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, 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.
AHA Journals, Author Interviews, Stroke / 11.09.2013

R. Gilberto González, MD, PhD Massachusetts General Hospital Department of Radiology, PO Box 9657 Boston, MAMedicalResearch.com Interview with: R. Gilberto González, MD, PhD Massachusetts General Hospital Department of Radiology, PO Box 9657 Boston, MA MedicalResearch.com: What are the main findings of the study? Dr. González: Administration of IV tPA to patients with a severe stroke syndrome caused by occlusion of the distal internal carotid artery and/or the proximal middle cerebral arteries results in good outcomes in 35% compared to 17% of similar patients who did not receive tPA.
Author Interviews, Diabetes, Kidney Disease, Stroke / 10.09.2013

MedicalResearch.com Interview with: Yongjun Wang, MD Department of Neurology, Beijing Tiantan Hospital Capital Medical University, Beijing, China MedicalResearch.com: What are the main findings of the study? Answer: Our study demonstrated that reduced eGFR was independently associated with all-cause mortality and other post-stroke outcomes in type 2 diabetic patients; stroke subtype analysis in our cohort showed that this association was only evident in ischemic stroke and TIA. We also observed a U-shaped relationship between variation of eGFR and post-stroke outcomes, that is, increased odds ratios were seen among those with low and high levels of eGFR. The cutoff points of eGFR associated with poor outcomes of stroke were eGFR<45 ml/min/1.73m2 and≥ 120 ml/min/1.73m2, respectively.
Author Interviews, Exercise - Fitness, Stroke / 26.07.2013

MedicalResearch.com Interview with: Michelle N. McDonnell, PhD Division of Health Sciences International Centre for Allied Health Evidence University of South Australia Adelaide, SA 5001 Australia.Michelle N. McDonnell, PhD Division of Health Sciences International Centre for Allied Health Evidence University of South Australia Adelaide, SA 5001 Australia. MedicalResearch.com: What are the main findings of the study? Dr. McDonnell: In this study, we asked people how many times a week they engaged in intense physical activity, enough to work up a sweat. People responded that they were physically active 0, 1-3 or 4 or more times a week. When we followed up these people for several years, those who did not do any vigorous exercise were 20% more likely to have a stroke, compared to those who exercised four or more times a week. However, when we adjusted these results for other risk factors, this attenuated the effect down to 14%  which was not statistically significant. We also noticed that people who exercised four or more times a week had less hypertension (high blood pressure), were less likely to be obese and less likely to have diabetes. Each of these things on their own reduces your risk of stroke, so when we adjust for that the association between physical activity and stroke is weaker (20% to 14%). So physical activity seems to have an effect on stroke risk by improving these other risk factors.
Author Interviews, Stroke / 22.06.2013

MedicalResearch.com Interview with: Saeid Shahidi, MD. Chief Consultant in supra-aortic surgery. Vascular Unit, Regional Hospital Slagelse, Region Zealand, Denmark. MedicalResearch.com: What is the background of your study? Answer: Our Prospective Population-based study showed, an expedited CEA can be performed in the subacute period ( >2 - <30 days) without significantly increasing the operative risk. The acute admission and urgent aggressive BMT with dual therapy in our cohort was associated with significant reduction P<0.00001 in the risk of early neurological recurrent (NR) in the CEA patient. It seems that in neurologically stable patients CEA can wait up to 30 days provided urgent BMT has been started in specialized stroke/ TIA clinics. Our study also adds to the data on the benefit of specialist TIA clinics.
Author Interviews, JAMA, Stroke / 22.05.2013

Dr. Rishi Gupta, MD Associate Professor of Neurology, Neurosurgery and Radiology Emory University School of Medicine Director, Vascular Neurology Fellowship Program Director, Multi-Hospital Acute Stroke Network Marcus Stroke and Neuroscience Center Grady Memorial Hospital MedicalResearch.com: What are the main findings of the study? Dr. Gupta: The main findings of this study are that patients with more proximal cerebral arterial occlusion involving the middle cerebral artery and internal carotid artery appear to be the targets for endovascular reperfusion therapy trials. Moreover, previous clinical trials have used a NIHSS > 8 or > 10 threshold to include patients into randomzed trials comparing endovascular therapy versus IV tPA. The threshold may need to be higher and in our analysis we found that threshold to be 14 or greater.
Author Interviews, Emergency Care, Stroke / 03.05.2013

MedicalResearch.com eInterview with with Dr. O. James Ekundayo, MD, DrPH Assistant Professor Department of Family & Community Medicine Meharry Medical College 1005 Dr. D.B. Todd Jr. Blvd. Nashville, TN 37208 Written Interview conducted with author by Editor Marie Benz, MD MedicalResearch.com What are the main findings of the study? Answer: The key findings are: ·         One third of stroke patients did not activate Emergency Medical Services (EMS). ·         Subgroups of patients who were less likely to use EMS include younger patients, patients of minority race or ethnicity, and those living in rural communities. ·         Prior history of stroke /TIA does not confer greater likelihood of EMS activation during subsequent stroke. ·         Patients who used EMS had shorter pre-hospital and in-hospital delay. They arrived early, had prompter evaluation, and received more rapid treatment. ·         More patients, who were eligible for clot-busting drug, received them. These happened because EMS gives the receiving hospital pre-notification about the arrival of the patient and the ER staff is ready to act as soon as the patient arrives.
Author Interviews, Exercise - Fitness, JAMA, Stroke / 19.03.2013

MedicalResearch.com Interview with Carron D. Gordon, PhD Section of Physical Therapy, University of the West Indies, Mona, Box 126, Kingston 7, Jamaica, West Indies MedicalResearch.com:  What are the main findings of the study? Dr. Gordon: The walking group showed a 17.6% improvement in distance walked in six minutes (measure of endurance) compared to 4% in the control group and 16.7% improvement in SF36-Physical Component (health-related quality of life) compared to 2.6% in the control group.
Author Interviews, Nutrition / 18.03.2013

MedicalResearch.com Interview with: Yoshihiro Kokubo, MD, PhD, FACC, FAHA, FESC Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, 5-7-1, Fujishiro-dai, Suita, Osaka, MedicalResearch.com: What are the main findings of the study? Dr. Kokubo:  In this study, higher green tea (2 or more cups/day) and coffee (3 to 6 times/week, 1 or more cups/day) consumption were found to be inversely associated with the incidences of cardiovascular disease and stroke. Higher green tea (2 or more cups/day) or coffee (1 or more cups/day) consumption reduced the risks of cardiovascular disease, strokes, and its subtypes, especially in intracerebral hemorrhage (P for interaction between green tea and coffee=0.04).