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stroke

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afp20200815p247.pdf

...Reduction in Cardiovascular Outcome After Ischemic Stroke with Lower LDL Target, but also Harms; No Change in All-Cause Mortality Clinical Question Does a lower low-density lipoprotein (LDL) tar- get following ischemic stroke reduce the likeli- hood of major adverse...

American Family Physician

https://www.aafp.org/afp/2020/0815/afp20200815p247.pdf

afp20200815p248.pdf

...Reduction in Cardiovascular Outcome After Ischemic Stroke with Lower LDL Target, but also Harms; No Change in All-Cause Mortality Clinical Question Does a lower low-density lipoprotein (LDL) tar- get following ischemic stroke reduce the likeli- hood of major adverse...

American Family Physician

https://www.aafp.org/afp/2020/0815/afp20200815p248.pdf

afp20200901od2.pdf

...Aspirin After Acute Ischemic Stroke John Conway, BS, and Benjamin W. Friedman, MD Details for This Review Study Population: Adults presenting with acute stroke Efficacy End Points: Death or dependence, recurrent stroke, complete recovery from stroke Harm End Points:...

American Family Physician

https://www.aafp.org/afp/2020/0901/afp20200901od2.pdf

afp20200901p271.pdf

...Effectiveness of PPAR Gamma Agonists in Preventing Recurrent Stroke and Other Vascular Events Madhavi Singh, MD; Kristen Grine, DO; and Amy Hays, MD, Penn State University College of Medicine, Hershey, Pennsylvania Author disclosure: No relevant financial affiliations....

American Family Physician

https://www.aafp.org/afp/2020/0901/afp20200901p271.pdf

afp20200901p272.pdf

...Effectiveness of PPAR Gamma Agonists in Preventing Recurrent Stroke and Other Vascular Events Madhavi Singh, MD; Kristen Grine, DO; and Amy Hays, MD, Penn State University College of Medicine, Hershey, Pennsylvania Author disclosure: No relevant financial affiliations....

American Family Physician

https://www.aafp.org/afp/2020/0901/afp20200901p272.pdf

afp20200915p332.pdf

...for dual antiplatelet therapy after stroke or transient ischemic attack? A 10- to 21-day course of dual antiplatelet ther- apy reduces stroke recurrence and improves quality of life after mild stroke or high-risk transient ischemic attack. Low-dose aspirin and a 300-mg loading dose...

American Family Physician

https://www.aafp.org/afp/2020/0915/afp20200915p332.pdf

afp20200915p335.pdf

...and muscle relax- ants.7 The use of nonopioid medications is often restricted by limited effectiveness or adverse effects, such as bleeding, strokes, and cardiovascular and renal disease with NSAIDs.8 Adjuvant medications such as gabapentin (Neurontin) have been used for nonapproved...

American Family Physician

https://www.aafp.org/afp/2020/0915/afp20200915p335.pdf

afp20200915p347.pdf

...outcome of cardiovascular death, myocardial infarction, or nonfatal stroke compared with those taking placebo (11.2% vs. 14.8%; HR = 0.74; 95% CI, 0.65 to 0.83; NNT = 28 over five years).39 Those taking icosapent also had lower cardio- vascular mortality (4.3% vs. 5.2%; HR = 0.80;...

American Family Physician

https://www.aafp.org/afp/2020/0915/afp20200915p347.pdf

afp20201015od3.pdf

...age, sex, education), smoking status, alcohol intake, and diagnoses of chronic medical conditions (e.g., diabetes mellitus, heart disease, stroke, cancer, chronic bronchitis). In addition to count- ing steps, step intensity was estimated based on extended bouts of stepping and peak...

American Family Physician

https://www.aafp.org/afp/2020/1015/afp20201015od3.pdf

afp20201015od4.pdf

...age, sex, education), smoking status, alcohol intake, and diagnoses of chronic medical conditions (e.g., diabetes mellitus, heart disease, stroke, cancer, chronic bronchitis). In addition to count- ing steps, step intensity was estimated based on extended bouts of stepping and peak...

American Family Physician

https://www.aafp.org/afp/2020/1015/afp20201015od4.pdf

afp20201015od5.pdf

...age, sex, education), smoking status, alcohol intake, and diagnoses of chronic medical conditions (e.g., diabetes mellitus, heart disease, stroke, cancer, chronic bronchitis). In addition to count- ing steps, step intensity was estimated based on extended bouts of stepping and peak...

American Family Physician

https://www.aafp.org/afp/2020/1015/afp20201015od5.pdf

afp20201015od6.pdf

...age, sex, education), smoking status, alcohol intake, and diagnoses of chronic medical conditions (e.g., diabetes mellitus, heart disease, stroke, cancer, chronic bronchitis). In addition to count- ing steps, step intensity was estimated based on extended bouts of stepping and peak...

American Family Physician

https://www.aafp.org/afp/2020/1015/afp20201015od6.pdf

afp20201015p478.pdf

...• Acute complications of COVID-19 include pneumonia, acute respiratory distress syndrome, stroke, and arterial and venous thrombosis. Hospitalized patients may have debil- ity 70 and mental health effects.71 Factors that may increase the risk of these complications include: ◦ A diet...

American Family Physician

https://www.aafp.org/afp/2020/1015/afp20201015p478.pdf

afp20201101p525.pdf

...which confers additional benefit over aspi- rin alone. Dual antiplatelet therapy decreases the risk of myocardial infarction and ischemic stroke (number needed to treat [NNT] = 77 and 43, respectively) with no change in mortality. Dual antiplatelet therapy is more beneficial in...

American Family Physician

https://www.aafp.org/afp/2020/1101/afp20201101p525.pdf

afp20201101p530.pdf

...were all-cause mortality, incidence of type 2 diabetes, serious adverse effects, cardiovascular mortality, nonfatal myocardial infarction or stroke, health- related quality of life, and socioeconomic effects. Patients who used metformin for one to five years were less likely to...

American Family Physician

https://www.aafp.org/afp/2020/1101/afp20201101p530.pdf

afp20201101p531.pdf

...were all-cause mortality, incidence of type 2 diabetes, serious adverse effects, cardiovascular mortality, nonfatal myocardial infarction or stroke, health- related quality of life, and socioeconomic effects. Patients who used metformin for one to five years were less likely to...

American Family Physician

https://www.aafp.org/afp/2020/1101/afp20201101p531.pdf

afp20201101p539.pdf

...each condition and be able to perform a basic eye examination. Patients with a central retinal artery occlusion require urgent referral for stroke eval- uation and should receive therapy to lower intraocular pressure and vasodilating agents to minimize retinal ischemia. Chemical...

American Family Physician

https://www.aafp.org/afp/2020/1101/afp20201101p539.pdf

afp20201101p562.pdf

...current evidence is insufficient to assess the balance of benefits and harms of ECG screening for AF because of a lack of information on stroke risk and benefit of anticoagulation in asymptomatic patients with screening-detected AF (as opposed to clinically detected).6,7 There are...

American Family Physician

https://www.aafp.org/afp/2020/1101/afp20201101p562.pdf

afp20201115p603.pdf

...P < .001).6 However, some studies have shown an association between vitamin E and an increased risk of prostate cancer and hemorrhagic stroke; one study demonstrated a reduction in thrombotic TABLE 5 Noninvasive Tests Helpful in Assessing the Likelihood of Hepatic Fibrosis...

American Family Physician

https://www.aafp.org/afp/2020/1115/afp20201115p603.pdf

afp20201115p627.pdf

...reluctant to start or add injectable treatment and for whom weight loss is desired. It does not increase major CV events (including nonfatal stroke or nonfatal myocardial infarc- tion) in higher-risk patients. The cost and hyperglycemia- lowering benefits of oral semaglutide are...

American Family Physician

https://www.aafp.org/afp/2020/1115/afp20201115p627.pdf

afp20201201p645a.pdf

...commonly headache, anosmia, and ageusia-in addition to the more well-recognized respiratory findings. Other manifestations include stroke, impairment of consciousness, coma, seizure, and encephalopathy.1 An early case series from Wuhan, China, identified neurologic features in 78 of...

American Family Physician

https://www.aafp.org/afp/2020/1201/afp20201201p645a.pdf

afp20201201p648.pdf

...commonly headache, anosmia, and ageusia-in addition to the more well-recognized respiratory findings. Other manifestations include stroke, impairment of consciousness, coma, seizure, and encephalopathy.1 An early case series from Wuhan, China, identified neurologic features in 78 of...

American Family Physician

https://www.aafp.org/afp/2020/1201/afp20201201p648.pdf

afp20201201p673.pdf

...in the likelihood of cancer or in the composite cardiovascular outcome (cardiovascular death, nonfatal myocardial infarc- tion, or ischemic stroke). In 2019, another POEM reported on the ASCEND (A Study of Cardiovascular Events in Dia- betes) trial of the use of omega-3 fatty acids...

American Family Physician

https://www.aafp.org/afp/2020/1201/afp20201201p673.pdf

afp20201201p679.pdf

...in the basal ganglia, particularly in the substan- tia nigra,2 and development of Lewy bodies in the dopaminergic neurons. Lewy bodies are the pathologic feature of Parkinson disease.3 How- ever, Lewy bodies are nonspecific for Parkinson disease and are found in multiple...

American Family Physician

https://www.aafp.org/afp/2020/1201/afp20201201p679.pdf

afp20201215p716.pdf

...serious post-COVID complications from those with less concerning symptoms. Serious complications include pulmonary embolus, heart failure, stroke, myocardial infarction, lung fibrosis, neurologic derangement, and severe deterioration in men- tal health. Patients presenting with...

American Family Physician

https://www.aafp.org/afp/2020/1215/afp20201215p716.pdf

afp20201215p740.pdf

...Brissaud reflex Stroking the sole of the foot results in a vigorous contraction of the ipsilat- eral tensor fasciae lata Not reported Lhermitte sign Flexion of the neck results in a shoot- ing, electrical sensation down the spine Not reported Information from references...

American Family Physician

https://www.aafp.org/afp/2020/1215/afp20201215p740.pdf

afp20201215p753.pdf

...for mild cognitive impairment or dementia; therefore, clinicians who have a high index of suspicion should use a screening tool for demen- tia such as the Mini-Cog (https:// mini-cog.com). Patients with dementia who are hospitalized are at high risk of iatrogenic harms, including...

American Family Physician

https://www.aafp.org/afp/2020/1215/afp20201215p753.pdf

afp20210101p42.pdf

...guide specific diagnostic imaging choices. Noncontrast head computed tomography is the first-line modality when a stroke is suspected. Magnetic resonance imaging stroke protocols and computed tomography perfusion scans can augment evaluation and poten- tially expand pharmacologic...

American Family Physician

https://www.aafp.org/afp/2021/0101/afp20210101p42.pdf

afp20210115od1.pdf

...women in the same age group with a previous hysterectomy. The original trials were stopped after 7.2 years because of an increased risk of stroke in the treatment groups. After the original trials were stopped, less than 4% of the women reported continuing hormone therapy. The...

American Family Physician

https://www.aafp.org/afp/2021/0115/afp20210115od1.pdf

afp20210115od2.pdf

...women in the same age group with a previous hysterectomy. The original trials were stopped after 7.2 years because of an increased risk of stroke in the treatment groups. After the original trials were stopped, less than 4% of the women reported continuing hormone therapy. The...

American Family Physician

https://www.aafp.org/afp/2021/0115/afp20210115od2.pdf

afp20210115od4.pdf

...women in the same age group with a previous hysterectomy. The original trials were stopped after 7.2 years because of an increased risk of stroke in the treatment groups. After the original trials were stopped, less than 4% of the women reported continuing hormone therapy. The...

American Family Physician

https://www.aafp.org/afp/2021/0115/afp20210115od4.pdf

afp20210115p117.pdf

...Icosapent Ethyl (Vascepa) for Hyperlipidemia/Hypercholesterolemia to Reduce Risk of Heart Attack and Stroke Leena Myran, PharmD, BCPS, and Thanh-Nga Nguyen, PharmD, MBA, BCACP University of Wyoming Family Medicine Residency Program, Cheyenne, Wyoming Icosapent ethyl (Vascepa)...

American Family Physician

https://www.aafp.org/afp/2021/0115/afp20210115p117.pdf

afp20210115p97.pdf

...Oropharyngeal Pathology Oropharyngeal dysphagia is most commonly related to chronic neurologic conditions, particularly Parkinson dis- ease, stroke, and dementia; it is not part of normal aging.5 Dysphagia: Evaluation and Collaborative Management John M. Wilkinson, MD; Don...

American Family Physician

https://www.aafp.org/afp/2021/0115/afp20210115p97.pdf

afp20210201p155.pdf

...medications, and even fewer benefit. Other limitations include serious adverse events, illustrated by a 20% to 30% rate of heart attack, stroke, or peripheral vascular events among patients taking ponatinib, which is used in treating chronic myelogenous leukemia. Immune checkpoint...

American Family Physician

https://www.aafp.org/afp/2021/0201/afp20210201p155.pdf

afp20210201p183.pdf

...In the United States, 5.8 million people 65 years and older (11.4% of this age group) are estimated to have clinical ATD.2,3 Deaths from stroke and heart disease have decreased over the past two decades while the number of deaths asso- ciated with clinical ATD has increased,...

American Family Physician

https://www.aafp.org/afp/2021/0201/afp20210201p183.pdf

afp20210215p219.pdf

...the number of health deficits and presence of multiple comorbidities.2 Patients diag- nosed with diabetes mellitus, respiratory disease, stroke, dementia, multiple sclerosis, connective tissue disease, osteoarthritis, and chronic fatigue syndrome have higher documented frailty...

American Family Physician

https://www.aafp.org/afp/2021/0215/afp20210215p219.pdf

afp20210215p227.pdf

...Neurologic disease: complex partial seizures, Huntington chorea, migraine headache, multiple sclerosis, neoplasm, stroke, traumatic brain injury, Wilson disease Vitamin deficiency: B12, folate, niacin, thiamine Medications Cardiovascular: captopril, hydralazine...

American Family Physician

https://www.aafp.org/afp/2021/0215/afp20210215p227.pdf

afp20210215p247.pdf

...Fewer Subsequent Strokes with Ticagrelor Plus Aspirin than with Aspirin Alone Clinical Question Is ticagrelor (Brilinta) plus aspirin superior to aspirin alone for decreasing the risk of subse- quent stroke or death in patients with acute isch- emic stroke? Bottom Line For...

American Family Physician

https://www.aafp.org/afp/2021/0215/afp20210215p247.pdf

afp20210215p247a.pdf

...Fewer Subsequent Strokes with Ticagrelor Plus Aspirin than with Aspirin Alone Clinical Question Is ticagrelor (Brilinta) plus aspirin superior to aspirin alone for decreasing the risk of subse- quent stroke or death in patients with acute isch- emic stroke? Bottom Line For...

American Family Physician

https://www.aafp.org/afp/2021/0215/afp20210215p247a.pdf

afp20210215p248.pdf

...Fewer Subsequent Strokes with Ticagrelor Plus Aspirin than with Aspirin Alone Clinical Question Is ticagrelor (Brilinta) plus aspirin superior to aspirin alone for decreasing the risk of subse- quent stroke or death in patients with acute isch- emic stroke? Bottom Line For...

American Family Physician

https://www.aafp.org/afp/2021/0215/afp20210215p248.pdf

afp20210215p249.pdf

...Fewer Subsequent Strokes with Ticagrelor Plus Aspirin than with Aspirin Alone Clinical Question Is ticagrelor (Brilinta) plus aspirin superior to aspirin alone for decreasing the risk of subse- quent stroke or death in patients with acute isch- emic stroke? Bottom Line For...

American Family Physician

https://www.aafp.org/afp/2021/0215/afp20210215p249.pdf

afp20210215p252.pdf

...and nausea and vomiting can also occur with heat exhaustion. Severe EAH presents with men- tal status changes similar to exertional heat stroke. High ambient temperatures increase the risk of EAH as well as heat illness. Injury logs from a national park showed that one in five...

American Family Physician

https://www.aafp.org/afp/2021/0215/afp20210215p252.pdf

afp20210301p291.pdf

...Stroke, previous or current 4 2 3 2 2 1 Surgery Major, without prolonged immobilization 2 1 1 1 1 1 Major, with prolonged immobilization 4 2 2 2 2 1 Minor 1 1 1 1 1 1 Systemic lupus erythematosus Positive antiphospholipid antibodies 4 3 3 3 3 1...

American Family Physician

https://www.aafp.org/afp/2021/0301/afp20210301p291.pdf

afp20210301p311.pdf

...for Stroke Prevention in Older Patients with Atrial Fibrillation Clinical Question Is low-dose edoxaban (Savaysa) safe and effective for stroke prevention in older patients with atrial fibrillation? Bottom Line A lower dose of edoxaban is effective in decreasing stroke and...

American Family Physician

https://www.aafp.org/afp/2021/0301/afp20210301p311.pdf

afp20210301p312a.pdf

...for Stroke Prevention in Older Patients with Atrial Fibrillation Clinical Question Is low-dose edoxaban (Savaysa) safe and effective for stroke prevention in older patients with atrial fibrillation? Bottom Line A lower dose of edoxaban is effective in decreasing stroke and...

American Family Physician

https://www.aafp.org/afp/2021/0301/afp20210301p312a.pdf

afp20210315p366.pdf

...There is adequate evidence that counseling interventions reduce overall CVD events (e.g., myocardial infarction and stroke). There is convincing evidence that counseling interventions improve blood pressure, lipid and fasting blood glucose levels, and body weight/adiposity....

American Family Physician

https://www.aafp.org/afp/2021/0315/afp20210315p366.pdf

afp20210401p404.pdf

...injection of corticosteroids into the epidural space of the spine may result in rare but serious adverse effects, including loss of vision, stroke, paralysis, and death.2 It has been suggested that these rare complications are the result of particulate steroids; no adverse outcomes...

American Family Physician

https://www.aafp.org/afp/2021/0401/afp20210401p404.pdf

afp20210401p405.pdf

...injection of corticosteroids into the epidural space of the spine may result in rare but serious adverse effects, including loss of vision, stroke, paralysis, and death.2 It has been suggested that these rare complications are the result of particulate steroids; no adverse outcomes...

American Family Physician

https://www.aafp.org/afp/2021/0401/afp20210401p405.pdf

afp20210401p439a.pdf

...In High-Risk Older Patients with Atrial Fibrillation, Rhythm Control Reduces Cardiovascular Death and Stroke, But at a Price Clinical Question For older patients at high cardiovascular risk, is a strategy of rate control or rhythm control preferred for recent-onset atrial...

American Family Physician

https://www.aafp.org/afp/2021/0401/afp20210401p439a.pdf

afp20210401p440.pdf

...In High-Risk Older Patients with Atrial Fibrillation, Rhythm Control Reduces Cardiovascular Death and Stroke, But at a Price Clinical Question For older patients at high cardiovascular risk, is a strategy of rate control or rhythm control preferred for recent-onset atrial...

American Family Physician

https://www.aafp.org/afp/2021/0401/afp20210401p440.pdf

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