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Five percent of transient ischemic attack (TIA) patients have a subsequent stroke within 7 days. The Canadian TIA Score uses clinical findings to calculate the subsequent stroke risk within 7 days. Our objectives were to assess 1) anticipated use; 2) component face validity; 3) risk strata for stroke within 7 days; and 4) actions required, for a given risk for subsequent stroke.
After a rigorous development process, a survey questionnaire was administered to a random sample of 300 emergency physicians selected from those registered in a national medical directory. The surveys were distributed using a modified Dillman technique.
From a total of 271 eligible surveys, we received 131 (48.3%) completed surveys; 96.2% of emergency physicians would use a validated Canadian TIA Score; 8 of 13 components comprising the Canadian TIA Score were rated as Very Important or Important by survey respondents. Risk categories for subsequent stroke were defined as minimal-risk: <1%; low-risk: 1%–4.9%; high-risk 5%–10%; critical-risk: > 10% risk of subsequent stroke within 7 days.
A validated Canadian TIA Score will likely be used by emergency physicians. Most components of the TIA Score have high face validity. Risk strata are definable, which may allow physicians to determine immediate actions, based on subsequent stroke risk, in the emergency department.
A cardiac source is often implicated in strokes where the deficit includes aphasia. However, less is known about the etiology of isolated aphasia during transient ischemic attack (TIA). Our objective was to determine whether patients with isolated aphasia are likely to have a cardioembolic etiology for their TIA.
We prospectively studied a cohort of TIA patients in eight tertiary-care emergency departments. Patients with isolated aphasia were identified by the treating physician at the time of emergency department presentation. Patients with dysarthria (i.e., a phonation disturbance) were not included. Potential cardiac sources for embolism were defined as atrial fibrillation on history, electrocardiogram, Holter monitor, atrial fibrillation on echocardiography, or thrombus on echocardiography.
Of the 2,360 TIA patients identified, 1,155 had neurological deficits at the time of the emergency physician assessment and were included in this analysis, and 41 had isolated aphasia as their only neurological deficit. Patients with isolated aphasia were older (73.9±10.0 v. 67.2±14.5 years; p=0.003), more likely to have a history of heart failure (9.8% v. 2.6%; p=0.027), and were twice as likely to have any cardiac source of embolism (22.0% v. 10.6%; p=0.037).
Isolated aphasia is associated with a high rate of cardioembolic sources of embolism after TIA. Emergency patients with isolated aphasia diagnosed with a TIA warrant a rapid and thorough assessment for a cardioembolic source.
SnO2-Fe2O3 composite thin films were deposited on quartz substrate at 650 °C by pulsed laser deposition with Fe2O3 content varying between 0 and 50 wt.%. The effect of increasing Fe2O3 content on structural, optical and electrical properties of SnO2-Fe2O3 films were investigated. X-ray diffraction analysis indicates that the nature of deposited composite films can be tune from crystalline to amorphous with increase in the Fe2O3 content. X-ray photoelectron spectroscopy studies confirm the presence of SnO2 and Fe2O3 in the microstructure. Atomic force microscopy studies of the deposited films indicate that RMS roughness vary between 114.4 and 1.48 nm. The average optical transmittance decreases from 92 to 72% with increasing Fe2O3 content of the deposited films. The optical bandgap was decreased from 3.69 to 3.31 eV with increase in Fe2O3 content. The minimum resistivity was observed 3.71 × 10−2 Ω cm for the 30 wt.% Fe2O3 composite film. The low resistivity and high transmittance in the visible region enables these films suitable for optoelectronic applications.