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Thursday, October 18, 2018

Maxy sez : A Diabetes Diagnosis After Age 50 May Be an Early Sign of Pancreatic Cancer in Black, Latino People

The findings may help doctors identify more people at risk for the potentially deadly cancer.
By Sheryl Huggins Salomon         Medically Reviewed by Kacy Church, MD
A type 2 diabetes diagnosis after age 50, called late-onset diabetes, is a known risk factor for pancreatic cancer, and in Latino and African-American people with diabetes who are diagnosed with pancreatic cancer within three years, pancreatic cancer itself may manifest as diabetes.

That’s what a study published June 18 in the Journal of the National Cancer Institute suggests, and the findings may help doctors identify more individuals at risk for pancreatic cancer, which has poor survival rates because doctors often don’t catch the disease early enough for treatment to be effective. Pancreatic cancer has a five-year survival rate of only 8.5 percent, according to the National Cancer Institute (NCI).

For the current study, authors studied the incidence of type 2 diabetes and pancreatic cancer in nearly 49,000 African-American and Latino people older than 50. From 1993 to 2013, about 32 percent, or about 15,800, of the study participants developed diabetes. During follow-up, researchers identified an additional 408 pancreatic cancer cases.

Over the study period, about 20 years, they found that diabetes was associated with a twofold risk of pancreatic cancer. But when researchers stratified the data, they observed the risk for pancreatic cancer was even higher among participants diagnosed with diabetes in the previous three years (called recent-onset diabetes). Within that time period, Latinos were four times more likely to develop pancreatic cancer, and African-Americans were three times more likely.

“Our results suggest that late-onset diabetes can be used as a marker to narrow down who is in a high-risk group for pancreatic cancer,” says the lead study author, V. Wendy Setiawan, PhD, an associate professor of preventive medicine at the Keck School of Medicine of the University of Southern California in Los Angeles. “Physicians should be aware that while the chance [of developing pancreatic cancer] is low, recent-onset diabetes could be an early sign of pancreatic cancer,” she adds.

The Association Between Pancreatic Cancer and Type 2 Diabetes in Minorities
The pancreas is a gland behind the stomach that secretes digestive enzymes and releases hormones, such as insulin and glucagon, that help to control blood glucose (sugar), according to Johns Hopkins University. According to the NCI, about 1.6 percent of people in the United States will be diagnosed with pancreatic cancer at some point in their lifetime.

The incidence of pancreatic cancer among black people specifically is about 25 percent higher than it is in white people, according to the American Cancer Society. Yet, says Setiawan, “Blacks and Latinos are understudied, and thus very little is known about the relationship between diabetes and pancreatic cancer in these two populations.”

Additionally, both black and Latino people have higher rates of type 2 diabetes than the general population, according to the American Diabetes Association. That’s why her team focused on those groups.

Rahil Bandukwala, DO, an endocrinologist at MemorialCare Saddleback Medical Center in Laguna Hills, California, who wasn’t involved in the research, says the results seem to align with what he’s seen in his nearly 20 years of practicing medicine, but he would be interested in seeing more long-term data. He notes a limitation of the study that the authors acknowledge in their paper: The research relied on self-reporting when determining the diabetes diagnoses, Medicare claims, and hospital discharge records. And so the recorded onset dates may have been imprecise. “It would be good to better understand when the diabetes truly came about and follow the participants out from there — to see who gets pancreatic cancer and who doesn’t.”

But previous research seems to support the current study’s findings. For example, nearly 40 percent of people with pancreatic cancer had also developed diabetes within the three years prior to their cancer diagnosis, according to the findings of a review of 500 medical records that was published in the March 2013 issue of Pancreas.

A Need for Better Pancreatic Cancer Screening Tools
Michael Choti, MD, a surgical oncologist at Banner MD Anderson Cancer Center in Gilbert, Arizona, who specializes in pancreatic cancer, says that study results so far, while interesting, aren’t cause for alarm. “Patients who develop late-onset diabetes shouldn’t panic and think Oh my God, that means I’m going to develop pancreatic cancer,” says Choti, who wasn’t involved in the current research.

But he notes that pancreatic cancer rates are on the rise, and current screenings for the disease fall short. Given that pancreatic cancer can be aggressive and survival rates so poor, he argues that better tools are needed to screen for early signs. “We don’t really have any screening tools, and even imaging [methods] of the pancreas, such as a CAT scan or MRI of the pancreas, are not perfect,” Choti explains. According to the U.S. Preventive Services Task Force, there are no official guidelines for pancreatic cancer screening.

Setiawan agrees with Choti. “There is an urgent need to find better ways to identify patients with early cancer in the group of patients who develop diabetes after age 50,” she says, adding that her team at the Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer are “working diligently to develop tests that can better identify patients with recent onset diabetes who actually have pancreatic cancer at its earliest stage.”

“Finding the cancer at an early stage and treating it with surgical removal provides the best chance for a cure of the disease,” she adds.

Sunday, September 23, 2018

Wise Advice about Life

An Obstacle

1. Have the courage to live a life true to yourself, not the life others expect of you.

2. Never attribute to malice that which can be adequately explained by stupidity.

3. “There is nothing noble in being superior to your fellow man; true nobility is being superior to your former self.” Ernest Hemingway

4. Don’t make decisions when you’re angry. Don’t make promises when you’re happy.

5. “Never argue with a stupid person, they’ll drag you down to their level and beat you with experience.” Mark twain

6. Only pack what you can carry yourself.

7. Remember you’ll always regret what you didn’t do rather than what you did.

8. “You’d worry less about what people think about you if you knew how seldom they do.” David Foster Wallace

9. If you blame it on someone else, don’t expect it to get better.

10. “You can be the ripest, juiciest peach in the world, but there will always be someone who hates peaches.” Dita von Teese

11. If the grass is greener on the other side, there’s probably more manure there.

12. Don’t give up what you want most for what you want now.

13. With regards to the opposite sex: If you look hungry, you’ll starve.

14. “Never let your sense of morals prevent you from doing what is right.” Isaac Asimov

15. Strive to be the man you want your daughter to marry.

16. “Remember only enemies speak the truth. Friends and lovers lie endlessly, caught in the web of duty.” Stephen King

17. Never forget your car keys will change your car from one tonne of inert metal into one of the most deadly killing machines that has been invented.

18. Wait 24 hours before getting mad and reacting about anything. If it doesn’t bother you in 24 hours time, it probably isn’t important enough to get mad over.

19. Never make someone a priority who only makes you an option.

20. Try not to take anything personally. No one thinks about you as much as you do.

21. “If you want to know what a man’s like, take a good look at how he treats his inferiors, not his equals.” Sirius Black

22. Figure out what you love to do, and then figure out how to get someone to pay you to do it.

23. If you treat a woman like a queen, and she treats you like a jester, your princess is in another castle.

24. Whenever something happens that makes you sad, ask yourself whether you’d still care about it when you’re ninety.

25. Be persistent. When knowledge and ability aren’t enough, be persistent.

26. “Life is scary. Get used to it. There are no magical fixes. It’s all up to you. So get up off your keister, get out of here, and go start doin’ the work. Nothing in this world that’s worth having comes easy.” Bob Kelso

27. Smart girls like to hear they’re pretty, pretty girls like to hear that they’re smart.

28. Happiness is a choice and everything else is a matter of perspective.



Tuesday, September 11, 2018

Maxy sez ::What your pee means ---3 red flags What Your Urine Says About Your Health

BY PATRICK SULLIVAN
Clear as urine. That’s not the expression, but perhaps it should be, at least when urine is healthy. Perfectly normal urine tends to be a pale, straw color or a clear yellow. “A lot of people don’t realize that when you’re well-hydrated, your urine should be close to running water,” explains urologist Arthur Crowley, MD. “People are confused about that. They’ll say it looks great but it’ll be dark.”

Urine gets its yellow color from a pigment called urochrome. “It has to do with the way the kidneys break things down,” says Dr. Crowley. In addition, healthy urine has a slight, mild smell. But what if your pee has a strong odor, or isn’t a mellow yellow? What if it’s pink? Or red? Chances are the cause is innocuous, but there are times when your body may be telling you something about an underlying medical condition.

What’s that smell?
Normal urine should smell unobtrusive, but there are several reasons why you might notice a stronger odor wafting up from the bowl. Dehydration can cast a distinct aroma if your urine isn’t as diluted as usual, signaling that you need to drink up. Vitamins—namely vitamin B6—and certain foods are other common suspects. “Vitamin B6 has a strong odor, almost like old urine,” says Crowley. “It’s more a nitrogen-type smell.” Garlic can make your pee as stinky as your breath, and asparagus is well known for scenting your urine, giving off a sulfur-like smell.

Sometimes, though, the smell may be a sign of trouble. Diabetics often have sweet-smelling urine due to the presence of sugar. A urinary tract infection (UTI) is another condition that brings along a strong smell, “almost like gunpowder,” says Crowley. “The bacteria that causes a UTI will split the urea molecules in urine apart, releasing the smell.”

(Not so) pretty in pink
Red or pink urine could indicate the presence of blood, but don’t panic just yet. Blueberries and rhubarb (did you overindulge in pie recently?) can do it. So can beets. Certain medications, such as senna laxatives or even ibuprofen, can cause blood in the urine. Crowley says if a lab analysis reveals no red blood cells in your urine sample, it’s probably something you ate. If it’s not your diet, blood in the urine may be a symptom of UTIs, bladder stones and cancer of the kidneys or bladder. It may also be due to long-distance running (joggers’ hematuria) or other strenuous exercise. If you haven’t recently chowed down on veggies that may be behind the color change, see your primary care physician and have a sample taken.

Very dark urine
If you’ve thought all along that dark-colored urine is the norm, think again. Severe dehydration is the best-case scenario for urine that’s amber or orange in color. Fortunately, it’s the most common diagnosis, according to Crowley. The fix is easy enough: Drink more water. If your urine is still dark, you might need to replenish your electrolytes as well. Sports drinks and Pedialyte can help.

But if dehydration isn’t causing the dark hue, it could be something more serious. “Cirrhosis of the liver and hepatitis are possibilities,” says Crowley. With liver issues, a pigment called bilirubin is turning the urine dark. “Bilirubin results from the breakdown of old red blood cells and normally can be converted to a water soluble substance by the liver,” Crowley says. If the liver is damaged, the bilirubin does not get broken down and passes through the bladder as a dark discoloration.

Maxy sez : Types of Vaginal Infections

Burning, itching, and an unpleasant odor are just some of the common symptoms of vaginal infections. But treatments vary by condition, so it's important to know which type of vaginal infection you have.
By Beth W. Orenstein
Medically Reviewed by Lindsey Marcellin, MD, MPH
Vaginal infections, or vaginitis, are very common — so much so that most women will experience some form of vaginal infection or inflammation during their lifetime.

“To the gynecologist, vaginitis is a vaginal discharge with or without itching and burning, with or without an odor,” says Gregory R. Moore, MD, MPH, an obstetrician-gynecologist and director of the University Health Service at the University of Kentucky in Lexington.
Some women seem to be more prone to vaginal infections than others for reasons that are not entirely obvious, Dr. Moore says.

What Upsets the Normal Vaginal Balance
A healthy vagina has many bacteria and yeast. However, some things can disturb that healthy balance. These include:
Douches
Hormone level changes
Antibiotics
Vaginal intercourse
Pregnancy and breastfeeding
The Most Common Types of Vaginal Infections
There are three very common types of vaginal infections, says Cynthia Krause, MD, assistant clinical professor of obstetrics and gynecology at Mount Sinai School of Medicine in New York City.

Yeast infections. The most common type of vaginitis, a yeast infection is caused by one of the many species of fungus known as Candida. Candida live naturally in your body in small numbers, including in the vagina, and usually don't cause any harm.

However, Candida thrive in a warm, moist, airless environment and, under those conditions, can grow in number, causing a vaginal infection. Dr. Krause says, “There are many species of yeast or Candida — Candida albicans is the most common.”

Symptoms of a vaginal yeast infection include a thick, white discharge that some women describe as resembling cottage cheese. Yeast infections also can cause vaginal itching and redness of the vulva (the lips of the external female genital area) and vagina.

Bacterial vaginosis. Along with yeast, “friendly” bacteria called lactobacilli live in the vagina. When the number of lactobacilli gets too low, it can trigger a condition called bacterial vaginosis (BV).

Why bacteria levels change is not known, but the normal lactobacilli can be replaced by other infection-causing bacteria. “Gardnerella is the bacteria most often associated with bacterial vaginosis,” Krause says. “It is the lack of lactobacilli and overgrowth with these other bacteria that cause the symptoms of infection.”

With bacterial vaginosis, a woman may see a thick or whitish discharge or one that is slippery and clear. It is not likely to itch or burn. A fishy odor may be noticeable, especially during intercourse.

Trichomonas. “Of the three most common vaginal infections, trichomonas vaginitis is the only one that is a true sexually transmitted infection,” Krause says. Commonly called “trich,” it is caused by a single-celled parasite, trichomonas vaginalis, and is passed from partner to partner during intercourse.

The symptoms of trichomonas vaginitis are similar to other vaginal infections: burning, irritation, redness, and swelling of the vulva, with a yellow-gray or greenish vaginal discharge, possibly with a fishy odor. Some women also experience pain during urination.

Other common vaginal infections and causes of vaginal itching include:

Chlamydia vaginitis. Chlamydia is a sexually transmitted disease that can cause inflammation of the vagina. Some women will have a discharge with chlamydia and some will not. A more common symptom is bleeding, especially after intercourse. “Sexually active women up to age 26 should be tested annually for chlamydia because it so often comes without symptoms and can linger and do a fair amount of damage to fertility,” Moore says.
Noninfectious vaginitis. Noninfectious vaginitis is when the skin around the vagina becomes sensitive to an irritant such as scented tampons, perfumed soaps, or fabric softeners. This is not an infection, and the solution is simple: “Not to be exposed to whatever you are having a reaction to,” Moore says.
Vulvodynia. This is a condition in which women have chronic pain or discomfort of the vulva without a known cause. The symptoms are similar to vaginal infections: burning, stinging, rawness, soreness, and swelling. Symptoms may be constant or occasional.
Viral vaginosis. Viruses also can cause vaginal infections. Most viruses are spread through sexual contact. “The herpes simplex virus is a common cause of viral vaginosis,” Moore says. Symptoms include pain in the genital area from lesions or sores. Most of the time, you can see the sores on the vulva or vagina, but they can also be hidden and seen only during an examination by your gynecologist.
Treatment for Vaginal Infections

All of these infections can be treated, but it is important to know which infection you have so that the right medication is prescribed.

“Yeast medication is available over the counter if you are certain that it is a yeast infection,” Krause says. “Sometimes women think they have a yeast infection and it is actually something else. If you try over-the-counter medications and they don’t work, you should see a doctor.”

Sunday, September 9, 2018

Maxy sez : Yeast Infections in Men: What to Know

By Joseph Bennington-Castro Medically Reviewed by Sanjai Sinha, MD
Yeast infections frequently occur in men, even though they're most common in women.
Men over 40 who have Type 2 diabetes may face an increased risk for developing penile yeast infections.Robert Nicholas/Getty Images
Yeast infections are usually associated with women, but men aren't safe from these infections, either.

The term "yeast infection" generally refers to a vaginal infection caused by the yeast Candida albicans, and less commonly other Candida species, including C. glabrata, C. parapsilosis, C. tropicalis, and C. krusei. (1)

But yeast infections, or candidiasis, can affect other areas of the body.

For instance, a yeast infection of the mouth is called thrush, or oral candidiasis, and a yeast infection of the skin (such as the armpits and groin) is called cutaneous candidiasis. (2,3)

A yeast infection of the penis is called candidal (or candida) balanitis, or balanitis thrush.

The term "balanitis" refers to an infection of the glans penis, which is the head of the penis. Candida infects the glans penis more often than any other infectious agent.

If the yeast infection also affects the foreskin, it is known as candidal balanoposthitis. (4)

Prevalence of Candidal Balanitis, a Yeast Infection of the Penis
Candida yeasts are responsible for 30 to 35 percent of all cases of balanitis, according to a report published in the journal Clinical Microbiology Reviews. (4)

Other infectious sources of balanitis include streptococci and staphylococci bacteria, Herpes simplex virus and human papillomavirus, and a sexually transmitted bacterium called Mycoplasma genitalium. (5)

But candida balanitis is not well studied, so it's unclear how many men the illness affects each year (though it's thought to be a rare condition).

Various Candida species, most notably C. albicans, live in the gastrointestinal tract and other warm areas of the body without causing illness (they only cause issues when they're present in large numbers). (4)

In fact, about 20 percent of women have Candida living in their vagina and don't experience any yeast infection symptoms, according to a report published in the journal The Lancet. (1)

Candida is commonly found on the penis, with studies suggesting that 16 to 26 percent of men carry the yeast. About 37 percent of men with Candida experience no symptoms, while 27 percent of them develop balanitis, according to a study of new attendees to a clinic for sexually transmitted diseases. (6)

Causes and Risk Factors of Candidal Balanitis or Penile Yeast Infection
Unlike with vaginal yeast infections, penile yeast infections are usually sexually acquired — when a man has sex with someone who has a yeast infection.

But candidal balanitis isn't considered a sexually transmitted disease (STD) because men can get the infection without having sex.

There are several risk factors that increase a man's risk of getting a penile yeast infection, including:

Antibiotics, which kill the "good" bacteria that keep Candida's numbers in check
Immune-suppressing illnesses, particularly HIV
Diabetes mellitus (aka diabetes)
Corticosteroids
Additionally, Candida yeast colonization and infection are more common among men with uncircumcised penises than men with circumcised penises (the warm, moist environment underneath the foreskin promotes yeast growth). (6)

A study published in the Journal of European Academy of Dermatology and Venereology found that candidal balanitis was strongly associated with age over 40 years and diabetes mellitus. And men older than 60 years were more likely to have Candida colonization. (7)

Hygiene may also play a role in candidal balanitis development.
Washing with perfumed shower gels and soaps can irritate the skin, potentially helping Candida multiply. (8)

Symptoms of Male Yeast Infections (Candidal Balanitis)
Common symptoms of candidal balanitis include:

Burning and itching around the head of the penis, which worsens after having sex
Redness and swelling
Small, rash-like bumps called papules, which may have pus
Pain during urination or sex
If you have candidal balanoposthitis, you may also have:

A thick, lumpy discharge under the foreskin
An unpleasant odor of the foreskin
Difficulty pulling back your foreskin
Men with diabetes may experience more severe symptoms, including fluid buildup and ulceration of the penis, as well as fissuring of the foreskin.

Complications with balanitis are rare, but may include an inability to retract the foreskin, cellulitis (inflammation of connective tissue beneath the skin), and a narrowing of the urethra that makes urinating difficult. (6,9)

Treating Penile Yeast Infections (Yeast Infection in Men)
Like vaginal yeast infections, penile yeast infections are easily treated with antifungal drugs called azoles.

There are a number of over-the-counter and prescription-based topical medicines available, including:

Lotrimin (clotrimazole)
Monistat (miconazole)
Spectazole (econazole)
In some cases, these drugs may be combined with hydrocortisone to reduce marked inflammation.

Importantly, topical oil-based medication cannot be used with latex condoms.

Alternatively, an oral azole medication called Diflucan (fluconazole) is effective for yeast infections.

If the topical or oral treatments don't work, make sure to see your doctor, as you may have another kind of balanitis or an infection by a Candida species resistant to azole antifungals. 

Friday, August 31, 2018

Maxy sez : Small Strokes Can Cause Big Damage

Under-detected "mini-strokes" cause brain damage, result in cognitive impairment, and dementia, says a new study.
 Chances are if you're a senior managing your health, you've already had a conversation with your doctor about stroke risk. While many patients know the warning signs of stroke — slurred speech, weakness on one side of the body, coordination problems, double vision, and headaches — health care providers often fail to educate patients about their risk for silent or "mini-strokes," which can cause progressive, permanent damage and lead to dementia.

A new study published in the Journal of Neuroscience, examined the effects of these so-called mini-strokes. They frequently are not diagnosed or detected by a doctor because a patient does not immediately present with stroke signs. Mini-strokes may lead to permanent neurological damage and increase risk for full blown stroke.

Experiencing a Chronic Condition? Find a Gastroenterologist Now. 
Maiken Nedergaard, MD, lead author of the study and professor of neurosurgery at the University of Rochester Medical Center, says at least half of individuals over the age of 60 will experience one mini-stroke in their lifetime. She calls the prevalence of mini-strokes "an epidemic."

"Often you don't have symptoms. That's the scary thing about them, you don't know they're occurring," says Dr. Nedergaard. "If you are elderly and something doesn't work quite right, you think, I should take a nap. You don't go to the hospital unless you have big stroke."

Mini-strokes often are detected well after the damage has been done, she says, and quite possibly by the time a patient has had several of them. A typical scenario, says Nedergaard, may be a patient who visits her doctor for chronic migraines. The doctor may order an MRI to rule out brain tumors, only to discover the patient has had several mini-strokes, which appear on a scan as "little dots where the tissue has grown," she says.

"When you have a stroke, there's an area of the brain that dies rapidly almost at the epicenter of the injury, but there are neurons around it that die slowly," says Larry Goldstein, MD, professor of medicine, director of the Stroke Center at Duke University and a spokesperson for the American Heart Association.

The study authors say mini-strokes are similar in nature to ischemic strokes, which are full blown episodes provoked by a loss of blood supply, depriving an area of the brain from oxygen. Ischemic stroke effects, including blurry vision, numbness, and slurred speech, are usually present immediately after the event. "A big stroke is caused by a clot in the artery. We assume that's the same that happens in the mini-stroke, but it's not clear," says Nedergaard. "What we do know is they cause this very delayed loss of cells in the brain."

Nedergaard and her colleagues used rodents to examine the impact of small strokes. Strokes were provoked by injecting mice with cholesterol crystals, she says. The researchers put the mice who had mini-stroke through a series of tasks, such as recalling objects and responding to audio cues. They found the mice who suffered strokes were more likely to fail these tasks.

"Silent strokes are really common but their effects are not silent," says Philip B. Gorelick, MD, MPH, medical director of the Hauenstein Neuroscience Center of Saint Mary's Health Care in Grand Rapids, Mich. He says one in three patients who have a mini-stroke will sustain permanent damage.

According to the Centers for Disease Control, stroke is the third leading cause of death in the United States. They typically occur in people over the age of 65, and cause more than 140,000 deaths each year. Around 795,000 people suffer a stroke annually. About 600,000 of these are first attacks and 185,000 are recurrent attacks. Strokes are common among people with atrial fibrillation, high blood pressure, and smokers.

Nedergaard says currently there's no treatment available to reverse brain damage caused by a stroke or to lower a patient's chances for having recurring episodes or developing dementia. This is why preventative medicine is crucial.

To lower one's risk for having a stroke, doctors advocate for preventive medicine and a healthy lifestyle, which includes a low sodium and low cholesterol diet, a regular exercise program, only moderate amounts of alcohol, and not smoking cigarettes. Some doctors may recommend cholesterol-busting medications such as Plavix and anticoagulants such as aspirin.

Friday, August 24, 2018

Maxy sez : Small Strokes Can Cause Big Damage

Under-detected "mini-strokes" cause brain damage, result in cognitive impairment, and dementia, says a new study.
By Jessica Firger
 Chances are if you're a senior managing your health, you've already had a conversation with your doctor about stroke risk. While many patients know the warning signs of stroke — slurred speech, weakness on one side of the body, coordination problems, double vision, and headaches — health care providers often fail to educate patients about their risk for silent or "mini-strokes," which can cause progressive, permanent damage and lead to dementia.

A new study published in the Journal of Neuroscience, examined the effects of these so-called mini-strokes. They frequently are not diagnosed or detected by a doctor because a patient does not immediately present with stroke signs. Mini-strokes may lead to permanent neurological damage and increase risk for full blown stroke.

Maiken Nedergaard, MD, lead author of the study and professor of neurosurgery at the University of Rochester Medical Center, says at least half of individuals over the age of 60 will experience one mini-stroke in their lifetime. She calls the prevalence of mini-strokes "an epidemic."

"Often you don't have symptoms. That's the scary thing about them, you don't know they're occurring," says Dr. Nedergaard. "If you are elderly and something doesn't work quite right, you think, I should take a nap. You don't go to the hospital unless you have big stroke."

Mini-strokes often are detected well after the damage has been done, she says, and quite possibly by the time a patient has had several of them. A typical scenario, says Nedergaard, may be a patient who visits her doctor for chronic migraines. The doctor may order an MRI to rule out brain tumors, only to discover the patient has had several mini-strokes, which appear on a scan as "little dots where the tissue has grown," she says.

"When you have a stroke, there's an area of the brain that dies rapidly almost at the epicenter of the injury, but there are neurons around it that die slowly," says Larry Goldstein, MD, professor of medicine, director of the Stroke Center at Duke University and a spokesperson for the American Heart Association.

The study authors say mini-strokes are similar in nature to ischemic strokes, which are full blown episodes provoked by a loss of blood supply, depriving an area of the brain from oxygen. Ischemic stroke effects, including blurry vision, numbness, and slurred speech, are usually present immediately after the event. "A big stroke is caused by a clot in the artery. We assume that's the same that happens in the mini-stroke, but it's not clear," says Nedergaard. "What we do know is they cause this very delayed loss of cells in the brain."

Nedergaard and her colleagues used rodents to examine the impact of small strokes. Strokes were provoked by injecting mice with cholesterol crystals, she says. The researchers put the mice who had mini-stroke through a series of tasks, such as recalling objects and responding to audio cues. They found the mice who suffered strokes were more likely to fail these tasks.

"Silent strokes are really common but their effects are not silent," says Philip B. Gorelick, MD, MPH, medical director of the Hauenstein Neuroscience Center of Saint Mary's Health Care in Grand Rapids, Mich. He says one in three patients who have a mini-stroke will sustain permanent damage.

According to the Centers for Disease Control, stroke is the third leading cause of death in the United States. They typically occur in people over the age of 65, and cause more than 140,000 deaths each year. Around 795,000 people suffer a stroke annually. About 600,000 of these are first attacks and 185,000 are recurrent attacks. Strokes are common among people with atrial fibrillation, high blood pressure, and smokers.

Nedergaard says currently there's no treatment available to reverse brain damage caused by a stroke or to lower a patient's chances for having recurring episodes or developing dementia. This is why preventative medicine is crucial.

To lower one's risk for having a stroke, doctors advocate for preventive medicine and a healthy lifestyle, which includes a low sodium and low cholesterol diet, a regular exercise program, only moderate amounts of alcohol, and not smoking cigarettes. Some doctors may recommend cholesterol-busting medications such as Plavix and anticoagulants such as aspirin.