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Modifiable Cardiovascular Risk Factors and Late-Life Brain Health

The major modifiable risk factors for cardiovascular diseases are delineated in Life’s Essential 8 (LE8), developed by the American Heart Association. These risk factors are blood pressure, glucose, cholesterol, body mass index, smoking, physical activity, diet, and sleep duration. The investigators in this analysis of two large databases in the United Kingdom and the United States demonstrated that cardiovascular health, as defined by the LE8, will also predict brain health later in life.

Treating Hereditary TTR Amyloid Polyneuropathy with Patisiran

A five-year study on patisiran for hereditary transthyretin (TTR) amyloid polyneuropathy found that 65% of patients had stable or improved neuropathy, with better outcomes linked to early treatment. Despite efficacy, 19.4% of patients died. The study underscores the importance of early diagnosis and intervention in managing this progressive disease.

Determinants of Long-Term Outcome After Concussion

This cohort study of U.S. veterans found that mild traumatic brain injuries occurring alongside psychological trauma are associated with long-term post-concussive symptoms and disability. The authors postulate that the traumatic context contributes to the development of post-traumatic stress disorder, which may in turn potentiate long-term sequelae.

Transcranial Magnetic Stimulation and Tai Chi for Older Adults with Sleep Disorders and MCI

This study showed improvement in sleep and cognitive endpoints in patients with sleep disorders and mild cognitive impairment (MCI) treated with a combination of repetitive transcranial magnetic stimulation and tai chi chuan.

Transfusion Therapy in Aneurysmal Subarachnoid Hemorrhage

The SAHARA trial evaluated liberal vs. restrictive red blood cell transfusion strategies in aneurysmal subarachnoid hemorrhage (SAH) patients with anemia. No significant difference in neurological outcomes at 12 months was found. Findings add to existing uncertainty regarding transfusion thresholds in SAH, highlighting the need for further research.

Diagnosis and Outcome of Reversible Cerebral Vasoconstriction Syndrome

Reversible cerebral vasoconstriction syndrome (RCVS) is a rare disorder characterized by thunderclap headaches and cerebral vasoconstriction resolving within 90 days. A retrospective study of 80 patients found favorable outcomes, with most treated using calcium channel blockers. However, challenges in RCVS diagnosis and classification may affect reported outcomes.

From Glucocentricity to a Multi-Risk Strategy: An Updated Approach to Managing Chronic Kidney Disease

This article discusses an important microvascular complication of diabetes mellitus, chronic kidney disease (CKD), which affects more than one-third of patients with diabetes. There is substantial evidence that early diagnosis and management can delay or prevent the progression of CKD, making its prevention, diagnosis, and treatment a priority for the primary care clinician.

DeWinter T Waves?

The electrocardiogram (ECG) in the figure was obtained from a woman with dyspnea and marked hypertension, but who had no chest pain. How would you interpret this ECG? Should you activate the cath lab?

Nemolizumab-Ilto (Nemluvio)

The U.S. Food and Drug Administration has approved nemolizumab, the first monoclonal antibody specifically targeting the interleukin-31 pathway linked to pruritus and skin inflammation associated with atopic dermatitis.

ABCD² Score as a Predictor of Three-Year Stroke Risk

This retrospective cohort study using the National Patient Registry in Denmark analyzed a three-year follow-up period following a transient ischemic attack, looking at the rate of recurrent stroke and mortality. The patients were divided into low risk (ABCD² score 0-3) and high risk (ABCD² score ≥ 4). The stroke rate was 6% in the high-risk group and 4% in the low-risk group.