Paradoxical embolism is a rare cause of ischemic stroke. We report the case of a 67-year-old man who had a saddle embolus to the carotid bifurcation successfully treated with emergency embolectomy. Transesophageal echocardiogram revealed a large patent foramen ovale and an easily demonstrable right-to-left shunt. Subsequent investigations revealed proximal deep venous thrombosis in the left femoral and popliteal veins and multiple pulmonary emboli. Long-term anticoagulation was instituted for the diagnosis of paradoxical embolism. The patient's recovery was uneventful, and he remained neurologically intact. A literature review emphasizes the role of transesophageal echocardiography and suggests that paradoxical embolism may be a more common cause of stroke than previously thought.
A 2 × 2 factorial experimental design was used to test the effect of cooperative advertising on an individual's propensity to visit an area. Cooperative advertising and co-op programs both refer to advertising communication whose sponsorship and cost are shared by more than one
party. The term partner refers to either other cities/towns or various types of business entities. For the tourism industry the main object of co-op programs is to create demand for an area as a tourist destination of choice and demand for local goods/services offered by co-op partners. Results
showed that visitor preference for cooperative advertisements increased in situations where advertisements were viewed for low effectiveness, that is, the level of advertising or copy effectiveness/believability was low. This was especially true for historical and average city types. Differences
in visiting preferences between business and leisure travelers were not supported by the data. It is suggested that small towns embrace cooperative advertising strategies to help attract tourists.
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