Aim: To investigate the association between specific dental therapy for periodontal disease and the risk of ischaemic stroke.
Materials And Methods: We conducted a population-based cohort study that used data from the Taiwan National Health Insurance Research Database 2005 for the period of 2000-2013. Our observations focused on patients with the diagnoses of gingivitis or periodontitis with and without specific treatment and subsequent incidence of ischaemic stroke. Dental care services include dental scaling, intensive treatment (subgingival curettage and root planing) and tooth extraction. Multivariate Cox regression analysis was used to estimate the hazard ratios and corresponding 95% confidence intervals (95% CI).
Results: Compared with those in the gingivitis cohort, patients with periodontitis have a higher risk of ischaemic stroke and a lower survival rate of stroke over the 10-year follow-up period. After integrative dental care, both dental scaling and intensive treatment, the risk was reduced, especially in patients with periodontitis, while patients with periodontal disease may have an increased risk of stroke after tooth extraction therapy.
Conclusions: Our study showed that periodontitis is a risk factor for ischaemic stroke. Both dental scaling and intensive treatment for periodontal disease are associated with a lower risk of further ischaemic stroke events.
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http://dx.doi.org/10.1111/jcpe.13113 | DOI Listing |
JAMA Neurol
January 2025
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Importance: Trials have not demonstrated superiority of alteplase or tenecteplase vs standard care in patients with mild stroke and have raised safety concerns. Prourokinase is an alternative fibrinolytic that may have a favorable safety profile, and the benefit-risk profile of prourokinase in mild stroke is unknown.
Objective: To investigate the efficacy and safety of prourokinase in mild ischemic stroke within 4.
Hum Brain Mapp
February 2025
Department of Neurology, Centre for Leading Medicine and Advanced Technologies of IHM, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
Apathy is a common neuropsychiatric symptom following stroke, characterized by reduced goal-directed behavior. The reward decision network (RDN), which plays a crucial role in regulating goal-directed behaviors, is closely associated with apathy. However, the relationship between poststroke apathy (PSA) and RDN dysfunction remains unclear due to apathy heterogeneity, the confounding effect of depression and individual variability in lesion impacts.
View Article and Find Full Text PDFJ Neuroimaging
January 2025
Department of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, Maryland, USA.
Background And Purpose: Prolonged length of stay (LOS) following a stroke is associated with unfavorable clinical outcomes. Factors predicting LOS in medium vessel occlusion (MeVO), impacting up to 40% of acute ischemic stroke (AIS) cases, remain underexplored. This study aims to investigate the predictors of LOS in AIS-MeVO.
View Article and Find Full Text PDFFront Neurol
January 2025
Department of Vascular Neurosurgery, New Era Stroke Care and Research Institute, The PLA Rocket Force Characteristic Medical Center, Beijing, China.
Objective: Carotid artery stenosis, primarily caused by atherosclerosis, is a major risk factor for ischemic stroke. Carotid endarterectomy (CEA) and carotid artery stenting (CAS) are established interventions to reduce stroke risk and restore cerebral blood flow. However, the effect of these treatments on circadian rhythms, and their influence on stroke recovery, remains underexplored.
View Article and Find Full Text PDFFront Neurol
January 2025
Department of Neurology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States.
We theorize that the southeastern United States has a higher stroke mortality rate and higher recurrent ischemic stroke rate than the rest of the United States due to (1) an increased prevalence of hypercoagulable states among young adults in the region, (2) failure to diagnose hypercoagulable states as the cause of ischemic stroke in young adults, and (3) underutilization of anticoagulation for ischemic stroke secondary prevention in young adults with hypercoagulable states. In an attempt to investigate this hypothesis, we conducted a retrospective chart review of 311 inpatients with first-ever ischemic stroke from age 18 to 55 years at an Oklahoma academic medical center from 1 July 2011 to 30 April 2017. Using Chi-squared test, we compared the stroke etiologic diagnosis of the attending neurologist at discharge-when hypercoagulable profile results were rarely available-to the diagnosis of a vascular neurologist postdischarge who had access to all available etiologic test results.
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