Background and purpose
Recently, brain and vascular imaging have been added to clinical variables to identify patients with transient ischaemic attack (
TIA
) with a high risk of stroke recurrence. ...The aim of our study was to externally validate the
ABCD
3‐I score and the same score taking into account intracranial circulation.
Methods
We analyzed data from 1137 patients with
TIA
from the
PROMAPA
study who underwent diffusion‐weighted magnetic resonance imaging (
DWI
) within 7 days of symptom onset. Clinical variables and diagnostic work‐up were recorded prospectively. The end‐points were subsequent stroke at 7 and 90 days follow‐up.
Results
A total of 463 (40.7%) subjects fulfilled all inclusion criteria. During follow‐up, eight patients (1.7%) had a stroke within 7 days, and 14 (3.1%) had a stroke within 3 months. In the Cox proportional hazard multivariate analyses, the combination of large‐artery atherosclerosis and positive
DWI
remained as independent predictors of stroke recurrence at 7‐ and 90‐day follow‐up
HR
8.23, 95% confidence interval (
CI
) 2.89–23.46,
P
< 0.001. The
ABCD
3‐I score was a powerful predictor of subsequent stroke. The area under the receiver operating characteristic curve was 0.83 (95%
CI
0.72–0.93) at 7 days and 0.69 (95%
CI
0.53–0.85) at 90 days. When we include intracranial vessel disease in the score, the area under the curve increases but the difference observed was non‐significant.
Conclusion
The inclusion of vascular and neuroimaging information to clinical scales (
ABCD
3‐I score) provides important prognostic information and also helps management decisions, although it cannot give a complete distinction between high‐risk and low‐risk groups.
Cardiovascular disease in CKD van den Broek, J. S.; Hoekstra, T.; Drechsler, C. ...
Nephrology, dialysis, transplantation,
05/2013, Letnik:
28, Številka:
suppl 1
Journal Article
Lateral internal sphincterotomy (LIS) can cause fecal incontinence. The aim of this study was to evaluate this sequelae after long-term follow-up of patients treated by LIS and to identify possible ...associated factors.
Data were retrospectively collected for patients with chronic anal fissure who had LIS between 1994 and 1997. Continence was assessed according to the incontinence score (IS) obtained by medical record review and telephone questionnaire. Statistical analysis was performed using by Student's t test for qualitative variables and chi-square test for qualitative variables.
All 68 patients evaluated had healed after fissure surgery. None of these patients had preoperative fecal incontinence neither recurrence at the time of follow-up. At a mean follow-up of 66.6 months (range, 30-84 months), 7 patients (10.2%) were incontinent (mean IS=8.2; range, 5-16) and none had recovered continence at the time of follow-up. There was no significant difference between patients with and without fecal incontinence relative to gender age, hemorrhoidectomy combined with LIS, or vaginal delivery.
Incontinence due to LIS does not recover after long-term follow-up and appears to be an independent cause of fecal incontinence.
Cancer is the second cause of death in developed countries. Many efforts to educate the public to more tumor free life-style and screening practice have been therefore adopted. Considering the high ...costs of diagnostic procedures and educational programs a cancer prevention/screening practice monitoring system is required to reduce costs, to assist health making policy decisions, and to tailor more targeted interventions whenever indicated. We, therefore, realized a computerized data-base able to assist medical personnel in health intervention monitoring and making policy at community level with a focus on the European region. An international medical board provided the translation of medical-related contents in English, French, German, Greek, Italian, Rumanian, Spanish and Turkish. The electronic system recognizes and finds relationships between screening events or secondary prevention tests and various causes of medical examinations (symptoms, diseases, professions, presence and type of health insurance, sex, age, medical history, family history, educational level, knowledge about cancer screening and prevention, patient location, type of community, region of provenance, etc). Due to its multi-language standardized characteristics its application may bridge European countries in cancer screening monitoring policy.
This report contains a description of the cellular localization and kinetics of proinflammatory cytokine expression in murine CIA, a model for rheumatoid arthritis. Tissue cryostat sections of ...undecalcified paws from type II collagen‐immunized DBA/1 mice, taken 1–10 days after the onset of clinical arthritis, were examined for the presence of tumour necrosis factor‐alpha (TNF‐α), IL‐1β and IL‐6 using an indirect immunoperoxidase technique. In parallel, interferon‐gamma (IFN‐γ) production by lymph node cells, stimulated in vitro with type II collagen, was assessed as a marker of T cell activity. The main areas of TNF‐α, IL‐1β and IL‐6 expression were in the synovial lining layer and in tissue contiguous with cartilage and bone (the marginal zone), in particular at sites of pannus formation and joint erosion. There was a progressive increase in the number of TNF‐α‐, IL‐1β‐ and IL‐6‐positive cells from day 1 to day 10 of arthritis, during which time IFN‐γ production by CD4+ T cells from draining lymph nodes declined sharply. A further finding of potential significance was that TNF‐α was consistently detected at day 1 of arthritis, whereas IL‐1β‐positive cells were not found until day 3, suggesting that the expression of TNF‐α precedes that of IL‐1β.
The immunosuppressive function of regulatory B cells has been shown in several murine models of chronic inflammation, including collagen-induced arthritis, inflammatory bowel disease, and ...experimental autoimmune encephalomyelitis. Despite interest in these cells, their relevance to the maintenance of peripheral tolerance in humans remains elusive. Here, we demonstrate that human CD19 super(+)CD24 super(hi)CD38 super(hi) B cells possessed regulatory capacity. After CD40 stimulation, CD19 super(+)CD24 super(hi)CD38 super(hi) B cells suppressed the differentiation of T helper 1 cells, partially via the provision of interleukin-10 (IL-10), but not transforming growth factor- beta (TGF- beta ), and their suppressive capacity was reversed by the addition of CD80 and CD86 mAbs. In addition, CD19 super(+)CD24 super(hi)CD38 super(hi) SLE B cells isolated from the peripheral blood of systemic lupus erythematosus (SLE) patients were refractory to further CD40 stimulation, produced less IL-10, and lacked the suppressive capacity of their healthy counterparts. Altered cellular function within this compartment may impact effector immune responses in SLE and other autoimmune disorders.
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