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Source: The American Journal of Medicine

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Total 259 results found since Jan 2013.

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

Can the reduction percentage LDL-C or Attained LDL-C levels or both add incremental prognostic value?
The role of low-density lipoprotein cholesterol (LDL-C) in the pathophysiology of atherosclerotic cardiovascular disease, which may present as coronary heart disease, stroke, and peripheral arterial disease, has been well documented in several studies.1,2,3,4 The decrease in LDL-C levels leads to a significant reduction in the risk of atherosclerotic cardiovascular disease.5
Source: The American Journal of Medicine - November 13, 2015 Category: Journals (General) Authors: Leonardo Roever Tags: Editorial Source Type: research

Early Cardiovascular Disease After the Diagnosis of Systemic Sclerosis
To assess risk and time trends of newly recorded myocardial infarction and stroke in cases with systemic sclerosis.
Source: The American Journal of Medicine - November 18, 2015 Category: Journals (General) Authors: J. Antonio Aviña-Zubieta, Ada Man, Marko Yurkovich, Kun Huang, Eric C. Sayre, Hyon K. Choi Tags: Clinical Research Study Source Type: research

Antithrombotic Treatment Patterns in Patients with Newly Diagnosed Nonvalvular Atrial Fibrillation: The GLORIA-AF Registry, Phase II
The Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF) was designed to provide prospectively collected information on patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke, with the aim of addressing treatment patterns and questions of effectiveness and safety.
Source: The American Journal of Medicine - July 31, 2015 Category: Journals (General) Authors: Menno V. Huisman, Kenneth J. Rothman, Miney Paquette, Christine Teutsch, Hans Christoph Diener, Sergio J. Dubner, Jonathan L. Halperin, Changsheng Ma, Kristina Zint, Amelie Elsaesser, Dorothee B. Bartels, Gregory Y.H. Lip, GLORIA-AF Investigators Tags: Clinical research study Source Type: research

Can the Reduction in Percent LDL Cholesterol or Attained LDL Cholesterol Levels or Both Add Incremental Prognostic Value?
The role of low-density lipoprotein cholesterol (LDL-C) in the pathophysiology of atherosclerotic cardiovascular disease, which may present as coronary heart disease, stroke, and peripheral arterial disease, has been well documented in several studies.1-4 The decrease in LDL-C levels leads to a significant reduction in the risk of atherosclerotic cardiovascular disease.5
Source: The American Journal of Medicine - November 13, 2015 Category: Journals (General) Authors: Leonardo Roever Tags: Editorial Source Type: research

Raised Intracranial Pressure Secondary to Vitamin Overdose
We report a patient for whom multi-vitamin ingestion was associated with neurological symptoms which mimicked acute stroke.
Source: The American Journal of Medicine - December 16, 2015 Category: Journals (General) Authors: Christopher Keith Oldroyd, Matthew Walters, Krishna Dani Tags: Clinical Communication to the Editor Source Type: research

Cardiovascular Benefits of the Mediterranean Diet Are Driven by Stroke Reduction and Possibly by Decreased Atrial Fibrillation Incidence
Widmer et al assemble a wealth of information on “The Mediterranean Diet, its Components, and Cardiovascular Disease,”1 a topic that is of ever-growing importance. They are right to call the Prevención con Dieta Mediterránea (PREDIMED) trial2 a “flagship study,” or, as I might paraphrase, a landmark study that changes clinical practice in terms of what diet we might recommend to our patients. PREDIMED was a well-designed randomized controlled trial with a significant sample size.
Source: The American Journal of Medicine - December 18, 2015 Category: Journals (General) Authors: Benjamin P. Geisler Tags: AJM online Source Type: research

Thrombolysis; a critical first-line therapy with an unfulfilled potential
A blood clot or thrombus triggers the onset of most vascular diseases, like stroke or heart attack. Thrombolysis is the only treatment that can restore blood flow rapidly and easily. Unfortunately, the standard thrombolytic, tissue plasminogen activator (tPA), has proven inadequate and is being replaced by invasive endovascular procedures, which are time-consuming and limited in their availability in relation to the scope of the problem. Historically, when tPA clinical trials began, it was insufficiently recognized that without the other natural plasminogen activator, prourokinase (proUK), thrombolysis by tPA was seriously compromised.
Source: The American Journal of Medicine - December 20, 2015 Category: Journals (General) Authors: Victor Gurewich Tags: Review Source Type: research

Migrating susceptibility vessel sign in posterior circulation stroke
A 95-year-old woman with atrial fibrillation was admitted with acute onset of disturbed consciousness. On admission, neurological deficits rapidly improved and completely disappeared. The prothrombin time-international normalized ratio (PT-INR) was 1.4 although she was medicated with warfarin (2.5 mg/day). Brain magnetic resonance (MR) imaging with diffusion-weighted imaging (DWI) findings on admission were normal, but MR angiography (MRA) detected basilar-top occlusion and susceptibility-weighted imaging (SWI) confirmed the susceptibility vessel sign at the basilar top (Fig.
Source: The American Journal of Medicine - March 11, 2016 Category: Journals (General) Authors: Teppei Komatsu, Hidetaka Mitsumura, Satoshi Matsushima, Yasuyuki Iguchi Tags: Clinical Communication to the Editor Source Type: research

Thrombolysis: A Critical First-Line Therapy with an Unfulfilled Potential
A blood clot or thrombus triggers the onset of most vascular diseases, like stroke or heart attack. Thrombolysis is the only treatment that can restore blood flow rapidly and easily. Unfortunately, the standard thrombolytic, tissue plasminogen activator (tPA), has proven inadequate and is being replaced by invasive endovascular procedures, which are time consuming and limited in their availability in relation to the scope of the problem. Historically, when tPA clinical trials began, it was not recognized sufficiently that without the other natural plasminogen activator, prourokinase (proUK), thrombolysis by tPA was seriously compromised.
Source: The American Journal of Medicine - December 20, 2015 Category: Journals (General) Authors: Victor Gurewich Tags: Review Source Type: research

Evaluation of the HAS-BLED, ATRIA, and ORBIT Bleeding Risk Scores in Patients with Atrial Fibrillation Taking Warfarin
Various bleeding risk prediction schemes, such as the Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile international normalized Ratio, Elderly, Drugs/alcohol (HAS-BLED), Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA), and Outcomes Registry for Better Informed Treatment (ORBIT) scores, have been proposed in patients with atrial fibrillation. We compared the relative predictive values of these bleeding risk scores for clinically relevant bleeding and the relationship of ATRIA and ORBIT scores to the quality of anticoagulation control on warfarin, as reflected by...
Source: The American Journal of Medicine - October 16, 2015 Category: Journals (General) Authors: Keitaro Senoo, Marco Proietti, Deirdre A. Lane, Gregory Y.H. Lip Tags: Clinical research study Source Type: research

Usefulness of CHADS2 and CHA2DS2-VASc scores in the prediction of new-onset atrial fibrillation: a population-based study
CHADS2 and CHA2DS2-VASc are validated scores used to predict stroke in patients with atrial fibrillation. Many of the individual risk factors included in these scores are also risk factors for atrial fibrillation. We aimed to examine the performance of CHADS2 and CHA2DS2-VASc scores in predicting new-onset atrial fibrillation in subjects without preexisting diagnosis of atrial fibrillation.
Source: The American Journal of Medicine - March 21, 2016 Category: Journals (General) Authors: Walid Saliba, Naomi Gronich, Ofra Barnett-Griness, Gad Rennert Tags: Clinical Research Study Source Type: research

Major Outcomes in Atrial Fibrillation Patients with One Risk Factor: Impact of Time in Therapeutic Range
The benefits and harms of oral anticoagulation (OAC) therapy in patients with only one stroke risk factor (i.e. CHA2DS2-VASc= 1 in males, or 2 in females) has been subject of debate.
Source: The American Journal of Medicine - April 14, 2016 Category: Journals (General) Authors: Marco Proietti, Gregory Y.H. Lip Tags: Clinical Research Study Source Type: research

Sudden cardiac arrest from heat stroke: Hidden dangers of hot yoga
A healthy 35-year-old female, 12 weeks post-partum, was in her hot yoga class when she suddenly became unresponsive. Cardiopulmonary Resuscitation (CPR) was started on the patient promptly. Emergency Medical Services (EMS) arrived 5 minutes into initiation of CPR. Exam revealed warm skin, dilated pupils and frank blood foaming from her mouth. Rhythm was consistent with ventricular fibrillation. 45 minutes of CPR was performed before return of spontaneous circulation, after which patient was placed on vasopressor support.
Source: The American Journal of Medicine - April 19, 2016 Category: Journals (General) Authors: Prajwal Boddu, Suhag Patel, Anahita Shahrrava Tags: Clinical Communication to the Editor Source Type: research

North American Thrombosis Forum, AF Action Initiative Consensus Document
The North American Thrombosis Forum Atrial Fibrillation Action Initiative consensus document is a comprehensive yet practical briefing document focusing on stroke and bleeding risk assessment in patients with atrial fibrillation, as well as recommendations regarding anticoagulation options and management. Despite the breadth of clinical trial data and guideline recommendation updates, many clinicians continue to struggle to synthesize the disparate information available. This problem slows the uptake and utilization of updated risk prediction tools and adoption of new oral anticoagulants.
Source: The American Journal of Medicine - April 26, 2016 Category: Journals (General) Authors: Christian T. Ruff, Jack E. Ansell, Richard C. Becker, Emelia J. Benjamin, David J. Deicicchi, N.A. Mark Estes, Michael D. Ezekowitz, John Fanikos, Jawed Fareed, David Garcia, Robert P. Giugliano, Samuel Z. Goldhaber, Christopher Granger, Jeff S. Healey, R Source Type: research