Carotid plaque section from a patient with atherosclerosis.

<p>A) Lipoprotein-associated phospholipase A2 (Lp-PLA₂) was detected by Immunohistochemistry (IHC) using anti- Lp-PLA₂ specific monoclonal antibody (diaDexus) and chromagen fast red; 400×. B) The five micron adjacent carotid plaque section from the same patient was stained as in A but the primary antibody was omitted as a control for specificity; 400×.</p

Correlations between serum Lp-PLA₂ activity, and plaque and serum Lp-PLA₂ mass.

<p><i>Abbreviations:</i> Lp-PLA₂, Lipoprotein-associated phospholipase A2.</p>a<p>Values expressed are for plaque Lp-PLA₂ grade of ≥1 as there were no significant correlations with grades >1.</p

Correlations among plaque characteristics and serum levels of inflammatory markers.

<p><i>Abbreviations:</i> Lp-PLA₂, Lipoprotein-associated phospholipase A2; Cpn, <i>C. pneumoniae</i>; qRT-PCR, quantitative real-time reverse transcription PCR; IL-6, interleukin-6; IHC, immunohistochemistry; CRP, C-reactive protein.</p>a<p>p<0.001.</p>b<p>p<0.01.</p>c<p>p<0.013.</p>d<p>p<0.05.</p

Clinical characteristics of study population by plaque Lp-PLA₂.^a

<p><i>Abbreviations:</i> Lp-PLA₂, Lipoprotein-associated phospholipase A2; CAD, Coronary Artery Disease.</p>a<p>Values expressed are for plaque Lp-PLA₂ grade of ≥1 as the results were the same for any grade ≥1.</p>b<p><i>P</i> values were generated by chi-square test except for age, where t-test was used for comparison.</p

Clinical characteristics of study population by serum Lp-PLA₂ activity.^a

<p><i>Abbreviations:</i> Lp-PLA₂, Lipoprotein-associated phospholipase A2; Lp-PLA₂.</p><p>Activity, range measured in nmol/min/mL; CAD, Coronary Artery Disease.</p>a<p>Lp-PLA₂ Activity range measured in nmol/min/mL.</p>b<p><i>P</i> values were generated by chi-square test except for age, where t-test was used for comparison.</p>c<p>Serum Lp-PLA2 activity information was missing for one person.</p

A Cross-Sectional Study of Individuals Seeking Information on Transient Ischemic Attack and Stroke Symptoms Online: A Target for Intervention?

<div><h3>Background</h3><p>Individuals with TIA/stroke symptoms often do not seek urgent medical attention. We assessed the feasibility of identifying individuals searching for information on TIA/stroke symptoms online as a target for future interventions to encourage urgent evaluation and we evaluated the performance of a self-reported risk score to identify subjects with true TIA or stroke.</p> <h3>Methodology/Principal Findings</h3><p>We placed online advertisements to target English-speaking adults in the United States searching for TIA/stroke-related keywords. After completing an online questionnaire, participants were telephoned by a vascular neurologist to assess the likelihood of TIA/stroke. We used logistic regression and the c-statistic to assess associations and model discrimination respectively. Over 122 days, 251 (1%) of 25,292 website visitors completed the online questionnaire and 175 were reached by telephone (mean age 58.5 years; 63% women) for follow-up. Of these participants, 37 (21%) had symptoms within 24 hours, 60 (34%) had not had a medical evaluation yet, and 68 (39%) had TIA/stroke. Applying a modified ABCD² score yielded a c-statistic of 0.66, but 2 of 12 with a zero score had a TIA/stroke. Those with new symptoms were more likely to have TIA/stroke (OR 4.90, 95% CI 2.56−9.09).</p> <h3>Conclusions/Significance</h3><p>Individuals with TIA/stroke that are seeking real-time information on symptoms online can be readily identified, in some cases before they have sought formal medical evaluation. Although a simple self-reported risk score was unable to identify a low-risk population in this selected group, this population may still present an attractive target for future interventions designed to encourage urgent medical evaluation.</p> </div

Multivariable Predictors of TIA/Stroke Diagnosis Among 175 Users Searching for Information on Transient Ischemic Attack or Mini-Stroke Symptoms Online.

<p>Components of the ABCD² score excluding acute blood pressure are included in Model 1. Model 2 adds the number of previous episodes of similar symptoms in the past year.</p

Characteristics of 175 users seeking information on Transient Ischemic Attack or Mini-Stroke Online.

*<p>n = 170; † n = 168; ‡ ABCD² score: age > = 60 = 1 point; Clinical Features: Speech Disturbance without weakness = 1 point, Unilateral Weakness = 2 points; Duration: 10–59 minutes = 1 point, >60 minutes = 2 points; Diabetes = 1 point. The blood pressure item was excluded since this was not likely to be available by self-report.</p

Percent of participants with transient ischemic attack or stroke by self-reported ABCD² score.

<p>A modified ABCD² score was calculated from self-reported components of the score (age > = 60 = 1 point; Clinical Features: Speech Disturbance without weakness = 1 point, Unilateral Weakness = 2 points; Duration: 10–59 minutes = 1 point, >60 minutes = 2 points; Diabetes = 1 point). The blood pressure item was excluded since this was not likely to be available by self-report, so the range of this risk score was 0 to 6. The grey bars show the proportion observed and the black vertical lines represent the 95% confidence interval around that proportion. The one enrollee with a score of 6 had migraine.</p

Predictors of institutional indirect rates.

<p>*Observations over the three survey periods.</p><p>#Rate differences and their 95% CI are shown in absolute terms.</p><p>Predictors of institutional indirect rates.</p