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Urgent Best Medical Therapy May Obviate the Need for Urgent Surgery in Patients With Symptomatic Carotid Stenosis Clinical Sciences
Conclusions— CEA can be performed in the subacute period without significantly increasing the operative risk. The urgent best medical treatment was associated with significant reduction in the risk of early NR in CEA patients. It seems that urgent aggressive best medical treatment may obviate the need for urgent CEA.
Source: Stroke - July 22, 2013 Category: Neurology Authors: Shahidi, S., Owen-Falkenberg, A., Hjerpsted, U., Rai, A., Ellemann, K. Tags: Secondary prevention, Antiplatelets, Carotid endarterectomy, Transient Ischemic Attacks Clinical Sciences Source Type: research

High salt levels in soluble drugs may raise heart risk
Conclusion This large case control study suggested that people who had experienced disease of the heart and blood vessels were more likely to have taken sodium-containing medicines than people without cardiovascular disease. Put in other words this can be interpreted that people who took sodium-containing medicines were at a higher risk of experiencing cardiovascular disease than people who took the same medications in formulations free of sodium. The increased risk appeared to be driven mostly by an increased risk of hypertension and to a lesser extent, non-fatal stroke. The study has some strengths including its large s...
Source: NHS News Feed - November 27, 2013 Category: Consumer Health News Tags: Heart/lungs Medication Medical practice Source Type: news

Implementation of best medical therapy for cardiovascular risk factors in vascular surgery patients treated in a tertiary referral regional unit
ConclusionDespite increased implementation of best medical therapy in the community with compliance rates greater than 73% for aspirin and statin therapy, further improvement is warranted. Vascular surgeons should remain vigilant for further opportunities to optimise medical therapy in this high‐risk patient group particularly with antithrombotic, lipid lowering and antihypertensive therapies.
Source: International Journal of Clinical Practice - March 27, 2014 Category: Internal Medicine Authors: D. McGrogan, D. Mark, B. Lee, M. E. O'Donnell Tags: Original Paper Source Type: research

Thoracoscopic Pulmonary Vein Isolation and Atrial Appendage Ligation (TPVIAL) versus Medical Management in Atrial Fibrillation Patients with Prior Stroke (P1.126)
CONCLUSIONS: TPVIAL may become an important therapeutic tool for reducing recurrent stroke in AF patients.Disclosure: Dr. Waters has nothing to disclose. Dr. Hedna has nothing to disclose. Dr. Khanna has nothing to disclose. Dr. Miles has nothing to disclose. Dr. Price has nothing to disclose. Dr. Schmalfuss has nothing to disclose. Dr. Robertson has nothing to disclose. Dr. Karimi has nothing to disclose. Dr. Beaver has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Waters, M., Hedna, V., Khanna, A., Miles, W., Price, C., Schmalfuss, I., Robertson, D., Karimi, A., Beaver, T. Tags: Cerebrovascular Disease and Interventional Neurology: Atrial Fibrillation and Miscellaneous Source Type: research

Thrombo-prophylaxis in acutely ill medical and critically ill patients
Saurabh Saigal, Jai Prakash Sharma, Rajnish Joshi, Dinesh Kumar SinghIndian Journal of Critical Care Medicine 2014 18(6):382-391Thrombo-prophylaxis has been shown to reduce the incidence of pulmonary embolism (PE) and mortality in surgical patients. The purpose of this review is to find out the evidence-based clinical practice criteria of deep vein thrombosis (DVT) prophylaxis in acutely ill medical and critically ill patients. English-language randomized controlled trials, systematic reviews, and meta-analysis were included if they provided clinical outcomes and evaluated therapy with low-dose heparin or related agents co...
Source: Indian Journal of Critical Care Medicine - June 4, 2014 Category: Intensive Care Authors: Saurabh SaigalJai Prakash SharmaRajnish JoshiDinesh Kumar Singh Source Type: research

Pharmacist‐Driven Renal Medication Dosing Intervention in a Primary Care Patient‐Centered Medical Home
ConclusionThese results demonstrate the impact of a pharmacist‐driven renal medication dosing intervention within a PCMH on medication use and safety for patients with CKD.
Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy - October 1, 2014 Category: Drugs & Pharmacology Authors: Kelli D. Barnes, Neeraj H. Tayal, Amy M. Lehman, Stuart J. Beatty Tags: Practice Insights Source Type: research

New heart attack test shows promise for women
Conclusion This new study showed how a more sensitive test of troponin levels would have led to a diagnosis of heart attack in double the number of women studied. The test made less of a difference to the diagnosis for men. This could be because the troponin levels in the standard test were much higher in men than women. The research also indicates that even with a diagnosis of heart attack, women were less likely to be referred to cardiologists or have any further investigations or treatment, such as a coronary angiography or coronary angioplasty. The researchers found women who would have been diagnosed with a heart at...
Source: NHS News Feed - January 22, 2015 Category: Consumer Health News Tags: Heart/lungs Medical practice Source Type: news

Comparison of Medical Costs of Patients With Atrial Fibrillation Unsuitable for Warfarin Treatment With Apixaban or Aspirin Based on AVERROES Trial
Conclusions: Based on AVERROES trial results, among patients with AF unsuitable for warfarin therapy, apixaban use was estimated to be associated with a mean medical cost avoidance of US$735 in a patient-year relative to aspirin. The primary driver was the significant reduction in ischemic stroke rate. The medical cost reduction associated with apixaban use was consistent in sensitivity analyses.
Source: Clinical and Applied Thrombosis/Hemostasis - February 27, 2015 Category: Hematology Authors: Amin, A., Deitelzweig, S., Jing, Y., Makenbaeva, D., Wiederkehr, D., Lin, J., Graham, J. Tags: Original Articles Source Type: research

Are patients with carotid stenosis receiving optimal medical therapy? (I2-1A)
Conclusion: Despite the presence of established large vessel atherosclerosis, a sizable proportion of patients reported that they were not receiving statin therapy or aspirin. Intensification of "real world" medical therapy will be important to reduce stroke rates and improve long-term survival.Disclosure: Dr. Koch has nothing to disclose. Dr. Chaturvedi has received personal compensation for activities with Genentech, Inc., Abbott Vascular, Boehringer-Ingelheim, WL Gore, and Merck. Dr. Chaturvedi has received personal compensation in an editorial capacity for NEJM Journal Watch Neurology. Dr. Romano has received personal ...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Koch, S., Chaturvedi, S., Romano, J. Tags: Management of Asymptomatic Cerebrovascular Lesions Data Blitz Presentations Source Type: research

Are patients with carotid stenosis receiving optimal medical therapy? (P2.265)
Conclusion: Despite the presence of established large vessel atherosclerosis, a sizable proportion of patients reported that they were not receiving statin therapy or aspirin. Intensification of "real world" medical therapy will be important to reduce stroke rates and improve long-term survival.Disclosure: Dr. Koch has nothing to disclose. Dr. Chaturvedi has received personal compensation for activities with Genentech, Inc., Abbott Vascular, Boehringer-Ingelheim, WL Gore, and Merck. Dr. Chaturvedi has received personal compensation in an editorial capacity for NEJM Journal Watch Neurology. Dr. Romano has received personal ...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Koch, S., Chaturvedi, S., Romano, J. Tags: Cerebrovascular Disease and Interventional Neurology: Carotid Disease and IMT Source Type: research

European Code against Cancer 4th edition: Medical exposures, including hormone therapy, and cancer
Publication date: Available online 26 September 2015 Source:Cancer Epidemiology Author(s): Søren Friis, Ausrele Kesminiene, Carolina Espina, Anssi Auvinen, Kurt Straif, Joachim Schüz The 4th edition of the European Code against Cancer recommends limiting – or avoiding when possible – the use of hormone replacement therapy (HRT) because of the increased risk of cancer, nevertheless acknowledging that prescription of HRT may be indicated under certain medical conditions. Current evidence shows that HRT, generally prescribed as menopausal hormone therapy, is associated with an increased risk of cancers of the br...
Source: Cancer Epidemiology - September 26, 2015 Category: Cancer & Oncology Source Type: research

Pharmacological Prophylaxis for Venous Thromboembolism Among Hospitalized Patients With Acute Medical Illness: An Electronic Medical Records Study
The objectives of this study were to examine pharmacological prophylaxis against VTE among hospitalized medically ill patients and to assess demographic and clinical correlates related to VTE prophylaxis. A retrospective (1999–2010) electronic medical records study included patients aged 40 years and older hospitalized for at least 3 days, with significant medical illness or with a VTE hospitalization 30–365 days before admission. Each patient's first qualifying hospitalization was analyzed. Exclusions were if VTE treatment was started within 1 day of admission, or if warfarin (and not heparin or enoxaparin) was used. ...
Source: American Journal of Therapeutics - March 1, 2016 Category: Drugs & Pharmacology Tags: Original Articles Source Type: research

A Case of Transient Global Amnesia: A Review and How It May Shed Further Insight into the Neurobiology of Delusions
Conclusion In closing, our patient’s episode of TGA combined with her emotional and perceptual response lends credence to the proposal of a “fear/paranoia” circuit in the genesis of paranoid delusions—a circuit incorporating amygdala, frontal, and parietal cortices. Here, neutral or irrelevant stimuli, thoughts, and percepts come to engender fear and anxiety, while dysfunction in frontoparietal circuitry engenders inappropriate social predictions and maladaptive inferences about the intentions of others.[54] Hippocampus relays information about contextual information based on past experiences and the current situat...
Source: Innovations in Clinical Neuroscience - April 1, 2016 Category: Neuroscience Authors: ICN Online Editor Tags: Anxiety Disorders Behavioral and Cognitive Neurology Case Report Cognition Current Issue Dementia Medical Issues Neurologic Systems and Symptoms Psychiatry Schizophrenia delusions hippocampus neurobiology Transient global amnesia Source Type: research

One in three heart attack cases 'misdiagnosed'
Conclusion This valuable audit looks at nine years' worth of data from NHS hospitals, finding about a third of people with two forms of heart attack – STEMI and NSTEMI – are often wrongly diagnosed initially. These people are less likely to receive the guideline-indicated treatments they need – and the delay in receiving correct treatment could have a harmful effect. The study also highlights the factors associated with a wrong diagnosis, including being of an older age, having heart failure, and atypical findings for either diagnosis. Unexpectedly, gender was also associated with a wrong initial diagnosis for women...
Source: NHS News Feed - August 30, 2016 Category: Consumer Health News Tags: Heart/lungs Medical practice Source Type: news

Patent foramen ovale closure versus medical therapy in cases with cryptogenic stroke, meta-analysis of randomized controlled trials
ConclusionPFO closure results in a significant reduction in the recurrence of ischemic stroke compared to medical therapy alone, primarily antiplatelet, among cases with PFO and cryptogenic stroke.
Source: Journal of Neurology - January 22, 2018 Category: Neurology Source Type: research