We retrospectively studied 90 patients with postinfarction seizures to determine the clinical features (onset, number, type), prognosis, and electroencephalographic and computed tomographic findings; we included infarctions of all etiologies. Thirty-three percent of the 90 seizures appeared early (within 2 weeks after the infarction), and 90% of the 30 early seizures appeared within 24 hours after the infarction. Seventy-three percent of the 90 seizures occurred within the first year, and only 2% occurred >2 years after the infarction. Fifty-six percent of the 90 seizures were single, and status epilepticus was seen in only 8%. Early-onset seizures were more likely to be partial (57% of 30); late-onset seizures were more likely to be generalized (65% of 60). Thirty-nine percent of the 90 initial seizures recurred, and there was no significant difference in recurrence rate between early-or late-onset initial seizures. Twenty-two percent of the 90 initial seizures became multiple recurrent seizures, and we could identify a precipitating factor in 86% of the 35 recurrent seizures. The most common electroencephalographic abnormality in the 61 patients so examined was focal slowing (61%), but recurrent seizures occurred in 100% of the four patients with periodic lateralized epileptiform discharges and in 75% of the eight patients with diffuse slowing. Computed tomography in 61 patients showed that large infarctions were associated with early (p<0.021) and multiple (/><0.05) seizures. Deep infarctions on computed tomograms (cortical infarctions extending to subcortical structures) tended to cause recurrent seizures (/><0.057). Seizures in 88% of the 90 patients could be managed with monotherapy.

No abstract

Silent cerebral infarction is frequently seen in asymptomatic patients with atrial fibrillation. Age, history of hypertension, active angina, and elevated mean systolic blood pressure were associated with silent infarction at entry. The sample size was too small to determine whether warfarin had an effect on the incidence of silent infarction during the trial. Active angina at baseline was the only significant independent predictor for the later development of symptomatic stroke.

Using a double-blind, placebo-controlled, crossover design, we studied the effect of bromocriptine (15 mg daily) in 20 men with chronic nonfluent aphasia. The study was conducted over a 28-week period in two phases. In phase I, the patients received either bromocriptine or placebo; in phase II the treatments were crossed over. We evaluated each patient's language and nonverbal cognitive skills at the beginning and end of each phase and 6 weeks after completion of phase II. When compared with placebo treatment, bromocriptine did not significantly improve the patient's speech fluency, language content, overall degree of aphasia severity, or nonverbal cognitive abilities. Based on these results, bromocriptine is not recommended as monotherapy for the treatment of chronic nonfluent aphasia.

The COVID-19 pandemic hit mankind at an unprecedented scale. In their attempt to continue functioning, organizations asked employees to work from home. Though employees experienced stress due to ‘forced’ work from home and blurring of work–family boundaries, they had to cope with the challenging times. The present study aimed to unearth the aspects of boundary management and adaptation in the context of work from home during the COVID-19 pandemic. Thus, we address the research question ‘how did the employees adapt to the sudden forced work from home during the COVID-19 pandemic?’ Since work from home was forced upon employees during the pandemic leading to the violation of boundaries, we invoked the boundary theory that highlights the boundaries that people draw between their personal and professional lives to maintain a balance. Further, we referred to the theory of cognitive adaptation to explain how employees adapted to the challenges while working from home during COVID-19. We conducted in-depth interviews of 30 experienced professionals working in the technology-enabled sectors in India. We applied Gioia’s methodology to analyse the qualitative data. Four aggregate dimensions emerged from the data analysis, as employees involuntarily worked from home: stress due to work disruptions, threats to employee well-being, boundary violation and employee resilience. Our findings contribute to the current theoretical understanding of employee stress, boundary management, adaptation or resilience and employee well-being, in the context of forced work from home. While employees were stressed and boundaries had blurred between work and family, they adapted and demonstrated resilience to the unprecedented changes in their lives. Practical implications of our study include managers’ conscious efforts towards respecting work–family boundaries, enhancing employee well-being and building a resilience-promoting work environment.

The relative risk of AAA is 2 to 3 times greater in patients with carotid stenosis compared with patients undergoing routine screening. However, only patients without diabetes account for the increased prevalence. Selective AAA screening of patients who are not diabetic with carotid stenosis is recommended.

No abstract

We retrospectively studied 46 patients with symptomatic retinal artery occlusion and assessed the pattern and extent of carotid artery disease ipsilateral to the retinal artery occlusion. Ipsilateral internal carotid artery atherosclerotic lesions were virtually limited to the cervical arterial segment; 50% of such lesions were plaques or stenoses of <60%, whereas 15% of the angiograms were normal. No clinical features were significantly associated with a flow-limiting carotid stenosis of >60%. Contrary to previous reports, the type of retinal artery occlusion, whether branch or central artery occlusion, was not predictive of severe underlying carotid stenosis or occlusion. Likely mechanisms of retinal artery occlusion include in situ thrombosis and emboli from carotid, and possibly cardiac, sources. Extension of thrombus from an occluded carotid artery into the ophthalmic artery did not appear to be a mechanism of retinal artery occlusion. (Stroke 1988; 19:1239-1242) R etinal artery occlusion (RAO) can be a central retinal artery occlusion (CRAO) or a branch retinal artery occlusion (BRAO). Since von Graefe first described CRAO in 1859, 1 the appearance of RAO has been well known.2 -4 There are various causes of RAO, including orbital trauma, coagulopathies (especially sickle cell disease), vasculopathies (systemic lupus erythematosus, temporal arteritis and other vasculitides, hairy cell leukemia), migraine, intravenous drug abuse, oral contraceptive use, cardiac disease (especially valvular disorders, myxoma), carotid artery disease, and procedures such as carotid angiography or endarterectomy. 5 -9 We reviewed the 17-year experience with RAO at our institution, attempting to define the pattern and extent of ipsilateral carotid artery disease associated with RAO. We examined various clinical features to see whether they would be predictive of severe carotid artery stenosis. The clinical features included the type of RAO (BRAO or CRAO), preexistent cardiovascular risk factors, a history of ipsilateral amaurosis fugax, transient ischemic attack (TIA) or stroke, and blood and coagulation parameters. Subjects and MethodsWe retrospectively studied 46 patients with symptomatic BRAO or CRAO seen at Loyola University Medical Center and Hines Veterans Administration Hospital from 1971 to early 1987; all patients had an ophthalmologic evaluation to confirm the diagnosis. We did not include cases of only amaurosis fugax and asymptomatic or incidental retinal emboli. The presence of cardiovascular risk factors or related clinical features such as diabetes mellitus, congestive heart failure, smoking, hypertension, angina, hyperlipidemia, cardiac arrhythmia, peripheral vascular disease, and myocardial infarction was determined by the recorded medical history, physical findings, and laboratory data. These risk factors or clinical features were evaluated as possible predictors for a flow-limiting carotid artery stenosis, defined as a cross-sectional stenosis of >60% present on an angiogram. Hemoglobin content, prothrombin...