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Transient ischaemic attack

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https://www.readbyqxmd.com/read/29330273/rheumatoid-disease-an-unusual-cause-of-relapsing-meningoencephalitis
#1
Sian K Alexander, Maria Di Cicco, Ute Pohl, Alberto Cifelli
A 73-year-old man presented with three episodes of dysphasia and disinhibited behaviour, a single seizure and transient ischaemic attack-like events characterised by right arm and/or leg weakness. These episodes were separated by month-long asymptomatic intervals. Medical history included rheumatoid arthritis, which was clinically quiescent on leflunomide.Repeated cerebrospinal fluid examination showed a persistent lymphocytosis with mildly reduced glucose and elevated protein; oligoclonal bands and viral PCR were negative...
January 12, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29301476/the-cutaneous-manifestations-are-significantly-related-to-cerebrovascular-in-a-serbian-cohort-of-patients-with-hughes-syndrome
#2
L Stojanovich, A Djokovic, N Stanisavljevic, M Zdravkovic
Objectives To investigate a possible relationship between cerebrovascular, such as stroke and transient ischaemic attack, and various cutaneous manifestations (livedo reticularis, skin ulcerations, pseudovasculitis lesions, superficial cutaneous necrosis and digital gangrene) in antiphospholipid syndrome (APS). This report is based on a Serbian cohort of APS patients. Methods A total of 508 antiphospholipid syndrome APS patients were assessed: 360 with primary (PAPS) and 148 with APS associated with SLE (SAPS)...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29282702/treatment-of-dizziness-an-interdisciplinary-update
#3
Rainer Spiegel, Heiko Rust, Thomas Baumann, Hergen Friedrich, Raoul Sutter, Martina Göldlin, Christiane Rosin, René Müri, Georgios Mantokoudis, Roland Bingisser, Michael Strupp, Roger Kalla
This review provides an update on interdisciplinary treatment for dizziness. Dizziness can have various causes and the treatment offered should depend on the cause. After reading this article, the clinician will have an overview of current treatment recommendations. Recommendations are made for the most prevalent causes of dizziness including acute and chronic vestibular syndromes, vestibular neuritis, benign paroxysmal positional vertigo, endolymphatic hydrops and Menière's disease, vestibular paroxysmia and vestibular migraine, cardiac causes, transient ischaemic attacks and strokes, episodic ataxia type 2, persistent postural-perceptual dizziness, bilateral vestibulopathy, degenerative, autoimmune and neoplastic diseases, upbeat- and downbeat nystagmus...
December 28, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29279254/factors-related-to-immediate-response-to-symptoms-in-patients-with-stroke-or-transient-ischaemic-attack
#4
R García Ruiz, J Silva Fernández, R M García Ruiz, M Recio Bermejo, Á Arias Arias, A Santos Pinto, A Lomas Meneses, E Botía Paniagua, J Abellán Alemán
INTRODUCTION: Despite recent advances in the management of acute stroke, fewer than 10% of patients receive reperfusion therapy. One of the main reasons for such a low rate of administration is the delay on the part of patients and their families in seeking medical attention. This study aimed to analyse this delay. METHODS: A prospective observational study was conducted on consecutive stroke or transient ischaemic attack. Data on sociodemographic and clinical parameters, decision delay, pre-hospital delay, and first medical contact were collected...
December 23, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/29277524/stroke-and-cannabis-use-in-patients-with-no-cardiovascular-risk-factors-a-systematic-review-of-case-reports
#5
S A Gómez Ochoa
INTRODUCTION: Cannabis and its synthetic analogues are currently the most widely consumed illicit substances worldwide. Multiple alterations have been linked to its use, including cerebrovascular disease (CVD) or stroke, whose association with the substance has been based mainly on the hypothesis of transient vasoconstriction, which explains a large proportion of the cases reported. However, epidemiological studies have not performed an individual analysis of patients without other cardiovascular risk factors, which may limit the estimation of the risk of stroke associated with cannabis use alone...
December 22, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/29277523/association-between-self-perceived-psychological-stress-and-transitory-ischaemic-attack-and-minor-stroke-a-case-control-study
#6
J M Ramírez-Moreno, P Muñoz Vega, S Espada, S Bartolomé Alberca, J Aguirre, D Peral
INTRODUCTION: Stroke has a complex aetiopathogenesis influenced by numerous risk factors. There is growing interest in the study of the pathophysiological changes associated with stress and their potential relationship with cerebrovascular disease. The purpose of this paper is to assess the strength of association between exposure to stress and stroke. METHODS: We conducted a case-control study (1:1) to compare exposure to stress in a group of patients with a history of a first transient ischaemic attack (TIA) or minor stroke and in a control group...
December 22, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/29274727/antiplatelet-therapy-with-aspirin-clopidogrel-and-dipyridamole-versus-clopidogrel-alone-or-aspirin-and-dipyridamole-in-patients-with-acute-cerebral-ischaemia-tardis-a-randomised-open-label-phase-3-superiority-trial
#7
Philip M Bath, Lisa J Woodhouse, Jason P Appleton, Maia Beridze, Hanne Christensen, Robert A Dineen, Lelia Duley, Timothy J England, Katie Flaherty, Diane Havard, Stan Heptinstall, Marilyn James, Kailash Krishnan, Hugh S Markus, Alan A Montgomery, Stuart J Pocock, Marc Randall, Annemarei Ranta, Thompson G Robinson, Polly Scutt, Graham S Venables, Nikola Sprigg
BACKGROUND: Intensive antiplatelet therapy with three agents might be more effective than guideline treatment for preventing recurrent events in patients with acute cerebral ischaemia. We aimed to compare the safety and efficacy of intensive antiplatelet therapy (combined aspirin, clopidogrel, and dipyridamole) with that of guideline-based antiplatelet therapy. METHODS: We did an international, prospective, randomised, open-label, blinded-endpoint trial in adult participants with ischaemic stroke or transient ischaemic attack (TIA) within 48 h of onset...
December 20, 2017: Lancet
https://www.readbyqxmd.com/read/29260427/efficacy-and-safety-of-dabigatran-in-patients-with-atrial-fibrillation-scheduled-for-transoesophageal-echocardiogram-guided-direct-electrical-current-cardioversion-a-prospective-propensity-score-matched-cohort-study
#8
Vincenzo Russo, Anna Rago, Andrea Antonio Papa, Antonio D'Onofrio, Paolo Golino, Gerardo Nigro
Patients with atrial fibrillation (AF) are predisposed to a hypercoagulable state and are at an increased risk for thromboembolic events when undergoing procedures. This study investigated the long-term efficacy and safety of newly initiated anticoagulation with dabigatran versus uninterrupted vitamin K antagonist (VKA) therapy in patients with AF scheduled for transesophageal echocardiogram (TEE)-guided direct electrical current cardioversion (DCC). Consecutive adult patients with persistent AF scheduled to undergo DCC were included in the study...
December 19, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29249611/actinic-keratosis-and-diabetes-complications-a-nationwide-population-based-study-in-south-korea-2009-2015
#9
Y Bok Lee, J Hyun Lee, J Young Choi, D Soo Yu, K Do Han, Y Gyu Park
AIM: As the associations between actinic keratosis (AK) and diabetes complications in patients with diabetes mellitus (DM) have never been investigated, this study aimed to evaluate any such associations in patients with DM. METHODS: This retrospective cohort study analyzed clinical data for DM patients aged>40 years who had undergone the health examination recommended by the South Korea National Health Insurance Program between 2009 and 2012 (n=2,056,580). All of these patients were classified according to the presence of diabetic retinopathy (DR), end-stage renal disease (ESRD) and history of DVD; myocardial infarction, stroke, transient ischaemic attacks...
November 29, 2017: Diabetes & Metabolism
https://www.readbyqxmd.com/read/29244081/atrial-fibrillation-type-matters-greater-infarct-volume-and-worse-neurological-defects-seen-in-acute-cardiogenic-cerebral-embolism-due-to-persistent-or-permanent-rather-than-paroxysmal-atrial-fibrillation
#10
Osamu Inaba, Yasuteru Yamauchi, Masahiro Sekigawa, Naoyuki Miwa, Junji Yamaguchi, Yasutoshi Nagata, Toru Obayashi, Takamichi Miyamoto, Tomoyuki Kamata, Mitsuaki Isobe, Masahiko Goya, Kenzo Hirao
Aims: Some studies have shown that the type of atrial fibrillation (AF), whether paroxysmal AF (PAF) or persistent or permanent AF (PeAF), affects the incidence of ischaemic stroke. This study sought to determine the relationship between the AF pattern and the severity and brain volume of infarction in an AF population including transient ischaemic attack (TIA) patients. Methods and results: This was a retrospective observational study. We studied 161 consecutive patients who were admitted to our stroke care unit with cardiogenic embolism or TIA related to non-valvular AF (age 79 ± 9...
December 12, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29235436/bioprosthetic-aortic-valve-leaflet-thrombosis-detected-by-multidetector-computed-tomography-is-associated-with-adverse-cerebrovascular-events-a-meta-analysis-of-observational-studies
#11
Hashrul N Rashid, Robert P Gooley, Nitesh Nerlekar, Abdul R Ihdayhid, Liam M McCormick, Arthur Nasis, James D Cameron, Adam J Brown
AIMS: Leaflet thrombosis (LT) has become increasingly recognised following transcatheter and surgical aortic ABV replacement and can be reliably identified by MDCT. However, it is ongoing debate whether MDCT-defined LT is associated with adverse cerebrovascular outcomes. We performed a systematic review and meta-analysis to assess the incidence and clinical outcomes associated with multidetector computed tomography (MDCT)-defined leaflet thrombosis following aortic bioprosthetic valve (ABV) replacement...
December 12, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29233087/stroke-prevention-rehabilitation-intervention-trial-of-exercise-sprite-a-randomised-feasibility-study
#12
Neil Heron, Frank Kee, Jonathan Mant, Philip M Reilly, Margaret Cupples, Mark Tully, Michael Donnelly
BACKGROUND: The value of cardiac rehabilitation (CR) after a transient ischaemic attack (TIA) or minor stroke is untested despite these conditions sharing similar pathology and risk factors to coronary heart disease. We aimed to evaluate the feasibility of conducting a trial of an adapted home-based CR programme, 'The Healthy Brain Rehabilitation Manual', for patients following a TIA/minor stroke, participants' views on the intervention and, to identify the behaviour change techniques (BCTs) used...
December 12, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29218612/transoesophageal-echocardiography-prior-to-catheter-ablation-could-be-avoided-in-atrial-fibrillation-patients-with-a-low-risk-of-stroke-and-without-filling-defects-in-the-late-phase-mdct-scan-a-retrospective-analysis-of-783-patients
#13
Zhengqin Zhai, Min Tang, Shu Zhang, Pihua Fang, Yuhe Jia, Tianjie Feng, Jiande Wang
OBJECTIVES: To test whether multidetector computed tomography (MDCT) could completely replace transoesophageal echocardiography (TEE) to detect left atrial appendage (LAA) thrombi in atrial fibrillation (AF) patients using a large sample size. METHODS: 783 patients with AF who underwent MDCT and TEE before catheter ablation were retrospectively included. Demographic data were obtained. Two radiologists blinded to clinical data made the imaging diagnosis. RESULTS: Most of the patients (96...
December 7, 2017: European Radiology
https://www.readbyqxmd.com/read/29205297/meta-analysis-of-the-procedural-risks-of-carotid-endarterectomy-and-carotid-artery-stenting-over-time
#14
REVIEW
K Lokuge, D D de Waard, A Halliday, A Gray, R Bulbulia, B Mihaylova
BACKGROUND: Stroke/death rates within 30 days of carotid endarterectomy (CEA) and carotid artery stenting (CAS) in RCTs inform current clinical guidelines. However, the risks may have changed in recent years with wider use of effective stroke prevention therapies, especially statins, improved patient selection and growing operator expertise. The aim of this study was to investigate whether the procedural stroke/death risks from CEA and CAS have changed over time. METHODS: MEDLINE and Embase were searched systematically from inception to May 2016 for observational cohort studies of CEA and CAS...
December 4, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/29197071/peroxisome-proliferator-activated-receptor-gamma-agonists-for-preventing-recurrent-stroke-and-other-vascular-events-in-people-with-stroke-or-transient-ischaemic-attack
#15
REVIEW
Jia Liu, Lu-Ning Wang
BACKGROUND: Peroxisome proliferator-activated receptor gamma (PPAR-γ) agonists are insulin-sensitising drugs used for the treatment of insulin resistance. In addition to lowering glucose in diabetes, these drugs may also protect against hyperlipidaemia and arteriosclerosis, which are risk factors for stroke. This is an update of a review first published in January 2014 and subsequently updated in October 2015. OBJECTIVES: To assess the efficacy and safety of PPAR-γ agonists in the secondary prevention of stroke and related vascular events for people with stroke or transient ischaemic attack (TIA)...
December 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29185347/hyperglycaemia-and-the-soar-stroke-score-in-predicting-mortality
#16
Stephen J McCall, Turkiah A Alanazi, Allan B Clark, Stanley D Musgrave, Joao H Bettencourt-Silva, Max O Bachmann, Anthony K Metcalf, Kristian M Bowles, Mamas A Mamas, John F Potter, Phyo K Myint
BACKGROUND: We assessed the association between admission blood glucose levels and acute stroke mortality and examined whether there was any incremental value of adding glucose status to the validated acute stroke mortality predictor - the SOAR (stroke subtype, Oxford Community Stroke Project classification, age, and pre-stroke modified Rankin) score. METHODS: Data from Norfolk and Norwich University Hospital stroke and Transient Ischaemic Attack register (2003-2013) and Anglia Stroke Clinical Network Evaluation Study (2009-2012) were analysed...
November 1, 2017: Diabetes & Vascular Disease Research
https://www.readbyqxmd.com/read/29183926/protocol-for-a-feasibility-randomised-controlled-trial-of-screening-and-enhanced-risk-management-for-vascular-event-related-decline-in-memory-served-memory
#17
Phyo Kyaw Myint, Yoon K Loke, William Davison, Katharina Mattishent, George Christopher Fox, Robert Fleetcroft, David Turner, Lee Shepstone, John F Potter
INTRODUCTION: Stroke is a leading cause of death and disability. The development of dementia after stroke is common. Vascular risk factors (VRF) which contribute to stroke risk can also contribute to cognitive decline, especially in vascular dementia (VaD). There is no established treatment for VaD, therefore strategies for prevention could have major health resource implications. This study was designed to assess whether patients with early cognitive decline after stroke/transient ischaemic attack (TIA) can be easily identified and whether target-driven VRF management can prevent progression to dementia...
November 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/29175888/when-has-service-provision-for-transient-ischaemic-attack-improved-enough-a-discrete-event-simulation-economic-modelling-study
#18
Pelham Barton, James P Sheppard, Cristina M Penaloza-Ramos, Sue Jowett, Gary A Ford, Daniel Lasserson, Jonathan Mant, Ruth M Mellor, Tom Quinn, Peter M Rothwell, David Sandler, Don Sims, Richard J McManus
OBJECTIVES: The aim of this study was to examine the impact of transient ischaemic attack (TIA) service modification in two hospitals on costs and clinical outcomes. DESIGN: Discrete event simulation model using data from routine electronic health records from 2011. PARTICIPANTS: Patients with suspected TIA were followed from symptom onset to presentation, referral to specialist clinics, treatment and subsequent stroke. INTERVENTIONS: Included existing versus previous (less same day clinics) and hypothetical service reconfiguration (7-day service with less availability of clinics per day)...
November 25, 2017: BMJ Open
https://www.readbyqxmd.com/read/29158247/predictive-values-of-referrals-for-transient-ischaemic-attack-from-first-contact-health-care-a-systematic-review
#19
Rebecca Kandiyali, Daniel S Lasserson, Penny Whiting, Alison Richards, Jonathan Mant
BACKGROUND: Over 150 000 cases of suspected transient ischaemic attack (TIA) are referred to outpatient clinics in England each year. The majority of referrals are made by GPs. AIM: This study aimed to identify how many patients referred to a TIA clinic actually have TIA (that is, calculate the positive predictive value [PPV] of first-contact healthcare referral) and to record the alternative diagnoses in patients without TIA, in order to determine the optimal service model for patients with suspected TIA...
November 20, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29148156/long-term-outcomes-for-different-surgical-strategies-to-treat-left-ventricular-outflow-tract-obstruction-in-hypertrophic-cardiomyopathy
#20
Richard Collis, Oliver Watkinson, Constantinos O'Mahony, Oliver P Guttmann, Antonis Pantazis, Maria Tome-Esteban, Victor Tsang, Venkatachalam Chandrasekaran, Christopher G A McGregor, Perry M Elliott
AIMS: Surgical intervention is used to treat dynamic left ventricular outflow tract obstruction (LVOTO) in hypertrophic cardiomyopathy. This study assesses the effect of different surgical strategies on long-term mortality and morbidity. METHODS AND RESULTS: In total, 347 patients underwent surgical intervention for LVOTO (1988-2015). Group A (n = 272) underwent septal myectomy; Group B (n = 33), septal myectomy and mitral valve (MV) repair; Group C (n = 22), myectomy and MV replacement; and Group D (n = 20), MV replacement alone...
November 16, 2017: European Journal of Heart Failure
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