Chronic Coronary Disease in Older Adults
Med Clin North Am. 2024 May;108(3):581-594. doi: 10.1016/j.mcna.2023.12.004. Epub 2024 Jan 4.ABSTRACTThe number of older adults age ≥75 with chronic coronary disease (CCD) continues to rise. CCD is a major contributor to morbidity, mortality, and disability in older adults. Older adults are underrepresented in randomized controlled trials of CCD, which limits generalizability to older adults living with multiple chronic conditions and geriatric syndromes. This review discusses the presentation of CCD in older adults, reviews the guideline-directed medical and invasive therapies, and recommends a patient-centric approach ...
Source: The Medical Clinics of North America - March 28, 2024 Category: General Medicine Authors: Alexander P Ambrosini Emily S Fishman Abdulla A Damluji Michael G Nanna Source Type: research

Racial and Ethnic Disparities in the Management of Chronic Coronary Disease
Med Clin North Am. 2024 May;108(3):595-607. doi: 10.1016/j.mcna.2023.11.008. Epub 2023 Dec 19.ABSTRACTChronic coronary disease (CCD) comprises a continuum of conditions that include obstructive and non-obstructive coronary artery disease with or without prior acute coronary syndrome. Racial and ethnic representation disparities are pervasive in CCD guideline-informing clinical trials and evidence-based management. These disparities manifest across the entire spectrum of CCD management, spanning from non-pharmacological lifestyle changes to guideline-directed medical therapy, and cardiac rehabilitation to invasive procedure...
Source: The Medical Clinics of North America - March 28, 2024 Category: General Medicine Authors: Wilson Lay Tang Fatima Rodriguez Source Type: research

Collaborative Care
Med Clin North Am. 2024 May;108(3):xv-xvi. doi: 10.1016/j.mcna.2024.01.001. Epub 2024 Feb 1.NO ABSTRACTPMID:38548467 | DOI:10.1016/j.mcna.2024.01.001 (Source: The Medical Clinics of North America)
Source: The Medical Clinics of North America - March 28, 2024 Category: General Medicine Authors: Jack Ende Source Type: research

Chronic Coronary Disease
Med Clin North Am. 2024 May;108(3):xvii-xx. doi: 10.1016/j.mcna.2023.12.007. Epub 2024 Jan 5.NO ABSTRACTPMID:38548468 | DOI:10.1016/j.mcna.2023.12.007 (Source: The Medical Clinics of North America)
Source: The Medical Clinics of North America - March 28, 2024 Category: General Medicine Authors: Alexander C Fanaroff John W Hirshfeld Source Type: research

Top-Down and Bottom-Up Mechanisms of Motor Recovery Poststroke
Phys Med Rehabil Clin N Am. 2024 May;35(2):235-257. doi: 10.1016/j.pmr.2023.07.006. Epub 2023 Aug 30.ABSTRACTStroke remains a leading cause of disability. Motor recovery requires the interaction of top-down and bottom-up mechanisms, which reinforce each other. Injury to the brain initiates a biphasic neuroimmune process, which opens a window for spontaneous recovery during which the brain is particularly sensitive to activity. Physical activity during this sensitive period can lead to rapid recovery by potentiating anti-inflammatory and neuroplastic processes. On the other hand, lack of physical activity can lead to early ...
Source: The Medical Clinics of North America - March 21, 2024 Category: General Medicine Authors: Preeti Raghavan Source Type: research

A Review of Poststroke Aphasia Recovery and Treatment Options
Phys Med Rehabil Clin N Am. 2024 May;35(2):419-431. doi: 10.1016/j.pmr.2023.06.010. Epub 2023 Jul 11.ABSTRACTPoststroke aphasia, which impacts expressive and receptive communication, can have detrimental effects on the psychosocial well-being and the quality of life of those affected. Aphasia recovery is multidimensional and can be influenced by several baseline, stroke-related, and treatment-related factors, including preexisting cerebrovascular conditions, stroke size and location, and amount of therapy received. Importantly, aphasia recovery can continue for many years after aphasia onset. Behavioral speech and language...
Source: The Medical Clinics of North America - March 21, 2024 Category: General Medicine Authors: Victoria E Tilton-Bolowsky Argye E Hillis Source Type: research

Dysphagia and Enteral Feeding After Stroke in the Rehabilitation Setting
Phys Med Rehabil Clin N Am. 2024 May;35(2):433-443. doi: 10.1016/j.pmr.2023.07.001. Epub 2023 Aug 17.ABSTRACTPhysiatrists play a vital role in post-stroke dysphagia management not only by providing guidance on the risks, benefits, and efficacy of various treatment options but also as advocates for patients' independence and quality of life. While swallow study results are often discussed broadly by acute stroke clinicians as "pass/fail" findings, physiatrists need a more nuanced working knowledge of dysphagia diagnosis and treatment that encompasses swallow pathophysiology, targeted treatment strategies, and prognosis for ...
Source: The Medical Clinics of North America - March 21, 2024 Category: General Medicine Authors: Robynne G Braun Jodi Arata Marlis Gonzalez-Fernandez Source Type: research

Top-Down and Bottom-Up Mechanisms of Motor Recovery Poststroke
Phys Med Rehabil Clin N Am. 2024 May;35(2):235-257. doi: 10.1016/j.pmr.2023.07.006. Epub 2023 Aug 30.ABSTRACTStroke remains a leading cause of disability. Motor recovery requires the interaction of top-down and bottom-up mechanisms, which reinforce each other. Injury to the brain initiates a biphasic neuroimmune process, which opens a window for spontaneous recovery during which the brain is particularly sensitive to activity. Physical activity during this sensitive period can lead to rapid recovery by potentiating anti-inflammatory and neuroplastic processes. On the other hand, lack of physical activity can lead to early ...
Source: The Medical Clinics of North America - March 21, 2024 Category: General Medicine Authors: Preeti Raghavan Source Type: research

A Review of Poststroke Aphasia Recovery and Treatment Options
Phys Med Rehabil Clin N Am. 2024 May;35(2):419-431. doi: 10.1016/j.pmr.2023.06.010. Epub 2023 Jul 11.ABSTRACTPoststroke aphasia, which impacts expressive and receptive communication, can have detrimental effects on the psychosocial well-being and the quality of life of those affected. Aphasia recovery is multidimensional and can be influenced by several baseline, stroke-related, and treatment-related factors, including preexisting cerebrovascular conditions, stroke size and location, and amount of therapy received. Importantly, aphasia recovery can continue for many years after aphasia onset. Behavioral speech and language...
Source: The Medical Clinics of North America - March 21, 2024 Category: General Medicine Authors: Victoria E Tilton-Bolowsky Argye E Hillis Source Type: research

Dysphagia and Enteral Feeding After Stroke in the Rehabilitation Setting
Phys Med Rehabil Clin N Am. 2024 May;35(2):433-443. doi: 10.1016/j.pmr.2023.07.001. Epub 2023 Aug 17.ABSTRACTPhysiatrists play a vital role in post-stroke dysphagia management not only by providing guidance on the risks, benefits, and efficacy of various treatment options but also as advocates for patients' independence and quality of life. While swallow study results are often discussed broadly by acute stroke clinicians as "pass/fail" findings, physiatrists need a more nuanced working knowledge of dysphagia diagnosis and treatment that encompasses swallow pathophysiology, targeted treatment strategies, and prognosis for ...
Source: The Medical Clinics of North America - March 21, 2024 Category: General Medicine Authors: Robynne G Braun Jodi Arata Marlis Gonzalez-Fernandez Source Type: research

Top-Down and Bottom-Up Mechanisms of Motor Recovery Poststroke
Phys Med Rehabil Clin N Am. 2024 May;35(2):235-257. doi: 10.1016/j.pmr.2023.07.006. Epub 2023 Aug 30.ABSTRACTStroke remains a leading cause of disability. Motor recovery requires the interaction of top-down and bottom-up mechanisms, which reinforce each other. Injury to the brain initiates a biphasic neuroimmune process, which opens a window for spontaneous recovery during which the brain is particularly sensitive to activity. Physical activity during this sensitive period can lead to rapid recovery by potentiating anti-inflammatory and neuroplastic processes. On the other hand, lack of physical activity can lead to early ...
Source: The Medical Clinics of North America - March 21, 2024 Category: General Medicine Authors: Preeti Raghavan Source Type: research

A Review of Poststroke Aphasia Recovery and Treatment Options
Phys Med Rehabil Clin N Am. 2024 May;35(2):419-431. doi: 10.1016/j.pmr.2023.06.010. Epub 2023 Jul 11.ABSTRACTPoststroke aphasia, which impacts expressive and receptive communication, can have detrimental effects on the psychosocial well-being and the quality of life of those affected. Aphasia recovery is multidimensional and can be influenced by several baseline, stroke-related, and treatment-related factors, including preexisting cerebrovascular conditions, stroke size and location, and amount of therapy received. Importantly, aphasia recovery can continue for many years after aphasia onset. Behavioral speech and language...
Source: The Medical Clinics of North America - March 21, 2024 Category: General Medicine Authors: Victoria E Tilton-Bolowsky Argye E Hillis Source Type: research

Dysphagia and Enteral Feeding After Stroke in the Rehabilitation Setting
Phys Med Rehabil Clin N Am. 2024 May;35(2):433-443. doi: 10.1016/j.pmr.2023.07.001. Epub 2023 Aug 17.ABSTRACTPhysiatrists play a vital role in post-stroke dysphagia management not only by providing guidance on the risks, benefits, and efficacy of various treatment options but also as advocates for patients' independence and quality of life. While swallow study results are often discussed broadly by acute stroke clinicians as "pass/fail" findings, physiatrists need a more nuanced working knowledge of dysphagia diagnosis and treatment that encompasses swallow pathophysiology, targeted treatment strategies, and prognosis for ...
Source: The Medical Clinics of North America - March 21, 2024 Category: General Medicine Authors: Robynne G Braun Jodi Arata Marlis Gonzalez-Fernandez Source Type: research

Top-Down and Bottom-Up Mechanisms of Motor Recovery Poststroke
Phys Med Rehabil Clin N Am. 2024 May;35(2):235-257. doi: 10.1016/j.pmr.2023.07.006. Epub 2023 Aug 30.ABSTRACTStroke remains a leading cause of disability. Motor recovery requires the interaction of top-down and bottom-up mechanisms, which reinforce each other. Injury to the brain initiates a biphasic neuroimmune process, which opens a window for spontaneous recovery during which the brain is particularly sensitive to activity. Physical activity during this sensitive period can lead to rapid recovery by potentiating anti-inflammatory and neuroplastic processes. On the other hand, lack of physical activity can lead to early ...
Source: The Medical Clinics of North America - March 21, 2024 Category: General Medicine Authors: Preeti Raghavan Source Type: research

A Review of Poststroke Aphasia Recovery and Treatment Options
Phys Med Rehabil Clin N Am. 2024 May;35(2):419-431. doi: 10.1016/j.pmr.2023.06.010. Epub 2023 Jul 11.ABSTRACTPoststroke aphasia, which impacts expressive and receptive communication, can have detrimental effects on the psychosocial well-being and the quality of life of those affected. Aphasia recovery is multidimensional and can be influenced by several baseline, stroke-related, and treatment-related factors, including preexisting cerebrovascular conditions, stroke size and location, and amount of therapy received. Importantly, aphasia recovery can continue for many years after aphasia onset. Behavioral speech and language...
Source: The Medical Clinics of North America - March 21, 2024 Category: General Medicine Authors: Victoria E Tilton-Bolowsky Argye E Hillis Source Type: research