medical society

2023-11-22 03:17:26

#clinical #trial #comparing #implantable #defibrillator #drug #drug

2023-11-17 03:36:27

#Apixaban #aspirin #preventing #stroke #patients #atrial #fibrillation

In celebration of World Stroke Day on October 29, the Korean Stroke Association (Chairman Eung-gyu Kim, Inje University College of Medicine, and Chairman Hee-jun Bae, Seoul National University College of Medicine) emphasized that receiving hyperacute treatment as quickly as possible within the golden time is directly related to stroke prognosis.

Every year, October 29th is ‘World Stroke Day’ designated by the World Stroke Organization. Stroke is the fourth leading cause of death in Korea, with more than 100,000 patients occurring annually, and the number of patients is expected to increase as the elderly population increases. Stroke is a disease caused by a sudden cerebral blood flow disorder (occlusion of a cerebral blood vessel: cerebral infarction, rupture of a cerebral blood vessel: cerebral hemorrhage). In cerebral infarction, which accounts for 80% of strokes, the ‘golden time’ is directly related to the patient’s life and sequelae, so it is important to start treatment as quickly as possible.

Bae Hee-jun, president of the Korean Stroke Association, said, “The golden time for cerebral infarction is ‘within 4.5 hours after symptom onset’, which is the time when intravenous thrombolytic medication can be administered. Considering the time to visit the hospital and prepare tests and drugs, at least 3 hours after symptom onset. Treatment can be started within 4.5 hours if you visit within 4.5 hours. If a large cerebral blood vessel is blocked after administering a thrombolytic agent, intra-arterial thrombectomy is performed. It is recommended that intra-arterial thrombectomy be performed within 6 hours of symptom onset, but brain imaging is recommended. “Depending on the cerebral infarction lesion identified, it can be performed up to 24 hours after symptom onset,” he explained.

Main symptom table released by the academic society

If intravenous thrombolytics are administered after a cerebral infarction, the probability of being able to live alone 3 months after the onset is twice as high as for patients who do not receive the treatment, and successful intra-arterial thrombectomy is 2.5 times more likely to have a good prognosis 3 months after the onset of cerebral infarction. Therefore, if symptoms of cerebral infarction occur, it is important to visit a hospital immediately and receive hyperacute treatment. After hyperacute and acute stroke treatment, risk factors such as high blood pressure, diabetes, hyperlipidemia, and atrial fibrillation are controlled, and in the case of cerebral infarction, antithrombotic drugs are taken to treat secondary prevention of stroke recurrence.

According to the annual report of the Korea Stroke Registration Project, less than 30% of patients visit hospitals 3 hours after a stroke for less than 10 years. Regarding this, Chairman Bae Hee-jun said, “70% of patients visited the hospital late after symptom onset, which means they did not receive treatment within the golden time. Treatment with intravenous thrombolysis and intra-arterial thrombectomy as soon as possible has a good prognosis. Therefore, if stroke symptoms occur, you must immediately call 119 and visit the hospital,” he emphasized.

In relation to this, Kim Tae-jeong, public relations director of the Korean Stroke Association, said, “Stroke is a problem that occurs in the brain blood vessels, so it has the characteristic of occurring suddenly. Even if it was normal a minute ago, a stroke may occur a minute later. Stroke symptoms are “neighbors, hands, “It’s important to remember your feet and gaze,” he explained.

In addition to the main symptoms, there may be a variety of other symptoms, such as headaches that you have never experienced before, severe dizziness, ataxia that does not allow you to keep your balance, and double vision. If any of these symptoms are abnormal, you should immediately call 119 and visit a stroke center.

There are a total of 83 stroke centers in Korea certified by the Korean Stroke Association that provide hyperacute treatment, including 73 stroke centers that provide reperfusion treatment (intravenous thrombolysis and intraarterial thrombectomy) and 10 general stroke centers.

Meanwhile, since its founding in 1998, the Korean Stroke Association has been active in the fields of stroke-related treatment, education, research, policy, and publicity, and has continued to establish a treatment system and prepare treatment guidelines to provide standardized, high-quality treatment to stroke patients. is progressing. Detailed information about stroke diagnosis and treatment can be found on the Korean Stroke Association’s YouTube channel, and stroke specialists provide explanations about common questions that the general public and patients have during the actual treatment process.

2023-10-23 03:45:58

#Remember #symptoms #stroke #center

The academic world is paying attention to research results showing that obesity surgery significantly lowers the risk of cardiovascular disease and blood cancer.

Just by correcting the workload, not only the risk of blood cancer but also the mortality rate can be lowered. Accordingly, experts believe that more attention should be paid to preventive measures through obesity surgery.

Research results have shown that obesity surgery is effective in preventing the risk of blood cancer.

On the 20th local time, the results of a large-scale study on the impact of obesity surgery on the risk of blood cancer were published in LANCET (10.1016/S2666-7568(23)00141-1).

It is well known that obesity directly affects serious comorbidities such as type 2 diabetes and cardiovascular disease.

Moreover, in recent years, awareness has been growing as the fact that obesity is a risk factor for various malignant tumors has been highlighted.

In particular, correction through obesity surgery has received attention as some studies have reported that severe obesity increases the risk of blood cancers such as multiple myeloma.

However, the medical evidence was still weak in that there were only retrospective studies and no prospective studies.

This is also the reason why a research team led by Professor Magdalena Taube of Gothenburg University in Sweden conducted a prospective study on this. This is to analyze the impact of actual obesity surgery on blood cancer.

Accordingly, the researchers conducted a prospectively controlled clinical trial targeting 2,007 people who underwent obesity surgery and 2,040 people who received general treatment, and monitored blood cancer cases such as malignant lymphoma and multiple myeloma.

As a result, a total of 34 patients who underwent obesity surgery were diagnosed with blood cancer, and a total of 51 patients in the general treatment group, or control group, were diagnosed with blood cancer.

After excluding all other factors and analyzing the risk ratio, it was found that the risk of blood cancer was reduced by 40% just by undergoing bariatric surgery.

The mortality rate due to this also showed the same trend. In the obesity surgery group, there were 3 deaths due to blood cancer, and in the control group, 13 people died from blood cancer.

Likewise, excluding other factors, it was confirmed that the risk of death was reduced by a whopping 78% just by undergoing bariatric surgery.

In particular, this trend was more noticeable in female patients. This is because for women, the risk of developing blood cancer is reduced by 56% when undergoing obesity surgery.

Professor Magdalena explained, “This effect seems to be related to the lowering of blood sugar levels caused by obesity surgery,” and “If you look at the characteristics of women who have a reduced risk of developing blood cancer, it is because their blood sugar levels were very high to begin with.”

He continued, “This study shows that obesity is a major risk factor for blood cancer and that bariatric surgery can significantly lower the risk. There is a need for the government to recommend bariatric surgery as a primary prevention method for blood cancer.” He said.

2023-09-21 03:03:42

#Obesity #surgery #stands #effectiveness #Prevents #cardiovascular #blood #cancer

The American Heart Association (AHA) issued a statement urging people to participate in efforts to lower low-density cholesterol (LDL-C) levels.

Although it is common knowledge in the medical community that the lower LDL-C is, the better, this is a rebuttal to the fact that aggressive cholesterol lowering led to negative research results in some studies.

On the 14th, the AHA issued a scientific statement regarding the impact of active LDL-C lowering on the risk of dementia and hemorrhagic stroke (doi.org/10.1161/ATV.0000000000000164).

The brain is the organ richest in cholesterol in the body. Some studies have made waves by showing that aggressive lowering of LDL-C induces abnormal structural and functional changes, including cognitive function and dementia.

In particular, as it is known that the cumulative total amount of LDL-C over a lifetime has a close impact on prognosis, there are voices calling for active efforts to lower LDL-C even in healthy people. In light of the conflicting views on LDL-C, This is a situation that needs to be sorted out.

The American Heart Association issued a scientific statement refuting the findings of some studies suggesting that active LDL-C reduction causes cognitive dysfunction.

The AHA determined whether aggressive LDL-C reduction efforts were realistic by evaluating the evidence for the conclusion that they lead to toxic effects on the brain, causing cognitive impairment, dementia, or hemorrhagic stroke.

AHA researchers examined the evidence by reviewing the literature, consulting published clinical and epidemiological studies, clinical and public health guidelines, and expert opinion.

“Some retrospective, case-control, and prospective longitudinal studies suggest that lowering LDL-C with statins is associated with cognitive impairment or dementia,” the AHA said. “However, data from a variety of observational studies and randomized trials do not “It does not support this conclusion,” he said.

A trend across several studies, including trials with a mean follow-up of up to 6 years, has shown no evidence that statins are associated with causing dementia.

He continued, “In patients without a history of cerebrovascular disease, the increased risk of hemorrhagic stroke associated with statin treatment is not significant,” and emphasized, “The risk does not increase even if LDL-C levels are very low.”

The AHA’s position is that data on the increased risk of hemorrhagic stroke through lipid-lowering treatment in patients with a history of hemorrhagic stroke are uncertain and that additional intensive research is needed.

The AHA explained that it found no evidence that ezetimibe, which is added as a combination therapy to PCSK9 inhibitors and statins, which are effective drugs for lowering LDL-C, also increases the risk of bleeding.

“There is no indication that hemorrhagic stroke is increased in patients or groups with low lifetime LDL-C levels,” the AHA said, adding, “There is little evidence of an increased risk even at very low LDL-C levels.”

“What is clear is that lower LDL-C levels are associated with a lower overall risk of stroke and stroke relapse, and are primarily associated with a reduction in ischemic stroke,” the AHA said. “Degradation treatment should not be hindered,” he added.

2023-09-19 02:58:56

#evidence #refute #American #Heart #Association #connection #statindementia #controversy