Stroke Archive

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Q. For the past few months, I get dizzy when I turn my head quickly or bend over. What could cause this?

A. You most likely have a bothersome, but not serious, condition called benign paroxysmal positional vertigo. The symptoms are brought on by head movement. They can be quite mild, with just a few seconds of a spinning or off-balance sensation when the head moves a certain way, but some people experience severe dizziness, along with nausea and possible falling.

There are ways to shorten flare-ups and, in some people, prevent them from recurring.

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Psoriasis is a big star on TV drug ads, but this autoimmune skin disease is something most people try to keep well hidden.

"Psoriasis is among the most common skin conditions, affecting about 2% of the U.S. population, and while the condition doesn't affect everyone the same way, the approach to treatment and prevention is often similar," says Dr. Gideon Smith, an assistant professor of dermatology at Harvard-affiliated Massachusetts General Hospital.

Vitamins don't seem to reduce cardiovascular risks, according to a new report.

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There may be reasons to take a multivitamin, but improving your cardiovascular health is not one of them, says a report in the July 10 issue of Circulation: Cardiovascular Quality and Outcomes. The authors found that for the average person, taking a multivitamin supplement didn't help prevent cardiovascular problems, such as heart attacks and strokes.

The findings were based on a review of general population studies conducted from 1970 to 2016, involving more than two million people. Researchers looked for associations between multivitamin supplementation and cardiovascular outcomes. But they weren't able to find any links.

In the journals

If you have problems sleeping through the night, you may be at risk for atrial fibrillation (afib), an irregular heart rate that may cause heart palpitations and is a leading cause of stroke.

A study published online June 25, 2018, by HeartRhythm reviewed four studies and found a link between afib and poor sleep. In one study, people with afib had more frequent nighttime awakenings compared with those who did not have the condition. In the other studies, poor sleep quality, including frequent nighttime awakenings and less REM (rapid eye movement) sleep, predicted which individuals would develop afib.

Ask the doctor

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Q. I've had several bouts of acute bronchitis in the past year. What causes it, and is it contagious?

A. Acute bronchitis is an inflammation of the breathing tubes in the lungs. It comes on suddenly and lasts for at least five days, often longer.

New medications add advantages to treatments that help prevent stroke, pulmonary embolism, and deep-vein thrombosis.

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The wait is over for an antidote to stop rare uncontrolled bleeding linked to some newer blood thinners. The FDA approved andexanet alfa (AndexXa) on May 3, 2018. It's the first and only antidote to reverse bleeding in people taking apixaban (Eliquis), rivaroxaban (Xarelto), or edoxaban (Savaysa).

Another newer blood thinner — dabigatran (Pradaxa) — already has an approved antidote called idarucizumab (Praxbind). A dose of vitamin K is used to reverse the action of warfarin (Coumadin), a blood thinner used routinely for more than half a century and, until recently, the only such option for most people.

Research we're watching

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About one in 10 people has eczema, a chronic inflammatory condition that leaves skin dry and itchy. People with more severe forms may experience a scaly rash or skin that cracks and oozes. These people may also be at greater risk for heart attack and stroke, according to a study in the May 23 issue of The BMJ.

For the study, researchers analyzed data from more than 385,000 adults with eczema, which was classified as mild, moderate, or severe. Each was matched with up to five people of similar age and sex who didn't have eczema.

Research we're watching

A bite from a lone star tick can trigger an unusual allergy that causes hives, swelling of the throat and lips, or an upset stomach when you eat red meat. But that's not all: people with this rare red meat allergy may be particularly prone to narrowed, stiff arteries in the heart, a new study finds.

Researchers analyzed blood samples from 118 adults living in Virginia and found that 26% had evidence of a red meat allergy (that is, they had antibodies to a molecule called alpha-gal, the main allergen in red meat). Lone star tick saliva may contain alpha-gal, so when a tick bites a person, it may trigger an immune response by the body, which then recurs when the body encounters alpha-gal in red meat. Lone star ticks are found throughout the southeastern and eastern United States.

In the journals

Many people with rheumatoid arthritis (RA) also deal with ongoing depression and anxiety related to their pain and disability. While drugs used to treat the disease help alleviate the joint pain and stiffness, a recent study suggests they may not extend to improving patients' mental health.

The findings, published online June 6, 2018, by Arthritis & Rheumatology, reviewed more than 70 clinical trials and found only a small association between various drugs used for RA, such as adalimumab (Humira), rituximab (Rituxan), abatacept (Orencia), and tocilizumab (Actemra), and mental health outcomes in patients.

Ask the doctors

Q. I recently saw something recommending that older Americans get screened for hepatitis C. I'm 68 years old. Should I be screened?

A. Yes. Since 2012, the CDC has recommended that all adults born from 1945 to 1965 be tested for hepatitis C, a bloodborne virus that affects anywhere from 2.7 million to 3.9 million Americans — many of whom don't know they have the condition. Hepatitis C can go undetected in the body for years, eventually leading to cirrhosis, liver damage, and liver cancer. You may be at risk even if you don't think you have any risk factors for the disease, which is most commonly transmitted today through intravenous drug use. People born from 1945 to 1965 are five times more likely than other Americans to have hepatitis C, although experts aren't sure why this is the case, according to the CDC. It's possible that some people were infected during health care procedures or blood transfusions that took place before the discovery of the hepatitis C virus. A study published in the April 2018 issue of Cancer Epidemiology, Biomarkers & Prevention found that less than 13% of these individuals have had the test. Since you're one of those who hasn't, it's a good idea to call your doctor and make a screening appointment.