Generalized seizure, the only manifestation of a small ischemic atherothrombotic infarction

BACKGROUND:According to the literature,generalized seizure as a presenting sign of stroke is rare,and in the reported cases it was accompanied by a focal neurological deficit.Presentation of a small ischemic atherothrombotic brain infarction with convulsive generalized seizure is very rare.METHODS:We reported a patient with acute small ischemic atherothrombotic infarction associated with an episode of generalized tonic-clonic seizure,a rare clinical manifestation in this type of stroke.The patient was treated with anti-epileptic therapy after admission.RESULTS:The patient was discharged with oral administration of phenytoin 100 mg TDS,aspirin 80 mg daily,and atorvastatin 40 mg daily.CONCLUSION:Small ischemic atherothrombotic infarction can present only with a seizure without any focal neurological deficit.

Correlation between Helicobacter pylori infection and atherothrombotic stroke

Previous studies have demonstrated that Helicobacterpylori infection is associated with coronary atherosclerotic heart disease, but the correlation between Helicobacterpylori infection and ischemic stroke remains unclear. The present study assessed the effects of Helicobacter pylori infection on atherothrombotic stroke. This study included 115 individuals with atherothrombotic stroke, all of whom were patients receiving treatment at the Department of Neurology, Aerospace Central Hospital （Aerospace Clinical Medical College Affiliated to Peking University） in China, from March 2006 to July 2009. In addition, 131 controls without the history of cardiovascular disease, cerebrovascular disease or atherothrombosis were also enrolled in the study. Results show that the Helicobacterpylori-lgG positive rate was greater in the atherothrombotic stroke patients than in the controls, but the difference was not statistically significant （67.8% vs. 61.8%, OR = 1.301,95%C/： 0.769-2.203, P = 0.327）. After correction for potential risk factors for Helicobacter pylori infection and known risk factors for ischemic stroke, no significant difference was detected between them （OR = 1.278, 95%C1： 0.667-2.449, P = 0.459）. These results indicate that there is no specific correlation between Helicobacterpylori infection and atherothrombotic stroke. This finding requires further verification in large-sample prospective studies.

Risk factors for an atherothrombotic event in patients with diabetic macular edema treated with intravitreal injections of bevacizumab

AIM:To identify risk factors for an atherothrombotic event(ATE)among patients who were treated for diabetic macular edema(DME)with intravitreal bevacizumab injections.METHODS:This retrospective study enrolled all consecutive patients with DME who were treated by intravitreal bevacizumab from 2009 through 2016 in a single center.They were divided into one group treated by bevacizumab and subsequently had an ATE and a second group also treated by bevacizumab and did not have an ATE.RESULTS:A total of 455 patients with DME were enrolled.Seventy-two of the patients had an ATE.A multivariate model adjusted for age,gender,smoking,body mass index,hemoglobin A1c(HbA1c),duration of diabetes,creatinine,and blood pressure revealed an increased risk for ATE in the patients with diabetic duration of more than 13 y,a systolic blood pressure over 153.5 mm Hg at first treatment,or having been treated by more than 4 intravitreal bevacizumab injections.Additionally,patients that had an ATE within 3 mo from the last intravitreal treatment underwent more bevacizumab injections(5.2±3.4 vs 3.07±1.86;P<0.001).CONCLUSION:The risk factors for an ATE identified in this study are systolic blood pressure>153.5 mm Hg,a history of diabetic mellitus for more than 13 y,and treatment with more than 4 intravitreal bevacizumab injections.These factors need to be borne in mind when bevacizumab is being considered in the management of patients with DME.

Effect of ncRNA ANRIL on atherothrombotic stroke risk

Objective:This study aimed to evaluate the association of ANRIL gene with atherosclerosis stroke(ATS)using single nucleotide polymorphism(SNP)in Han Chinese population;Methods:Han Chinese populations with ischemic stroke(IS)in Sichuan were chosen for this study using the case-control design from January 2012 to December 2013.The unrelated age-and sex-matched healthy controls were selected from volunteers accepting health examinations in the same hospital during the same period.The candidate gene association study design was employed to analyze the relationship of the ANRIL gene and ATS risk in entire samples and subgroup populations(sex and age(<45 or≥45 years)subgroups),and gene-enviromental interaction analyses were also carried out to get an insight of the risk factors for ATS;Results:200 cases with ATS and 205 healthy controls in all were entered into the final analyses.Dyslipidemia(OR=15.538,P<0.001 in overall people),AA genotype of rs2184061 and rs7044859 loci increased the risk for ATS in overall people(For rs2184061,OR=1.635,P=0.034;for rs7044859:OR=1.657,P=0.029)or≥45 years group(For rs2184061,OR=1.749,P=0.023;for rs7044859:OR=1.721,P=0.027).The AAAGAT haplotype were significantly associated with ATS risk in Men,Women or population aged 45 or older years(for Men:OR=4.697,P=0.0003;Women:OR=3.113,P=0.028;≥45 years:OR=3.376,P=0.0002).At the same,interaction of dyslipidemia,rs7044859 and rs10757269 polymorphism was related to ATS(P=0.0101);Conclusions:Dyslipidemia and ANRIL gene are associated with ATS risk in Han nationality of Chinese population.

Vorapaxar in patients with diabetes mellitus and previous myocardial infarction: Findings from the thrombin receptor antagonist in secondary prevention of atherothrombotic ischemic events-TIMI 50 trial

Background Vorapaxar reduces cardiovascular death, myocardial infarction （MI）, or stroke in patients with previous MI while increasing bleeding. Patients with diabetes mellitus （DM） are at high risk of recurrent thrombotic events despite standard therapy and may derive particular benefit from antithrombotic therapies. The Thrombin Receptor Antagonist in Secondary Prevention of Atherothrombotic Ischemic Events-TIMI 50 trial was a randomized, double-blind, placebo-controlled trial of vorapaxar in patients with stable atherosclerosis.