European Stroke Organisation (ESO) guidelines on management of transient ischaemic attack.

The aim of the present European Stroke Organisation Transient Ischaemic Attack (TIA) management guideline document is to provide clinically useful evidence-based recommendations on approaches to triage, investigation and secondary prevention, particularly in the acute phase following TIA. The guidelines were prepared following the Standard Operational Procedure for a European Stroke Organisation guideline document and according to GRADE methodology. As a basic principle, we defined TIA clinically and pragmatically for generalisability as transient neurological symptoms, likely to be due to focal cerebral or ocular ischaemia, which last less than 24 hours.

European Stroke Organisation (ESO) guidelines on management of transient ischaemic attack.

The aim of the present European Stroke Organisation Transient Ischaemic Attack (TIA) management guideline document is to provide clinically useful evidence-based recommendations on approaches to triage, investigation and secondary prevention, particularly in the acute phase following TIA. The guidelines were prepared following the Standard Operational Procedure for a European Stroke Organisation guideline document and according to GRADE methodology. As a basic principle, we defined TIA clinically and pragmatically for generalisability as transient neurological symptoms, likely to be due to focal cerebral or ocular ischaemia, which last less than 24 hours.

Colchicine for prevention of vascular inflammation in Non-CardioEmbolic stroke (CONVINCE) - study protocol for a randomised controlled trial.

Background: Inflammation contributes to unstable atherosclerotic plaque and stroke. In randomised trials in patients with coronary disease, canukinumab (an interleukin-1B antagonist) and colchicine (a tubulin inhibitor with pleiotropic anti-inflammatory effects) reduced recurrent vascular events.Hypothesis: Anti-inflammatory therapy with low-dose colchicine plus usual care will reduce recurrent vascular events in patients with non-severe, non-cardioembolic stroke and TIA compared with usual care alone.

Stress level assessment among health care workers involved in the management of critically ill COVID-19 patients.

Background: Intensive care health care workers (HCWs) are frontlines of this crisis as they deal with critically ill COVID-19 patients which can potentially affect their mental well-being and causes different levels of stress.

Aim: To determine the prevalence of stress among HCWs involved in the management of critically ill COVID-19 patient, identify the factors associated with stress, and highlight the availability of psychological support provided to HCWs.

Methods: A cross-sectional multicenter, international study using a web-based questionnaire of 27 questions including the Perceived Stress Scale-10 (PSS-10) for assessment of stress level.

An Updated Meta-Analysis of RCTs of Colchicine for Stroke Prevention in Patients with Coronary Artery Disease.

Emerging evidence from randomized controlled clinical trials (RCTs) suggests that colchicine has cardiovascular benefits for patients with coronary disease, including benefits for stroke prevention. We performed an updated systematic review and meta-analysis of all RCTs reporting on stroke outcomes during the follow-up of patients with a history of cardiovascular disease randomized to colchicine treatment or control (placebo or usual care). We identified 6 RCTs including a total of 11,870 patients (mean age 63 years, 83% males) with a mean follow-up of 2 years.

The role of endomyocardial biopsy in suspected myocarditis in the contemporary era: a 10-year National Transplant Centre experience.

Background: Diagnostic endomyocardial biopsy (EMB) in patients with suspected myocarditis helps to direct therapy and guide prognosis. This study aimed to investigate the correlation between the 2007 clinical guideline indications for EMB and the presence of a diagnostic biopsy result and associated outcomes in patients with suspected myocarditis in a national quaternary referral center in a contemporary cohort.

Methods: All cases of suspected myocarditis referred to the National Cardiac Transplant Centre who underwent EMB between 2009 and 2019 were identified retrospectively through pathology records.

A New Smartphone-Based Optic Nerve Head Biometric for Verification and Change Detection.

Purpose: Lens adapted smartphones are being used regularly instead of ophthalmoscopes. The most common causes of preventable blindness in the world, which are glaucoma and diabetic retinopathy, can develop asymptomatic changes to the optic nerve head (ONH) especially in the developing world where there is a dire shortage of ophthalmologists but ubiquitous mobile phones. We developed a proof-of-concept ONH biometric (application [APP]) to use as a routine biometric on a mobile phone.

Inflammation and Stroke Risk: A New Target for Prevention.

New therapeutic approaches are required for secondary prevention of residual vascular risk after stroke. Diverse sources of evidence support a causal role for inflammation in the pathogenesis of stroke. Randomized controlled trials of anti-inflammatory agents have reported benefit for secondary prevention in patients with coronary disease.

The Effect of Lidocaine and Bosutinib on 4T1 Murine Breast Cancer Cell Behaviour .

Background/aim: Systemic lidocaine has recently emerged as a promising agent possessing numerous potentially anti-neoplastic effects. In vitro studies suggest that lidocaine may prevent metastasis by acting on the tyrosine kinase enzyme Src. Intravenous lidocaine has been reported to reduce pulmonary metastasis in vivo in a murine breast cancer model, however the beneficial effect is abolished by the Src inhibitor bosutinib.

Association Between Anesthetic Dose and Technique and Oncologic Outcomes After Surgical Resection of Non-Small Cell Lung Cancer.

Objectives: Because of the biologic effects of volatile anesthetics on the immune system and cancer cells, it has been hypothesized that their use during non-small cell lung cancer (NSCLC) surgery may negatively affect cancer outcomes compared with total intravenous anesthesia (TIVA) with propofol. The present study evaluated the relationship between anesthetic technique and dose and oncologic outcome in NSCLC surgery.

Design: Retrospective cohort study.

A survey of patient blood management for patients undergoing cardiac surgery in nine European countries.

Study Objective: To describe and compare patient blood management (PBM) practices in cardiac surgery in nine European countries and identify the main risk factors for bleeding or transfusion according to the surveyed centres.

Design: We set up an online survey to evaluate PBM practices in two clinical scenarios, risk factors for bleeding or transfusion, and previous experience with antifibrinolytics.

Setting: This survey was completed by European anesthesiologists in 2019.

The role of PoCUS in the assessment of COVID-19 patients.

The Coronavirus disease 19 (COVID-19) pandemic has increased the burden of stress on the global healthcare system in 2020. Point of care ultrasound (PoCUS) is used effectively in the management of pulmonary, cardiac and vascular pathologies. POCUS is the use of traditional ultrasound imaging techniques in a focused binary manner to answer a specific set of clinical questions.

Lung ultrasound for the early diagnosis of COVID-19 pneumonia: an international multicenter study.

Purpose: To analyze the application of a lung ultrasound (LUS)-based diagnostic approach to patients suspected of COVID-19, combining the LUS likelihood of COVID-19 pneumonia with patient's symptoms and clinical history.

Methods: This is an international multicenter observational study in 20 US and European hospitals. Patients suspected of COVID-19 were tested with reverse transcription-polymerase chain reaction (RT-PCR) swab test and had an LUS examination.

Use of Mini-Percutaneous Nephrolithotomy Technique to Remove Extra-Peritoneal Foreign Bodies.

BACKGROUND Foreign bodies (FBs) in the intra- or extra-peritoneal cavity are relatively rare. The aim of treatment is to remove the FB to prevent chronic inflammation and/or infection. Traditionally, surgical management is necessary, as the detection and localization of FBs can be difficult.

Effectiveness of intubation devices in patients with cervical spine immobilisation: a systematic review and network meta-analysis.

Background: Cervical spine immobilisation increases the difficulty of tracheal intubation. Many intubation devices have been evaluated in this setting, but their relative performance remains uncertain.

Methods: MEDLINE, EMBASE, and the Cochrane Library were searched to identify randomised trials comparing two or more intubation devices in adults with cervical spine immobilisation.

Inflammatory cytokines, high-sensitivity C-reactive protein, and risk of one-year vascular events, death, and poor functional outcome after stroke and transient ischemic attack.

Background: Inflammation driven by pro-inflammatory cytokines is a new therapeutic target in coronary disease. Few data exist on the association of key upstream cytokines and post-stroke recurrence. In a prospective cohort study, we investigated the association between pivotal cytokines, high-sensitivity C-reactive protein (hsCRP) and one-year outcomes.

The role of regional anaesthesia in the emerging subspecialty of onco-anaesthesia: a state-of-the-art review.

Cancer accounts for millions of deaths globally each year, predominantly due to recurrence and metastatic disease. The majority of patients with primary solid organ cancers require surgery, however, some degree of tumour dissemination related to surgery is inevitable. The surgical stress response and associated immunosuppression, pain, inflammation, tissue hypoxia and angiogenesis have all been implicated in promoting tumour survival, proliferation and recurrence.

Tenosynovial chondromatosis of the flexor pollicis longus tendon: A subtype of primary synovial chondromatosis.

Primary synovial chondromatosis is a rare benign neoplastic process, in which cartilaginous nodules are produced in the subsynovial tissue. It has 3 main subtypes (intra-articular, tenosynovial and bursal). We present the case of a 61-year-old female, with a mass involving her right thumb for at least 5 years, which had recently increased in size.

Which patients are at high risk of recurrent venous thromboembolism (deep vein thrombosis and pulmonary embolism)?

Recurrent venous thromboembolism (VTE, or deep vein thrombosis and pulmonary embolism) is associated with mortality and long-term morbidity. The circumstances in which an index VTE event occurred are crucial when personalized VTE recurrence risk is assessed. Patients who experience a VTE event in the setting of a transient major risk factor (such as surgery associated with general anesthesia for >30 minutes) are predicted to have a low VTE recurrence risk following discontinuation of anticoagulation, and limited-duration anticoagulation is generally recommended.