February 26th 2024
At 3 months following ischemic stroke, lower mean oxygen saturation but not apnea-hypopnea index was associated with functional deficits, according to a French research team.
Heroic Measures Extend Life of Surgical Pioneer and Stir Debate
January 5th 2007HOUSTON -- Running counter to the 97-year old patient's expressed wishes, surgeons here repaired a dissecting aortic aneurysm in Michael DeBakey, M.D., the legendary heart surgeon. The case stimulated questions about patients' rights, end-of-life care, and costs.
Cholesterol Lowering and Cancer: A Connection?
January 1st 2007In his "Consultations & Comments" response to a reader’scomments about statins and cancer risk in elderly patients(CONSULTANT, October 2003, page 1389), Dr David Nashnotes that the increased number of deaths from cancer thatoccurred in the second year of the Pravastatin in Elderly Individualsat Risk of Vascular Disease (PROSPER) study canprobably be attributed to disease that was already present beforethe start of the trial.
Older Woman With Recent Abdominal Pain and Fullness
December 31st 2006On her eighth day in the hospital for acute pulmonaryembolism, an 88-year-old woman complains of nauseaand abdominal pain and fullness of 12 hours’ duration.The pain is localized to the mid epigastric area and radiatesinto the right lower quadrant. The patient deniesvomiting, melena, and dysuria; she has refused to eat allday.
Ambulatory BP Monitoring: Time for an Expanded Role in Office Practice?
December 31st 2006Twenty-four-hour ambulatory blood pressure (BP) monitoringis a more accurate predictor of stroke and myocardialinfarction than office BP measurement, according tothe results of the recent Office Versus Ambulatory BloodPressure Study. This prospective trial followed 1963 patientswith treated hypertension for 5 years.
Central Retinal Artery Occlusion in a 70-Year-Old Man
December 31st 2006A 70-year-old man complains of a sudden, painless loss ofvision in the left eye that occurred several hours earlier. He denies traumaand previous visual disturbances. His history is significant for peripheralvascular disease and type 2 diabetes mellitus.
Rightward Shift in Axis or Right Axis Deviation?
December 31st 2006In their “Photoclinic” case of a patient with acute pulmonary embolism(CONSULTANT, December 2003, page 1741), Drs Tapas Bandyopadhyay andIsmael Martin state that the patient’s 12-lead ECG (which accompanies the casediscussion) exhibits right axis deviation.
Surgery for Cerebral Arteriovenous Malformation
December 14th 2006WASHINGTON -- The stroke-like symptoms suffered by Senator Tim Johnson, a Democrat from South Dakota, were caused by a congenital arteriovenous malformation, his office said today. Johnson was in critical condition after overnight surgery.
Treatment for Cerebral Arteriovenous Malformation
December 14th 2006WASHINGTON -- The stroke-like symptoms suffered by Senator Tim Johnson, a Democrat from South Dakota, were caused by a congenital arteriovenous malformation, his office said today. Johnson was in critical condition after overnight surgery.
Disoriented Senator: Possible Stroke
December 13th 2006WASHINGTON -- Senator Tim Johnson, a Democrat from South Dakota, was taken to George Washington University today with a possible stroke, his office said. If Johnson, who will be 60 this month, should be incapacitated and unable to serve, it would throw into question the Democrats? takeover of the Senate by a 51 to 49 majority, scheduled for next month. The governor of South Dakota, who would appoint a new senator, is a Republican. Johnson became disoriented while speaking to reporters around noon. After Johnson walked back to his office, he did not feel well, and he was examined by the Capitol physician, who recommended hospitalization.
Acute Ischemic Stroke: REFERENCES:
November 1st 2006ABSTRACT: Establishing the time of symptom onset is essential to selecting the appropriate therapy. Intravenous tissue-type plasminogen activator (t-PA), administered within 3 hours of symptom onset, is the only FDA-approved treatment for acute ischemic stroke. Intra-arterial and combined intra-arterial-intravenous thrombolytic therapy may be considered for patients whose condition does not improve or who present within 3 to 6 hours of symptom onset. Other options for treating acute ischemic stroke are balloon angioplasty with or without stenting (for symptomatic patients with more than 50% intracranial stenosis in whom medical therapy has failed) and mechanical clot retrieval (for those with an NIH Stroke Scale score greater than 10 who present after the 3-hour window for intravenous t-PA and can be treated within 8 hours of symptom onset or who present within 3 hours of symptom onset but in whom intravenous thrombolysis is contraindicated).