1,721,269 research outputs found
Migraine and the Risk for Stroke and Cardiovascular Disease
No full textNumerous data have pointed to an association between migraine and cardiovascular diseases. The majority of the available data have indicated that migraine with aura can be considered a risk factor for ischemic stroke, whereas migraine without aura cannot be reliably considered as such. High frequency of attacks and a recent onset of migraine have been related to an increased ischemic stroke risk. In addition, in young subjects with ischemic stroke migraine with aura represents an independent risk factor of overall recurrent vascular events and of recurrent ischemic stroke. Also the risk of transient ischemic attack seems to be increased in migraineurs, although this issue has not been extensively investigated. Several studies have also addressed the possible association between migraine and hemorrhagic stroke. Although the results of these individual studies were conflicting, their meta-analysis showed that migraine is associated with a 1.5-fold increase in the risk of hemorrhagic stroke (including intracerebral and subarachnoid hemorrhage). Some studies have identified migraine also as a possible risk factor for cardiac vascular events while others have yielded negative results. A meta-analysis did not show an increased risk of myocardial infarction in subjects with any migraine vs no migraine but subsequently, data has pointed to an association between any migraine with cardiac ischemic disease. Migraine has also been associated by some studies with vascular mortality and with vascular diseases in regions other than the brain and the heart. Several studies have also indicated that compared with nonmigraineurs, migraineurs have a higher burden of asymptomatic white matter brain lesions and, according to some studies, also infarct-like lesions at brain magnetic resonance. The mechanisms underlying the relationship between migraine and cardiovascular disease are still unclear. The possible explanation may rely on a peculiar vascular vulnerability of migraineurs that may contribute to the pathogenesis of migraine and, in the presence of some other unknown factors may also contribute, over time, to the development of cardiovascular disease. At the moment, there are no reliable features that may indicate which subjects, across the overall migraine population, will develop vascular events and so far, no drugs are recommended for the vascular prevention in migraineurs unless other clear indications are present. In general, the acute treatment and the secondary prevention measures of a patient with stroke who has a history of migraine do not differ from that of other stroke patients. There is currently no direct evidence to support that a migraine prophylactic treatment will reduce future stroke risk in secondary prevention
Estimating the incidence of Parkinson's disease: The importance of adjustment for mortality
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The Reconstructed Cohort Design: A Method to Study Rare Neurodegenerative Diseases in Population-Based Settings
Full text linkRare neurodegenerative diseases are characterized by high heterogeneity and high clinical complexity, as well as low incidence and prevalence, thus making tracking small numbers of incident cases in the general population very challenging. Since it is not possible to use classical cohort studies to estimate the incidence of these rare diseases, we can "reconstruct" a theoretical cohort using case information from a well-defined geographic region collected through a surveillance system. The incidence rate is estimated as the ratio between the number of individuals at risk who were diagnosed with the disease of interest during the study period and the estimated overall amount of time individuals in the reference population spent at risk during the study period. If a series of assumptions are met, the approximate incidence proportion of a closed theoretical cohort without competing events and with the same follow-up duration can be calculated by multiplying the incidence rate with the length of the study time. This rationale relies on the presence of an effective referral system, which links all levels of the healthcare system together in the region, from general practitioners to specialized clinical centers. The reconstructed cohort design is a valid and cost-effective method to collect data on the incidence of rare neurodegenerative diseases and represents the theoretical framework for building up population-based registries
Post-surgical follow-up treatment in canine mammary tumors with biological remedies
No full textIn this clinical study, the efficacy of an adjuvant therapy with the homeopathic combination remedies Para-Benzochinon-Injeel forte, Coenzyme compositum, Ubichinon compositum and Lymphomyosot after surgical resection of mammary tumors was examined in 34 dogs. The results concerning survival rate and the frequency of recurrence and metastasis were compared to data from literature, in which only a surgical resection of the tumors without adjuvant therapy was done, In highly malignant tumors, the poor prognosis and the progressive course of the disease could not or only to a low degree be influenced by the postsurgical biological treatment. However, good results were achieved in tumors with low or medium malignancy. In these cases, the survival rate and especially the number of recurrences and metastasis could clearly be improved, compared to the data from literature. Due to the positive results of treatment and the high acceptance and safety, the treatment fits well for the needs of practice. Further schemes of treatment for other types of tumors should be evaluated
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