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54-Year-Old Woman With Altered Mental Status and Abdominal Pain
A 54-year-old woman was transferred to our medical center with altered mental status, abdominal pain, and hypotension. Her medical history included type 2 diabetes mellitus, hypertension, hyperlipidemia, active tobacco use, prior cholecystectomy, and a recent stroke. One month earlier, she presented to an outside facility with right-sided facial weakness and numbness. Brain magnetic resonance imaging (MRI) at that time revealed multiple small lacunar-type infarcts. Computed tomography (CT) angiography of the head and neck, 48-hour Holter monitoring, and transesophageal echocardiography did not reveal an embolic source.
Source: Mayo Clinic Proceedings - June 29, 2022 Category: Internal Medicine Authors: Caroline L. Matchett, Nikita Rafie, Jacob C. Jentzer Tags: Residents ’ Clinic Source Type: research

Predicting Who Will Experience Cerebral Hemorrhage When Anticoagulated
The most feared hemorrhagic complication of anticoagulating patients with atrial fibrillation is intracerebral hemorrhage (ICH). However, not anticoagulating high-risk patients with atrial fibrillation can lead to cardioembolic stroke, another disastrous outcome. Physicians may tend to avoid blame by inaction, which can result in underprescribing. Such clinical inertia is not unique to anticoagulating patients with atrial fibrillation. Clinical inertia has been noted in the treatment of several common chronic conditions, such as treating blood pressure in patients with hypertension and treating hyperglycemia in patients wi...
Source: Mayo Clinic Proceedings - September 30, 2020 Category: Internal Medicine Authors: James F. Meschia Tags: Editorial Source Type: research

91-Year-Old Man With Upper Extremity Ecchymoses
A 91-year-old man with a medical history significant for previous ischemic stroke, tuberculosis status post lung resection, and type 2 diabetes mellitus presented to his primary care physician with extensive non-traumatic bruising of the bilateral upper extremities.
Source: Mayo Clinic Proceedings - February 29, 2020 Category: Internal Medicine Authors: Ryan B. Khodadadi, John R. Ogden, Ariela L. Marshall Tags: Residents ’ clinic Source Type: research

82-Year-Old Woman With Acute-Onset Left-Sided Weakness
An 82-year-old woman with a history of type 2 diabetes mellitus, hyperlipidemia, and hypertension presented to the emergency department with sudden onset of left arm and leg weakness. She was sitting in church when she developed left-sided posterior neck and shoulder pain, followed 1 hour later by sudden-onset dense left-sided weakness. Emergency medical services were called, and they activated the prehospital stroke-notification protocol. The patient arrived at the emergency department approximately 30 minutes after the onset of the weakness.
Source: Mayo Clinic Proceedings - December 31, 2019 Category: Internal Medicine Authors: Ronstan Lobo, Adam P. Sawatsky Tags: Residents ’ clinic Source Type: research

Cardiovascular Disease in Type 2 Diabetes: A Review of Sex-Related Differences in Predisposition and Prevention
Type 2 diabetes mellitus is a major risk factor for cardiovascular disease. However, compiled data suggest that type 2 diabetes affects the risk of cardiovascular disease differentially according to sex. In recent years, large meta-analyses have confirmed that women with type 2 diabetes have a higher relative risk of incident coronary heart disease, fatal coronary heart disease, and stroke compared with their male counterparts. The reasons for these disparities are not completely elucidated. A greater burden of cardiometabolic risk in women was proposed as a partial explanation.
Source: Mayo Clinic Proceedings - January 31, 2019 Category: Internal Medicine Authors: Abdallah Al-Salameh, Philippe Chanson, Sophie Bucher, Virginie Ringa, Laurent Becquemont Tags: Review Source Type: research

CHA2DS2-VASc Score: A Predictor of Thromboembolic Events and Mortality in Patients With an Implantable Monitoring Device Without Atrial Fibrillation
To determine if the CHA2DS2-VASc score (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke or transient ischemic attack, vascular disease, age 65-74 years, sex category) predicts thromboembolism and death in patients without atrial fibrillation in a population with implantable cardiac monitoring devices.
Source: Mayo Clinic Proceedings - February 28, 2017 Category: Internal Medicine Authors: Christine Parsons, Salma I. Patel, Stephen Cha, Win-Kuang Shen, Santosh Desai, Alanna M. Chamberlain, Sushil Allen Luis, Maria I. Aguilar, Bart M. Demaerschalk, Farouk Mookadam, Fadi Shamoun Tags: Original article Source Type: research

CHADS Scores as a Predictor of Ischemic Stroke in Patients With Peripheral Artery Disease
To assess the predictive value of CHADS2 (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke) scores for stroke risk in patients with peripheral artery disease (PAD).
Source: Mayo Clinic Proceedings - December 8, 2015 Category: Internal Medicine Authors: Yu-Wan Yang, Yi-Hsin Chen, Chia-Chun Hsu, Ching-Chih Lee, Yu-Hung Kuo, Hsun-Yang Chuang, Teng-Fu Hsieh Tags: Original article Source Type: research

Increased Risk of First-Ever Stroke in Younger Patients With Atrial Fibrillation Not Recommended for Antithrombotic Therapy by Current Guidelines: A Population-Based Study in an East Asian Cohort of 22 Million People
To assess the risk of first-ever ischemic stroke in younger patients with atrial fibrillation (AF) who have none of the CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, previous stroke/transient ischemic attack, vascular disease, age 65-74 years, sex category [female sex]) risk factors (excluding female sex) by using the National Health Insurance research database in Taiwan.
Source: Mayo Clinic Proceedings - November 1, 2014 Category: Internal Medicine Authors: Kuan-Cheng Chang, Yu-Chen Wang, Po-Yen Ko, Hung-Pin Wu, Yu-Wei Chen, Chih-Hsin Muo, Fung-Chang Sung, Tsai-Chung Li, Chung Y. Hsu Tags: Original article Source Type: research