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Introduction: Patients with transient ischemic attack (TIA) and minor stroke demonstrate cognitive impairment, and a four-fold risk of late-life dementia. Aim: To study the extent to which the rates of brain volume loss in TIA patients differ from healthy controls and how they are correlated with cognitive impairment. Methods: TIA or minor stroke patients were tested with a neuropsychological battery and underwent T1 weighted volumetric magnetic resonance imaging scans at fixed intervals over a 3 years period. Linear mixed effects regression models were used to compare brain atrophy rates between groups, and to determine the relationship between atrophy rates and cognitive function in TIA and minor stroke patients. Results: Whole brain atrophy rates were calculated for the TIA and minor stroke patients; n = 38 between 24 h and 18 months, and n = 68 participants between 18 and 36 months, and were compared to healthy controls. TIA and minor stroke patients demonstrated a significantly higher whole brain atrophy rate than healthy controls over a 3 years interval (p = 0.043). Diabetes (p = 0.012) independently predicted higher atrophy rate across groups. There was a relationship between higher rates of brain atrophy and processing speed (composite P = 0.047 and digit symbol coding P = 0.02), but there was no relationship with brain atrophy rates and memory or executive composite scores or individual cognitive tests for language (Boston naming, memory recall, verbal fluency or Trails A or B score). Conclusion: TIA and minor stroke patients experience a significantly higher rate of whole brain atrophy. In this cohort of TIA and minor stroke patients changes in brain volume over time precede cognitive decline.

Objectives: The FOAM Impact study sought to examine baseline rates of intravenous (IV) lidocaine usage for the treatment of renal colic and to compare rates of use between FOAM utilizers and nonutilizers. We sought to measure the effect of FOAM resources on clinical practice by timing the release of FOAM content with publication of the LIDOKET trial. Methods: A cross‐sectional before‐and‐after survey was conducted and disseminated on two social media platforms. The 13‐question, anonymous survey was posted for 1 week prior following the release of the LIDOKET study. Descriptive statistics, Mann‐Whitney t‐test, and chi‐square test statistics were used to describe survey respondent characteristics and Likert responses. Results: There were a total of 472 survey respondents. A total of 321 physicians (75.7% of total respondents) provided pre‐ and postpublication survey answers. There was no significant change in the use of analgesics before and after publication of LIDOKET and concurrent REBEL EM blog post. A total of 197 (42%) survey respondents reported using lidocaine for renal colic, of which 60 respondents (13%) reported frequent or occasional use. The mean difference in perceived efficacy of lidocaine before and after publication was −0.30 (95% confidence interval [CI] = −0.80 to 0.19, p = 0.15). Being a FOAM user was not associated with changes in mean difference in perception of lidocaine efficacy (F = 0.127, p = 0.72); however, there was a significant difference in perception of lidocaine's efficacy following LIDOKET and REBEL EM publication (F = 4.718, p = 0.03). Conclusions: Using an online survey‐based technique, no appreciable impact of FOAM resources was immediately apparent; however, engagement with FOAM was associated with a change in perception of IV lidocaine's efficacy. To our knowledge, this is the first study of its kind to evaluate the impact of FOAM on clinical practice. The unique method of coordinating FOAM distribution with traditional medical publication may provide future opportunities for measuring the impact of asynchronous medical education resources on medical practice. [ABSTRACT FROM AUTHOR]

Introduction: Patients with transient ischemic attack (TIA) and minor stroke demonstrate cognitive impairment, and a four-fold risk of late-life dementia. Aim: To study the extent to which the rates of brain volume loss in TIA patients differ from healthy controls and how they are correlated with cognitive impairment. Methods: TIA or minor stroke patients were tested with a neuropsychological battery and underwent T1 weighted volumetric magnetic resonance imaging scans at fixed intervals over a 3 years period. Linear mixed effects regression models were used to compare brain atrophy rates between groups, and to determine the relationship between atrophy rates and cognitive function in TIA and minor stroke patients. Results: Whole brain atrophy rates were calculated for the TIA and minor stroke patients; n = 38 between 24 h and 18 months, and n = 68 participants between 18 and 36 months, and were compared to healthy controls. TIA and minor stroke patients demonstrated a significantly higher whole brain atrophy rate than healthy controls over a 3 years interval ( p = 0.043). Diabetes ( p = 0.012) independently predicted higher atrophy rate across groups. There was a relationship between higher rates of brain atrophy and processing speed (composite P = 0.047 and digit symbol coding P = 0.02), but there was no relationship with brain atrophy rates and memory or executive composite scores or individual cognitive tests for language (Boston naming, memory recall, verbal fluency or Trails A or B score). Conclusion: TIA and minor stroke patients experience a significantly higher rate of whole brain atrophy. In this cohort of TIA and minor stroke patients changes in brain volume over time precede cognitive decline.