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Quiz case: a clinical reasoning challenge in the emergency stroke setting
AbstractA right-handed woman in her 80s was admitted to the emergency department 1 h after sudden-onset global aphasia and right-sided hemiparesis. Medical history included arterial hypertension, dyslipidemia, hyperuricemia, aortic stenosis, osteoporosis, and recent pulmonary embolism. Medication consisted of apixaban, bisoprolol, hydrochlorothiazide, allopurinol, fenofibrate, and vitamin D. Vital parameters (blood pressure, heart rate, body temperature, oxygen saturation) and glycemia were all within normal range. Electrocardiogram showed a first-degree atrioventricular block. The patient was promptly transported to the e...
Source: Neurological Sciences - August 5, 2023 Category: Neurology Source Type: research

Sickle cell bone disease and response to intravenous bisphosphonates in children
ConclusionChildren with SCD have the potential for extensive and early-onset bone morbidity. In this series, IV bisphosphonates were effective for bone pain analgesia and did not trigger sickle cell complications.
Source: Osteoporosis International - July 29, 2022 Category: Orthopaedics Source Type: research

Thoracic Aortic < sup > 18 < /sup > F-Sodium Fluoride Activity and Ischemic Stroke in Patients With Established Cardiovascular Disease
CONCLUSIONS: In patients with established cardiovascular disease, thoracic aortic 18F-sodium fluoride activity is associated with the progression of atherosclerosis and future ischemic stroke. Arterial 18F-sodium fluoride activity identifies localized areas of atherosclerotic disease activity that are directly linked to disease progression and downstream regional clinical atherothrombotic events. (DIAMOND - Dual Antiplatelet Therapy to Reduce Myocardial Injury [DIAMOND], NCT02110303; Study Investigating the Effect of Drugs Used to Treat Osteoporosis on the Progression of Calcific Aortic Stenosis [SALTIRE II], NCT02132026; ...
Source: Atherosclerosis - February 20, 2022 Category: Cardiology Authors: Alexander J Fletcher Yong Y Tew Evangelos Tzolos Shruti S Joshi Jakub Kaczynski Jennifer Nash Samuel Debono Maria Lembo Jacek Kwiecinski Rong Bing Maaz B J Syed Mhairi K Doris Edwin J R van Beek Alistair J Moss William S Jenkins Niki L Walker Nikhil V Jos Source Type: research

Gait speed and spasticity are independently associated with estimated failure load in the distal tibia after stroke: an HR-pQCT study
ConclusionThe paretic distal tibia showed more compromised vBMD, cortical area, cortical thickness, and estimated failure load than the non-paretic tibia. Gait speed and spasticity were independently associated with estimated failure load. As treatment programs focusing on these potentially modifiable stroke-related impairments are feasible to administer, future studies are needed to determine the efficacy of such intervention strategies for improving bone strength in individuals with chronic stroke.
Source: Osteoporosis International - October 12, 2021 Category: Orthopaedics Source Type: research

Relationship between bone strength index of the hemiparetic tibial diaphysis and muscle strength in people with chronic stroke: influence of muscle contraction type and speed
ConclusionsConcentric muscle power was more predictive of %SSD in p-SSI at the tibial diaphysis than other contraction types and may be an important target for intervention to promote bone health in people with chronic stroke.
Source: Osteoporosis International - November 7, 2020 Category: Orthopaedics Source Type: research

Calcium supplements linked to post-stroke dementia in women
Conclusion The media paint this as a troubling study for older women who take calcium to strengthen their bones. However the small size of the study (only 98 women took calcium supplements, and only 14 of those got dementia) and its observational nature mean that we cannot rely on the results. As the researchers mention, it is possible that those taking supplements were less healthy than those that didn't in some unmeasured way. Further research may improve our confidence in these results. Broken bones are not a trivial matter for older people – a broken hip can be the difference between being able to live independentl...
Source: NHS News Feed - August 18, 2016 Category: Consumer Health News Tags: Neurology Medication Older people Source Type: news

Correlation between tibial measurements using peripheral quantitative computed tomography and hip areal bone density measurements in ambulatory chronic stroke patients.
CONCLUSIONS: Based on the good correlations between tibial pQCT variables and hip aBMD, the clinical use of pQCT in assessing bone health in this population should be further pursued. PMID: 26647174 [PubMed - as supplied by publisher]
Source: Brain Injury - February 14, 2016 Category: Neurology Tags: Brain Inj Source Type: research

Chronic effects of stroke on hip bone density and tibial morphology: a longitudinal study
Conclusions There is evidence of continuous trabecular bone loss in the paretic tibial distal epiphysis among chronic stroke patients, but it tends to plateau after 2 years of stroke onset. The steady state may have been reached earlier in the hip and tibial diaphysis.
Source: Osteoporosis International - September 2, 2015 Category: Orthopaedics Source Type: research

Osteoporosis as an independent risk factor for silent brain infarction and white matter changes in men and women: the PRESENT project
Conclusions Severe bone mass loss may be an independent risk factor for brain WMC/SI in men and women. Low BMD may cause brain WMC/SI in the step that leads to stroke. Although there are well-designed studies on the prevention of cerebral infarction in patients with brain WMC/SI, a specific prevention method, such as aspirin, should be used for patients with low BMD who have WMC/SI. Screening for low BMD as an independent vascular risk factor in healthy subjects may be required to prevent stroke.
Source: Osteoporosis International - September 26, 2014 Category: Orthopaedics Source Type: research

Lack of parental warmth, abuse in childhood linked to multiple health risks in adulthood
This study was also supported by the MacArthur Research Network on Socioeconomic Status and Health through grants from the John D. and Catherine T. MacArthur Foundation, and by grant T32-MH19925 and the Cousins Center for Psychoneuroimmunology at the UCLA.   The UCLA Cousins Center for Psychoneuroimmunology encompasses an interdisciplinary network of scientists working to advance the understanding of psychoneuroimmunology by linking basic and clinical research programs and by translating findings into clinical practice. The center is affiliated with the Semel Institute for Neuroscience and Human Behavior and the David...
Source: UCLA Newsroom: Health Sciences - October 1, 2013 Category: Universities & Medical Training Source Type: news