Are Workaholics More Susceptible To Stroke?

Are Workaholics More Susceptible To Stroke?
Stroke risk climbs to 33% for those who work more than 55 hours per week.

A study recently published in Lancet says yes. Compared to people who worked 35 to 40 hours per week, those who worked 41 to 48 hours were 10% more likely to suffer a stroke, and those who worked 40 to 54 hours were 27% more likely. Stroke risk climbs to 33% for those who work more than 55 hours per week. The same seems to hold true for heart disease, but the increase is less at 13% for those who work over 55 hours.

There is still hope for workaholics. It is likely that they spend more time sitting at their desks and do not exercise. Even if they can exercise, sitting for long periods increases risk of cardiovascular disease. Also, they are more likely to unwind with alcohol, and heavy drinking is a recognized risk factor for stroke. Workaholics also are more likely to be under more stress, also deleterious to the cardiovascular system.

If you must be a workaholic, as many doctors are, get a standing desk or buy a Fitbit or an Apple Watch to guilt you into standing and moving.

Jack Florin, MD
Neurologist

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What Causes Sudden Death In Epilepsy?

Every year, 5000 people with epilepsy die of sudden, unexpected death (SUDEP) in the United States alone. This is a twenty-fold increased risk compared to the general population. Risk factors are young men who are noncompliant and have uncontrolled generalized tonic-clonic (grand mal) seizures. The longstanding theory was that since epilepsy comes from the brain, the cause must be in the brain. A new study, however, points to the fact that SUDEP is associated with a higher prevalence of congenital / inherited heart disease such as prolonged QT syndrome and hypertrophic cardiomyopathy. These disorders are recognized to cause sudden death in young athletes who do not have epilepsy. Should all young patients with epilepsy be screened with an EKG and an echocardiogram?

Jack Florin, MD
Neurologist

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More on marijuana and Multiple Sclerosis

Marijuana use for Multiple Sclerosis patients
40% of MS patients have used cannabis

Forty percent of Multiple Sclerosis patients have used cannabis (Marijuana), and more than 50% of MS patients have some cognitive dysfunction. Marijuana is used to treat pain, spasticity, and urinary symptoms. Studies show that cannabis does not affect mood or cause anxiety or psychosis. A new study, however, shows that it may compromise already impaired cognitive dysfunction. Also, cannabis users are more likely to be unemployed than nonusers.

Jack Florin, MD
Neurologist

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Does Marijuana Help Children With Severe Epilepsy?

According to a new study, it shows promise. Dravet syndrome and Lennox-Gastaut syndrome are examples of severe epilepsy in children. Current medications are usually only partly helpful. Cannabidiol is the component of marijuana that does not include the psychoactive part of the plant. It is a liquid taken daily by mouth. In the study, there was an over 50% reduction in the number of seizures with this treatment. Six percent stopped taking the drug because of side effects, which were mainly drowsiness, diarrhea, decreased appetite. These findings will lead to larger placebo-controlled double-blind trials.

This study was presented at the AAN 67th Annual Meeting by Dr Orrin Devinsky of the NYU Epilepsy Center.

Jack Florin, MD
Neurologist

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Skin Biopsies May Be Able To Diagnose Alzheimer’s And Parkinson’s

Given that there are no available drugs which would slow the progression of Alzheimer’s or Parkinson’s, early diagnosis is of limited clinical benefit. A new study, presented at an Alzheimer’s conference recently, has shown that monoclonal antibodies may be able to slow the progression. Early diagnosis of Alzheimer’s is possible utilizing amyloid PET scans, which are expensive, and testing amyloid and tau in spinal fluid, which requires a spinal tap. No blood tests are yet reliable.

A new study used skin biopsy. Patients with Alzheimer’s or Parkinson’s had 7 times higher levels of tau, and those with Parkinson’s had 8 times higher level of alpha-synuclein than the control group.

If these results can be verified, the test would be helpful for clinical trials, diagnosing patients with atypical symptoms, and hopefully in the future to identify patients for neuroprotective drugs.

Jack Florin, MD
Neurologist

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Sleeping Pills. Maybe You Shouldn’t Drug Yourself To Sleep

sleeping pills drugs
You Shouldn’t Drug Yourself To Sleep

A new study shows that cognitive behavioral therapy, which includes stimulus control, sleep restriction, sleep hygiene, and relaxation seems to be as or more effective and safer than sleeping pills. There were over a thousand patients. They fell asleep an average of 20 minutes sooner, slept an average of 26 minutes longer, and their sleep efficiency, as measured by sleep studies, improved by 10%.

See the June 9th issue of Annals of Internal Medicine.

Jack Florin, MD
Neurologist

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Does Coffee Reduce The Risk Of Multiple Sclerosis?

Coffee and multiple Sclerosis
Coffee may protect us against developing MS.

Studies have shown that caffeine intake leads to reduced risk of Parkinson’s and Alzheimer’s, and a new study shows that it may also protect against developing Multiple Sclerosis. There were 2 groups of patients. The Swedish study found that people who did not drink at least 6 cups of coffee per day for at least 1 year up to 10 years before symptoms had a 1-1/2 times increased risk of developing MS. In the U.S. group, 4 or more cups of coffee showed an effect. Further studies on the impact of caffeine on relapses and long-term disability in patients with established MS will likely be done.

This was presented at the American Academy of Neurology 67th Annual Meeting.

Jack Florin, MD
Neurologist

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What Types Of Physical Activity Lead To Better Sleep?

Many studies have shown that people who sleep less than 7 hours have a greater risk of poor health outcomes and that physical activity is associated with healthy sleep. But studies have not shown which activities are best. Now, a new study concludes that running, yoga, gardening, golf, aerobics, biking, weightlifting lead to better sleep. Walking is less helpful. Household work and childcare were associated with insufficient sleep. This is not surprising, as home and work demands are probably the main reason people lose sleep.

Physical Activity Lead To Better Sleep
Physical Activity Leads To Better Sleep

Presented at the Annual Meeting of the Associated Professional Sleep Societies, 2015.

 

Jack Florin, MD
Neurologist

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