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How long should we wait to start oral anticoagulation after cardioembolic stroke?
As a neurology resident many years ago, I carried in the pocket of my white coat a small notebook. I used this as a quick reference guide, recording the diagnostic and treatment recommendations of the neurology professors training me. I still have the book, and occasionally amuse myself by perusing the entry for acute stroke, satisfying in its pure simplicity: "If Afib present > start IV heparin; if no Afib > start aspirin." As is so often the case, clinical trial data soon enough proved this received wisdom wrong. In the Heparin in Acute Embolic Stroke Trial, which enrolled patients with stroke and atrial fibrillati...
Source: Neurology - October 30, 2016 Category: Neurology Authors: Cucchiara, B. Tags: Stroke prevention, Clinical trials Observational study (Cohort, Case control) EDITORIALS Source Type: research

Check the pulse to track irregular heartbeats after a stroke
The rapid, irregular heartbeat known as atrial fibrillation is a key cause of stroke. New research suggests that it's to blame for more strokes than doctors realized, and that simply measuring the pulse could help detect unrecognized atrial fibrillation and avert a second stroke, reports the October 2014 Harvard Heart Letter. Atrial fibrillation can come and go, lasting from a few seconds to several days. Some people have distressing symptoms such as palpitations, dizziness, or chest pressure. For many others, atrial fibrillation passes silently. Either way, blood can pool in the heart's upper chambers, or atria. This stag...
Source: New Harvard Health Information - September 30, 2014 Category: Consumer Health News Source Type: news

Clinical Performance Measures that Matter —Are You Ready?
Conclusion The future will belong to those who can prove value. The use of a clinical performance dashboard and comparisons to national data will help to ensure that when the payers come knocking on our doors looking for "proof" that what we do enhances patient care and improves patient outcome, we’ll have an answer! This is the first in a yearlong series of articles developed by the Academy of International Mobile Healthcare Integration (AIMHI).The AIMHI article series is developed in partnership with JEMS to help educate EMS agencies on the hallmarks and attributes of high-performance/high-value EMS system de...
Source: JEMS Special Topics - December 11, 2018 Category: Emergency Medicine Authors: Wayne C. Harbour, NRP Tags: Exclusive Articles Operations Administration and Leadership Source Type: news

Daily Aspirin No Longer Recommended To Prevent Heart Attacks In Older Adults
(CNN) — If you’re a healthy older adult looking for ways to reduce your risk of heart attack and stroke, don’t turn to that age-old standby: daily low-dose aspirin. It’s no longer recommended as a preventative for older adults who don’t have a high risk or existing heart disease, according to guidelines announced Sunday by the American College of Cardiology and the American Heart Association. “For the most part, we are now much better at treating risk factors such as hypertension, diabetes and especially high cholesterol,” said North Carolina cardiologist Dr. Kevin Campbell, who wa...
Source: WBZ-TV - Breaking News, Weather and Sports for Boston, Worcester and New Hampshire - March 18, 2019 Category: Consumer Health News Authors: Health – CBS Boston Tags: Health News aspirin CNN Source Type: news

Hypertension care in Aseer region, Saudi Arabia: Barriers and solutions.
This study revealed that HTN patients received insufficient care, which could be attributed to many different barriers. In order to improve the quality of HTN care for HTN, these barriers should be overcome by implementation of the recommendations. PMID: 25394461 [PubMed - in process]
Source: Saudi Journal of Kidney Diseases and Transplantation - November 1, 2014 Category: Urology & Nephrology Authors: Al-Saleem SA, Al-Shahrani A, Al-Khaldi YM Tags: Saudi J Kidney Dis Transpl Source Type: research

Turmeric: Nature ’s Miracle Root for Disease
My friends Lelir and Westi in Bali don’t like to go to doctors. Nature is their pharmacy. You see, Lelir is a Balian. That means “herbal healer.” And Westi’s plantation is bursting with healing plants.  But one plant stands out above all the others. Lelir uses it to make a daily immune-boosting elixir as well as an anti-aging facial scrub. Balians use it as an antibiotic and for liver support. They boil it with milk and sugar to treat the common cold and allergies. Rural doctors make it into a paste with lime to ease sore joints. They make drinks to treat fevers and stomach pain. They mix it wi...
Source: Al Sears, MD Natural Remedies - September 20, 2016 Category: Complementary Medicine Authors: Al Sears Tags: Natural Cures Source Type: news

Refractory Mycoplasma pneumoniae pneumonia with concomitant acute cerebral infarction in a child: A case report and literature review
We present a 7-year-old boy with severe M pneumoniae pneumonia who developed impaired consciousness, aphasia, and reduced limb muscle power 7 days postadmission. Diagnoses: Mycoplasma pneumoniae pneumonia with concomitant acute cerebral infarction. Interventions: The patient recovered with aggressive antibiotic therapy, antiinflammation therapy with methylprednisolone, and gamma immunoglobulin and anticoagulation therapy with aspirin and low molecular weight heparin along with rehabilitation training. Outcomes: At 8 days postadmission, his consciousness was improved and at the 6-month follow-up visit, his muscle p...
Source: Medicine - March 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Not Just Acid Reflux: The Need to Think Worst First
Discussion Heart disease is the leading cause of death in the United States.1 This year, 720,000 Americans will have a new coronary event—defined as first hospitalized myocardial infarction (MI) or coronary heart disease death—and around 335,000 will have a recurrent event. Approximately 35% of people who experience a coronary event in a given year and around 14% of patients who have an acute coronary syndrome will die from it.1 Roughly 60% of patients with an acute coronary syndrome are transported to the emergency department via ambulance.2–4. Up to one-third of patients experiencing an MI may not complain of chest...
Source: JEMS Special Topics - January 13, 2019 Category: Emergency Medicine Authors: Stephen Sanko, MD, FACEP Tags: Exclusive Articles Cardiac & Resuscitation Source Type: news

Effectiveness of polypill for primary and secondary prevention of cardiovascular diseases (PolyIran): a pragmatic, cluster-randomised trial
Publication date: 24–30 August 2019Source: The Lancet, Volume 394, Issue 10199Author(s): Gholamreza Roshandel, Masoud Khoshnia, Hossein Poustchi, Karla Hemming, Farin Kamangar, Abdolsamad Gharavi, Mohammad Reza Ostovaneh, Alireza Nateghi, Masoud Majed, Behrooz Navabakhsh, Shahin Merat, Akram Pourshams, Mahdi Nalini, Fatemeh Malekzadeh, Masoumeh Sadeghi, Noushin Mohammadifard, Nizal Sarrafzadegan, Mohammad Naemi-Tabiei, Abdolreza Fazel, Paul BrennanSummaryBackgroundA fixed-dose combination therapy (polypill strategy) has been proposed as an approach to reduce the burden of cardiovascular disease, especially in low-income ...
Source: The Lancet - August 23, 2019 Category: General Medicine Source Type: research