2012 May 23 - Recombinant tissue plasminogen activator for acute ischaemic stroke

Prof Joanna M Wardlaw MD , Prof Veronica Murray MD, Prof Eivind Berge MD, Prof Gregory del Zoppo MD, Prof Peter Sandercock DM , Prof Richard L Lindley MD, Geoff Cohen PhD. The Lancet, Early Online Publication, 23 May 2012

Recombinant tissue plasminogen activator (rt-PA, alteplase) improved functional outcome in patients treated soon after acute ischaemic stroke in randomised trials, but licensing is restrictive and use varies widely. The IST-3 trial adds substantial new data. We therefore assessed all the evidence from randomised trials for rt-PA in acute ischaemic stroke in an updated systematic review and meta-analysis.

Read more ...

2012 April 10 - Prediction of potential for organ donation after cardiac death

Prof Alejandro A Rabinstein MD , Alan H Yee DO, Jay Mandrekar PhD, Jennifer E Fugate DO, Yorick J de Groot MD, Erwin JO Kompanje PhD, Lori A Shutter MD, W David Freeman MD, Michael A Rubin MD, Eelco FM Wijdicks MD. The Lancet Neurology, Volume 11, Issue 5, Pages 414 - 419, May 2012
Successful donation of organs after cardiac death (DCD) requires identification of patients who will die within 60 min of withdrawal of life-sustaining treatment (WLST). We aimed to validate a straightforward model to predict the likelihood of death within 60 min of WLST in patients with irreversible brain injury.

Read more ...

2012 Feb 17 - Optimisation of infection prevention and control in acute health care by use of behaviour change

Rachel Edwards MSc , Esmita Charani MPharm, Nick Sevdalis PhD, Banos Alexandrou MSc, Eleanor Sibley MPhil, David Mullett MA, Heather P Loveday MA, Lydia N Drumright PhD, Prof Alison Holmes MD. The Lancet Infectious Diseases, Early Online Publication, 17 February 2012
Changes in the behaviour of health-care workers (HCWs) are required to improve adherence to infection prevention and control (IPC) guidelines. Despite heavy investment in strategies to change behaviour, effectiveness has not been adequately assessed. We did a systematic review to assess the effectiveness and sustainability of interventions to change IPC behaviour and assessed exploratory literature for barriers to and facilitators of behaviour change.

Read more ...

2012 Feb - Cardiovascular and neurological causes of sudden death after ischaemic stroke

Dr Peter Sörös MD, Prof Vladimir Hachinski MD
The Lancet Neurology, Volume 11, Issue 2, Pages 179 - 188, February 2012

Sudden death is an important but widely under-recognised consequence of stroke. Acute stroke can disturb central autonomic control, resulting in myocardial injury, electrocardiographic abnormalities, cardiac arrhythmias, and ultimately sudden death.

Read more ...

2012 Feb - Surgical treatment of drug-resistant tuberculosis

Dr Russell R Kempker MD , Sergo Vashakidze MD, Nelly Solomonia MD, Nino Dzidzikashvili MD, Prof M Blumberg MD
The Lancet Infectious Diseases,
Volume 12, Issue 2, Pages 157 - 166, February 2012
Summary: The global emergence and spread of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis has led to the re-examination of surgery as a possible adjunctive treatment. We present the case of a 26-year-old HIV-seronegative patient with XDR pulmonary tuberculosis refractory to medical therapy....

Read more ...

2012 Jan 21 - A stray bullet in the brain