RESUMEN
Background and aim: Paraneoplastic coagulopathy can present as stroke and is associated with specific biomarker changes. Identifying paraneoplastic coagulopathy can help guide secondary prevention in stroke patients, and early cancer detection might improve outcomes. However, unlike ischemic stroke, it remains unclear whether paraneoplastic coagulopathy is associated with transient ischemic attacks (TIA). This study assessed the presence of cancer-related biomarkers in TIA patients and evaluated long-term mortality rates in patients with and without active cancer. Methods: Active cancer was retrospectively identified in consecutive TIA patients treated at a comprehensive stroke center between 2015 and 2019. An association between the presence of cancer and cancer-related biomarkers was assessed using multivariable logistic regression. Long-term mortality after TIA was analyzed using multivariable Cox regression. Results: Among 1436 TIA patients, 72 had active cancer (5%), of which 17 were occult (1.2%). Cancer-related TIA was associated with male gender (adjusted odds ratio [aOR] 2.29, 95% CI 1.12-4.68), history of smoking (aOR 2.77, 95% CI 1.34-5.7), elevated D-dimer (aOR 1.77, 95% CI 1.26-2.49), lactate dehydrogenase (aOR 1.003, 95% CI 1.00-1.005), lower leukocyte count (aOR 1.20, 95% CI 1.04-1.38), and lower hemoglobin (aOR 1.02, 95% CI 1.00-1.04). Long-term mortality was associated with both active cancer (adjusted hazard ratios [aHR] 2.47, 95% CI 1.58-3.88) and occult cancer (aHR 3.08, 95% CI 1.30-7.32). Conclusion: Cancer-related TIA is not uncommon. Biomarkers known to be associated with cancer-related stroke also seem to be present in TIA patients. Early identification would enable targeted treatment strategies and could improve outcomes in this patient population.
RESUMEN
Climacteric Japanese plums were harvested at six developmental stages with no intermediate storage period, and cell wall compositional changes were analyzed. Arabinose proved to be the principal neutral monosaccharide constituent in cell walls during growth and the most dynamic neutral sugar in pectic fractions. Arabinose loss from tightly bound pectins was found to be a relatively early feature in the sequence of cell wall biochemical modifications, thus suggesting a softening-related role during Japanese plum on-tree ripening. Depolymerization of matrix glycans started at the end of the cell expansion phase and increased throughout ripening. Pectin solubilization was first detected during early ripening. Firmness loss did not correlate with polyuronide depolymerization early in ripening, but the last softening phase was associated with a strong depolymerization of cell wall polyuronides as well as a decrease in the arabinose/galactose ratio in loosely bound pectins. This is the first work that characterizes the temporal sequence of cell wall polysaccharide changes in Japanese plum.