Active clinical trials for "Stroke"

Pneumonia is a frequent complication of acute stroke and is associated with increased mortality and long-term impairment in the affected subjects. In previous studies, a number of clinical (e.g., dysphagia, severe neurological impairment, mechanical ventilation), radiological (e.g., large infarctions in the territory of middle cerebral artery, insular infarction) and biochemical (e.g., increased serum levels of C-reactive protein, decreased levels of CD4+ T-lymphocytes) findings have been reported as risk factors of stroke-related chest infection. The present study (PRECAST) aims to identify a small set out of these previously described risk factors that can predict stroke-related pneumonia with high sensitivity and specificity.

The purpose of this trial is to determine if an experimental remote video camera system is an effective way for a stroke specialist to evaluate stroke patients from a distant site.

Treatment of acute stroke is still difficult and the only specific drug approved (rtPA) can only be administered if treatment starts within 3 hours after onset of symptoms. This results in a still too small number of patients treated with rtPA ( < 15% in best clinical care institutions ). Ancrod is a differently acting biological drug which has been used for a long time but not for acute stroke treatment. STAT was the first RCT of medium size to show a significant benefit/risk ration if treatment starts within 3 hours. ESTAT was designed closely related to STAT but with a longer 6 hours window and specifically extended inclusion/exclusion criteria to avoid secondary complications possibly related to a longer time window.

To explore the role of insulin growth factor in cardiovascular disease in older men and women.

This study will determine in stroke patients whether stimulation of the injured side of the brain combined with stimulation of the weak hand can temporarily improve motor function of the paralyzed hand. It will also examine whether stimulation of the healthy side of the brain combined with stimulation of the weak hand can temporarily improve motor function in the paralyzed hand. Healthy adult volunteers and adults who have had a stroke more than 3 months before entering the study may be eligible to participate. Candidates are screened with a physical and neurological examination. Stroke patients also have magnetic resonance imaging (MRI), a test that uses a strong magnetic field and radio waves to obtain images of the brain. Participants perform several tasks (described below) in a practice session and then during five more sessions on separate days. They perform the tasks before and after undergoing transcranial direct current stimulation (tDCS) plus electrical stimulation (ES), and during a procedure that involves sham stimulation. For tDCS, small rubber electrodes are soaked with water and taped to the subject's head, one above the eye and the other on the back of the head. The current passes between the two electrodes. For ES, two pairs of electrodes are attached to the subject's wrist with a paste. A very short pulse of current is passed between the electrodes, creating an electrical field that stimulates the brain. For the sham stimulation, the electrodes are similarly placed, but there is no stimulation. The tasks are: Jebsen-Taylor test: Subjects write, lift small common objects like paper clips, and perform activities like turning pages, stacking checkers or lifting large objects. They do these tasks as fast as possible. Pinch force: Subjects press a wedged instrument between their thumb and index finger as hard as they can. There are several trials every 10 seconds. Speed tapping: Subjects press a key on a keyboard as quickly as possible for 10 seconds. Simple reaction time task: Subjects perform a quick wrist movement as quickly as possible in response to a "go" signal presented on a computer monitor. Muscle activity in the forearm is recorded using electrodes. Motor sequence learning/Learning a finger movement sequence: Subjects practice a finger movement exercise on a keyboard by pressing keys that correspond to a number displayed on a video screen. Visual analog scales: Subjects complete three questionnaires about their attention, fatigue, and mood. Sensory monitoring: Subjects are blindfolded and asked to judge the difference in various sensations, such as the feel of plastic domes with gratings, vibration, or a plastic hair applied to their fingertip. Scoring MRC scale: The muscle strength of the subject's hands is measured. Fugl-Meyer scale: The subject's ability to move his or her limbs is measured. Mini-mental state examination: The subject's mental ability is measured briefly. Handedness questionnaire: The subject's dominant hand is determined. Participants also undergo transcranial magnetic stimulation (TMS) and electromyography (EMG) before, during and after these activities. For TMS, a wire coil is held on the scalp. A brief electrical current is passed through the coil, creating a magnetic pulse that stimulates the brain. The effect of TMS on the muscles is detected with small electrodes taped to the skin of the arms or legs. EMG measures the electrical activity of the muscles. For this test, small electrodes are taped to the skin over the muscle.

The purpose of this study is to provide further information regarding the risks and benefits of Dysport in marketed indications.

Patients with a diagnosis of stroke or TIA, who are already included in the RIALTO-cohort study are asked to participate in a RCT after discharge from hospital. Patients in the intervention group will receive four visits by a study nurse with the aim of controlling the patient's hypertension, reducing risk factors like tobacco smoking and obesity, and motivating the patient to physical activity and to a healthy diet.Patients in the control group will receive the usual treatment. This study is aimed at testing the hypothesis, that Primary outcome: the blood pressure lowering will be greater in the intervention group Secondary outcomes: the blood pressure will be lower in the intervention group and the number of patients who have stopped smoking will be greater in the intervention group The number of obese patients who have reduced their BMI will be greater in the intervention group The number of patients with a Rankin Scale<3 who are physically active for four hours a week will be greater in the intervention group Time to recurrent stroke, MI and death will be longer in the intervention group Outcomes are measured by follow up visit one and two years after inclusion in the study Expected Total Enrollment: 342 in the RCT, 1200 in the cohort Study Start: 011205 (PREVENT) Study Completion: January 2009(PREVENT), September 2013 (RIALTO Cohort study)

To conduct a large-scale demonstration and education project designed to evaluate the feasibility and effectiveness of long-term community health education directed toward lowering cardiovascular disease risk, morbidity, and mortality. Targeted risk factors included general lifestyle, smoking, blood pressure, nutrition and weight, and exercise. The program was evaluated by biennial cross-sectional independent surveys, longitudinal studies, and morbidity and mortality surveillance.

To conduct a large-scale community-based demonstration and education research project designed to evaluate the effectiveness of multiple educational strategies on risk factor reduction and the primary prevention of population-wide cardiovascular diseases in three intervention communities compared with three control communities. The program was evaluated by cross-sectional surveys, a longitudinal survey, and morbidity and mortality surveillance.

To test whether sleep-disordered breathing is associated with an increased risk of coronary heart disease, stroke, all-cause mortality, and hypertension. The multicenter, longitudinal study draws on existing, well-characterized, and established epidemiologic cohorts.