1
|
Kalaria RN, Akinyemi RO, Paddick SM, Ihara M. Current perspectives on prevention of vascular cognitive impairment and promotion of vascular brain health. Expert Rev Neurother 2024; 24:25-44. [PMID: 37916306 PMCID: PMC10872925 DOI: 10.1080/14737175.2023.2273393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/17/2023] [Indexed: 11/03/2023]
Abstract
INTRODUCTION The true global burden of vascular cognitive impairment (VCI) is unknown. Reducing risk factors for stroke and cardiovascular disease would inevitably curtail VCI. AREAS COVERED The authors review current diagnosis, epidemiology, and risk factors for VCI. VCI increases in older age and by inheritance of known genetic traits. They emphasize modifiable risk factors identified by the 2020 Lancet Dementia Commission. The most profound risks for VCI also include lower education, cardiometabolic factors, and compromised cognitive reserve. Finally, they discuss pharmacological and non-pharmacological interventions. EXPERT OPINION By virtue of the high frequencies of stroke and cardiovascular disease the global prevalence of VCI is expectedly higher than prevalent neurodegenerative disorders causing dementia. Since ~ 90% of the global burden of stroke can be attributed to modifiable risk factors, a formidable opportunity arises to reduce the burden of not only stroke but VCI outcomes including progression from mild to the major in form of vascular dementia. Strict control of vascular risk factors and secondary prevention of cerebrovascular disease via pharmacological interventions will impact on burden of VCI. Non-pharmacological measures by adopting healthy diets and encouraging physical and cognitive activities and urging multidomain approaches are important for prevention of VCI and preservation of vascular brain health.
Collapse
Affiliation(s)
- Raj N Kalaria
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Rufus O Akinyemi
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Stella-Maria Paddick
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Masafumi Ihara
- Department of Neurology, National Cerebral and Cardiovascular Centre, Osaka, Japan
| |
Collapse
|
2
|
Singh P, Faisal AR, Alam MM, Saeed A, Haider T, Asif HMA, Rauniyar J, Rai N, Janjua MAK, Pasha AR. An Assessment of Personal Hygiene Practices Among Young Adults: A Cross-Sectional, Descriptive Study. Cureus 2023; 15:e44308. [PMID: 37779771 PMCID: PMC10535016 DOI: 10.7759/cureus.44308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2023] [Indexed: 10/03/2023] Open
Abstract
Background Personal Hygiene behavior and practices play a major role in health promotion and disease prevention. Socio-demographic, behavioral, and psychological factors sway a person's overall adaptation of good practices. Disease burden leading to loss of productivity and its influence on the economy cannot be overstated. As medical professionals come in contact with a large number of people, they carry the potential to be super-spreaders in disease outbreaks. Thus, it is of utmost importance that medics and paramedics maintain hygiene to the highest standards. Method This cross-sectional study comprised 323 young adult participants from Muslim Town, Faisalabad. A structured questionnaire containing close-ended questions was used for data collection regarding personal hygiene behavior and practices. Dependency between various qualitative categorical variables and hygiene practices was analyzed using Chi-squared tests. Results It was found that although the majority of the participants followed good hygiene for most of the practices; laziness, lack of relevant education, improper time management, and unreliable water supply posed a significant barrier to good practices. Females had demonstrably better practices compared to males. Urbanity did not have a significant correlation with the results. Conclusion We conclude that a rigorous program of awareness and education regarding this subject is the need of the hour to facilitate an improvement in predictive and preventive health care and reduce morbidity and mortality. Steps should be taken to ease the barriers that are obstructing optimal hygienic practices.
Collapse
Affiliation(s)
- Pramod Singh
- Nephrology, Punjab Medical College, Faisalabad Medical University, Faisalabad, PAK
| | | | | | - Ahmad Saeed
- Nephrology Department, Faisalabad Medical University, Faisalabad, PAK
| | | | | | | | - Niraj Rai
- Psychiatry, Punjab Medical College, Faisalabad Medical University, Faisalabad, PAK
| | | | | |
Collapse
|
3
|
Kuang J, Yang L, Lv R, Li J, Zhou K, Xu M. The mediating effect of post-stroke depression between social support and quality of life among stroke survivors: A meta-analytic structural equation modeling. Int J Geriatr Psychiatry 2022; 37. [PMID: 36317324 DOI: 10.1002/gps.5820] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 09/29/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES The aim was to confirm the relationship between social support (SS), post-stroke depression (PSD), and quality of life (QOL) and determine the mediating effect of PSD in stroke survivors. Additionally, we tested the impact of economic development level (in developed or developing countries) on the relationship between SS, PSD, and QOL. METHODS This study utilized meta-analytic structural equation modeling on systematically searched articles from PubMed, MEDLINE, Cochrane Library, Scopus, PsycINFO, Web of Science, China National Knowledge Infrastructure, and WanFang data published from inception to February 2022. Collect the sample size (n) of each study and the associations of observed variables, and conduct meta-analysis path analysis using AMOS 23.0 to assess the relationships. Concurrently, the effects of the national economic development level were extracted for moderator analysis. RESULTS A total of 28 studies (N = 3967) were included for analysis. SS and PSD were significant predictors of QOL (both p < 0.01). PSD mediated the relationship between SS and QOL (β = 0.31; 95% confidence interval 0.273-0.345; p < 0.01). Furthermore, in developed countries, SS was not statistically correlated with PSD (p = 0.811) compared to developing countries. CONCLUSIONS Improving SS may help improve the QOL of stroke patients. PSD should be addressed using a comprehensive approach that includes interventions to enhance the QOL. Additionally, people have different psychological reactions to SS at different stages of economic development; thus, further research is needed to develop different measurement standards for patients according to the country's level of economic development.
Collapse
Affiliation(s)
- Jinke Kuang
- School of Nursing, Qingdao University, Qingdao, Shandong Province, China
| | - Li Yang
- School of Nursing, Qingdao University, Qingdao, Shandong Province, China
| | - Runtian Lv
- School of Nursing, Qingdao University, Qingdao, Shandong Province, China
| | - Jia Li
- School of Nursing, Qingdao University, Qingdao, Shandong Province, China
| | - Kexin Zhou
- School of Nursing, Qingdao University, Qingdao, Shandong Province, China
| | - Mengfan Xu
- School of Nursing, Qingdao University, Qingdao, Shandong Province, China
| |
Collapse
|
4
|
Clavijo Prado CA, Aroca Torres J, Abadía Rincon AL, Vargas Ramírez AM, Chauvez Gallego A. Aproximación diagnóstica de la neurosífilis. REPERTORIO DE MEDICINA Y CIRUGÍA 2022. [DOI: 10.31260/repertmedcir.01217372.1185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
La neurosífilis es la enfermedad del sistema nervioso central (SNC) causada por Treponema pallidum, perteneciente al grupo de las espiroquetas; se puede presentar en pacientes inmunocompetentes pero existe una asociación mayor con el virus de inmunodeficiencia humana (VIH). Estos casos son más severos y con manifestaciones neurológicas variables. Si bien la forma típica es la más frecuente, existen expresiones atípicas que pueden llegar a presentarse en 30% de los casos según los estudios radiológicos, por lo cual es importante reconocerlas a fin de garantizar un diagnóstico temprano y una intervención oportuna. No solo es un problema de salud pública por su prevalencia sino también por el amplio espectro clínico que le ha valido el nombre de gran simuladora, siendo desconocidas en muchas ocasiones por los médicos de atención primaria. El siguiente trabajo ha sido planteado con base en tres casos clínicos (2 de vasculitis en SNC, una panuveítis) con el objetivo de desmitificar los tiempos de presentación y aclarar las manifestaciones clínicas que comprometen el SNC, tratando de precisar el diagnóstico para la realización de un tratamiento pertinente y oportuno que reduzca las secuelas.
Collapse
|
5
|
Soheili A, Askari-Majdabadi H, Basereh Z, Powers K, Soleimani M, Mirmohammdkhani M, Saleh T. Current status of acute ischemic stroke management in Iran: Findings from a single-center study. Turk J Emerg Med 2022; 22:213-220. [DOI: 10.4103/2452-2473.357344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 07/15/2022] [Accepted: 07/16/2022] [Indexed: 11/04/2022] Open
|
6
|
Samoilova EM, Yusubalieva GM, Belopasov VV, Ekusheva EV, Baklaushev VP. [Infections and inflammation in the development of stroke]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:11-21. [PMID: 34553576 DOI: 10.17116/jnevro202112108211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The review systematizes data on the role of infectious diseases and systemic inflammation in the pathogenesis of stroke. Various risk factors for stroke associated with pro-inflammatory reactions and their contribution to the pathogenesis of cerebrovascular pathology are analyzed. The interaction of systemic inflammation with hemostasis disturbances and clots formation, activation of autoreactive clones of cytotoxic lymphocytes, the progression of endothelial damage, and other processes is shown. Along with infection, these factors increase the risk of stroke. The key mechanisms of the pathogenesis from the development of acute or chronic inflammation to the preconditions of stroke are presented. The mechanisms of the acting of the infectious process as a trigger factor and/or medium-term or long-term risk factors of stroke are described. A separate section is devoted to the mechanisms of developing cerebrovascular diseases after COVID-19. Identifying an increased risk of stroke due to infection can be of great preventive value. Understanding of this risk by specialists followed by correction of drug therapy and rehabilitation measures can reduce the incidence of cerebrovascular complications in infectious patients.
Collapse
Affiliation(s)
- E M Samoilova
- Federal Scientific and Clinical Center of Specialized Types of Medical Care and Medical Technologies of the Federal Medical and Biological Agency of Russia, Moscow, Russia
| | - G M Yusubalieva
- Federal Scientific and Clinical Center of Specialized Types of Medical Care and Medical Technologies of the Federal Medical and Biological Agency of Russia, Moscow, Russia
| | - V V Belopasov
- Astrakhan State Medical University, Astrakhan, Russia
| | - E V Ekusheva
- Academy of Postgraduate Education of the Federal Scientific and Clinical Center for Specialized Types of Medical Care and Medical Technologies FMBA of Russia, Moscow, Russia.,Belgorod State National Research University, Belgorod, Russia
| | - V P Baklaushev
- Federal Scientific and Clinical Center of Specialized Types of Medical Care and Medical Technologies of the Federal Medical and Biological Agency of Russia, Moscow, Russia
| |
Collapse
|
7
|
Shinjyo N, Kagaya W, Pekna M. Interaction Between the Complement System and Infectious Agents - A Potential Mechanistic Link to Neurodegeneration and Dementia. Front Cell Neurosci 2021; 15:710390. [PMID: 34408631 PMCID: PMC8365172 DOI: 10.3389/fncel.2021.710390] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 07/09/2021] [Indexed: 12/24/2022] Open
Abstract
As part of the innate immune system, complement plays a critical role in the elimination of pathogens and mobilization of cellular immune responses. In the central nervous system (CNS), many complement proteins are locally produced and regulate nervous system development and physiological processes such as neural plasticity. However, aberrant complement activation has been implicated in neurodegeneration, including Alzheimer’s disease. There is a growing list of pathogens that have been shown to interact with the complement system in the brain but the short- and long-term consequences of infection-induced complement activation for neuronal functioning are largely elusive. Available evidence suggests that the infection-induced complement activation could be protective or harmful, depending on the context. Here we summarize how various infectious agents, including bacteria (e.g., Streptococcus spp.), viruses (e.g., HIV and measles virus), fungi (e.g., Candida spp.), parasites (e.g., Toxoplasma gondii and Plasmodium spp.), and prion proteins activate and manipulate the complement system in the CNS. We also discuss the potential mechanisms by which the interaction between the infectious agents and the complement system can play a role in neurodegeneration and dementia.
Collapse
Affiliation(s)
- Noriko Shinjyo
- Laboratory of Immune Homeostasis, WPI Immunology Frontier Research Center, Osaka University, Osaka, Japan.,School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Wataru Kagaya
- Department of Parasitology and Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Marcela Pekna
- Laboratory of Regenerative Neuroimmunology, Center for Brain Repair, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
| |
Collapse
|
8
|
Yoo JE, Kim D, Choi H, Kang YA, Han K, Lee H, Shin DW. Anemia, sarcopenia, physical activity, and the risk of tuberculosis in the older population: a nationwide cohort study. Ther Adv Chronic Dis 2021; 12:20406223211015959. [PMID: 34104377 PMCID: PMC8170360 DOI: 10.1177/20406223211015959] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 04/20/2021] [Indexed: 01/17/2023] Open
Abstract
Background: The aim of this study was to investigate whether physical activity,
sarcopenia, and anemia are associated an with increased risk of tuberculosis
(TB) among the older population. Methods: We included 1,245,640 66-year-old subjects who participated in the National
Screening Program for Transitional Ages for Koreans from 2009 to 2014. At
baseline, we assessed common health problems in the older population,
including anemia and sarcopenia. The subjects’ performance in the timed
up-and-go (TUG) test was used to predict sarcopenia. The incidence of TB was
determined using claims data from the National Health Insurance Service
database. Results: The median follow-up duration was 6.4 years. There was a significant
association between the severity of anemia and TB incidence, with an
adjusted hazard ratio (aHR) of 1.28 [95% confidence interval (CI),
1.20–1.36] for mild anemia and 1.69 (95% CI, 1.51–1.88) for moderate to
severe anemia. Compared with those who had normal TUG times, participants
with slow TUG times (⩾15 s) had a significantly increased risk of TB (aHR
1.19, 95% CI, 1.07–1.33). On the other hand, both irregular (aHR 0.88, 95%
CI 0.83–0.93) and regular (aHR 0.84, 95% CI, 0.78–0.92) physical activity
reduced the risk of TB. Male sex, lower income, alcohol consumption,
smoking, diabetes, and asthma/chronic obstructive pulmonary disease
increased the risk of TB. Conclusion: The risk of TB among older adults increased with worsening anemia,
sarcopenia, and physical inactivity. Physicians should be aware of those
modifiable predictors for TB among the older population.
Collapse
Affiliation(s)
- Jung Eun Yoo
- Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Dahye Kim
- Department of Biostatistics, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hayoung Choi
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Young Ae Kang
- Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Dongjak-gu, Seoul, Republic of Korea
| | - Hyun Lee
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang Medical Center, Hanyang University College of Medicine, 222-1 Wangsimni-ro, Seoul, Seongdong-gu 04763, Republic of Korea
| | - Dong Wook Shin
- Shin Department of Family Medicine/Supportive Care Center, Samsung Medical Center, Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, 81 Irwon-Ro, Seoul, Gangnam-gu 06351, Republic of Korea
| |
Collapse
|
9
|
Li W, Kim J, Zhang J, Bang OY. Infectious causes of acute ischemic stroke: pathomechanisms and distribution of brain infarct. PRECISION AND FUTURE MEDICINE 2020. [DOI: 10.23838/pfm.2020.00079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
10
|
Odonkor ST, Kitcher J, Okyere M, Mahami T. Self-Assessment of Hygiene Practices towards Predictive and Preventive Medicine Intervention: A Case Study of University Students in Ghana. BIOMED RESEARCH INTERNATIONAL 2019; 2019:3868537. [PMID: 31467889 PMCID: PMC6699301 DOI: 10.1155/2019/3868537] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 06/05/2019] [Accepted: 06/11/2019] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Personal hygiene is essential to the current paradigm shift towards predictive, preventive, and personalized medicine, which enables the prediction and prevention of infectious disease outbreaks. OBJECTIVE The aim of this paper was to evaluate the personal hygiene practices among university students aiming at providing a basis for preventive and predictive medical interventions and to make future efforts improve target interventions for young people. METHODS The study was conducted using a cross-sectional study. Validated instruments that related personal hygiene practices were used to obtain quantitative data from 412 tertiary students from seven universities in Accra, Ghana. The resulting data were analyzed with IBM-SPSS, version 23. RESULTS There were more female respondents (54.4%) in the study than male respondents (45.6%). Respondents between the age group of 19-24 years constituted majority (59.7%) of the respondents in the study. Respondents from urban areas exhibited good hygiene practice compared to those from urban residences. There was a significant association between residence and hygiene practice (χ 2=17.8, P≤0.001). We also observed that those respondents within the upper class in society had a poor hygiene practice, compared to the Lower Class and Middle Class respondents. Lack of education (63.1%) was observed as the main barrier to personal hygiene among the respondents. Future of the society depends on the health of its youth. CONCLUSION A significant number of students are not actively practicing good hygiene. There is a need for deployment of preventive medicine interventions targeted at young people. It calls for improvement in methods of hygiene education for young people in tertiary institutions and the inclusion of hygiene in school curricula.
Collapse
Affiliation(s)
- Stephen T. Odonkor
- School of Public Services and Governance, Ghana Institute of Management and Public Administration, Accra, Ghana
| | - Jones Kitcher
- Metropolitan Research and Education Bureau, Accra, Ghana
| | | | - Tahiru Mahami
- Ghana Atomic Energy Commission, Kwabenya-Accra, Ghana
| |
Collapse
|