Significant improvement in hand function could be achieved with constraint-induced movement therapy in subacute stroke patients, which was maintained up to 12 week follow-up.

No abstract

In patients with ACS or STEMI, esomeprazole is superior to famotidine in preventing upper gastrointestinal complications related to aspirin, clopidogrel, and enoxaparin or thrombolytics.

Summary Background:  In average‐risk patients, the new anti‐platelet agent, clopidogrel, causes less upper gastrointestinal adverse events than aspirin. However, there are no safety data on the use of clopidogrel in high‐risk patients. Aim:  To evaluate the safety of clopidogrel in patients with peptic ulcer disease in a retrospective cohort longitudinal study. Methods:  During the period from January 2000 to May 2002, 70 patients who were prescribed clopidogrel (75 mg/day) for a previous history of non‐aspirin‐related peptic ulcer disease or a history of aspirin‐related gastrointestinal complications (dyspepsia or peptic ulcer) were recruited. The occurrence of ulcer complications (bleeding/perforation/obstruction) was the primary end‐point. Results:  After a median follow‐up of 1 year, nine patients (12%) developed gastrointestinal bleeding and one had a perforated peptic ulcer. Clopidogrel‐associated gastrointestinal bleeding was significantly more common in patients with a history of gastrointestinal bleeding than in those without (22% vs. 0%; P = 0.007; odds ratio, 1.3; 95% confidence interval, 1.1–1.5). Conclusions:  Clopidogrel is associated with a high incidence of upper gastrointestinal bleeding in high‐risk patients. A previous history of gastrointestinal bleeding appears to be a predictor of adverse gastrointestinal events.

Low dose lisinopril given to older tube-fed patients with neurologic dysphagia resulted in increased mortality, although swallowing function showed marginal improvement. ACE inhibitors did not prevent pneumonia in older patients with neurologic dysphagia and might increase mortality.