Background and Purpose—The authors present an overview of the current evidence and management recommendations for evaluation and treatment of adults with acute ischemic stroke. The intended audienc...

/pdf/guidelines-for-the-early-management-of-patients-with-acute-19udbft6e7.pdf

Guidelines for the Early Management of Patients With Acute Ischemic Stroke A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association

Secret History: Return of the Black Death Channel 4, 7-8pm In 1348 the Black Death swept through London, killing people within days of the appearance of their first symptoms. Exactly how many died, and why, has long been a mystery. This Secret History documentary follows experts as they pick through the evidence and reveal why the plague killed on such a scale. And they ask, what might be coming next?

Medscape

The Structural Transformation of the Public Sphere: An Inquiry into a Category of Bourgeois Society

2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular riskThe Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS)

Chronic kidney disease1 (CKD) is a worldwide public health problem. In the United States, there is a rising incidence and prevalence of kidney failure, with poor outcomes and high cost. The number of individuals with kidney failure treated by dialysis and transplantation exceeded 320 000 in 1998 and is expected to surpass 650 000 by 2010.1,2 There is an even higher prevalence of earlier stages of CKD (Table 1).1,3 Kidney failure requiring treatment with dialysis or transplantation is the most visible outcome of CKD. However, cardiovascular disease (CVD) is also frequently associated with CKD, which is important because individuals with CKD are more likely to die of CVD than to develop kidney failure,4 CVD in CKD is treatable and potentially preventable, and CKD appears to be a risk factor for CVD. In 1998, the National Kidney Foundation (NKF) Task Force on Cardiovascular Disease in Chronic Renal Disease issued a report emphasizing the high risk of CVD in CKD.5 This report showed that there was a high prevalence of CVD in CKD and that mortality due to CVD was 10 to 30 times higher in dialysis patients than in the general population (Figure 1 and Table 2).6–18 The task force recommended that patients with CKD be considered in the “highest risk group” for subsequent CVD events and that treatment recommendations based on CVD risk stratification should take into account the highest-risk status of patients with CKD. 

View this table:

TABLE 1. Stages of CKD 





Figure 1. Cardiovascular mortality defined by death due to arrhythmias, cardiomyopathy, cardiac arrest, myocardial infarction, atherosclerotic heart disease, and pulmonary edema in general population (GP; National Center for Health Statistics [NCHS] multiple cause of mortality data files International Classification of Diseases, 9th Revision [ICD 9] codes 402, 404, 410 to 414, and …

Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention.

Recent negative findings regarding differences in blood pressure (BP) and heart rate (HR) reactivity at work between Type A and Type B workers may stem from the failure to note the stressors to which they were exposed. In this naturalistic study, an objective work stressor--varying levels of ambient noise--was individually monitored among 123 normotensive males. We examined the relationship of Type A behavior (assessed by the Thurstone Temperament Schedule) to ambulatory BP and HR reactivity under high and low noise conditions. We also tested the hypothesized mediating function of tension arousal. Results of multiple regression analyses indicated that when workers were exposed to high noise levels (> or = 80 dB(A)), Type A behavior was positively related to diastolic BP (p = 0.029) and HR reactivity (p = 0.0001), even after adjusting for clinic values, time of measurement, worker activities, and body position during measurement. When the same workers were exposed to low noise levels, the results were not significant. This suggests that noise constitutes a stressor for Type A individuals, and highlights the importance of noting the actual stressor-exposure condition. In addition, Type A individuals reported high tension, noted concurrently with the ambulatory measurements. Tension arousal was also related to BP and HR reactivity. Adding the tension variable to the above regressions weakened the relationship between Type A behavior and BP and HR reactivity. Thus, the tension experienced by Type A workers exposed to noise stress may have served as a mediator of cardiovascular reactivity.

Type A Behavior, Tension, and Ambulatory Cardiovascular Reactivity in Workers Exposed to Noise Stress

Body mass index is associated with differential seasonal change in ambulatory blood pressure levels.

Myocarditis after BNT162b2 Vaccination in Israeli Adolescents

Summary Background Social inequalities affect the COVID-19 burden and vaccine uptake. The aim of this study was to explore inequalities in the incidence and mortality rate of SARS-CoV-2 infection and vaccine uptake in various sociodemographic and population group strata in Israel. Methods We analysed nationwide publicly available, aggregated data on PCR-confirmed SARS-CoV-2 infections and COVID-19 deaths between March 2020 and February 2021, as well as the first three months of COVID-19 immunisation according to sociodemographics, including population group and residential socioeconomic status (SES). We computed incidence and mortality rates of COVID-19. Comparisons between towns with predominantly Arab, ultra-Orthodox Jewish (the minorities), general Jewish populations, and according to SES, were conducted using generalised linear models with negative binomial distribution. Findings Overall, 774,030 individuals had SARS-CoV-2 infection (cumulative incidence 84•5 per 1,000 persons) and 5687 COVID-19 patients had died (mortality rate 62•8 per 100,000 persons). The highest mortality rate was found amongst the elderly. Most (>75%) individuals aged 60 years or above have been vaccinated with BNT162b2 vaccine. The risk of SARS-CoV-2 infection was higher in towns with predominantly Arab and ultra-Orthodox Jewish populations than in the general Jewish population, and in low SES communities. COVID-19 mortality rate was highest amongst Arabs. Conversely, vaccine uptake was lower amongst Arab and ultra-Orthodox Jewish populations and low SES communities. Interpretation Ethnic and religious minorities and low SES communities experience substantial COVID-19 burden, and have lower vaccine uptake, even in a society with universal accessibility to healthcare. Quantifying these inequalities is fundamental towards reducing these gaps, which imposes a designated apportion of resources to adequately control the pandemic. Funding No external funding was available for this study.

Manfred S. Green

Papers

Type A Behavior, Tension, and Ambulatory Cardiovascular Reactivity in Workers Exposed to Noise Stress

Body mass index is associated with differential seasonal change in ambulatory blood pressure levels.

Myocarditis after BNT162b2 Vaccination in Israeli Adolescents

A nationwide analysis of population group differences in the COVID-19 epidemic in Israel, February 2020–February 2021

In a population-based cohort of diabetes patients, men and women had similar risks for all-cause mortality.