Rationale for screening selected patients for asymptomatic carotid artery stenosis.

Rationale for screening selected patients for asymptomatic carotid artery stenosis. Curr Med Res Opin. 2020 Jan 08;:1 Authors: Paraskevas KI, Eckstein HH, Mikhailidis DP, Veith FJ, Spence JD Abstract Stroke is a leading cause of death and disability worldwide. Approximately 15% of all first-ever strokes occur due to atheroembolism from a previously undetected/untreated asymptomatic carotid stenosis (ACS). Despite that, international guidelines do not recommend screening for ACS. The rationale for not recommending screening include: a) the harm associated with screening, b) the questionable clinical benefit associated with surgery, c) the lack of proven reduction in the risk of stroke, d) the large number of false positive/false negative tests, and e) the cost-effectiveness of such screening programs.A critical analysis of each of these arguments is presented. Patients with ACS have a very high risk of all-cause and cardiac mortality. Detection of ACS should not be viewed as an indication for surgery, but rather as an opportunity to implement best medical treatment (BMT) and lifestyle changes to prevent not only strokes, but also cardiac events. The implementation of screening programs for abdominal aortic aneurysms (AAAs) has led to a considerable reduction in the number of ruptured AAAs and AAA-related deaths. Similarly, screening high-risk individuals for ACS would enable timely identification of patients with ACS and implementation of BMT and lifestyle...
Source: Current Medical Research and Opinion - Category: Research Tags: Curr Med Res Opin Source Type: research

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Sufficient Lumbar Lateral Recess Decompression Acquired by Undercutting "Superior Articular Process Neck" Plus Intervertebral Disk Annuloplasty in Percutaneous Transforaminal Endoscopic Surgery. Med Sci Monit. 2020 Apr 03;26:e921119 Authors: Liu X, Peng Y, Pei L, Zhu Y Abstract BACKGROUND Percutaneous transforaminal endoscopic surgery has been used as a surgical measure for lumbar lateral recess stenosis. However, the necessary decompressive range has never been clearly documented in detail. Here, we discuss the effectiveness of a percutaneous transforaminal endoscopic procedure with clearly ...
Source: Medical Science Monitor - Category: Research Tags: Med Sci Monit Source Type: research
Authors: Dell'Aquila A, Sciatti E, Vizzardi E, Metra M Abstract We hereby report a puzzling case of multiple sclerosis (MS) relapse presenting as Takotsubo syndrome (TTS). Female, 42-years old, who presented herself to the Emergency Room of University Hospital "ASST Spedali Civili" of Brescia, Italy, for a severe headache and a non-ST-segment elevation acute coronary syndrome. Coronary angiogram showed no signs of coronary atherosclerosis. Upon further neurological evaluation, a diagnosis of MS relapse, related to TTS, was made, and treatment was started accordingly. The patient was discharged after 12 da...
Source: Monaldi Archives for Chest Disease - Category: Respiratory Medicine Tags: Monaldi Arch Chest Dis Source Type: research
Authors: Bombardini T, Cortigiani L, Ciampi Q, Ostojic MC, Kovacevic-Preradovic T, Picano E Abstract Background: The ventricular stroke work (SW) refers to the work done by the left ventricle to eject the volume of blood during one cardiac cycle. The cath-lab relationship between SW and end-diastolic volume (EDV) is the preload-recruitable SW (PRSW). Recently a non-invasive single-beat PRSW (SBPRSW) has been proposed. However, the single beat formula needs mathematical skillness, and extra software. Aim of this study was to compare the non-invasive SBPRSW with the simpler non-invasive SW/EDVratio in the stress-echo...
Source: Acta Cardiologica - Category: Cardiology Tags: Acta Cardiol Source Type: research
Authors: Poszepczyński J, Andrzejewski K, Rokicki R, Krzymiński M, Grabowski R, Lesman J, Domżalski M Abstract A talus fracture accompanied by trochlear dislocation is an ever-present therapeutic problem as it requires immediate surgery since any delay may result in necrosis of soft tissues and the talus, which, consequently, leads to permanent disability. Of crucial importance in the treatment of such injury is accurate analysis of fracture morphology, immediate institution of treatment and minimally invasive surgery allowing early movement of the affected limb. We operated on a male patient after a high-energy...
Source: Ortopedia Traumatologia Rehabilitacja - Category: Orthopaedics Tags: Ortop Traumatol Rehabil Source Type: research
CONCLUSIONS: Our findings reflect that psychosocial factors, such as the approach of the last day of the month override the intrinsic effect of disturbances of the circadian rhythm on stroke incidence. PMID: 32241570 [PubMed - as supplied by publisher]
Source: Revue Neurologique - Category: Neurology Tags: Rev Neurol (Paris) Source Type: research
People with learning disabilities have been told by GP surgeries they are unlikely to be prioritised for hospital care if they contract covid-19, because they could be too “frail”.
Source: HSJ - Category: UK Health Source Type: news
Conclusions: CRF denervation of the SIJ can safely elicit pain and disability relief, and reduce opioid use, regardless of intervention success. Future studies may support CRF denervation as a dependable therapy to alleviate opioid use in patients with SIJ-derived LBP and show that opioid use measurements can be a surrogate indicator of pain. PMID: 32235019 [PubMed]
Source: Korean Journal of Pain - Category: Anesthesiology Tags: Korean J Pain Source Type: research
Publication date: 4–10 April 2020Source: The Lancet, Volume 395, Issue 10230Author(s): The Lancet
Source: The Lancet - Category: General Medicine Source Type: research
Conclusion: Results of this study could be used to facilitate radial force control and longitudinal flexibility enhancement in the design of aortic stent-grafts. PMID: 32233714 [PubMed - as supplied by publisher]
Source: Minimally Invasive Therapy and Allied Technologies - Category: Surgery Tags: Minim Invasive Ther Allied Technol Source Type: research
In conclusion, senescence of vascular cells promotes the development of age-related disorders, including heart failure, diabetes, and atherosclerotic diseases, while suppression of vascular cell senescence ameliorates phenotypic features of aging in various models. Recent findings have indicated that specific depletion of senescent cells reverses age-related changes. Although the biological networks contributing to maintenance of homeostasis are extremely complex, it seems reasonable to explore senolytic agents that can act on specific cellular components or tissues. Several clinical trials of senolytic agents are currentl...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
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