Higher frequency of atrial fibrillation linked to colder seasons and air temperature on the day of ischemic stroke onset.

BACKGROUND: Whether a seasonal variation of atrial fibrillation among acute ischemic stroke (AIS) patients occurs is unknown. We studied the distribution of atrial fibrillation across seasons and air temperatures in a cohort of AIS patients. METHODS: We selected 899 AIS patients from the Argentinean Stroke Registry (ReNACer), who were admitted to 43 centers in the Province of Buenos Aires. We recorded the minimum and maximum temperatures at local weather centers on the day and the city where each stroke occurred. We used the goodness-of-fit χ(2) test to assess the distribution of atrial fibrillation across seasons and air temperatures and the Pearson correlation coefficient to assess the relationship between these variables. We developed a regression model for testing the association between seasons and atrial fibrillation. RESULTS: We found a seasonal variation in the occurrence of atrial fibrillation, with a peak in winter and a valley in summer (23.1% versus 14.0%, P < .001). The semester comprised by autumn and winter was associated with atrial fibrillation (Pearson P < .001). Atrial fibrillation showed a nonhomogeneous distribution across ranges of temperature (P < .001, goodness-of-fit test), with a peak between 5°C and 9°C, and was associated with minimum (Pearson P = .042) and maximum (Pearson P = .002) air temperature. After adjusting for significant covariates, there was a 2-fold risk of atrial fibrillation during autumn and winter. CONCLUSIONS: In this cohort of AIS patients, atrial fibrillation showed a seasonal variation and a nonhomogeneous distribution across air temperatures, with peaks in cold seasons and low temperatures on the day of stroke onset.

Unemployment: a social risk factor associated with early ischemic stroke mortality? Results from the Argentinean National Stroke Registry (ReNACer).

Employment is an indicator of socioeconomic status. Unemployment is a worldwide social challenge, especially in emerging countries, accounting for a proportion of the overall higher mortality rates found in these nations. We assessed the relationship between employment status and in-hospital mortality among acute ischemic stroke patients participating in the Argentinean National Stroke Registry (ReNACer), a prospective, country-wide, hospital-based stroke registry aimed at improving quality of stroke care in Argentina. We compared demographic and socioeconomic characteristics, risk factors, acute treatment, and stroke severity between employed and unemployed patients with acute ischemic stroke participating in ReNACer. We developed a multiple logistic regression model to identify predictors of in-hospital mortality. Among the 726 patients with acute ischemic stroke included in the study, 39.5% were unemployed. In-hospital mortality was higher in the patients who were unemployed at the time of the stroke compared with those who were employed (12.0% v 5.0%; P = .003). On multivariate analysis, being unemployed (odds ratio [OR], 3.58; 95% confidence interval [CI], 1.36-7.37; P = .005), stroke severity (OR, 3.54; 95% CI 1.11-10.40; P = .018), and infarct size >15 mm (OR, 2.80; 95% CI, 1.18-6.60; P = .019) were associated with in-hospital mortality after adjusting for relevant covariates. Social factors may influence poor outcomes after stroke. In the present study, unemployment was associated with a higher risk of adjusted in-hospital mortality. Strategies targeting individuals at high risk of cardiovascular diseases and poorer outcomes should be implemented to reduce stroke impact.

Disecciones arteriales: diagnóstico y tratamiento / Arterial dissections: diagnosis and treatment

In a prospective study of 10 patients in 2 years we investigated the role of early anticoagulatio and folow-up with non invasive studies on patients with intra and extracranial arterial dissections. Arterial dissections are an infrequent cause of Cerebrovascular Disease, despite that at presents they are diagnosed with increased frequency...The most common complications are: distal embolization, complete occlusion of a vessel or aneurysmatic dilatations.Intracranial dissections have a poorer prognosis as compared with extracranial dissections, specially because they can originate a Subarachnoid hemorrhage.The authors study pathogenesis, clinical features, diagnoisis and treatment, and the results oabtained with the management instituted are described

Disecciones arteriales: diagnóstico y tratamiento / Arterial dissections: diagnosis and treatment

In a prospective study of 10 patients in 2 years we investigated the role of early anticoagulatio and folow-up with non invasive studies on patients with intra and extracranial arterial dissections. Arterial dissections are an infrequent cause of Cerebrovascular Disease, despite that at presents they are diagnosed with increased frequency...The most common complications are: distal embolization, complete occlusion of a vessel or aneurysmatic dilatations.Intracranial dissections have a poorer prognosis as compared with extracranial dissections, specially because they can originate a Subarachnoid hemorrhage.The authors study pathogenesis, clinical features, diagnoisis and treatment, and the results oabtained with the management instituted are described