AHA Journals, Author Interviews, Nutrition, Stroke / 14.05.2014

MedicalResearch Interview with: Dr. Yan Qu Qingdao Municipal hospital Fruits and Vegetables Consumption and Risk of Stroke A Meta-Analysis of Prospective Cohort Studies MedicalResearch: What are the main findings of the study? Reply: First, both fruits and vegetables were found inversely associated with risk of stroke, and the relationships might be linear. Second, the inverse association of fruits and vegetables consumption with risk of stroke is consistent across subgroup analysis by outcome (stroke incidence and stroke mortality), location where the study was conducted (USA, Europe and Asia), sex (male and female), and stroke subtypes (ischemic and hemorrhagic). Third, citrus fruits, leafy vegetables and apples/pears were found inversely associated with risk of stroke. Fourth, very similar results were found in the subgroup analysis by status [yes: 0.78 (0.71-0.86) or no: 0.79 (0.74-0.85)] of adjusting for 6 or more of the 7 covariates (smoking, alcohol, blood pressure/hypertension, serum cholesterol, physical activity, body mass index, ≥3 dietary variables). These findings generally indicated that the association of fruits and vegetables consumption with the reduced risk of stroke may not be the result of confounding by the known factors.
Cannabis, Neurology, Stroke / 09.05.2014

MedicalResearch.com Interview with: Tara Dutta M.D. Vascular Neurology Fellow University of Maryland Medical Center MedicalResearch: What are the main findings of the study? Dr. Dutta: We analyzed data from the Stroke Prevention in Young Adults Study in order to evaluate for an association between self-reported marijuana use and ischemic stroke.   1,101 cases and 1,154 age, gender, and race-matched controls, aged 15-49 years old, were recruited from the greater Baltimore-Washington area between 1992 and 2008. Interviews were conducted to assess for various potential stroke risk factors, including illicit drug, alcohol, and tobacco use. Individuals reporting use of vasoactive illicit drugs, including cocaine and amphetamines, were excluded, yielding 751 cases and 813 controls. Logistic regression analysis was used to determine the association between marijuana use and ischemic stroke, adjusting for age, gender, race, current tobacco use, current alcohol use, hypertension, and diabetes. We did not find a positive association between marijuana use and ischemic stroke risk in our population of young-onset stroke patients compared to matched controls, even after controlling for current tobacco and alcohol use, hypertension, and diabetes.   A statistically significant inverse relationship was observed between remote use (defined as any use over one year ago) and stroke risk (adjusted OR 0.77, CI 0.61-0.98, p = 0.03). We also looked to see whether recent use (in the past 30 days), and particularly recent heavy use, was associated with ischemic stroke risk as has been suggested in the medical literature. Though our data did not show this association, the number of patients reporting recent use in our study was very small­­­­­­­.
Author Interviews, Mayo Clinic, Neurology, Stroke / 06.05.2014

Kejal Kantarci, M.D. M.S. Professor of Radiology Division of Neuroradiology Mayo Clinic, Rochester, MN 55905 MedicalResearch.com Interview with: Kejal Kantarci, M.D. M.S. Professor of Radiology Division of Neuroradiology Mayo Clinic, Rochester, MN 55905 MedicalResearch: What are the main findings of the study? Dr. Kantarci: Microinfarcts are one of the most common pathologies identified in the brains of older individuals and they impact cognition. However they are invisible lesions on MRI. We demonstrated that presence of microinfarcts in autopsied individuals are associated with the macroinfarcts identified on their MRI scans than they were alive. We also demonstrated that the presence of these invisible lesions are related to greater brain atrophy rates that are localized to watershed zones.
Author Interviews, Infections, Stroke / 01.05.2014

Professor Stuart Allan Faculty of Life Sciences, AV Hill Building The University of Manchester Manchester, M13 9PTMedicalResearch.com Interview with: Professor Stuart Allan Faculty of Life Sciences, AV Hill Building The University of Manchester Manchester, M13 9PT MedicalResearch.com: What are the main findings of the study? Dr. Allan: Using an experimental model of stroke it was found that animals with preceding Streptococcus pneumoniae infection had a worse outcome than uninfected animals. This confirms and extends previous data, both clinical and preclinical, that systemic inflammation is a key contributor to stroke outcome. Importantly, effects of infection were also demonstrated in animals with co-morbidities associated with stroke (atherosclerosis and age), with outcomes worse than observed in healthy young subjects. Exacerbating effects of infection on stroke are mediated via the pro-inflammatory cytokine, interleukin-1 (IL-1), shown by reversal of the increased ischaemic brain damage and functional impairments by treatment with the IL-1 receptor antagonist (IL-1Ra). Infection also leads to increased platelet activation and microvascular coagulation after stroke, which contributes to the increased injury. Collectively, these data are the first to show, how systemic inflammatory mechanisms induced by one of the most common non-invasive, human S.pneumoniae isolates, lead to critical illness after stroke in different rodent species and strains, and how common stroke comorbidities interact with infection to worsen outcome after stroke.
Author Interviews, Erasmus, Neurology, Stroke / 25.04.2014

M. Arfan Ikram, MD, PhD Assistant professor in Neuroepidemiology Erasmus Medical Center Rotterdam, the NetherlandsMedicalResearch.com Interview with: M. Arfan Ikram, MD, PhD Assistant professor in Neuroepidemiology Erasmus Medical Center Rotterdam, the Netherlands MedicalResearch.com: What are the main findings of this study? Dr. Ikram: We show that the risk of stroke might be increased due to an increased risk of ischemic stroke or increased risk of hemorrhagic stroke. Because these subtypes of stroke require different -often opposite- clinical management, currently available prediction rules for any stroke are insufficient. We propose a novel prediction rule that provides separate risks for ischemic stroke and hemorrhagic stroke.
Author Interviews, JAMA, Stroke, UCLA / 24.04.2014

Dr. Gregg C. Fonarow MD Director, Ahmanson-UCLA Cardiomyopathy Center UCLA CHAMP - Cholesterol, Hypertension, and Atherosclerosis Management Program Professor, Department of Medicine Associate Chief, Cardiology David Geffen School of Medicine Los Angeles, CAMedicalResearch.com Interview with: Dr. Gregg C. Fonarow MD Director, Ahmanson-UCLA Cardiomyopathy Center Professor, Department of Medicine Associate Chief, Cardiology David Geffen School of Medicine Los Angeles, CA MedicalResearch.com: What are the main findings of the study? Dr. Fonarow: This study examined data from hospitals that have adopted the American Heart Association/ American Stroke Association’s national quality initiative, Target: Stroke, which aims to increase the number of stroke patients treated with clot-busting drugs for ischemic stroke within 60 minutes or less after hospital arrival.  Initiated nationwide in 2010, Target: Stroke provided 10 key strategies as well as tools to facilitate timely tPA administration, as well as additional approaches to improve stroke care and outcome. Data from 71,169 tPA-treated stroke patients at 1,030 hospitals participating in Target: Stroke were analyzed to compared the time to treatment and incidence of complications before implementation, from 2003 to 2009, to the post-implementation years, from 2010 to 2013. This study found that the percentage of patients treated within the recommended timeframe increased from less than one-third before Target: Stroke to more than half afterwards. The Target: Stroke program goal of 50 percent or more of patients having door-to-needle times within 60 minutes was successfully achieved. In addition, the average time to treatment dropped by 15 minutes, from 74 to 59 minutes. Faster treatment was associated with lower rates of complications, including death. Before Target: Stroke, 9.9% of stroke patients died in the hospital, compared to 8.3% of patients treated after the initiative started, a difference which was statistically significant. In addition, patients treated by Target: Stroke strategies were less likely to develop the complication of symptomatic intracranial hemorrhage.
Author Interviews, JAMA, Outcomes & Safety, Stroke / 22.04.2014

Priv.-Doz. Dr. med. Dr. phil. Martin Ebinger Oberarzt der Klinik und Hochschulambulanz für Neurologie am Campus Charité Mitte Center for Stroke Research Berlin (CSB) Charité - Universitätsmedizin Berlin | CCM Charitéplatz 1 | 10117 Berlin | GermanyMedicalResearch.com Interview with: Priv.-Doz. Dr. med. Dr. phil. Martin Ebinger Oberarzt der Klinik und Hochschulambulanz für Neurologie am Campus Charité Mitte Center for Stroke Research Berlin (CSB) Charité - Universitätsmedizin Berlin | CCM Charitéplatz 1 | 10117 Berlin | Germany MedicalResearch.com: What are the main findings of the study? Dr. Ebinger: The main findings of our study was a significant time reduction during randomized weeks with prehospital thrombolysis compared to control weeks with regular care.
Author Interviews, Blood Pressure - Hypertension, CMAJ, McGill, Stroke / 14.04.2014

Finlay A McAlister MD Division of General Internal Medicine Patient Health Outcomes Research and Clinical Effectiveness Unit Epidemiology Coordinating and Research (EPICORE) Centre McGill University, Montréal, QuebecMedicalResearch.com Interview with: Finlay A McAlister MD University of Alberta, Edmonton, Canada MedicalResearch.com: What are the main findings of the study? Dr. McAlister: We tested 2 systems of case management on top of usual care (note that at baseline more than 3/4 of our study patients were already taking medications to lower blood pressure (BP) and/or cholesterol but none were at guideline-recommended targets). The first (our "control" group) was a nurse seeing patients monthly x 6 months, measuring their blood pressure and LDL cholesterol, counseling them about risk factor reduction strategies (including lifestyle and medication adherence), and faxing results of BP/cholesterol to their primary care physicians with advice to patients who had blood pressure or cholesterol above guideline-recommended targets to see their primary care physician. The second (our "intervention" group) was a pharmacist seeing patients monthly x 6 months, measuring their blood pressure and LDL cholesterol, counseling them about risk factor reduction strategies (including lifestyle and medication adherence), and faxing results of BP/cholesterol to their primary care physicians.  However, if patients had blood pressure or cholesterol above guideline-recommended targets instead of just recommending that the patient see their primary care physician the pharmacist provided them with a prescription for medication (or up-titration of their current medications) to address the uncontrolled risk factor. Both groups improved substantially over usual care, but the intervention group improved even more (13% absolute improvement in control of BP/cholesterol levels compared to the nurse-led control arm) .
Author Interviews, Outcomes & Safety, Stroke / 02.04.2014

Sripal Bangalore, MD, MHA, FACC, FAHA, FSCAI, Director of Research, Cardiac Catheterization Laboratory, Director, Cardiovascular Outcomes Group, The Leon H. Charney Division of Cardiology, Associate Professor of Medicine, New York University School of Medicine, New York, NY 10016.MedicalResearch.com Interview with: Sripal Bangalore, MD, MHA, FACC, FAHA, FSCAI, Director of Research, Cardiac Catheterization Laboratory, Director, Cardiovascular Outcomes Group, Associate Professor of Medicine, New York University School of Medicine New York, NY 10016. MedicalResearch.com: What are the main findings of your study? Dr. Bangalore: Patients with transient ischemic attack (TIA) are at increased risk of future full blown stroke, making institution of secondary prevention measures critical Our data from 858,835 patients from 1545 sites indicate that hospital adherence to evidence-based secondary prevention discharge measures was consistently less for patients with transient ischemic attack when compared with those with ischemic stroke, thus representing a missed opportunity at instituting preventive measures to reduce the risk of future stroke.
AHA Journals, Author Interviews, Social Issues, Stroke / 25.03.2014

Jill Cameron, PhD M.Ed., B.Sc. O.T CIHR New Investigator, Associate Professor, Department of Occupational Science and Occupational Therapy Graduate Department of Rehabilitation Science Faculty of Medicine, University of Toronto Adjunct Scientist, UHN-Toronto Rehabilitation InstituteMedicalResearch.com Interview with: Jill Cameron, PhD CIHR New Investigator, Associate Professor, Department of Occupational Science and Occupational Therapy Graduate Department of Rehabilitation Science Faculty of Medicine, University of Toronto Adjunct Scientist, UHN-Toronto Rehabilitation Institute MedicalResearch.com: What are the main findings of the study? Dr. Cameron: In our study with 399 stroke survivor, caregiver dyads, caregivers reported more psychological wellbeing when they provided more assistance to stroke survivors who had fewer symptoms of depression, better cognitive functioning, and who had more severe strokes.  In addition, caregivers who maintained participation in valued activities, had more mastery, gained personally providing care, were in better physical health, and were older reported more psychological wellbeing.
AHA Journals, Author Interviews, Race/Ethnic Diversity, Stroke, University of Michigan / 14.03.2014

Lynda D. Lisabeth, PhD Interim Chair and Associate Professor Department of Epidemiology University of Michigan Ann Arbor, MichiganMedicalResearch.com Interview with: Lynda D. Lisabeth, PhD Interim Chair and Associate Professor Department of Epidemiology University of Michigan Ann Arbor, Michigan MedicalResearch.com: What are the main findings of the study? Dr. Lisabeth: The main findings were that Mexican Americans scored worse than non-Hispanic whites on all outcomes measured at 90 days following stroke, including neurologic, functional and cognitive outcomes, after adjustment for confounding factors. Further, we found that one-third of Mexican American stroke survivors have post-stroke dementia. Mexican Americans experienced more aphasia than non-Hispanic whites. Levels of functional impairment were substantial, with Mexican Americans on average experiencing moderate functional disability. Mexican Americans reported significantly greater difficulty than non-Hispanic whites with all activities of daily living (ADLs) and instrumental activities of daily living (IADLs) that were studied.
AHA Journals, Author Interviews, Stroke / 14.03.2014

Atte Meretoja, MD, PhD, MSc (Stroke Medicine) Associate Professor and Principal Fellow (Neurology), University of Melbourne The Royal Melbourne Hospital L4C, Grattan St, Parkville VIC 3050, Australia Associate Professor of Neurology, University of Helsinki Helsinki University Central Hospital, FinlandMedicalResearch.com Interview with: Atte Meretoja, MD, PhD, MSc (Stroke Medicine) Associate Professor and Principal Fellow (Neurology), University of Melbourne The Royal Melbourne Hospital Australia Associate Professor of Neurology, University of Helsinki Helsinki University Central Hospital, Finland MedicalResearch.com: What are the main findings of the study? Dr. Meretoja: We used observational prospective data of consecutive stroke patients (n=2258) treated with intravenous thrombolysis in Australian and Finnish centers and a pooled analysis of thrombolysis trials to model the shift in patient outcomes with reducing treatment delays. We found out that each minute the treatment can be delivered faster granted on average 1.8 days of extra healthy life (95% prediction interval 0.9 to 2.7). In practice, this means that each 15 minute decrease in treatment delays provides an average equivalent of one month of additional disability-free life.
Author Interviews, Blood Pressure - Hypertension, Stroke / 12.03.2014

MedicalResearch.com Interview with: Dingli Xu, MD From Department of Cardiology Nanfang Hospital, Southern Medical University, Guangzhou, China MedicalResearch.com:  What are the main findings of the study? Answer:Our study showed that after controlling for multiple cardiovascular risk factors, the blood pressure range at 120-139/80-89 mm Hg (defined as ‘prehypertension’ in JNC 7), is significant associated with long-term risk of stroke. The results were consistent across stroke type, stroke endpoint, age, study characteristics, follow-up duration, and ethnicity. More importantly, even low-range prehypertension (BP 120-129/80-84mmHg) increased the risk of stroke compared with optimal BP (<120/80 mm Hg), and the risk was higher in individuals with high-range prehypertension (BP 130-139/85-85mmHg). In particular, we found that compared with individuals with optimal blood pressure individuals with low-range prehypertension were 44% more likely to develop stroke, and this risk was even greater (95%) in individuals with high-range prehypertension.
Author Interviews, Diabetes, Diabetologia, Gender Differences, Stroke / 27.02.2014

MedicalResearch.com Interview with: Gang Hu, MD, MPH, PhD, FAHA Assistant professor & Director, Chronic Disease Epidemiology Lab Adjunct assistant professor, School of Public Health, LSU Health Sciences Center Pennington Biomedical Research Center, Baton Rouge, LouisianaGang Hu, MD, MPH, PhD, FAHA Assistant professor & Director Chronic Disease Epidemiology Lab Adjunct assistant professor, School of Public Health LSU Health Sciences Center Pennington Biomedical Research Center, Baton Rouge, Louisiana MedicalResearch.com: What are the main findings of the study? Dr. Gang Hu:  Our study suggests a graded association between HbA1c and the risk of stroke among female patients with type 2 diabetes and poor control of blood sugar has a stronger effect in women older than 55 years.
AHA Journals, Author Interviews, Stroke / 26.02.2014

MedicalResearch.com Interview with: Daniel Strbian, MD, PhD, MSc (Stroke Med), FESO Neurologist, Associate Professor Department of Neurology Helsinki University Central Hospital MedicalResearch.com: What are the main findings of the study?  Dr. Strbian: That even if the SEDAN score had the best performance, none of the scores showed better than a moderate performance.
Clots - Coagulation, OBGYNE, Stroke / 20.02.2014

Dr.Hooman Kamel MD Department of Neurology and the Brain and Mind Research Institute Weill Cornell Medical College in New York City.MedicalResearch.com Interview with: Dr.Hooman Kamel MD Department of Neurology and the Brain and Mind Research Institute Weill Cornell Medical College in New York City. MedicalResearch.com: What are the main findings of the study? Dr. Kamel: The risk of thrombotic events remains higher than normal for twice as long after childbirth as previously thought. However, the absolute risk in any given patient is low, especially after the first 6 weeks.
Brigham & Women's - Harvard, Duke, Medical Research Centers, Stroke, UCLA / 18.02.2014

Gregg C Fonarow, UCLA Medical Ctr, Los Angeles, CA; Director, Ahmanson-UCLA Cardiomyopathy Center Professor, Department of Medicine Associate Chief, Cardiology David Geffen School of MedicineMedicalResearch.com Interview with: Gregg C Fonarow, UCLA Medical Ctr, Los Angeles, CA; Director, Ahmanson-UCLA Cardiomyopathy Center Professor, Department of Medicine Associate Chief, Cardiology David Geffen School of Medicine MedicalResearch.com: What are the main findings of the study? Dr. Fonarow: The study examined data from hospitals that have adopted the American Heart Association/ American Stroke Association’s national quality initiative, Target: Stroke. The primary aim of Target: Stroke is to increase the number of stroke patients treated with tPA for acute ischemic stroke within 60 minutes or less after hospital arrival. The study demonstrated that patients received stroke therapy significantly faster in hospitals that participated in Target: Stroke. Between 2010 and 2013, the time between hospital arrival and use of tPA (door-to-needle time) dropped by 15 minutes, from 74 to 59 minutes, in hospitals that participated in Target: Stroke. This study found that the percentage of patients treated within the recommended timeframe increased from less than one-third before Target: Stroke to more than half afterwards. The Target: Stroke program goal of 50 percent or more of patients having door-to-needle times within 60 minutes was successfully achieved. Faster treatment was associated with improved patient outcomes and fewer complications, including death.
Author Interviews, Erasmus, JAMA, Stroke / 18.02.2014

dr_Arfan_IkramMedicalResearch.com Interview with: M. Arfan Ikram, MD, PhD Departments of Radiology, Epidemiology, and Neurology Erasmus Medical Center, Rotterdam, the Netherlands MedicalResearch.com:  What are the main findings of the study? Dr. Ikram: The main finding of the study, carried out within the Rotterdam Study and led by drs. Daniel Bos and Arfan Ikram (both from the Erasmus Medical Center Rotterdam, the Netherlands), was that intracranial atherosclerosis is a major risk factor for stroke in the Western (white) population. Traditionally, intracranial atherosclerosis has not been considered of major importance to stroke risk in Western populations. In contrast, most research on intracranial atherosclerosis originates from Asian and African populations, where is was actually recognized as the most important risk factor of stroke. Our study demonstrates that also in the Western population intracranial atherosclerosis is a major risk factor for stroke and should get more focus in clinical practice. Moreover, our findings indicate that its contribution to the proportion of all strokes is greater than that of atherosclerosis in other vessel beds that are further away from the brain.
AHA Journals, Author Interviews, Cost of Health Care, Stroke / 08.01.2014

Dr. James Sheppard MRC Research Fellow Department of Primary Care Health Sciences University of OxfordMedicalResearch.com Interview with Dr. James Sheppard MRC Research Fellow Department of Primary Care Health Sciences University of Oxford MedicalResearch.com: What are the main findings of the study? Dr. Sheppard: The aim of our study was to develop a decision-tree model which estimates the cost-effectiveness and potential implementation costs of a series of interventions which increase thrombolysis rates in acute stroke. The model examined all possible acute stroke patient pathways and was based on real life patient data. We found all proposed interventions to be cost saving whilst increasing patient quality of life after stroke. We estimate that, assuming a "willingness-to-pay"  of USD $30,000 per quality adjusted life year gained, the potential budget available to deliver interventions which improve acute stroke care range from USD $50,000 to USD $144,000.
Author Interviews, Stroke / 23.11.2013

Andrew D. Barreto, M.D. Assistant Professor of Neurology University of Texas, HoustonMedicalResearch.com Interview with: Andrew D. Barreto, M.D. Assistant Professor of Neurology University of Texas, Houston   MedicalResearch.com: What are the main findings of the study? Dr. Barreto: Applying a novel, operator-independent device used to produce ultrasound energy through the skull of stroke patients receiving IV-tPA (intravenous clot-busting medication that is the standard treatment for stroke patients) was safe – no signal of increased risk of symptomatic intracerebral hemorrhage (brain bleeding). Rates of recanalization (clot dissolution) were consistent with prior work that suggest aiming transcranial Doppler ultrasound energy at the clot amplifies the clot-busting effect of tPA alone.
Addiction, Author Interviews, Cannabis, Stroke / 22.11.2013

W. Scott Burgin, MD Professor and Chief Cerebrovascular Division Director, Comprehensive Stroke Center Department of Neurology USF College of Medicine Tampa General Hospital Stroke CenterMedicalResearch.com Interview with: W. Scott Burgin, MD Professor and Chief, Cerebrovascular Division Director, Comprehensive Stroke Center Department of Neurology USF College of Medicine Tampa General Hospital Stroke Center. MedicalResearch.com What are the main findings of the study? Dr. Burgin: Two cases of stroke, of embolic appearance, shortly after smoking synthetic marijuana.
Author Interviews, Johns Hopkins, Stroke / 12.11.2013

Yogesh Moradiya MBBS From the Neurosciences Critical Care Division Johns Hopkins University, Baltimore, MD;MedicalResearch.com Interview with: Yogesh Moradiya MBBS From the Neurosciences Critical Care Division Johns Hopkins University, Baltimore, MD;   MedicalResearch.com: What are the main findings of the study? Answer: We studied 712,433 stroke cases in 6,839 hospital samples in United States over 11-year study period (2000-2010) and found that hospitals with neurology residency training program treated stroke patients with tissue plasminogen activator (tPA) more frequently than other teaching or non-teaching hospitals. The higher tPA utilization in hospitals with neurology residencies was independent of patient age, gender, ethnicity, insurance status, comorbidities, hospital geographic location, stroke case volume, calendar year and the Joint Commission Primary Stroke Center certification.
AHA Journals, Author Interviews, Lancet, Stroke / 07.11.2013

Dr. Colin Derdeyn Mallinckrodt Institute of Radiology and the Departments of Neurology and Neurosurgery Washington University School of Medicine, St Louis, MO, USAMedicalResearch.com Interview with: Dr. Colin Derdeyn Mallinckrodt Institute of Radiology and the Departments of Neurology and Neurosurgery Washington University School of Medicine, St Louis, MO, USA MedicalResearch.com: What are the main findings of the study?  Dr. Derdeyn: The primary results indicate that medical management, consisting of dual antiplatelets for 3 months after a transient ischemic attack (TIA) or stroke, and rapid, effective control of blood pressure (systolic BP less than 140 mm Hg and 130 mm Hg if diabetic) and LDL-cholesterol (less than 70 mg/dl), in addition to management of other risk factors, is superior to angioplasty and stenting in addition to the same medical regimen for reducing the risk of future stroke in patients with severe atherosclerotic stenosis (>70%) of a major intracranial artery.    In addition, while there were subgroups at higher risk for stroke on medical treatment (older age, female gender, prior stroke in the territory),  none of these subgroups appeared to have a benefit from stenting (i.e. stroke rates in the stenting groups in these subgroups was higher too).
Author Interviews, Diabetes, Diabetes Care, Stroke / 23.10.2013

MedicalResearch.com Interview with: Stefanie Hägg, MB Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki Division of Nephrology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland MedicalResearch.com: What are the main findings of the study? Answer: We studied the incidence of stroke in a large cohort of patients with type 1 diabetes in Finland. During 36,680 person-years of follow-up, we found that the incidence of total stroke, and the subtypes cerebral infarction and cerebral hemorrhage was 406, 286, and 120 per 100,000 person-years, respectively, which is higher than in the Finnish general population, for whom the incidence of stroke varies between 135 and 236 per 100,000 person years. Furthermore, we studied the impact of two diabetic microvascular complications, diabetic nephropathy and severe diabetic retinopathy, on the risk of stroke, as well as for the subtypes of stroke. The incidence of stroke, cerebral infarction, and cerebral hemorrhage increased with both the presence of severe diabetic retinopathy and with advancing diabetic nephropathy. Furthermore, we found that both diabetic nephropathy and severe diabetic retinopathy increased the risk for all subtypes of stroke, independently of traditional risk factors. A novel finding was that already incipient diabetic nephropathy (microalbuminuria) increased the risk of stroke, cerebral infarction, and cerebral hemorrhage more than 3-fold, compared with patients free of renal disease. The highest risk of stroke was seen in patients with end-stage renal disease.
Author Interviews, Heart Disease, Mineral Metabolism, Stroke / 14.10.2013

Abhishek Sharma, M.B.B.S. Maimonides Medical Center in Brooklyn, N.Y.MedicalResearch.com Interview with: Abhishek Sharma, M.B.B.S. Maimonides Medical Center in Brooklyn, N.Y.   MedicalResearch.com: What are the main findings of the study? Answer:  Evidence from RCT's and observational studies suggests a significantly increased risk of atrial fibrillation (AF) requiring hospitalization, but no increase in risk of stroke or cardiovascular mortality with the use of bisphosphonate.
Author Interviews, CMAJ, MRI, Stroke / 17.09.2013

Tobias Saam, MD Institute of Clinical Radiology Ludwig-Maximilians-Univ Hosp Munich, GermanyMedicalResearch.com Interview with: Tobias Saam, MD Institute of Clinical Radiology Ludwig-Maximilians-Univ Hosp Munich, Germany MedicalResearch.com: What are the main findings of the study? Dr. Saam: The results of our meta-analysis suggest that despite a large degree of detected heterogeneity of the published studies, the presence of intraplaque hemorrhage by MRI in patients with carotid artery disease is associated with an approximately 5.6-fold higher risk for cerebrovascular events, such as TIA or stroke, as compared to subjects without intraplaque hemorrhage.
Author Interviews, Diabetes, MRI, Nature, Stroke / 13.09.2013

Fabian Bamberg, MD, MPH Department of Clinical Radiology Ludwig Maximilians University, Klinikum Grosshadern Marchioninistrasse 15, 81377 Munich, GermanyMedicalResearch.com Interview with: Fabian Bamberg, MD, MPH Department of Clinical Radiology Ludwig Maximilians University, Klinikum Grosshadern Marchioninistrasse 15, 81377 Munich, Germany  MedicalResearch.com: What are the main findings of the study?  Dr. Bamberg: Our study shows that there is a substantial and heterogenous degree of subclinical cardiovascular disease burden in patients with diabetes undergoing whole-body MRI. These whole-body MRI findings have significant prognostic relevance. For instance, our results show that patients without any pathologic findings experience no adverse cardiovascular event over a period of six years while the risk for a heart attack or stroke increases with the degree of disease burden.
Author Interviews, Heart Disease, Stroke / 13.09.2013

Dr. Eung Y. Kim Department of Radiology, Research Institute of Radiological Science, Department of Neurology, and Biostatistics Collaboration Unit, Medical Research Center, Yonsei University College of Medicine, Seoul, Korea;MedicalResearch.com Interview with: Dr. Eung Y. Kim Department of Radiology Gachon University Medical Center Incheon, South Korea.   MedicalResearch.com: What are the main findings of the study? Answer: The extent of calcification involving intracranial artery significantly correlates with that of coronary artery in patients with ischemic stroke. The Agatston score measured in the intracranial arteries may be an independent predictor of asymptomatic coronary artery disease in patients with ischemic stroke.