Influenza vaccination and cardiovascular risk in patients with recent TIA and stroke

OBJECTIVES: To determine whether current influenza vaccination is associated with reduced risk of major vascular events in patients with recent ischemic stroke or TIA of mainly atherothrombotic origin. METHODS: Data were pooled from 2 prospective cohort studies, the OPTIC Registry (n = 3,635) and the AMISTAD Study (n = 618), and from the randomized PERFORM Trial (n = 19,120), all of which included patients with recent ischemic stroke or TIA. Influenza vaccination status was determined in 23,110 patients. The primary outcome was a composite of nonfatal myocardial infarction, nonfatal stroke, or vascular death up to 2 years. Secondary outcomes were myocardial infarction and stroke separately. RESULTS: Influenza vaccination had no association with the primary outcome in the propensity score-matched cohort (hazard ratio 0.97, 95% confidence interval [CI] 0.85-1.11; p = 0.67) or in the propensity score-adjusted cohort (hazard ratio 1.00, 95% CI 0.89-1.12; p = 0.99). Similarly, the risk of stroke and myocardial infarction did not differ between the vaccinated group and the unvaccinated group; in the matched cohort, the hazard ratio was 1.01 (95% CI 0.88-1.17; p = 0.89) for stroke and 0.84 (95% CI 0.59-1.18; p = 0.30) for myocardial infarction. CONCLUSIONS: Influenza vaccination was not associated with reduced outcome events in patients with recent atherothrombotic ischemic stroke after considering all baseline characteristics (including concomitant medications) associated with influenza vaccination.

Die Blutbeschuldigung von Tißa-Eßlar

beleuchtet von M. Kayserling

Die Menschenliebe, die Zivilisation und die Gerechtigkeit vom Standpunkte der jüngsten Vorgänge in Tißa-Eßlar aus betrachtet

von K. Lippe

Tißa-Eßlár in der Vergangenheit und Gegenwart : über die Juden im allgemeinen, jüdische Glaubens-Mysterien, rituelle Mordthaten u. Blutopfer, der Tißa-Eßlárer Fall

von Géza von Ónody. Autoris. Übers. aus d. Ungar. von Georg von Marczianyi

Sēder qînôt miṭ ṭaiṭš : ke-minhag q"q aškenazzîm weil ich hob gizehn doś di (qines) di mir an (Tišaʿ be-Av) ṭun zogn zain ... šwer tzu fur šṭin ...

Digitalisat der Ausg. Amśṭrdm, [1717/18]

Awareness of Stroke Risk after TIA in Swiss General Practitioners and Hospital Physicians.

BACKGROUND Transient ischemic attacks (TIA) are stroke warning signs and emergency situations, and, if immediately investigated, doctors can intervene to prevent strokes. Nevertheless, many patients delay going to the doctor, and doctors might delay urgently needed investigations and preventative treatments. We set out to determine how much general practitioners (GPs) and hospital physicians (HPs) knew about stroke risk after TIA, and to measure their referral rates. METHODS We used a structured questionnaire to ask GPs and HPs in the catchment area of the University Hospital of Bern to estimate a patient's risk of stroke after TIA. We also assessed their referral behavior. We then statistically analysed their reasons for deciding not to immediately refer patients. RESULTS Of the 1545 physicians, 40% (614) returned the survey. Of these, 75% (457) overestimated stroke risk within 24 hours, and 40% (245) overestimated risk within 3 months after TIA. Only 9% (53) underestimated stroke risk within 24 hours and 26% (158) underestimated risk within 3 months; 78% (473) of physicians overestimated the amount that carotid endarterectomy reduces stroke risk; 93% (543) would rigorously investigate the cause of a TIA, but only 38% (229) would refer TIA patients for urgent investigations "very often". Physicians most commonly gave these reasons for not making emergency referrals: patient's advanced age; patient's preference; patient was multimorbid; and, patient needed long-term care. CONCLUSIONS Although physicians overestimate stroke risk after TIA, their rate of emergency referral is modest, mainly because they tend not to refer multimorbid and elderly patients at the appropriate rate. Since old and frail patients benefit from urgent investigations and treatment after TIA as much as younger patients, future educational campaigns should focus on the importance of emergency evaluations for all TIA patients.

Hirnschlagrisiko nach transient ischämischer Attacke (TIA)

Eine transiente ischämische Attacke (TIA) kann Vorbote eines drohenden Hirnschlags sein und sollte rasch abgeklärt werden. In einer Studie hat das BIHAM untersucht, ob das Risiko eines Hirnschlags nach TIA unter Haus- und Spitalärzten richtig eingeschätzt wird und wie bezüglich weiterer Abklärungen vorgegangen wird. Eine Studie von Hausärzten über Hausärzte – Was lief dabei gut, was weniger?

Incipit scriptu[m] sup[er] primo sente[n]tia[rum] / editum a fratre Ioanne duns ordinis fratrum mino[rum] doctore subtilissimo ...

Marca tip. de los editores en 2i10r (Kristeller. It.B., 238)

Explicit summa Angelica de casib[us] [con]sci[enti]e / p[er] fratre[m] Angelu[m] d[e] clauasio co[m]pilata ; maxima cu[m] dilige[n]tia reuisa, [et] fideli studio emendata ; sicut ip[sum] op[us] p[er] se sat[is] attestabit[ur].

Huecos para iniciales

Habes humane lector, Gabrielis de Tarrega ... opera breuissima, theorica[m] et prathica[m], medicinalis scie[n]tie pro maiori parte amplexa[n]tia facili ingeniosoq[ue] stillo per ipsum accumulata, medicis instrue[n]dis utilissima ...

Fecha tomada del colofón en M4v de la cuarta secuencia

Itinerarium paradisi / religiosissimi patris artium ac sacre pagine p[ro]fessoris Parisien[sis] diuiniq[ue] verbi declamatoris facundissimi magistri Ioannis Raulin ordinis Cluniace[nsis] ; co[m]plecte[n]s sermones de Penite[n]tia [et] eius partibus ... ; cui adiuncti sunt no[n] minus co[m]menda[n]di sermones euisdem grauissimi patris de matrimonio ac viduitate

Sign.: [calderón]6, A-Q8

Doctrinale mortis / venerandi patris artiu[m] ac sacre pagine p[ro]fessoris Parisien[sis] Ioa[n]nis Raulin ordinis Cluniacen[sis] ; opus egregium corporalis mortis doctrinas leges et co[n]comita[n]tia ; ac detestabilis culpe mirabilia ; necno[n] gehenne docume[n]ta vías horribiles et tormenta diffuse complecte[n]s ... ; iamiam diligenti accuratione recognitum et a multis me[n]dis castigatu[m]

Pie de imp. tomado del colofón

Curioso romance, en que se da cuenta de un maravilloso sucesso, y caso prodigioso, que sucedio en la ciudad de Vitervo : y fue, que una desalmada muger mato a su marido,y a una tia suya, y le saco el corazon, por gozar de un mancebo que tenia por galan, con el cual se huyo : dase cuenta como dieron en poder del moro, donde el fue muerto, y ella cautiva : y el fin dechoso que tuvo, por la devocion de la Virgen de los Remedios : Camila

Sign.: []2