Intensive heart rhythm monitoring to decrease ischemic stroke and systemic embolism-the Find-AF 2 study-rationale and design.

Background: Atrial fibrillation (AF) is one of the most frequent causes of stroke. Several randomized trials have shown that prolonged monitoring increases the detection of AF, but the effect on reducing recurrent cardioembolism, ie, ischemic stroke and systemic embolism, remains unknown. We aim to evaluate whether a risk-adapted, intensified heart rhythm monitoring with consequent guideline conform treatment, which implies initiation of oral anticoagulation (OAC), leads to a reduction of recurrent cardioembolism.

Effects of the COVID-19 Pandemic on Patients With NMO Spectrum Disorders and MOG-Antibody-Associated Diseases: COPANMO(G)-Study.

Background And Objectives: To evaluate the effects of the coronavirus disease 2019 (COVID-19) pandemic on the life of patients with neuromyelitis optica spectrum disorders (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated diseases (MOGAD).

Methods: This multicenter, cross-sectional study included data of 187 patients recruited from 19 different German and Austrian Neuromyelitis Optica Study Group (NEMOS) centers between July 2021 and March 2022. The effects of the pandemic on immunotherapeutic treatment and access to care, the possible severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and the potential effect of vaccination against SARS-CoV-2 on disease incidence and relapse risk were assessed using a patient questionnaire.

[Reflex syncope-or more? : Ictal asystole!].

A 59-year-old male patient was admitted for possible reflex syncope following loss of consciousness during urination. During the visit, a malaise with unconsciousness occurred. Holter ECG at that time showed increasing sinus bradycardia with transition to a junctional escape rhythm (30/min); in addition, there were several sinus pauses > 2.

[First clinical manifestation of chronic hepatitis C in painless progressive atrophic monoparesis of the right leg].

History And Clinical Findings: A 60-year-old male patient was admitted with a painless reduction in the circumference of the right calf with mild gait disturbance that had been increasing for 6 months. Neurological findings included atrophic monoparesis of the right lower leg with preserved muscle reflexes without sensory disturbances.

Investigations: Electrophysiologically and neuroradiologically, only the right triceps surae muscle showed signs of combined acute and chronic damage and marked atrophy with diffuse muscle oedema.

First manifestation of Fabry's disease by psychotic episode associated with thalamic ischemic stroke - case report and review of literature.

Fabry's disease is a X-linked inherited multisystem disorder with deficient activity of the lysosomal enzyme α-galactosidase which neuropsychiatric manifestations comprise mainly small fiber neuropathy, cerebral microangiopathy, and depression. This report describes a patient in who psychotic symptoms were associated with a thalamic ischemic stroke and the first manifestation of Fabry's disease. Reviewing the current literature and the hitherto reported cases of psychosis in Fabry's disease, the inclusion of psychiatric exploration and screening in the routine examination of patients with Fabry's disease as well as a brain MRI on initial diagnosis of Fabry's disease should be considered.

Case series of introducing palliative care consultation in psychiatry.

Background: The significance of palliative care consultation in psychiatry is unclear.

Actual Case Series: Analysis of the introduction of palliative care consultation in a large psychiatric hospital.

Possible Courses Of Action: Continue without offering, survey the need for or offer palliative care consultation, and analyse its introduction.

Repeated early thrombolysis in cervical spinal cord ischemia.

Specific therapy of acute spinal ischemia is not established. We report the first case of an MRI-verified cervical spinal ischemia treated by thrombolysis and review the literature. A 72-year old woman with right-sided motor hemiparesis and trunk ataxia was treated by intravenous thrombolysis with full recovery.

Smoking increases the risk of delirium for older inpatients: a prospective population-based study.

Objectives: To investigate the association between smoking in the older population and the risk of inpatient delirium, which is common and has adverse consequences.

Method: Participants (N=3754) were insurants aged ≥55years of the largest German statutory health insurance company, who enrolled in a 6-year prospective population-based study. Baseline smoking, adjusted for age, sex, depressive symptoms, cognitive impairment and alcohol consumption, was analyzed as risk factor of inpatient delirium.

Kidney disease as a determinant of cognitive decline and dementia.

Chronic kidney disease (CKD) has evolved as a possible new determinant of cognitive decline and dementia. This review outlines the presumed pathophysiology of cognitive decline in CKD, which consists of traditional and new vascular risk factors as well as nonvascular risk factors and metabolic and biochemical abnormalities within the central nervous system caused by CKD. The recent major cross-sectional studies and longitudinal studies - including one meta-analysis - that mostly suggest an association of cognitive decline and CKD are discussed.

B-type natriuretic peptides help in cardioembolic stroke diagnosis: pooled data meta-analysis.

Background And Purpose: Determining the underlying cause of stroke is important to optimize secondary prevention treatment. Increased blood levels of natriuretic peptides (B-type natriuretic peptide/N-terminal pro-BNP [BNP/NT-proBNP]) have been repeatedly associated with cardioembolic stroke. Here, we evaluate their clinical value as pathogenic biomarkers for stroke through a literature systematic review and individual participants' data meta-analysis.

Inflammatory markers and extent and progression of early atherosclerosis: Meta-analysis of individual-participant-data from 20 prospective studies of the PROG-IMT collaboration.

Background: Large-scale epidemiological evidence on the role of inflammation in early atherosclerosis, assessed by carotid ultrasound, is lacking. We aimed to quantify cross-sectional and longitudinal associations of inflammatory markers with common-carotid-artery intima-media thickness (CCA-IMT) in the general population.

Methods: Information on high-sensitivity C-reactive protein, fibrinogen, leucocyte count and CCA-IMT was available in 20 prospective cohort studies of the PROG-IMT collaboration involving 49,097 participants free of pre-existing cardiovascular disease.

Suitability of the 6CIT as a screening test for dementia in primary care patients.

Objectives: To map the suitability of the Six Item Cognitive Impairment Test's (6CIT) as a screening instrument for dementia in primary care and to assess its feasibility, reliability, and validity in a real-world setting.

Method: The present study was part of a population-based prospective trial aimed at reducing the incidence of stroke and dementia. The 6CIT was administered by general practitioners (GPs) at routine examinations every two years.

B-type natriuretic peptides and mortality after stroke: a systematic review and meta-analysis.

Objective: To measure the association of B-type natriuretic peptide (BNP) and N-terminal fragment of BNP (NT-proBNP) with all-cause mortality after stroke, and to evaluate the additional predictive value of BNP/NT-proBNP over clinical information.

Methods: Suitable studies for meta-analysis were found by searching MEDLINE and EMBASE databases until October 26, 2012. Weighted mean differences measured effect size; meta-regression and publication bias were assessed.

Thrombolysis for ischemic stroke in patients with brain tumors.

Background: Thrombolysis is the most successful therapy in acute ischemic stroke. Limitations comprise strict eligibility criteria including many contraindications for thrombolysis, and in particular clinical situations lack of evidence-based data resulting in recommendations based on single experiences. Therefore, the risk-benefit effect of thrombolysis in the presence of brain tumor is unknown.

Brain size and white matter content of cerebrospinal tracts determine the upper cervical cord area: evidence from structural brain MRI.

Introduction: Measurement of the upper cervical cord area (UCCA) from brain MRI may be an effective way to quantify spinal cord involvement in neurological disorders such as multiple sclerosis. However, knowledge on the determinants of UCCA in healthy controls (HCs) is limited.

Methods: In two cohorts of 133 and 285 HCs, we studied the influence of different demographic, body-related, and brain-related parameters on UCCA by simple and partial correlation analyses as well as by voxel-based morphometry (VBM) across both cerebral gray matter (GM) and white matter (WM).

Insertable cardiac event recorder in detection of atrial fibrillation after cryptogenic stroke: an audit report.

Background And Purpose: Atrial fibrillation (AF) is the most frequent risk factor in ischemic stroke but often remains undetected. We analyzed the value of insertable cardiac event recorder in detection of AF in a 1-year cohort of patients with cryptogenic ischemic stroke.

Methods: All patients with cryptogenic stroke and eligibility for oral anticoagulation were offered the insertion of a cardiac event recorder.

Depressive symptoms and the risk of ischemic stroke in the elderly--influence of age and sex.

Although a relationship between depression and cardiovascular events has been suggested, past study results regarding the risk of stroke in relation to depression by subgroups are ambiguous. The aim of this study was to investigate the influence of depressive symptoms on risk of incident ischemic stroke in elderly according to age and sex. This prospective cohort study followed up 3852 subjects older than 55 years.