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Obstructive Sleep Apnea: A New Preventive and Therapeutic Target for Stroke A new kid on the block
Stroke is the second leading cause of death worldwide and a major cause of mental and physical impairment. Numerous studies have identified risk factors for stroke, including hypertension, atrial fibrillation, diabetes, and smoking. However, even after considering these well-recognized risk factors, there is substantial variation in stroke rates and stroke-related outcomes. There is emerging evidence that obstructive sleep apnea increases the risk of stroke independent of traditional risk factors.
Source: The American Journal of Medicine - February 28, 2015 Category: Journals (General) Authors: Vahid Mohsenin Source Type: research

Obstructive Sleep Apnea: A New Preventive and Therapeutic Target for Stroke
Stroke is the second leading cause of death worldwide and a major cause of mental and physical impairment. Numerous studies have identified risk factors for stroke, including hypertension, atrial fibrillation, diabetes, and smoking. However, even after considering these well-recognized risk factors, there is substantial variation in stroke rates and stroke-related outcomes. There is emerging evidence that obstructive sleep apnea increases the risk of stroke independently of traditional risk factors.
Source: The American Journal of Medicine - February 28, 2015 Category: Journals (General) Authors: Vahid Mohsenin Tags: Review Source Type: research

Effects of Anticoagulation on Low-Density Lipoprotein-Cholesterol and Ischemic Stroke in Patients with Nonvalvular Atrial Fibrillation
The study by Omelchenko et al1 concluded that, unlike the general population, low-density lipoprotein-cholesterol (LDL-C) levels were not associated with ischemic stroke risk among patients with atrial fibrillation treated with direct oral anticoagulants (DOACs). To arrive at this conclusion, they retrospectively analyzed data of 21,229 patients with a first-time diagnosis of nonvalvular atrial fibrillation treated with DOACs categorized according to the congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke or transient ischemic attack (TIA), vascular disease, age 65 to 74 years, sex category, ...
Source: The American Journal of Medicine - September 28, 2021 Category: General Medicine Authors: Zeeshan H. Ismail, Zekarias T. Asnake, Joshua K. Salabei Tags: Letter Source Type: research

Does CHA2DS2-VASc Improve Stroke Risk Stratification in Postmenopausal Women with Atrial Fibrillation?
Abstract: Background: Risk stratification of atrial fibrillation patients with a congestive heart failure (C), hypertension (H), age ≥ 75 (A), diabetes (D), stroke or transient ischemic attack (TIA) (S2) (CHADS2) score of
Source: The American Journal of Medicine - October 18, 2013 Category: Journals (General) Authors: JoEllyn M. Abraham, Joseph Larson, Mina K. Chung, Anne B. Curtis, Kamakshi Lakshminarayan, Jonathan D. Newman, Marco Perez, Kathryn Rexrode, Nawar M. Shara, Allen J. Solomon, Marcia L. Stefanick, James C. Torner, Bruce L. Wilkoff, Sylvia Wassertheil-Smoll Tags: Clinical research studies Source Type: research

NSAID Use and Association with Cardiovascular Outcomes in Outpatients with Stable Atherothrombotic Disease
Abstract: Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) other than aspirin have been linked to heart failure, salt retention, adverse ventricular remodeling, and thrombosis. We therefore sought to assess their impact on cardiovascular events in outpatients with stable atherothrombotic disease.Methods: We analyzed 44,095 patients in the REduction of Atherothrombosis for Continued Health (REACH) registry with information on NSAID use and 4-year follow-up. Cox proportional hazard models, including NSAID use as a time-dependent covariate, were constructed and adjusted for key baseline characteristics. End points of...
Source: The American Journal of Medicine - November 25, 2013 Category: Journals (General) Authors: Payal Kohli, Ph. Gabriel Steg, Christopher P. Cannon, Sidney C. Smith, Kim A. Eagle, E. Magnus Ohman, Mark J. Alberts, Elaine Hoffman, Jianping Guo, Tabassome Simon, Emmanuel Sorbets, Shinya Goto, Deepak L. Bhatt, REACH Registry Investigators Tags: Clinical research studies Source Type: research

Vascular Risk Factors, Cardiovascular Disease, and Restless Legs Syndrome in Women
Conclusions: In this large cohort of female health professionals, various vascular risk factors are associated with the prevalence of restless legs syndrome. We could not confirm the results of previous reports indicating an association between prevalent cardiovascular disease and restless legs syndrome.
Source: The American Journal of Medicine - February 15, 2013 Category: Journals (General) Authors: Anke C. Winter, Markus Schürks, Robert J. Glynn, Julie E. Buring, J. Michael Gaziano, Klaus Berger, Tobias Kurth Tags: Clinical research studies Source Type: research

Vascular Risk Factors, Cardiovascular Disease, and Restless Legs Syndrome in Men
Conclusions: The restless legs syndrome prevalence among US male physicians is similar to that of men of the same age group in other western countries. A history of diabetes is the most consistent risk factor associated with restless legs syndrome. Prevalent stroke and myocardial infarction are related to restless legs syndrome prevalence.
Source: The American Journal of Medicine - February 15, 2013 Category: Journals (General) Authors: Anke C. Winter, Klaus Berger, Robert J. Glynn, Julie E. Buring, J. Michael Gaziano, Markus Schürks, Tobias Kurth Tags: Clinical research studies Source Type: research

CHA2DS2-VASc Score Is Directly Associated with the Risk of Pulmonary Embolism in Patients with Atrial Fibrillation
Conclusions: CHA2DS2-VASc score is directly associated with the incidence of pulmonary embolism in atrial fibrillation.
Source: The American Journal of Medicine - January 1, 2014 Category: Journals (General) Authors: Walid Saliba, Gad Rennert Tags: Clinical research studies Source Type: research

Quality of Care Among Patients with Diabetes and Cerebrovascular Disease. Insights from The Diabetes Collaborative Registry
Not only do patients with type 2 diabetes have increased risks of coronary artery disease and peripheral artery disease, but they also have least a two-fold increased risk of experiencing a stroke. Further, patients with type 2 diabetes who have a stroke have worse outcomes compared with those without type 2 diabetes.1 While secondary prevention strategies and the quality of care of patients with type 2 diabetes and concomitant coronary artery disease have been well-studied,2 less is known about the management of patients with type 2 diabetes and cerebrovascular disease (e.g., stroke, transient ischemic attack, carotid artery disease).
Source: The American Journal of Medicine - July 21, 2022 Category: General Medicine Authors: Justin B. Echouffo-Tcheugui, Alexander Turchin, Robert S. Rosenson, Gregg C. Fonarow, Abhinav Goyal, James A. de Lemos, Suzanne V. Arnold Tags: Clinical Research Study Source Type: research

CHADS2 Score, Statin Therapy, and Risks of Atrial Fibrillation
This study aimed to evaluate the efficacy of statin treatment for atrial fibrillation prevention in elderly patients with hypertension, and to determine if comorbidity or CHADS2 (Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, prior Stroke or transient ischemic attack) score can predict the effectiveness of statin treatment. Methods: Patients aged ≥65 years with hypertension were identified from a National Health Insurance research database (a systemic sampling from 2000 to 2009 with a total of 1,000,000 subjects). Medical records of 27,002 patients were used in this study, in which 2400 (8....
Source: The American Journal of Medicine - January 17, 2013 Category: Journals (General) Authors: Chen-Ying Hung, Ching-Heng Lin, El-Wui Loh, Chih-Tai Ting, Tsu-Juey Wu Tags: Clinical research studies Source Type: research

ALTITUDE Trial and Dual RAS Blockade: The Alluring but Soft Science of the Surrogate End Point
On December 20, 2011, the large, landmark Aliskiren Trial in Type 2 Diabetes Using Cardio-Renal Endpoints (ALTITUDE) was terminated on the basis of the recommendations of the Data and Safety Monitoring Board. The ALTITUDE was designed to evaluate the effects of aliskiren versus placebo on top of an angiotensin receptor blocker or an angiotensin-converting enzyme inhibitor in more than 8000 patients with type II diabetes and renal impairment. An increased incidence of hypotension, hyperkalemia, renal complications, and nonfatal stroke (HR = 1.25; 95% CI 0.98-1.60; P = .07) was observed in the aliskiren arm during the follow...
Source: The American Journal of Medicine - January 17, 2013 Category: Journals (General) Authors: Franz H. Messerli, Sripal Bangalore Tags: Commentary Source Type: research

Prevalence of Hyponatremia and Association with Mortality: Results from NHANES
Abstract: Background: Hyponatremia is the most common electrolyte abnormality in hospitalized patients and is associated with adverse outcomes, but its prevalence and significance in the general US population is unknown. Our aims were to determine the prevalence of hyponatremia and its association with mortality in the population.Methods: We performed a population-based, cross-sectional study of 14,697 adults aged ≥18 years who participated in the nationally representative National Health and Nutrition Examination Survey for 1999-2004. By using measurements of serum sodium corrected for dilutional effect of hyperglycemia...
Source: The American Journal of Medicine - November 27, 2013 Category: Journals (General) Authors: Sumit Mohan, Sue Gu, Amay Parikh, Jai Radhakrishnan Tags: Clinical research studies Source Type: research

Treat or Eat: Food Insecurity, Cost-related Medication Underuse, and Unmet Needs
Conclusions: Approximately 1 in 3 chronically ill NHIS participants are unable to afford food, medications, or both. WIC and public health insurance participation are associated with less food insecurity and cost-related medication underuse.
Source: The American Journal of Medicine - January 21, 2014 Category: Journals (General) Authors: Seth A. Berkowitz, Hilary K. Seligman, Niteesh K. Choudhry Tags: Clinical research studies Source Type: research

The Diabetes Shared Care Program and Risks of Cardiovascular Events in Type 2 Diabetes
The Diabetes Shared Care Program (DSCP) is an integrated diabetes care model designed to increase the quality of diabetes care in Taiwan. The efficacy of this program is unknown. Therefore, we evaluated whether participating patients had reduced risks of cardiovascular events, including coronary heart disease, stroke, and all-cause mortality.
Source: The American Journal of Medicine - April 20, 2015 Category: Journals (General) Authors: Edy Kornelius, Jeng-Yuan Chiou, Yi-Sun Yang, Ying-Li Lu, Chiung-Huei Peng, Chien-Ning Huang Tags: Clinical Research Study Source Type: research

A cryptic case: isolated cerebral mucormycosis
A rare infection raging within the brain of a 50-year-old African-American man was impossible to diagnose until after his death. He presented to the emergency department after the acute onset of garbled speech, confusion, right-arm weakness, and right facial droop. His medical history was significant for poorly controlled diabetes mellitus and polysubstance abuse, including intravenous drug abuse. He had never had a stroke, had no sick contacts, and had not traveled recently.
Source: The American Journal of Medicine - October 5, 2015 Category: Journals (General) Authors: Monica B. Dhakar, Mahmoud Rayes, William Kupsky, Tselis Alexandros, Gregory Norris Tags: Diagnostic Dilemma Source Type: research

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