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Bilateral ptosis caused by patent foramen ovale-associated stroke
A 39-year-old woman presented with sudden onset bilateral ptosis and binocular diplopia for 3 days. The double vision was horizontal and most prominent when she was looking to the left side. The severity of symptoms does not vary over the day. She denied vertigo, headache, ocular pain, limb weakness, paresthesia, alcohol usage and botulinum toxin injection. Past medical history and family history were unremarkable. Neurological examination revealed bilateral ptosis, limited adduction in the right eye and normal pupils (Figure  1A). Other cranial nerves, extremity strength, coordination and sensory tests were intact. Deep ...
Source: QJM - August 16, 2022 Category: Internal Medicine Source Type: research

Characteristics of Ischemic Versus Hemorrhagic Stroke in Patients Receiving Oral Anticoagulants: Results of the PASTA Study
Conclusion The presence of CMBs, a history of stroke, natriuretic peptide and D-dimer levels, and PT-INR may be useful for risk stratification of either IS/TIA or ICH development in patients with AF receiving OACs.PMID:34483213 | DOI:10.2169/internalmedicine.8113-21
Source: Internal Medicine - September 6, 2021 Category: Internal Medicine Authors: Satoshi Suda Arata Abe Yasuyuki Iguchi Yoshiki Yagita Takao Kanzawa Seiji Okubo Nobuyuki Ohara Takayuki Mizunari Mineo Yamazaki Nobuhito Nakajima Kimito Kondo Shigeru Fujimoto Takeshi Inoue Takeshi Iwanaga Yuka Terasawa Kensaku Shibazaki Yu Kono Makoto Na Source Type: research

Important factors affecting the choice of an oral anticoagulant may be missed in database studies
This article is protected by copyright. All rights reserved.
Source: Journal of Internal Medicine - September 7, 2017 Category: Internal Medicine Authors: Emma Aarnio, Risto Huupponen, Maarit Jaana Korhonen Tags: Letter to the Editor Source Type: research

Homocysteine and all-cause mortality in hypertensive adults without pre-existing cardiovascular conditions: Effect modification by MTHFR C677T polymorphism
Background: Previous studies support an association between elevated total homocysteine (tHcy) levels and increased all-cause mortality. However, few prospective studies have examined this association in hypertensive patients, and/or tested any effect modification by the methylene tetrahydrofolate reductase (MTHFR) C677T genotype. Methods: This was a post hoc analysis of the China Stroke Primary Prevention Trial. Serum tHcy and folate were measured at baseline. Individual MTHFR C677T genotype (CC, CT, and TT) was determined. Evidence for death included death certificates or home visits. Cumulative hazards of all-cause mor...
Source: Medicine - February 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research

Long-term supplementation with multivitamins and minerals did not improve male US physicians' cardiovascular health or prolong their lives
Commentary on: Sesso HD, Christen WG, Bubes V, et al.. Multivitamins in the prevention of cardiovascular disease in men: the Physicians’ Health Study II randomized controlled trial. JAMA 2012;308:1751–60. Context Cardiovascular disease (CVD) is the leading cause of death and disability worldwide. Behavioural risk factors, including tobacco use, physical inactivity, unhealthy diet and the harmful use of alcohol, are estimated to be responsible for about 80% of coronary heart disease and cerebrovascular disease.1 Until 2000, observational studies found inverse associations between vitamin intake and CVD outcomes....
Source: Evidence-Based Medicine - November 21, 2013 Category: Internal Medicine Authors: Ebbing, M., Vollset, S. E. Tags: Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Diet, Ischaemic heart disease Therapeutics Source Type: research