAMA. 2010; 303(22):2312-2312. doi: 10.1001/jama.303.22.2312
  • JAMA August 12, 2009

    Figure 1: Timing of Neonatal Deaths Ascribed to Intrapartum Anoxia and Other Causes

    Pediatric classifications in the other causes category included antepartum anoxia, birth trauma, pulmonary complications of prematurity, intracranial hemorrhage, infection, hemorrhage (other), miscellaneous, and unexplained (including sudden infant death syndrome). Comparing deaths ascribed to intrapartum anoxia with deaths ascribed to other causes, P < .001 by χ2 test.
  • JAMA August 12, 2009

    Figure 4: Annual Rate of Delivery-Related Perinatal Death Ascribed to Intrapartum Anoxia and Other Causes vs Cesarean Delivery Rate

    Each point represents the pair of values for a given year. The period of analysis was between 1988 and 2007. Pediatric classifications in the other causes category included antepartum anoxia, birth trauma, pulmonary complications of prematurity, intracranial hemorrhage, infection, hemorrhage (other), miscellaneous, and unexplained (including sudden infant death syndrome).
  • JAMA August 12, 2009

    Figure 2: Incidence and Trend of Delivery-Related Perinatal Death Ascribed to All-Cause Mortality and Intrapartum Anoxia and Other Causes in Scotland Between 1988 and 2007

    For all-cause mortality, the solid fitted line is the predicted probability from a univariate logistic regression model with year as a linear predictor; dashed curves are the associated 95% confidence intervals (CIs) (unadjusted odds ratio [OR], 0.62; 95% CI, 0.49-0.79). For deaths ascribed to intrapartum anoxia and other causes, the solid fitted line is the modeled value for death ascribed to anoxia and the dashed fitted line is the modeled value for deaths ascribed to other causes, with the associated 95% CIs omitted for clarity (intrapartum anoxia: unadjusted OR, 0.52; 95% CI, 0.38-0.71; other causes: unadjusted OR, 0.81; 95% CI, 0.55-1.19). Pediatric classifications in the other causes category included antepartum anoxia, birth trauma, pulmonary complications of prematurity, intracranial hemorrhage, infection, hemorrhage (other), miscellaneous, and unexplained (including sudden infant death syndrome).
  • Benefits and Risks of Drug Treatments: How to Combine the Best Evidence on Benefits With the Best Data About Adverse Effects

    Abstract Full Text
    JAMA. 2008; 300(20):2417-2419. doi: 10.1001/jama.2008.723