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Huang M, Cheng S, Li Z, Chen J, Wang C, Li J, Zheng H. Preconditioning Exercise Inhibits Neuron Ferroptosis and Ameliorates Brain Ischemia Damage by Skeletal Muscle-Derived Exosomes via Regulating miR-484/ACSL4 Axis. Antioxid Redox Signal 2024. [PMID: 38545792 DOI: 10.1089/ars.2023.0492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
Aims: Although there is evidence that patients with stroke who exercise regularly before stroke have a better prognosis than those who do not exercise, the detailed mechanism remains unclear. Moreover, neuronal death plays a central role in neurological dysfunction caused by ischemic stroke. Thus, we investigated whether exercise could reduce stroke-induced neuronal death and its associated mediators in the current study. Results: Ferroptosis was the most dominant form of programmed cell death in neurons. Preconditioning exercise before stroke improved the neurological function and decreased the infarct area in rats with ischemic stroke. Preconditioning exercise attenuated stroke-induced ferroptosis by reducing lipid peroxidation (LPO) production, upregulating glutathione peroxidase 4 (GPX4) and solute carrier family 7 member 11 (SLC7A11), and downregulating acyl-CoA synthetase long-chain family member 4 (ACSL4). High-throughput sequencing and dual luciferase reporter assays revealed that exercise-induced exosomal miR-484 inhibits Acsl4 expression. Moreover, we showed that exercise-induced exosomal miR-484 is mainly derived from skeletal muscle, and the neuroprotective effect of preconditioning exercise is suppressed by inhibiting miR-484 production in skeletal muscle. Innovation: This study suggested that neuronal ferroptosis is the most dominant form of programmed cell death in a hypoxic environment. Moreover, we showed that the ferroptosis pathway is a potential therapeutic target in ischemic stroke and that preconditioning exercise could be an effective antioxidant intervention for cerebral ischemia. Conclusion: Our work revealed that preconditioning exercise before stroke exerts neuroprotective effects against brain ischemia by skeletal muscle-derived exosomal miR-484 via inhibiting ferroptosis.
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Affiliation(s)
- Mudan Huang
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Shimei Cheng
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Ziwen Li
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Jinshuo Chen
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Chuangjia Wang
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Jun Li
- Department of Biochemistry, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Haiqing Zheng
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
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Zhang H, Chang Y, Li Y, Wei J, Ma X, Zhou W, Zang X, Jin T, Wu S. Effects of CASZ1, WNT2B and PTPRG SNPs on stroke susceptibility in the Chinese Han population. Eur J Clin Invest 2024; 54:e14144. [PMID: 38059696 DOI: 10.1111/eci.14144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 10/20/2023] [Accepted: 11/19/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Stroke is an important cause of death and disability worldwide, ranking second in the cause of death, and it is thought to be related to genetic factors. The purpose of our study is to investigate the association between CASZ1, WNT2B and PTPRG single nucleotide polymorphisms (SNPs) and stroke risk in the Chinese population. METHODS We recruited 1418 volunteers, comprised of 710 stroke cases and 708 controls in this study. We used MassARRAY iPLEX GOLD method to genotype the three SNPs on CASZ1, WNT2B and PTPRG. Logistic regression was used to analyse the association between these SNPs and stroke, and odds ratios (ORs) and 95% confidence intervals (CIs) were then calculated. What's more, the interactions among SNPs were predicted by multi-factor dimensionality reduction (MDR) analysis. RESULTS This research demonstrated that CASZ1 rs880315 and PTPRG rs704341 were associated with reduced stroke susceptibility. More precisely, CASZ1 rs880315 was associated with reduced stroke susceptibility in people aged ≤64 years and women. PTPRG rs704341 was associated with reduced stroke susceptibility in people aged >64 years, women, non-smokers and non-drinkers. Conversely, WNT2B rs12037987 was related to elevated stroke susceptibility in people aged >64 years, women and non-smokers. In addition, CASZ1 rs880315, WNT2B rs12037987 and PTPRG rs704341 had a strong redundancy relationship. CONCLUSION Our study concludes that CASZ1 rs880315, WNT2B rs12037987 and PTPRG rs704341 are associated with stroke, and the study provides a basis for assessing genetic variants associated with stroke risk in the Han Chinese population.
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Affiliation(s)
- Huan Zhang
- College of Life Science, Northwest University, Xi'an, Shaanxi, China
- Key Laboratory of Resource Biology and Biotechnology in Western China (Northwest University), School of Life Sciences, Ministry of Education, Northwest University, Xi'an, Shaanxi, China
- Provincial Key Laboratory of Biotechnology of Shaanxi Province, Northwest University, Xi'an, Shaanxi, China
- Department of Neurology, The First Hospital of Xi'an, The First Affiliated Hospital of Northwest University, Xi'an, Shaanxi, China
| | - Yanting Chang
- College of Life Science, Northwest University, Xi'an, Shaanxi, China
- Key Laboratory of Resource Biology and Biotechnology in Western China (Northwest University), School of Life Sciences, Ministry of Education, Northwest University, Xi'an, Shaanxi, China
- Provincial Key Laboratory of Biotechnology of Shaanxi Province, Northwest University, Xi'an, Shaanxi, China
- Department of Neurology, The First Hospital of Xi'an, The First Affiliated Hospital of Northwest University, Xi'an, Shaanxi, China
| | - Yujie Li
- College of Life Science, Northwest University, Xi'an, Shaanxi, China
- Key Laboratory of Resource Biology and Biotechnology in Western China (Northwest University), School of Life Sciences, Ministry of Education, Northwest University, Xi'an, Shaanxi, China
- Provincial Key Laboratory of Biotechnology of Shaanxi Province, Northwest University, Xi'an, Shaanxi, China
| | - Jie Wei
- College of Life Science, Northwest University, Xi'an, Shaanxi, China
- Key Laboratory of Resource Biology and Biotechnology in Western China (Northwest University), School of Life Sciences, Ministry of Education, Northwest University, Xi'an, Shaanxi, China
- Provincial Key Laboratory of Biotechnology of Shaanxi Province, Northwest University, Xi'an, Shaanxi, China
| | - Xiaoya Ma
- College of Life Science, Northwest University, Xi'an, Shaanxi, China
- Key Laboratory of Resource Biology and Biotechnology in Western China (Northwest University), School of Life Sciences, Ministry of Education, Northwest University, Xi'an, Shaanxi, China
- Provincial Key Laboratory of Biotechnology of Shaanxi Province, Northwest University, Xi'an, Shaanxi, China
| | - Wenqian Zhou
- College of Life Science, Northwest University, Xi'an, Shaanxi, China
- Key Laboratory of Resource Biology and Biotechnology in Western China (Northwest University), School of Life Sciences, Ministry of Education, Northwest University, Xi'an, Shaanxi, China
- Provincial Key Laboratory of Biotechnology of Shaanxi Province, Northwest University, Xi'an, Shaanxi, China
| | - Xufeng Zang
- College of Life Science, Northwest University, Xi'an, Shaanxi, China
- Key Laboratory of Resource Biology and Biotechnology in Western China (Northwest University), School of Life Sciences, Ministry of Education, Northwest University, Xi'an, Shaanxi, China
- Provincial Key Laboratory of Biotechnology of Shaanxi Province, Northwest University, Xi'an, Shaanxi, China
| | - Tianbo Jin
- College of Life Science, Northwest University, Xi'an, Shaanxi, China
- Key Laboratory of Resource Biology and Biotechnology in Western China (Northwest University), School of Life Sciences, Ministry of Education, Northwest University, Xi'an, Shaanxi, China
- Provincial Key Laboratory of Biotechnology of Shaanxi Province, Northwest University, Xi'an, Shaanxi, China
| | - Songdi Wu
- College of Life Science, Northwest University, Xi'an, Shaanxi, China
- Department of Neurology, The First Hospital of Xi'an, The First Affiliated Hospital of Northwest University, Xi'an, Shaanxi, China
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Zhang X, Lv H, Chen X, Li M, Zhou X, Jia X. Analysis of ischemic stroke burden in Asia from 1990 to 2019: based on the global burden of disease 2019 data. Front Neurol 2023; 14:1309931. [PMID: 38187147 PMCID: PMC10770854 DOI: 10.3389/fneur.2023.1309931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 11/28/2023] [Indexed: 01/09/2024] Open
Abstract
Background Ischemic stroke has the characteristics of high morbidity, mortality, and recurrence rate. This study aimed to describe and assess the burden of ischemic stroke in Asia based on the global burden of disease (GBD) 2019 data and provide a crucial scientific foundation for the prevention and control of this life-threatening disease. Method This study used the GBD 2019 data to assess the burden of ischemic stroke. The indicators used in this study were derived from the following methods: (i) the incidence of ischemic stroke was estimated using the disability model for the global burden of disease study-mixed effects regression (DisMod-MR), a Bayesian meta-regression disease modeling tool; (ii) the non-specific codes of all available data on mortality were corrected and used to estimate mortality rates for ischemic stroke and the cause of death ensemble model was used to estimate mortality rates; and (iii) the disability-adjusted life years (DALYs) is the sum of years lived with disability (YLD) and the years of life lost (YLL), which quantifies the health loss due to specific diseases and injuries. In addition, the joinpoint regression model was adopted to analyze the temporal trend of ischemic stroke from 1990 to 2019 in Asia. Result This study found an increase in the burden of ischemic stroke in 2019 compared to 1990. Moreover, the age-standardized incidence rate (ASIR) of ischemic stroke showed a gradual upward trend over the specific period. The age-standardized mortality rate (ASMR) showed a downward trend in Asia from 1990 to 2019. The burden of ischemic stroke was more concentrated on older age groups, particularly those older than 65 years. East Asia had the highest burden of ischemic stroke compared to other regions in Asia. Particularly, China, India, Indonesia, and Japan had the highest burdens of ischemic stroke among the Asian countries and regions. However, the population with the highest burden of ischemic stroke was still the elderly group. Conclusion Based on our study, it is evident that the burden of ischemic stroke exists substantially and exhibits variations in the aspects of age, gender, and geographical region in Asia. Without targeted implementation of population-wide primary strategies for prevention and control, the burden of ischemic stroke is likely to worsen significantly in the future.
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Affiliation(s)
- Xueli Zhang
- School of Health Management, Changchun University of Chinese Medicine, Changchun, China
- Jilin Provincial People’s Hospital, Changchun, China
| | - Hengliang Lv
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Xin Chen
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Maoxuan Li
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Xiaojing Zhou
- Department of Biochemistry, Clinical Medical College, Changchun University of Chinese Medicine, Changchun, China
| | - Xiaoying Jia
- School of Health Management, Changchun University of Chinese Medicine, Changchun, China
- Jilin Provincial People’s Hospital, Changchun, China
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Chen W, Chen Y, Wu L, Gao Y, Zhu H, Li Y, Ji X, Wang Z, Wang W, Han L, Zhu B, Wang H, Xu M. Identification of cell death-related biomarkers and immune infiltration in ischemic stroke between male and female patients. Front Immunol 2023; 14:1164742. [PMID: 37435058 PMCID: PMC10332266 DOI: 10.3389/fimmu.2023.1164742] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/17/2023] [Indexed: 07/13/2023] Open
Abstract
Background Stroke is the second leading cause of death and the third leading cause of disability worldwide, with ischemic stroke (IS) being the most prevalent. A substantial number of irreversible brain cell death occur in the short term, leading to impairment or death in IS. Limiting the loss of brain cells is the primary therapy target and a significant clinical issue for IS therapy. Our study aims to establish the gender specificity pattern from immune cell infiltration and four kinds of cell-death perspectives to improve IS diagnosis and therapy. Methods Combining and standardizing two IS datasets (GSE16561 and GSE22255) from the GEO database, we used the CIBERSORT algorithm to investigate and compare the immune cell infiltration in different groups and genders. Then, ferroptosis-related differently expressed genes (FRDEGs), pyroptosis-related DEGs (PRDEGs), anoikis-related DEGs (ARDEGs), and cuproptosis-related DEGs (CRDEGs) between the IS patient group and the healthy control group were identified in men and women, respectively. Machine learning (ML) was finally used to generate the disease prediction model for cell death-related DEGs (CDRDEGs) and to screen biomarkers related to cell death involved in IS. Results Significant changes were observed in 4 types of immune cells in male IS patients and 10 types in female IS patients compared with healthy controls. In total, 10 FRDEGs, 11 PRDEGs, 3 ARDEGs, and 1 CRDEG were present in male IS patients, while 6 FRDEGs, 16 PRDEGs, 4 ARDEGs, and 1 CRDEG existed in female IS patients. ML techniques indicated that the best diagnostic model for both male and female patients was the support vector machine (SVM) for CDRDEG genes. SVM's feature importance analysis demonstrated that SLC2A3, MMP9, C5AR1, ACSL1, and NLRP3 were the top five feature-important CDRDEGs in male IS patients. Meanwhile, the PDK4, SCL40A1, FAR1, CD163, and CD96 displayed their overwhelming influence on female IS patients. Conclusion These findings contribute to a better knowledge of immune cell infiltration and their corresponding molecular mechanisms of cell death and offer distinct clinically relevant biological targets for IS patients of different genders.
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Affiliation(s)
- Wenli Chen
- Department of Rehabilitation Medicine, ZhongDa Hospital Southeast University, Nanjing, China
| | - Yuanfang Chen
- Engineering Research Center of Health Emergency, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
- Jiangsu Province Engineering Research Center of Health Emergency, Nanjing, China
| | - Liting Wu
- Engineering Research Center of Health Emergency, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yue Gao
- Jiangsu Province Engineering Research Center of Health Emergency, Nanjing, China
- Department of Occupational Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Hangju Zhu
- Jiangsu Province Engineering Research Center of Health Emergency, Nanjing, China
- Jiangsu Cancer Center, Jiangsu Cancer Hospital, Nanjing, China
| | - Ye Li
- Jiangsu Province Engineering Research Center of Health Emergency, Nanjing, China
- Department of Occupational Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Xinyu Ji
- Engineering Research Center of Health Emergency, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
- Jiangsu Province Engineering Research Center of Health Emergency, Nanjing, China
| | - Ziyi Wang
- Engineering Research Center of Health Emergency, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Wen Wang
- Engineering Research Center of Health Emergency, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Lei Han
- Jiangsu Province Engineering Research Center of Health Emergency, Nanjing, China
- Department of Occupational Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Baoli Zhu
- Jiangsu Province Engineering Research Center of Health Emergency, Nanjing, China
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Hongxing Wang
- Department of Rehabilitation Medicine, ZhongDa Hospital Southeast University, Nanjing, China
| | - Ming Xu
- Engineering Research Center of Health Emergency, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
- Jiangsu Province Engineering Research Center of Health Emergency, Nanjing, China
- School of Public Health, Nanjing Medical University, Nanjing, China
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Pallier PN, Ferrara M, Romagnolo F, Ferretti MT, Soreq H, Cerase A. Chromosomal and environmental contributions to sex differences in the vulnerability to neurological and neuropsychiatric disorders: Implications for therapeutic interventions. Prog Neurobiol 2022; 219:102353. [PMID: 36100191 DOI: 10.1016/j.pneurobio.2022.102353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 08/22/2022] [Accepted: 09/06/2022] [Indexed: 10/14/2022]
Abstract
Neurological and neuropsychiatric disorders affect men and women differently. Multiple sclerosis, Alzheimer's disease, anxiety disorders, depression, meningiomas and late-onset schizophrenia affect women more frequently than men. By contrast, Parkinson's disease, autism spectrum condition, attention-deficit hyperactivity disorder, Tourette's syndrome, amyotrophic lateral sclerosis and early-onset schizophrenia are more prevalent in men. Women have been historically under-recruited or excluded from clinical trials, and most basic research uses male rodent cells or animals as disease models, rarely studying both sexes and factoring sex as a potential source of variation, resulting in a poor understanding of the underlying biological reasons for sex and gender differences in the development of such diseases. Putative pathophysiological contributors include hormones and epigenetics regulators but additional biological and non-biological influences may be at play. We review here the evidence for the underpinning role of the sex chromosome complement, X chromosome inactivation, and environmental and epigenetic regulators in sex differences in the vulnerability to brain disease. We conclude that there is a pressing need for a better understanding of the genetic, epigenetic and environmental mechanisms sustaining sex differences in such diseases, which is critical for developing a precision medicine approach based on sex-tailored prevention and treatment.
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Affiliation(s)
- Patrick N Pallier
- Blizard Institute, Centre for Neuroscience, Surgery and Trauma, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK.
| | - Maria Ferrara
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; Department of Psychiatry, Yale University, School of Medicine, New Haven, CT, United States; Women's Brain Project (WBP), Switzerland
| | - Francesca Romagnolo
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | | | - Hermona Soreq
- The Edmond and Lily Safra Center of Brain Science, The Hebrew University of Jerusalem, 9190401, Israel
| | - Andrea Cerase
- EMBL-Rome, Via Ramarini 32, 00015 Monterotondo, RM, Italy; Blizard Institute, Centre for Genomics and Child Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK; Department of Biology, University of Pisa, SS12 Abetone e Brennero 4, 56127 Pisa, Italy.
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Ma Q, Li R, Wang L, Yin P, Wang Y, Yan C, Ren Y, Qian Z, Vaughn MG, McMillin SE, Hay SI, Naghavi M, Cai M, Wang C, Zhang Z, Zhou M, Lin H, Yang Y. Temporal trend and attributable risk factors of stroke burden in China, 1990–2019: an analysis for the Global Burden of Disease Study 2019. Lancet Public Health 2021; 6:e897-e906. [PMID: 34838196 PMCID: PMC9047702 DOI: 10.1016/s2468-2667(21)00228-0] [Citation(s) in RCA: 260] [Impact Index Per Article: 86.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 09/11/2021] [Accepted: 09/14/2021] [Indexed: 11/16/2022]
Abstract
Background Understanding the temporal trend of the disease burden of stroke and its attributable risk factors in China, especially at provincial levels, is important for effective prevention strategies and improvement. The aim of this analysis from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) is to investigate the disease burden of stroke and its risk factors at national and provincial levels in China from 1990 to 2019. Methods Following the methodology in the GBD 2019, the incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) of stroke cases in the Chinese population were estimated by sex, age, year, stroke subtypes (ischaemic stroke, intracerebral haemorrhage, and subarachnoid haemorrhage), and across 33 provincial administrative units in China from 1990 to 2019. Attributable mortality and DALYs of underlying risk factors were calculated by a comparative risk assessment. Findings In 2019, there were 3·94 million (95% uncertainty interval 3·43–4·58) new stroke cases in China. The incidence rate of stroke increased by 86·0% (73·2–99·0) from 1990, reaching 276·7 (241·3–322·0) per 100 000 population in 2019. The age-standardised incidence rate declined by 9·3% (3·3–15·5) from 1990 to 2019. Among 28·76 million (25·60–32·21) prevalent cases of stroke in 2019, 24·18 million (20·80–27·87) were ischaemic stroke, 4·36 million (3·69–5·05) were intracerebral haemorrhage, and 1·58 million (1·32–1·91) were subarachnoid haemorrhage. The prevalence rate increased by 106·0% (93·7–118·8) and age-standardised prevalence rate increased by 13·2% (7·7–19·1) from 1990 to 2019. In 2019, there were 2·19 million (1·89–2·51) deaths and 45·9 million (39·8–52·3) DALYs due to stroke. The mortality rate increased by 32·3% (8·6–59·0) from 1990 to 2019. Over the same period, the age-standardised mortality rate decreased by 39·8% (28·6–50·7) and the DALY rate decreased by 41·6% (30·7–50·9). High systolic blood pressure, ambient particulate matter pollution exposure, smoking, and diet high in sodium were four major risk factors for stroke burden in 2019. Moreover, we found marked differences of stroke burden and attributable risk factors across provinces in China from 1990 to 2019. Interpretation The disease burden of stroke is still severe in China, although the age-standardised incidence and mortality rates have decreased since 1990. The stroke burden in China might be reduced through blood pressure management, lifestyle interventions, and air pollution control. Moreover, because substantial heterogeneity of stroke burden existed in different provinces, improved health care is needed in provinces with heavy stroke burden. Funding National Key Research and Development Program of China and Taikang Yicai Public Health and Epidemic Control Fund.
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Abate TW, Zeleke B, Genanew A, Abate BW. The burden of stroke and modifiable risk factors in Ethiopia: A systemic review and meta-analysis. PLoS One 2021; 16:e0259244. [PMID: 34723996 PMCID: PMC8559958 DOI: 10.1371/journal.pone.0259244] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 10/16/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The burden and contribution of modifiable risk factors of stroke in Ethiopia are unclear. Knowledge about this burden and modifying risk factors is pivotal for establishing stroke prevention strategies. In recent decades, the issue of lifestyle and behavioral modification is a key to improve the quality of life. The modifiable risk factors are an importance as intervention strategies aimed at reducing these factors can subsequently reduce the risk of stroke. So far, many primary studies were conducted to estimate the burden of stroke and modifiable risk factors in Ethiopia. However, the lack of a nationwide study that determines the overall pooled estimation of burden and modifiable risk factors of stroke is a research gap. METHODS To conduct this systemic review and meta-analysis, we are following the PRISMA checklist. Three authors searched and extracted the data from the CINAHL (EBSCO), MEDLINE (via Ovid), PubMed, EMcare, African Journals Online (AJOL), and Google scholar. The quality of the primary study was assessed using the Newcastle-Ottawa Scale (NOS) by two independent reviewers. The primary studies with low and moderate risk of bias were included in the final analysis. The authors presented the pooled estimated burden of stroke and its modifiable risk factors. The registered protocol number in PROSPERO was CRD42020221906. RESULTS In this study, the pooled burden of hemorrhagic and ischemic stroke were 46.42% (95%CI: 41.82-51.53; I2 = 91.6%) and 51.40% (95%CI: 46.97-55.82; I2 = 85.5%) respectively. The overall magnitude of modifiable risk factor of hypertension, alcohol consumption and dyslipidemia among stroke patients were 49% (95%CI: 43.59, 54.41), 24.96% (95CI%:15.01, 34.90), and 20.99% (95%CI: 11.10, 30.88), respectively. The least proportion of stroke recovery was in the Oromia region (67.38 (95%CI: 41.60-93.17; I2 = 98.1%). Farther more, the proportion of stroke recovery was decreased after 2017 (70.50 (56.80-84.20). CONCLUSIONS In our study, more than 90% of stroke patients had one or more modifiable risk factors. All identified modifiable stroke risk factors are major public health issues in Ethiopia. Therefore, strategy is designed for stroke prevention to decrease stroke burden through targeted modification of a single risk factor, or a cluster of multiple risk factors, used on a population, community, or individual level.
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Affiliation(s)
- Teshager Weldegiorgis Abate
- Department of Adult Health Nursing, School of Health Science, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Balew Zeleke
- Department of Pediatric and Child Health Nursing, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Ashenafi Genanew
- Department of Pharmacology, School of Health Sciences, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
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Poupore N, Chosed R, Arce S, Rainer R, Goodwin RL, Nathaniel TI. Metabolomic Profiles of Men and Women Ischemic Stroke Patients. Diagnostics (Basel) 2021; 11:diagnostics11101786. [PMID: 34679483 PMCID: PMC8534835 DOI: 10.3390/diagnostics11101786] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Stroke is known to affect both men and women; however, incidence and outcomes differ between them. Therefore, the discovery of novel, sex-specific, blood-based biomarkers for acute ischemic stroke (AIS) patients has the potential to enhance the understanding of the etiology of this deadly disease in the content of sex. The objective of this study was to identify serum metabolites associated with male and female AIS patients. Methods: Metabolites were measured with the use of untargeted, reverse-phase ultra-performance liquid chromatography-tandem mass spectrometry quantification from blood specimens collected from AIS patients. Samples were collected from 36 patients comprising each of 18 men and women with matched controls. Metabolic pathway analysis and principal component analysis (PCA) was used to differentiate metabolite profiles for male and female AIS patients from the control, while logistic regression was used to determine differences in metabolites between male and female AIS patients. Results: In female AIS patients, 14 distinct altered metabolic pathways and 49 corresponding metabolites were identified, while 39 metabolites and 5 metabolic pathways were identified in male patients. Metabolites that are predictive of ischemic stroke in female patients were 1-(1-enyl-palmitoyl)-2-arachidonoyl-GPC (P-16:0/20:4) (AUC = 0.914, 0.765–1.000), 1-(1-enyl-palmitoyl)-2-palmitoyl-GPC (P-16:0/16:0) (AUC = 0.840, 0.656–1.000), and 5,6-dihydrouracil (P-16:0/20:2) (AUC = 0.815, 0.601–1.000). Significant metabolites that were predictive of stroke in male patients were 5alpha-androstan-3alpha,17beta-diol disulfate (AUC = 0.951, 0.857–1.000), alpha-hydroxyisocaproate (AUC = 0.938, 0.832–1.000), threonate (AUC = 0.877, 0.716–1.000), and bilirubin (AUC = 0.817, 0.746–1.000). Conclusions: In the current study, the untargeted serum metabolomics platform identified multiple pathways and metabolites associated with male and female AIS patients. Further research is necessary to characterize how these metabolites are associated with the pathophysiology in male and female AIS patients.
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Affiliation(s)
- Nicolas Poupore
- School of Medicine Greenville, University of South Carolina, Greenville, SC 29605, USA; (N.P.); (R.C.); (S.A.); (R.L.G.)
| | - Renee Chosed
- School of Medicine Greenville, University of South Carolina, Greenville, SC 29605, USA; (N.P.); (R.C.); (S.A.); (R.L.G.)
| | - Sergio Arce
- School of Medicine Greenville, University of South Carolina, Greenville, SC 29605, USA; (N.P.); (R.C.); (S.A.); (R.L.G.)
| | | | - Richard L. Goodwin
- School of Medicine Greenville, University of South Carolina, Greenville, SC 29605, USA; (N.P.); (R.C.); (S.A.); (R.L.G.)
| | - Thomas I. Nathaniel
- School of Medicine Greenville, University of South Carolina, Greenville, SC 29605, USA; (N.P.); (R.C.); (S.A.); (R.L.G.)
- Correspondence: ; Tel.: +1-8644559846; Fax: +1-8644558404
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Vijayan B, Ramanathan M, Rangamani S, Joe W, Gopinathan S, Mishra US. Treatment and rehabilitation of stroke patients in India: A gendered analysis based on repeated cross-sectional national sample surveys on health, 2014 and 2019. Health Care Women Int 2021; 42:1237-1254. [PMID: 34125652 DOI: 10.1080/07399332.2021.1931226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We attempt a gendered inspection of sex differentials in care following stroke in India using data from two rounds of NSSO. While almost all men and women receive allopathic care, a higher percentage of women (51.8%) were treated in public hospitals compared to men (32.6%) in 2014 and 2017-18 (45.8% vs 41.4%). Men were preponderantly treated in private hospitals (67.4%) compared to women (48.2%) in 2014 and 2017-18 (58.6% vs 54.2%). We provide evidence that for rehabilitation, at the highest decile for expenditure, men spend more than women. This preliminary exploration is indicative of a gendered dimension in care-seeking for stroke.
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Affiliation(s)
- Bevin Vijayan
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Mala Ramanathan
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Sukanya Rangamani
- National Centre for Disease Informatics and Research, Indian Council of Medical Research, Bengaluru, Karnataka, India
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Padilla CM, Foucault A, Grimaud O, Nowak E, Timsit S. Gender difference of geographic distribution of the stroke incidence affected by socioeconomic, clinical and urban-rural factors: an ecological study based on data from the Brest stroke registry in France. BMC Public Health 2021; 21:39. [PMID: 33407274 PMCID: PMC7788878 DOI: 10.1186/s12889-020-10026-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 12/09/2020] [Indexed: 11/10/2022] Open
Abstract
Background Mapping the spatial distribution of disease occurrence is a strategy to identify contextual factors that could be useful for public health policies. The purpose of this ecological study was to examine to which extent the socioeconomic deprivation and the urbanization level can explain gender difference of geographic distribution in stroke incidence in Pays de Brest, France between 2008 and 2013. Methods Stroke cases aged 60 years or more were extracted from the Brest stroke registry and combined at the census block level. Contextual socioeconomic, demographic, and geographic variables at the census block level come from the 2013 national census. We used spatial and non-spatial regression models to study the geographic correlation between socioeconomic deprivation, degree or urbanization and stroke incidence. We generated maps using spatial geographically weighted models, after longitude and latitude smoothing and adjustment for covariates. Results Stroke incidence was comparable in women and men (6.26 ± 3.5 vs 6.91 ± 3.3 per 1000 inhabitants-year, respectively). Results showed different patterns of the distribution of stroke risk and its association with deprivation or urbanisation across gender. For women, stroke incidence was spatially homogeneous over the entire study area, but was associated with deprivation level in urban census blocks: age adjusted risk ratio of high versus low deprivation = 1.24, [95%CI 1.04–1.46]. For men, three geographic clusters were identified. One located in the northern rural and deprived census blocks with a 9–14% increase in the risk of stroke. Two others clusters located in the south-eastern (mostly urban part) and south-western (suburban and rural part) with low deprivation level and associated with higher risk of stroke incidence between (3 and 8%) and (8.5 and 19%) respectively. There were no differences in profile of cardiovascular risk factors, stroke type and stroke severity between clusters, or when comparing clusters cases to the rest of the study population. Conclusions Understanding whether and how neighborhood and patient’s characteristics influence stroke risk may be useful for both epidemiological research and healthcare service planning.
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Affiliation(s)
- Cindy M Padilla
- Univ Rennes, EHESP, REPERES (Recherche en pharmaco-épidémiologie et recours aux soins) - EA 7449, 15, Avenue du Professeur Léon Bernard, 35043, Rennes, France.
| | - Anais Foucault
- Univ Rennes, EHESP, REPERES (Recherche en pharmaco-épidémiologie et recours aux soins) - EA 7449, 15, Avenue du Professeur Léon Bernard, 35043, Rennes, France
| | - Olivier Grimaud
- Univ Rennes, EHESP, REPERES (Recherche en pharmaco-épidémiologie et recours aux soins) - EA 7449, 15, Avenue du Professeur Léon Bernard, 35043, Rennes, France
| | - Emmanuel Nowak
- Centre d'Investigation Clinique-INSERM CIC 1412, CHRU, Brest, France
| | - Serge Timsit
- Univ Brest, Inserm, EFS, UMR 1078, GGB, Neurology and Stroke unit Department, CHRU de Brest, Université de Bretagne Occidentale, Inserm 1078, Brest, F-29200, France
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Huang M, Hong Z, Xiao C, Li L, Chen L, Cheng S, Lei T, Zheng H. Effects of Exosomes on Neurological Function Recovery for Ischemic Stroke in Pre-clinical Studies: A Meta-analysis. Front Cell Neurosci 2020; 14:593130. [PMID: 33324166 PMCID: PMC7726242 DOI: 10.3389/fncel.2020.593130] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 10/23/2020] [Indexed: 12/18/2022] Open
Abstract
Background: Exosomes, especially stem cell-derived exosomes, have been widely studied in pre-clinical research of ischemic stroke. However, their pooled effects remain inconclusive. Methods: Relevant literature concerning the effects of exosomes on neurological performance in a rodent model of ischemic stroke was identified via searching electronic databases, including PubMed, Embase, and Web of Science. The primary outcomes included neurological function scores (NFS) and infarct volume (IV), and the secondary outcomes were several pro-inflammatory factors and terminal deoxynucleotidyl transferase deoxyuridine triphosphate nick end labeling-positive cells. Subgroup analyses regarding several factors potentially influencing the effects of exosomes on NFS and IV were also conducted. Results: We identified 21 experiments from 18 studies in the meta-analysis. Pooled analyses showed the positive and significant effects of exosomes on NFS (standardized mean difference -2.79; 95% confidence interval -3.81 to -1.76) and IV (standardized mean difference -3.16; 95% confidence interval -4.18 to -2.15). Our data revealed that the effects of exosomes on neurological outcomes in rodent stroke models might be related to routes of administration and exosomes sources. In addition, there was significant attenuation in pro-inflammatory factors, including interleukin-6, tumor necrosis factor-α and interleukin-1β, and terminal deoxynucleotidyl transferase deoxyuridine triphosphate nick end labeling-positive cells when undergoing exosomes treatment. Conclusion: Cell-derived exosomes treatment demonstrated statistically significant improvements in structural and neurological function recovery in animal models of ischemic stroke. Our results also provide relatively robust evidence supporting cell-derived exosomes as a promising therapy to promote neurological recovery in stroke individuals.
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Affiliation(s)
| | | | | | | | | | | | | | - Haiqing Zheng
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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12
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Marins FR, Limborço-Filho M, D'Abreu BF, Machado de Almeida PW, Gavioli M, Xavier CH, Oppenheimer SM, Guatimosim S, Fontes MAP. Autonomic and cardiovascular consequences resulting from experimental hemorrhagic stroke in the left or right intermediate insular cortex in rats. Auton Neurosci 2020; 227:102695. [PMID: 32629215 DOI: 10.1016/j.autneu.2020.102695] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/20/2020] [Accepted: 06/21/2020] [Indexed: 11/17/2022]
Abstract
Damage to the insular cortex (IC) results in serious cardiovascular consequences and evidence indicates that the characteristics are lateralized. However, a study comparing the effects of focal experimental hemorrhage between IC sides was never performed. We compared the cardiovascular, autonomic and cardiac changes produced by focal experimental hemorrhage (ICH) into the left (L) or right (R) IC. Wistar rats were submitted to microinjection of autologous blood (ICH) or saline (n = 6 each side/group) into the R or L IC. Blood pressure (BP), heart rate (HR) and renal sympathetic activity (RSNA) were recorded. Measurements of calcium transient and sarcoplasmic Ca2+ ATPase expression in cardiomyocytes were performed. ICH increased baseline HR (Δ:L-ICH 452 ± 13 vs saline 407 ± 11 bpm; R-ICH 450 ± 7 vs saline 406 ± 8 bpm, P < 0.05) without changing BP. HR was restored to baseline levels after i.v. atenolol. Strikingly, ICH rats presented a reduced baseline RSNA (Δ:L-ICH 122 ± 4 vs saline 148 ± 11 spikes/s; R-ICH 112 ± 5 vs saline 148 ± 7 spikes/s, P < 0.05). After 24 h of ICH we observed a marked increase in cardiac ectopies and this number was greater after ICH R-IC. Heart weight, calcium amplitude and SERCA expression were reduced only in ICH R-IC. Focal stroke into IC can alter the cardiac and renal autonomic control. Damage to the R-IC produces a greater number of arrhythmias and changes in calcium dynamics in cardiac cells indicating that the cardiovascular consequences are hemisphere-dependent. These findings confirm asymmetry for cardiac autonomic control at the IC and help to understand the cardiac and renal implications observed after specific side cortical damage.
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Affiliation(s)
- Fernanda Ribeiro Marins
- Departamento de Fisiologia & Biofísica, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Marcelo Limborço-Filho
- Departamento de Fisiologia & Biofísica, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Bárbara Flecha D'Abreu
- Departamento de Fisiologia & Biofísica, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Pedro W Machado de Almeida
- Departamento de Fisiologia & Biofísica, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Mariana Gavioli
- Departamento de Fisiologia & Biofísica, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Carlos Henrique Xavier
- Departamento de Ciências Fisiológicas, Instituto de Ciências Biológicas, Universidade Federal de Goiás, Goiânia, Brazil.
| | - Stephen M Oppenheimer
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Silvia Guatimosim
- Departamento de Fisiologia & Biofísica, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Marco Antônio Peliky Fontes
- Departamento de Fisiologia & Biofísica, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
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Guennoun R, Zhu X, Fréchou M, Gaignard P, Slama A, Liere P, Schumacher M. Steroids in Stroke with Special Reference to Progesterone. Cell Mol Neurobiol 2018; 39:551-568. [DOI: 10.1007/s10571-018-0627-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 10/05/2018] [Indexed: 12/21/2022]
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Li Z, Tremble SM, Cipolla MJ. Implications for understanding ischemic stroke as a sexually dimorphic disease: the role of pial collateral circulations. Am J Physiol Heart Circ Physiol 2018; 315:H1703-H1712. [PMID: 30239233 DOI: 10.1152/ajpheart.00402.2018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
We investigated structural and functional differences in primary and pial collateral circulations in adult normotensive male and female Wistar rats. Male ( n = 10) and female ( n = 7) rats were subjected to middle cerebral artery (MCA) occlusion and changes in relative cerebral blood flow in MCA and pial collateral territories were measured by multisite laser-Doppler flowmetry. Rats were then transcardially perfused with a mixture of carbon black and latex, perfusion fixed, and imaged to compare primary and pial collateral structure between male ( n = 4) and female ( n = 3) rats, including lumen diameters and number. To study pial collateral function, leptomeningeal anastomoses (LMAs) were isolated and pressurized from male ( n = 7) and female ( n = 6) rats. Myogenic tone and reactivity to pressure, vascular function to pharmacological activator, or inhibitor of ion channels was measured and compared. There was no difference between relative cerebral blood flow in both MCA and pial collateral territories during occlusion and reperfusion between groups. Compared with male LMAs, female LMAs had similar myogenic tone (24.0 ± 7.3% vs. 16.0 ± 3.7%, P > 0.05) and reactivity to increased pressure and similar vascular responses to vasoconstrictive and vasodilatory stimuli. Additionally, compared with female LMAs, male LMAs had similar numbers (21 ± 1 vs. 20 ± 2, P > 0.05) and diameters (30.5 ± 2.0 vs. 26.2 ± 0.6 μm, P > 0.05), and no sex difference was detected in the diameter of arterial segments of circle of Willis. Together, our data establish no sex difference of cerebral collateral structure or function, suggesting that the reduced severity of stroke outcome in female rats is not likely due to differences in the cerebral collateral circulation. NEW & NOTEWORTHY Our work compared the function of leptomeningeal anastomoses between male and female adult normotensive rats with no sex difference found. We also confirmed no sex difference in primary and pial collateral structure in Wistar rats. Our findings suggest that the reduced severity of stroke in premenopausal women and reproductively intact female rodents is not likely due to improved primary and pial collateral circulations.
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Affiliation(s)
- Zhaojin Li
- Department of Neurological Sciences, University of Vermont Robert Larner College of Medicine , Burlington, Vermont
| | - Sarah M Tremble
- Department of Neurological Sciences, University of Vermont Robert Larner College of Medicine , Burlington, Vermont
| | - Marilyn J Cipolla
- Department of Neurological Sciences, University of Vermont Robert Larner College of Medicine , Burlington, Vermont.,Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Vermont Robert Larner College of Medicine , Burlington, Vermont.,Department of Pharmacology, University of Vermont Robert Larner College of Medicine , Burlington, Vermont
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Gender Gap and Risk Factors for Poor Stroke Outcomes: A Single Hospital-Based Prospective Cohort Study. J Stroke Cerebrovasc Dis 2018; 27:2250-2258. [PMID: 29779883 DOI: 10.1016/j.jstrokecerebrovasdis.2018.04.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 04/01/2018] [Accepted: 04/11/2018] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND This study intended to investigate whether etiological stroke subtypes and their corresponding major risk factors have differential effects on outcomes between genders. PATIENTS AND METHODS We enrolled 403 consecutive patients with first-ever acute ischemic stroke (170 women, 233 men), from a referral hospital in Taiwan over a 2-year period. Gender differences in demographics, vascular risk factors, access to health care, etiological stroke subtypes, stroke severity, and outcomes were examined. The primary outcome variable of the study was any unfavorable outcome due to acute ischemic stroke, defined as a modified Rankin Scale score of 3 or higher at 90 days after stroke. Multivariable logistic regression models were used to identify predictors of poor outcomes. RESULTS There were no gender disparities in baseline severity, stroke subtypes, access to health care, and medical comorbidities. Although women had poorer outcomes, female gender was not a predictor of unfavorable outcomes. Important predictors included age of 75years or older (odds ratio [OR] = 2.67; 95% confidence interval [CI], 1.46-4.90), National Institutes of Health Stroke Scale greater than or equal to 8 (OR = 8.38; 95% CI, 4.61-15.2), lack of cohabitation (OR = 2.13; 95% CI, 1.26-3.61), subtypes of cardioembolism (OR = 2.76; 95% CI, 1.29-5.93), and large-artery atherosclerosis (OR = 2.93; 95% CI, 1.47-5.85). In subgroup analyses, the gender-specific independent predictors were cardioembolism (OR = 7.42; 95% CI, 2.21-24.9) or atrial fibrillation (OR = 3.57; 95% CI, 1.31-9.74) in women, and large-artery atherosclerosis (OR = 3.35; 95% CI, 1.30-8.64) or symptomatic large-artery stenosis (OR = 3.42; 95% CI, 1.69-6.96) in men. The differential effects of these predictors according to gender were revealed by interaction tests. CONCLUSION Atrial fibrillation and symptomatic large-artery stenosis are predictors of poor stroke outcomes in women and men, respectively.
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Alhazzani AA, Mahfouz AA, Abolyazid AY, Awadalla NJ, Aftab R, Faraheen A, Khalil SN. Study of Stroke Incidence in the Aseer Region, Southwestern Saudi Arabia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E215. [PMID: 29373563 PMCID: PMC5858284 DOI: 10.3390/ijerph15020215] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 01/12/2018] [Accepted: 01/22/2018] [Indexed: 11/16/2022]
Abstract
Recent data regarding first-stroke incidence in Saudi Arabia in general and in the Aseer region in particular are scarce and even lacking. The aim of this work was to study the first-time stroke incidence in the Aseer region, southwestern Saudi Arabia. All first-stroke patients admitted to all hospitals in the Aseer region over a one-year period (January through December 2016) were included. Stroke patients outside the Aseer region were excluded from the study. The incidence per 100,000 patients and the concomitant 95% CI (Confidence Intervals) were computed. The present study included 1249 first-time stroke patients and calculated an overall minimal incidence rate of hospitalized first-time stroke of 57.64 per 100,000 persons per year (95% CI: 57.57-57.70). A steady increase was noticed depending on the patients' age, reaching a figure of 851.81 (95% CI: 849.2-854.5) for those patients aged 70 years and more. Overall, the incidence rate for females (48.14; 95% CI: 48.04-48.24) was lower compared to males (65.52; 95% CI: 65.1-66.0). Taking into consideration the expected rise of the elderly because of the prominent medical services provided by the Saudi government, leading to a subsequent change in the horizontal and vertical age distribution structure of the population, an increase in the number of stroke patients is expected. It is suggested to establish a nationwide stroke surveillance system in the Kingdom, with the objective to report, analyze, and maintain an updated overview of the stroke status in Saudi Arabia.
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Affiliation(s)
- Adel A Alhazzani
- Department of Internal Medicine, College of Medicine, King Khalid University, P.O. Box 641, Abha 61421, Saudi Arabia.
| | - Ahmed A Mahfouz
- Department of Family and Community Medicine, College of Medicine, King Khalid University, P.O. Box 641, Abha 61421, Saudi Arabia.
- Department of Epidemiology, High Institute of Public Health, Alexandria University, Alexandria 21511, Egypt.
| | - Ahmed Y Abolyazid
- Department of Family and Community Medicine, College of Medicine, King Khalid University, P.O. Box 641, Abha 61421, Saudi Arabia.
- Department of Community Medicine, College of Medicine, Mansoura University, Mansoura 35516, Egypt.
| | - Nabil J Awadalla
- Department of Family and Community Medicine, College of Medicine, King Khalid University, P.O. Box 641, Abha 61421, Saudi Arabia.
- Department of Community Medicine, College of Medicine, Mansoura University, Mansoura 35516, Egypt.
| | - Razia Aftab
- Department of Family and Community Medicine, College of Medicine, King Khalid University, P.O. Box 641, Abha 61421, Saudi Arabia.
| | - Aesha Faraheen
- Department of Family and Community Medicine, College of Medicine, King Khalid University, P.O. Box 641, Abha 61421, Saudi Arabia.
| | - Shamsun Nahar Khalil
- Department of Family and Community Medicine, College of Medicine, King Khalid University, P.O. Box 641, Abha 61421, Saudi Arabia.
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Dissociations between Spatial and Temporal Order Memory: A Neuropsychological Patient Study. J Int Neuropsychol Soc 2017; 23:421-430. [PMID: 28481196 DOI: 10.1017/s1355617717000212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES In complex real life situations, memories for temporal and spatial information are naturally linked since sequential events coincide in time and space. Whether this connection is inseparable or instead whether these processes are functionally dissociable was investigated in this patient study. METHODS Spatial object-location and temporal order memory tasks were administered to 36 stroke patients and 44 healthy control participants. RESULTS On group level, patients with a stroke in the left hemisphere performed worse on temporal order memory, compared to the control participants. On individual level, using a multiple case-study approach, a clear pattern of dissociations was found between memory for temporal and for spatial features. CONCLUSIONS These findings indicate that location and temporal order memory contain functionally separable processes. This adds to our understanding of how context information is processed in human memory. (JINS, 2017, 23, 421-430).
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Lima IBD, Pernambuco L. Morbidade hospitalar por acidente vascular encefálico e cobertura fonoaudiológica no Estado da Paraíba, Brasil. AUDIOLOGY: COMMUNICATION RESEARCH 2017. [DOI: 10.1590/2317-6431-2016-1822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
RESUMO Introdução O acidente vascular encefálico (AVE) é uma condição neurológica associada à morbidade hospitalar e que requer cuidados fonoaudiológicos, em razão de suas sequelas. Objetivo Analisar o perfil de morbidade hospitalar por acidente vascular encefálico e sua relação com a cobertura fonoaudiológica no Estado da Paraíba, Brasil. Métodos Estudo do tipo ecológico, realizado com dados obtidos no Sistema de Informações Hospitalares (SIH/SUS) e no Cadastro Nacional de Estabelecimentos de Saúde (CNES), nos anos de 2010 e 2014, considerando o número de autorizações de internação hospitalar aprovadas, sexo, faixa etária, valor médio gasto por internação, média de dias de internação e número de fonoaudiólogos no regime hospitalar público. Calculou-se a taxa de internação hospitalar, o coeficiente de incidência de hospitalização por AVE e a proporção de internações por AVE, em relação à cobertura fonoaudiológica. Resultados Houve declínio nas internações por AVE no Estado da Paraíba, entre 2010 e 2014. Ocorreu maior concentração de hospitalizações fora da Região Metropolitana de João Pessoa, em ambos os anos, aumento de 9,8% no valor gasto por internação e permanência de sete dias, em média, no ambiente hospitalar. O número de internações foi maior em indivíduos com 60 anos ou mais, com proporção semelhante quanto ao sexo. O número de fonoaudiólogos vinculados ao regime hospitalar público aumentou 82,8% em 2014, porém, com maior concentração na Região Metropolitana de João Pessoa. Em ambos os anos, a proporção de internações por AVE, em relação à cobertura fonoaudiológica, foi maior fora da Região Metropolitana de João Pessoa. Conclusão No Estado da Paraíba, entre 2010 e 2014, houve declínio da hospitalização por AVE, maior concentração de internações de indivíduos idosos fora da Região Metropolitana de João Pessoa, com mesma proporção entre os sexos. A cobertura fonoaudiológica foi mais escassa nas regiões mais distantes da capital.
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Maga-Nteve C, Vasilopoulou CG, Constantinou C, Margarity M, Klapa MI. Sex-comparative study of mouse cerebellum physiology under adult-onset hypothyroidism: The significance of GC–MS metabolomic data normalization in meta-analysis. J Chromatogr B Analyt Technol Biomed Life Sci 2017; 1041-1042:158-166. [DOI: 10.1016/j.jchromb.2016.12.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 12/06/2016] [Accepted: 12/09/2016] [Indexed: 01/21/2023]
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Pinceti E, Shults CL, Rao YS, Pak TR. Differential Effects of E2 on MAPK Activity in the Brain and Heart of Aged Female Rats. PLoS One 2016; 11:e0160276. [PMID: 27487271 PMCID: PMC4972350 DOI: 10.1371/journal.pone.0160276] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 07/15/2016] [Indexed: 12/21/2022] Open
Abstract
Aging and the coincident loss of circulating estrogens at menopause lead to increased risks for neurological and cardiovascular pathologies. Clinical studies show that estrogen therapy (ET) can be beneficial in mitigating these negative effects, in both the brain and heart, when it is initiated shortly after the perimenopausal transition. However, this same therapy is detrimental when initiated >10 years postmenopause. Importantly, the molecular mechanisms underlying this age-related switch in ET efficacy are unknown. Estrogen receptors (ERs) mediate the neuroprotective and cardioprotective functions of estrogens by modulating gene transcription or, non-genomically, by activating second messenger signaling pathways, such as mitogen activated protein kinases (MAPK). These kinases are critical regulators of cell signaling pathways and have widespread downstream effects. Our hypothesis is that age and estrogen deprivation following menopause alters the expression and activation of the MAPK family members p38 and ERK in the brain and heart. To test this hypothesis, we used a surgically induced model of menopause in 18 month old rats through bilateral ovariectomy (OVX) followed by an acute dose of 17β-estradiol (E2) administered at varying time points post-OVX (1 week, 4 weeks, 8 weeks, or 12 weeks). Age and E2 treatment differentially regulated kinase activity in both the brain and heart, and the effects were also brain region specific. MAPK signaling plays an integral role in aging, and the aberrant regulation of those signaling pathways might be involved in age-related disorders. Clinical studies show benefits of ET during early menopause but detrimental effects later, which might be reflective of changes in kinase expression and activation status.
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Affiliation(s)
- Elena Pinceti
- Department of Cell and Molecular Physiology, Health Science Division, Loyola University Chicago, Maywood, Illinois, United States of America
| | - Cody L. Shults
- Department of Cell and Molecular Physiology, Health Science Division, Loyola University Chicago, Maywood, Illinois, United States of America
| | - Yathindar S. Rao
- Department of Cell and Molecular Physiology, Health Science Division, Loyola University Chicago, Maywood, Illinois, United States of America
| | - Toni R. Pak
- Department of Cell and Molecular Physiology, Health Science Division, Loyola University Chicago, Maywood, Illinois, United States of America
- * E-mail:
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Geronikolou S, Zimeras S, Davos CH, Michalopoulos I, Tsitomeneas S. Diverse radiofrequency sensitivity and radiofrequency effects of mobile or cordless phone near fields exposure in Drosophila melanogaster. PLoS One 2014; 9:e112139. [PMID: 25402465 PMCID: PMC4234246 DOI: 10.1371/journal.pone.0112139] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 10/13/2014] [Indexed: 12/22/2022] Open
Abstract
Introduction The impact of electromagnetic fields on health is of increasing scientific interest. The aim of this study was to examine how the Drosophila melanogaster animal model is affected when exposed to portable or mobile phone fields. Methods/Results Two experiments have been designed and performed in the same laboratory conditions. Insect cultures were exposed to the near field of a 2G mobile phone (the GSM 2G networks support and complement in parallel the 3G wide band or in other words the transmission of information via voice signals is served by the 2G technology in both mobile phones generations) and a 1880 MHz cordless phone both digitally modulated by human voice. Comparison with advanced statistics of the egg laying of the second generation exposed and non-exposed cultures showed limited statistical significance for the cordless phone exposed culture and statistical significance for the 900 MHz exposed insects. We calculated by physics, simulated and illustrated in three dimensional figures the calculated near fields of radiation inside the experimenting vials and their difference. Comparison of the power of the two fields showed that the difference between them becomes null when the experimental cylinder radius and the height of the antenna increase. Conclusions/Significance Our results suggest a possible radiofrequency sensitivity difference in insects which may be due to the distance from the antenna or to unexplored intimate factors. Comparing the near fields of the two frequencies bands, we see similar not identical geometry in length and height from the antenna and that lower frequencies tend to drive to increased radiofrequency effects.
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Affiliation(s)
- Styliani Geronikolou
- Biomedical Research Foundation of Academy of Athens, 4 Soranou Efessiou Str, 11527, Athens, Greece
- * E-mail:
| | - Stelios Zimeras
- Department of Mathematics, Division of Statistics and Actuarial-Financial Mathematics, University of the Aegean, 82300, Karlovassi, Samos, Greece
| | - Constantinos H. Davos
- Biomedical Research Foundation of Academy of Athens, 4 Soranou Efessiou Str, 11527, Athens, Greece
| | - Ioannis Michalopoulos
- Biomedical Research Foundation of Academy of Athens, 4 Soranou Efessiou Str, 11527, Athens, Greece
| | - Stephanos Tsitomeneas
- Department of Electronics, TEI of Piraeus, Petrou Ralli & Thivon 250, 122 44, Athens, Greece
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Functional correlates of prospective memory in stroke. Neuropsychologia 2014; 60:77-83. [PMID: 24892223 DOI: 10.1016/j.neuropsychologia.2014.05.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 05/19/2014] [Accepted: 05/22/2014] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Prospective memory is the ability to remember actions to be performed later in time or when a certain event occurs. Multiple cognitive processes are involved in prospective memory, and the degree to which automatic or effortful processes are involved may differ for different types of prospective memory tasks. This study aimed to investigate prospective memory (dys)functioning in stroke patients, and to get more insight in which cognitive processes are involved in time- versus event-based prospective memory. METHODS We investigated 39 community-dwelling stroke survivors and 53 matched control participants. Assessment included naturalistic and experimental event- and time-based prospective memory tasks, as well as standard neuropsychological measures of (retrospective) memory, processing speed and attention/executive functioning. RESULTS 41% of the stroke patients performed significantly worse than control participants on prospective memory tasks. Deficits in prospective memory occurred as frequently as impairments in retrospective memory (33%, χ(2)(1, N=39)=3.4, p=.066), and more often than impairments in attention/executive functioning (15%, χ(2)(1, N=39)=5.2, p=.022) and speed of processing (23%, χ(2)(1, N=39)=6.5, p=.011). Regression analyses showed that event-based ('focal') prospective memory is supported by retrospective memory, indicating that it is a relatively simple and automatic process. Time-based (non-'focal') prospective memory proved to be a more complex process, requiring active monitoring of the environment. Performance was predicted by speed of processing, attention/executive functioning and retrospective memory. Thirteen percent of the patients suffered from selective prospective memory impairment, which was associated with damage to the superior temporal gyrus. CONCLUSIONS Impairment of prospective memory occurs frequently after stroke. Different cognitive operations are involved in distinct types of prospective memory. Results fit within the multi-process framework of prospective memory and help further specify its contents.
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Vemuganti R. All's well that transcribes well: non-coding RNAs and post-stroke brain damage. Neurochem Int 2013; 63:438-49. [PMID: 23954844 PMCID: PMC3805745 DOI: 10.1016/j.neuint.2013.07.014] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 07/26/2013] [Accepted: 07/28/2013] [Indexed: 12/13/2022]
Abstract
The mammalian genome is replete with various classes of non-coding (nc) RNA genes. Many of them actively transcribe, and their relevance to CNS diseases is just beginning to be understood. CNS is one of the organs in the body that shows very high ncRNAs activity. Recent studies demonstrated that cerebral ischemia rapidly changes the expression profiles of different classes of ncRNAs: including microRNA, long noncoding RNA and piwi-interacting RNA. Several studies further showed that post-ischemic neuronal death and/or plasticity/regeneration can be altered by modulating specific microRNAs. These studies are of interest for therapeutic development as they may contribute to identifying new ncRNA targets that can be modulated to prevent secondary brain damage after stroke.
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Affiliation(s)
- Raghu Vemuganti
- Department of Neurological Surgery, University of Wisconsin, Madison, WI, USA.
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Wattanapermpool J, de Tombe PP, Pak TR. Sex differences in health and disease: brain and heart connections--a special issue. Pflugers Arch 2013; 465:555-6. [PMID: 23588381 DOI: 10.1007/s00424-013-1279-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Accepted: 04/03/2013] [Indexed: 11/28/2022]
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