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Reverté-Villarroya S, Suñer-Soler R, Zaragoza-Brunet J, Martín-Ozaeta G, Esteve-Belloch P, Payo-Froiz I, Sauras-Colón E, Lopez-Espuela F. Vascular Risk Factors in Ischemic Stroke Survivors: A Retrospective Study in Catalonia, Spain. Healthcare (Basel) 2022; 10:healthcare10112219. [PMID: 36360560 PMCID: PMC9690451 DOI: 10.3390/healthcare10112219] [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: 10/10/2022] [Revised: 10/29/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022] Open
Abstract
Background: The distribution of vascular risk factors (VRFs) and stroke management vary by geographic area. Our aim was to examine the percentage of the VRFs according to age and sex in ischemic stroke survivors in a geographical area on the Mediterranean coast of Southern Catalonia, Spain. Methods: This was a multicenter, observational, retrospective, community-based study of a cohort, the data of which we obtained from digital clinical records of the Catalan Institute of Health. The study included all patients with a confirmed diagnosis of ischemic stroke who were treated between 1 January 2011 and 31 December 2020. Patients met the following inclusion criteria: residing in the study area, age ≥ 18 years, and presenting ≥1 modifiable vascular risk factor. The exclusion criteria were as follows: death patients (non-survivors) and patients without modifiable VRFs. We collected the demographic, clinical, and VRF variables of the total of 2054 cases included, and we analyzed the data according to age groups, sex, and number of VRFs. Results: Most of the patients included were in the 55−80 age group (n = 1139; 55.45%). Of the patients, 56.48% (n = 1160) presented ≤ 2 modifiable VRFs, and the age group <55 years old (67.01%) presented more VRFs. Hypertension and (>80 years old (38.82%)) and dyslipidemia (<55 years (28.33%)) were the most prevalent VRFs. In the age group 55−80 (69.59% men), the prevalence of VRFs was higher ((3−4 VRF (42.76%) and >4 VRF (5.35%)). Conclusions: These results suggest the presence of many VRFs in people diagnosed with ischemic stroke—although with a lower percentage compared to other studies—and the need for specific individualized interventions for the control of modifiable RFs related to primary and secondary prevention of stroke.
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Affiliation(s)
- Silvia Reverté-Villarroya
- Nursing Department, Universitat Rovira Virgili, Avenue Remolins, 13-15, 43500 Tortosa, Spain
- Hospital de Tortosa Verge de la Cinta, ICS, IISPV, C/Esplanetes no 14, 43500 Tortosa, Spain
| | - Rosa Suñer-Soler
- Faculty of Nursing, University of Girona, Emili Grahit, 77, 17071 Girona, Spain
- Correspondence: (R.S.-S.); (J.Z.-B.)
| | - Jose Zaragoza-Brunet
- Hospital de Tortosa Verge de la Cinta, ICS, IISPV, C/Esplanetes no 14, 43500 Tortosa, Spain
- Correspondence: (R.S.-S.); (J.Z.-B.)
| | - Gisela Martín-Ozaeta
- Hospital de Tortosa Verge de la Cinta, ICS, IISPV, C/Esplanetes no 14, 43500 Tortosa, Spain
| | | | - Iago Payo-Froiz
- Hospital de Tortosa Verge de la Cinta, ICS, IISPV, C/Esplanetes no 14, 43500 Tortosa, Spain
| | - Esther Sauras-Colón
- Hospital de Tortosa Verge de la Cinta, ICS, IISPV, C/Esplanetes no 14, 43500 Tortosa, Spain
| | - Fidel Lopez-Espuela
- Metabolic Bone Diseases Research Group, Nursing Department, Occupational Therapy College, University of Extremadura, Avenue of the University s/n, 10003 Cáceres, Spain
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Nathal E, Serrano-Rubio A, Maciel E, Arauz A. Moyamoya disease in Mexico: our experience. NEUROLOGÍA (ENGLISH EDITION) 2021; 36:603-610. [PMID: 34654535 DOI: 10.1016/j.nrleng.2020.08.002] [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: 12/10/2017] [Accepted: 05/13/2018] [Indexed: 10/23/2022] Open
Abstract
INTRODUCTION Moyamoya disease (MD) is a progressive, occlusive disease of the arteries of the anterior cerebral circulation that may cause ischaemia or haemorrhage. Patient management aims to prevent new cerebrovascular events through surgical revascularisation and/or pharmacological treatment. MATERIALS AND METHODS We studied a series of 17 patients with MD (n = 14) or moyamoya syndrome (MS; n = 3), who were evaluated between January 1989 and December 2016; 11 patients were women and 6 were men. Thirteen patients had definitive MD (76%), one had unilateral MD (5.2%), and 3 had MS (18%). The condition manifested as intraparenchymal haemorrhage (in 35.2% of patients), brain ischaemia (29.4%), subarachnoid haemorrhage (17.6%), seizures (11.7%), and headache with no associated haemorrhage (1 patient). RESULTS Ten patients (58.8%) underwent revascularisation and 7 (41.2%) received pharmacological treatment. All patients were evaluated with the modified Rankin Scale (mRs) at admission and at the last consultation; mRs scores were significantly lower in the group undergoing surgery (P < .04). During follow-up, none of the patients undergoing revascularisation experienced recurrences, whereas 2 patients receiving pharmacological treatment did experience a new vascular event (one ischaemic and one haemorrhagic) (P < .05). No significant differences were observed between the treatment outcomes of different revascularisation techniques. CONCLUSIONS Although our population has different demographic characteristics from those of other non-Asian populations, ours is the largest published series of Hispanic individuals with MD. Our results support the use of revascularisation procedures to improve these patients' neurological status and to prevent new cerebrovascular events.
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Affiliation(s)
- E Nathal
- Departamento de Neurocirugía, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Ciudad de México, Mexico.
| | - A Serrano-Rubio
- Departamento de Neurocirugía, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Ciudad de México, Mexico
| | - E Maciel
- Escuela de Medicina, Instituto Tecnológico de Monterrey Campus Guadalajara, Guadalajara, Mexico
| | - A Arauz
- Departamento de Neurología Vascular, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Ciudadde México, Mexico
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Soto-Vidal C, Pacheco-da-Costa S, Calvo-Fuente V, Fernández-Guinea S, González-Alted C, Gallego-Izquierdo T. Validation of the Spanish Version of Newcastle Stroke-Specific Quality of Life Measure (NEWSQOL). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4237. [PMID: 32545844 PMCID: PMC7345147 DOI: 10.3390/ijerph17124237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/09/2020] [Accepted: 06/11/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Stroke causes a wide variety of clinical manifestations that may have a negative impact on quality of life. Therefore, it is very important to use specific instruments for measuring quality of life in individuals who suffered a stroke. The aim of this study was to develop a psychometrically validated Spanish version of the Newcastle stroke-specific quality of life measure (NEWSQOL). METHODS A psychometric validation of the Spanish version of the NEWSQOL questionnaire was carried out in 159 patients. The reliability (intraclass correlation coefficient and Cronbach's alpha coefficient), validity (factorial analysis and Spearman's coefficient), feasibility (response rate), and the ceiling and floor effects were calculated. RESULTS Internal consistency showed that Cronbach's alpha coefficient was 0.93. The test-retest reliability was high or excellent for all domains (range 0.71-0.97 p < 0.001). The response rate of the questionnaire was 100% and the average administration time was 20.5 (±7.2) min. No ceiling effect was detected and two domains (pain and vision) may have a significant potential for floor effect. Construct validity showed that all the variables are important enough to keep them all in the questionnaire. Concerning convergent construct validity, a high correlation was found with the Nottingham Health Profile, the Barthel Index, and the Modified Rankin Scale. CONCLUSION The Spanish version of the NEWSQOL questionnaire is reliable, valid, and feasible to evaluate quality of life in the Spanish population.
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Affiliation(s)
- Concepción Soto-Vidal
- Department of Nursing and Physiotherapy, University of Alcala, 28871 Madrid, Spain; (C.S.-V.); (V.C.-F.); (T.G.-I.)
| | - Soraya Pacheco-da-Costa
- Department of Nursing and Physiotherapy, University of Alcala, 28871 Madrid, Spain; (C.S.-V.); (V.C.-F.); (T.G.-I.)
| | - Victoria Calvo-Fuente
- Department of Nursing and Physiotherapy, University of Alcala, 28871 Madrid, Spain; (C.S.-V.); (V.C.-F.); (T.G.-I.)
| | - Sara Fernández-Guinea
- Department of Experimental Psychology, Complutense University of Madrid, 28040 Madrid, Spain;
| | | | - Tomás Gallego-Izquierdo
- Department of Nursing and Physiotherapy, University of Alcala, 28871 Madrid, Spain; (C.S.-V.); (V.C.-F.); (T.G.-I.)
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Nathal E, Serrano-Rubio A, Maciel E, Arauz A. Moyamoya disease in Mexico: Our experience. Neurologia 2018; 36:S0213-4853(18)30179-8. [PMID: 30076039 DOI: 10.1016/j.nrl.2018.05.006] [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: 12/10/2017] [Revised: 05/06/2018] [Accepted: 05/13/2018] [Indexed: 10/28/2022] Open
Abstract
INTRODUCTION Moyamoya disease (MD) is a progressive, occlusive disease of the arteries of the anterior cerebral circulation that may cause ischaemia or haemorrhage. Patient management aims to prevent new cerebrovascular events through surgical revascularisation and/or pharmacological treatment. METHODS We studied a series of 17 patients with MD (n = 14) or moyamoya syndrome (n = 3), who were evaluated between January 1989 and December 2016; 11 patients were women and 6 were men. Thirteen patients had definitive MD (76%), one had unilateral MD (5.2%), and 3 had moyamoya syndrome (18%). The condition manifested as intraparenchymal haemorrhage (in 35.2% of patients), brain ischaemia (29.4%), subarachnoid haemorrhage (17.6%), seizures (11.7%), and headache with no associated haemorrhage (one patient). RESULTS Ten patients (58.8%) underwent revascularisation and 7 (41.2%) received pharmacological treatment. All patients were evaluated with the modified Rankin Scale (mRs) at admission and at the last consultation; mRs scores were significantly lower in the group undergoing surgery (P < .04). During follow-up, none of the patients undergoing revascularisation experienced recurrences, whereas 2 patients receiving pharmacological treatment did experience a new vascular event (one ischaemic and one haemorrhagic) (P < .05). No significant differences were observed between the treatment outcomes of different revascularisation techniques. CONCLUSIONS Although our population has different demographic characteristics from those of other non-Asian populations, ours is the largest published series of Hispanic individuals with MD. Our results support the use of revascularisation procedures to improve these patients' neurological status and to prevent new cerebrovascular events.
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Affiliation(s)
- E Nathal
- Departamento de Neurocirugía, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Ciudad de México, México.
| | - A Serrano-Rubio
- Departamento de Neurocirugía, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Ciudad de México, México
| | - E Maciel
- Escuela de Medicina, Instituto Tecnológico de Monterrey Campus Guadalajara, Guadalajara, México
| | - A Arauz
- Departamento de Neurología Vascular, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Ciudad de México, México
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Dulicek P, Ivanova E, Kostal M, Sadilek P, Beranek M, Zak P, Hirmerova J. Analysis of Risk Factors of Stroke and Venous Thromboembolism in Females With Oral Contraceptives Use. Clin Appl Thromb Hemost 2017; 24:797-802. [PMID: 28884608 DOI: 10.1177/1076029617727857] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Thrombotic diathesis has been a well-known complication of oral contraceptive use for more than 50 years. This is true not only for venous thrombosis but also for an arterial one. The etiology is usually multifactorial and depends on several additional risk factors. We analyzed the prevalence of inherited and acquired thrombophilia in a cohort of 770 females who had a thrombotic event in association with oral contraceptive use (700 women with venous thromboembolism [VTE], 70 with stroke). Moreover, we tried to identify additional risk factors. Inherited thrombophilia was found in 44.5% with higher frequency in the cohort with VTE (42%) than in females with stroke (24%). The most frequent finding was factor V Leiden. Cigarette smoking was significantly more frequent in the group with stroke (50% vs 25%). The prevalence of cigarette smoking in the group with VTE did not exceed the frequency in general population. Women on oral contraceptive pills have higher risk of venous as well as arterial thrombosis. The risk of venous thrombosis is increased in females with inherited thrombophilia, whereas those with some additional acquired risk factors (especially smoking) may be predisposed to arterial thrombosis. However, the absolute risk of thrombosis in healthy women is low, far less than the risk of unintended pregnancy. Moreover, the risk may be reduced by keeping some rules before the prescription of the pills, healthy life style, and a proper choice of contraception.
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Affiliation(s)
- Petr Dulicek
- 1 4th Department of Internal Medicine and Hematology, University Hospital and Medical Faculty in Hradec Kralove, Hradec Kralove, Czech Republic
| | - Eva Ivanova
- 1 4th Department of Internal Medicine and Hematology, University Hospital and Medical Faculty in Hradec Kralove, Hradec Kralove, Czech Republic
| | - Milan Kostal
- 1 4th Department of Internal Medicine and Hematology, University Hospital and Medical Faculty in Hradec Kralove, Hradec Kralove, Czech Republic
| | - Petr Sadilek
- 1 4th Department of Internal Medicine and Hematology, University Hospital and Medical Faculty in Hradec Kralove, Hradec Kralove, Czech Republic
| | - Martin Beranek
- 2 Department of Clinical Biochemistry, University Hospital and Medical Faculty in Hradec Kralove, Hradec Kralove, Czech Republic
| | - Pavel Zak
- 1 4th Department of Internal Medicine and Hematology, University Hospital and Medical Faculty in Hradec Kralove, Hradec Kralove, Czech Republic
| | - Jana Hirmerova
- 3 2nd Department of Internal Medicine, Charles University Medical Faculty in Pilsen, Pilsen, Czech Republic.,4 Biomedical Centre, Charles University Medical Faculty in Pilsen, Pilsen, Czech Republic
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