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stroke

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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

afp20180801p154.pdf

...glycemic control reduces the risk of cardiovascular disease by 42% and severe cardiovascular events (nonfatal myo- cardial infarction, stroke, or death from cardiovascular disease) by 57% over 11 years among patients with type 1 diabetes.3 Long-term follow-up of the Diabetes Control...

American Family Physician

https://www.aafp.org/afp/2018/0801/afp20180801p154.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

afp20180815p256.pdf

...4. Vermeulen MJ, Schull MJ. Missed diagnosis of subarach- noid hemorrhage in the emergency department. Stroke. 2007; 38(4): 1216-1221. 5. Carpenter CR, Hussain AM, Ward MJ, et al. Spontaneous subarachnoid hemorrhage: a systematic review and meta-analysis describing the...

American Family Physician

https://www.aafp.org/afp/2018/0815/afp20180815p256.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

afp20181001od1.pdf

...Harm End Points: Stroke, thromboembolic event (deep venous thrombosis plus pulmonary embolism) or pulmo- nary embolism Narrative: In 2012, the Danish Osteoporosis Prevention Study published a study in the British Medical Journal that compared hormone therapy with placebo and...

American Family Physician

https://www.aafp.org/afp/2018/1001/afp20181001od1.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

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

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

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

afp20190115p78.pdf

...should be considered to prevent embolic stroke when atrial fibrillation is present, depending on the individual’s risk score (a risk calculator is available at https:// www.mdcalc.com/cha2ds2-vasc-score- atrial-fibrillation-stroke-risk) and bleeding risk. Fitness-Related...

American Family Physician

https://www.aafp.org/afp/2019/0115/afp20190115p78.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

afp20190201p188a.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/afp20190201p188a.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

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

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

afp20190401p459.pdf

...intention-to-treat analysis, after five years the rate of events (a composite of myo- cardial infarction, stroke, cardiovascular death, unstable angina, or transient ischemic attack) was similar between the treatment groups (4.3% vs. 4.5%, respectively). The overall death rate was...

American Family Physician

https://www.aafp.org/afp/2019/0401/afp20190401p459.pdf

afp20190401p459a.pdf

...intention-to-treat analysis, after five years the rate of events (a composite of myo- cardial infarction, stroke, cardiovascular death, unstable angina, or transient ischemic attack) was similar between the treatment groups (4.3% vs. 4.5%, respectively). The overall death rate was...

American Family Physician

https://www.aafp.org/afp/2019/0401/afp20190401p459a.pdf

afp20190401p460.pdf

...intention-to-treat analysis, after five years the rate of events (a composite of myo- cardial infarction, stroke, cardiovascular death, unstable angina, or transient ischemic attack) was similar between the treatment groups (4.3% vs. 4.5%, respectively). The overall death rate was...

American Family Physician

https://www.aafp.org/afp/2019/0401/afp20190401p460.pdf

afp20190415p478.pdf

...Magnetic resonance imaging without contrast media is the preferred imaging test to exclude other intracranial abnormalities, such as stroke, subdural hematoma, normal-pressure hydro- cephalus, or a treatable mass. https://www.aafp.org/afp/2018/0315/p398.html Does unrestricted...

American Family Physician

https://www.aafp.org/afp/2019/0415/afp20190415p478.pdf

afp20190415p482.pdf

...ranging from heat edema and exercise-associated muscle cramps to exercise-associated collapse, heat exhaustion, and life-threatening heat stroke.1,2 The latter two conditions typically manifest with an ele- vated core body temperature.3 Athletes, military personnel, and outdoor...

American Family Physician

https://www.aafp.org/afp/2019/0415/afp20190415p482.pdf

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