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Hiroya Takafuji, Tetsuya Kobayashi, Nahoko Kato, Kotaro Obunai
Familial cryptogenic stroke associated with atrial septal defect and patent foramen ovale is rare. The presence of a family history of cryptogenic stroke may lead to the requirement for careful follow-up for younger family members.
May 2024: Clinical Case Reports
#2
Wajeeh Ur Rehman, Eeman Ahmad, Arsalan Nadeem, Shahzaib Ahmed, Imam Ali Shah
This case report delves into the intricate diagnostic journey of a 42-year-old male presenting with jaundice, abdominal distension, and ascites, where medical imaging, including CT scans and ultrasound, played a central role. Noteworthy radiological findings, such as irregular nodular margins and caudate lobe hypertrophy, illuminated the distinctive pathophysiology of cryptogenic cirrhosis. The study underscores the pivotal role of medical imaging in elucidating complex liver pathologies, emphasizing the relevance of radiological approaches in diagnosing cryptogenic cirrhosis and guiding comprehensive management strategies...
July 2024: Radiology Case Reports
#3
JOURNAL ARTICLE
Juan Sempere-Valverde, Pablo Saenz-Arias, Anastasiia Martynova, Ons Benzarti, Ramla Bouhlel, Carlos María López Fe de la Cuadra, José Manuel Guerra-García, Sahar Chebaane
Plastic debris is a significant and rapidly developing ecological issue in coastal marine ecosystems, especially in areas where it accumulates. This study introduces "plasticlusters", a new form of floating debris agglomeration found in the Yasmine Hammamet marina (Tunisia, North-Africa), loosely attached to pontoon ropes around the water surface level. The analysis of two samples revealed that they were formed primarily by average 2.11 mm polystyrene fragments, 3.43 mm fibers, 104 mm polypropylene and polyethylene sheets, and 122 mm decomposing seagrass leaves...
April 26, 2024: Marine Pollution Bulletin
#4
JOURNAL ARTICLE
Florencio J D M Machado, Juan Marta-Enguita, Susan U Gómez, Jose A Rodriguez, José Antonio Páramo-Fernández, María Herrera, Beatriz Zandio, Nuria Aymerich, Roberto Muñoz, Rebeca Bermejo, Javier Marta-Moreno, Begoña López, Arantxa González, Carmen Roncal, Josune Orbe
Accurate etiologic diagnosis provides an appropriate secondary prevention and better prognosis in ischemic stroke (IS) patients; still, 45% of IS are cryptogenic, urging us to enhance diagnostic precision. We have studied the transcriptomic content of plasma extracellular vesicles (EVs) ( n = 21) to identify potential biomarkers of IS etiologies. The proteins encoded by the selected genes were measured in the sera of IS patients ( n = 114) and in hypertensive patients with ( n = 78) and without atrial fibrillation (AF) ( n = 20)...
April 16, 2024: International Journal of Molecular Sciences
#5
Cryptogenic Stroke Complicated by Infective Endocarditis: Exploring the Multidisciplinary Interplay.
Ameer Khan, Faisal Hanif, Amina Arif, Fawzhiah T Haque, Sean Donnelly
Infective endocarditis (IE) poses a significant clinical challenge due to its non-specific symptoms and variety of complications. Complications can include ischaemic stroke, valve dysfunction, discitis, and osteomyelitis, highlighting the complexity of IE management. We present a case of a male in his 40s, admitted with an ischaemic stroke, eventually being found to have underlying IE with a plethora of complications. This case highlights the importance of collaboration among specialists to form a multidisciplinary team, which is essential for the effective delivery of care...
April 2024: Curēus
#6
JOURNAL ARTICLE
Yumiko Nakamura, Masayuki Ueda, Satoshi Kodama, Tomohiko Kimura, Yuichiro Shirota, Masashi Hamada, Hiroyuki Ishiura, Takahiro Iizuka, Tatsushi Toda
A 35-year-old woman with no prior history of epilepsy developed status epilepticus (SE), which was highly resistant to multiple antiseizure medications and sedatives. The etiology of SE was not identified despite extensive investigation, and the patient was diagnosed with cryptogenic new-onset refractory status epilepticus (C-NORSE). Although first-line immunotherapies such as high-dose corticosteroids and plasma exchange were ineffective, the patient manifested a resolution of SE after the administration of tocilizumab, which inhibits interleukin-6...
April 23, 2024: Internal Medicine
#7
JOURNAL ARTICLE
Dominik Paugsch, Margret Dabrowski
Ischaemic stroke results from a sudden interruption of cerebral blood flow, often caused by thrombosis, embolism or hypoperfusion. Rarely, cardiac tumours are the cause of an embolic event. We report on an 80-year-old woman with a cerebral stroke. Successful thrombectomy revealed a histopathologically confirmed papillary fibroelastoma as the embolic source. Although it was not detectable on initial echocardiography, the tumour was discovered by transesophageal echocardiography. This case emphasises the importance of considering primary cardiac tumours as potential sources of emboli in ischaemic stroke...
March 2024: Praxis
#8
JOURNAL ARTICLE
Patrick A Twohig, Thoetchai Bee Peeraphatdit, Kaeli Samson, Makayla Schissel, Lynette Smith, Allison Ashford, Laura Freese, Timothy McCashland
BACKGROUND: Over 50% of hospitalizations from hepatic encephalopathy (HE) are preventable, but patients often do not receive medical treatment. AIMS: To use a multimodal education intervention (MMEI) to increase HE treatment rates and to evaluate (1) trends in HE treatment, (2) predictors of receiving treatment, and (3) the impact of treatment on hospitalization outcomes. METHODS: Prospective single-center cohort study of patients hospitalized with HE from April 1, 2020-September 30, 2022...
April 23, 2024: Digestive Diseases and Sciences
#9
REVIEW
Jiayu Xiao, Roy A Poblete, Alexander Lerner, Peggy L Nguyen, Jae W Song, Nerses Sanossian, Alison G Wilcox, Shlee S Song, Patrick D Lyden, Jeffrey L Saver, Bruce A Wasserman, Zhaoyang Fan
Cryptogenic stroke refers to a stroke of undetermined etiology. It accounts for approximately one-fifth of ischemic strokes and has a higher prevalence in younger patients. Embolic stroke of undetermined source (ESUS) refers to a subgroup of patients with nonlacunar cryptogenic strokes in whom embolism is the suspected stroke mechanism. Under the classifications of cryptogenic stroke or ESUS, there is wide heterogeneity in possible stroke mechanisms. In the absence of a confirmed stroke etiology, there is no established treatment for secondary prevention of stroke in patients experiencing cryptogenic stroke or ESUS, despite several clinical trials, leaving physicians with a clinical dilemma...
April 2024: Radiology
#10
JOURNAL ARTICLE
Sarah J Flynn, Varun Saxena, Danielle Brandman
OBJECTIVES: Patients with pre-transplant metabolic dysfunction-associated steatohepatitis (MASH) are at high risk of metabolic syndrome (MetS) after liver transplant. While many patients are co-managed by a transplant team, most preventative screening and MetS management may occur in the primary care setting. We aimed to evaluate primary care utilization by MASH liver transplant recipients as well as MetS screening and control. METHODS: We conducted a retrospective chart review that included adults who underwent liver transplant for MASH or cryptogenic cirrhosis at a single institution from January 2010 to December 2016, had available primary care data, and at least 36-months of follow-up post-transplant...
2024: Journal of Primary Care & Community Health
#11
JOURNAL ARTICLE
Marco B Ancona, Domitilla Gentile, Luca A Ferri, Fabrizio Monaco, Filippo Russo, Barbara Bellini, Ciro Vella, Giulia Ghizzoni, Greca Zanda, Eustachio Agricola, Giulio Truci, Luigi Beretta, Stefano Turi, Giovanni Landoni, Matteo Montorfano
Patent foramen ovale (PFO) is a remnant of normal fetal anatomy which may persist into adulthood, mostly asymptomatic. In some adults, PFO may result in a potential for shunting venous thromboembolism to the arterial circulation; less frequently it can cause interatrial, right-to-left shunting of deoxygenated blood. The pathogenesis of several medical conditions is related to the presence of PFO. Some randomized clinical trials have shown evidence of benefit for device closure as compared with medical therapy in patients with cryptogenic stroke...
May 2024: Giornale Italiano di Cardiologia
#12
JOURNAL ARTICLE
Tobias Uhe, Janina Keilitz, Jörg Berrouschot, Rolf Wachter
Background Continuous monitoring using implantable cardiac monitors (ICMs) results in atrial fibrillation (AF) detection rates of up to 30% in patients with cryptogenic stroke (CS). Although higher age is an independent risk factor for AF, there are no age-specific recommendations for the implantation of ICM. Objective The aim of this study was to analyze age-related AF rates in patients with CS and continuous rhythm monitoring, to determine the rates of oral anticoagulation (OAC) and recurrent cerebrovascular events (stroke or transient ischemic attack) in patients with ICM-detected AF, and to describe the temporal relationship of AF detection and recurrent cerebrovascular events...
April 2024: TH Open: Companion Journal to Thrombosis and Haemostasis
#13
JOURNAL ARTICLE
Hye Bin Gwag, Nak Gyeong Ko, Mihyeon Jin
BACKGROUND/AIMS: The reimbursement policy for cryptogenic stroke (CS) was expanded in November 2018 from recurrent strokes to the first stroke episode. No reports have demonstrated whether this policy change has affected trends in implantable loop recorder (ILR) utilization. METHODS: We identified patients who received an ILR implant using the Korea Health Insurance Review and Assessment Service database between July 2016 and October 2021. Patients meeting all the following criteria were considered to have CS indication: 1) prior stroke history, 2) no previous history of atrial fibrillation or flutter (AF/AFL), and 3) no maintenance of oral anticoagulant for ≥4 weeks within a year before ILR implant...
April 18, 2024: Korean Journal of Internal Medicine
#14
JOURNAL ARTICLE
Massimiliano Maines, Francesco Rotondi, Fabrizio Guarracini, Cristina Esposito, Francesco Peruzza, Paolo Vitillo, Nertil Kola, Silvia Quintarelli, Fabio Franculli, Paola Napoli, Daniele Giacopelli, Maurizio Del Greco, Emilio Di Lorenzo, Massimiliano Marini
AIMS: In this study, we investigated a cohort of unselected patients with various indications for an implantable cardiac monitor (ICM). Our main objectives were to determine the incidence of arrhythmic diagnoses, both anticipated and incidental in relation to the ICM indication, and to assess their clinical relevance. METHODS: We examined remote monitoring transmissions from patients with an ICM at four Italian sites to identify occurrences of cardiac arrhythmias...
April 9, 2024: Journal of Cardiovascular Medicine
#15
JOURNAL ARTICLE
Anthony D Jimenez, Margaret Gopaul, Hannah Asbell, Seyhmus Aydemir, Maysaa M Basha, Ayush Batra, Charlotte Damien, Gregory S Day, Onome Eka, Krista Eschbach, Safoora Fatima, Madeline C Fields, Brandon Foreman, Elizabeth E Gerard, Teneille E Gofton, Hiba A Haider, Stephen T Hantus, Sara Hocker, Amy Jongeling, Mariel Kalkach Aparicio, Padmaja Kandula, Peter Kang, Karnig Kazazian, Marissa A Kellogg, Minjee Kim, Jong Woo Lee, Lara V Marcuse, Christopher M McGraw, Wazim Mohamed, Janet Orozco, Cederic Pimentel, Vineet Punia, Alexandra M Ramirez, Claude Steriade, Aaron F Struck, Olga Taraschenko, Andrew K Treister, Ji Yeoun Yoo, Sahar Zafar, Daniel J Zhou, Deepti Zutshi, Nicolas Gaspard, Lawrence J Hirsch, Aurelie Hanin
Febrile infection-related epilepsy syndrome (FIRES) is a subset of new onset refractory status epilepticus (NORSE) that involves a febrile infection prior to the onset of the refractory status epilepticus. It is unclear whether FIRES and non-FIRES NORSE are distinct conditions. Here, we compare 34 patients with FIRES to 30 patients with non-FIRES NORSE for demographics, clinical features, neuroimaging, and outcomes. Because patients with FIRES were younger than patients with non-FIRES NORSE (median = 28 vs...
April 16, 2024: Epilepsia
#16
JOURNAL ARTICLE
J Leskelä, J Putaala, N Martinez-Majander, L Tulkki, M Manzoor, S Zaric, P Ylikotila, R Lautamäki, A Saraste, S Suihko, E Könönen, J Sinisalo, P J Pussinen, S Paju
Periodontitis is associated with an increased risk of ischemic stroke, and the risk may be particularly high among young people with unexplained stroke etiology. Thus, we investigated in a case-control study whether periodontitis or recent invasive dental treatments are associated with young-onset cryptogenic ischemic stroke (CIS). We enrolled participants from a multicenter case-control SECRETO study including adults aged 18 to 49 y presenting with an imaging-positive first-ever CIS and stroke-free age- and sex-matched controls...
April 16, 2024: Journal of Dental Research
#17
JOURNAL ARTICLE
Kei Kaburagi, Yuta Hagiwara, Keiji Tachikawa, Noriko Miyake, Hisanao Akiyama, Yosuke Kawai, Yosuke Omae, Katsushi Tokunaga, Yoshihisa Yamano, Takahiro Shimizu, Satomi Mitsuhashi
BACKGROUND: Ischemic stroke in young adults can be caused by a variety of etiologies including the monogenic disorders. Visceral heterotaxy is a condition caused by abnormal left-right determinations during embryonic development. We aimed to determine the cause of a young ischemic stroke patient with visceral heterotaxy. CASE PRESENTATION: We performed neurological, radiological, and genetic evaluations in a 17-year-old male patient presenting ischemic stroke and visceral heterotaxy to determine the underlying cause of this rare disease combination...
April 11, 2024: BMC Neurology
#18
JOURNAL ARTICLE
Vincent Norlock, Reynaldo Vazquez, Alexandria Dunn, Christian Siegfried, Manish Wadhwa, Goran Medic
Aim: Patients with ischemic stroke (IS) commonly undergo monitoring to identify atrial fibrillation with mobile cardiac outpatient telemetry (MCOT) or implantable loop recorders (ILRs). The authors compared readmission, healthcare cost and survival in patients monitored post-stroke with either MCOT or ILR. Materials & methods: The authors used claims data from Optum's de-identified Clinformatics® Data Mart Database to identify patients with IS hospitalized from January 2017 to December 2020 who were prescribed ambulatory cardiac monitoring via MCOT or ILR...
April 11, 2024: Journal of Comparative Effectiveness Research
#19
Louis Deprez, Gauthier Kempinaire, Félicie Lorthioir, Martin Moïse
Carotid artery atherosclerosis is one of the leading causes of stroke. Even though the association between the risk of stroke and the level of morphological stenosis of a carotid plaque has been known for a long time, growing evidence has since proven necessary to assess the composition of the plaque itself to identify vulnerability predictors. These vulnerable plaques, even more if non-stenosing, may be responsible for a significant - but hard to quantify - proportion of strokes so far classified cryptogenic...
April 2024: Revue Médicale de Liège
#20
JOURNAL ARTICLE
Hee Jun Park, Sunyoung Lee, Jae Seung Lee
PURPOSE: International expert panels proposed new nomenclatures, metabolic dysfunction-associated fatty liver disease (MAFLD) in 2020 and metabolic dysfunction-associated steatotic liver disease (MASLD) in 2023, along with revised diagnostic criteria to replace non-alcoholic fatty liver disease (NAFLD). We aimed to investigate the differences in NAFLD, MAFLD, and MASLD prevalence with changing nomenclature in a health check-up using magnetic resonance imaging-derived proton density fat fraction (MRI-PDFF) to assess hepatic steatosis...
April 8, 2024: Abdominal Radiology
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