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Management of acid-related disorders in patients with dysphagia
Publication date: 6 September 2004 Source:The American Journal of Medicine Supplements, Volume 117, Issue 5, Supplement 1 Author(s): Colin W. Howden Dysphagia affects a large and growing number of individuals in the United States, particularly the elderly and those who are neurologically impaired. Swallowing difficulties may be due to age-related changes in oropharyngeal and esophageal functioning as well as central nervous system diseases such as stroke, Parkinson disease, and dementia. Among institutionalized individuals, dysphagia is associated with increased morbidity and mortality. An appreciation of the physiology ...
Source: The American Journal of Medicine Supplements - November 6, 2014 Category: Drugs & Pharmacology Source Type: research

Daily low-dose aspirin can prevent heart attack and stroke but is often misused
Aspirin is often hailed as a wonder drug, thanks to its ability to help stave off heart attacks and clot-caused strokes. But fewer than half of people who could benefit from a daily low-dose aspirin take it, while many others take it when they shouldn't, reports the January 2014 Harvard Heart Letter. If you don't have heart disease, but do have high blood pressure, diabetes, or other risk factors for heart disease, don't automatically assume that taking aspirin every day is a good idea. "A lot of people take aspirin who really shouldn't," says Dr. Christopher Cannon, a cardiologist at Brigham and Women's Hospital and profe...
Source: New Harvard Health Information - December 20, 2013 Category: Consumer Health News Source Type: news

Recurrent headaches: a case of neurological Behçet's disease.
Abstract A 48-year-old black male, of Nigerian heritage, presented with a 24-hour history of frontal headache of gradual onset. The headache characteristic was migranous, being described as throbbing in nature and located to the right frontal area with associated blurring of vision. Although similar to prior frequent headaches, there was now increasing unsteadiness on walking. Diagnosed 10 years earlier with Behçet's disease, the initial presentation was with oral and genital ulceration. Recurrent episodes of headache caused by neurological flare-ups resulted in a stroke at the age of 46 years. This previous stro...
Source: British Journal of Hospital Medicine - October 9, 2013 Category: Internal Medicine Authors: M Ismail A, W Dubrey S, C Patel M Tags: Br J Hosp Med (Lond) Source Type: research

Electrolyte imbalance triggering relapse of inflammatory neuropathy
We describe a case of a 71 year old female with a fourteen year history of chronic inflammatory demyelinating polyneuropathy (CIDP) and stable monoclonal gammopathy, normally maintained on three–weekly intravenous immunoglobulin (IVIG) therapy. At her best baseline, she has a normal motor examination and reduced vibration sense only to the ankles. She presented with a four week history of progressive numbness and paresthesiae in all four limbs, reduced balance, a decline in mobility with frequent falls and reduced hand function. The deterioration developed after a week of non–bloody diarrhoea with night sweats ...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Keshavan, A., Gandhi, S., Lunn, M., Reilly, M. Tags: Neurogastroenterology, Immunology (including allergy), Drugs: CNS (not psychiatric), Multiple sclerosis, Neuromuscular disease, Peripheral nerve disease, Stroke, Hypertension Association of British Neurologists (ABN) joint meeting with the Royal College Source Type: research

Taking over the counter pain relievers safely
For aching joints or a throbbing head, millions of Americans turn to aspirin, ibuprofen (Advil, Motrin), or other nonsteroidal anti-inflammatory drugs (NSAIDs) every day. They are generally safe, but if not used carefully NSAIDs can have a dark side, according to the September 2013 Harvard Women's Health Watch. NSAIDs are widely used because they perform double duty. “They not only relieve pain, but they reduce inflammation too,” says Dr. Lucy Chen, an assistant professor at Harvard Medical School and attending physician in the anesthesia, critical care, and pain medicine department at Massachusetts General Hos...
Source: New Harvard Health Information - August 23, 2013 Category: Consumer Health News Source Type: news

Lack of association between proton pump inhibitors and adverse events in patients taking clopidogrel and aspirin
Commentary on Douglas IJ, Evans SJ, Hingorani AD, et al.. Clopidogrel and interaction with proton pump inhibitors: comparison between cohort and within person study designs. BMJ 2012;345:e4388 Context Clopidogrel inhibits the P2Y12 platelet receptor and is used in patients with acute coronary syndromes or ischaemic stroke to prevent recurrent vascular events. Proton pump inhibitors (PPIs), however, have been shown to reduce the pharmacodynamic effect of clopidogrel upon platelet inhibition, and have been linked in retrospective studies to a higher rate of ischaemic outcomes in patients taking clopidogrel. Methods A total o...
Source: Evidence-Based Medicine - May 15, 2013 Category: Internal Medicine Authors: Waksman, R., Gaglia, M. A. Tags: Smoking and tobacco, Epidemiologic studies, Drugs: cardiovascular system, Stroke, Ischaemic heart disease, Health education, Smoking Aetiology Source Type: research

Reversible stroke-like symptoms with severe hyponatremia.
Abstract A 65-year-old Caucasian female was brought to the Emergency Department by her husband for increasing generalized weakness, slurred speech and new-onset facial droop. A non-contrast computerized tomography scan of her brain was negative; however, she was found to have a sodium level of 99 mmol/L. Her daily medications included hydrochlorothiazide, omeprazole and irbesartan. On physical examination, she was found to have slight confusion, lethargy, slowed speech, generalized weakness and left-sided facial droop but no other focal deficits. Over the course of her hospital stay, the patient's sodium levels we...
Source: Tennessee Medicine - February 1, 2013 Category: Internal Medicine Authors: Holloman LN, Kolade VO, Zapko DR, Youngblood LB Tags: Tenn Med Source Type: research

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