A 59-year-old woman had aphasia and right-sided weakness after a routine total knee replacement. CT and MRI scans revealed a large left middle cerebral artery infarct. A CT angiogram showed no significant disease of the cerebrovascular arteries. Test results for the lupus anticoagulant were positive. A venous study of the legs showed no deep venous thrombosis. She was treated with warfarin and aspirin and discharged. After speech and physical therapy, she had mild residual aphasia.
A 37-year-old man was brought to the emergency department (ED) after he had 2 near-syncopal events. The first occurred in the morning and rapidly resolved; the second occurred later in the day at work. The night before he had a headache and neck pain. In the ED, he reported left arm and leg weakness and was noted to have left facial droop.
A 68-year-old woman with a history of hypertension, hyperlipidemia, and tobacco use presented with her third stroke in the past 7 years. Neurological deficits included dysarthria and left-sided motor and sensory loss. A previous transthoracic echocardiogram with a bubble study did not reveal any cardiac source of embolism. Axial MRI of the brain on admission showed an abnormal signal in the bilateral hemispheres representative of multiple subacute infarcts
The elderly patient has had type 2 diabetes for 15 years is now home bound after a stroke. Her HbA1c is 9.6; random blood sugar, 450; triglycerides, 350; HDL, 40; LDL, 110 (calculated); total cholesterol, 220; and non-HDL,180. She takes only metformin. Would you consider more aggressive treatment of... More »
Drinking sugar-sweetened beverages is known to cause weight gain and heightens the risk of type 2 diabetes. A recent study suggests that even 1 can of soda or other sugary drink a day leads to a significant increase in the risk of coronary heart disease and levels of inflammatory biomarkers. Here to... More »
Is PAD as prevalent in women as in men? Does CAD present differently in women and men? Is coronary angiography the most accurate diagnostic modality for women? Find answers and more details, here. More »
Use of CT/CT angiography, often more readily available than MRI, after a transient ischemic attack or minor stroke predicts risk of recurrent stroke and clinical outcome. More »
Biopsy-proven lupus nephritis (LN) may be an affair of the heart as much as of the kidneys, according to a study recently published in the Journal of Rheumatology. More »
Cardiovascular MRI beats SPECT in diagnosing heart disease, according to the authors of a major British study published online on Dec. 23 in The Lancet. More »
CHICAGO — The review of coronary angiography results have showed significant differences between men and women in risk factors for coronary artery disease as well as major adverse cardiac events, according to a study presented Wednesday at RSNA. More »
Coronary artery calcification (CAC) scores of zero don’t give patients a pass from obstructive coronary artery disease, according to a study using coronary computed tomography angiography (CCTA) on patients with symptoms of coronary artery disease. More »
Diffusion-weighted MRI patterns can guide the work-up for patients presenting with acute ischemic stroke symptoms, according to a study in the November Journal of Neurology, Neurosurgery & Psychiatry. More »
Changes in cerebral hemodynamics underlie a broad spectrum of ischemic cerebrovascular disorders. An ability to accurately and quantitatively measure hemodynamic (cerebral blood flow and cerebral blood volume) and related metabolic (cerebral metabolic rate of oxygen) parameters is important for understanding healthy brain function and comparative dysfunction in ischemia. Although positron emission tomography, single-photon emission tomography, and gadolinium-MRI approaches are common, more recently MRI
Developmental origins of cerebrovasculardisease should synchronize neuroscience advances with classic neurodevelopmental principles, as discussed in part 1 of this review. The ontogenetic interplay of nature and nurture influencing cerebrovascular development during the prenatal and early postnatal time periods should be considered when designing neuroprotective strategies, as discussed in part 2. Appreciation of adaptive and maladaptive effects of developmental neuroplasticity requires a systems bio
Erectile dysfunction (ED) is a common sexual disease in male patients with multiple sclerosis (MS). Viagra (Sildenafil citrate)is considered as an effective drug for the treatment of ED in thegeneral population,but it has not been systematically...
Anderson-Fabry disease is a rare X-linked recessive (inherited) lysosomal storage disease. Lysosomal disorders are triggered when a particular enzyme exists in too small an amount or is missing altogether; thus substances that should be broken down by t...
There is a strong association between sleep-related problems and neurologic diseases. Neurologic diseases of the CNS can directly cause sleep problems when sleep-wake mechanisms associated with the ascending reticular activating system are involved. The major sleep disorders associated with neurologic problems are outlined in the International Classification of Sleep Disorders, 2nd edition, as hypersomnias of central origin, sleep-related breathing disorders, the insomnias, circadian rhythm sleep disorder
22407112 2012 03 12 2012 04 25 2012 05 02 1535-7228 169 3 Mar Am J Psychiatry 251-4 Doraiswamy P Murali PM eng Comment Editorial United States Am J Psychiatry 0370512 0002-953X AIM IM Am J Psychiatry. 2012 Mar; 169( 3): 300-8 22193532 complications
22222890 2012 01 06 2012 04 23 1473-6551 25 1 Feb Curr. Opin. Neurol. 1-4 Sacco Ralph L RL Rundek Tatjana T eng Editorial Introductory Journal Article England Curr Opin Neurol 9319162 1080-8248 IM diagnosis prevention &control therapy
22119229 2012 01 09 2012 02 23 1532-2165 43 2 Feb Eur J Vasc Endovasc Surg 160 Department of Vascular Surgery, University of Patras Medical School, Patras 26 504, Greece. kakkos@upatras.gr Kakkos S K SK Tsolakis I A IA eng Comment Journal Article
22275490 2012 01 25 2012 03 12 1758-1095 105 1 Jan J R Soc Med 5 Sharma Pankaj P Abbasi Kamran K eng Editorial England J R Soc Med 7802879 0141-0768 IM Research/Reviews.
To prevent recurrence of cerebrovasculardisease (CVD), adequate control of blood pressure (BP) is extremely important for the treatment of hypertensive CVD patients. As absence of the nocturnal fall of BP by the expected 10-20% from daytime levels is reported to exaggerate target organ injury, 24-h ambulatory blood pressure monitoring (ABPM) was conducted, especially to obtain data during nighttime sleep. Forty-eight elderly bedridden chronic phase CVD hypertensive patients (assessed 1-3 mo after CVD accident) participated. As a group, nocturnal BP was higher than diurnal BP, whereas nocturnal pulse rate was lower than diurnal pulse rate. The nocturnal BP fall was blunted in most (90%) of the patients. These results suggest that to perform a rational drug treatment, it is essential to do 24-h ABPM before initiation of antihypertensive therapy in elderly bedridden hypertensive CVD patients.
Date of origin: 1996 Last review date: 2011 ACR Appropriateness Criteria 1 CerebrovascularDisease American College of Radiology ACR Appropriateness Criteria Clinical Condition: CerebrovascularDisease Variant 1: Asymptomatic. ... .
Physician Performance Goals Are Great, But Balance Is More Realistic Jennifer Frank, MD, May 15, 2012 Performance measurements for physicians are well-intentioned and get me to rethink how I practice. But in the end I won't make the goals, so I'll have to go with balance over perfection.
Designing the Perfect Business Card for Your Medical Practice C. Noel Henley, MD, May 11, 2012 Does your business card say anything substantive about the valuable work you do in your practice? Here’s how to re-design your next business card for maximum impact and engagement.
Registered Nurses an Ideal Fit for Primary Care Practices Audrey "Christie" McLaughlin, RN, May 10, 2012 Here are four good reasons to hire a registered nurse for your primary care practice …maybe even instead of a medical assistant.
The Five Biggest Medical Practice Marketing Mistakes James Doulgeris, May 10, 2012 There are best practices to marketing your practice, but often, success is more about knowing what not to do. Here are the five most common pitfalls …and how to avoid them.
Can You Practice Medicine and Manage Your Practice? Rosemarie Nelson, May 9, 2012 Whether you practice alone, or in a group, if you're trying to see patients in this pay-for-volume environment and also run the business of your practice, you may be missing out on important opportunities.
A 59-year-old woman had aphasia and right-sided weakness after a routine total knee replacement. CT and MRI scans revealed a large left middle cerebral artery infarct. A CT angiogram showed no significant disease of the cerebrovascular arteries. Test results for the lupus anticoagulant were positive. A venous study of the legs showed no deep venous thrombosis. She was treated with warfarin and aspirin and discharged. After speech and physical therapy, she had mild residual aphasia.
A 37-year-old man was brought to the emergency department (ED) after he had 2 near-syncopal events. The first occurred in the morning and rapidly resolved; the second occurred later in the day at work. The night before he had a headache and neck pain. In the ED, he reported left arm and leg weakness and was noted to have left facial droop.
A 68-year-old woman with a history of hypertension, hyperlipidemia, and tobacco use presented with her third stroke in the past 7 years. Neurological deficits included dysarthria and left-sided motor and sensory loss. A previous transthoracic echocardiogram with a bubble study did not reveal any cardiac source of embolism. Axial MRI of the brain on admission showed an abnormal signal in the bilateral hemispheres representative of multiple subacute infarcts
The Los Angeles county coroner’s office recently ruled that singer Whitney Houston drowned in her hotel bathtub but that... 