Stroke Archive

Ask the doctors

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Q. I was recently diagnosed with eczema. Is this condition treatable without the use of steroids? I'd like to avoid using them if I can.

A. Eczema, also known as atopic dermatitis, is a chronic inflammatory skin condition. Some people with eczema have mild dryness or itchiness, while others experience more severe symptoms, such a scaly rash or skin that cracks and oozes. Eczema is more common in childhood, affecting up to 20% of children, but it also affects adults. The good news is it's not contagious, and in some cases, it's possible to manage the condition without using steroids.

Research we're watching

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Roaring jets, rumbling trains, and revving automobiles may have a detrimental effect on your cardiovascular health.

According to a review article in the Feb. 13, 2018, Journal of the American College of Cardiology, many studies have observed a connection between transportation-related noise and a slightly higher risk of high blood pressure, coronary artery disease, stroke, and heart failure. The association persists even after adjustment for possible confounding factors, such as air pollution and socioeconomic status.

Ask the doctor

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Q. I'm an 87-year-old man. Over the past year I've lost considerable weight, and I didn't have that much to lose. My doctor can't find any reason for my weight loss and is advising me to eat ice cream. But isn't that risky for my heart?

A. I smiled when I read your letter, because I've occasionally said that if I were to develop a terminal condition, the silver lining on that cloud would be that I could finally eat all the hot fudge sundaes I wanted.

News briefs

The American Stroke Association has made a major change to its recommendations for a first-line stroke therapy. The group's new guidelines, published online Jan. 24, 2018, by Stroke, say that instead of having just six hours from the onset of stroke symptoms to reach into a blood vessel, grab the clot, and pull it out, doctors now have up to 24 hours to perform the procedure (depending on the circumstances). The new recommendation will be helpful for people who suffer a stroke while sleeping and therefore don't know at what time the symptoms began. A thrombectomy may be combined with the other first-line treatment for stroke caused by a blood clot: a clot-busting drug called tissue plasminogen activator, or tPA. The treatment window to use tPA is just three to four hours, so it's imperative that you call 911 at the first sign of stroke symptoms. Those include the sudden onset of confusion, difficulty talking, weakness or numbness on one side of the body, or difficulty walking.

News briefs

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Exercise is considered the most effective pill-free treatment to cope with the pain and stiffness of arthritis. And more people are getting advice from their health care providers about how to stay active, according to a study published online Jan. 5, 2018, by the CDC's Morbidity and Mortality Weekly Report. Researchers looked at national health surveys gathered from 2002 to 2014. In that period, there was an increase in the proportion of people with arthritis (osteoarthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia) who said their clinician suggested physical activity to help reduce symptoms — from 52% in 2002 to about 60% in 2014. But by 2014, about 40% of arthritis sufferers still said they weren't getting exercise counseling. That's significant, considering that 91 million people ages 18 or older are affected by arthritis, according to a study published online Nov. 27, 2017, by Arthritis & Rheumatology. You don't have to wait for a doctor to suggest exercise as an arthritis treatment. Try something gentle, like walking, tai chi, or modified yoga. For more ideas, check out the Harvard Special Health Report The Joint Pain Relief Workout (www.health.harvard.edu/jprw).

Research we're watching

Smoking just one cigarette a day appears to raise the risk of heart disease and stroke by between 48% and 74%, according to a study in the Jan. 24, 2018, issue of The BMJ.

Researchers pooled data from 141 studies done in 21 countries and regions, together involving millions of people. They analyzed the risks associated with smoking one, five, or 20 cigarettes per day, taking into account age, sex, and other possible confounding factors. Just one cigarette per day accounted for half of the risk seen with smoking 20 cigarettes a day in men, and for one-third of the risk in women, they discovered.

On call

Q. There has been a lot of talk about the severity of this flu season, and I recently heard that influenza also can trigger a heart attack. Should I worry?

A. Influenza is responsible for about 10,000 to 20,000 annual deaths, mostly from pneumonia or internal organ failure. In other situations, influenza infection strains a person's health, which can worsen underlying conditions, such as heart disease.

In the journals

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Migraine sufferers may be able to prevent future attacks with a new medication called galcanezumab, suggests a study published online Dec. 18, 2017, by JAMA Neurology. Currently, there are five FDA-approved drugs for migraines, but none were designed specifically for treating attacks or addressing the mechanisms at work.

In comparison, galcanezumab works to suppress the activity of calcitonin gene–related peptide (CGRP) in people. That molecule is believed to play an integral role in migraines and cluster headaches.

The health risks of loneliness and isolation have been known for some time, but more recently research has shown the specific effects in the brain. Finding ways to make connections with other people is the best "medicine" to alleviate the mental and physical effects of loneliness.