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Migraine & Stroke Risk

Migraine & Stroke Risk

Migraines affect more than 10% of all Americans and are three times more common in women than in men, according to data from the National Institute of Neurological Disorders and Stroke (NINDS). Although the link between migraine and stroke is not fully understood, research suggests that the two conditions have some clinical features that overlap. The NINDS has reported that risk factors for stroke with migraine-like features include being female, being older than 40, and having low cardiovascular risk profiles. Over the years, many studies have suggested that migraine is a risk factor for stroke. Some analyses have shown that stroke risks are twice as high in people who suffer from migraine with aura than those without aura. For women, stroke risks have been reported to be three times higher when they have migraine with aura. “To date, most of the research examining the link between stroke and migraine has shown that there is a correlation in migraineurs with aura,” says Teshamae S. Monteith, MD.   Taking a Deeper Look For a study published in Neurology, Dr. Monteith and colleagues aimed to determine the association between migraine and stroke and a combination of vascular events, including stroke, heart attack, and death. Participants in the study were from the Northern Manhattan Study, a population-based cohort of stroke incidence. The participants were from an older, ethnically-diverse community in which the population was predominately Hispanic, a patient group that has historically been at a higher risk for stroke. The association between migraine and the combination of vascular events was estimated over an average follow-up of 11 years. After reviewing 1,292 people who reported...
Tobacco Control & Treatment

Tobacco Control & Treatment

Tobacco use has been cited as the top cause of preventable death and disability in the United States. However, tobacco control and treatment are not commonly addressed by physicians in their daily practices, according to Frank T. Leone, MD, MS. “To help close the gap,” he says, “the Tobacco Action Committee of the American Thoracic Society (ATS) developed a research statement to summarize current understanding about the mechanisms available to address the tobacco use epidemic. The document also provides clinicians with the tools needed to address the issue in their own practices and communities.”   A Look to the Future The ATS statement, published in the American Journal of Respiratory and Critical Care Medicine, includes recommendations that look to the future and point to the types of questions that clinicians should be asking themselves, says Dr. Leone, who was lead author of the statement. The statement also challenges clinicians to consider the social constructs responsible for the propagation of tobacco dependence as an epidemic, according to Dr. Leone. “We wanted to highlight how dependence as an illness is moving through the population in manners that are very reminiscent of an epidemic,” he says. “We also thought it was important to provide an update on treatment strategies and the biological basis of dependence, why some medications work for achieving cessation and others don’t, how these medications are most effectively used, and some of the important questions that remain unanswered.” According to Dr. Leone, the most important of these unanswered questions is how to conceptually transition tobacco dependence treatment away from a smoking cessation model, in which patients are either successful...
Smoking Cessation After a Cancer Diagnosis

Smoking Cessation After a Cancer Diagnosis

Published research has established that smoking is a significant risk factor for many cancers and can impede treatment, but some survivors continue to smoke even after they are diagnosed. According to current estimates, there are about 13.7 million cancer survivors in the United States, but the prevalence of smoking in these individuals varies between 15% and 33% depending on the type of cancer, age, and the time since diagnosis. Some studies have suggested that a cancer diagnosis can be a teachable moment for people who smoke. “We can take advantage of visits with cancer patients by talking to them about smoking and providing cessation assistance,” says J. Lee Westmaas, PhD. “After a diagnosis, patients may be more motivated to quit and receptive to interventions.” The concept of using a cancer diagnosis as a teachable moment for smoking cessation would be better accepted if it could be shown that smokers recently diagnosed with the disease are more likely to quit smoking. Most investigations looking at the link between a cancer diagnosis and smoking cessation have included all people diagnosed with the disease, regardless of its site or stage at diagnosis. However, this data may be lacking because some cancers make it more difficult to smoke. In addition, previous research has not explored whether or not patients are more motivated to quit smoking by a desire to reduce their cancer-related risks. Examining the Data For a study published in the Journal of Clinical Oncology, Dr. Westmaas and colleagues examined data from the Cancer Prevention Study-II Nutrition Cohort to see if a recent cancer diagnosis was associated with a higher rate of...
CME: Smoking Cessation After PCI

CME: Smoking Cessation After PCI

It has been well-documented in clinical studies that smoking cessation after patients undergo PCI can improve outcomes. Some research has identified certain predictors of smoking cessation after PCI, including previous cigarette consumption and the number of coexisting coronary artery disease risk factors. Few studies, however, have assessed current trends in smoking cessation after PCI and looked at the potential impact of smoke-free policies that are being enacted throughout many parts of the United States. “Historically, patients who undergo PCI are a group that has more difficulty quitting smoking than others,” says Randal J. Thomas, MD, MS. The Effect of Smoke-Free Policies In a study published in the February 15, 2015 issue of the American Journal of Cardiology, Dr. Thomas and colleagues assessed trends and predictors of smoking cessation after PCI in Olmsted County, Minnesota. The investigators conducted the research at a time when local and statewide smoke-free public policies were enacted in Olmsted County. The study followed 2,306 patients who underwent their first PCI from 1999 to 2009 for 12 months. The researchers conducted structured telephone surveys at 6 and 12 months after PCI to assess smoking status and quit rates during the 10-year period. The authors paid particular attention to quite rates around two dates when three smoke-free ordinances were implemented to reduce secondhand tobacco exposure in Olmsted County. The first date was January 1, 2002, when an ordinance was passed requiring restaurants to be smoke-free. The second was October 1, 2007, when ordinances required both workplaces and the entire state of Minnesota to be smoke-free. The data were then analyzed according to three time periods: 1991 to 2001, 2002...
Smoking Cessation After PCI

Smoking Cessation After PCI

It has been well-documented in clinical studies that smoking cessation after patients undergo PCI can improve outcomes. Some research has identified certain predictors of smoking cessation after PCI, including previous cigarette consumption and the number of coexisting coronary artery disease risk factors. Few studies, however, have assessed current trends in smoking cessation after PCI and looked at the potential impact of smoke-free policies that are being enacted throughout many parts of the United States. “Historically, patients who undergo PCI are a group that has more difficulty quitting smoking than others,” says Randal J. Thomas, MD, MS. The Effect of Smoke-Free Policies In a study published in the February 15, 2015 issue of the American Journal of Cardiology, Dr. Thomas and colleagues assessed trends and predictors of smoking cessation after PCI in Olmsted County, Minnesota. The investigators conducted the research at a time when local and statewide smoke-free public policies were enacted in Olmsted County. The study followed 2,306 patients who underwent their first PCI from 1999 to 2009 for 12 months. The researchers conducted structured telephone surveys at 6 and 12 months after PCI to assess smoking status and quit rates during the 10-year period. The authors paid particular attention to quite rates around two dates when three smoke-free ordinances were implemented to reduce secondhand tobacco exposure in Olmsted County. The first date was January 1, 2002, when an ordinance was passed requiring restaurants to be smoke-free. The second was October 1, 2007, when ordinances required both workplaces and the entire state of Minnesota to be smoke-free. The data were then analyzed according to three time periods: 1991 to 2001, 2002...
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