Background: The configuration of aortic plaque appears to be as important as its thickness when it acts as an embolic source to the brain. The frequency and clinical predictors of ulcerated plaque at the aortic arch identified using transoesophageal echocardiography (TOE) in patients with stroke were determined, and the association between the ulcer and recent ischaemic stroke, particularly multiple brain infarcts, which appear to indicate embolic stroke, was examined.
Methods: Aortic and cardiac embolic sources were evaluated using TOE in 360 patients with fresh ischaemic stroke proven by diffusion-weighted MRI, including 210 patients with a single infarct and 150 with multiple infarcts, as well as in 101 non-stroke control patients. An ulcer was defined as a crater on the plaque ≥2.0 mm in depth and width.
Results: An ulcerated plaque was identified in 10.6% of patients with stroke versus 2.0% of non-stroke patients, showing a 5.11-fold higher frequency in patients with stroke (95% CI 1.51 to 31.96) after adjustment for age and sex. After multivariate adjustment for clinical and ultrasonographic features, multiple-infarct patients had a 7.61-fold higher risk (95% CI 1.99 to 50.43) of having an ulcer than control patients and a 3.32-fold higher risk (95% CI 1.61 to 7.18) of having an ulcer than single-infarct patients. Diabetes mellitus and drinking habit were independently related to the presence of ulcerated plaque in patients with stroke.
Conclusions: Ulcerated plaque in the aortic arch was associated with the development of ischaemic stroke, especially multiple brain infarcts, probably involving, at least in part, an embolic mechanism.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1136/jnnp.2009.198606 | DOI Listing |
Int Med Case Rep J
January 2025
Department of Oral Medicine, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia.
Introduction: The Behçet's Disease Current Activity Form (BDCAF) is crucial for monitoring the progression and treatment efficacy of Behçet's Disease (BD), an autoimmune disorder that can be triggered or exacerbated by viral infections. Herpes simplex virus type 1 (HSV-1) has long been recognized as a potential trigger for BD, as it can induce systemic inflammation and exacerbate symptoms. In contrast, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has recently emerged and may also initiate or worsen BD symptoms.
View Article and Find Full Text PDFIDCases
December 2024
Department of Medicine, College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.
Background: Ecthyma is a deeper form of impetigo involving the epidermis and dermis causing ulcerative plaques. Pathogens commonly responsible for the disease (group A beta-hemolytic streptococcus and Staphylococcus aureus) typically afflicts children, presenting during early stages with skin lesions that can closely resemble other vesicular and ulcerative dermatoses, such as those observed in mpox infection. The ongoing global outbreak of monkeypox has escalated the urgency for clinicians to accurately differentiate between these conditions due to their overlapping dermatological manifestations.
View Article and Find Full Text PDFBiomedicines
December 2024
Division of Cardiology, Department of Internal Medicine, Konyang University Hospital, Daejeon 35365, Republic of Korea.
Intermediate lesions (ILs) present challenges in making therapeutic decisions. This study aimed to determine the practical coronary angiographic predictors for revascularization in patients with ILs who underwent repeated angiograms. This study was a retrospective single-center study.
View Article and Find Full Text PDFMed
December 2024
Technophage, Investigação e Desenvolvimento em Biotecnologia S.A., Lisbon, Portugal.
Background: Phage therapy offers a promising alternative for treating serious infections, including diabetic foot ulcers (DFUs), through the lytic action of phages. This randomized double-blind study was conducted to evaluate the safety and tolerability of the TP-102 bacteriophage cocktail in patients with DFUs non-infected and infected with Staphylococcus aureus, Pseudomonas aeruginosa, and/or Acinetobacter baumannii.
Methods: Nineteen participants with DFUs were randomized after susceptibility testing.
BMC Med Res Methodol
December 2024
Janssen Research & Development LLC, Global Epidemiology Organization, Raritan, NJ, USA.
Background: Autoimmune disorders have primary manifestations such as joint pain and bowel inflammation but can also have secondary manifestations such as non-infectious uveitis (NIU). A regulatory health authority raised concerns after receiving spontaneous reports for NIU following exposure to Remicade, a biologic therapy with multiple indications for which alternative therapies are available. In assessment of this clinical question, we applied validity diagnostics to support observational data causal inferences.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!