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https://www.readbyqxmd.com/read/29321107/can-i-send-this-patient-with-stroke-home-strategies-managing-transient-ischemic-attack-and-minor-stroke-in-the-emergency-department
#1
Bernard P Chang, Sara Rostanski, Joshua Willey, Benjamin Kummer, Eliza Miller, Mitchell Elkind
BACKGROUND: While transient ischemic attack and minor stroke (TIAMS) are common conditions evaluated in the emergency department (ED), there is controversy regarding the most effective and efficient strategies for managing them in the ED. Some patients are discharged after evaluation in the ED and cared for in the outpatient setting, while others remain in an observation unit without being admitted or discharged, and others experience prolonged and potentially costly inpatient admissions...
January 8, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29251055/validation-of-a-multivariate-clinical-prediction-model-for-the-diagnosis-of-mild-stroke-transient-ischemic-attack-in-physician-first-contact-patient-settings
#2
Maximilian B Bibok, Andrew M Penn, Mary L Lesperance, Kristine Votova, Robert Balshaw
We validate our previously developed (DOI: 10.1101/089227) clinical prediction rule for diagnosing transient ischemic attack on the basis of presenting clinical symptoms and compare its performance with the ABCD2 score in first-contact patient settings. Two independent and prospectively collected patient validation cohorts were used: (a) referral cohort-prospectively referred emergency department and general practitioner patients ( N = 877); and (b) SpecTRA cohort-participants recruited as part of the SpecTRA biomarker project ( N = 545)...
December 1, 2017: Health Informatics Journal
https://www.readbyqxmd.com/read/29212745/factors-associated-with-focal-computed-tomographic-perfusion-abnormalities-in-supratentorial-transient-ischemic-attacks
#3
Ivo A Meyer, Carlo W Cereda, Pamela N Correia, Jean-Baptiste Zerlauth, Francesco Puccinelli, David C Rotzinger, Michael Amiguet, Philippe Maeder, Reto A Meuli, Patrik Michel
BACKGROUND AND PURPOSE: Computed tomographic perfusion (CTP) is useful in diagnosis of patients with transient focal neurological symptoms. In acute imaging of patients with a suspected transient ischemic attack (TIA), it remains unclear which patients develop focal perfusion abnormalities (FPA), that is, hypoperfusion or hyperperfusion. We aimed at determining independent factors associated with FPA in patients with supratentorial TIAs. METHODS: We prospectively collected consecutive patients with supratentorial TIAs defined by the traditional time-based definition who underwent CTP within 24 hours of symptom onset...
December 6, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29175888/when-has-service-provision-for-transient-ischaemic-attack-improved-enough-a-discrete-event-simulation-economic-modelling-study
#4
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/29145195/contemporary-epidemiology-of-transient-ischemic-attack-in-dijon-france-2013-2015
#5
Yannick Béjot, Céline Brenière, Mathilde Graber, Lucie Garnier, Jérôme Durier, Christelle Blanc-Labarre, Benoit Delpont, Maurice Giroud
BACKGROUND: We aimed to evaluate the epidemiological features of transient ischemic attack (TIA). METHODS: All TIAs were prospectively collected in Dijon, France, using a population-based registry (2013-2015). TIAs were considered the first-ever in patients who had no previous cerebrovascular events (CVEs); otherwise they were considered recurrent TIAs. Annual incidence (first-ever TIAs) and attack rates (first-ever and recurrent TIAs) were calculated. RESULTS: Four hundred twenty TIAs were registered (255 first-ever and 165 recurrent TIAs, mean age: 74...
November 16, 2017: Neuroepidemiology
https://www.readbyqxmd.com/read/29108805/stroke-risk-is-low-after-urgently-treated-transient-ischemic-attack
#6
Thea Vigen, Bente Thommessen, Ole Morten Rønning
BACKGROUND: Over the last decades, the approach to patients with transient ischemic attack (TIA) has shifted from treating only patients considered at high risk of recurrent stroke, to referring all patients with TIA to urgent assessment and immediate initiation of preventive treatment. The data on how this change has influenced the stroke rate after TIA are limited. Thus, the primary aim of this study was to identify the incidence of stroke recurrence after TIA. Second, we wanted to evaluate the ABCD2 score as a predictor of recurrent stroke...
November 3, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29053901/familial-hypercholesterolaemia-in-patients-with-ischemic-stroke-or-transient-ischemic-attack
#7
Thomas Toell, Lukas Mayer, Raimund Pechlaner, Stefan Krebs, Karin Willeit, Clemens Lang, Christian Boehme, Barbara Prantl, Michael Knoflach, Julia Ferrari, Philipp Fuchs, Wolfgang Prokop, Andrea Griesmacher, Wilfried Lang, Stefan Kiechl, Johann Willeit
BACKGROUND AND AIMS: Identification of patients with familial hypercholesterolemia (FH) is a prerequisite for the appropriate management of their excess cardiovascular risk. It is currently unknown how many patients with acute ischemic stroke or transient ischemic attack (TIA) are affected by FH and whether systematic screening for FH is warranted in these patients. METHODS: The prevalence of a clinical diagnosis of FH was estimated in a large representative series of patients with acute ischemic stroke or TIA (ABCD2 score ≥3) using the Dutch Lipid Clinic Network Algorithm (DLCNA; possible FH ≥3, probable/definite FH ≥6)...
October 20, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28940847/genetic-mapping-using-1-4m-snp-array-refined-loci-for-fatty-acid-composition-traits-in-chinese-erhualian-and-bamaxiang-pigs
#8
J Zhang, Y Zhang, H Gong, L Cui, T Huang, H Ai, J Ren, L Huang, B Yang
Chinese indigenous pigs display marked genetic and phenotypic differences compared with western commercial pigs. In this study, we tested the association between 660K SNPs and longissimus muscle fatty acid composition traits in Chinese Erhualian (n = 331) and Bamaxiang (n = 315) pigs based on a customized 1.4 million SNP array. We identified a total of 64 significant associations for 20 fatty acid composition traits at the p-value threshold of 1 × 10(-6) among which 42 associations in low linkage disequilibrium (r(2 ) < ...
September 20, 2017: Journal of Animal Breeding and Genetics, Zeitschrift Für Tierzüchtung und Züchtungsbiologie
https://www.readbyqxmd.com/read/28814097/prominent-deep-medullary-veins-a-predictive-biomarker-for-stroke-risk-from-transient-ischemic-attack
#9
Yang Duan, Zhihua Xu, Hongyi Li, Xiaonan Cai, Cancan Chang, Benqiang Yang
Background Deep medullary veins (DMVs) are a biomarker of severity and prognosis in patients with acute cerebral infarction. However, their clinical significance remains unclear in patients with transient ischemic attack (TIA). Purpose To determine whether prominent deep medullary veins (PDMVs) are a predictive biomarker for stroke risk after TIA. Material and Methods Clinical and imaging data of 49 patients with TIA and 49 sex- and age-matched controls were studied. PDMVs were defined as DMVs with a score of 3 (TDMVs) or asymmetric DMVs (ADMVs), and the relationship between PDMVs and clinical features was analyzed...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/28737695/predictive-structure-and-topology-of-peroxisomal-atp-binding-cassette-abc-transporters
#10
Pierre Andreoletti, Quentin Raas, Catherine Gondcaille, Mustapha Cherkaoui-Malki, Doriane Trompier, Stéphane Savary
The peroxisomal ATP-binding Cassette (ABC) transporters, which are called ABCD1, ABCD2 and ABCD3, are transmembrane proteins involved in the transport of various lipids that allow their degradation inside the organelle. Defective ABCD1 leads to the accumulation of very long-chain fatty acids and is associated with a complex and severe neurodegenerative disorder called X-linked adrenoleukodystrophy (X-ALD). Although the nucleotide-binding domain is highly conserved and characterized within the ABC transporters family, solid data are missing for the transmembrane domain (TMD) of ABCD proteins...
July 22, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28647418/comparison-of-stroke-prediction-accuracy-of-abcd2-and-abcd3-i-in-patients-with-transient-ischemic-attack-a-meta-analysis
#11
Meng Zhao, Shuo Wang, Dong Zhang, Yan Zhang, Xiaofeng Deng, Jizong Zhao
BACKGROUND: A direct comparison of the stroke prediction utility of the ABCD2 and ABCD3-I scores has not been performed. Thus, we conducted a diagnostic meta-analysis and applied the results to a hypothetical cohort of 1000 patients with transient ischemic attack (TIA) to assess the power of stroke prediction by ABCD2 and ABCD3-I scores. METHODS: Medline, PubMed, Embase, and manuscript references were searched to identify studies that directly compared the stroke predictive powers of ABCD2 and ABCD3-I scores...
October 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28603135/report-impact-of-drug-combination-of-clopidogrel-and-pantoprazole-in-the-prognosis-of-patients-with-transient-ischemic-attack
#12
RANDOMIZED CONTROLLED TRIAL
Min Lu
The study aimed to investigate the impact of clopidogrel combined with proton pump inhibitors (PPI) pantoprazole treatment on the prognosis of patients with transient ischemic attack (TIA). A total of 478 cases of TIA patients treated with clopidogrel were randomly assigned half to clopidogrel combined with pantoprazole treatment and the control groups (clopidogrel treatment alone) from January 2012 to January 20l4. The platelet aggregation before and after treatment and cerebrovascular events incidence within 90 days were compared and analyzed...
January 2017: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28592454/coated-platelets-predict-stroke-at-30-days-following-tia
#13
Angelia C Kirkpatrick, Andrea S Vincent, George L Dale, Calin I Prodan
OBJECTIVE: To examine the potential for coated-platelets, a subset of highly procoagulant platelets observed on dual agonist stimulation with collagen and thrombin, for predicting stroke at 30 days in patients with TIA. METHODS: Consecutive patients with TIA were enrolled and followed up prospectively. ABCD2 scores were obtained for each patient. Coated-platelet levels, reported as percent of cells converted to coated-platelets, were determined at baseline. The primary endpoint was the occurrence of stroke at 30 days...
July 11, 2017: Neurology
https://www.readbyqxmd.com/read/28506591/early-echocardiography-has-a-low-yield-in-patients-with-transient-ischemic-attack
#14
Elie Harmouche, Ghada A Mahmoud, Michael Ross, Jason Hockenberry, Robin Dharia, Fadi Nahab
STUDY OBJECTIVE: Current guidelines recommend patients presenting with transient ischemic attack (TIA) undergo echocardiography to evaluate for a cardiac source. However, echocardiography is not available daily at many centers. We assessed the yield from early transthoracic echocardiography (TTE) in consecutive patients with TIA evaluated in an emergency department observation unit (EDOU) protocol. METHODS: This observational cohort study took place in an academic medical center from January 1, 2011 to July 31, 2013...
May 11, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28500226/mr-perfusion-lesions-after-tia-or-minor-stroke-are-associated-with-new-infarction-at-7-days
#15
Jun Lee, Manabu Inoue, Michael Mlynash, Sharanpal K Mann, Carlo W Cereda, Michael Ke, Gregory W Albers, Jean M Olivot
OBJECTIVE: To investigate the relationship between acute perfusion-weighted imaging (PWI) lesions occurring within the first hours after a TIA or a minor brain infarction (BI) and the incidence of new BI detected on a systematic MRI at 1 week. METHODS: Consecutive patients who experienced a TIA or BI with a neurologic deficit that lasted <24 hours, did not receive any revascularization therapy (thrombolysis/thrombectomy), and underwent DWI/PWI at baseline and fluid-attenuated inversion recovery (FLAIR)/DWI 1 week after symptom onset were enrolled...
June 13, 2017: Neurology
https://www.readbyqxmd.com/read/28409470/flow-cytometric-analysis-of-the-expression-pattern-of-peroxisomal-proteins-abcd1-abcd2-and-abcd3-in-bv-2-murine-microglial-cells
#16
Meryam Debbabi, Thomas Nury, Imen Helali, El Mostafa Karym, Flore Geillon, Catherine Gondcaille, Doriane Trompier, Amina Najid, Sébastien Terreau, Maryem Bezine, Amira Zarrouk, Anne Vejux, Pierre Andreoletti, Mustapha Cherkaoui-Malki, Stéphane Savary, Gérard Lizard
Microglial cells play important roles in neurodegenerative diseases including peroxisomal leukodystrophies. The BV-2 murine immortalized cells are widely used in the context of neurodegenerative researches. It is therefore important to establish the expression pattern of peroxisomal proteins by flow cytometry in these cells. So, the expression pattern of various peroxisomal transporters (Abcd1, Abcd2, Abcd3) contributing to peroxisomal β-oxidation was evaluated on BV-2 cells by flow cytometry and complementary methods (fluorescence microscopy, and RT-qPCR)...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28370438/differential-activities-of-peroxisomes-along-the-mouse-intestinal-epithelium
#17
Petruta L Morvay, Myriam Baes, Paul P Van Veldhoven
The presence of peroxisomes in mammalian intestine has been revealed formerly by catalase staining combined with electron microscopy. Despite the central role of intestine in lipid uptake and the established importance of peroxisomes in different lipid-related pathways, few data are available on the physiological role of peroxisomes in intestinal metabolism, more specifically, α-, β-oxidation, and etherlipid synthesis. Hence, the peroxisomal compartment was analyzed in more detail in mouse intestine. On the basis of immunohistochemistry, the organelles are mainly confined to the epithelial cells...
April 2017: Cell Biochemistry and Function
https://www.readbyqxmd.com/read/28258215/peroxisomal-atp-binding-cassette-transporters-form-mainly-tetramers
#18
Flore Geillon, Catherine Gondcaille, Quentin Raas, Alexandre M M Dias, Delphine Pecqueur, Caroline Truntzer, Géraldine Lucchi, Patrick Ducoroy, Pierre Falson, Stéphane Savary, Doriane Trompier
ABCD1 and its homolog ABCD2 are peroxisomal ATP-binding cassette (ABC) half-transporters of fatty acyl-CoAs with both distinct and overlapping substrate specificities. Although it is established that ABC half-transporters have at least to dimerize to generate a functional unit, functional equivalents of tetramers (i.e. dimers of full-length transporters) have also been reported. However, oligomerization of peroxisomal ABCD transporters is incompletely understood but is of potential significance because more complex oligomerization might lead to differences in substrate specificity...
April 28, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28256416/the-triage-score-for-vertigo-or-dizziness-a-diagnostic-model-for-stroke-in-the-emergency-department
#19
R Kuroda, T Nakada, T Ojima, M Serizawa, N Imai, N Yagi, A Tasaki, M Aoki, T Oiwa, T Ogane, K Mochizuki, M Kobari, H Miyajima
BACKGROUND: Vertigo or dizziness is a common occurrence, but it remains a challenging symptom when encountered in the emergency department (ED). A diagnostic score for stroke with high accuracy is therefore required. METHODS: A single-center observational study (498 patients) was conducted. The predictor variables were derived from a multivariate logistic regression analysis with Akaike information criterion. The outcome was the occurrence of stroke. We evaluated the utility of a new diagnostic score (TriAGe+) and compared it with the ABCD2 score...
February 27, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28196949/referral-pathways-for-patients-with-tia-avoiding-hospital-admission-a-scoping-review
#20
Bridie Angela Evans, Khalid Ali, Jenna Bulger, Gary A Ford, Matthew Jones, Chris Moore, Alison Porter, Alan David Pryce, Tom Quinn, Anne C Seagrove, Helen Snooks, Shirley Whitman, Nigel Rees
OBJECTIVE: To identify the features and effects of a pathway for emergency assessment and referral of patients with suspected transient ischaemic attack (TIA) in order to avoid admission to hospital. DESIGN: Scoping review. DATA SOURCES: PubMed, CINAHL Web of Science, Scopus. STUDY SELECTION: Reports of primary research on referral of patients with suspected TIA directly to specialist outpatient services. DATA EXTRACTION: We screened studies for eligibility and extracted data from relevant studies...
February 14, 2017: BMJ Open
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