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Glycaemic control and cardiovascular disease: is there a light at the end of the tunnel?
AbstractPatients with type 2 diabetes mellitus (T2DM) have been shown by numerous studies to have a substantially increased risk of cardiovascular disease (CVD), including coronary artery disease, ischemic stroke and heart failure, even after adjusting for other known risk factors.1,2 First reported in the Framingham studies and followed by additional data including a meta-analysis of 102 prospective studies, diabetes confers about a two-fold excess risk for coronary heart disease and ischemic stroke in both men and women, and about a 2-fold and 5-fold excess risk of heart failure in diabetic men and women.1 –3 However, ...
Source: QJM - August 13, 2016 Category: Internal Medicine Source Type: research

Dementia in the acute hospital: the prevalence and clinical outcomes of acutely unwell patients with dementia
Conclusion</strong>: A diagnosis of dementia confers an increased risk of either death or further admission within the following 12 months, highlighting the need for better cognitive screening in the acute setting, as well as targeted intervention such as comprehensive geriatric assessment.</span>
Source: QJM - August 1, 2016 Category: Internal Medicine Source Type: research

Do traditional risk stratification models for cerebrovascular events apply in irradiated head and neck cancer patients?
Conclusions: Traditional vascular risk factors do not play a role in radiation-induced carotid atherosclerosis. Clinicians should be aware that traditional risk prediction models may under-estimate stroke risk in these patients.
Source: QJM - June 8, 2016 Category: Internal Medicine Authors: Gujral, D. M., Shah, B. N., Chahal, N. S., Bhattacharyya, S., Senior, R., Harrington, K. J., Nutting, C. M. Tags: Original papers Source Type: research

Attitudes to outcomes measured in clinical trials of cardiovascular prevention
Conclusion: Cognitive and functional outcomes are important patient-relevant outcomes, sometimes more important than major vascular events. Incorporating these outcomes into trials may encourage patient participation and adherence to preventative regimens.
Source: QJM - June 8, 2016 Category: Internal Medicine Authors: Canavan, M., Smyth, A., Robinson, S. M., Gibson, I., Costello, C., OKeeffe, S. T., Walsh, T., Mulkerrin, E. C., ODonnell, M. J. Tags: Original papers Source Type: research

Antipsychotic prescription amongst hospitalized patients with dementia
Conclusion</strong>: Antipsychotic medications are commonly prescribed for hospitalized patients with dementia in Ireland. Ward environments and dementia-related governance structures are suboptimal.</span>
Source: QJM - March 13, 2016 Category: Internal Medicine Source Type: research

Takayasu arteritis and ischaemic stroke
Source: QJM - December 29, 2015 Category: Internal Medicine Authors: Maeda, Y., Taguchi, H., Kudo, T., Okano, Y. Tags: Case reports Source Type: research

Occams razor or Hickams dictum: a rare case of pulmonary embolism after myocardial infarction and stroke from aortic arch thrombi
Source: QJM - November 24, 2015 Category: Internal Medicine Authors: Velagapudi, P., Turagam, M. K., Dohrmann, M. Tags: Case reports Source Type: research

Running, ischaemic stroke and carotid artery dissection
Source: QJM - November 24, 2015 Category: Internal Medicine Authors: Evans, N. R., Harper, V., Scoffings, D. J., Warburton, E. A. Tags: Case reports Source Type: research

Syncope causes transient focal neurological symptoms
Conclusion: One in 20 patients with syncope/pre-syncope have co-extant FN, which during 24-month follow-up, does not progress to a persistent deficit (>24 h). Awareness of co-occurrence of FN and syncope is important as stroke misdiagnosis results in aggressive anti-hypertensive management and future events may ensue.
Source: QJM - August 27, 2015 Category: Internal Medicine Authors: Ryan, D. J., Harbison, J. A., Meaney, J. F., Rice, C. P., King-Kallimanis, B., Kenny, R. A. Tags: Original papers Source Type: research

Bleeding risk, physical functioning and non-use of anticoagulation among patients with stroke and atrial fibrillation
Conclusion: It appears that in this sample, post-stroke anticoagulation decisions appear to be made based on clinical factors associated with bleed risk and motor deficits or physical functioning. However, opportunities may exist for improving clinician documentation of specific reasoning for non-anticoagulation prescription.
Source: QJM - February 23, 2015 Category: Internal Medicine Authors: Schmid, A. A., Ofner, S., Shorr, R. I., Williams, L. S., Bravata, D. M. Tags: Original papers Source Type: research

Can we reduce the risk of dementia?
Public health and therapeutic measures to reduce cardiac and stroke risk may already be reducing risks of dementia in populations. In routine clinical care, dementia risk could be further reduced by optimized management of delirium, depressive disorders, traumatic brain injury and stroke. These are opportunities to minimize risk of progression to dementia during acute care and subsequent rehabilitation. Although interventions to protect against progress to dementia may be of small effect in each clinical situation, awareness of dementia risk and appropriate steps to reduce that risk should contribute to an overall reductio...
Source: QJM - January 28, 2015 Category: Internal Medicine Authors: Robertson, M., Seaton, A., Whalley, L. J. Tags: Review Source Type: research

Periprocedural stroke presenting as isolated unilateral internuclear ophthalmoplegia
Source: QJM - January 28, 2015 Category: Internal Medicine Authors: Saini, M., Bte Idu Jion, Y. Tags: Clinical pictures Source Type: research

Advance preferences regarding thrombolysis in patients at risk for stroke: a cross-sectional study
Conclusion: Advance discussion of the potential risks and benefits of thrombolysis in at-risk patients may improve decision making if thrombolysis is being considered and the patient can no longer make a decision.
Source: QJM - December 28, 2014 Category: Internal Medicine Authors: O Flatharta, T., Khan, A., Walsh, T., O'Donnell, M., O'Keefe, S. T. Tags: Original papers Source Type: research

Is female sex a risk factor for stroke and thromboembolism in patients with atrial fibrillation? A systematic review and meta-analysis
Conclusions: Women with AF are at increased risk of stroke, particularly elderly women. Comprehensive stroke risk assessment, including sex as a risk factor, should be undertaken in all AF patients.
Source: QJM - November 24, 2014 Category: Internal Medicine Authors: Wagstaff, A. J., Overvad, T. F., Lip, G. Y. H., Lane, D. A. Tags: Reviews Source Type: research

Helicobacter pylori infection increases subsequent ischemic stroke risk: a nationwide population-based retrospective cohort study
Conclusion: Chronic HP-I is significantly associated with an increased risk of IS, particularly nonembolic IS. Anti-HP therapy may be beneficial to IS prevention.
Source: QJM - November 24, 2014 Category: Internal Medicine Authors: Huang, W.- S., Tseng, C.- H., Lin, C.- L., Tsai, C.- H., Kao, C.- H. Tags: Original papers Source Type: research

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