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Inflammation May Be the Culprit Behind Our Deadliest Diseases
In the early days of my medical residency, I met a man whom we’ll call Jason. He arrived to our emergency room on a holiday, nonchalant yet amiable, and complained of mild chest pain. Jason was tall and trim, with a strong South Boston accent and fingertips still faintly stained from his last home-improvement project. He was only 45 years old, but he looked much younger. He didn’t smoke, barely drank alcohol, and his cholesterol levels had always been normal. No one in his family had a history of heart disease. He asked us if we could work quickly—he wanted to be home for dinner with his daughters. [time-...
Source: TIME: Health - April 11, 2023 Category: Consumer Health News Authors: Shilpa Ravella Tags: Uncategorized freelance health Source Type: news

Is There a Brain/Heart Interaction in Rheumatoid Arthritis and Seronegative Spondyloartropathies? A Combined Brain/Heart Magnetic Resonance Imaging Reveals the Answer
AbstractPurpose of ReviewTo present the interaction between brain/heart and emphasize the role of combined brain/heart magnetic resonance imaging (MRI) in patients with rheumatoid arthritis (RA) and other seronegative spondyloarthropathies (SNA).Recent FindingsBoth traditional cardiovascular disease (CVD) risk factors and intrinsic RA/SNA features contribute to the increased CVD-related morbidity/mortality. CVD in RA usually occurs a decade earlier than age- and sex-matched controls, and RA patients are twice more likely to develop myocardial infarction irrespective of age, history of prior CVD, and traditional CVD risk fa...
Source: Current Rheumatology Reports - June 18, 2020 Category: Rheumatology Source Type: research

Q Fever, CNS Vasculitis, and Stroke: A Case Report
A 43-year-old male pet shop owner on leflunomide for seronegative rheumatoid arthritis presented locally with strange behavior and aphasia, preceded by flu-like symptoms and high fevers. Initial workup revealed cerebrospinal fluid lymphocytic pleocytosis (22 cells, 74% lymphocytes), for which he was started on empiric antimicrobial therapy. Magnetic resonance imaging of the brain revealed extensive, bilateral ischemic strokes (Figure). A transesophageal echocardiogram was negative. He was then transferred to our institution for further evaluation.
Source: The American Journal of Medicine - May 27, 2020 Category: General Medicine Authors: Jason Maljaars, Santiago Ortega-Gutierrez, Tracey Cho, Amir Shaban Tags: Clinical Communication to the Editor Source Type: research

Embolic Stroke due to Carotidynia Potentially Associated with Moving Carotid Artery Caused by Swallowing
A 63-year-old woman with end-stage renal disease on maintenance hemodialysis discontinued her medication for rheumatoid arthritis with prednisolone and azathioprine. One month later, she was admitted because of consciousness disturbance and right hemiparesis. Diffusion-weighted brain magnetic resonance imaging (MRI) revealed multiple hyperintensities in her left frontal and parietal lobes. She also developed high fever and left neck pain. Carotid ultrasonography showed calcified plaque with vessel wall swelling at the bifurcation of the left common carotid artery (LCCA) and surrounding hypoechoic soft tissue.
Source: Journal of Stroke and Cerebrovascular Diseases - November 15, 2017 Category: Neurology Authors: Yoshitaka Yamaguchi, Mikito Hayakawa, Naoto Kinoshita, Chiaki Yokota, Toshiya Ishihara, Kazunori Toyoda Tags: Case Studies Source Type: research

Assessment of intracranial vessels in association with carotid atherosclerosis and brain vascular lesions in rheumatoid arthritis
Stroke has been associated with rheumatoid arthritis (RA). We assessed patients with RA and healthy control subjects by transcranial Doppler (TCD), carotid ultrasonography and brain magnetic resonance imaging ...
Source: Arthritis Research and Therapy - September 26, 2017 Category: Rheumatology Authors: Csaba Ol áh, Zsófia Kardos, Mariann Sepsi, Attila Sas, László Kostyál, Harjit Pal Bhattoa, Katalin Hodosi, György Kerekes, László Tamási, Attila Valikovics, Dániel Bereczki and Zoltán Szekanecz Tags: Research article Source Type: research

Non-Bacterial Thrombotic Endocarditis in a Patient with Rheumatoid Arthritis.
Authors: Choi JH, Park JE, Kim JY, Kang T Abstract Rheumatoid arthritis (RA) is frequently associated with various extra-joint complications. Although rare, thromboembolic complications are associated with high morbidity and mortality. We experienced a very rare case of nonbacterial thrombotic endocarditis (NBTE) and subsequent embolic stroke in a patient with RA. A 72-year-old male with a 15-year history of RA suddenly developed neurologic symptoms of vomiting and dizziness. Brain magnetic resonance imaging revealed recently developed multiple cerebellar and cerebral lacunar infarctions. Echocardiography showed a ...
Source: Korean Circulation Journal - June 10, 2016 Category: Cardiology Tags: Korean Circ J Source Type: research

Cerebrovascular Disease in Rheumatic Diseases: A Systematic Review and Meta-Analysis Clinical Sciences
Conclusions— Risk of any stroke is higher in most rheumatic diseases than in the general population, particularly <50 years. Rheumatoid arthritis and systemic lupus erythematosus increase ischemic and hemorrhagic stroke risk by 60% to 100% relative to the general population.
Source: Stroke - March 27, 2016 Category: Neurology Authors: Wiseman, S. J., Ralston, S. H., Wardlaw, J. M. Tags: Imaging, Cerebrovascular Disease/Stroke, Ischemic Stroke Clinical Sciences Source Type: research

Diagnostic Magnetic Resonance Imaging of Atherosclerosis in Apolipoprotein E Knockout Mouse Model Using Macrophage-Targeted Gadolinium-Containing Synthetic Lipopeptide Nanoparticles
by Zu T. Shen, Shaokuan Zheng, Matthew J. Gounis, Alexander B. Sigalov Cardiovascular disease is the leading cause of death in Western cultures. The vast majority of cardiovascular events, including stroke and myocardial infarction, result from the rupture of vulnerable atherosclerotic plaques, which are characterized by high and active macrophage content. Current imaging modalities including magnetic resonance imaging (MRI) aim to characterize anatomic and structural features of plaques rather than their content. Previously, we reported that macrophage-targeted delivery of gadolinium (Gd)-based contrast agent (GBCA-HDL) ...
Source: PLoS One - November 16, 2015 Category: Biomedical Science Authors: Zu T. Shen et al. Source Type: research

Rheumatoid Arthritis–Induced Lateral Atlantoaxial Subluxation With Multiple Vertebrobasilar Infarctions
Conclusion. In patients with RA, the potential risk of AAS should be recognized. Lateral AAS in particular may induce cerebral ischemia by positional VA occlusion in advanced stages of the disease. Level of Evidence: N/A
Source: Spine - January 31, 2015 Category: Orthopaedics Tags: Case Report Source Type: research