Missing Components in Discharge Summaries to Subacute Care Centers
Hospital Medicine
Summary and Comment
Delayed discharge summary creation and lack of training are associated with omissions.
Ischemia Reduction vs. Bleeding After Acute Coronary Syndromes: Minimizing the Trade-Off
Cardiology
Summary and Comment
Free
In ATLAS ACS 2–TIMI 51, adding low-dose rivaroxaban to secondary prevention regimens slightly but significantly improved outcomes in low-risk patients.
By Beat J. Meyer, MD
November 13, 2011
Covering:
Mega JL et al. for the ATLAS ACS 2–TIMI 51 Investigators., N Engl J Med 2011 Nov 13
Roe MT and Ohman EM., N Engl J Med 2011 Nov 13
Ischemic-Event Reduction After Acute Coronary Syndromes: Another Drug Strikes Out
Cardiology
Summary and Comment
The thrombin-receptor antagonist vorapaxar increased risk for major bleeding without reducing ischemic events in patients with non–ST-segment-elevation ACS.
By Beat J. Meyer, MD
November 13, 2011
Covering:
Tricoci P et al for the TRACER Investigators., N Engl J Med 2011 Nov 13
Circulatory Arrest or Cerebral Perfusion During Pulmonary Endarterectomy?
Cardiology
Summary and Comment
Surprisingly, cognitive function was similar after both procedures, suggesting no benefit of cerebral perfusion.
By Beat J. Meyer, MD
November 9, 2011
Covering:
Vuylsteke A et al., Lancet 2011 Oct 15; 378:1379
Jamieson S., Lancet 2011 Oct 15; 378:1359
Depression as a Stroke Risk Factor
Psychiatry
Summary and Comment
Free
A systematic review and meta-analysis find that depression increases the risk for stroke.
The Importance of Good Supportive Care for Stroke
Neurology
Summary and Comment
Implementation of a nursing-based protocol for managing acute stroke complications significantly improved outcomes.
By Hooman Kamel, MD
November 1, 2011
Covering:
Middleton S et al., Lancet 2011 Oct 12
Depression as a Stroke Risk Factor
Neurology
Summary and Comment
A systematic review and meta-analysis finds that depression increases the risk for stroke.
Short-Term Stroke Risk in Patients Who Suffer Transient Ischemic Attacks
General Medicine
Summary and Comment
Combining magnetic resonance imaging and ABCD2 scoring improves stroke prediction.
By Allan S. Brett, MD
October 27, 2011
Covering:
Giles MF et al., Neurology 2011 Sep 27; 77:1222
Diet, Genes, and Stroke Risk: Another Look at Homocysteine and Folate
Neurology
Summary and Comment
Free
A genetic analysis and a meta-analysis suggest that lowering homocysteine levels reduces stroke risk more in low-folate regions than in areas with folate fortification, and that folate status modifies the effect of <$EMPH_O>MTHFR<$EMPH_C> alleles on stroke risk.
By Amytis Towfighi, MD
October 25, 2011
Covering:
Holmes MV et al., Lancet 2011 Aug 13; 378:584
Isotretinoin Does Not Appear to Increase Acute Risk for Thromboembolic Disease
Dermatology
Summary and Comment
Free
Patients might have long-term risk that is manifested with the use of isotretinoin but not necessarily caused by it.
Xanthelasma, but Not Arcus Senilis, Predicts Atherosclerotic Vascular Disease and Death
Dermatology
Summary and Comment
A relatively common clinical finding is a marker of increased risk for cardiovascular disease.
Briefly Noted
Associations of neurologic disorders with bullous pemphigoid and of disrupted glucose metabolism with porphyria cutanea tarda
Prehypertension and the Continuum of Stroke Risk
Neurology
Summary and Comment
Free
Prehypertension, especially in the higher range, is associated with incident stroke.
By Philip B. Gorelick, MD, MPH
October 18, 2011
Covering:
Lee M et al., Neurology 2011 Oct 4; 77:1330
Carotid Artery Stenting in the Real World
Neurology
Summary and Comment
An analysis of operator experience and outcomes raises questions about who should perform carotid artery stenting, and who should undergo it.
By Hooman Kamel, MD
October 18, 2011
Covering:
Nallamothu BK et al., JAMA 2011 Sep 28; 306:1338
Halm EA., JAMA 2011 Sep 28; 306:1378
Detection and Treatment of Depression in Neurological Disorders
Neurology
Summary and Comment
A review and meta-analysis of randomized controlled trials shows that antidepressants are effective for treating depression in the context of various neurological disorders, but effects on functioning and quality of life remain unclear.
By Jaime Toro, MD
October 18, 2011
Covering:
Price A et al., J Neurol Neurosurg Psychiatry 2011 Aug; 82:914
Tissue-Based Definition of TIA Is Superior to Time-Based Definition for Predicting Recurrent Stroke
Emergency Medicine
Summary and Comment
Rates of recurrent stroke were 7.1% in patients with tissue-positive TIA and 0.4% in those with tissue-negative TIA.
Symptomatic Carotid Stenosis and Short-Term Recurrent Stroke Risk
Neurology
Summary and Comment
A prospective, community-based study indicates that even short delays in surgery may expose patients to unnecessary risk.
By Hooman Kamel, MD
October 4, 2011
Covering:
Marnane M et al., Neurology 2011 Aug 23; 77:738
Intracranial Hemorrhage After Revascularization
Neurology
Summary and Comment
Overall, hemorrhage rates and mortality were higher after angioplasty with stenting than after endarterectomy in the National Inpatient Sample database.
Severe Psoriasis Increases Risk for Cardiovascular Disease
Dermatology
Summary and Comment
Free
Two newly published cohort studies have again linked severe psoriasis to cardiovascular disease.
By Jeffrey P. Callen, MD
September 30, 2011
Covering:
Mehta NN et al., Am J Med 2011 Aug; 124:775
Ahlehoff O et al., Eur Heart J 2011 Aug 12
Medical Management Is Superior to Stenting for Intracranial Arterial Stenosis
General Medicine
Summary and Comment
The rate of postprocedural strokes was unacceptably high in patients who received stents.
By Allan S. Brett, MD
September 29, 2011
Covering:
Chimowitz MI et al., N Engl J Med 2011 Sep 15; 365:993
Imaging-Based Patient Selection for Late Endovascular Stroke Therapy
Neurology
Summary and Comment
Free
A retrospective cohort study shows encouraging results from endovascular therapy performed beyond 8 hours in patients with a favorable imaging profile — paving the way for a randomized trial.
By Maarten G. Lansberg, MD, PhD
September 27, 2011
Covering:
Jovin TG et al., Stroke 2011 Aug; 42:2206
Pregnancy-Related Stroke: An Ominous Trend?
Women's Health
Summary and Comment
Incidence of stroke during pregnancy and postpartum is on the rise.
Intensive Medical Therapy vs. Stenting for Severe Symptomatic Intracranial Stenosis
Neurology
Summary and Comment
Free
Intensive medical therapy alone won out in the SAMMPRIS trial.
Body-Weight–Supported Treadmill Rehabilitation After Stroke
Neurology
Summary and Comment
In a randomized trial, this intervention was no better than home physical therapy.
Are Major Adverse Cardiovascular Events Associated with Anti–IL-12/23 Therapies?
Dermatology
Summary and Comment
Free
The authors found no statistically significant rise in risk, and experts disagree on how to interpret the findings.