ITEMS IN AFP WITH KEYWORD:
Stroke and TIA
Although the association between stroke and depression is well known and prevalent, it is often overlooked.
For nonhypoxic patients with acute stroke, routine oxygen therapy for 72 hours, either continuously or at night only, does not improve functional outcomes at 90 days. Long-term outcomes were not assessed in this study, and the question remains whether 90 days is an adequate length of time to see most of the meaningful recovery from stroke.
Prescription niacin (nicotinic acid, vitamin B3) does not reduce myocardial infarctions, strokes, or overall mortality when used for primary or secondary prevention.
Antiplatelet therapy, such as aspirin, clopidogrel, and aspirin/dipyridamole, is recommended to reduce the risk of recurrence after an initial stroke. Controlling risk factors and implementing lifestyle modifications, including smoking cessation, reducing alcohol intake, and increasing physical activity, are also important.
Jun 1, 2017 Issue
Physical Fitness Training for Patients with Stroke [Cochrane for Clinicians]
There is moderate-quality evidence that physical fitness training improves disability after stroke. Cardiovascular training that includes only aerobic exercise has a moderate effect on disability (standard mean difference [SMD] = 0.52 on a pooled disability scale), although it is not clear whether t...
Nov 1, 2016 Issue
The Risk of MI and Ischemic Stroke with Combined Oral Contraceptives [Cochrane for Clinicians]
The overall risk of MI and ischemic stroke is increased in women who use combined oral contraceptives. The relative risk of MI and ischemic stroke increases as estrogen dose rises, increasing by 60% with doses of 20 mcg and more than doubling when doses of 50 mcg or more are used.
In patients with a recent stroke or TIA and evidence of insulin resistance, pioglitazone reduces the likelihood of myocardial infarction (MI) or stroke (number needed to treat [NNT] = 36 over five years) but increases the risk of significant weight gain (number needed to treat to harm [NNTH] =14), edema (NNTH = 9), and fracture (NNTH = 53).
These two randomized trials, one with short-term outcomes and the other with five-year outcomes, demonstrate that carotid artery stenting results in more frequent strokes (clinical and radiographically detected) than carotid endarterectomy (CEA). However, the rate of fatal and disabling strokes is comparable.
N.C. is a 65-year-old woman who presents for her yearly checkup. She walks one to two miles daily, is in generally good health, has no significant cardiovascular history, and has no health concerns at today's visit.
May 15, 2015 Issue
Screening for Asymptomatic Carotid Artery Stenosis: Recommendation Statement [U.S. Preventive Services Task Force]
The USPSTF recommends against screening for asymptomatic carotid artery stenosis in the general adult population.