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stroke

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afp20180701p54a.pdf

...with the use of statins, regardless of the initial LDL level. For the combined outcome of car- diovascular death, myocardial infarction, and stroke, the relative risk reduction was 25% for those with an initial LDL level of at least 190 mg per dL. There were favorable trends (not...

American Family Physician

https://www.aafp.org/afp/2018/0701/afp20180701p54a.pdf

afp20180701p55.pdf

...with the use of statins, regardless of the initial LDL level. For the combined outcome of car- diovascular death, myocardial infarction, and stroke, the relative risk reduction was 25% for those with an initial LDL level of at least 190 mg per dL. There were favorable trends (not...

American Family Physician

https://www.aafp.org/afp/2018/0701/afp20180701p55.pdf

afp20180701p56.pdf

...with the use of statins, regardless of the initial LDL level. For the combined outcome of car- diovascular death, myocardial infarction, and stroke, the relative risk reduction was 25% for those with an initial LDL level of at least 190 mg per dL. There were favorable trends (not...

American Family Physician

https://www.aafp.org/afp/2018/0701/afp20180701p56.pdf

afp20180715p117.pdf

...tia in patients receiving combined estrogen/pro- gesterone therapy. Patients had an increased risk of coronary events, venous thromboembolism, breast cancer, gallbladder disease, and death from lung cancer. Patients who received estrogen-only therapy had an increased risk of stroke,...

American Family Physician

https://www.aafp.org/afp/2018/0715/afp20180715p117.pdf

afp20180715p85.pdf

...cocaine-associated vasospasm and hypertension have been associated with acute aortic dissection, in addition to ischemic and hem- orrhagic stroke.30 BEHAVIORAL THERAPY A 2016 Cochrane review concluded that compared with usual treatment (typically group counseling or case man-...

American Family Physician

https://www.aafp.org/afp/2018/0715/afp20180715p85.pdf

afp20180715p93.pdf

...not prescribe niacin, either alone or in com- bination with a statin, to prevent cardiovascular mortality, nonfatal myocardial infarction, stroke, or the need for revascularization. Lipid treatment for primary prevention not effective in older adults25 Do not initiate a statin...

American Family Physician

https://www.aafp.org/afp/2018/0715/afp20180715p93.pdf

afp20180801p154-s1.pdf

...What problems can type 1 diabetes cause? People with type 1 diabetes have a higher risk of heart disease, stroke, kidney failure, high blood pressure, blindness, nerve damage, and gum disease. These things happen two to four times more often in people with diabetes than in people...

American Family Physician

https://www.aafp.org/afp/2018/0801/afp20180801p154-s1.pdf

afp20180815p214.pdf

...a quick screening tool in the outpatient setting12 (Table 333). If the Mini-Cog screening is positive, further clinical assessment for demen- tia is warranted.33 SORT: KEY RECOMMENDATIONS FOR PRACTICE Clinical recommendation Evidence rating References Older adults planning...

American Family Physician

https://www.aafp.org/afp/2018/0815/afp20180815p214.pdf

afp20180815p248.pdf

...including the Cochrane Library, to identify ran- domized and nonrandomized controlled trials in English that enrolled adults without demen- tia. They also searched reference lists of previous studies and included a previous report that eval- uated interventions to prevent cognitive...

American Family Physician

https://www.aafp.org/afp/2018/0815/afp20180815p248.pdf

afp20180815p248a.pdf

...including the Cochrane Library, to identify ran- domized and nonrandomized controlled trials in English that enrolled adults without demen- tia. They also searched reference lists of previous studies and included a previous report that eval- uated interventions to prevent cognitive...

American Family Physician

https://www.aafp.org/afp/2018/0815/afp20180815p248a.pdf

afp20180815p249.pdf

...including the Cochrane Library, to identify ran- domized and nonrandomized controlled trials in English that enrolled adults without demen- tia. They also searched reference lists of previous studies and included a previous report that eval- uated interventions to prevent cognitive...

American Family Physician

https://www.aafp.org/afp/2018/0815/afp20180815p249.pdf

afp20180815p250.pdf

...including the Cochrane Library, to identify ran- domized and nonrandomized controlled trials in English that enrolled adults without demen- tia. They also searched reference lists of previous studies and included a previous report that eval- uated interventions to prevent cognitive...

American Family Physician

https://www.aafp.org/afp/2018/0815/afp20180815p250.pdf

afp20180901p275.pdf

...and 9,484 patients. Participants were being treated for hypertension and had a documented cardiovascular history of myocar- dial infarction, stroke, ischemic heart disease, peripheral vascular disease, or angina. The inter- vention was a lower BP target (135/85 mm Hg or less) vs....

American Family Physician

https://www.aafp.org/afp/2018/0901/afp20180901p275.pdf

afp20180901p276.pdf

...and 9,484 patients. Participants were being treated for hypertension and had a documented cardiovascular history of myocar- dial infarction, stroke, ischemic heart disease, peripheral vascular disease, or angina. The inter- vention was a lower BP target (135/85 mm Hg or less) vs....

American Family Physician

https://www.aafp.org/afp/2018/0901/afp20180901p276.pdf

afp20180915od1.pdf

...Angiography and revascu- larization are associated with harms, including bleeding, contrast-induced nephropathy, cardiac arrhythmia, stroke, myocardial infarction, cor- onary artery dissection, allergic reaction to the contrast agent, and death. Current Practice. Although many...

American Family Physician

https://www.aafp.org/afp/2018/0915/afp20180915od1.pdf

afp20181001p413.pdf

...of chronic hepatitis C, persons who achieve SVR have a lower incidence of diabetes mellitus, glomerulonephritis, non-Hodgkin lym- phoma, stroke, and other conditions.15 It is not clear whether the high cost of direct- acting antivirals is offset by long-term savings related to...

American Family Physician

https://www.aafp.org/afp/2018/1001/afp20181001p413.pdf

afp20181015p496.pdf

...from 19% to 47% in the early recovery period; a study of 80 consecutive adults under- going inpatient rehabilitation after a first ischemic stroke found that 23 had evidence of urinary retention on admission, but only four still did by the time of discharge.23 OTHER CAUSES The...

American Family Physician

https://www.aafp.org/afp/2018/1015/afp20181015p496.pdf

afp20181015p508.pdf

...is a 19-item screening tool that can be used in older patients. It retains its validity when used in patients with demen- tia, unlike the Geriatric Depression Scale. The Cornell Scale for Depression in Dementia has a sensitivity of 93% and specificity of 97%.38 The PHQ-2 can be...

American Family Physician

https://www.aafp.org/afp/2018/1015/afp20181015p508.pdf

afp20181201p630.pdf

...event (cardiac death, nonfatal myocardial infarction, revasculariza- tion procedure, hospitalization for acute coro- nary syndrome, or stroke),2 to no effect on any outcome.3 Although the two latest niacin trials did not show a benefit for niacin, it has been suggested that...

American Family Physician

https://www.aafp.org/afp/2018/1201/afp20181201p630.pdf

afp20181201p631.pdf

...event (cardiac death, nonfatal myocardial infarction, revasculariza- tion procedure, hospitalization for acute coro- nary syndrome, or stroke),2 to no effect on any outcome.3 Although the two latest niacin trials did not show a benefit for niacin, it has been suggested that...

American Family Physician

https://www.aafp.org/afp/2018/1201/afp20181201p631.pdf

afp20181201p645.pdf

...ref- erence values (e.g., hematocrit greater than 50%).5,6,45,49 Data on patient-oriented outcomes (e.g., death, thromboembolic disease, stroke, osteoporosis, liver toxicity, myocardial infarc- tion) are sparse. Despite possible metabolic effects, few seri- ous events have been...

American Family Physician

https://www.aafp.org/afp/2018/1201/afp20181201p645.pdf

afp20181201p682.pdf

...and between 10% and 55% had experienced a previous stroke. After perform- ing a random effects meta-analysis, the authors found that patients randomized to receive direct oral anticoagulants were less likely to experience a stroke or systemic embo- lism (hazard ratio [HR] = 0.78;...

American Family Physician

https://www.aafp.org/afp/2018/1201/afp20181201p682.pdf

afp20181201p682a.pdf

...and between 10% and 55% had experienced a previous stroke. After perform- ing a random effects meta-analysis, the authors found that patients randomized to receive direct oral anticoagulants were less likely to experience a stroke or systemic embo- lism (hazard ratio [HR] = 0.78;...

American Family Physician

https://www.aafp.org/afp/2018/1201/afp20181201p682a.pdf

afp20181201p683.pdf

...and between 10% and 55% had experienced a previous stroke. After perform- ing a random effects meta-analysis, the authors found that patients randomized to receive direct oral anticoagulants were less likely to experience a stroke or systemic embo- lism (hazard ratio [HR] = 0.78;...

American Family Physician

https://www.aafp.org/afp/2018/1201/afp20181201p683.pdf

afp20181201p683a.pdf

...and between 10% and 55% had experienced a previous stroke. After perform- ing a random effects meta-analysis, the authors found that patients randomized to receive direct oral anticoagulants were less likely to experience a stroke or systemic embo- lism (hazard ratio [HR] = 0.78;...

American Family Physician

https://www.aafp.org/afp/2018/1201/afp20181201p683a.pdf

afp20181215p719.pdf

...misuse. However, it has been applied to other health issues such as reducing stroke risk28 (Table 43,15,27,28). To facilitate collaboration, the physician obtains the patient’s permis- sion before providing information. By granting permis- sion, patients maintain control, implicitly...

American Family Physician

https://www.aafp.org/afp/2018/1215/afp20181215p719.pdf

afp20181215p729.pdf

...tools.acc.org/ASCVD-Risk-Estimator-Plus/#!/calculate/ estimate/) can be used to determine the 10-year risk of car- diovascular events or stroke in men 40 to 79 years of age. Obesity. Height and weight measurements should be obtained at every visit to calculate BMI.18 An abdominal...

American Family Physician

https://www.aafp.org/afp/2018/1215/afp20181215p729.pdf

afp20181215p751.pdf

...(NVAF), what is the best way to determine if the benefits of stroke reduction exceed the harms of bleeding from anticoagulants? Evidence Summary In patients with NVAF, anticoagulants decrease the risk of stroke by approximately 60%.1 However, they also significantly increase the...

American Family Physician

https://www.aafp.org/afp/2018/1215/afp20181215p751.pdf

afp20190101od1.pdf

...review included 25 randomized controlled trials involving 16,037 patients with the following conditions: sepsis, critical illness, stroke, trauma, myocardial infarction, and cardiac arrest. Oxygen saturation was reported as fraction of inspired oxygen (FiO2), arterial partial...

American Family Physician

https://www.aafp.org/afp/2019/0101/afp20190101od1.pdf

afp20190101p10.pdf

...for primary pre- vention of heart attack, angina, revascularization, or death from any cause. However, there were increases in the risk of stroke (number needed to harm [NNH] = 165), blood clot in a leg or lung (NNH = 118), and blood clot in a lung (NNH = 242) in patients receiving...

American Family Physician

https://www.aafp.org/afp/2019/0101/afp20190101p10.pdf

afp20190101p47.pdf

...for about five years. The patient’s history included tobacco use, newly diag- nosed hypertension, and a recent transient ischemic attack. Before the transient ischemic attack, he was not seeing a physician regularly. Physical examination revealed nontender, red-yellow papules...

American Family Physician

https://www.aafp.org/afp/2019/0101/afp20190101p47.pdf

afp20190115od1.pdf

...heart disease] or Pooled Cohort Equations [which estimate 10-year risk of myocardial infarction, death from coronary heart disease, or stroke]) may improve calibration (agreement between observed and predicted outcomes), discrimination (ability to distinguish between people who...

American Family Physician

https://www.aafp.org/afp/2019/0115/afp20190115od1.pdf

afp20190115p101.pdf

...Stroke Traumatic brain injury Other medical or neurologic condition Common primary care referral questions/expectations Document functional limitations (e.g., driving, independent living) Establish baseline cognitive functioning Establish or confirm diagnosis...

American Family Physician

https://www.aafp.org/afp/2019/0115/afp20190115p101.pdf

afp20190115p74.pdf

...The sentence should have read: Vitamin K antagonists are the first-line option, with high-quality data indicating that they have a lower stroke risk and all-cause mortality vs. pla- cebo. The online version of the article has been corrected. ■

American Family Physician

https://www.aafp.org/afp/2019/0115/afp20190115p74.pdf

afp20190115p76.pdf

...The sentence should have read: Vitamin K antagonists are the first-line option, with high-quality data indicating that they have a lower stroke risk and all-cause mortality vs. pla- cebo. The online version of the article has been corrected. ■

American Family Physician

https://www.aafp.org/afp/2019/0115/afp20190115p76.pdf

afp20190115p77.pdf

...The sentence should have read: Vitamin K antagonists are the first-line option, with high-quality data indicating that they have a lower stroke risk and all-cause mortality vs. pla- cebo. The online version of the article has been corrected. ■

American Family Physician

https://www.aafp.org/afp/2019/0115/afp20190115p77.pdf

afp20190201p188.pdf

...Plus Aspirin Provides More Net Benefit Than Aspirin Alone After Minor Stroke or TIA Clinical Question Does adding clopidogrel (Plavix) to aspirin fol- lowing a transient ischemic attack (TIA) or minor stroke safely improve outcomes? Bottom Line This study provides support for...

American Family Physician

https://www.aafp.org/afp/2019/0201/afp20190201p188.pdf

afp20190201p189.pdf

...Plus Aspirin Provides More Net Benefit Than Aspirin Alone After Minor Stroke or TIA Clinical Question Does adding clopidogrel (Plavix) to aspirin fol- lowing a transient ischemic attack (TIA) or minor stroke safely improve outcomes? Bottom Line This study provides support for...

American Family Physician

https://www.aafp.org/afp/2019/0201/afp20190201p189.pdf

afp20190201p190.pdf

...Plus Aspirin Provides More Net Benefit Than Aspirin Alone After Minor Stroke or TIA Clinical Question Does adding clopidogrel (Plavix) to aspirin fol- lowing a transient ischemic attack (TIA) or minor stroke safely improve outcomes? Bottom Line This study provides support for...

American Family Physician

https://www.aafp.org/afp/2019/0201/afp20190201p190.pdf

afp20190201p191.pdf

...Additionally, magnetic resonance imaging with and without contrast media was obtained during a prior emergency department visit as part of a stroke workup. It showed chronic microvascular ischemic disease with no evidence of a mass. Question Based on the patient’s history and...

American Family Physician

https://www.aafp.org/afp/2019/0201/afp20190201p191.pdf

afp20190215p237.pdf

...and islet cell dysfunction. Our patients with diabetes depend on us to help reduce their long-term risk of myocardial infarction, stroke, amputa- tion, dialysis, and premature mortality. Several recent large randomized controlled trials have significantly improved our knowledge...

American Family Physician

https://www.aafp.org/afp/2019/0215/afp20190215p237.pdf

afp20190215p248.pdf

...identified rare serious adverse events associ- ated with SMT including cauda equina syndrome, lumbar disk herniation, fractures, hematoma, stroke, vertebrobas- ilar accident, cerebrovascular accident, and death.23,24 In children, serious adverse events resulting in hospitaliza-...

American Family Physician

https://www.aafp.org/afp/2019/0215/afp20190215p248.pdf

afp20190315od1.pdf

...is a major risk factor for ischemic stroke, increasing risk of stroke by as much as 5-fold. Approximately 20% of patients who have a stroke associated with atrial fibrillation are first diagnosed with atrial fibrillation at the time of stroke or shortly thereafter. DETECTION...

American Family Physician

https://www.aafp.org/afp/2019/0315/afp20190315od1.pdf

afp20190315p354.pdf

...and with more comorbid conditions have led to an increase in the prevalence of atrial fibrilla- tion (AF), a condition associated with stroke and heart failure.1,2 AF is often asymptomatic. Oral anticoagulants are an accepted therapy for selected patients with AF. These factors have...

American Family Physician

https://www.aafp.org/afp/2019/0315/afp20190315p354.pdf

afp20190315p362.pdf

...large cohort study found the most significant risk factors for development of CLI were diabetes, renal failure, heart fail- ure, and prior stroke.17 Annual mortality rates of patients with CLI are approximately 25%.18 ACUTE LIMB ISCHEMIA Acute limb ischemia is a medical...

American Family Physician

https://www.aafp.org/afp/2019/0315/afp20190315p362.pdf

afp20190315p383.pdf

...with ECG on clinical outcomes. The USPSTF found adequate evidence that treatment with anticoagulant therapy reduces the incidence of stroke in patients with symptomatic atrial fibrillation. The USPSTF found ade- quate evidence that screening for atrial fibrillation with ECG is...

American Family Physician

https://www.aafp.org/afp/2019/0315/afp20190315p383.pdf

afp20190315p392.pdf

...it has not been studied in these groups. It should not be used in patients with severe coronary insufficiency, recent myocardial infarction, stroke, renal failure, or significant bradycardia. Central nervous system depression is a serious risk, especially if lofexidine is taken in...

American Family Physician

https://www.aafp.org/afp/2019/0315/afp20190315p392.pdf

afp20190401p420.pdf

...in!-which I begged him to take down, considering there had been burglaries nearby. He continued to drive to church despite experiencing mini-strokes. I called him every night during those years. He’d say things like, I’m standing at the kitchen counter, but my legs won’t support me....

American Family Physician

https://www.aafp.org/afp/2019/0401/afp20190401p420.pdf

afp20190401p421.pdf

...Direct Oral Anticoagulants vs. Warfarin to Prevent Stroke and Embolic Events in Patients with Atrial Fibrillation and CKD John W. Lax, MD, Uniformed Services University of the Health Sciences, Bethesda, Maryland Racheal Wood, DNP, ACCNS-AG, Fort Belvoir Community Hospital, Fort...

American Family Physician

https://www.aafp.org/afp/2019/0401/afp20190401p421.pdf

afp20190401p422.pdf

...Direct Oral Anticoagulants vs. Warfarin to Prevent Stroke and Embolic Events in Patients with Atrial Fibrillation and CKD John W. Lax, MD, Uniformed Services University of the Health Sciences, Bethesda, Maryland Racheal Wood, DNP, ACCNS-AG, Fort Belvoir Community Hospital, Fort...

American Family Physician

https://www.aafp.org/afp/2019/0401/afp20190401p422.pdf

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