Hypothesis of "stroke-stop" formula: a tool for risk index determination in development of acute cerebrovascular disease in asymptomatic individuals with carotid stenosis.

BACKGROUND: Extracranial carotid artery disease is considered a risk factor for developing acute cerebrovascular diseases. The paper suggests the "Stroke-Stop" formula as hypothesis for the determination of the risk of developing stroke in asymptomatic individuals with carotid stenosis. The formula is based on a mathematical calculation of the major risk factors for stroke: the degree of ICA (internal carotid artery) stenosis, the morphological structure of the atherosclerotic plaque and the level of lipoprotein-associated phospholipase A2 (Lp-PLA2) concentration. METHODS: The cross sectional study included 70 patients with atherosclerotic ICA stenosis. Among vascular inflammatory markers, Lp-PLA2 was determined with concentration 252.7-328.6 mg/l. The obtained results were evaluated using descriptive statistics (the frequency, percentage ratio) as well as the one-way analysis of variance (ANOVA) and chi-square test. RESULTS: The risk of stroke development is eminently increasing with the progression of ICA stenosis and elevation of Lp-PLA2 levels. In patients with echolucent plaque, the risk of stroke development was significantly higher in correlation with patients with echogenic plaque. Based on calculations using "Stroke-Stop" formula, three main groups were generated: low (< 70 points), medium (70-100 points) and high (> 100 points) risk of stroke development. CONCLUSIONS: Hypothesis of "Stroke-Stop" formula is proposed for better selection of patients who should be indicated for surgical treatment and will be evaluated in prospective study. In order to verify this hypothesis, we plan to do prospective study using "Stroke-Stop" formula for ipsilateral annual stroke rate in asymptomatic individuals with carotid stenosis who receive conservative therapy.

Path-Dependent Supercooling of the

We examine the discontinuous first-order superfluid ^{3}He A to B transition in the vicinity of the polycritical point (2.232 mK and 21.22 bar). We find path-dependent transitions: cooling at fixed pressure yields a well-defined transition line in the temperature-pressure plane, but this line can be reliably crossed by depressurizing at nearly constant temperature after transiting T_{c} at a higher pressure. This path dependence is not consistent with any of the standard B-phase nucleation mechanisms in the literature. This symmetry breaking transition is a potential simulator for first order transitions in the early Universe.