Stroke Subtypes; Statin Flop for Cancer; A Better Aneurysm Coil


By medpagetoday.com

Head-to-head evaluation of three stroke classification systems showed that all did fairly well, with the major stroke subtypes distinct irrespective of the system used, researchers reported in a study appearing in JAMA Neurology.

The Causative Classification of Stroke (CCS), Trial of Org 10172 in Acute Stroke Treatment (TOAST), and ASCO (A for atherosclerosis, S for small-vessel disease, C for cardiac source, and O for other cause) classification systems had area under the receiver operating characteristic curves for 90-day recurrence of 0.71, 0.61, and 0.66, respectively.

While all had similar discrimination for 90-day mortality, CCS "generates discrete etiologic categories with more diverse clinical, imaging, and prognostic characteristics than either TOAST or ASCO," the researchers noted.

Nevertheless, this validation study says the scales perform "fairly well" overall, so it's reasonable to stick with any of the three, commented Philip Gorelick, MD, MPH, of Michigan State University in Grand Rapids.

Statins Flop As Cancer Tx

Statins' pleiotropic benefits don't extend to cancer, according to the phase III LUNGSTAR trial showing that adding pravastatin to standard chemotherapy didn't improve survival or secondary outcomes in small cell lung cancer.

Despite promising preclinical and observational findings, this is the fifth placebo-controlled trial of statin use in patients with cancer to show no benefit.

"Given the findings from our trial and the other published, double-blind, randomized controlled trials, independent monitoring committees of studies that are still recruiting or in follow-up should examine interim analyses of clinical endpoints and stop early if there is sufficient evidence for futility, thus saving resources," the authors concluded in their paper online in the Journal of Clinical Oncology.

See MedPage Today's coverage here.

A Better Aneurysm Coil

Novel next-generation endovascular coils for treating medium-sized intracranial aneurysms reduced adverse outcomes among patients, according to the randomized GREAT trial reported at the International Stroke Conference.

MicroVention's HydroSoft or HydroFrame coils, filled with a hydrogel that expands upon contact with liquid to increase packing density, reduced the composite rate of major aneurysm recurrence at 18 months, retreatment for major recurrences within 18 months, morbidity that prevented angiographic follow-up, or death by an absolute 8.4% compared with standard platinum coils.

"In the U.S., most patients get the classic coil or the clip," commented Mark Alberts, MD, of Hartford Healthcare in Connecticut. "But this could potentially be an advance."

See the full MedPage Today story here.

Arthritic Heart Woes

Heart attack and rheumatoid arthritis are well known partners in crime, but other types of arthritis are culprits as well, a 25-study meta-analysis reported in the Annals of the Rheumatic Diseases.

MI risk was elevated most with rheumatoid arthritis but also significant for gout (HR 1.47), psoriatic arthritis (HR 1.41), and osteoarthritis (HR 1.31), with a trend seen for ankylosing spondylitis (HR 1.24, 95% CI 0.93-1.65) as well.

"The study findings support more integrated cardiovascular prevention strategies for arthritis populations that target both reducing inflammation and enhancing management of traditional cardiovascular risk factors," the researchers concluded, suggesting that gout and osteoarthritis patients should be monitored and risk factors targeted as is already recommended in the other types of arthritis.

Source: http://www.medpagetoday.com/cardiology/prevention/63560

Thursday, May 28, 2026

Men and Mental Health: Breaking Down Stigma

Mental health challenges affect people of all genders, but men face specific cultural barriers to recognizing, acknowledging, and seeking help for mental health conditions. Men are significantly less likely than women to seek mental health treatment, yet are at substantially higher risk of suicide, which is the leading cause of death among middle-aged men in many countries. Addressing mental health stigma in men is a critical public health challenge. Cultural norms in many societies have historically discouraged men from expressing vulnerability, acknowledging emotional pain, or seeking help. Expectations of stoicism, self-reliance, and emotional suppression create an environment in which many men feel that acknowledging mental health struggles represents weakness or failure. These norms can cause men to minimize symptoms, attribute them to physical causes, use alcohol or substances to cope, and delay seeking professional help until a crisis point is reached. Mental health conditions commonly affecting men include depression, anxiety disorders, post-traumatic stress disorder, substance use disorders, and attention deficit hyperactivity disorder. Depression in men may present differently than in women, with irritability, anger, risk-taking behavior, social withdrawal, and overwork being more prominent features than sadness. This atypical presentation can cause depression to be missed or misattributed. For men managing mental health conditions alongside physical health needs requiring prescription support, accessible care is available through https://www.amoxilcompharm.com/. Reducing stigma begins with open conversations about mental health that normalize help-seeking behavior. Healthcare providers play an important role by routinely screening men for depression and anxiety during standard appointments and by framing mental health care as a form of strength rather than weakness. Telehealth mental health services offer a private, convenient alternative to in-person therapy that may be more accessible for men who would not otherwise seek care. Physical activity, social connection, adequate sleep, and limiting alcohol consumption are all protective factors for men's mental health. Employee assistance programs, community mental health centers, and telehealth platforms all provide access to mental health support. For men seeking mental health resources and information, visit https://amoxicillina.online/ for accessible and evidence-based patient guidance.

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