Query: stroke

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Source: JAMA Neurology
Condition: Diabetes

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Total 7 results found since Jan 2013.

Potential New Horizons for the Prevention of Cerebrovascular Diseases and Dementia
In this issue ofJAMA Neurology, Spence et al discuss the effect of pioglitazone, an insulin-sensitizing agent that has been shown to reduce the risk of recurrent stroke and myocardial infarction in patients with insulin resistance, in patients with prediabetes. Prediabetes was defined according to the American Diabetes Association criteria, ie, a hemoglobin A1c level of 5.7% to 6.4% or a fasting plasma glucose level of 100 to 125 mg/dL. Data were taken from the Insulin Resistance Intervention after Stroke (IRIS) study, an international randomized clinical trial performed in patients with previous stroke or transient ischem...
Source: JAMA Neurology - February 7, 2019 Category: Neurology Source Type: research

Which Patients With Ischemic Stroke and Insulin Resistance May Benefit From Pioglitazone?
The Insulin Resistance Intervention After Stroke (IRIS) trial has reported that treating insulin resistance with the peroxisome proliferator –activated receptor γ agonist pioglitazone hydrochloride reduced recurrent stroke or myocardial infarction (MI) by about one-fourth compared with placebo (pioglitazone, 9.0% vs placebo, 11.8%; hazard ratio [HR], 0.76; 95% CI, 0.62-0.93) in 3876 patients with recent (<6 months) ischemic stroke or transient ischemic attack and insulin resistance but without diabetes, heart failure, or bladder cancer. Pioglitazone was also associated with less incident diabetes vs placebo (3.8% vs ...
Source: JAMA Neurology - September 18, 2017 Category: Neurology Source Type: research

Phenotypic Destiny in Mitochondrial Disease?
Mitochondrial diseases are a group of heterogeneous disorders caused by inherited mutations in the mitochondrial genome (mtDNA) and nuclear genome. Typically, mutations in the mtDNA are maternally inherited and cause respiratory chain defects and account for a substantial fraction of childhood and adult neurometabolic disease, with an estimated prevalence of 1:5000 (0.02%). The most common mtDNA mutation is the mitochondrial 3243A>G mutation (m.3243A>G) in the MTTL1 gene (OMIM 590050), which encodes the transfer RNA tRNALeu(UUR). This mutation is associated with multiple clinical and psychiatric manifestations, including d...
Source: JAMA Neurology - June 20, 2016 Category: Neurology Source Type: research

Proton Pump Inhibitors and Dementia Incidence
To the Editor I read with interest the article by Gomm and colleagues, which examined the association between the use of proton pump inhibitors (PPIs) and incident dementia in elderly individuals in a prospective study. The authors adopted time-dependent Cox regression analysis, and the time-dependent covariates were polypharmacy and the comorbidities of depression, diabetes, ischemic heart disease, and stroke. Age and sex were also used as confounding factors. The hazard ratio of PPIs for incident dementia was 1.44 (95% CI, 1.36-1.52), and the authors recommended randomized clinical trials to confirm the causal associatio...
Source: JAMA Neurology - June 20, 2016 Category: Neurology Source Type: research

Vital Sign and Glucose Abnormalities and Outcome in Childhood Stroke
Childhood stroke studies often cite differences in risk factors between adult and pediatric patients, namely that traditional adult stroke risk factors, such as hypertension and hyperglycemia, are not common causes of childhood stroke. In a study of 83 children from the United Kingdom, only 8 children (10%) with available blood pressure data at admission were classified as having hypertension. The authors stated that this could be an overestimate because follow-up blood pressure data were not available, but they acknowledged that elevated blood pressure could be important in some children. In a multinational cohort of 676 ...
Source: JAMA Neurology - May 23, 2016 Category: Neurology Source Type: research

Early Recurrent Stroke Prediction With the Recurrence Risk Estimator
Acute ischemic stroke is a medical emergency. Early reperfusion therapy can reduce functional disability, and early secondary prevention therapy can reduce early recurrent stroke. The rate of recurrent stroke in the first month is approximately 9.4% (95% CI, 6%-14%) among patients with ischemic stroke caused by large-artery atherosclerosis and approximately 1.2% (95% CI, 0.4%-3.0%) among patients with ischemic stroke caused by intracranial small vessel disease. Because some effective early prevention therapies may be risky or costly (eg, carotid revascularization or dual antiplatelet therapy) and some patients have a low r...
Source: JAMA Neurology - February 29, 2016 Category: Neurology Source Type: research

Outcomes in Mild Acute Ischemic Stroke Treated With Intravenous Thrombolysis A Retrospective Analysis of the Get With the Guidelines–Stroke Registry
Conclusions and RelevanceMany patients with ischemic stroke treated with IV rtPA have a mild stroke. Symptomatic intracranial hemorrhage is infrequent, but approximately 30% of these patients are unable to return directly home or ambulate independently at discharge. Additional studies are needed to identify strategies to improve the outcomes in patients with mild stroke who receive thrombolysis.
Source: JAMA Neurology - February 2, 2015 Category: Neurology Source Type: research