Migraine, stroke, and the heart

2020 ◽  
pp. 98-109
Author(s):  
Simona Sacco ◽  
Antonio Carolei
Keyword(s):  
Risk Factor ◽  
Migraine Attack ◽  
Patent Foramen Ovale ◽  
Heart Diseases ◽  
Clinical Manifestations ◽  
Vascular Events ◽  
Increased Risk ◽  
Genetically Determined ◽  
Relationship Of ◽  
The Relationship

Accumulating data have linked migraine to cerebrovascular and heart diseases. The relationship between migraine and stroke is complex and bidirectional. A stroke, either ischaemic or haemorrhagic, may produce symptoms mimicking a migraine attack; a migraine attack may mimic a stroke; migraine may be directly associated with an ischaemic stroke (migrainous infarction); migraine may represent a risk factor for stroke; several diseases, mostly genetically determined, include among their clinical manifestations attacks of migraine and stroke; lastly, migraine has been associated with subclinical infarct-like brain lesions and white matter hyperintensities. The risk of cardiac vascular events in migraineurs varies greatly among studies, ranging from a lower-than-average to a moderately increased risk as suggested by the most recent data. Initial evidence also suggested an association between migraine and patent foramen ovale, but this possibility has been recently challenged. The mechanisms underlying the relationship of migraine with cerebrovascular and cardiovascular diseases are still cryptic and rather complex. In migraineurs, a heightened vigilance toward some comorbid risk factor is warranted together with caution in prescribing oral contraceptives.

scholarly journals Increased lipoprotein(a) concentrations in chronic renal failure.

1992 ◽  
Vol 3 (5) ◽  
pp. 1156-1162
Author(s):  
S M Haffner ◽  
K K Gruber ◽  
G Aldrete ◽  
P A Morales ◽  
M P Stern ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Renal Failure ◽  
Risk Factor ◽  
Heart Disease ◽  
Chronic Renal Failure ◽  
Mexican Americans ◽  
Increased Risk ◽  
Relationship Of ◽  
The Relationship ◽  
Hispanic White

Subjects with chronic renal failure have a greatly increased risk of coronary heart disease and dyslipidemia. Relatively few studies have examined the relationship of chronic renal failure to lipoprotein (Lp)(a) concentrations, an important risk factor for coronary heart disease. Diabetic subjects have been reported to have both increased Lp(a) concentrations and an increased risk of renal failure, thereby possibly confounding the Lp(a)-renal failure association. The association between Lp(a) and chronic renal failure in 359 control subjects and 111 subjects with renal failure was examined. Lp(a) (in milligrams per deciliter) was elevated in subjects with chronic renal failure, regardless of ethnicity (Mexican Americans, 19.8 +/- 2.7 versus 14.1 +/- 1.3; P = 0.03; non-Hispanic white patients, 24.9 +/- 3.0 versus 16.3 +/- 1.2; P = 0.006;). These differences persisted after adjustment for diabetes and ethnicity (P < 0.001). The type of treatment for chronic renal failure (diet, hemodialysis, or peritoneal dialysis) did not have an effect on Lp(a) concentrations. Lp(a) levels were not correlated with the level of creatinine in subjects with chronic renal failure. Thus, the elevation of Lp(a) levels in renal failure must occur early in renal failure, or alternatively, elevated Lp(a) levels may promote progression to chronic renal failure. These results indicate that Lp(a) concentrations are increased in chronic renal failure and may increase the risk for coronary heart disease in these subjects.

Infantile Apnea

1984 ◽  
Vol 5 (9) ◽  
pp. 275-284
Author(s):  
John T. McBride
Keyword(s):  
Risk Factor ◽  
Bacterial Infections ◽  
Upper Airway ◽  
Unexpected Death ◽  
Lead Placement ◽  
Increased Risk ◽  
Common Causes ◽  
Shallow Breathing ◽  
Relationship Of ◽  
The Relationship

There is presently no test capable of predicting an infant's risk for SIDS: there is no screening test for susceptibility to SIDS. The nature of a child's apneic episode is somewhat predictive of that infant's risk for subsequent unexpected death. Early signs suggesting respiratory center dysfunction are upper airway obstruction during sleep and hypoventilation during sleep. The most common causes of frequent "false" apnea alarms are poor lead placement, defective lead wires, improper sensitivity settings, and shallow breathing. Clearance of methylxanthines is lower in infancy than later in childhood; lower doses are necessary to avoid toxicity in infants. The relationship of infantile apnea to SIDS has not been firmly established. Infants who have had choking episodes and associated respiratory pauses are, in general, at no increased risk of sudden unexpected death. Apnea associated with acute viral or bacterial infections has not been shown to be a risk factor for subsequent SIDS.

The relationship of patent foramen ovale location with severity of stroke: A new risk factor for paradoxical embolism

2016 ◽  
Vol 71 (3) ◽  
pp. 149-153 ◽  
Author(s):  
Mustafa Fatih Erkoç ◽  
Bilge Öztoprak ◽  
Aylin Okur ◽  
Hüseyin Ede ◽  
Özcan Örsçelik ◽  
...  
Keyword(s):  
Risk Factor ◽  
Patent Foramen Ovale ◽  
Paradoxical Embolism ◽  
Foramen Ovale ◽  
Relationship Of ◽  
The Relationship

scholarly journals Diabetes and COVID19: a bidirectional relationship

2021 ◽  
Author(s):  
Ranjit Unnikrishnan ◽  
Anoop Misra
Keyword(s):  
Clinical Care ◽  
Severe Disease ◽  
Respiratory Involvement ◽  
Pancreatic Damage ◽  
Increased Risk ◽  
Bidirectional Relationship ◽  
Rapid Spread ◽  
Relationship Of ◽  
The Relationship ◽  
New Onset

AbstractThe advent and rapid spread of the coronavirus disease-2019 (COVID19) pandemic across the world has focused attention on the relationship of commonly occurring comorbidities such as diabetes on the course and outcomes of this infection. While diabetes does not seem to be associated with an increased risk of COVID19 infection per se, it has been clearly demonstrated that the presence of hyperglycemia of any degree predisposes to worse outcomes, such as more severe respiratory involvement, ICU admissions, need for mechanical ventilation and mortality. Further, COVID19 infection has been associated with the development of new-onset hyperglycemia and diabetes, and worsening of glycemic control in pre-existing diabetes, due to direct pancreatic damage by the virus, body’s stress response to infection (including cytokine storm) and use of diabetogenic drugs such as corticosteroids in the treatment of severe COVID19. In addition, public health measures taken to flatten the pandemic curve (such as lockdowns) can also adversely impact persons with diabetes by limiting their access to clinical care, healthy diet, and opportunities to exercise. Most antidiabetic medications can continue to be used in patients with mild COVID19 but switching over to insulin is preferred in severe disease.

scholarly journals Diabetes and COVID19: a bidirectional relationship

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ranjit Unnikrishnan ◽  
Anoop Misra
Keyword(s):  
Clinical Care ◽  
Severe Disease ◽  
Respiratory Involvement ◽  
Pancreatic Damage ◽  
Increased Risk ◽  
Bidirectional Relationship ◽  
Rapid Spread ◽  
Relationship Of ◽  
The Relationship ◽  
New Onset

AbstractThe advent and rapid spread of the coronavirus disease-2019 (COVID19) pandemic across the world has focused attention on the relationship of commonly occurring comorbidities such as diabetes on the course and outcomes of this infection. While diabetes does not seem to be associated with an increased risk of COVID19 infection per se, it has been clearly demonstrated that the presence of hyperglycemia of any degree predisposes to worse outcomes, such as more severe respiratory involvement, ICU admissions, need for mechanical ventilation and mortality. Further, COVID19 infection has been associated with the development of new-onset hyperglycemia and diabetes, and worsening of glycemic control in pre-existing diabetes, due to direct pancreatic damage by the virus, body’s stress response to infection (including cytokine storm) and use of diabetogenic drugs such as corticosteroids in the treatment of severe COVID19. In addition, public health measures taken to flatten the pandemic curve (such as lockdowns) can also adversely impact persons with diabetes by limiting their access to clinical care, healthy diet, and opportunities to exercise. Most antidiabetic medications can continue to be used in patients with mild COVID19 but switching over to insulin is preferred in severe disease.

scholarly journals Relationship between benzodiazepine prescription, aggressive behavior, and behavioral disinhibition: a retrospective study in a Swiss prison

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Stéphanie Baggio ◽  
Vladan Starcevic ◽  
Patrick Heller ◽  
Karen Brändle ◽  
Irina Franke ◽  
...  
Keyword(s):  
Propensity Score ◽  
Aggressive Behavior ◽  
Propensity Score Matching ◽  
Potential Role ◽  
Behavioral Disinhibition ◽  
Increased Risk ◽  
Benzodiazepine Use ◽  
Logistic Regressions ◽  
Relationship Of ◽  
The Relationship

Abstract Background Benzodiazepines are commonly prescribed in prisons amidst the controversies surrounding their potential role in causing behavioral disinhibition and aggressive behavior and their association with use and trafficking of illicit and addictive substances. The present study aimed to (1) ascertain the relationship between benzodiazepine prescription (including their dosage and duration of use) and aggressive behavior and behavioral disinhibition in prison and (2) investigate whether there was an association between benzodiazepine prescription, (including their dosage and duration of use) and using and trafficking illicit and addictive substances during imprisonment. Methods Data were extracted from the electronic database of an “open” Swiss prison (n = 1206, 1379 measures) over a 5-year period (2010–2015). Measures included benzodiazepine prescription, duration of benzodiazepine use and mean dosage, and punishable behaviors (physical and verbal aggression, disinhibited but not directly aggressive behaviors, property damage or theft, substance-related offenses, and rule transgression). We assessed the relationship between benzodiazepine prescription and punishable behaviors after propensity score matching. Logistic regressions were also used to test the relationship of benzodiazepine use duration and dosage with punishable behaviors among participants who received benzodiazepines. Results After propensity score matching, benzodiazepine prescription was not significantly associated with any punishable behavior. Among detained persons who took benzodiazepines, there was no significant association of dosage and duration of use with offenses involving illicit or addictive substance use or trafficking. Conclusions Our study did not empirically support the occurrence of increased aggressive or disinhibited behaviors or increased risk of substance abuse in detained persons who received benzodiazepines in prison. This suggests a need to reconsider restrictions in prescribing benzodiazepines in the prison setting.

Surgical Anatomy for Extended Facelift Techniques

2020 ◽  
Vol 36 (03) ◽  
pp. 309-316
Author(s):  
Ozcan Cakmak ◽  
Ismet Emrah Emre
Keyword(s):  
Facial Nerve ◽  
Soft Tissues ◽  
Extended Techniques ◽  
Surgical Anatomy ◽  
Superficial Musculoaponeurotic System ◽  
Increased Risk ◽  
The Face ◽  
Facial Soft Tissues ◽  
Relationship Of ◽  
The Relationship

AbstractPreservation of the facial nerve is crucial in any type of facial procedure. This is even more important when performing plastic surgery on the face. An intricate knowledge of the course of the facial nerve is a requisite prior to performing facelifts, regardless of the technique used. The complex relationship of the ligaments and the facial nerve may put the nerve at an increased risk of damage, especially if its anatomy is not fully understood. There are several danger zones during dissection where the nerve is more likely to be injured. These include the areas where the nerve branches become more superficial in the dissection plane, and where they traverse between the retaining ligaments of the face. Addressing these ligaments is crucial, as they prevent the transmission of traction during facelifts. Without sufficient release, a satisfying pull on the soft tissues may be limited. Traditional superficial musculoaponeurotic system techniques such as plication or imbrication do not include surgical release of these attachments. Extended facelift techniques include additional dissection to release the retaining ligaments to obtain a more balanced and healthier look. However, these techniques are often the subject of much debate due to the extended dissection that carries a higher risk of nerve complications. In this article we aim to present the relationship of both the nerve and ligaments with an emphasis on the exact location of these structures, both in regard to one another and to their locations within the facial soft tissues, to perform extended techniques safely.

scholarly journals Associations of CTLA4 Gene Polymorphisms with Graves’ Ophthalmopathy: A Meta-Analysis

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Pengfei Du ◽  
Xiaojie Ma ◽  
Changjiang Wang
Keyword(s):  
Genetic Model ◽  
Meta Analysis ◽  
Case Control Studies ◽  
Graves Ophthalmopathy ◽  
Increased Risk ◽  
Exon 1 ◽  
Ctla4 Gene ◽  
Relationship Of ◽  
The Relationship ◽  
Susceptible Gene

Many studies have established that T-lymphocyte antigen-4 (CTLA4) is a susceptible gene for Graves’ disease (GD). Also many studies showed the association between the CTLA4 exon-1 49A/G polymorphism and the risk of developing Graves’ ophthalmopathy (GO) in GD patients. But those results were inconsistent. In recent years many new studies were published which helped to shed light on the relationship of CTLA4 SNP49 with GO. So we performed the meta-analysis to explore the association between the SNP49 and GO susceptibility in GD patients. Studies up to February 29, 2012, were searched by using PubMed. The odds ratio was used to evaluate the strength of the association. Altogether 12 case-control studies involving 2,505 participants were included in the meta-analysis. Results showed that the G allele was related to the increased risk of GO compared with the A allele under allelic genetic model (OR = 1.14, 95% CI: 1.14–1.72,P=0.001) in European subgroup. No publication bias was detected. Our results showed that the SNP49 polymorphism of CTLA4 gene was related to increased risk of GO.

Abstract 3632: Secondary Vascular Events and Sleep Adequacy: the SWIFT Study

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
LAURA EVENSEN ◽  
Nan Liu ◽  
Yijun Wang ◽  
Bernadette Boden-Albala
Keyword(s):  
Risk Factors ◽  
Recurrent Events ◽  
Sleep Problems ◽  
Recurrent Event ◽  
Vascular Events ◽  
Respiratory Impairment ◽  
Vascular Death ◽  
Increased Risk ◽  
Falling Asleep ◽  
The Relationship

Objective: To describe the relationship between sleep problems, measured by the Medical Outcomes Sleep scale (MOS) at baseline, in ischemic stroke and TIA (IS/TIA) patients and the likelihood of having a recurrent event, leading to vascular death. Background: Among IS/TIA patients, there is increased risk for recurrent vascular events, including stroke, MI and vascular death. While history of stroke is a major predictor of recurrent events, there may be unidentified factors in play. Sleep quality may predict recurrent vascular events, but little is known about the relationship between sleep and recurrent events in IS/TIA patients. Methods: The Stroke Warning Information and Faster Treatment (SWIFT) Study is an NINDS SPOTRIAS funded randomized trial to study the effect of culturally appropriate, interactive education on stroke knowledge and time to arrival after IS/TIA. Sleep problems and recurrent event information were collected among consentable IS/TIA patients. Cox proportional hazards models were used to describe relationships between sleep and recurrent vascular events in IS/TIA patients. The MOS, a 12 item sleep assessment, measures 6 dimensions of sleep: initiation, maintenance, quantity, adequacy, somnolence and respiratory impairment. Results: Over 5 years, the SWIFT study cohort of 1198 [77% IS; 23% TIA] patients were prospectively enrolled. This cohort was 50% female; 50% Hispanic, 31% White and 18% Black, with a mean NIHSS of 3.2 [SD ±3.8]. 750 subjects completed the MOS scale at baseline. In a multivariate analysis, after adjusting for demographics and vascular risk factors: gender, age, race ethnicity, NIHSS, stroke history, qualifying event type, hypertension, diabetes, smoking and family stroke history, longer sleep initiation is associated with combined outcome of IS/TIA, MI and vascular death [p=0.1, HR=1.09]. Significant predictors of vascular death included: trouble falling asleep (initiation) [p=0.05, HR=1.15]; not ‘getting enough sleep to feel rested’ and not ‘getting the amount of sleep you need’ (adequacy) [p=0.06, HR=1.18 and p=0.03, HR=1.18, respectively]; shortness of breath or headache upon waking (respiratory impairment) [p=0.003, HR=1.33]; restless sleep [p=0.07, HR=1.15] and waking at night with trouble resuming sleep [p=0.004, HR=1.23] (maintenance); daytime drowsiness [p=0.05, HR=1.18] and trouble staying awake [p=0.01, HR=1.25] (somnolence); and taking naps (quantity) [p=0.03, HR=1.22]. Conclusions: Sleep problems represent diverse, modifiable risk factors for secondary vascular events, particularly vascular death. Exploring sleep dimensions may yield crucial information for reduction of secondary vascular events in IS/TIA patients. Further investigation is needed to fully understand the effects of sleep on secondary vascular event incidence.

scholarly journals THE RISK OF FALLS IN PATIENTS WITH RHEUMATOID ARTHRITIS

2017 ◽  
Vol 54 (6) ◽  
pp. 705-711 ◽  
Author(s):  
N. V. Toroptsova ◽  
A. Yu. Feklistov
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
Risk Of Falls ◽  
Relationship Of ◽  
The Relationship

The paper discusses the materials of investigations dealing with falls as an independent risk factor for fractures in patients with rheumatoid arthritis (RA). It gives data on the incidence and possible risk factors of falls in this category of patients. According to the data obtained, the prevalence of falls in different countries varies from 10 to 50%, which may be related to differences in the methods of collecting information, and the relationship of the investigated factors with the risk of falls in patients with RA is uniquely unproven and calls for further investigations.

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