Medical Bulletin 08/ April/ 2025 - Video

A new study has found that individuals who have experienced a minor stroke or a transient ischemic attack remain at an elevated risk of suffering a more severe stroke for several years following the initial event. Findings are published in JAMA.

Anonymized data on 171,068 patients who experienced a minor stroke or transient ischemic attack were analyzed from hospital- or community-based studies conducted across four continents spanning 20 countries. Khan says the findings are relevant to everyone no matter where they live in the world.

The findings show that risks of a subsequent stroke are 5.9 percent in the first year, 12.8 percent within five years, and 19.8 percent within 10 years.

A lot of focus has been put on preventing stroke in the first 90-days post- transient ischemic attack or minor stroke, which is when a person is at the highest risk of a second stroke. However, what we're seeing in this study is that the risk continues and remains high for at least the next decade," says Dr. Faizan Khan, PhD, postdoctoral fellow at the Cumming School of Medicine and lead author of the study. What's really important from these findings is that people need to stay vigilant. Attention to and treatment of stroke risk factors, such as high blood pressure, is essential not just when people are released from hospital, but for their lifetime."

Reference: https://news.ucalgary.ca/news/global-study-led-ucalgary-researchers-establishes-long-term-risk-stroke

Two plant-based diets were associated with similar survival benefits and low environmental impact, according to research presented today at European Society of Cardiology Preventive Cardiology 2025.

In the analysis, data on food intake were collected from 11,488 participants between June 2008 and October 2010. The Planetary Health Diet Index was calculated for each participant based on their consumption of 15 food groups: whole grains, starchy vegetables, vegetables, whole fruits, dairy foods, red/processed meat, chicken and other poultry, eggs, fish/shellfish, nuts, non-soy legumes, soybean/soy foods, added saturated and trans-fat, added unsaturated oils, and added sugar and fruit juice. Adherence to the Mediterranean Diet was assessed using the 14-item MEDAS score, which is based on components such as using olive oil for cooking and dressings, eating white meat and seafood over red meat, the consumption of fruits, vegetables, legumes and nuts, and low intake of high-fat dairy products, commercial baked goods and sugar-sweetened/carbonated beverages. Mortality data were obtained from the National Death Index of Spain.

Higher adherence to the Planetary Health Diet and Mediterranean Diet was similarly associated with lower all-cause mortality. Participants in the top third for adherence to the Planetary Health Diet had a 22% lower chance of dying than those in the lowest third. For the Mediterranean Diet, participants in the top third for adherence had a 21% lower chance of dying than those in the lowest third. Adherence to some components of the Planetary Health Diet (fruits, dairy and unsaturated oils) and the Mediterranean Diet (nuts, low consumption of soda and pastries) was independently associated with lower mortality. In terms of environmental impact, both diets had similarly low footprints. For the PHD, the average level of greenhouse gas emissions was 4.15 kg of CO2 per day and average level of land use was 5.54 m2 per daily food intake. The average level of greenhouse gas emissions for the Mediterranean Diet including dairy was 4.36 kg of CO2 per day and the average level of land use was 5.43 m2 per daily food intake.

Reference: https://www.escardio.org/The-ESC/Press-Office/Press-releases/Planetary-Health-Diet-and-Mediterranean-Diet-Associated-with-Similar-Survival-and-Sustainability-Benefits

A new study showed that the Xpert MTB/Ultra molecular diagnostic test for stool samples, until now recommended only for children, could be established as an additional test for diagnosing tuberculosis in adults living with HIV. The results, published in The Lancet Microbe, could represent a paradigm shift in the diagnosis of the disease in this population.

Researchers from the Stool4TB project proposed using a molecular test, currently used on respiratory samples, on stool samples. This test is already recommended for children because they have difficulty producing sputum. The research was conducted between December 2021 and August 2024 in medical centres in three African countries -Eswatini, Mozambique, and Uganda-, and recruited 677 patients over 15 years old with HIV and suspected TB. Participants provided sputum, urine, stool, and blood samples.

The results showed that the stool test had a sensitivity of 23.7% and a specificity of 94.0%, compared with the reference standard. In patients with CD4 counts below 200 cells/μl, sensitivity increased to 45.5%. The Stool Ultra test identified additional cases that were not detected by TB-LAM, Ultra in sputum or bacterial culture.

“The results of our study support the use of the Stool Ultra test as a complementary tool for diagnosing tuberculosis in people living with HIV, especially in those with advanced AIDS, where the risk of tuberculosis is higher,” says Alberto L. García-Basteiro, a researcher at ISGlobal and head of the Vaccine and Immune Response to Infections Unit at Hospital Clínic de Barcelona.

Reference: Kasule, G., Hermans, S., Acacio, S., et al, Performance of stool Xpert MTB/RIF Ultra for detection of Mycobacterium tuberculosis among adult people living with HIV: a prospective multicentre diagnostic study. Lancet Microbe (2025). https://doi.org/10.1016/j.lanmic.2025.101085