506 research outputs found
Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial
- Author
- Abano Nenette
- Abbdul-saheb Mudhar
- Adedoyin Temi
- Adell Victoria
- Adesina Tolu
- Adie Katja
- Adil-Smith Jennifer
- Ahmad Nasar
- Ahmed Ashraf
- Ahmed Iman
- Al-Mayhani Talal
- Al-Shahi Salman Rustam
- Al-Shahi Salman Rustam
- Alam Mohammad Irfan
- Albazzaz Mo
- Ali Ali
- Alipio Francis
- Allen Christopher
- Allison Joanna
- Amey Isobel
- Amis Elaine
- Amlani Sageet
- Amoils Shannon
- Amor Kelly
- Anderson Rosemary
- Andole Sreeman
- Anjum Talat
- Ankolekar Sandeep
- Annamalai Arunkumar
- Anthony Alpha
- Anversha Ajmal
- Anwar Ijaz
- Anwar Sajjad
- Appleton Jason
- Argandona Lucia
- Armitage Jane
- Ashton Amy
- Atkinson Natalie
- Auld Grace
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- Aweid Basaam
- Ayres Georgina
- Azhar Khalid
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- Vasileiadis Evangelos
- Vassallo Joseph
- Venter Marius
- Veraque Emelda
- Verrion Anna
- Vettimootal Johnson Venetia
- Vickers Carinna
- Walford Jamie
- Walker Allan
- Walker Marion
- Walker Pauli
- Walker Susannah
- Wallace Aine
- Wallace Rebecca
- Wallace Rebecca
- Walstow Deborah
- Walter Deborah
- Walters Ashleigh
- Wani Mushtaq
- Ward Deborah
- Wardlaw Joanna M
- Watchurst Caroline
- Waterfield Kelly
- Waterfield Kelly
- Watson Fran
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- Webber Adam
- Webster Timothy
- Weinling Marie
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- Weir Pauline
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- Werring David
- Werring David J
- Whitcher Alison
- White James
- White Julie
- White Philip M
- White Susan
- Whiteley William
- Whiteley William N
- Whiteman Jessica
- Whiteman Jessica
- Whiting Robert
- Whittamore Katherine
- Wiggam Ivan
- Wilding Peter
- Wilkes Gwendoline
- Wilkinson Mark
- Willberry Angela
- Williams Carol
- Williams Rebecca
- Williams-Yesson Barbara
- Willmot Mark
- Wilson David
- Wilson Duncan
- Wilson Jenny
- Wilson Lisa
- Wilson Sarah
- Wiltshire Alison
- Wood Diane
- Wood Edith
- Wood Lisa
- Woodward Stephen
- Wright Fiona
- Wroath Belinda
- Wynter Inez
- Yadava Rajendra
- Yip Brigitte
- Young Andrew
- Zachariah George
- Zahoor Tajammal
- Zoe Mellor
- Publication venue
- 'Elsevier BV'
- Publication date
- 22/05/2019
- Field of study
Background
Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy
Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis
- Author
- Aahlin Eirik Kjus
- Aamer Ahmed
- Aaniana Kenneth
- Ababneh Ali
- Abaliksta Tomas
- Abantanga Francis
- Abbas Athar
- Abbasy Jibran
- Abbo Olivier
- Abbott Tom
- Abbouch Meryem
- Abd El-Latif Nadia Khalid
- Abd Elkhalek Esraa
- Abd-Elmawla Manar
- Abdallah Emad
- Abdel-Aty Abdulrahman
- Abdel-Hameed Noran
- Abdel-Kader Sara Mahmoud
- Abdelaal Abdelaziz
- Abdelaty Mohamed
- Abdelazeam Anan Rady
- Abdelazim Galaleldin
- Abdelaziz Mohamed A.
- Abdelbadeai Kholoud
- Abdelfatah Afnan
- Abdelhady Samar
- Abdelhamed Rasha
- Abdelhamid Amina
- Abdelhaq Aram
- Abdelkader Mostafa
- Abdelkader Omar
- Abdelkhalek Mohamed
- Abdelmageed Eman
- Abdelmotaleb Ibrahem
- Abdelraouf Ahmed Mahmoud
- Abdelrouf Doaa Maher
- Abdelshakour Mahmoud
- Abdrabou Abdulshafi Khaled
- Abdul-Latif Saiba
- Abdulaziz Hager
- Abdulaziz Mustafa
- Abdulbagi Omar
- Abdulhakeem Eman Mahmoud
- Abdullah Mohamed Abozed
- Abdullah Nik Azim Nik
- Abdullah Noha
- Abdullahi Lawal
- Abdurrazzaaq Abdussemiu
- Abem Owusu Emmanuel
- Abiola Olajide
- Aboelella Majed
- Aboelmagd Omnia
- Aboelsoud Moustafa R.
- Aboul-Naga Mariam Saad
- Abouzaid Arwa
- Abu Qumbos Amjad
- Abu-toyour Maram
- Abubakr Marwan
- Abuowda Yousef
- Abuqwaider Eman
- Abusalem Lana
- Abushamleh Soha
- Ackom Eric
- Acquah Emmanuel
- Adam Ali
- Adam Nourhan
- Adamu Ahmed
- Adawi Ihdaa
- Adawi Mohammad
- Adebanjo Ademola
- Adebola Oluwaseyi
- Adedeji Adesina
- Adel Badr Eldin
- Adel Israa
- Adella Fidelis Jacklyn
- Adelshone Abdelrahman
- Ademuyiwa Adesoji
- Ademuyiwa Adesoji O.
- Ademuyiwa Adesoji O.
- Adenekan Babajide
- Adeniran James
- Adeniyi Adewale
- Adesanya Opeoluwa
- Adesina Alaba
- Adeyeye Ademola
- Adeyeye Ademola
- Adhitama Novia
- Adil Muhammad
- Adisa Adewale O.
- Adiyaman Can
- Adu-Aryee Niiarmah
- Afana Samah
- Agalianos Christos
- Agarwal Arnav
- Agarwal Arnav
- Agbedinu Kwabena
- Aglan Amro
- Aguado Suarez Nuria
- Aguilera Maria Lorena
- Aguilera Maria Lorena
- Aguilera-Arevalo Maria-Lorena
- Ahlonsou Germain
- Ahlqvist Sandra
- Ahlqvist Sandra
- Ahmed Asdaq
- Ahmed Ataa
- Ahmed Hayam
- Ahmed Hussien
- Ahmed Lopna Ahmed Mohamed
- Ahmed Sara
- Ahmed Saraibrahim
- Ahounou Ernest Yemalin Stephane
- Ajah Jonathan
- Ajai Olalekan
- Ajao Akinlabi
- Ajiboye Anthony
- Akoto Elliot
- Akpenyi Onyinye
- Al Amin Shadid
- Al Attar Samaa Mahmoud
- Al Barraw Fayez Elian
- Al Bastawis Fatema
- Al Meligy Amgad
- Al Rafati Ahmad Abdel Razaq
- Al Raouf Eman Abd
- Al Saied Ghiath
- Al Subaie Norah
- Al-Bahrani Ahmed
- Al-Buhaisi Alaa
- Al-Dakka Emad
- Al-faqawi Maha
- Al-farram Hadeel
- Al-khatib Ahmed
- Al-Marakby Dina
- Al-saqqa Sara
- Al-Saqqa Sara W.
- Al-Slaibi Ibrahim
- Al-taher Taher
- AlaaelDein Shahinaz
- Alada Muslimat
- Alakaloko Felix
- Alaloul Enas
- Alamin Shadid
- Alamoudi Mohammed
- Albiety Adel
- Alcca Ticona Willy
- Alejos Bermudez Ysabel Esthefany
- Alexander Philip
- Alexander Philip
- Alexandre Challine
- Alghamdi Ahmed
- Alghamdi Mohammed Saleh A.
- Alhady Khaled
- Alhammali Tariq
- Alhassan Basmah
- Alhazmi Wedyan
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- Mano Maria Jesusa B.
- Manrique Sila George Christian
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- Tew Yong Yong
- Thabet Waleed
- Thalgaspitiya S. P. B.
- Theodosopoulos Theodosios
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- Thorell Anders
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- Ting Jesse Ron Swire
- To Kathleen
- Tolonen Matti
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- Tomas Kadir
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- Torres Cardozo Jorge
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- Townsend Dominic
- Trompetto Mario
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- Tshisola Serge Kapenda
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- Turkustani Sondos
- Turpo Espinoza Kenny
- Turpo Espinoza Kevin
- Tutino Roberta
- Tverskis Zygimantas
- Tyler Robert
- Tze R. Goh Ern
- Tzikos Georgios
- Ubiali Paolo
- Ukwenya Yahaya
- ul Razi Syed Asaat
- Ulusahin Mehmet
- Upadhyaya Vijaid
- Urbonas Tomas
- Urniezius Zigmantas
- Uscinas Laimonas
- Uzabumwana Norbert
- Vaicius Arturas
- Valcarcel-Saldana Maria
- Valioulis Ioannis
- Van Der Naald Niels
- Van Niekerk Michael
- Van Straten Stephanie
- Vargas Marvin
- Vartanoglu Talar
- Vartic Mihaela
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- Vasquez Idelso
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- Velasquez Ricardo
- Venclauskas Linas
- Vendramin Elena
- Venskutonis Donatas
- Venskutonis Donatas
- Verbeek Anna
- Vergara Mejia Angelica Genoveva
- Verjee Azmina
- Vermaas Maarten
- Vicario Erika
- Vicenta Collado Maria
- Vida Lucian Corneliu
- Vilcinskas Mantas
- Villalobos Santiago
- Violi Paola
- Visinskas Petras
- Voulgaris Evangelos
- Wael Noha
- Wakefield Rebecca
- Waledziak Maciej
- Walker Michael
- Walker Nathan
- Walls Luke
- Walsh Michael
- Waqar Muhammad
- Warren Oliver
- Waterman Ade
- Werder Gabriela
- Whitaker John
- White Rebecca
- Whitehurst Katharine
- Wiborg Joachim
- Widiastini T. Ariani
- Widmer Lukas Werner
- Wijayarathna L. S.
- Williams Omolara
- Wilson Ling
- Wilson Michael
- Wilson Michael
- Wimalge P. M. S. N.
- Wogensen Fredrik
- Wolf Bernhard
- Wondoh Paul
- Wondoh Paul
- Wong Chui Yee
- Wong Francisca
- Wong Hong Yee
- Wood Greta
- Worku Mengistu
- Worku Tewodros
- Wright Naomi
- Yahaya Muhammad Taqiyuddin
- Yakubu Musah
- Yam Sir Young
- Yang James
- Yap Suhhuey
- Yau Jih Dar
- Ye Joselyn
- Yeang Li Jing
- Yeung Man Hon Andrew
- Yifieyeh Abiboye
- Yildirim Reyyan
- Yip Chingwan
- Ymeri Shpetim
- Yoganathan Pigeneswaren
- Yolcu Sinem
- Yong Guo Liang
- Younis Abobaker
- Youssef Mohamed
- Yuksek Mahmut Arif
- Yusufali Taha
- Zaa'treh Rula
- Zadoroznas Antanas
- Zahran Diaaaldin
- Zakaria Esraay
- Zakaria Mahmoud
- Zakaria Yehia
- Zaki Ahmed
- Zammit Stefan
- Zampitis Nikolaos
- Zani Augusto
- Zani Augusto
- Zanini Nicola
- Zapata Felipe
- Zarb Ciskje
- Zeta Solis Ludwing Alexander
- Zielinski Martin
- Zilinskas Justas
- Zilinskas Justas
- Zilinskas Justas
- Zilinskiene Reda
- Ziubryte Greta
- Zohair Ahmed
- Zuber Markus
- Zuk Grzegorz
- Zulkifli Athirah
- Zumbuhl Lucius
- Publication venue
- Elsevier
- Publication date
- 01/06/2003
- Field of study
BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London
Gender Gap in Parental Leave Intentions: Evidence from 37 Countries
- Author
- Aarntzen Lianne
- Adamus Magdalena
- ainsaar Mare
- Anderson Joel
- Atkinson Ciara
- Avicenna Mohamad
- Barth Markus
- Benson-Greenwald Tessa
- Berent Jacques
- Bergsieker Hilary
- Biernat Monica
- Birneanu Andreea, Georgiana
- Block Katharina
- Bodinaku Blerta
- Bosak Janine
- Bosson Jennifer K.
- Branković Marija
- Burkauskas Julius
- Bąbel Przemysław
- Cheryan Sapna
- Choi Eunsoo
- Choi Incheol
- Contreras-Ibáñez Carlos C.
- Coogan Andrew
- Croft Alyssa
- Danyliuk Ivan
- Dar-Nimrod Ilan
- Dasgupta Nilanjana
- David Grijalva Isaac
- de Lemus Soledad
- Devos Thierry
- Diab Marwan
- Diekman Amanda
- Efremova Maria
- Eisner Léïla
- Eller Anja
- Erentaite Rasa
- Fedáková Denisa
- Franc Renata
- Gartzia Leire
- Gavreliuc Alin
- Gavreliuc Dana
- Gecaite-Stonciene Julija
- Germano Adriana
- Giovannelli Ilaria
- Gismondi Diaz Renzo
- Gitikhmayeva Lyudmila
- Giuseppina Pacilli Maria
- Gjoneska Biljana
- González Roberto
- Gustafsson Sendén Marie
- Güngör Derya
- Hall William W.
- Harb Charles
- Hassan Bushra
- Henningsen Levke
- Hoppe Annedore
- Hässler Tabea
- Ishii Keiko
- Jakšić Ivana
- Jasini Alba
- Jurkevičienė Jurgita
- Kelmendi Kaltrina
- Kirby Teri A.
- Kitakaji Yoko
- Kosakowska-Berezecka Natasza
- Kozytska Inna
- Kulich Clara
- Kundtová-Klocová Eva
- Kunuroglu Filiz
- Lapytskaia Aidy Christina
- Lee Albert
- Lemma Melka Tizita
- Lindqvist Anna
- Luzvinda Liany
- LÓPEZ-LÓPEZ WILSON
- Maloku Edona
- Maricchiolo Fridanna
- Martinot Delphine
- Martiny Sarah E.
- Martínez González Omar
- McNamara Rita Anne
- Meeussen Loes
- Meister Alyson
- Menkir Gizaw Abiy
- Mickuviene Narseta
- Miranda-Orrego María Isabel
- Mkamwa Thadeus
- Morandini James
- Morton Thomas
- Mrisho David
- Nikitin Jana
- Olsson Maria Ingrid Teresa
- Otten Sabine
- Page-Gould Elizabeth
- Perandrés Ana
- Pizarro Jon
- Pop-Jordanova Nada
- Pyrkosz-Pacyna Joanna
- Quta Sameir
- R. Hawi Diala
- Ramis TamilSelvan
- Rani Nitya
- Redersdorff Sandrine
- Renström Emma A.
- Rivera-Rodriguez Adrian
- Ryabichenko Tatiana
- Régner Isabelle
- Saab Rim
- Sakata Kiriko
- Samekin Adil
- Scheifele Carolin
- Schmader Toni
- Schulmeyer Marion K.
- Schuster Carolin
- Sczesny Sabine
- Sirlopú David
- Smith-Castro Vanessa
- Soo Kadri
- Spaccatini Federica
- Steele Jennifer R.
- Steffens Melanie C.
- Sucic Ines
- Sun Molly Shuyi
- Sánchez-Pachecho Tracy
- Tania Esmeralda Rocha Sánchez
- van Grootel Sanne
- Van Laar Colette
- Vandello Joseph A.
- Velásquez-Díaz Laura Maria
- Vink Melissa
- Vives Eva
- Warkineh Turuwark Zalalam
- Zhang Xiaoxiao
- Zhao Xian
- Čavojová Vladimíra
- Žeželj Iris L.
- Publication venue
- 'Wiley'
- Publication date
- 01/01/2022
- Field of study
Despite global commitments and efforts, a gender-based division of paid and unpaid work persists. To identify how psychological factors, national policies, and the broader sociocultural context contribute to this inequality, we assessed parental-leave intentions in young adults (18–30 years old) planning to have children (N = 13,942; 8,880 identified as women; 5,062 identified as men) across 37 countries that varied in parental-leave policies and societal gender equality. In all countries, women intended to take longer leave than men. National parental-leave policies and women’s political representation partially explained cross-national variations in the gender gap. Gender gaps in leave intentions were paradoxically larger in countries with more gender-egalitarian parental-leave policies (i.e., longer leave available to both fathers and mothers). Interestingly, this cross-national variation in the gender gap was driven by cross-national variations in women’s (rather than men’s) leave intentions. Financially generous leave and gender-egalitarian policies (linked to men’s higher uptake in prior research) were not associated with leave intentions in men. Rather, men’s leave intentions were related to their individual gender attitudes. Leave intentions were inversely related to career ambitions. The potential for existing policies to foster gender equality in paid and unpaid work is discussed.Gender Gap in Parental Leave Intentions: Evidence from 37 CountriespublishedVersio
Gender Gap in Parental Leave Intentions: Evidence from 37 Countries
- Author
- Aarntzen Lianne
- Adamus Magdalena
- ainsaar Mare
- Anderson Joel
- Atkinson Ciara
- Avicenna Mohamad
- Barth Markus
- Benson-Greenwald Tessa
- Berent Jacques
- Bergsieker Hilary
- Biernat Monica
- Birneanu Andreea, Georgiana
- Block Katharina
- Bodinaku Blerta
- Bosak Janine
- Bosson Jennifer K.
- Branković Marija
- Burkauskas Julius
- Bąbel Przemysław
- Cheryan Sapna
- Choi Eunsoo
- Choi Incheol
- Contreras-Ibáñez Carlos C.
- Coogan Andrew
- Croft Alyssa
- Danyliuk Ivan
- Dar-Nimrod Ilan
- Dasgupta Nilanjana
- David Grijalva Isaac
- de Lemus Soledad
- Devos Thierry
- Diab Marwan
- Diekman Amanda
- Efremova Maria
- Eisner Léïla
- Eller Anja
- Erentaite Rasa
- Fedáková Denisa
- Franc Renata
- Gartzia Leire
- Gavreliuc Alin
- Gavreliuc Dana
- Gecaite-Stonciene Julija
- Germano Adriana
- Giovannelli Ilaria
- Gismondi Diaz Renzo
- Gitikhmayeva Lyudmila
- Giuseppina Pacilli Maria
- Gjoneska Biljana
- González Roberto
- Gustafsson Sendén Marie
- Güngör Derya
- Hall William W.
- Harb Charles
- Hassan Bushra
- Henningsen Levke
- Hoppe Annedore
- Hässler Tabea
- Ishii Keiko
- Jakšić Ivana
- Jasini Alba
- Jurkevičienė Jurgita
- Kelmendi Kaltrina
- Kirby Teri A.
- Kitakaji Yoko
- Kosakowska-Berezecka Natasza
- Kozytska Inna
- Kulich Clara
- Kundtová-Klocová Eva
- Kunuroglu Filiz
- Lapytskaia Aidy Christina
- Lee Albert
- Lemma Melka Tizita
- Lindqvist Anna
- Luzvinda Liany
- LÓPEZ-LÓPEZ WILSON
- Maloku Edona
- Maricchiolo Fridanna
- Martinot Delphine
- Martiny Sarah E.
- Martínez González Omar
- McNamara Rita Anne
- Meeussen Loes
- Meister Alyson
- Menkir Gizaw Abiy
- Mickuviene Narseta
- Miranda-Orrego María Isabel
- Mkamwa Thadeus
- Morandini James
- Morton Thomas
- Mrisho David
- Nikitin Jana
- Olsson Maria Ingrid Teresa
- Otten Sabine
- Page-Gould Elizabeth
- Perandrés Ana
- Pizarro Jon
- Pop-Jordanova Nada
- Pyrkosz-Pacyna Joanna
- Quta Sameir
- R. Hawi Diala
- Ramis TamilSelvan
- Rani Nitya
- Redersdorff Sandrine
- Renström Emma A.
- Rivera-Rodriguez Adrian
- Ryabichenko Tatiana
- Régner Isabelle
- Saab Rim
- Sakata Kiriko
- Samekin Adil
- Scheifele Carolin
- Schmader Toni
- Schulmeyer Marion K.
- Schuster Carolin
- Sczesny Sabine
- Sirlopú David
- Smith-Castro Vanessa
- Soo Kadri
- Spaccatini Federica
- Steele Jennifer R.
- Steffens Melanie C.
- Sucic Ines
- Sun Molly Shuyi
- Sánchez-Pachecho Tracy
- Tania Esmeralda Rocha Sánchez
- van Grootel Sanne
- Van Laar Colette
- Vandello Joseph A.
- Velásquez-Díaz Laura Maria
- Vink Melissa
- Vives Eva
- Warkineh Turuwark Zalalam
- Zhang Xiaoxiao
- Zhao Xian
- Čavojová Vladimíra
- Žeželj Iris L.
- Publication venue
- 'Wiley'
- Publication date
- 23/01/2023
- Field of study
Despite global commitments and efforts, a gender-based division of paid and unpaid work persists. To identify how psychological factors, national policies, and the broader sociocultural context contribute to this inequality, we assessed parental-leave intentions in young adults (18–30 years old) planning to have children (N = 13,942; 8,880 identified as women; 5,062 identified as men) across 37 countries that varied in parental-leave policies and societal gender equality. In all countries, women intended to take longer leave than men. National parental-leave
policies and women’s political representation partially explained cross-national
variations in the gender gap. Gender gaps in leave intentions were paradoxically
larger in countries with more gender-egalitarian parental-leave policies (i.e., longer leave available to both fathers and mothers). Interestingly, this cross-national
variation in the gender gap was driven by cross-national variations in women’s (rather than men’s) leave intentions. Financially generous leave and gender-egalitarian policies (linked to men’s higher uptake in prior research) were not associated with leave intentions in men. Rather, men’s leave intentions were related to their individual gender attitudes. Leave intentions were inversely related to career ambitions. The potential for existing policies to foster gender equality in paid and unpaid work is discussed
Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial
- Author
- Abano Nenette
- Abbdul-saheb Mudhar
- Adedoyin Temi
- Adell Victoria
- Adesina Tolu
- Adie Katja
- Adil-Smith Jennifer
- Ahmad Nasar
- Ahmed Ashraf
- Ahmed Iman
- Al-Mayhani Talal
- Al-Shahi Salman Rustam
- Alam Mohammad Irfan
- Albazzaz Mo
- Ali Ali
- Alipio Francis
- Allen Christopher
- Allison Joanna
- Amey Isobel
- Amis Elaine
- Amlani Sageet
- Amoils Shannon
- Amor Kelly
- Anderson Rosemary
- Andole Sreeman
- Anjum Talat
- Ankolekar Sandeep
- Annamalai Arunkumar
- Anthony Alpha
- Anversha Ajmal
- Anwar Ijaz
- Anwar Sajjad
- Appleton Jason
- Argandona Lucia
- Armitage Jane
- Ashton Amy
- Atkinson Natalie
- Auld Grace
- Avis Joanne
- Aweid Basaam
- Ayres Georgina
- Azhar Khalid
- Bagnall Caroline
- Baig Farrukh
- Baigent Colin
- Bailey Duncan
- Baird Yolanda
- Bakawala Rehana
- Baker John
- Baker Pauline
- Balazikova Olga
- Balian Linda
- Baliga Vidya
- Balitska Olesia
- Ball Julie
- Ball Margaret
- Ballantine Robert
- Bamford John
- Banaras Azra
- Barber Mark
- Barbon Emma
- Barker James
- Barr Charlotte
- Barrie Elizabeth
- Barron Luke
- Barry Adrian
- Bateman Gavin
- Bates Michelle
- Bathula Rajaram
- Battersby-Wood Emma
- Bayliss Pauline
- Beadle Hannah
- Bearne Helen
- Beaty Teresa
- Beaves Emily
- Bell Angela
- Bell Jo
- Bell Murdina
- Bellfield Ruth
- Beranova Eva
- Bergin Adrian
- Bhakri Harbens
- Bhalla Ajay
- Bharaj Kiranjit
- Bhargava Maneesh
- Bhaskaran Biju
- Bhatnagar Priya
- Birchall Kathryn
- Birns Jonathan
- Black Toby
- Blades Alex
- Blair Caroline
- Blair Caroline
- Blair Gordon
- Blane Sujata
- Blank Catrin
- Blight Adrian
- Board Joanne
- Board Sarah
- Bokhari Maria
- Bond Kirsty
- Bowring Angela
- Boxall Cherish
- Breeds Joanna
- Brew Helen
- Brezitski Maria
- Bridger Hayley
- Brodie Fiona
- Brotherton Lucy
- Broughton David
- Brown Claire
- Brown Ellen
- Brown Pauline
- Brown Sarah
- Bruce David
- Buchanan David
- Buck Amanda
- Buckle Steve
- Buckle Steve
- Buckley Clare
- Bunea George
- Burger Ilse
- Burgess Laura
- Burgess Seona
- Burssens Evelyne
- Butler Adrian
- Butler Donna
- Butler Rebecca
- Butterworth-Cowin Nicola
- Button Denise
- Buxton Jean
- Byrne Anthony
- Cageao Julie
- Caine Sarah
- Campbell Robert
- Carpenter Michael
- Carpio Racquel
- Carrie Johanna
- Cassidy Tim
- Causley Chelsea
- Chadbourn Indra
- Chadha Dinesh
- Chamberlain Angela
- Chan Kelly
- Chandrakumar Aberami
- Chapman Kath
- Chapman Nicola
- Charles Bethan
- Chatterjee Kausic
- Chaudhry Afnan
- Chauhan Meena
- Chenna Srikanth
- Cherian Suja
- Cheripelli Bharath Kumar
- Chopra Neha
- Choulerton James
- Choy Lillian
- Clarke Brian
- Clarke Caroline
- Clarke Judith
- Clarke Natasha
- Clarke Rebecca
- Clarke Samantha
- Clarkson Emma
- Clay Caroline
- Clayton Susan
- Clayton-Evans Lisa
- Cluckie Gillian
- Cochrane Helen
- Codd Laura
- Cohen David
- Collins Kayleigh
- Connor Lynda
- Constantin Carmen
- Cook Angela
- Cooper Martin
- Copeland Claire
- Cosier Tracey
- Courtauld Gillian
- Couser Mandy
- Coward Lucy
- Cowie Linda
- Cox Chantel
- Cox Chloe
- Cox Penelope
- Crabtree Karen
- Crawford Pam
- Crawford Susan
- Creeden Robyn
- Crisp Sarah
- Cronin Julie
- Crook Luci
- Crosbie Caroline
- Crouch Nichola
- Crown Rachel
- Crowther Hannah
- Cuddy Sarah
- Cuenoud Larissa
- Cullen Claire
- Culmsee Charlotte
- Cunningham James
- Cunningham Mishell
- Cvoro Vera
- Dacey Lynne
- Dakin Katy
- Dallol Bander
- Dangri Puneet
- Datta Prabal
- Davey Richard
- David Anette
- David Owen
- Davies Caroline
- Davies Ruth
- Davies Silvie
- Davis Fiona
- Davis Michelle
- Day Nicola
- Dayal Nilofer
- De Berker Henry
- Deary Ann
- Denic Hayley
- Dennis MS
- Denniss Carol
- Devine Joseph
- Devitt Nicola
- Dewar Richard
- Dhakal Mahesh
- Dhar Saikat
- Dickinson Christina
- Dickson Christine
- Dima Sofia
- Dinsmore Lynn
- Dixon Lynn
- Dobson Tracey
- Dodd Angela
- Dodd Emily
- Doherty Mandy
- Doherty Mandy
- Donaldson Denise
- Donnelly Richard
- Doubal Fergus
- Dow Lindsey
- Downham Susan
- Doyle Clare
- Doyle Donna
- Drever Jonathan
- du Plessis Johannes
- Dube Judith
- Duberley Stephen
- Dunn Linda
- Dunne Karen
- Durairaj Ramesh
- Durman Helen
- Dutta Dipankar
- Dynan Kevin
- Edwards Mandy
- Egerton Shuna
- Eglinton Charlotte
- Eglinton Charlotte
- El Tawil Salwa
- Elfandi Khaled
- Elliot Jennifer
- Elliott Emma
- Ellis Sam
- Emberson Jonathan
- Emsley Hedley
- England Timothy
- Epstein Daniel
- Erande Renuka
- Erumere Esther
- Esisi Bernard
- Esisi Bernard
- Esson Derek
- Esson Derek
- Evans Rachel
- Evans Sue
- Eveson David
- Ewing Jordan
- Fathima Razik
- Fawcett Michelle
- Feerick Shez
- Fennelly Ruth
- Ferdinand Phillip
- Findlay Paul
- Finlay Sarah
- Finney Kay
- Fitzell Pauline
- Fitzsimmons Paul
- Fletcher Glyn
- Fletcher Jo
- Fong Rosanna
- Foot Jayne
- Foote Leanne
- Ford Gary
- Foster Eliza
- Fotherby Ken
- Fox Charlotte
- Francia Nina
- Francis Jobbin
- Fraser Ruth
- Fraser Ruth
- Fuller Tracy
- Fulton Ailsa
- Furnace Jacqueline
- Gadapa Naveen
- Gainard Glyn
- Gainsborough Nicola
- Gallagher Jill
- Gallagher Louise
- Gallifent Rachel
- Gamble Ed
- Garcia Tatiana
- Gardener Léjeune
- Garfield-Smith Joanne
- Garside Mark
- Gartrell Imogen
- Gascoyne Rachel
- Gattringer Thomas
- Gautam Nikki
- Gaylard Jane
- Gbadamoshi Lukuman
- Geraghty Olivia
- Ghaly George
- Ghatala Rita
- Ghosh Sandip
- Giallombardo Elio
- Gilham Ellie
- Gilmour Danielle
- Gilzeane Nicola
- Glass Jon
- Gleave Laura
- Glover Rachel
- Godfrey Margi
- Goff Anita
- Goorah Neetish
- Gott Valerie
- Gow Heather
- Graham Carol
- Graham Ruth
- Gray Jane
- Green Carole
- Greenwood Richard
- Gregory Bindu
- Greig Jill
- Grimwood Gemma
- Grocott Jeanette
- Grue Rebecca
- Gulliver Diane
- Guo Fenglin
- Gupwell Karin
- Guthrie Lucy Belle
- Guy Helen
- Guyler Paul
- Hague Adam
- Haider Syed
- Hairsine Brigid
- Hakim Eluzai
- Hall Andrea
- Halse Omid
- Handley Dominic
- Hann Gail
- Hannon Niamh
- Hansen Christian
- Haque Mohammad
- Hardwick Anne
- Harkness Kirsty
- Harrington Frances
- Harrington-Davies Yasmin
- Harrison Louise
- Harrison Melanie
- Harrison Thomas
- Harston George
- Harvey Kirsten
- Harvey Miriam
- Hassan Ahamad
- Hassan Hardi
- Havard Diane
- Hayes Anne
- Hayhoe Helen
- Hayman Rachel
- Hays Carole
- Hazel Beth
- Hedstrom Amanda
- Hedstrom Amanda
- Hemsley Anthony
- Henry Margo
- Herman Jane
- Hervey Simon
- Hewitt Jonathan
- Hiden Joanne
- Hogan Caroline
- Hogg Valerie
- Holden Melinda
- Holmes Clare
- Homan Jane
- Hooley Michaela
- Horan Kathleen
- Horton Sarah
- Hostettler Isabel
- Hove Dionne
- Howaniec Laura
- Howard Gabriella
- Howard Joanne
- Howard Peter
- Howcroft Deborah
- Howe Jo
- Huang Xuya
- Huggett Isabel
- Hughes Chloe
- Hughes Claire
- Hughes Tom
- Humphreys Louise
- Humphries Fiona
- Hunt Benjamin
- Hunt Nicholas
- Hunter Annemarie
- Hunter Neil
- Hurford Frances
- Hurley Jennifer
- Hussain Malik
- Hutchison Aidan
- Hyams Benjamin
- Hyatt Lisa
- Imam Javed
- Ingham Andrea
- Ingram Tanya
- Innes Karen
- Iqbal Arshi
- Iqbal Mohammad Shahzad
- Irvine Janice
- Ispoglou Sissy
- Ivatts Simone
- Jackson Benjamin
- Jackson Linda
- Jagger Jenny
- Jagpal Baljit
- James Ali
- James Claire
- James Martin
- Jarapa Rowilson
- Jarrett David
- Jeffs Carol
- Jelley Benjamin
- Jenkins Colin
- Jennings-Preece Karla
- Jeyaraj Naomi
- Jha Ratneshwari
- Jinks Emma
- Johnes Mary
- Johnson Sharon
- Jones Ifan
- Jones Ifan
- Jones Kirsty
- Jones Rachael
- Jones Stephanie
- Jones Terry
- Jones Val
- Jordan Carla
- Jose Deepa
- Jose Josin
- Joshi Yogish
- Joyson Anu
- Jupp Becky
- Justin Frances
- Kakar Puneet
- Kalathil Latheef
- Kalladka Dheeraj
- Kamara Christine
- Kambafwile Mary
- Kane Ingrid
- Kar Arindam
- Keegan Breffni
- Keeling Elizabeth
- Keenan Samantha
- Kelavkar Shyam
- Kelly Christine
- Kelly Debs
- Kelly Jim
- Kelly Siobhan
- Keltos Marketa
- Kennedy James
- Kennedy Kate
- Kenton Antony
- Kerin Lourda
- Kerr Enda
- Kerr Gillian
- Keshvara Rekha
- Khan Mohammad
- Khan Shagufta
- Khan Usman
- Khan Uzma
- Kibutu Faith
- King Sam
- Kingwell Hayley
- Kini Manohar
- Klaasen Katrina
- Knops Kerstin
- Krishnamoorthy Shrivakumar
- Krishnamurthy Ramesh
- Krishnamurthy Vinodh
- Krishnan Kailash
- Krishnan Manju
- Krommyda Magdalini
- Kullane Sagal
- Kumar Balakrishna
- Kumar Pradeep
- Kunhunny Swapna
- Lam Man Yee
- Lambert Caroline
- Landers Geraldine
- Langhorne Peter
- Lasserson Daniel
- Latter Laura
- Law Zhe
- Lawrence Tara
- Lawson Heidi
- Leason Sandra
- Lee Stephanie
- Leggett Jacqui
- Lenti Giulia
- Lerpiniere Christine
- Lerpiniere Christine
- Licenik Radim
- Lindert Ralf
- Little Victoria
- Littleton Edward
- Ljubez Anja
- Loganathan Thayalini
- Longland Barbara
- Lopez Paula
- Lovelock Caroline
- Lowe Gordon
- Lucas Linda
- Lucas Suzanne
- Luder Robert
- Lyjko Sue
- Maanoosi Mehran
- Maatouk Ahmad
- Macaden Ashish
- MacInnes Brian
- MacLennan Beverly
- MacLeod Mary
- Macleod MR
- MacLiver Linda
- MacRaild Allan
- Maddula Mohana
- Madigan Barbara
- Maguire Holly
- Maguire Stuart
- Maiden Susan
- Majis Arshad
- Majmudar Nikhil
- Makawa Linetty
- Mangion David
- Manning Lisa
- Manoj Aravind
- Mardania Rina
- Marigold James Richard
- Markova Skarlet
- Marks Katherine
- Marsden Tracy
- Marshall Sally
- Martin Irene
- Mashate Sheila
- Mason Cathy
- Mate Abhijit
- Mathieson Philip
- Matias Oliver
- Matthews Christopher
- Maund Bev
- McAlpine Christine
- McArdle Damian
- Mcauley Sean
- McCann Stephanie
- McCarron Mark
- McClelland Beverley
- McCormick Katrina
- McCormick Katrina
- McDonald Shanni
- McDonald Susan
- Mcgee Joanne
- McGhee Caroline
- McGill Connor
- McGrath Aileen
- McIlmoyle James
- McKee Jacqueline
- McLoughlin Alison
- McVerry Ferghal
- Mead Denise
- Mead Gillian
- Meir Julie
- Menon Nisha
- Mercer Lily
- Metcalf Kneale
- Miller Keniesha
- Miller Richard
- Milligan Josette
- Minks David
- Miriam Skelton
- Mistri Amit
- Mitchell Jennifer
- Mitra Dipayan
- Mohammed Niaz
- Mohd Nor Azlisham
- Mokoena Betty
- Moores Andrew
- Moqsith Mohammed
- Morell Jordi
- Moreton Fiona
- Morgan Debbie
- Moroney Helen
- Morse Bethan
- Moseley Sally
- Motherwell Nichola
- Moynihan Barry
- Mpelembue Mushiya
- Mudd Paul
- Muddegowda Girish
- Muir Keith
- Mukherjee Indranil
- Murali Elodie
- Murphy Peter
- Murray GD
- Musarrat Kashif
- Myint Min
- Naeem Muhammad
- Naing Zin
- Nair Anand
- Nallasivan Arumugam
- Nasar Mohammad
- Nasim Ashraf
- Naylor Charde
- Needle Ann
- Nelson Sandra
- Newby DE
- Newton Sophie
- Ng Kheng Xiong
- Ngo David
- Nguyen Vinh
- Ngwako Mmua
- Ni Hlaing
- Nicholas Paul
- Nicolson Anne
- Niranchanan Rangah
- Nisar Nabeela
- Njoku Kelechi
- Nott Claire
- Nott Claire
- Nozedar Tarn
- Nyabadza Sheila
- O'Brien Eoin
- O'Brien Richard
- O'Brien Richard
- O'Connell Janice
- O'Connell Susan
- O'Loughlin Victoria
- O'Reilly Joanna
- O'Toole Sarah
- Oji Nnebuife
- Orath Prabakaran Rajalakshmi
- Orefo Chukwuka
- Orugun Enoch
- Osborn Mairead
- Osborne Emily
- Oshodi Anne
- Osman Ahmed
- Ovington Catherine
- Owings Paula
- Owoyele Emmanuelle
- Owusu-Agyei Peter
- Pai Yogish
- Palmer Jeb
- Papavasileiou Vasileios
- Parakramawansha Ruwan
- Parker Richard
- Parry Anthea
- Parry-Jones Adrian
- Pasco Kath
- Patel Bhavini
- Patel Champa
- Patel Farzana
- Patel Krishna
- Patterson Chris
- Paulton Ruth
- Pawley Corinne
- Peixoto Cassilda
- Penge Justin
- Perez Jane
- Perfitt Rebekah
- Perkins Charlotte
- Perry David
- Perry Jack
- Persad Nicola
- Peters Jenny
- Pettitt Kerry
- Phiri Duke
- Pitt-Ford Alexandra
- Pitt-Kerby Tressy
- Plewa Catherine
- Poku Philip
- Ponnambath Suheil
- Poultney Una
- Pound Susan
- Power Michael
- Pressly Vanessa
- Price Fiona
- Proeschel Harald
- Punekar Shuja
- Punter Martin
- Pusalkar Aparna
- Putterill Janet
- Quinn Leanne
- Quinn Outi
- Qureshi Sammie
- Ragab Suzanne
- Raghunathan Senthil
- Rahman Bithi
- Rai Baljinder
- Raj Sonia
- Rajapakse Anoja
- Rajkumar Chakravarthi
- Ramachandran Sankaranarayana
- Ramadan Hawraman
- Ramshaw Alex
- Rana Pratap
- Randall Marc
- Rashed Khalid
- Rashmi Sindhu
- Ravenhill Garth
- Rayessa Rayessa
- Reckless Ian
- Reddan Julie
- Reddan Julie
- Redgrave Jessica
- Redjep Ozlem
- Remegoso Alda
- Richard Bella
- Richards Emma
- Rinkel Gabriel
- Roberts Josh
- Robinson Matthew
- Robinson Naomi
- Rodgers Alicia
- Rodriguez Aryelly
- Roffe Christine
- Roffe Jack
- Roganova Tatjana
- Rogers Emily
- Rogers Gill
- Rojas Javier
- Ross Sarah
- Roughan Caroline
- Rudd Tony
- Rudenko Hannah
- Saada Janak
- Saastamoinen Kari
- Sajid Mahmud
- Sakka Eleni
- Salehin Maqsud
- Salek-Haddadi Afraim
- Salih Isam
- Sally Moore
- Sandercock PAG
- Sangombe Mirriam
- Sangster Graeme
- Sanyal Ranjan
- Sarah Procter
- Sarah Procter
- Sattar Naweed
- Sattar Saira
- Saulat Afaq
- Saulat Afaq
- Schofield Christine
- Schulz Ursula
- Schumacher Natasha
- Schwarz Stefan
- Seagrave Samantha
- Sekaran Lakshmanan
- Sesay Juliana
- Sethuraman Sakthivel
- Shackcloth Daniela
- Shah Alex
- Shah Sweni
- Shahmehri Shahrzad
- Sharma Nikhil
- Sharpe Simon
- Shaw Kelly Marie
- Shaw Louise
- Sheikh Saima
- Shekhar Raj
- Shelton Faye
- Shinh Naval
- Shread Ian
- Shukla Avani
- Siddegowda Prasad
- Siddiq Muhammad
- Siddiqui Amber
- Siddiqui Anwer
- Sigsworth Andrew
- Simon Rohan
- Sims Don
- Singh Arun
- Sinha Devesh
- Skinner Helen
- Slade Peter
- Smart Amanda
- Smith Andrew
- Smith Fiona
- Smith Gemma Marie
- Smith Simon
- Smith Wilma
- Smyth Nigel
- Spencer Jayne
- Sprigg N
- Srinivasan Meena
- Stafford Samantha
- Stafford Samantha
- Stanners Andrew
- Steele Amy
- Stephen J
- Stephens Claire
- Stevens Angela
- Stevens Stephanie
- Stevenson Sarah
- Stewart Kelvin
- Stocks Kathy
- Stone Andrew
- Storton Sharon
- Strain David
- Subramonian Santhosh
- Sudlow CLM
- Sukdeo Varthi
- Sullivan Frank
- Sultan Sulaiman
- Suttling Anne
- Sutton Claire
- Sutton Patrick
- Sutton Victoria
- Sword Jane
- Sykes Lucy
- Symonds Stuart
- Szabo Susan
- Tallantyre Emma
- Tanate Alfonso
- Tandy Jane
- Tate Margaret
- Tauro Suzanne
- Tayler Michelle
- Taylor Pat
- Taylor Vicky
- Teal Rachel
- Temple Natalie
- Thant Hlaing
- Thavanesan Kamy
- Thomas Isobel
- Thomas Kelly
- Thomas Philip
- Thomas Sarah
- Thompson Philip
- Thompson Susan
- Thompson Teresa
- Thompson-Jones Helen
- Thomson Audrey
- Thornthwaite Sarah
- Thorpe Kevin
- Tilley Victoria
- Tiwari Divya
- Tomlin Dawn
- Tomlinson Benjamin
- Treadwell Shelley
- Tribbeck Michele
- Trippier Sarah
- Triscott Claire
- Triscott Claire
- Tryambake Dinesh
- Tucker Laura
- Tucker Susan
- Turfrey Jennifer
- Tysoe Sharon
- Ullah Khalil
- Valentine Stacey
- van Someren Chloe
- Varquez Resti
- Vasileiadis Evangelos
- Vassallo Joseph
- Venter Marius
- Veraque Emelda
- Verrion Anna
- Vettimootal Johnson Venetia
- Vickers Carinna
- Walford Jamie
- Walker Allan
- Walker Marion
- Walker Pauli
- Walker Susannah
- Wallace Aine
- Wallace Rebecca
- Wallace Rebecca
- Walstow Deborah
- Walter Deborah
- Walters Ashleigh
- Wani Mushtaq
- Ward Deborah
- Wardlaw JM
- Watchurst Caroline
- Waterfield Kelly
- Waterfield Kelly
- Watson Fran
- Waugh Dean
- Webb Tom
- Webber Adam
- Webster Timothy
- Weinling Marie
- Weir Nic
- Weir Pauline
- Welch Angela
- Werring DJ
- Whitcher Alison
- White James
- White Julie
- White PM
- White Susan
- Whiteley WN
- Whiteman Jessica
- Whiteman Jessica
- Whiting Robert
- Whittamore Katherine
- Wiggam Ivan
- Wilding Peter
- Wilkes Gwendoline
- Wilkinson Mark
- Willberry Angela
- Williams Carol
- Williams Rebecca
- Williams-Yesson Barbara
- Willmot Mark
- Wilson David
- Wilson Duncan
- Wilson Jenny
- Wilson Lisa
- Wilson Sarah
- Wiltshire Alison
- Wood Diane
- Wood Edith
- Wood Lisa
- Woodward Stephen
- Wright Fiona
- Wroath Belinda
- Wynter Inez
- Yadava Rajendra
- Yip Brigitte
- Young Andrew
- Zachariah George
- Zahoor Tajammal
- Zoe Mellor
- Publication venue
- 'Elsevier BV'
- Publication date
- 29/06/2019
- Field of study
Background:
Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events.
Methods:
The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627).
Findings:
Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92).
Interpretation:
These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention
Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial
- Author
- Abano Nenette
- Abbdul-saheb Mudhar
- Adedoyin Temi
- Adell Victoria
- Adesina Tolu
- Adie Katja
- Adil-Smith Jennifer
- Ahmad Nasar
- Ahmed Ashraf
- Ahmed Iman
- Al-Mayhani Talal
- Al-Shahi Salman Rustam
- Alam Mohammad Irfan
- Albazzaz Mo
- Ali Ali
- Alipio Francis
- Allen Christopher
- Allison Joanna
- Amey Isobel
- Amis Elaine
- Amlani Sageet
- Amoils Shannon
- Amor Kelly
- Anderson Rosemary
- Andole Sreeman
- Anjum Talat
- Ankolekar Sandeep
- Annamalai Arunkumar
- Anthony Alpha
- Anversha Ajmal
- Anwar Ijaz
- Anwar Sajjad
- Appleton Jason
- Argandona Lucia
- Armitage Jane
- Ashton Amy
- Atkinson Natalie
- Auld Grace
- Avis Joanne
- Aweid Basaam
- Ayres Georgina
- Azhar Khalid
- Bagnall Caroline
- Baig Farrukh
- Baigent Colin
- Bailey Duncan
- Baird Yolanda
- Bakawala Rehana
- Baker John
- Baker Pauline
- Balazikova Olga
- Balian Linda
- Baliga Vidya
- Balitska Olesia
- Ball Julie
- Ball Margaret
- Ballantine Robert
- Bamford John
- Banaras Azra
- Barber Mark
- Barbon Emma
- Barker James
- Barr Charlotte
- Barrie Elizabeth
- Barron Luke
- Barry Adrian
- Bateman Gavin
- Bates Michelle
- Bathula Rajaram
- Battersby-Wood Emma
- Bayliss Pauline
- Beadle Hannah
- Bearne Helen
- Beaty Teresa
- Beaves Emily
- Bell Angela
- Bell Jo
- Bell Murdina
- Bellfield Ruth
- Beranova Eva
- Bergin Adrian
- Bhakri Harbens
- Bhalla Ajay
- Bharaj Kiranjit
- Bhargava Maneesh
- Bhaskaran Biju
- Bhatnagar Priya
- Birchall Kathryn
- Birns Jonathan
- Black Toby
- Blades Alex
- Blair Caroline
- Blair Caroline
- Blair Gordon
- Blane Sujata
- Blank Catrin
- Blight Adrian
- Board Joanne
- Board Sarah
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- Bond Kirsty
- Bowring Angela
- Boxall Cherish
- Breeds Joanna
- Brew Helen
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- Epstein Daniel
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- Wallace Rebecca
- Wallace Rebecca
- Walstow Deborah
- Walter Deborah
- Walters Ashleigh
- Wani Mushtaq
- Ward Deborah
- Wardlaw JM
- Watchurst Caroline
- Waterfield Kelly
- Waterfield Kelly
- Watson Fran
- Waugh Dean
- Webb Tom
- Webber Adam
- Webster Timothy
- Weinling Marie
- Weir Nic
- Weir Pauline
- Welch Angela
- Werring DJ
- Whitcher Alison
- White James
- White Julie
- White PM
- White Susan
- Whiteley WN
- Whiteman Jessica
- Whiteman Jessica
- Whiting Robert
- Whittamore Katherine
- Wiggam Ivan
- Wilding Peter
- Wilkes Gwendoline
- Wilkinson Mark
- Willberry Angela
- Williams Carol
- Williams Rebecca
- Williams-Yesson Barbara
- Willmot Mark
- Wilson David
- Wilson Duncan
- Wilson Jenny
- Wilson Lisa
- Wilson Sarah
- Wiltshire Alison
- Wood Diane
- Wood Edith
- Wood Lisa
- Woodward Stephen
- Wright Fiona
- Wroath Belinda
- Wynter Inez
- Yadava Rajendra
- Yip Brigitte
- Young Andrew
- Zachariah George
- Zahoor Tajammal
- Zoe Mellor
- Publication venue
- 'Elsevier BV'
- Publication date
- 29/06/2019
- Field of study
Background:
Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events.
Methods:
The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627).
Findings:
Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92).
Interpretation:
These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention
Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries
- Author
- Aamir Faiqa Binte
- Aamir Syed Roohan
- Ababneh Adnan
- Abbal Muhammad Anas
- Abbas Ahmed M
- Abbas Mostafa
- Abd-Albain Montasir A
- Abdalei Abdulwahab
- Abdalla Ahmed
- Abdalla Ahmed Yassir
- Abdalla Mohamed Galal Ali
- Abdalla Zainab
- Abdallah Mohamed M
- Abdalmahmoud Noon Ezzeldien
- Abdalsadeg Rowa
- Abdelaal Ahmed M
- Abdelbagi Alnazeer Y
- Abdelbaky Mostafa
- Abdelbaset Doaa
- AbdElbaset Esraa
- Abdelbast Menhag
- Abdelfatah Mohammed Abdelnasser
- Abdelgawad Samia
- Abdelhamid Mohamed M
- Abdeljaber Mahmoud
- Abdelkhalig Mubarak
- Abdelmaksoud Mohamed
- Abdelmeguid Rana
- Abdelmelek Dhia Errahmane
- Abdelnaeam Samah
- Abdelnasser Mohammad K
- Abdelrahim Najwa
- Abdelrahman Amira
- Abdelrahman Ayman
- Abdelsalam Hebatalla
- Abdelsamed Enas Abdelbaset
- Abdelwahab Khaled
- Abdoun Meriem
- Abdulali Fatima
- Abdulaziz Mohamed
- Abdulla Dheba Almukhtar
- Abdullah Bahiyah
- Abdullah Bahiyah
- Abdullah Walaa
- Abdullahi Habiba Ibrahim
- Abdulrahman Ahmed
- Abdulrasheed Lubabatu
- Abdulwahed Eman
- Abdulwahed Eman
- Abeysirigunawardana Dewmi
- Abidin Muhammad Fihmi Zainal
- Abiola Olukayode
- Abiyere Henry
- Abodina Ahmed Mohammed
- Aboelela Reham
- AboElfarh Hadeer Elsaeed
- Aboudlal Husein
- AbouHiekal Osama
- Aboulfotouh Ahmed
- Abozid Anwaar
- Abubaker Noora
- Abubaker Noora
- Abufanas Asma
- Abughanima Mahmoud
- Abuhashem Shehab
- Abulafia Daniel
- Abushaala Fatima
- Abushanab Khaled
- AbuShawareb Issa
- Abuuqteish Hamza
- Abuzaho Amany
- Achem Arome
- Adam Eithar
- Adam Mohammed
- Adam Mohammed A
- Addalla Mohamed
- Addley Jordan
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- Zaed Moahmed
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- Zaheer Adil
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- Zakaria Ahmed
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- Zakaria Mohd Zaim
- Zalloum Jihad
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- Zambon Mattia
- Zapsalis Konstantinos
- Zargar Kamran
- Zarzour Mohamed A
- Zeng Raymond
- Zeng Raymond
- Zengin Kagan
- Zertuche Juventino Tadeo Guerrero
- Zhang Caitlin
- Zhang Edward
- Zhang Shane
- Zhang Yichi
- Zhao Hailin
- Zheng Helen
- Zhou Karen
- Zhou Yida
- Ziergiebel Felix
- Zou Peishan
- Zuylekom Kate Van
- Zuylekom Katie Van
- Zwain Yasir Adnan
- Zyul'korneeva Sof'ya
- Aladna Abdallah
- Aljoumaa Abdullah
- Nawfal Hamdi
- Niazi Ammar
- Publication venue
- Publication date
- 01/01/2024
- Field of study
Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely
Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study
- Author
- Aahlin Eirik Kjus
- Aamer Ahmed
- Aaniana Kenneth
- Ababneh Ali
- Abaliksta Tomas
- Abantanga Francis
- Abbas Athar
- Abbasy Jibran
- Abbo Olivier
- Abbott Tom
- Abbouch Meryem
- Abd El-Latif Nadia Khalid
- Abd Elkhalek Esraa
- Abd-Elmawla Manar
- Abdallah Emad
- Abdel-Aty Abdulrahman
- Abdel-Hameed Noran
- Abdel-Kader Sara Mahmoud
- Abdelaal Abdelaziz
- Abdelaty Mohamed
- Abdelazeam Anan Rady
- Abdelazim Galaleldin
- Abdelaziz Mohamed A
- Abdelbadeai Kholoud
- Abdelfatah Afnan
- Abdelhady Samar
- Abdelhamed Rasha
- Abdelhamid Amina
- Abdelhaq Aram
- Abdelkader Mostafa
- Abdelkader Omar
- Abdelkhalek Mohamed
- Abdelmageed Eman
- Abdelmotaleb Ibrahem
- Abdelraouf Ahmed Mahmoud
- Abdelrouf Doaa Maher
- Abdelshakour Mahmoud
- Abdrabou Abdulshafi Khaled
- Abdul-Latif Saiba
- Abdulaziz Hager
- Abdulaziz Mustafa
- Abdulbagi Omar
- Abdulhakeem Eman Mahmoud
- Abdullah Mohamed Abozed
- Abdullah Nik Azim Nik
- Abdullah Noha
- Abdullahi Lawal
- Abdurrazzaaq Abdussemiu
- Abem Owusu Emmanuel
- Abiola Olajide
- Aboelella Majed
- Aboelmagd Omnia
- Aboelsoud Moustafa R
- Aboul-Naga Mariam Saad
- Abouzaid Arwa
- Abu Qumbos Amjad
- Abu-toyour Maram
- Abubakr Marwan
- Abuowda Yousef
- Abuqwaider Eman
- Abusalem Lana
- Abushamleh Soha
- Ackom Eric
- Acquah Emmanuel
- Adam Ali
- Adam Nourhan
- Adamu Ahmed
- Adawi Ihdaa
- Adawi Mohammad
- Adebanjo Ademola
- Adebola Oluwaseyi
- Adedeji Adesina
- Adel Badr Eldin
- Adel Israa
- Adella Fidelis Jacklyn
- Adelshone Abdelrahman
- Ademuyiwa Adesoji
- Ademuyiwa Adesoji O
- Ademuyiwa Adesoji O
- Adenekan Babajide
- Adeniran James
- Adeniyi Adewale
- Adesanya Opeoluwa
- Adesina Alaba
- Adeyeye Ademola
- Adeyeye Ademola
- Adhitama Novia
- Adil Muhammad
- Adisa Adewale O
- Adiyaman Can
- Adu-Aryee Niiarmah
- Afana Samah
- Agalianos Christos
- Agarwal Arnav
- Agarwal Arnav
- Agbedinu Kwabena
- Aglan Amro
- Aguado Suarez Nuria
- Aguilera Maria Lorena
- Aguilera Maria Lorena
- Aguilera-Arevalo Maria-Lorena
- Ahlonsou Germain
- Ahlqvist Sandra
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- Upadhyaya Vijaid
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- Wijayarathna LS
- Williams Omolara
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- Wilson Michael
- Wilson Michael
- Wimalge PMSN
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- Wolf Bernhard
- Wondoh Paul
- Wondoh Paul
- Wong Chui Yee
- Wong Francisca
- Wong Hong Yee
- Wood Greta
- Worku Mengistu
- Worku Tewodros
- Wright Naomi
- Yahaya Muhammad Taqiyuddin
- Yakubu Musah
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- Yang James
- Yap Suhhuey
- Yau Jih Dar
- Ye Joselyn
- Yeang Li Jing
- Yeung Man Hon Andrew
- Yifieyeh Abiboye
- Yildirim Reyyan
- Yip Chingwan
- Ymeri Shpetim
- Yoganathan Pigeneswaren
- Yolcu Sinem
- Yong Guo Liang
- Younis Abobaker
- Youssef Mohamed
- Yuksek Mahmut Arif
- Yusufali Taha
- Zaa'treh Rula
- Zadoroznas Antanas
- Zahran Diaaaldin
- Zakaria Esraay
- Zakaria Mahmoud
- Zakaria Yehia
- Zaki Ahmed
- Zammit Stefan
- Zampitis Nikolaos
- Zani Augusto
- Zani Augusto
- Zanini Nicola
- Zapata Felipe
- Zarb Ciskje
- Zeta Solis Ludwing Alexander
- Zielinski Martin
- Zilinskas Justas
- Zilinskas Justas
- Zilinskas Justas
- Zilinskiene Reda
- Ziubryte Greta
- Zohair Ahmed
- Zuber Markus
- Zuk Grzegorz
- Zulkifli Athirah
- Zumbuhl Lucius
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2018
- Field of study
Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world.
Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231.
Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001).
Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication
Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial
- Author
- Aberami Chandrakumar
- Abhijit Mate
- Adam Hague
- Adam Webber
- Adrian Barry
- Adrian Bergin
- Adrian Blight
- Adrian Butler
- Adrian Parry-Jones
- Afaq Saulat
- Afaq Saulat
- Afnan Chaudhry
- Afraim Salek-Haddadi
- Aguilar
- Ahamad Hassan
- Ahmad Maatouk
- Ahmed Osman
- Aidan Hutchison
- Aileen McGrath
- Ailsa Fulton
- Aine Wallace
- Ajay Bhalla
- Ajmal Anversha
- Al-Shahi Salman
- Al-Shahi Salman
- Al-Shahi Salman
- Alda Remegoso
- Alex Blades
- Alex Ramshaw
- Alex Shah
- Alexandra Pitt-Ford
- Alfonso Tanate
- Ali Ali
- Ali James
- Alicia Rodgers
- Alison McLoughlin
- Alison Whitcher
- Alison Wiltshire
- Allan MacRaild
- Allan Walker
- Alpha Anthony
- Amanda Buck
- Amanda Hedstrom
- Amanda Hedstrom
- Amanda Smart
- Amber Siddiqui
- Amit Mistri
- Amy Ashton
- Amy Steele
- Anand Nair
- Andrea Hall
- Andrea Ingham
- Andrew Moores
- Andrew Sigsworth
- Andrew Smith
- Andrew Stanners
- Andrew Stone
- Andrew Young
- Anette David
- Angela Bell
- Angela Bowring
- Angela Chamberlain
- Angela Cook
- Angela Dodd
- Angela Stevens
- Angela Welch
- Angela Willberry
- Anita Goff
- Anja Ljubez
- Ann Deary
- Ann Needle
- Anna Verrion
- Anne Hardwick
- Anne Hayes
- Anne Nicolson
- Anne Oshodi
- Anne Suttling
- Annemarie Hunter
- Anoja Rajapakse
- Anthea Parry
- Anthony Byrne
- Anthony Hemsley
- Antony Kenton
- Anu Joyson
- Anwer Siddiqui
- Aparna Pusalkar
- Aravind Manoj
- Arindam Kar
- Arshad Majis
- Arshi Iqbal
- Arumugam Nallasivan
- Arun Singh
- Arunkumar Annamalai
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- Sarah Ross
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- Sarah Thornthwaite
- Sarah Trippier
- Sarah Wilson
- Sean Mcauley
- Senthil Raghunathan
- Seona Burgess
- Shagufta Khan
- Shahrzad Shahmehri
- Shanni McDonald
- Shannon Amoils
- Sharon Johnson
- Sharon Storton
- Sharon Tysoe
- Sheila Mashate
- Sheila Nyabadza
- Shelley Treadwell
- Shez Feerick
- Shrivakumar Krishnamoorthy
- Shuja Punekar
- Shuna Egerton
- Shyam Kelavkar
- Silvie Davies
- Simon Hervey
- Simon Sharpe
- Simon Smith
- Simone Ivatts
- Sindhu Rashmi
- Siobhan Kelly
- Sissy Ispoglou
- Skarlet Markova
- Skelton Miriam
- Sofia Dima
- Sonia Raj
- Sophie Newton
- Sreeman Andole
- Srikanth Chenna
- Stacey Valentine
- Stefan Schwarz
- Steiner
- Steinhubl
- Stephanie Jones
- Stephanie Lee
- Stephanie McCann
- Stephanie Stevens
- Stephen Duberley
- Stephen Woodward
- Steve Buckle
- Steve Buckle
- Stuart Maguire
- Stuart Symonds
- Sue Evans
- Sue Lyjko
- Suheil Ponnambath
- Suja Cherian
- Sujata Blane
- Sulaiman Sultan
- Susan Clayton
- Susan Crawford
- Susan Downham
- Susan Maiden
- Susan McDonald
- Susan O'Connell
- Susan Pound
- Susan Szabo
- Susan Thompson
- Susan Tucker
- Susan White
- Susannah Walker
- Suzanne Lucas
- Suzanne Ragab
- Suzanne Tauro
- Swapna Kunhunny
- Sweni Shah
- Syed Haider
- Tajammal Zahoor
- Talal Al-Mayhani
- Talat Anjum
- Tanya Ingram
- Tara Lawrence
- Tarn Nozedar
- Tatiana Garcia
- Tatjana Roganova
- Temi Adedoyin
- Teo
- Teresa Beaty
- Teresa Thompson
- Terry Jones
- Thayalini Loganathan
- Thomas Gattringer
- Thomas Harrison
- Tim Cassidy
- Timothy England
- Timothy Webster
- Toby Black
- Tolu Adesina
- Tom Hughes
- Tom Webb
- Tony Rudd
- Tracey Cosier
- Tracey Dobson
- Tracy Fuller
- Tracy Marsden
- Tressy Pitt-Kerby
- Una Poultney
- Ursula Schulz
- Usman Khan
- Uzma Khan
- Val Jones
- Valerie Gott
- Valerie Hogg
- van Asch
- Vanessa Pressly
- Varthi Sukdeo
- Vasileios Papavasileiou
- Venetia Vettimootal Johnson
- Vera Cvoro
- Vicky Taylor
- Victoria Adell
- Victoria Little
- Victoria O'Loughlin
- Victoria Sutton
- Victoria Tilley
- Vidya Baliga
- Vinh Nguyen
- Vinodh Krishnamurthy
- Wilma Smith
- WN Whiteley
- Wong
- Wood
- Xuya Huang
- Yasmin Harrington-Davies
- Yogish Joshi
- Yogish Pai
- Yolanda Baird
- Zhe Law
- Zin Naing
- Publication venue
- 'Elsevier BV'
- Publication date
- 21/05/2019
- Field of study
BACKGROUND: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. METHODS: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). FINDINGS: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29-146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0- 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25-1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39-1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65-1·60]; p=0·92). INTERPRETATION: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention. FUNDING: British Heart Foundation
31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two
- Author
- Abassi Yama
- Abelin Jennifer G
- Abolhalaj Milad
- Abraham Tara S
- Adam Ammar
- Adams David
- Adams Homer
- Adams Sarah F
- Adamus Tomasz
- Addepalli Murali
- Addepalli Murali
- Adjei Alex A
- Agapova Larissa
- Agarwala Sanjiv
- Ager Casey
- Aggarwal Charu
- Agnello Giulia
- Agudo Judith
- Aguilar Ethan G
- Aguilera Todd
- Ahamadi Malidi
- Ahn Yong-Oon
- Ahrens Eric T
- Aizer Ayal
- Ajina Reham
- Akerley Wallace
- Al-Muftah Mariam
- Albershardt Tina C
- Albershardt Tina C
- Albrekt Ann-Sofie
- Alekar Shilpa
- Alemany Ramon
- Alemany Ramon
- Alexander Brian
- Allbritton Omaira
- Allen Clint T
- Alley Evan W
- Allison James
- Allison James
- Allison James
- Alston Tesha
- Alt Jürgen
- Alters Susan
- Amatulli Michael
- Anand Snjezana
- Anand Snjezana
- Anand Snjezana
- Anderson Clark
- Anderson Mark
- Andersson Bengt
- Andre Pascale
- Andtbacka Robert H I
- Andtbacka Robert H I
- Angiuoli Sam
- Ansari Tameem
- Anthony Scott
- Antonarakis Emmanuel S
- Antonia Scott J
- Anwar Firoz
- Aquino-Michaels Keston
- Archer Jacob F
- Arina Ainhoa
- Armand Philippe
- Armenta Paul
- Armet Caroline M
- Arnoux Thomas
- Ascarateil Stephane
- Askmyr David
- Atkins Michael
- Atkins Michael B
- Atkinson Victoria
- Au Katrina
- Autio Karen A
- Awad Mark
- Bagarazzi Mark
- Bai Dina
- Baia Gilson
- Baird Jason
- Bajaj Anshika
- Balatoni Timea
- Balboni Tracy
- Balch Leslie
- Bang Andrew
- Bao Riyue
- Bao Yangyi
- Bao Yangyi
- Barakat David
- Barberi Theresa
- Barker Christopher A
- Barnea Eytan
- Barras David
- Bartkowiak Todd
- Bartlett David
- Bartlett David
- Bartlett David
- Bartlett David
- Barton Sunjay M
- Barve Minal
- Bauer Todd
- Bauer Todd W
- Bauman Julie
- Baumgaertner Petra
- Bauml Joshua
- Beceren-Braun Figen
- Beck Kristen
- Becker Annette
- Beckers Johannes
- Beckett Michael A
- Bedognetti Davide
- Bedognetti Davide
- Bedognetti Davide
- Bell Bryan
- Bell Charles J M
- Bell Peter
- Beltran Pedro
- Bender Lewis H
- Bender Steven
- Bennett Mark K
- Benz Steven
- Bera Tapan
- Berglund Peter
- Berglund Peter
- Berkey Sara
- Bernatchez Chantale
- Berry John S
- Berzofsky Jay A
- Bhardwaj Nina
- Bian Zhen
- Bianco Alberto
- Biediger Ronald J
- Bifulco Carlo
- Bigley Alison
- Bingham Patrick
- Biniszkiewicz Detlev M
- Bischoff Helge
- Blake Zoe
- Blake Zoe
- Blakely Collin
- Blazar Bruce R
- Blogowski Wojciech
- Bloom Anja C
- Boehm Jesse
- Bokovanov Vladimir
- Bommareddy Praveen K
- Bommareddy Praveen K
- Bommareddy Praveen K
- Bommareddy Praveen K
- Booth Jamie
- Bornschlegl Svetlana
- Bose Nandita
- Bossenmaier Birgit
- Boughorbel Sabri
- Boyer Jean
- Bramante Simona
- Branstetter Daniel
- Brech Dorothee
- Brenin David
- Broaddus V. C
- Brockstedt Dirk G
- Brockstedt Dirk G
- Brody Joshua
- Bronson Roderick
- Brooks Alan
- Brooks Alan D
- Broucek Joseph
- Brown Alice
- Brown Brian
- Brown Brittany
- Brown Gail L
- Brown Sheila
- Bruce Jeffrey N
- Brunet Laura R
- Bruno Tullia C
- Bryan Jennifer
- Bryant Richard
- Buchbinder Elizabeth
- Bucsek Mark
- Budhu Sadna
- Budhu Sadna
- Budkowska Marta
- Bueno Raphael
- Buettner Florian
- Buettner Nico
- Bullock Kim
- Bullock Kim
- Burova Elena
- Burrill Joel
- Bussler Holm
- Butterfield Lisa H
- Butterfield Lisa H
- Byrne-Steele Miranda
- Cagney Daniel
- Calderon Hugo
- Callahan Margaret K
- Campesato Luis F
- Campogan Dwayne
- Cao Felicia
- Capasso Cristian
- Capasso Cristian
- Caplazi Patrick
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- Zeng Weiping
- Zeng Xue
- Zha Yuanyuan
- Zhang Danhui
- Zhang Jing
- Zhang Ping
- Zhang Qifang
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- Zhang Winter
- Zhang Yanping
- Zhao Fei
- Zhao Leyna
- Zhao Xingli
- Zheng Lianxing
- Zheng Wenxin
- Zheng Xianxian
- Zheng Yi
- Zhong Hong
- Zhou Li
- Zhou Xiangjun
- Zippelius Alfred
- Zloza Andrew
- Zloza Andrew
- Zloza Andrew
- Zloza Andrew
- Zloza Andrew
- Zou Jun
- Zuba-Surma Ewa
- Zubkova Olga
- Zureikat Amer
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2016
- Field of study
Background
The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd.
Methods
We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background.
Results
First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001).
Conclusions
In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival
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