Differential Etiology Research Articles

Abstract 4137672: Prevalence, Clinical Characteristics, and Outcomes in Heart Failure with Improved Ejection Fraction by Sex

Background: Heart failure with improved ejection fraction (HFimpEF) is a growing clinical entity. While males are more likely to present with HFrEF, there remains little understanding of how sex relates to the epidemiology, predictors, and progression of HFimpEF. Research Question: What are the differences in epidemiology, clinical characteristics, medical management, and outcomes in patients (pts) with HFimpEF based on sex. Methods: We identified adults age ≥18 years with incident HFrEF (EF ≤40%) between January 2013 and December 2018 within Kaiser Permanente Northern California, an integrated health system serving >4.5 million members. HFimpEF was defined as subsequent EF measurement >40% within the following 12 months. Sex was based on self-report. Among pts with HFimpEF, we examined guideline-directed medical therapy (GDMT) use at time of incident HFimpEF, and at 6- and 12-months post-HFimpEF, stratified by sex. The incidence of worsening HF (WHF) events and all-cause death was assessed in a landmark analysis at 12 months post-HFrEF. We compared event rates between patients with HFimpEF and persistent HFrEF using Cox proportional hazards models adjusted for baseline age and EF. Results: Among 12,639 patients with incident HFrEF (female: 36%), 33% experienced HFimpEF. Females were more likely to experience HFimpEF in the 12 months following HFrEF than males (34% vs. 32%, p<0.01). Among pts with HFimpEF, treatment with GDMT was similar among males and females and declined after incident HFimpEF in both sexes (Figure, Panel A). Females had similar rates of WHF or all-cause death compared to males (adjusted [a]HR: 1.10, 95% CI: 0.96, 1.26, P=0.17). Compared with those with persistent HFrEF, pts with HFimpEF had lower rates of WHF or all-cause death, a finding which was consistent by sex (male: aHR: 0.55, 95% CI: 0.50 to 0.61, female: aHR: 0.54, 95% CI: 0.48 to 0.62; Pinteraction by sex=0.78; Figure, Panel B). Conclusions: HFimpEF is more common among females compared to males, but prognosis is similar. Despite similar medical therapy, GDMT discontinuation after EF improvement is prevalent. Improvement in EF is similarly associated with improved outcomes across sex. Further data are needed to elucidate the differential etiologies of HF by sex.

Biomarkers in diabetes mellitus: Advancements, challenges, and future perspectives

Diabetes mellitus (DM) represents a multifaceted metabolic disorder characterized by hyperglycemia and dysregulated metabolism, stemming from a myriad of factors including insulin insufficiency and impaired glucose utilization. Its complications span a broad spectrum, encompassing vascular diseases and neurological impairments. While some risk factors are beyond control, such as age and genetics, others like diet and exercise offer avenues for risk mitigation. This review delineates the distinct pathogenic processes of the two primary forms of DM, type 1 and type 2, emphasizing their differential etiologies and epidemiological trends. Biomarkers play a pivotal role in the diagnosis and management of DM, offering insights into disease progression, beta-cell function, and therapeutic responses. Traditional biomarkers, alongside predictive markers like autoantibodies, facilitate early detection and intervention strategies. Moreover, advancements in high-throughput "-omics" technologies have unraveled the molecular intricacies underlying disease progression, heralding the discovery of potential serum protein biomarkers in type 1 DM and unveiling promising candidates such as unmethylated insulin DNA and dysregulated microRNAs. In type 2 DM, traditional biomarkers like fructosamine, glycated albumin, and 1,5-anhydroglucitol offer valuable tools for glycemic control assessment, with emerging biomarkers like zinc-alpha-2-glycoprotein holding promise for diabetic nephropathy detection. Despite challenges, ongoing research endeavors hold promise for refining these biomarkers and enhancing diabetes management strategies, thus improving patient outcomes.

Reported Personality Traits and Histories of Childhood Maltreatment in Borderline Personality Disorder and Bipolar 2 Disorder: A Comparative Study

This study compared borderline personality disorder (BPD) and bipolar 2 disorder (BP 2 disorder) with respect to reported childhood trauma and Five-Factor personality traits using the Childhood Trauma Questionnaire (CTQ) and the NEO Five-Factor Inventory (NEO-FFI). Participants were 50 men and women, aged 18-45, with DSM-5-diagnosed BPD and 50 men and women in the same age group with DSM-5-diagnosed BP 2 disorder. Participants could not meet criteria for both BPD and BP 2 disorder. Borderline participants had significantly higher scores on the neuroticism subscale and significantly lower scores on the agreeableness subscale of the NEO-FFI. After correction for multiple comparisons, there were no between-group differences on CTQ scores. Study results suggest that BPD and BP 2 disorder differ primarily with respect to underlying temperament/genetic architecture and that environmental factors have only a limited role in the differential etiologies of the two disorders.

18 Nightmares Independently Predict Neurobehavioral Symptoms in Adults with mTBI

Objective:To investigate the informative value of nightmares on neurobehavioral functioning in individuals with mild traumatic brain injury (mTBI) beyond general sleep disturbance.Participants and Methods:A sample of 146 adults with mTBI (mean age = 45.1±16.0), recruited from a specialized concussion treatment center, underwent an assessment of neurobehavioral functioning using the Behavioral Assessment Screening Tool (BAST), self-reported habitual sleep disturbance and quality (via the Pittsburgh Sleep Quality Index; PSQI), and reported nightmare frequency in the past two weeks.Results:Nightmare frequency was the strongest predictor of negative affect (ß = .362, p <.001), anxiety (ß = .332, p <.001), and impulsivity (ß = .270, p <.001) after controlling for sex and age. Sleep disturbance accounted for the greatest variance in depression (ß = .493, p <.001), burden from concussion (ß = .477, p <.001), and fatigue (ß = .449, p <.001) after controlling for sex and age.Conclusions:Nightmares independently associate with neurobehavioral symptoms and likely have differential etiology from reported sleep disturbance. Nightmare frequency was more strongly related to positive neurobehavioral symptoms (i.e., added factors that impact functioning, e.g., anxiety), while general sleep disturbance was associated with negative neurobehavioral symptoms (i.e., factors taken away that impact functioning, e.g., lack of energy). Our findings suggest that neuropsychological evaluations of individuals with mTBI should assess for sleep disturbance and nightmare frequency as risk factors for neurobehavioral barriers to functioning.

Before blaming levodopa/carbidopa intestinal gel for demyelinating polyneuropathy, all differential aetiologies must be ruled out.

Before blaming levodopa/carbidopa intestinal gel for demyelinating polyneuropathy, all differential aetiologies must be ruled out.

Response to 'Before blaming levodopa/carbidopa intestinal gel for demyelinating polyneuropathy, all differential aetiologies must be ruled out'.

Response to 'Before blaming levodopa/carbidopa intestinal gel for demyelinating polyneuropathy, all differential aetiologies must be ruled out'.

Hypocalcemia in thalassemia major patients requires an extra-careful approach

Thalassemia is a hematological disorder caused by a gene mutation that leads to defective synthesis of hemoglobin complex. One of the complications of thalassemia is hypocalcemia which is presented with paresthesia, muscle spasm, low-serum calcium, and intracranial calcification. Hypocalcemia can affect thalassemic patients via various mechanisms. Blood transfusion-related and transfusion-independent iron overload, drug side effects, vitamin D3 deficiency, and genetic disorders and polymorphisms are among the etiologies of hypocalcemia in major thalassemia. A careful approach to the differential etiology of this phenomenon is crucial for a resultful treatment.

Assessing animal welfare during a stranding of pygmy killer whales (Feresa attenuata)

AbstractEmpirical assessment of cetacean welfare to inform stranding interventions is lacking. Here, potential welfare indicators are described for two stranded pygmy killer whales (Feresa attenuata), along with euthanasia procedures and pathology of potential relevance. The animals were filmed for 3.5 and 1.5 hr, respectively, allowing assessment of 19 indicators, including animal behaviors and human interventions. Eight interventions and 19 animal behaviors were identified; 17 and 11 behaviors were displayed by animal 1 and 2, respectively. Examination of ballistics euthanasia revealed atypical projectile placement and characterized animal behavioral responses, but welfare implications could not be assessed as insensibility was not verified in‐field. Pulmonary edema and renal degeneration were documented in both animals; differential etiologies include ischemia–reperfusion, shock, and/or myopathy. Potential relationships among histopathology and welfare indicators are explored to infer affective experiences. For example, simultaneous head‐lifting with respiration increased over time which, alongside pulmonary edema, suggests these animals experienced breathlessness. Other likely affective states include fatigue and discomfort; there are insufficient data to estimate the intensity or duration of these experiences or to provide an overall welfare grade/score. Further data are required to validate the proposed welfare indicators and to progress development of holistic approaches to welfare assessment at cetacean strandings.

Diagnostic investigation of Mycoplasma hyorhinis as a potential pathogen associated with neurological clinical signs and central nervous system lesions in pigs

Mycoplasma hyorhinis (M. hyorhinis) is a commensal of the upper respiratory tract in swine with the typical clinical presentations of arthritis and polyserositis in postweaning pigs. However, it has also been associated with conjunctivitis and otitis media, and recently has been isolated from meningeal swabs and/or cerebrospinal fluid of piglets with neurological signs. The objective of this study is to evaluate the role of M. hyorhinis as a potential pathogen associated with neurological clinical signs and central nervous system lesions in pigs. The presence of M. hyorhinis was evaluated in a clinical outbreak and a six-year retrospective study by qPCR detection, bacteriological culture, in situ hybridization (RNAscope®), and phylogenetic analysis and with immunohistochemistry characterization of the inflammatory response associated with its infection. M. hyorhinis was confirmed by bacteriological culture and within central nervous system lesions by in situ hybridization on animals with neurological signs during the clinical outbreak. The isolates from the brain had close genetic similarities from those previously reported and isolated from eye, lung, or fibrin. Nevertheless, the retrospective study confirmed by qPCR the presence of M. hyorhinis in 9.9% of cases reported with neurological clinical signs and histological lesions of encephalitis or meningoencephalitis of unknown etiology. M. hyorhinis mRNA was confirmed within cerebrum, cerebellum, and choroid plexus lesions by in situ hybridization (RNAscope®) with a positive rate of 72.7%. Here we present strong evidence that M. hyorhinis should be included as a differential etiology in pigs with neurological signs and central nervous system inflammatory lesions.

Comparative Transcriptome of Dorsal Root Ganglia Reveals Distinct Etiologies of Paclitaxel- and Oxaliplatin-induced Peripheral Neuropathy in Rats.

Chemotherapy-induced peripheral neuropathy is one of the most common side effects of anticancer therapy. It is anticipated that chemotherapies with different mechanisms of action may affect somatosensory neurons differently. This study aimed to explore similar and differential etiologies of oxaliplatin- and paclitaxel-induced neuropathy by comparing the transcriptomes of dorsal root ganglia (DRGs). We retrieved our previously published transcriptome data of DRGs extracted from vehicle-, oxaliplatin- and paclitaxel-treated rats (GSE160543), to analyze in parallel the differentially expressed genes (DEGs) and Gene ontology (GO) terms enrichment. We found that both oxaliplatin and paclitaxel treatments consistently produced mechanical allodynia, thermal hyperalgesia, and cold hyperalgesia in rats. Compared to vehicle, 320 and 150 DEGs were identified after oxaliplatin and paclitaxel treatment, respectively. Only 17 DEGs were commonly dysregulated by the two reagents. Activating transcription factor 3 (Atf3), a marker of nerve injury, was elevated only after paclitaxel treatment. GO analysis suggested that paclitaxel treatment was associated with neuronal changes characterized by numerous terms that are related to synaptic transmission, while oxaliplatin was more likely to affect dividing cells (e.g., the glia) and neuroinflammation. Notably, 29 biological processes GO terms were commonly enriched in response to both drugs. However, 28 out of 29 terms were oppositely modulated. This study suggests that distinct mechanisms underly paclitaxel- and oxaliplatin-induced neuropathy. Paclitaxel might directly affect somatosensory neurons while oxaliplatin primarily targets dividing cells and immune cells.

Binge drinking and violence in the transition to adulthood.

We analyzed data from the National Longitudinal Study of Adolescent Health (Add Health) to test the hypothesis that binge drinking, rather than frequency of any drinking, would predict violent behavior in the transition from adolescence to adulthood (TAA). In conservative models, accounting for a host of factors relevant to the TAA, we find that binge drinking, but not frequency of drinking, is associated with violent behavior. The models included a control for nonviolent offending, conforming to studies of the "differential etiology of violence" thesis. In addition, we tested whether this association fell away among participants over the age of 21 and found that underage status did not mediate the association between binge drinking and violent behavior.

Before Attributing Polyradiculitis to an Anti-SARS-CoV-2 Vaccine, Differential Etiologies need to be Ruled Out.

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Examining the Relationship Between Cognitive Ability and Arrest Using a Differential Offenses Hypothesis: Evidence of Inconsistent Mediation

The current study assessed the role of differential offense category involvement in the link between cognitive ability and arrest. Using structural equation modeling, the current study relied on data from the Pathways ( n = 1,354) and Add Health ( n = 3,605) to address three research questions on the differential etiology of offending category (aggressive and property), the mediating effects of disaggregated offending on the relationship between IQ and arrest, and how those effects vary across samples. The results suggested the negative association between IQ and arrest masked more complex processes encompassing opposing indirect paths through aggressive (negative) and property (positive) offending, suggesting inconsistent mediation. As a result, the total indirect effect of IQ on arrest through offending was suppressed when an aggregated offending measure was used, highlighting the value of disaggregating offending categories.

Acute flaccid rhombencephalomyelitis with radiculitis in a child with an enterovirus A71 infection seen for the first time in Denmark: a case report

BackgroundAcute flaccid myelitis is a serious condition of the spinal cord. More than 80% of patients experience a mild respiratory illness or fever consistent with a viral infection prior to acute flaccid myelitis development. Enterovirus A71 is known to circulate in Denmark, and has previously been associated with severe neurological symptoms. In this case report we describe acute flaccid rhombencephalomyelitis with radiculitis in an infant with an enterovirus infection.Case presentationThe 8-month-old male of Asian origin presented with fever and gastrointestinal symptoms, followed by severe neurological deficits such as flaccid paralysis of the neck and upper extremities. An initial magnetic resonance imaging scan of the brain was normal, and the boy was treated for encephalitis. A follow-up magnetic resonance imaging scan of the brain and spinal cord 1 week later showed the development of pathological symmetrical gray matter hyperintensity lesions on T2-weighted images in the brainstem and upper medulla spinalis, and nerve enhancement in the terminal thread of the spinal cord and the cervical roots; findings consistent with rhombencephalomyelitis with radiculitis causing flaccid paralysis. Enterovirus A71 was detected in both nasopharyngeal and fecal specimens. Other differential diagnostic etiologies of viral and bacterial encephalitis, including poliovirus, were excluded.ConclusionsThis is the first case in Denmark of a patient diagnosed with acute flaccid rhombencephalomyelitis strongly linked to an enterovirus A71 infection. This case emphasizes the diagnostic importance of combining a history of respiratory and/or gastrointestinal illness, fever, and delayed onset of varying degrees of paralysis with progressive characteristic spinal and brain lesions. Analysis of respiratory, fecal, and cerebrospinal samples for the presence of enterovirus, and eliminating other differential pathogens, is essential to confirm the diagnosis.

Sex differences in incidence of out-of-hospital cardiac arrest across ethnic and socioeconomic groups: a population-based cohort study in the Netherlands

Abstract Background Current out-of-hospital cardiac arrest (OHCA) prevention strategies are suboptimal due to the inability to identify subgroups at high risk. Insight into the occurrence of OHCA within general populations may help to target prevention strategies. Case registries suggest that there may be substantial differences in emergency medical service (EMS)-attended OHCA incidence between men and women. However, due to a lack of individual-level prospective data, relative sex differences across ethnic groups and socioeconomic (SES) groups have not been studied. Purpose We investigated sex differences in OHCA incidence, overall and across ethnic groups and SES groups. Methods We performed a retrospective population-based cohort study, combining individual-level data on ethnicity and income (as SES measure) from Statistics Netherlands of all men and women aged ≥25 years living in one study region in the Netherlands on 01–01–2009 (n=1,688,285) with prospectively collected EMS-attended OHCA cases (n=5,676) from the ARREST registry until 31-12-2015. We calculated age-standardised incidence rates of OHCA. Sex differences were assessed with Cox proportional hazards regression analyses, adjusted for age, ethnicity and income, in the overall population, and across ethnic and SES groups. Results Overall, the age-standardised incidence rate of OHCA was lower in women than in men (30.9 versus 87.3 per 100,000 person-years), corresponding with a hazard ratio (HR) of 0.33 (95% confidence interval [CI] 0.31–0.35). While incidence rates varied across subgroups (range: 22.6–104.6 per 100,000 person-years), the sex differences in hazard for OHCA existed in all income quintiles (HR range: 0.30–0.35) and ethnic groups (HR range: 0.19–0.40), except among Moroccans (HR 0.89, 95% CI 0.51–1.57). Conclusion In most ethnic groups and all SES groups, women have a substantial, yet lower OHCA incidence rate than men. This confirms that men are an important target group for OHCA prevention strategies across social strata. Nevertheless, considering potentially differential aetiology as well as the lower survival rates among women, women will also benefit from targeted prevention strategies. Funding Acknowledgement Type of funding sources: Public grant(s) – EU funding. Main funding source(s): European Union's Horizon 2020 research and innovation programme under acronym ESCAPE-NET (grant number 733381) and the COST Action PARQ (grant agreement number CA19137).ZonMw Gender and Health (grant number 8492ehab724.06458) and Gender and Prevention (grant number 555003016) programmes.

Evaluating current chest imaging practices of pediatric patients with COVID-19: A retrospective analysis

PurposeThis retrospective analysis aims to examine the effectiveness of the current chest imaging guidelines regarding COVID-19 positive pediatric patients on our study group of patients aged 0 to 18. Materials and methodsWe examined clinical and imaging data of 178 pediatric COVID-19 positive patients confirmed by PCR admitted to the Children's Hospital of Los Angeles between March 6, 2020 and June 23, 2020. ResultsOf 178 patients, only 46 (27%) patients underwent any form of chest imaging. Thirteen (28%) of 46 imaged patients had positive chest X-rays (CXR) or computed tomography (CT) chest findings, with 8 (62%) of the 13 patients suggesting pneumonia or multifocal pneumonia, 3 (23%) patients having acute respiratory distress syndrome, and 2 (15%) patients demonstrating left sided pleural effusions thought to be the result of ruptured appendicitis unrelated to their COVID-19 diagnosis. All but one patient had significant prior medical histories with an associated comorbid medical condition. Of the 46 imaged patients, 17 (37%) patients had a negative chest X-ray, and 15 (33%) patients had suggestive findings of viral etiology. 132 patients were not imaged. ConclusionOur study population corroborated current chest imaging guidelines in pediatric patients. Chest imaging modalities such as CXR and CT should be reserved for patients who are severely symptomatic and/or possess prior comorbidities such as immunosuppression, diabetes, asthma, obesity, or where other differential etiologies must be entertained.

Hematologic Emergencies in the Postoperative Neurointensive Care Unit Setting: Illustrative Case Series and Differential Diagnosis

ObjectivesInvestigating the development of acute thrombocytopenia, differential etiologies, and potentially the rare manifestation of disseminated intravascular coagulation after brain tumor resection of primary and secondary malignancies. Materials and methodsWe performed a retrospective review of a case series of post-operative neurosurgical patients which developed thrombocytopenia. We applied National Library of Medicine search engine methodology using the terms disseminated intravascular coagulation and brain tumors. ResultsWe report clinical, radiographic, and laboratory data of four Neurointensive care unit patients that developed thrombocytopenia, three with disseminated intravascular coagulation after craniotomy, and one with heparin-induced thrombocytopenia masquerading as low grade disseminated intravascular coagulation. All four patients presented with cranial lesions and underwent neurosurgical resection. Underlying disorders included: high grade glioma, stage IV lung cancer with metastases, and meningioma. One patient survived and was able to recover after several days of hospitalization, while another patient was discharged to hospice. Search results illustrated that disseminated intravascular coagulation in the presence of glioblastoma multiforme is rare (only four patients) and may be due to a release of coagulation factors like tissue plasminogen activator, treated with antifibrinolytic agents. Searching the terms disseminated intravascular coagulation and brain tumors in the National Library of Medicine search engine yielded 116 results; eight were relevant to our study. ConclusionsCorrelation of thrombocytopenia after neurosurgery for glioblastoma multiforme and disseminated intravascular coagulation is rare. It is extremely challenging to manage these patients with concomitant deep vein thrombosis/pulmonary embolism and intracranial bleeding. Heparin-induced thrombocytopenia is common yet possesses a different hematological coagulation profile and has more pharmacologic options. Neurointensive care unit teams should recognize intraoperative and post-operative disseminated intravascular coagulation cases, and heparin-induced thrombocytopenia in the differential of post-operative thrombocytopenia with specific pharmacologic interventions.

Molecular study and genotype–phenotype in Chinese female patients with 46, XY disorders of sex development

Objective The rare condition 46, XY disorders of sex development (DSDs) is characterized by the female phenotype and male karyotype. We aimed to describe the genetic basis of 46, XY DSDs in nine patients and the genotype–phenotype relationships of the genes involved. Methods Targeted next-generation sequencing (NGS) was used to analyze the underlying hereditary etiology in nine female patients with 46, XY DSDs. In silico analyses were used to predict the effects of novel variants on the protein function of the identified genes. Results Primary amenorrhea with the absence of puberty, inguinal hernia, and clitoridauxe were common complaints. All enrolled patients had a differential etiology by genetic testing, and five novel genetic variants involved in four genes (SRY, AR, NR5A1, and LHCGR) were identified. A novel nonsense variant of SRY c.51C > G was found in XY patients without testicles. Two novel heterozygous variants, i.e. c.265A > T (Ile89Leu) and c.422T > C (Val141Ala), of the LHCGR gene were found in male pseudo-hermaphroditism. Conclusions We expanded the genetic mutation spectrum and described in detail the genotype–phenotype relationships of 46, XY DSDs. DNA sequencing for SRY should be a priority in female patients with 46, XY DSDs. NGS is useful for clarifying genetic pathogenesis and could provide a basis for clinical diagnosis and treatments of patients with 46, XY DSDs.

Small intestinal pseudodiverticulosis in a pony mare

A 14-y-old pony mare was referred after 30-d duration of intermittent pyrexia, anorexia, weight loss, and change in manure consistency. Physical examination revealed a palpable but reducible ventral abdominal mass. Transabdominal ultrasonography revealed multiple distended, hypomotile, and thickened small intestinal loops in close approximation with numerous, well-defined, hyperechoic masses. There was a large amount of echogenic peritoneal fluid; abdominocentesis revealed a neutrophilic and macrophagic inflammatory exudate, and a mixed bacterial population was cultured. Given the poor prognosis, the mare was euthanized. The autopsy findings included a large abdominal abscess, serosanguineous peritoneal fluid with fibrin strands, and ~50 outpouches communicating with the lumen and extending from the anti-mesenteric aspect of the duodenum, jejunum, and ileum. These structures were classified as pseudodiverticula based on the histologic absence of the tunica muscularis layer of the intestinal wall. Pseudodiverticula should be included as a differential etiology in horses when clinical signs consistent with colic, diarrhea, or weight loss are recognized and, when on examination, one or more organized masses are palpated or visualized on transabdominal ultrasound, as well as visualization of small intestinal loops with thickened walls.

Detection of Atrial Fibrillation After Central Retinal Artery Occlusion.

Central retinal artery occlusion (CRAO) causes sudden, irreversible blindness and is a form of acute ischemic stroke. In this study, we sought to determine the proportion of patients in whom atrial fibrillation (AF) is detected by extended cardiac monitoring after CRAO. We performed a retrospective, observational cohort study using data from the Optum deidentified electronic health record of 30.8 million people cross-referenced with the Medtronic CareLink database of 2.7 million people with cardiac monitoring devices in situ. We enrolled patients in 3 groups: (1) CRAO, (2) cerebral ischemic stroke, and (3) age-, sex-, and comorbidity-matched controls. The primary end point was the detection of new AF (defined as ≥2 minutes of AF detected on a cardiac monitoring device). We reviewed 884 431 patient records in common between the two databases to identify 100 patients with CRAO, 6559 with ischemic stroke, and 1000 matched controls. After CRAO, the cumulative incidence of new AF at 2 years was 49.6% (95% CI, 37.4%–61.7%). Patients with CRAO had a higher rate of AF than controls (hazard ratio, 1.64 [95% CI, 1.17–2.31]) and a comparable rate to patients with stroke (hazard ratio, 1.01 [95% CI, 0.75–1.36]). CRAO was associated with a higher incidence of new stroke compared with matched controls (hazard ratio, 2.85 [95% CI, 1.29–6.29]). The rate of AF detection after CRAO is higher than that seen in age-, sex-, and comorbidity-matched controls and comparable to that seen after ischemic cerebral stroke. Paroxysmal AF should be considered as part of the differential etiology of CRAO, and those patients may benefit from long-term cardiac monitoring.