LV‐GLS 18% predicts mortality, recurrent stroke, and poor mRS-based functional outcome after acute ischemic stroke. @Minkwan_Kim84

LV‐GLS Globally, stroke is the second‐leading cause of death and the third most common cause of combined death and disability.¹ Over the past decade, stroke‐related death has been steadily declining; however, health care expenditures associated with stroke have continued to increase.^{1, 2} Recurrence of ischemic stroke adversely affects patient prognosis and increases the mortality rate.³ Previous studies have identified several clinical factors contributing to the occurrence and recurrence of ischemic stroke, including stroke subtype, age, hypertension, atrial fibrillation (AF), heart failure (HF), and diabetes.^{2, 4}

HF is also a risk factor for stroke and is associated with stroke recurrence and death.^{5, 6} Left ventricular (LV) global longitudinal strain (LV‐GLS), a measure of myocardial deformation along the long axis of the left ventricle, is assessed using the speckle‐tracking method. It is a sensitive measure of myocardial fiber shortening and has become a reliable parameter for evaluating subtle systolic dysfunction.⁷ In patients with acute HF, LV‐GLS is frequently reduced regardless of the LV ejection fraction (LVEF), the traditional measure of LV systolic function. LV‐GLS has also been shown to be a superior prognostic marker for death than LVEF.⁸ Furthermore, in severe mitral regurgitation and severe aortic stenosis, LV‐GLS has proven useful as a predictor of postoperative outcomes and a tool for identifying patients who may benefit from early surgical intervention.^{9, 10} Recent research has demonstrated that LV‐GLS can effectively predict incident strokes in patients who are stroke naïve.¹¹ However, to date, no study has evaluated the prognostic implications of LV‐GLS in patients with acute ischemic stroke (AIS) about subsequent cardiovascular outcomes. In this study, we aimed to investigate the prognostic utility of LV‐GLS, a novel marker of subclinical LV dysfunction, in patients with AIS.

It’s well known that exercise is good for health and helps to prevent serious diseases, like cancer and heart disease, along with simply making people feel better overall. However, the molecular mechanisms responsible for preventing cancer or slowing its progression are not well understood. But, a new study, published in the Proceedings of the National Academy of Sciences, reveals how exercise can increase glucose and oxygen uptake in the skeletal and cardiac muscles, instead of allowing it to “feed” tumors.

Reduced tumor growth in exercised mice To study how exercise-induced metabolic changes affect tumor growth, the research team injected mice with breast cancer cells and fed some of the mice a high-fat diet (HFD), consisting of 60% calories from fat, while others were fed a normal diet as a control. The HFD mice were given running wheels for exercise, although exercise was voluntary. The team used stable isotope tracer studies [U-13C6] glucose and [U-13C5] glutamine to track metabolic changes.

After 4 weeks of wheel running, the team found a significant difference in tumor sizes between mice that chose to exercise, compared to those that did not—even when they were fed the same diet.

Patients with a unique cellular disorder are helping researchers understand a series of health complications better. For the first time, researchers led by Newcastle University, UK have identified a group of patients with neurological disease who lack a critical cell process called autophagy. The

Access to antiretroviral therapy (ART) appears to improve when Medicare beneficiaries with HIV transition to long-term nursing homes, but nursing homes miss opportunities for initiation, as most stays without ART never had ART before admission.

This cohort study aimed to understand changes in ART use for Medicare beneficiaries with HIV transitioning from the community to long NH stays. We found that among a group with a mean age of 61 years, ART use seemed to improve after the transition, that there was no ART use before or after the transition for nearly one-quarter of our sample, and that comorbidities and frailty had no association with ART changes. These findings are contrary to our hypothesis that posited lower ART use after the transition and that lower NH quality rating would be associated with even lower ART use. These findings are critically important to our understanding of NH care for people with HIV because they dispel select concerns that the transition to long-stay NH resident and the transition from Medicare Part A to Part D medication benefits are opportunities for reduced ART use.

Few NHs have experience caring for people with HIV, with many seeing only 1 or 2 individuals in a 3-year span.⁹ Experience with HIV care correlates with better health outcomes in both the NH setting and the outpatient setting.⁸ Many community-based studies have found that better adherence to ART is associated with older age,^{29, 30} and 1 study of NH residents with HIV showed that longer duration of an NH stay was associated with better ART adherence,¹³ although that same study found that 21% of people with HIV in NHs had no ART. Without following people from the outpatient or community setting into the NH setting, these previous studies were limited in their generalizability because of selection bias; they examined only people with HIV using outpatient services, or only people with HIV using NHs.

Hypothyroidism and hyperthyroidism are associated with gain and loss of body weight, respectively. This Review discusses the epidemiological evidence for weight changes in thyroid dysfunction, the role of thyroid hormone in weight regulation, the effect of treatment and the implications for population health.