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Price RS. Exploring what progress is being made in the development of health promotion material for vascular dementia: A systematic review of the evidence. Aging Med (Milton) 2023; 6:184-194. [PMID: 37287679 PMCID: PMC10242248 DOI: 10.1002/agm2.12253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/03/2023] [Accepted: 04/09/2023] [Indexed: 06/09/2023] Open
Abstract
A systematic review conducted by Price and Keady (Journal of Nursing and Healthcare of Chronic Illness, 2, 88 and 2010) demonstrated that there was a dearth of health-promoting literature available for people diagnosed with vascular dementia. The correlation between health behavior and the onset of cardiovascular change that can lead to vascular dementia had demonstrated a need for health education and health-promoting information to be made accessible to vulnerable populations to ameliorate the risk of cognitive decline because of cardiovascular disease. Dementia is a progressive and life-limiting condition and with limited treatment options and a lack of progress in identifying a way to delay onset or even cure the condition. Focus must be targeted towards risk reduction strategies that serve to reduce onset and decline and limit the global burden on not only the individual with the condition and their carers but also to the health and social care economy. To identify the progress that has been made in developing health-promoting literature and patient education guidance since 2010 a systematic literature review was undertaken. Using thematic analysis, CINAHL, MEDLINE, and psych INFO databases were accessed and following PRISMA guidelines an inclusion and exclusion criteria was developed in order to locate peer-reviewed articles. Titles and abstracts were reviewed to identify a match with key terms, and from 133 screened abstracts eight studies met the inclusion requirements. From the eight studies, thematic analysis was implemented to identify shared understanding of experiences relating to health promotion in vascular dementia. The methodology for the study was replicated from the authors' previous systematic review in 2010. Five key themes were identified in the literature (Healthy heart healthy brain; Risk factors; Risk reduction/modification; Interventions; Absence of targeted health promotion). From what little evidence was available to review the thematic analysis has demonstrated developments in knowledge into the link between the onset of cognitive impairment and vascular dementia because of compromised cardiovascular health. Modifying health behavior has become essential in ameliorating the risk of vascular cognitive decline. With these developments the synthesis of the literature demonstrates that even with these insights there continues to be a lack of targeted material that individuals can access to understand the link between cardiovascular health and cognitive decline. It is recognized that maximizing cardiovascular health has the potential to lessen the risk of vascular cognitive impairment and vascular dementia developing and progressing yet targeted health promoting material remains lacking. With the developments in understanding the causal links between poor cardiovascular health, vascular cognitive impairment, and vascular dementia progress now needs to be made in developing targeted health promotion material for individuals to access to share this knowledge to reduce the potential onset and subsequent burden of dementia.
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Chen FJ, Yin MC, Chen PY, Lin MH, Peng YH, Ho WC, Chen PC, Hsu CY. Association between Statin Use and Diabetes Risk in Patients with Transient Ischemic Attack. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13770. [PMID: 36360652 PMCID: PMC9658048 DOI: 10.3390/ijerph192113770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/17/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
Statin therapy can effectively reduce recurrent transient ischemic attack (TIA) risk. However, studies have reported that statin use is associated with incidence of diabetes mellitus (DM). Whether statin therapy remains associated with higher DM risk in patients with TIA remains unknown. This study investigated whether statin treatment influences incident DM risk in patients with TIA. We conducted a retrospective cohort study using the Longitudinal Health Insurance Database 2000. Participants who were newly diagnosed with TIA (ICD-9-CM code 435) from 1 January 1997 to 31 December 2011 were recruited. The Kaplan-Meier method and Cox proportional risk model of time-dependent covariance were used. We enrolled 8342 patients with newly diagnosed TIA from 1 January 1997 to 31 December 2011. Of these, 1255 patients were classified as statin users and 7087 as nonusers. During the 14-year follow-up, the incidence of newly diagnosed DM was 0.545-fold lower in the statins group compared with nonusers (95% confidence interval [CI] = 0.457-0.650). According to cumulative defined daily doses (cDDDs), the adjusted hazard ratios for DM were 0.689, 0.594, and 0.463 when patients were treated with statins at cDDDs = 28-89, 90-180, and >180, respectively. In patients with TIA, statin use is associated with a lower incident DM risk compared with the nonuse of statins.
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Affiliation(s)
- Fu-Jun Chen
- Department of Public Health, China Medical University, No. 91, Hsueh-Shih Road, Taichung 404327, Taiwan
- Centers for Disease Control Ministry of Health and Welfare, Taichung 40855, Taiwan
| | - Ming-Chien Yin
- Division of Respiratory Therapy, China Medical University Hospital, Taichung 404327, Taiwan
| | - Pei-Yun Chen
- Department of Public Health, China Medical University, No. 91, Hsueh-Shih Road, Taichung 404327, Taiwan
- Department of Nursing, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli 35664, Taiwan
| | - Min-Hua Lin
- Department of Dietetics, Yunlin Christian Hospital, Yunlin 64866, Taiwan
- Department of Nutrition, China Medical University, Taichung 404327, Taiwan
| | - Yi-Hao Peng
- Department of Respiratory Therapy, Asia University Hospital, Asia University, Taichung 41354, Taiwan
- Department of Nursing, Asia University, Taichung 41354, Taiwan
| | - Wen-Chao Ho
- Department of Public Health, China Medical University, No. 91, Hsueh-Shih Road, Taichung 404327, Taiwan
| | - Pau-Chung Chen
- Department of Public Health, National Taiwan University, Taipei 10617, Taiwan
- National Institute of Environmental Health Sciences, Miaoli 35053, Taiwan
| | - Chung Y. Hsu
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404327, Taiwan
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Burrello J, Bianco G, Burrello A, Manno C, Maulucci F, Pileggi M, Nannoni S, Michel P, Bolis S, Melli G, Vassalli G, Albers GW, Cianfoni A, Barile L, Cereda CW. Extracellular Vesicle Surface Markers as a Diagnostic Tool in Transient Ischemic Attacks. Stroke 2021; 52:3335-3347. [PMID: 34344167 DOI: 10.1161/strokeaha.120.033170] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND PURPOSE Extracellular vesicles (EVs) are promising biomarkers for cerebral ischemic diseases, but not systematically tested in patients with transient ischemic attacks (TIAs). We aimed at (1) investigating the profile of EV-surface antigens in patients with symptoms suspicious for TIA; (2) developing and validating a predictive model for TIA diagnosis based on a specific EV-surface antigen profile. METHODS We analyzed 40 subjects with symptoms suspicious for TIA and 20 healthy controls from a training cohort. An independent cohort of 28 subjects served as external validation. Patients were stratified according to likelihood of having a real ischemic event using the Precise Diagnostic Score, defined as: unlikely (score 0-1), possible-probable (score 2-3), or very likely (score 4-8). Serum vesicles were quantified by nanoparticle tracking analysis and EV-surface antigen profile characterized by multiplex flow cytometry. RESULTS EV concentration increased in patients with very likely or possible-probable TIA (P<0.05) compared with controls. Nanoparticle concentration was directly correlated with the Precise Diagnostic score (R=0.712; P<0.001). After EV immuno-capturing, CD8, CD2, CD62P, melanoma-associated chondroitin sulfate proteoglycan, CD42a, CD44, CD326, CD142, CD31, and CD14 were identified as discriminants between groups. Receiver operating characteristic curve analysis confirmed a reliable diagnostic performance for each of these markers taken individually and for a compound marker derived from their linear combinations (area under the curve, 0.851). Finally, a random forest model combining the expression levels of selected markers achieved an accuracy of 96% and 78.9% for discriminating patients with a very likely TIA, in the training and external validation cohort, respectively. CONCLUSIONS The EV-surface antigen profile appears to be different in patients with transient symptoms adjudicated to be very likely caused by brain ischemia compared with patients whose symptoms were less likely to due to brain ischemia. We propose an algorithm based on an EV-surface-antigen specific signature that might aid in the recognition of TIA.
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Affiliation(s)
- Jacopo Burrello
- Cellular and Molecular Cardiology Laboratory, Istituto Cardiocentro Ticino, Ente Ospedaliero Cantonale, Lugano, Switzerland (J.B., G.V.)
| | - Giovanni Bianco
- Neurology Clinic, Stroke Center, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano (G.B., C.M., F.M., G.M., C.W.C.)
| | - Alessio Burrello
- Department of Electrical, Electronic and Information Engineering (DEI), University of Bologna, Italy (A.B.)
| | - Concetta Manno
- Neurology Clinic, Stroke Center, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano (G.B., C.M., F.M., G.M., C.W.C.)
| | - Francesco Maulucci
- Neurology Clinic, Stroke Center, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano (G.B., C.M., F.M., G.M., C.W.C.)
| | - Marco Pileggi
- Department of Neuroradiology, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano (M.P., A.C.)
| | - Stefania Nannoni
- Stroke Center, Neurology Service, Lausanne University Hospital, Switzerland (S.N., P.M., C.W.C.)
| | - Patrik Michel
- Stroke Center, Neurology Service, Lausanne University Hospital, Switzerland (S.N., P.M., C.W.C.)
| | - Sara Bolis
- Laboratory for Cardiovascular Theranostics, Istituto Cardiocentro Ticino, Ente Ospedaliero Cantonale, Lugano, Switzerland (S.B., L.B.)
| | - Giorgia Melli
- Neurology Clinic, Stroke Center, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano (G.B., C.M., F.M., G.M., C.W.C.).,Faculty of Biomedical Sciences, Università Svizzera italiana, Lugano, Switzerland (G.M., G.V., L.B., C.W.C)
| | - Giuseppe Vassalli
- Cellular and Molecular Cardiology Laboratory, Istituto Cardiocentro Ticino, Ente Ospedaliero Cantonale, Lugano, Switzerland (J.B., G.V.).,Faculty of Biomedical Sciences, Università Svizzera italiana, Lugano, Switzerland (G.M., G.V., L.B., C.W.C)
| | - Gregory W Albers
- Department of Neurology & Neurologic Sciences, Stanford University, Stanford Stroke Center (G.W.A.)
| | - Alessandro Cianfoni
- Department of Neuroradiology, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano (M.P., A.C.)
| | - Lucio Barile
- Laboratory for Cardiovascular Theranostics, Istituto Cardiocentro Ticino, Ente Ospedaliero Cantonale, Lugano, Switzerland (S.B., L.B.).,Faculty of Biomedical Sciences, Università Svizzera italiana, Lugano, Switzerland (G.M., G.V., L.B., C.W.C)
| | - Carlo W Cereda
- Neurology Clinic, Stroke Center, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano (G.B., C.M., F.M., G.M., C.W.C.).,Stroke Center, Neurology Service, Lausanne University Hospital, Switzerland (S.N., P.M., C.W.C.).,Faculty of Biomedical Sciences, Università Svizzera italiana, Lugano, Switzerland (G.M., G.V., L.B., C.W.C)
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Evaluation of Cerebral Blood Flow Dynamics in Transient Ischemic Attacks Patients with Fast Cine Phase Contrast Magnetic Resonance Angiography. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2021; 2020:4097829. [PMID: 32351613 PMCID: PMC7174936 DOI: 10.1155/2020/4097829] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 03/25/2020] [Indexed: 11/26/2022]
Abstract
Fast cine phase contrast magnetic resonance angiography (PC-MRA) has the potential to provide a quantitative measurement method for the diagnosis and treatment of cerebrovascular disease. To evaluation the changes of cerebral blood flow and the characteristics of artery lesion distribution in the patients of transient ischemic attacks (TIA). In all, 98 normal subjects and 106 TIA patients who underwent MRI examination within 72 h after the last symptom onset including the DWI sequence to exclude acute cerebral infarction were enrolled. The blood flow of the cranial total, the area of the internal carotid artery and vertebral artery, the average velocity, and the average blood flow were obtained and compared in normal subjects and TIA group. Analysis of Variance (ANOVA), t-test, and Kruskal-Wallis test were used for statistical assessments. The total cerebral blood flow of the TIA group and normal control group was no significant statistical difference (P > 0.05). The total blood flow decreased with increasing age, and the TIA group was much lower than the control group. The blood flow of the right internal carotid artery in the TIA group had a significant difference compared with controls (P < 0.05). However, the same situation did not happen in both of the left internal carotid artery and vertebral artery. Phase contrast magnetic resonance imaging has the potential to evaluate the change of cerebral blood flow in TIA patients. The decrease in the total blood flow and the symptom onset of TIA is consistent. Phase contrast magnetic resonance imaging could provide guidance to the diagnosis of TIA.
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