BACKGROUND AND PURPOSE: 3D FSE T1WI has recently been used for carotid plaque imaging, given the potential advantages in contrast and spatial resolutions. However, its diagnostic performance remains unclear. Hence, we compared the ability of this technique to readily assess plaque characteristics with that of conventional images and validated the results with histologic classification.

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The effectiveness of Electronic Medication Packaging devices for monitoring drug adherence has been widely reported. However, conventional devices are expensive for routine use and cannot confirm whether the medication was administered. We aimed to determine, in a pilot and feasibility study, the impact of introducing a new medication support device, the Pletaal Assist System ® , to monitor and improve cilostazol adherence for stroke prevention at an outpatient clinic. Patients and Methods: We assessed consecutive patients treated with cilostazol for >3 months at our stroke outpatient clinic from January 2018 to March 2020. The adherence rate was assessed as follows: (the number of pills prescribed minus the number of remaining pills)/the number of pills prescribed. We compared the adherence rates before, during, and after Pletaal Assist System ® usage, respectively. Results: Overall, 25 patients (median age, 68.5 years; range, 51-86 years; male, 64%) were enrolled. All participants were prescribed cilostazol (100 mg) twice a day. There was no significant difference in the adherence rate among the three periods. However, in 10 patients with adherence rate below 100%, the adherence rate during Pletaal Assist System ® usage was higher than before usage (99.5% vs 95%, p=0.04), and the rate after using the Pletaal Assist System ® tended to be lower compared to the rate during usage (99.5% vs 96%, p=0.05). Conclusion:Our preliminary evidence suggest that the Pletaal Assist System ® could further improve cilostazol adherence in outpatients with poor drug adherence and may reduce the risk of recurrent strokes by improving adherence of patients with a history of stroke.

Objectives Although the vagus nerve (VN) is easily observed by ultrasonography, few studies have evaluated the cross-sectional area (CSA) of the VN in healthy older individuals from East Asia. In this study, we aimed to report reference values for the CSA of the VN in community-dwelling elderly Japanese individuals and to identify any associated medical history and/or lifestyle factors. Methods The present study included 336 participants aged >= 65 years from a prospective cohort study conducted in Yahaba, Japan from October 2021 to February 2022. The CSA of the VN was measured bilaterally at the level of the thyroid gland by ultrasonography. Univariate and multivariable linear regression analyses were conducted to identify the associations between clinical and background factors and the CSA of the VN on each side. Results In our cohort, the median CSA of the VN was 1.3 mm2 (interquartile range [IQR] 1.1–1.6) on the right side and 1.2 mm2 (IQR 1.0–1.4) on the left side. Multivariable linear regression analysis showed that history of head injury (β = -0.15, p < .01), history of convulsion (β = 0.19, p < .01), and BMI (β = 0.30, p < .01) were independently associated with the CSA of the VN on the left side. In contrast, there were no independent associations between any of the assessed variables and the CSA on the right side. Conclusion We have reported reference VN CSA values for community-dwelling elderly Japanese individuals. In addition, we showed that the CSA of the VN on the left side was positively associated with a history of convulsive seizure and BMI and inversely associated with a history of head injury.

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