CHIP is stroke risk
Why is it that most people who have heart attacks or strokes have few or no conventional risk factors, such as high cholesterol and blood pressure, a history of smoking or diabetes, or a family history of cardiovascular disease? Scientists may have figured it out, reports The New York Times. They have learned that a bizarre accumulation of mutated stem cells in bone marrow increases a person’s risk of dying within a decade, usually from a heart attack or stroke, by 40 or 50 percent. They named the condition clonal hematopoiesis of indeterminate potential, or CHIP. CHIP has emerged as a risk for heart attack and stroke that is as powerful as high LDL or high blood pressure but it acts independently of them. And CHIP is not uncommon. The condition becomes more likely with age. Up to 20 percent of people in their 60s have it, and perhaps 50 percent of those in their 80s.
Expecting the unexpected
Excel Medical, Jupiter, Florida, launched the first FDA-cleared patient surveillance system, an always-on remote monitoring platform that displays near real-time clinical views of physiologic and medically relevant data including waveforms and alarms for at-risk patients across hospital workstations, mobile devices and inside electronic medical records. The WAVE Clinical Platform automatically calculates risk, giving an at-a-glance early warning of patient deterioration up to six hours in advance of when clinicians would otherwise notice – and while there is still time to prevent further deterioration. There are more than 400,000 unexpected deaths in U.S. hospitals annually, says Excel.
Blood sugar levels and cognitive decline
Increasing blood sugar levels are associated with cognitive decline, a long-term study has found, reports The New York Times. Researchers assessed cognitive function in 5,189 people, average age 66, and tested their blood sugar using HbA1c, a test that accurately measures blood glucose levels over a period of weeks or months. They followed the group for up to 10 years, tracking blood glucose levels and periodically testing cognitive ability. The study is in the journal Diabetologia. There was no association between blood sugar levels and cognition at the start of the study. But consistently over time, scores on the tests of memory and executive function declined as HbA1c levels increased, even in people without diabetes.
Treatment for ischemic stroke
The physical removal of a blood clot in the brain, called a thrombectomy, was recently approved for use up to six hours after a stroke in research funded by the National Institutes of Health’s National Institute of Neurological Disorders and Stroke. “Although stroke is a medical emergency that should be treated as soon as possible,” said researcher Dr. Gregory Albers, Stanford University, “[this finding] opens the door to treatment even for some patients who wake up with a stroke or arrive at the hospital many hours after their initial symptoms.” NIH ended the study early because of overwhelming evidence of benefit from the clot-removing procedure.
Benefits of gastric bypass surgery
For obese people with diabetes, doctors have increasingly been offering gastric bypass surgery as a way to lose weight and control blood glucose levels. Short-term results are often impressive, but questions have remained about the long-term benefits of such operations. Now, a large, international study funded by the National Institutes of Health has shown that about 50 percent of folks not only lost weight, but they also showed well-controlled blood glucose, cholesterol, and blood pressure. The good news is that five years later about half of those who originally showed those broad benefits of surgery maintained that healthy profile. The not-so-good news is that the other half, while they generally continued to sustain weight loss and better glucose control, began to show signs of increasing risk for cardiovascular complications.
Dental care for stroke prevention
Regular dental care may significantly lower patients’ stroke risk, according to a January 15 study published in the journal Stroke. This research furthers the scientific evidence that cardiovascular health is deeply connected to oral health, reports Dr. Biscupid. The study, which included thousands of U.S. adults, found a significant association between inflamed gums and ischemic stroke incidence. Inflammation may be the link between periodontal disease and stroke, and further studies are needed to better understand how dental treatment can reduce stroke risk, according to the researchers.
Who’s best at treating sleep apnea?
Patients with obstructive sleep apnea (OSA) can achieve similar outcomes receiving care from a sleep specialist or a non-sleep specialist, such as a primary care physician. The findings of a systematic review are published in Annals of Internal Medicine. Researchers from the Minneapolis Veterans Affairs Health Care System Evidence-based Synthesis Program and the University of Minnesota, School of Medicine reviewed 12 published studies to evaluate the effectiveness and harms of care by non-sleep specialists versus sleep specialists for patients with suspected or diagnosed OSA. The data showed low-strength evidence that OSA management outcomes are similar whether provided by primary care physicians, sleep specialist nurses, or sleep specialist physicians.
Mythbusters
Some studies have suggested that, in infants who are genetically susceptible, early exposure to complex foreign proteins, like those in cow’s milk, may increase the risk for an immune system reaction to beta cells and development of type 1 diabetes. It’s not true, says an international group of researchers, who tested this idea in a study of infants in 15 countries. Funded in part by NIH’s Eunice Kennedy Shriver National Institute of Child Health and Development (NICHD) and National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the researchers enrolled more than 2,000 infants with a known genetic susceptibility to type 1 diabetes (in the gene for human leukocyte antigen, or HLA) and a close relative with the disease. The infants were randomly assigned to receive either a cow’s milk formula or an extensively hydrolyzed formula, in which the complex milk proteins have been broken down into small pieces. The researchers found that weaning with the hydrolyzed formula did not significantly decrease the incidence of type 1 diabetes compared to conventional formula after a median of 11.5 years.