Knowledge of factors contributing to sustained work ability after stroke is limited. This study explored the association between perceived work ability and personal, stroke-related and work-related factors.

Cross-sectional study.

Individuals working 1 year after stroke.

A postal survey was completed by 88 individuals. The survey comprised questions on demographics, personal, stroke-related and work-related factors, and a set of validated questionnaires including the Work Ability Index (WAI). Data were analysed using logistic regression analyses with perceived overall work ability (WAI item 1) as the dependent variable (good or excellent vs poor or moderate work ability).

Good or excellent work ability was perceived by 59% of the participants. In the final multivariable regression analyses, greater fatigue (OR 0.4; p < 0.001) and a poor work-life balance (OR 0.4; p < 0.005) were associated with lower odds for perceiving good or excellent work ability, whereas a higher monthly income (OR 5.8; p < 0.008) and greater mastery of work (OR 3.2; p < 0.007) were associated with higher odds.

Both stroke-related and work-related factors were associated with perceived work ability among individuals working 1 year after stroke. This indicates that several aspects need to be addressed to accomplish a sustainable work situation after stroke.

A 14-month-old, male castrated, 3,9-kg Singapura cat was referred for treatment of severe pulmonary valve stenosis associated with tricuspid valve dysplasia. The cat was pretreated with atenolol and scheduled for pulmonary balloon valvuloplasty. Because the right femoral vein could not accommodate a 5 Fr introducer, vascular access was obtained via the left external jugular vein, followed by right ventricular catheterisation, pressure measurement and angiography. A 10 mm low pressure balloon catheter was advanced over a guidewire to the level of the pulmonary valve and inflated once, resulting in complete loss of the balloon waist. During the procedure, the cat was severely hypotensive for 30 minutes, lasting from the time of ca-theterisation of the right ventricular outflow tract until nearly the end of anaesthesia. Postoperative tachypnoea was attributed to congestive heart failure, although aspiration pneumonia could not be excluded. The patient was discharged the day after the intervention following a single dose of furosemide and received amoxicillin-clavulanate for ten days. Echocardiography after eleven days, three months and 16 months demonstrated a marked and sustained reduction of the transvalvular pressure gradient. The cat showed an improved activity level after the procedure, which persisted over the 16-month follow-up period.

IgA vasculitis (IgAV), a small-vessel systemic vasculitis characterised by arthritis, renal involvement and palpable purpura without thrombocytopenia, predominantly affects children and is rare in adults. Immunosuppressive treatment is typically reserved for significant renal involvement or refractory abdominal and joint pain. However, therapeutic targets for gastrointestinal involvement remain poorly defined. A man in his 20s with no medical history presented with weeks of abdominal pain, post-prandial vomiting, purpuric rash, arthralgia and hypertension. Urine studies showed subnephrotic range proteinuria and colonoscopy revealed ileal ulceration. Immunofluorescence of skin, ileal and renal biopsies demonstrated perivascular IgA deposition, confirming IgAV. Although renal involvement did not necessitate treatment, recurrent severe gastrointestinal symptoms and biochemical evidence of liver involvement prompted a 6-week course of oral prednisone following multidisciplinary consultation. His symptoms resolved, with complete normalisation of renal function and liver enzymes.

Myocardial infarction (MI) induces cardiac muscle death and its subsequent replacement by a noncontractile fibrotic scar, which underlies progression to heart failure. Current treatments restore blood flow and assist with cardiac workload but do not promote regeneration. We have previously shown endogenous growth of the cardiac lymphatic system following MI and further stimulation with the lymphatic endothelial specific mutated Vascular Endothelial Growth Factor-C (VEGF-C) isoform, VEGFC-C156S, resolves the immune response and improves cardiac function. However, the short half-life of VEGFC-C156S makes it suboptimal for clinical use, highlighting the need for alternative prolymphangiogenic strategies. We established a spheroid-based sprouting assay using human lymphatic endothelial cells to mimic lymphangiogenesis and performed a phenotypic screen of focused libraries of epigenetic regulators, kinase inhibitors, and stem cell modulators. Automated imaging and quantitative analysis identified several kinase inhibitors, previously characterized as GSK3ß inhibitors, as prolymphangiogenic regulators. Among them, the most potent was kenpaullone, which activated the same canonical prolymphangiogenic ERK pathway as VEGF-C, but induced a distinct transcriptional response in treated spheroids. Using kenpaullone-derived chemical probes and target-validation approaches, we identified MAP4K4 as a molecular target mediating the prolymphangiogenic effect observed. Finally, in a mouse MI model, kenpaullone enhanced cardiac lymphangiogenesis and improved cardiac function.

Hyperphosphatemia is a key component of chronic kidney disease-mineral and bone disorder and is associated with cardiovascular morbidity and mortality in patients receiving dialysis. Non-calcium-based phosphate binders, including sevelamer and lanthanum carbonate, are widely used, yet comparative evidence on clinical outcomes remains limited.

We emulated a target trial using data from the China Renal Data System to compare lanthanum carbonate versus sevelamer initiation among patients receiving dialysis with hyperphosphatemia and no documented prior major adverse cardiovascular events (MACE). Using an active-comparator, new-user design, patients were matched 1:1 by propensity scores. The primary outcome was incident MACE, defined as a composite of myocardial infarction, stroke, or cardiovascular death. Secondary outcomes included all-cause and cardiovascular mortality. Cox proportional hazards models were used to estimate hazard ratios (HRs), and cumulative incidence was estimated using the Kaplan-Meier method.

Among 10,518 matched patients (5,259 per group), 325 MACE events occurred in the sevelamer group and 280 in the lanthanum carbonate group over 3 years. The cumulative incidence of MACE was 12.2% versus 9.5%, respectively. Lanthanum carbonate initiation was associated with a lower risk of MACE (HR, 0.79; 95% CI, 0.68 to 0.92), corresponding to an absolute risk reduction of 2.68% and a number needed to treat of 37. Lanthanum carbonate was also associated with lower risks of all-cause mortality (HR, 0.83; 95% CI, 0.75 to 0.93) and cardiovascular mortality (HR, 0.72; 95% CI, 0.59 to 0.88). Results were consistent across sensitivity and subgroup analyses. In competing-risk analyses, the association with lower MACE risk remained significant.

In this target trial emulation, initiation of lanthanum carbonate was associated with lower risks of cardiovascular events and mortality compared with sevelamer among patients receiving dialysis with hyperphosphatemia and no documented prior MACE.

Early menopause is an established female-specific risk enhancer for incident cardiovascular disease, but its prognostic value after acute coronary syndrome (ACS) remains uncertain. We evaluated whether menopause before age 45 years was associated with long-term ischemic/cardiovascular outcomes after ACS in midlife women.

We analyzed a multicenter registry of women hospitalized with ACS from February 1, 2020 through February 28, 2025. The primary cohort included women whose menopause preceded or coincided with the index event. Menopausal age was obtained from structured registry/clinical history fields. The primary outcome was a prespecified ischemic/cardiovascular major adverse cardiovascular event.

Among 1,039 records, 857 had valid menopausal age data and 728 met temporal criteria. Menopause before age 45 years was present in 124 women; median follow-up was 3.52 years. Crude post-index event rates were higher with early versus later menopause for the primary outcome (21.1% vs. 13.3%), death (8.9% vs. 4.6%), and the composite outcome (25.2% vs. 15.3%). In the primary clinical Cox model, early menopause was associated with the primary outcome (hazard ratio [HR], 1.78; 95% CI, 1.11-2.85), death (HR, 2.57; 95% CI, 1.18-5.57), and the composite outcome (HR, 1.87; 95% CI, 1.21-2.89). Associations attenuated in extended exploratory models including previous vascular disease, surgical menopause, and hormone therapy.

Menopause before age 45 years identified a higher risk post ACS phenotype. Findings extend incident risk evidence into secondary prevention and support routine recording of menopausal age; causality cannot be inferred.

Ischemic stroke is one of the leading causes of disability and death among adults worldwide. It occurs when blood flow to the brain is interrupted. Currently available treatments for patients with ischemic stroke focus solely on restoring blood flow. Therefore, there is a lack of methods that would accelerate brain regeneration after a stroke or even provide a protective effect. This study describes the role of the astrocyte-secreted protein CHI3L1 (chitinase-3-like protein 1) in the pathophysiology of stroke, as well as other diseases of the central nervous system. The structure of the protein, the receptors to which CHI3L1 binds and the activated signaling pathways along with the resulting biological effects relevant to ischemic stroke are discussed. It is indicated that changes in CHI3L1 levels potentially influence post-stroke regeneration in both humans and animal models. The common mechanisms of CHI3L1 action across various neurological diseases suggest its significant role in the future diagnosis and treatment of ischemic stroke, Alzheimer’s and Parkinson’s diseases, and glioma.

The left atrial appendage (LAA) is nowadays recognized as both an arrhythmogenic substrate and the dominant source of thromboembolism in atrial fibrillation (AF). In this review we tried to summarize recent data on the anatomy, physiology, and imaging of the LAA, and examine how these findings help guide rhythm-control and stroke-prevention strategies.

High-resolution mapping confirms the LAA as a non-pulmonary-vein trigger source in persistent and post-ablation AF, supporting LAA electrical isolation in selected patients, though isolation may induce mechanical standstill and mandate continued thromboprophylaxis. The 2024 ESC guidelines reframed stroke-risk assessment around the sex-neutral CHA₂DS₂-VA score within the AF-CARE pathway. An important recent study was the OPTION trial, which showed that LAA closure after AF ablation was as effective as oral anticoagulation for preventing death, stroke, or systemic embolism and was associated with less non-procedure-related bleeding. These findings support the use of LAA closure in selected patients after ablation. New imaging and emerging computational tools may also improve patient selection and help guide device sizing. A comprehensive assessment of the anatomy, function, and electrical activity of the LAA can help adapt AF treatment to each patient.

Tuberculosis (TB) treatment is often associated with adverse drug reactions (ADRs) of varying severity, which may negatively affect treatment adherence and outcomes. This study aimed to identify ADRs related to first-line anti-TB drugs, determine associated factors, and evaluate treatment outcomes among TB patients in the Laâyoune-Sakia El Hamra region of Morocco. A retrospective study was conducted in southern Morocco from January 1, 2023 to December 31, 2024. Data were collected from clinical charts of TB patients treated at the Center for Tuberculosis and Respiratory Diseases of Laâyoune (CDTMRL). Adverse drug reactions were evaluated by a specialist clinician throughout treatment, and outcomes were assessed according to World Health Organization guidelines. Among 354 TB patients, 26.55% experienced ADRs, most commonly during the intensive treatment phase. ADRs were significantly associated with gender, age, smoking status, and comorbidities, particularly diabetes and HIV infection. The majority of ADRs were hepatic (13.87%) and gastrointestinal (9.83%). Cutaneous (6.36%), articular (6.07%), and renal (5.78%) ADRs occurred at similar frequencies. Neurological, immunoallergic, cardiovascular, and urogenital ADRs were comparatively less frequent. Most reactions were mild to moderate and managed symptomatically, with few requiring treatment modifications and no ADR-related deaths. Treatment success outcomes were achieved in 81.1% of patients and unsuccessful treatment accounted for 10.73%. Adverse reactions to first-line anti-TB medications are relatively common and highlight the need for close clinical monitoring throughout the treatment period. Strengthening pharmacovigilance and improving patient education may help enhance treatment adherence and reduce complications.

The current single-center, retrospective, observational cohort study with a cross-sectional design was conducted to evaluate the association between androgenic profile and metabolic cardiovascular risk (mCVR) factors and to explore whether testosterone deficiency was associated with an unfavourable cardiometabolic profile in a large community-recruited cohort of 659 young men aged 18-35 years.

Participants underwent comprehensive assessment of anthropometric, biochemical, clinical, and hormonal parameters.

Body mass index (BMI), expression of generalized obesity, waist circumference (WC), expression of abdominal/visceral obesity, diastolic blood pressure (DBP) and triglycerides (TG) significantly and progressively decreased and high-density lipoprotein (HDL)-cholesterol significantly increased across total testosterone (TT) tertiles. Similarly, weight, BMI, WC, systolic blood pressure (SBP), DBP and TG significantly decreased and HDL-cholesterol significantly increased across SHBG tertiles. Weight and adiposity-related anthropometric parameters, namely BMI and WC, significantly and progressively decreased across calculated free testosterone (cFT) tertiles. Spearman correlation analysis showed that TT and SHBG were significantly and negatively correlated with weight (r=-0.149, r=-0.154), BMI (r=-0.204, r=-0.165), WC (r=-0.234, r=-0.225), SBP (r=-0.112, r=-0.142) and TG (r=-0.117, r=-0.204), and significantly and positively correlated with HDL-cholesterol (r = 0.167, r = 0.251). Additionally, SHBG was significantly and negatively correlated with DBP (r=-0.173). cFT was significantly and negatively correlated with age (r=-0.108) and BMI (r=-0.132). In a multiple linear regression analysis in models adjusted for age, BMI and WC, TT and SHBG were independently associated with HDL-cholesterol (β = 0.151, β = 0.186), and SHBG was independently associated with SBP (β=-0.177) and DBP (β=-0.204). Men with testosterone below the normal range (Hypo-T group) showed a significantly higher prevalence of generalized obesity and abdominal obesity than men with testosterone within the normal range (Normal-T group). Conversely, Overweight/Obese men exhibited significantly lower TT and a significantly higher prevalence of testosterone deficiency than Normal-Weight men.

In young adult men, androgenic profile was found to be robustly associated with mCVR factors; however, causality and temporal directionality cannot be inferred because of the cross-sectional design of the study.