Obstructive Sleep Apnea and Stroke: Determining the Mechanisms Behind their Association and Treatment Options.

Sleep-disordered breathing (SDB) can be a sequela of stroke caused by vascular injury to vital respiratory centers, cerebral edema, and increased intracranial pressure of space-occupying lesions. Likewise, obstructive sleep apnea (OSA) contributes to increased stroke risk through local mechanisms such as impaired ischemic cerebrovascular response and systemic effects such as promoting atherosclerosis, hypercoagulability, cardiac arrhythmias, vascular-endothelial dysfunction, and metabolic syndrome. The impact of OSA on stroke outcomes has been established, yet it receives less attention in national guidelines on stroke management than hyperglycemia and blood pressure dysregulation.

Genetic screening and counseling: family medicine obstetrics.

Genetic screening and counseling have become routinely offered during prenatal care in the United States, involving invasive and noninvasive options for assessing fetal genetics. As DNA testing continues to expand proportionately to the increasing ability to detect genetic variations, ethical and fiscal concerns arise. Societal shifts, such as delayed childbearing and the associated genetic consequences, have made antenatal genetic screening more common.