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Tan X, Ding Z, Guo C, Sun P. Re-evaluation of Mirror Visual Feedback Therapy for a Systematic Evaluation/Meta-analysis of Physical Function Re-education After Stroke. Am J Phys Med Rehabil 2023; 102:229-234. [PMID: 35944079 DOI: 10.1097/phm.0000000000002078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE The aim of the study is to re-evaluate the methodological quality and quality of evidence for a systematic evaluation/meta-analysis of the effect of mirror visual feedback therapy on physical function re-education after stroke. METHODS Systematic evaluations/meta-analyses of mirror visual feedback therapy on physical function re-education after stroke were searched in the China Knowledge Network database, Wanfang database, Vipers database, China Biomedical Literature database, PubMed, Web of Science, and Embase using a computer, and the search time frame was up to January 2022. Methodological quality and quality of evidence ratings of the included studies were determined using the AMSTAR2 scale and GRADE classification by two authors. RESULTS Seventeen publications were included. The evaluation with the AMSTAR2 scale showed that one study had an intermediate quality rating, five had a low-quality rating, and the remaining 11 were all very low quality. The GRADE scale showed 93 outcome indicators, of which 6 were intermediate, 23 were low grades, and the rest were very low grades, with low overall quality. CONCLUSIONS Mirror visual feedback therapy is efficacious for physical function re-education after stroke and promotes recovery from physical dysfunction, but the methodological quality and quality of evidence from the related systematic evaluations/meta-analyses are low.
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Affiliation(s)
- Xuefeng Tan
- From the School of Physical Education and Sports, Beijing Normal University, Beijing, China (XT, CG, PS); and School of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China (ZD)
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2
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Toyoda K, Yoshimura S, Tanaka K, Ogasawara K, Rha JH. The 10th Korea-Japan Joint Stroke Conference (KJJSC) at Osaka: The First-Ever and Hopefully, the Last Virtual Conference. J Stroke 2023; 25:177-178. [PMID: 36746386 PMCID: PMC9911837 DOI: 10.5853/jos.2023.00052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 02/04/2023] Open
Affiliation(s)
- Kazunori Toyoda
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan,Correspondence: Kazunori Toyoda Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565, Japan Tel: +81-6-6170-1070 E-mail:
| | - Sohei Yoshimura
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kanta Tanaka
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | | | - Joung-Ho Rha
- Department of Neurology, Inha University School of Medicine, Incheon, Korea
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Wu YY, Chen PY, Wu CC, Chen HJ, Liang CL, Lee YC, Lin CW, Hung CM, Lin IF, Wang HK. Long-term mortality rates of young stroke in Taiwan: A decade-long epidemiology population-based study. Eur Stroke J 2022; 7:447-455. [PMID: 36478751 PMCID: PMC9720855 DOI: 10.1177/23969873221115268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/04/2022] [Indexed: 09/08/2023] Open
Abstract
INTRODUCTION Stroke remains a leading cause of death worldwide. Stroke in young adults is an important issue, gaining extra attention in recent years. This study aims to investigate the mortality after stroke in young adults in Taiwan. PATIENTS AND METHODS This is a registry- and population-based study in Taiwan of patients aged 20-50 years with first-ever stroke between 1999 and 2012, with follow-up until January 1, 2022. Patients and mortalities were identified through Taiwan National Health Insurance database. RESULTS The study population included 65,097 patients with stroke (mean age, 42.6 ± 6.6 years; 30.5% woman). There were 23,481 (36.1%) intracranial hemorrhage, 37,522 (57.6%) ischemic stroke, and 4094 (6.3%) stroke not otherwise specified. At the end of follow-up, a total of 18,248 deaths (28.0%) occurred during a median follow-up of 9.8 years (interquartile range, 6.4-13.7 years). CONCLUSION Taiwan young adults who were 30-day survivors of first-ever stroke have significantly higher long-term mortality rates when compared to other population-based studies.
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Affiliation(s)
- Yu-ying Wu
- School of Medicine, College of
Medicine, I-Shou University, Kaohsiung
- Department of Neurosurgery, E-Da
Hospital, Kaohsiung
| | - Po-Yuan Chen
- School of Medicine, College of
Medicine, I-Shou University, Kaohsiung
- Department of Neurosurgery, E-Da
Hospital, Kaohsiung
| | - Cheng-Chun Wu
- School of Medicine, College of
Medicine, I-Shou University, Kaohsiung
| | - Han-Jung Chen
- School of Medicine, College of
Medicine, I-Shou University, Kaohsiung
- Department of Neurosurgery, E-Da
Hospital, Kaohsiung
| | - Cheng-Loong Liang
- School of Medicine, College of
Medicine, I-Shou University, Kaohsiung
- Department of Neurosurgery, E-Da
Hospital, Kaohsiung
| | - Yi-Che Lee
- School of Medicine, College of
Medicine, I-Shou University, Kaohsiung
- Department of Nephrology, E-Da
Hospital, Kaohsiung
| | - Chi-Wei Lin
- School of Medicine, College of
Medicine, I-Shou University, Kaohsiung
- Department of Family Medicine, E-Da
Hospital, Kaohsiung
| | - Chao-Ming Hung
- School of Medicine, College of
Medicine, I-Shou University, Kaohsiung
- Department of General Surgery, E-Da
cancer Hospital, Kaohsiung
| | - I-Fan Lin
- School of Medicine, College of
Medicine, I-Shou University, Kaohsiung
- Department of Infectious Disease, E-Da
Hospital, Kaohsiung
| | - Hao-Kuang Wang
- School of Medicine, College of
Medicine, I-Shou University, Kaohsiung
- Department of Neurosurgery, E-Da
Hospital, Kaohsiung
- Department of Neurosurgery, E-Da Cancer
Hospital, Kaohsiung
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Tang L, Liu S, Gan L, Ding H, Huang QM, Gao F, Li Y. Effects of dry needling intervention on lower limb dysfunction after stroke: study protocol for a randomised controlled trial. BMJ Open 2022; 12:e062494. [PMID: 36288843 PMCID: PMC9615970 DOI: 10.1136/bmjopen-2022-062494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Lower limb dysfunction is among the common sequelae of patients who had a poststroke and often results in the reduction of the quality of life. This study aims to assess the short and interim-term efficacy of dry needling (DN) intervention on lower extremity function, balance and gait in lower limb dysfunction after stroke. METHODS AND ANALYSIS This protocol entails an assessor and statistician-blinded, single-centre study with a randomised controlled trial. Forty-four patients who had a poststroke will be randomly allocated (1:1) to either the conventional treatment group (n=22) or the DN group (n=22). The conventional treatment group will receive conventional rehabilitation treatment once a day for 40 min each time. The treatment will be performed five times a week for 2 weeks. In the DN group, participants will be treated with DN on the basis of the conventional treatment. The intervention will be performed thrice a week for 2 weeks. The primary outcome that determines the efficacy of lower limb dysfunction will be the change in the Fugl-Meyer Assessment of Lower Extremity scale. The secondary indicators include the range of motion of knee and ankle joints, limits of stability, modified Clinical Test of Sensory Interaction on Balance, Timed Up and Go test, Modified Ashworth Scale and Barthel Index. Results will be evaluated at baseline, at 24 hours after intervention, at 2 weeks after intervention and at 3-month follow-up. Data will be released after the completion of the study. Adverse events will be reported. ETHICS AND DISSEMINATION The experiment was approved by the Ethical Committee of Shanghai Tong Ren Hospital in October 2021 (approval number: 202105702). The results of this study will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER ChiCTR2000040754.
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Affiliation(s)
- Li Tang
- Department of Rehabilitation, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shanshan Liu
- Department of Rehabilitation, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lin Gan
- Department of Rehabilitation, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hao Ding
- Department of Rehabilitation, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiang-Min Huang
- Department of Sport Rehabilitation, School of kinesiology, Shanghai University of Sport, Shanghai, China
| | - Fang Gao
- Department of Rehabilitation, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Li
- Department of Rehabilitation, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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5
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Relationship Between Brainstem Auditory Evoked Potentials and Clinical Function in Patients With Cerebral Infarction. J Clin Neurophysiol 2022; 39:383-389. [DOI: 10.1097/wnp.0000000000000773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Fallahzadeh A, Esfahani Z, Sheikhy A, Keykhaei M, Moghaddam SS, Tehrani YS, Rezaei N, Ghasemi E, Azadnajafabad S, Mohammadi E, Koolaji S, Shahin S, Rezaei N, Larijani B, Farzadfar F. National and subnational burden of stroke in Iran from 1990 to 2019. Ann Clin Transl Neurol 2022; 9:669-683. [PMID: 35395141 PMCID: PMC9082377 DOI: 10.1002/acn3.51547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 02/05/2022] [Accepted: 03/01/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Data on the burden of stroke and changing trends at national and subnational levels are necessary for policymakers to allocate recourses appropriately. This study presents estimates of the stroke burden from 1990 to 2019 using the results of the Global Burden of Disease (GBD) 2019 study. METHODS For the GBD 2019, verbal autopsy and vital registration data were used to estimate stroke mortality. Cause-specific mortality served as the basis for estimating incidence, prevalence, and disability-adjusted life years (DALYs). The burden attributable to stroke risk factors was calculated by a comparative risk assessment. Decomposition analysis was applied to determine the contribution of population aging, population growth, and changes in the age-specific incidence rates. RESULTS In 2019, the number of prevalent cases, incident cases, and deaths due to stroke in Iran were 963,512; 102,778; and 40,912, respectively. The age-standardized incidence rate (ASIR) and the age-standardized death rate (ASDR) decreased from 1990 to 2019. Of national stroke ASDRs in 2019, 44.7% (35.7-54.7%) were attributable to hypertension and 28.8% (15.2-57.4) to high fasting plasma glucose. At the subnational level, the trend of the stroke incidence and mortality rate decreased in all provinces. Stroke was responsible for 4.48% of total DALYs in 2019 (3.38% due to ischemic stroke, 0.87% due to intracerebral hemorrhage, and 0.22% due to subarachnoid hemorrhage). CONCLUSION ASIR and ASDR of stroke are decreasing nationally and subnationally; however, the number of incident cases and deaths are increasing in all SDI quintiles, possibly due to population growth.
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Affiliation(s)
- Aida Fallahzadeh
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Zahra Esfahani
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
- Department of BiostatisticsUniversity of Social Welfare and Rehabilitation SciencesTehranIran
| | - Ali Sheikhy
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Mohammad Keykhaei
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
- Feinberg Cardiovascular Research InstituteFeinberg School of Medicine, Northwestern UniversityChicagoIllinois60611USA
| | - Sahar Saeedi Moghaddam
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Yeganeh Sharifnejad Tehrani
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Negar Rezaei
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Erfan Ghasemi
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Sina Azadnajafabad
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Esmaeil Mohammadi
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Sogol Koolaji
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Sarvenaz Shahin
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Nazila Rezaei
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Farshad Farzadfar
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
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Kim KT, Chang WK, Jung YS, Jee S, Sohn MK, Ko SH, Shin YI, Leigh JH, Kim WS, Paik NJ. Unmet Needs for Rehabilitative Management in Common Health-Related Problems Negatively Impact the Quality of Life of Community-Dwelling Stroke Survivors. Front Neurol 2022; 12:758536. [PMID: 35002922 PMCID: PMC8733320 DOI: 10.3389/fneur.2021.758536] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 12/07/2021] [Indexed: 01/01/2023] Open
Abstract
Purpose: Community-dwelling stroke survivors have various unmet needs for rehabilitative management, but there is a lack of in-depth investigations on common health problems after stroke. Moreover, the association between unmet needs and health-related quality of life (HRQoL) has not been thoroughly investigated. This study aimed to investigate the unmet needs for rehabilitative management in common problems after stroke and their associations with HRQoL among community-dwelling stroke survivors. Methods: A face-to-face cross-sectional survey was conducted among community-dwelling stroke survivors visiting outpatient clinics of rehabilitation departments between June and October 2020 in three university-affiliated hospitals. Unmet needs for common problems after stroke were assessed across eight domains based on the post-stroke checklist: spasticity, dysphagia, communication, cognition, ambulation, pain/discomfort, anxiety/depression, and self-care. HRQoL was measured using the EuroQoL-5D three level (EQ-5D). The prevalence of unmet needs for rehabilitative management and their associations with the EQ-5D index were analyzed. Results: Among the 239 participants who responded to the survey, 63% (n = 150) were men. The mean age was 63 ± 13 years, and the mean duration of stroke onset was 55.6 months. Overall, 49% reported at least one unmet need, and the most frequently reported unmet needs were anxiety/depression (20.9%), self-care (20.9%), and pain/discomfort (18.0%). The highest proportion of unmet needs was in the anxiety/depression, communication, and cognition domains. Patients with unmet needs for cognition and pain/discomfort showed a significantly lower EQ-5D index, even after adjusting for age, sex, and modified Rankin scale scores. The total number of unmet needs was significantly correlated with a lower EQ-5D index (Pearson's r = -0.329, p < 0.001) in the multivariate linear regression model. Conclusions: Unmet rehabilitative needs are prevalent among community-dwelling stroke survivors, and the proportion of unmet needs was high among non-physical domains such as anxiety/depression. The number of unmet needs is an independent negative predictor of HRQoL. Systematic approaches to identify unmet needs and provide appropriate rehabilitative management are required in long-term stroke survivors.
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Affiliation(s)
- Kyoung Tae Kim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.,Department of Rehabilitation Medicine, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, South Korea
| | - Won Kee Chang
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Yun-Sun Jung
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Sungju Jee
- Department of Rehabilitation Medicine, Chungnam National University College of Medicine, Chugnam National University Hospital, Daejeon, South Korea
| | - Min Kyun Sohn
- Department of Rehabilitation Medicine, Chungnam National University College of Medicine, Chugnam National University Hospital, Daejeon, South Korea
| | - Sung-Hwa Ko
- Department of Rehabilitation Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Yong-Il Shin
- Department of Rehabilitation Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Ja-Ho Leigh
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, South Korea.,National Traffic Injury Rehabilitation Research Institute, National Traffic Injury Rehabilitation Hospital, Yangpyeong, South Korea
| | - Won-Seok Kim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Nam-Jong Paik
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
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8
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Tan KS, Yoon BW, Lin RT, Mehndiratta MM, Suwanwela NC, Venketasubramanian N. 10th Anniversary of Asia Pacific Stroke Organization: State of Stroke Care and Stroke Research in the Asia Pacific. Cerebrovasc Dis Extra 2021; 12:14-22. [PMID: 34856544 PMCID: PMC8958597 DOI: 10.1159/000521272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 11/28/2021] [Indexed: 11/25/2022] Open
Abstract
The Asia Pacific Stroke Organization is the largest international and professional stroke group in the region. It has worked consistently over the last 10 years to gain visibility and consistency across the Asia-Pacific and beyond. The 10-year journey will be reviewed in the background of many internal and external developments including changes in Asia-Pacific stroke epidemiology, stroke care systems, and stroke service developments as well as major research studies in the Asia-Pacific.
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Affiliation(s)
- Kay-Sin Tan
- Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- *Kay-Sin Tan,
| | - Byung-Woo Yoon
- Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Gyeonggi-do, Republic of Korea
| | - Ruey-Tay Lin
- Department of Neurology, Stroke Centre, Kaohsiung Medical University and Hospital, Kaohsiung, Taiwan
| | - Man Mohan Mehndiratta
- Department of Neurology, B.L.Kapur Hospital (Max Health Care Group), Centre for Neurosciences, New Dehli, India
| | - Nijasri C. Suwanwela
- 7th Floor, Chulalongkorn Comprehensive Stroke Center, Bhumisiri Building, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
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Cui Y, Zhu C, Lian Z, Han X, Xiang Q, Liu Z, Zhou Y. Prospective association between depressive symptoms and stroke risk among middle-aged and older Chinese. BMC Psychiatry 2021; 21:532. [PMID: 34706692 PMCID: PMC8555147 DOI: 10.1186/s12888-021-03492-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 09/23/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND This study aimed to assess the association between baseline symptoms and changes in depressive symptoms and stroke incidents. METHODS We used data from the Chinese Health and Retirement Longitudinal Study conducted in 2013, 2015, and 2018. In total, 10,100 individuals aged ≥45 years and without a history of stroke in 2013 were included. Depressive symptoms were measured using the 10-item version of the Center for Epidemiological Studied Depression scale (elevated depressive symptoms cutoff ≥10). Changes of depressive symptoms were assessed by two successive surveys (stable low/no, recent onset, recently remitted, and stable high depressive symptoms). We assessed whether baseline depressive symptoms and changes of them were associated with stroke incidents reported through 2018. Logistic regression analyses adjusted for age, gender, education, marital status and other potential confounders were performed. RESULTS For the analysis of baseline depressive symptoms and stroke (n = 10,100), 545 (5.4%) reported stroke incidents in the following 5-year period. Individuals with elevated depressive symptoms in 2013 experienced a markedly higher stroke risk (odds ratio (OR) = 1.53, 95% confidence interval (CI) = 1.28-1.84) compared with those without elevated depressive symptoms. In the analysis of changes in depressive symptoms (n = 8491, 430 (5.1%) stroke events), participants with stable high (OR = 2.01, 95% CI = 1.58-2.56) and recent-onset (OR = 1.39, 95% CI = 1.04-1.85) depressive symptoms presented higher stroke risk compared to those with stable low/no depressive symptoms, while recently remitted symptoms (OR = 1.12, 95% CI = 0.80-1.57) were not associated with stroke risk. CONCLUSIONS In conclusion, stable high and newly started depressive symptoms were associated with increased stroke risk, whereas the improvement of depressive symptoms was not related to increase in stroke risk, suggesting that stroke risk may be decreased by effective management of depressive symptoms.
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Affiliation(s)
- Yimin Cui
- Department of Pharmacy, Peking University First Hospital, No. 6, Dahongluochang Street, Xicheng District, Beijing, 100034, China.
- School of Pharmaceutical Sciences, Peking University, Beijing, China.
| | - Chunsu Zhu
- Department of Pharmacy, Peking University First Hospital, No. 6, Dahongluochang Street, Xicheng District, Beijing, 100034, China
- School of Pharmaceutical Sciences, Peking University, Beijing, China
| | - Zhiwei Lian
- Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China
| | - Xueyan Han
- Department of Medical Statistics, Peking University First Hospital, Beijing, China
| | - Qian Xiang
- Department of Pharmacy, Peking University First Hospital, No. 6, Dahongluochang Street, Xicheng District, Beijing, 100034, China
| | - Zhenming Liu
- School of Pharmaceutical Sciences, Peking University, Beijing, China
| | - Ying Zhou
- Department of Pharmacy, Peking University First Hospital, No. 6, Dahongluochang Street, Xicheng District, Beijing, 100034, China
- School of Pharmaceutical Sciences, Peking University, Beijing, China
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10
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Strilciuc S, Grad DA, Radu C, Chira D, Stan A, Ungureanu M, Gheorghe A, Muresanu FD. The economic burden of stroke: a systematic review of cost of illness studies. J Med Life 2021; 14:606-619. [PMID: 35027963 PMCID: PMC8742896 DOI: 10.25122/jml-2021-0361] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 09/23/2021] [Indexed: 01/02/2023] Open
Abstract
Stroke is one of the leading causes of morbidity and mortality worldwide. As the number of stroke cases is rising from one year to another, policymakers require data on the amount spent on stroke to enforce better financing policies for prevention, hospital care, outpatient rehabilitation services and social services. We aimed to systematically assess the economic burden of stroke at global level. Cost of stroke studies were retrieved from five databases. We retrieved the average cost per patient, where specified, or estimated it using a top-down approach. Resulting costs were grouped in two main categories: per patient per year and per patient lifetime. We extracted information from forty-six cost of illness studies. Per patient per year costs are larger in high income countries and in studies conducted from the payer perspective. The highest average per patient per year cost by country was reported in the United States ($59,900), followed by Sweden ($52,725) and Spain ($41,950). The highest per patient lifetime costs were reported in Australia ($232,100) for all identified definitions of stroke. Existing literature regarding the economic burden of stroke is concentrated in high-income settings, with very few studies conducted in South America and Africa. Published manuscripts on this topic highlight substantial methodological heterogeneity, rendering comparisons difficult or impossible, even within the same country or among studies with similar costing perspectives.
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Affiliation(s)
- Stefan Strilciuc
- Department of Neuroscience, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
- Department of Public Health, Faculty of Political, Administrative and Communication Sciences, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Diana Alecsandra Grad
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
- Department of Public Health, Faculty of Political, Administrative and Communication Sciences, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Constantin Radu
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Diana Chira
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Adina Stan
- Department of Neuroscience, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Marius Ungureanu
- Department of Public Health, Faculty of Political, Administrative and Communication Sciences, Babes-Bolyai University, Cluj-Napoca, Romania
- Center for Health Workforce Research and Policy, Faculty of Political, Administrative and Communication Sciences, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Adrian Gheorghe
- Department of Infectious Disease Epidemiology, Global Health and Development Group, Imperial College London, London, United Kingdom
| | - Fior-Dafin Muresanu
- Department of Neuroscience, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
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11
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Khurana S, Gourie-Devi M, Sharma S, Kushwaha S. Burden of Stroke in India During 1960 to 2018: A Systematic Review and Meta-Analysis of Community Based Surveys. Neurol India 2021; 69:547-559. [PMID: 34169841 DOI: 10.4103/0028-3886.317240] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Stroke is a heterogeneous disorder comprising of clinical subtypes and many risk factors, also alluded to as cerebrovascular disorders (CVDs). Increase in the global burden of stroke in developed and developing countries has been alarming. To galvanize the efforts towards the prevention and treatment, there is a need for robust data on the burden of stroke. Objective The aim of this study was to estimate the burden of stroke, a systematic review of community-based studies was conducted. Material and Methods Systematic search of PubMed and Google Scholar for studies from January 1960 to December 2018 was done. The articles were screened and the data was retrieved and sorted into incidence, prevalence and mortality rates. Meta-analysis was done on Medcalc statistical software version 19.2.6. Results Prevalence rate of stroke for total population inclusive of urban and rural population, varied from 44.54 to 150/100000.For the urban population prevalence rate was 45 to 487/100000 and 55 to 388.4/100000 for rural population. The incidence rate varied from 33 to 123/100000 in the urban population and in the rural population it was estimated to be 123.57/100000. The 30 days case fatality rate of stroke varied from 41.08% to 42.06% in urban population and 18% to 46.3%.in the rural population. Conclusions Systematic review and meta-analysis reveal that the stroke burden in India is quite high.
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Affiliation(s)
- Sarbjeet Khurana
- Associate Professor and Head, Department of Epidemiology, ICMR, Delhi, India
| | | | - Shweta Sharma
- Scientist C (Medical), Division of NCD, ICMR, Delhi, India
| | - Suman Kushwaha
- Associate Professor and Head, Department of Neurology, Institute of Human Behaviour and Allied Sciences [IHBAS], Dilshad Garden, Delhi, India
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The Experiences of Couples Affected by Stroke and Nurses Managing Patient Rehabilitation: A Descriptive Study in Singapore. J Nurs Res 2021; 28:e113. [PMID: 32568954 DOI: 10.1097/jnr.0000000000000392] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Stroke in a family affects both patients and their spousal caregivers. Despite advances in the medical management of stroke, less is known about the social and cultural factors that impact couples regarding stroke recovery. PURPOSE The purpose of this study was to explore the experiences of stroke from the perspectives of couples affected by stroke and the nurses managing patient rehabilitation. METHODS An interpretive descriptive study was conducted. Purposive sampling was used to enroll 17 participants, comprising eight nurses, five spousal caregivers, and four stroke survivors. Individual, in-depth interviews were performed at a rehabilitation hospital in Singapore in June 2018. RESULTS The primary theme was the diverse meanings of stroke recovery attributed to limited conversations about the care decisions made by couples and rehabilitation nurses. The second theme was the challenges in nursing responsibilities that hindered the recovery of patients with stroke. CONCLUSIONS/IMPLICATIONS FOR PRACTICE The meaning of recovery differs between patients and their informal and formal care providers. This issue should be explored in patient-provider conversations, as these conversations highlight the values and preferences that affect the stroke recovery trajectory. Enhancing shared decision making by patients, spousal caregivers, and healthcare providers during the stroke trajectory may promote the alignment of values that are critical to the stroke recovery experience. Further research into whether and how to incorporate shared decision making in rehabilitation hospital settings as an interventional component is warranted to better support stroke survivors before discharge.
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Kristinsson S, Zhang W, Rorden C, Newman‐Norlund R, Basilakos A, Bonilha L, Yourganov G, Xiao F, Hillis A, Fridriksson J. Machine learning-based multimodal prediction of language outcomes in chronic aphasia. Hum Brain Mapp 2021; 42:1682-1698. [PMID: 33377592 PMCID: PMC7978124 DOI: 10.1002/hbm.25321] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 11/11/2020] [Accepted: 12/02/2020] [Indexed: 12/26/2022] Open
Abstract
Recent studies have combined multiple neuroimaging modalities to gain further understanding of the neurobiological substrates of aphasia. Following this line of work, the current study uses machine learning approaches to predict aphasia severity and specific language measures based on a multimodal neuroimaging dataset. A total of 116 individuals with chronic left-hemisphere stroke were included in the study. Neuroimaging data included task-based functional magnetic resonance imaging (fMRI), diffusion-based fractional anisotropy (FA)-values, cerebral blood flow (CBF), and lesion-load data. The Western Aphasia Battery was used to measure aphasia severity and specific language functions. As a primary analysis, we constructed support vector regression (SVR) models predicting language measures based on (i) each neuroimaging modality separately, (ii) lesion volume alone, and (iii) a combination of all modalities. Prediction accuracy across models was subsequently statistically compared. Prediction accuracy across modalities and language measures varied substantially (predicted vs. empirical correlation range: r = .00-.67). The multimodal prediction model yielded the most accurate prediction in all cases (r = .53-.67). Statistical superiority in favor of the multimodal model was achieved in 28/30 model comparisons (p-value range: <.001-.046). Our results indicate that different neuroimaging modalities carry complementary information that can be integrated to more accurately depict how brain damage and remaining functionality of intact brain tissue translate into language function in aphasia.
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Affiliation(s)
- Sigfus Kristinsson
- Center for the Study of Aphasia RecoveryUniversity of South CarolinaColumbiaSouth CarolinaUSA
| | - Wanfang Zhang
- Department of Epidemiology and BiostatisticsUniversity of South CarolinaColumbiaSouth CarolinaUSA
| | - Chris Rorden
- Department of PsychologyUniversity of South CarolinaColumbiaSouth CarolinaUSA
| | | | - Alexandra Basilakos
- Center for the Study of Aphasia RecoveryUniversity of South CarolinaColumbiaSouth CarolinaUSA
| | - Leonardo Bonilha
- Department of NeurologyMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | - Grigori Yourganov
- Advanced Computing and Data Science, Cyberinfrastructure and Technology IntegrationClemson UniversityClemsonSouth CarolinaUSA
| | - Feifei Xiao
- Department of Epidemiology and BiostatisticsUniversity of South CarolinaColumbiaSouth CarolinaUSA
| | - Argye Hillis
- Department of Neurology and Physical Medicine and RehabilitationJohns Hopkins School of MedicineBaltimoreMarylandUSA
- Department of Cognitive ScienceJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Julius Fridriksson
- Center for the Study of Aphasia RecoveryUniversity of South CarolinaColumbiaSouth CarolinaUSA
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14
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Lee JJ, Tsang WN, Yang SC, Kwok JYY, Lou VWQ, Lau KK. Qualitative Study of Chinese Stroke Caregivers' Caregiving Experience During the COVID-19 Pandemic. Stroke 2021; 52:1407-1414. [PMID: 33588588 DOI: 10.1161/strokeaha.120.032250] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE The coronavirus disease 2019 (COVID-19) outbreak has led to disruptions in health care service delivery worldwide, inevitably affecting stroke survivors requiring ongoing rehabilitation and chronic illness management. To date, no published research has been found on stroke caregiving during the COVID-19 pandemic. This study aimed to explore Hong Kong stroke caregivers' caregiving experiences in the midst of this difficult time. METHODS Individual semistructured interviews were conducted with 25 Chinese adult primary stroke caregivers from May to June 2020 via telephone. Interviews were transcribed verbatim and analyzed using an interpretive description approach and constant comparison strategy. RESULTS Five themes of the stroke caregiving experience during the COVID-19 pandemic emerged: care service adversities, additional caregiving workload and strain, threatened relationship between caregiver and stroke survivors, threats to caregivers' physical and psychological well-being, and needs for continuing caregiving roles. Our findings suggested that caregivers have worsened physical and psychological well-being because of increases in care burden with simultaneously reduced formal and informal support. The relationship between caregiver and stroke survivor was subsequently affected, placing some survivors at heightened risk of abuse. CONCLUSIONS Our study provides valuable findings about stroke caregiving experiences and needs during the pandemic. Delivery of psychological support, telemedicine, and household hygiene resources would be useful to mitigate caregivers' psychological distress during the COVID-19 pandemic.
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Affiliation(s)
- Jung Jae Lee
- School of Nursing (J.J.L., W.N.T., J.Y.Y.K.), The University of Hong Kong, Hong Kong SAR
| | - Wing Nga Tsang
- School of Nursing (J.J.L., W.N.T., J.Y.Y.K.), The University of Hong Kong, Hong Kong SAR
| | - Sook Ching Yang
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, United Kingdom (S.C.Y.).,Now with Central Coast Local Health District, New South Wales Health, Australia (S.C.Y)
| | - Jojo Yan Yan Kwok
- School of Nursing (J.J.L., W.N.T., J.Y.Y.K.), The University of Hong Kong, Hong Kong SAR
| | - Vivian W Q Lou
- Sau Po Centre on Ageing, Department of Social Work and Social Administration (V.W.Q.L.), The University of Hong Kong, Hong Kong SAR
| | - Kui Kai Lau
- Division of Neurology, Department of Medicine, Queen Mary Hospital, LKS Faculty of Medicine (K.K.L.), The University of Hong Kong, Hong Kong SAR
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Iwase M, Komorita Y, Ohkuma T, Fujii H, Ide H, Yoshinari M, Oku Y, Higashi T, Nakamura U, Kitazono T. Incidence of stroke and its association with glycemic control and lifestyle in Japanese patients with type 2 diabetes mellitus: The Fukuoka diabetes registry. Diabetes Res Clin Pract 2021; 172:108518. [PMID: 33096191 DOI: 10.1016/j.diabres.2020.108518] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 10/07/2020] [Accepted: 10/12/2020] [Indexed: 11/22/2022]
Abstract
AIMS We prospectively investigated the incidence of stroke and its subtypes, risk factors and prognosis in Japanese patients with type 2 diabetes. METHODS A total of 4,875 participants with type 2 diabetes (mean age 65.4 years, male 57%, previous stroke 10%) were investigated for the development of stroke for 5 years. Risk factors were evaluated using multivariable adjusted Cox proportional models. RESULTS The incidence rates per 1,000 person-years were 6.7 for new-onset stroke (ischemic 5.5, hemorrhagic 1.2) and 22.7 for recurrent stroke (ischemic 18.8, hemorrhagic 3.8), respectively. Ischemic stroke was significantly associated with age, male, reduced regular physical activity, HbA1c, diabetic kidney disease and previous stroke. Lacunar infarction was significantly associated with obesity, reduced regular physical activity, HbA1c and diabetic kidney disease, whereas atherothrombotic stroke was significantly associated with age, reduced intake of dietary fiber, reduced regular physical activity, HbA1c and previous stroke. Recurrent stroke was significantly associated with depressive symptom. Thirty-day and one-year survival was 76% and 64% for hemorrhagic stroke, and 96% and 91% for ischemic stroke, respectively. CONCLUSIONS The current study reemphasized the importance of glycemic control and lifestyle modification such as regular physical exercise for stroke prevention in patients with type 2 diabetes.
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Affiliation(s)
- Masanori Iwase
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Diabetes Center and Clinical Research Center, Hakujyuji Hospital, Fukuoka, Japan.
| | - Yuji Komorita
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiaki Ohkuma
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroki Fujii
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hitoshi Ide
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Diabetes Center and Clinical Research Center, Hakujyuji Hospital, Fukuoka, Japan
| | - Masahito Yoshinari
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yutaro Oku
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Taiki Higashi
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Udai Nakamura
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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16
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Admission serum cholinesterase concentration for prediction of in-hospital mortality in very elderly patients with acute ischemic stroke: a retrospective study. Aging Clin Exp Res 2020; 32:2667-2675. [PMID: 32067216 DOI: 10.1007/s40520-020-01498-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 01/28/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Cholinesterase as a sensitive biomarker for prognosis in a variety of conditions but it is rare in stroke studies. The very elderly (≥ 80 years of age) represent the most susceptible group of ischemic stroke. We aimed to determine whether admission serum cholinesterase concentration had any effect on clinical outcome in very elderly patients (individuals aged ≥ 80 years) with acute ischemic stroke. METHODS A retrospective record review was conducted in two tertiary university hospitals. Elderly patients aged ≥ 80 years admitted with a diagnosis of acute ischemic stroke from January 1, 2014 to November 30, 2019, who had a cholinesterase concentration drawn, were included. The patients were grouped based on the inflection points of the locally weighted regression and smoothing scatterplot (LOESS) curve between cholinesterase levels and in-hospital mortality (study outcome) with lower concentration as reference group. RESULTS A total of 612 patients were admitted with a diagnosis of acute ischemic stroke, and 569 met the inclusion criteria. A threshold effect was identified using regression smoothing scatterplot (LOESS), with one cutoff point of 4.0 KU/L. There was a significant difference in-hospital mortality was observed (P < 0.001). After adjusted demographic and clinical features, the OR of cholinesterase for mortality was 0.43 (95% CI 0.34-0.54, P < 0.001), suggesting that lower admission cholinesterase level was an independent risk factors for all-cause mortality among patients with AIS. CONCLUSIONS We have demonstrated a significant association between admission cholinesterase concentration and in-hospital mortality in very elderly patients with AIS.
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17
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Wang C, Yatsuya H, Lin Y, Sasakabe T, Kawai S, Kikuchi S, Iso H, Tamakoshi A. Milk Intake and Stroke Mortality in the Japan Collaborative Cohort Study-A Bayesian Survival Analysis. Nutrients 2020; 12:nu12092743. [PMID: 32916842 PMCID: PMC7550994 DOI: 10.3390/nu12092743] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 08/30/2020] [Accepted: 09/03/2020] [Indexed: 12/28/2022] Open
Abstract
The aim of this study was to further examine the relationship between milk intake and stroke mortality among the Japanese population. We used data from the Japan Collaborative Cohort (JACC) Study (total number of participants = 110,585, age range: 40–79) to estimate the posterior acceleration factors (AF) as well as the hazard ratios (HR) comparing individuals with different milk intake frequencies against those who never consumed milk at the study baseline. These estimations were computed through a series of Bayesian survival models that employed a Markov Chain Monte Carlo simulation process. In total, 100,000 posterior samples were generated separately through four independent chains after model convergency was confirmed. Posterior probabilites that daily milk consumers had lower hazard or delayed mortality from strokes compared to non-consumers was 99.0% and 78.0% for men and women, respectively. Accordingly, the estimated posterior means of AF and HR for daily milk consumers were 0.88 (95% Credible Interval, CrI: 0.81, 0.96) and 0.80 (95% CrI: 0.69, 0.93) for men and 0.97 (95% CrI: 0.88, 1.10) and 0.95 (95% CrI: 0.80, 1.17) for women. In conclusion, data from the JACC study provided strong evidence that daily milk intake among Japanese men was associated with delayed and lower risk of mortality from stroke especially cerebral infarction.
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Affiliation(s)
- Chaochen Wang
- Department of Public Health, Aichi Medical University School of Medicine, 480-1195 Aichi, Japan; (Y.L.); (T.S.); (S.K.); (S.K.)
- Correspondence: ; Tel.: +81-561-62-3311
| | - Hiroshi Yatsuya
- Department of Public Health, Fujita Health University School of Medicine, Toyoake 470-1192, Japan;
| | - Yingsong Lin
- Department of Public Health, Aichi Medical University School of Medicine, 480-1195 Aichi, Japan; (Y.L.); (T.S.); (S.K.); (S.K.)
| | - Tae Sasakabe
- Department of Public Health, Aichi Medical University School of Medicine, 480-1195 Aichi, Japan; (Y.L.); (T.S.); (S.K.); (S.K.)
| | - Sayo Kawai
- Department of Public Health, Aichi Medical University School of Medicine, 480-1195 Aichi, Japan; (Y.L.); (T.S.); (S.K.); (S.K.)
| | - Shogo Kikuchi
- Department of Public Health, Aichi Medical University School of Medicine, 480-1195 Aichi, Japan; (Y.L.); (T.S.); (S.K.); (S.K.)
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan;
| | - Akiko Tamakoshi
- Department of Public Health, Hokkaido University, Faculty of Medicine, Sapporo 002-8501, Japan;
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Ghannadi S, Shariat A, Ansari NN, Tavakol Z, Honarpishe R, Dommerholt J, Noormohammadpour P, Ingle L. The Effect of Dry Needling on Lower Limb Dysfunction in Poststroke Survivors. J Stroke Cerebrovasc Dis 2020; 29:104814. [PMID: 32327366 DOI: 10.1016/j.jstrokecerebrovasdis.2020.104814] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 03/09/2020] [Accepted: 03/13/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Spasticity is one of the main complications in poststroke survivors leading to difficulties in walking and standing resulting in high levels of disability. OBJECTIVE The aim of the study was to investigate the effects of deep dry needling on lower limb dysfunction in poststroke spastic patients. METHODS A randomized clinical trial conducted in poststroke survivors who were assigned to one of 2 groups: Deep dry needling (intervention group) and sham dry needling (control group). The primary outcome measures were Modified Modified Ashworth Scale (MMAS) and functional tests (timed up and go test, 10-meter walk test). Secondary outcome measures were active ankle dorsiflexion range of motion (AROM), passive ankle dorsiflexion range of motion (PROM), single leg stance test, and Barthel index. All measurements were assessed at baseline (T0), immediately after the third session 1 week later (T1), and 1 month after the end of the intervention (T2). RESULTS We recruited 24 patients (71% male; mean age 57 ± 10 years; 26.4 ± 1.8 kg•m-2; time since event: 25.2 ± 12.5 months). There were significant improvements in MMAS, timed up and go test, 10-meter walk test, Barthel scale, and PROM (P < .05) in the intervention group compared to controls across the time-points. There were no significant improvements in AROM assessments (P > .05). CONCLUSIONS Deep dry needling decreases muscle spasticity and improves lower limb function and gait speed in poststroke survivors.
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Affiliation(s)
- Shima Ghannadi
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ardalan Shariat
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Noureddin Nakhostin Ansari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Tavakol
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Roshanak Honarpishe
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Jan Dommerholt
- Bethesda Physiocare, Bethesda, Maryland; Myopain Seminars, Bethesda, Maryland
| | - Pardis Noormohammadpour
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Lee Ingle
- Sport, Health & Exercise Science, University of Hull, Kingston-upon-Hull, United Kingdom
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Rouzbahani A, Khodadadi E, Fooladi M. Impact of Mild Hypothermia on Final Outcome of Patients with Acute Stroke: A Randomized Clinical Trial. INDIAN JOURNAL OF NEUROTRAUMA 2020. [DOI: 10.1055/s-0040-1713462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Abstract
Background and Aim Stroke is a sudden neurological disorder caused by disturbances in the brain blood flow and loss of normal brain function. Stroke is also the second leading cause of death worldwide. In the last two decades, among the various treatment options for stroke, hypothermia has shown the promise of improving the final outcome. This study aimed to investigate the effect of noninvasive hypothermia on the final outcome of patients with an acute stroke in Iran.
Methods In a randomized clinical trial, 60 Iranian patients diagnosed with acute stroke were enrolled in 2018. Patients were selected by convenience sampling method and then randomized in two groups as experimental (n = 30) and control (n = 30). Mild hypothermia was applied using a cooling device for 72 hours on the patients’ heads and intervention results were compared with the control group. Data were collected by using Acute Physiology and Chronic Health Evaluation III (APACHE III), Full Outline of Un-Responsiveness (FOUR), and National Institutes of Health Stroke Scale (NIHSS), and later analyzed by Statistical Package for the Social Sciences (SPSS) software version 22.
Results No significant difference was found in the mean scores of all three scales before and after the intervention in control group (p > 0.05) but statistically significant difference was found in the mean scores of all three scales for the intervention group (p < 0.05). The intervention group had an increased mean score in FOUR, while APACHE and NIHSS values dropped. Researchers found statistically significant difference between the mean scores after the intervention in the experimental group compared with the control group in all three scales (p < 0.05).
Conclusion The findings of this study indicate that hypothermia has a significant statistical and clinical effect on the acute stroke outcome and it can be argued that hypothermia therapy can increase the level of consciousness and reduce the risk of death in stroke patients.
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Affiliation(s)
- Abbas Rouzbahani
- Nursing and Midwifery School, Islamic Azad University, Urmia, Iran
| | | | - Marjaneh Fooladi
- World Wide Nursing Service Network, PLLC, El Paso, Texas, United States
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The Unmet Needs of Stroke Survivors and Stroke Caregivers: A Systematic Narrative Review. J Stroke Cerebrovasc Dis 2020; 29:104875. [PMID: 32689648 DOI: 10.1016/j.jstrokecerebrovasdis.2020.104875] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 04/04/2020] [Accepted: 04/06/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Facilitating stroke survivors and their caregivers to lead a fulfilling life after stroke requires service providers to think about their different needs. Poor post stroke care may lead to unmet needs in stroke survivors and stroke caregivers. This may compromise them in leading their lives optimally after stroke. OBJECTIVES & METHODOLOGY This systematic narrative review examines articles published from 1990 to 2017, generated from Ovid, MEDLINE, CINAHL, and PubMed. The search was also supplemented by an examination of reference lists for related articles via Scopus. We included 105 articles. FINDINGS We found that the type of unmet needs in stroke survivors and the contributing factors were substantially different from their caregivers. The unmet needs in stroke survivors ranged from health-related needs to re-integration into the community; while the unmet needs in stroke caregivers ranged from information needs to support in caring for the stroke survivors and caring for themselves. Additionally, the unmet needs in both groups were associated with different factors. CONCLUSION More research is required to understand the unmet needs of stroke survivors and stroke caregivers to improve the overall post-stroke care services.
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Takahashi Y, Saito S, Yamamoto Y, Uehara T, Yokota C, Sakai G, Nishida N, Takahashi R, Kalaria RN, Toyoda K, Nagatsuka K, Ihara M. Visually-Rated Medial Temporal Lobe Atrophy with Lower Educational History as a Quick Indicator of Amnestic Cognitive Impairment after Stroke. J Alzheimers Dis 2020; 67:621-629. [PMID: 30584149 DOI: 10.3233/jad-180976] [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] [Indexed: 12/15/2022]
Abstract
BACKGROUND Time and resource limitations prevent cognitive assessment in acute-to-subacute settings, even in comprehensive stroke centers. OBJECTIVE To assess cognitive function in acute stroke patients undergoing routine clinical, laboratory, and radiological investigations, with a view to improving post-stroke care and treatment. METHODS Sixty-nine patients (72.6±11.1 years; 65% male) were prospectively enrolled within 14 days of acute ischemic stroke. Patients with altered consciousness, aphasia, or dysarthria were excluded. Clinical features including modified Rankin and NIH stroke scales, and vascular risk factors were assessed, as well as neuroimaging parameters by semi-quantitative evaluation of medial temporal lobe atrophy (MTLA) using MRA source images, FLAIR images for white matter changes (Fazekas scores), and T2∗ images for cerebral microbleeds. Neuropsychological screening was conducted using the Montreal Cognitive Assessment (MoCA) test. Univariate and multivariate analyses were used to evaluate the influence of variables on MoCA total and subscale scores. RESULTS Lower MoCA scores of 22 or less were associated with MTLA [OR (95% CI), 5.3 (1.0-27.5); p = 0.045], education years [OR (95% CI), 0.71 (0.55-0.91); p = 0.007], and modified Rankin scale at discharge [OR (95% CI), 2.4 (1.3-4.5); p = 0.007]. The delayed recall MoCA score was correlated with MTLA (r = - 0.452, p < 0.001), periventricular (r = - 0.273, p = 0.024), and deep (r = - 0.242, p = 0.046), white matter changes. CONCLUSIONS MTLA, together with lower educational history, are quick indicators of amnestic cognitive impairment after stroke. The association between cognitive impairment and physical disability at discharge may signify the importance of earlier cognitive assessment.
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Affiliation(s)
- Yukako Takahashi
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan.,Department of Neurology, Kyoto University Graduate School of Medicine, Osaka, Japan
| | - Satoshi Saito
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Yumi Yamamoto
- Department of Regenerative Medicine and Tissue Engineering, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Toshiyuki Uehara
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.,Department of Stroke Rehabilitation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Chiaki Yokota
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.,Department of Stroke Rehabilitation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Go Sakai
- Department of Diagnostic Radiology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan
| | - Norifumi Nishida
- Department of Diagnostic Radiology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan
| | - Ryosuke Takahashi
- Department of Neurology, Kyoto University Graduate School of Medicine, Osaka, Japan
| | - Raj N Kalaria
- Institute of Neuroscience, Newcastle University, Campus for Ageing and Vitality, Newcastle, UK
| | - Kazunori Toyoda
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kazuyuki Nagatsuka
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Masafumi Ihara
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
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Wei M, Wang D, Kang D, Lee MS, Choi TY, Ang L, Song E. Overview of Cochrane reviews on Chinese herbal medicine for stroke. Integr Med Res 2020; 9:5-9. [PMID: 31908922 PMCID: PMC6938924 DOI: 10.1016/j.imr.2019.11.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 10/29/2019] [Accepted: 11/14/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Stroke is a major health issue worldwide. Since Chinese herbal medicine is widely used for the treatment of stroke, there is a need to evaluate its efficacy as an alternative treatment option. The aim of this paper is to carry out an overview of Chinese herbal medicine for the treatment of stroke by summarizing and evaluating all existing Cochrane reviews. METHODS The Cochrane Database of Systematic Reviews was searched from its inception date to August 2019 using "stroke" and "herbal medicine" or "traditional medicine" as search terms. For the methodological quality assessment of the Cochrane reviews, the Assessment of Multiple Systematic Reviews (AMSTAR) tool was used. RESULTS Eight Cochrane reviews that evaluated the efficacy of herbal medicine for the treatment of stroke were included in this overview. There were 71 randomized controlled trials, with 5770 patients in total. The AMSTAR scores of the Cochrane reviews included in this study ranged from 9 to 11 with a mean score of 10. Three reviews met all the 11-item criteria of the AMSTAR. All reviews presented potential efficacy of herbal medicine for stroke treatment in terms of improvement of neurological deficit. CONCLUSION This overview reveals the potential efficacy of herbal medicines for the treatment of stroke in terms of neurological deficit improvement. However, due to the high risk of bias in the reviews' studies, an affirmative conclusion for the recommendation of herbal medicine for clinical practice could not be drawn.
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Affiliation(s)
- Maoling Wei
- The Center for Evidence-based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu, China
| | - Deren Wang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Deying Kang
- The Center for Evidence-based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu, China
| | - Myeong Soo Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Korea
- Korean Convergence Medicine, University of Science and Technology, Daejeon, Korea
| | - Tae-Young Choi
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Lin Ang
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Korea
- Korean Convergence Medicine, University of Science and Technology, Daejeon, Korea
| | - Eunhye Song
- Global Strategy Division, Korea Institute of Oriental Medicine, Daejeon, Korea
- Department of Preventive Medicine, College of Korean Medicine, Daejeon University, Daejeon, Korea
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Propagating Relationship of Cerebral Oximetric Volume and the Clinical Outcome of Recombinant Tissue Plasminogen Activator (r-TPA) Therapy on Acute Cerebral Ischemic Stroke Patients. ADVANCED JOURNAL OF EMERGENCY MEDICINE 2020; 4:e7. [PMID: 31938776 PMCID: PMC6955029 DOI: 10.22114/ajem.v0i0.174] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Introduction: Currently, the most available treatment for acute ischemic stroke (AIS) is thrombolytic therapy with recombinant tissue plasminogen activator (r-TPA). A challenge in r-TPA therapy is the prediction of recovery in each case. Objective: The aim was to find a possible relationship between the cerebral oximetry indexes and the clinical outcome of r-TPA therapy to assess the cerebral oximetry as a non-invasive monitoring agent for therapy. Methods: The inclusion criteria were all patients with AIS who received r-TPA. The neurologic status was evaluated based on the national institutes of health stroke scale (NIHSS) score at arrival, and after a period of 24 hours. In addition, the levels of brain oxygenation in both hemispheres were measured before and continuously over the first 24 hours after r-TPA injection, using an oximetric sensor in the frontal lobes. The clinical success was defined as a 4-point improvement from the baseline NIHSS. Results: Total 44 patients with the mean age of 58.2 ± 2.18 years were enrolled, of whom 68.18% were male. Twenty-eight patients remained clinically unimproved and 16 patients were improved. A significant difference was found in the mean surface area under the brain oximetric curve in the 24 hour, in the affected hemisphere in the improved group, compared to the unimproved group (P = 0.007). There was a significant difference between the mean increase in brain oxygenation within 24 hours in the improved and unimproved groups (P = 0.002). Conclusion: It is likely that, The cerebral oximetry could contribute to predict the likelihood of r-TPA prognosis in patients with AIS.
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Kate MP, Arora D, Verma SJ, Sylaja PN, Renjith V, Sharma M, Pandian JD. Secondary Prevention by Structured Semi-Interactive Stroke Prevention Package in India (SPRINT INDIA) study protocol. Int J Stroke 2020; 15:109-115. [PMID: 31852411 DOI: 10.1177/1747493019895653] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
RATIONALE Recurrent stroke, cardiovascular morbidity, and mortality are important causes of poor outcome in patients with index stroke. Despite the availability of best medical management recurrent stroke occur in up to 15-20% of patients with stroke in India. Education for stroke prevention could be a strategy to prevent recurrent strokes. HYPOTHESIS We hypothesize that a structured semi-interactive stroke prevention package can reduce the risk of recurrent strokes, acute coronary artery syndrome, and death in patients with sub-acute stroke at the end of one year. DESIGN Secondary Prevention by Structured Semi-Interactive Stroke Prevention Package in INDIA (SPRINT INDIA) is a multi-center stroke trial involving 25 centers under the Indian Stroke Clinical Trial Network. Patients with first ever sub-acute stroke within two days to three months of onset, age 18-85 years, mRS <5, showing recent stroke in imaging are included. Participants or caregivers able to read and complete tasks suggested in a stroke prevention workbook and have a cellular device for receiving short message service and watching videos. A total of 5830 stroke patients speaking 11 different languages are being randomized to intervention or control arm. Patients in the intervention arm are receiving a stroke prevention workbook, regular educational short messages, and videos. All patients in the control arm are receiving standard of care management. SUMMARY Structured semi-interactive stroke prevention package may reduce the risk of recurrent strokes, acute coronary artery syndrome, and death in patients with sub-acute stroke. TRIAL REGISTRATION This trial is registered with clinicaltrials.gov (NCT03228979) and CTRI (Clinical Trial Registry India; CTRI/2017/09/009600).
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Affiliation(s)
| | - Deepti Arora
- Department of Neurology, Christian Medical College, Ludhiana, India
| | | | - P N Sylaja
- Department of Neurology, Sri Chitra Tirunal Institute of Medical Sciences and Technology, Thiruvananthapuram, India
| | - Vishnu Renjith
- Department of Neurology, Sri Chitra Tirunal Institute of Medical Sciences and Technology, Thiruvananthapuram, India
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Zheng K, Guo X, Yi F, Wang L, Mancuso A, Qi X. No Association between Ischemic Stroke and Portal Vein Thrombosis in Liver Cirrhosis. BIOMED RESEARCH INTERNATIONAL 2020; 2020:8172673. [PMID: 32714987 PMCID: PMC7352149 DOI: 10.1155/2020/8172673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/17/2020] [Accepted: 06/11/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS There seems to be a higher risk of ischemic stroke and portal vein thrombosis in liver cirrhosis. Both of them may be associated with hypercoagulability. We aim to explore the association between ischemic stroke and portal vein thrombosis in liver cirrhosis. Study Design and Methods. We selected patients from our prospectively established database of liver cirrhosis from December 2014 to July 2019. The difference between patients with and without stroke was compared. A 1 : 1 propensity score matching (PSM) analysis was performed to adjust the effect of age, sex, Child-Pugh score, and MELD score on our statistical results. RESULTS There were 349 cirrhotic patients in the cross-sectional study. The prevalence of stroke, ischemic stroke, hemorrhagic stroke, and portal vein thrombosis was 8.88% (31/349), 8.31% (29/349), 1.15% (4/349), and 28.65% (100/349) in liver cirrhosis, respectively. Patients with ischemic stroke were significantly older and had significantly higher proportions of alcohol abuse, smoking, and arterial hypertension and higher levels of white blood cell and low-density lipoprotein. However, statistical analyses with and without PSM did not find any significant association between ischemic stroke and portal vein thrombosis in patients with liver cirrhosis. CONCLUSION Ischemic stroke might not be associated with portal vein thrombosis in liver cirrhosis.
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Affiliation(s)
- Kexin Zheng
- 1Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), Shenyang, Liaoning Province, China
- 2Postgraduate College, Jinzhou Medical University, Jinzhou, Liaoning Province, China
| | - Xiaozhong Guo
- 1Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), Shenyang, Liaoning Province, China
| | - Fangfang Yi
- 1Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), Shenyang, Liaoning Province, China
- 3Postgraduate College, Dalian Medical University, Dalian, Liaoning Province, China
| | - Le Wang
- 1Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), Shenyang, Liaoning Province, China
- 3Postgraduate College, Dalian Medical University, Dalian, Liaoning Province, China
| | - Andrea Mancuso
- 4Medicina Interna 1, Azienda di Rilievo Nazionale ad Alta Specializzazione Civico-Di Cristina-Benfratelli, Piazzale Leotta 4, 90100 Palermo, Italy
| | - Xingshun Qi
- 1Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), Shenyang, Liaoning Province, China
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Kong APH, Law SP. Cantonese AphasiaBank: An annotated database of spoken discourse and co-verbal gestures by healthy and language-impaired native Cantonese speakers. Behav Res Methods 2019; 51:1131-1144. [PMID: 29693232 PMCID: PMC6200664 DOI: 10.3758/s13428-018-1043-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This article reports the construction of a multimodal annotated database of spoken discourse and co-verbal gestures by native healthy speakers of Cantonese and individuals with language impairment: the Cantonese AphasiaBank. This corpus was established as a foundation for aphasiologists and clinicians to use in designing and conducting research investigations into theoretical and clinical issues related to acquired language disorders in Chinese. Details in terms of the purpose, structure, and levels of annotation of the database (containing part-of-speech-annotated orthographic transcripts with Romanization and the corresponding videos) are described. The discussion presents the challenges of building a spoken database of a language that is not linguistically well-researched and that does not have a standardized written form for many of its lexical items, as well as presenting how these issues were addressed. Most importantly, the article highlights the potential of Cantonese AphasiaBank as a powerful research tool for linguists and psycholinguists.
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Affiliation(s)
- Anthony Pak-Hin Kong
- Department of Communication Sciences and Disorders, University of Central Florida, Room 106, Health and Public Affairs II, Orlando, FL, 32816-2215, USA.
| | - Sam-Po Law
- Division of Speech and Hearing Sciences, University of Hong Kong, Pok Fu Lam, Hong Kong SAR
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Li Y, Zhang X, Sang H, Niu X, Liu T, Liu W, Li J. Urban-rural differences in risk factors for ischemic stroke in northern China. Medicine (Baltimore) 2019; 98:e15782. [PMID: 31124971 PMCID: PMC6571368 DOI: 10.1097/md.0000000000015782] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 04/08/2019] [Accepted: 05/01/2019] [Indexed: 12/13/2022] Open
Abstract
This study aims to investigate urban-rural differences in characteristics and risk factors of ischemic stroke in northern China.The present cross-sectional study was based on the High-risk Population Screening and Intervention Project for Stroke. The cluster sampling method was used to select urban and rural screening sites in northern China. By collecting information and screening the data, patients with ischemic stroke were obtained and a control group with similar gender, age, and regional distribution was selected among the nonischemic stroke patients. Then, the demographic and risk factors of patients with ischemic stroke were described and analyzed.The prevalence of ischemic stroke in northern China was 2.88%, with a greater prevalence in rural areas than in urban areas (3.32% vs 2.43%), and a greater prevalence in males than in females (3.06% vs 2.73%). Furthermore, rural stroke patients were younger than urban stroke patients. Hypertension, family history of stroke, and smoking were the top 3 independent risk factors for ischemic stroke. Overweight/obesity and low education were associated with increased ischemic stroke in urban areas, while low education was associated with less ischemic stroke in rural areas. In addition, the prevalence of alcoholism, dyslipidemia, diabetes, and obvious overweight/obesity was greater in urban areas, while high-salt diet and low education and income were more prevalent in rural regions. Moreover, the smoking index was higher in rural areas than in urban areas.The characteristics and risk factors of ischemic stroke differ between rural and urban areas, which could be used to design specific preventative measures.
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Affiliation(s)
- Yang Li
- Department of Neurology, the First Hospital of Shanxi Medical University, Taiyuan
| | - Xin Zhang
- Department of Neurology, with the Coal Group General Hospital, Datong
| | - Hui Sang
- Department of Neurology, Taiyuan Central Hospital, Taiyuan
| | - Xiaoyuan Niu
- Department of Neurology, the First Hospital of Shanxi Medical University, Taiyuan
| | - Tingting Liu
- Department of Neurology, the First Hospital of Shanxi Medical University, Taiyuan
| | - Weidong Liu
- Neurosurgical Department, Liaocheng People's Hospital, Liaocheng
| | - Jian Li
- Department of Neurology, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, China
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Wei GJ, Yuan MQ, Jiang LH, Lu YL, Liu CH, Luo HC, Huang HT, Qi ZQ, Wei YS. A Genetic Variant of miR-34a Contributes to Susceptibility of Ischemic Stroke Among Chinese Population. Front Physiol 2019; 10:432. [PMID: 31068831 PMCID: PMC6491571 DOI: 10.3389/fphys.2019.00432] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 03/28/2019] [Indexed: 12/22/2022] Open
Abstract
miRNAs are small non-coding RNAs modulating gene expression, and variants in miRNA genes are involved in the pathogenesis of ischemic stroke (IS). However, the effect of miR-34a polymorphisms on IS susceptibility has rarely been reported. In the present study, we investigated the association between rs12128240, rs2666433, and rs6577555 of the miR-34a gene and IS susceptibility. Snapshot assay was used to detect miR-34a polymorphisms in 548 IS patients and 560 controls. Relative expression of miR-34a was measured by quantitative real-time PCR. We found that rs2666433 was associated with a significantly increased risk of IS (AA vs. GG: OR = 1.61, 95% CI = 1.05-2.52, P = 0.031; AA vs. GG+GA: OR = 1.58, 95% CI = 1.05-2.45, P = 0.026). For the IS subtypes, rs2666433 was associated with large artery atherosclerosis (AA vs. GG: OR = 2.09, 95% CI = 1.16-3.51, P = 0.007; AA vs. GG+GA: OR = 2.02, 95% CI = 1.15-3.33, P = 0.007; A vs. G: OR = 1.36, 95% CI = 1.07-1.81, P = 0.021). Additionally, the level of miR-34a was significantly up-regulated in IS patients compared to the controls (P < 0.001), and patients with rs2666433 AA genotype had a higher level of miR-34a than those with GG+GA genotypes (P < 0.001). Furthermore, increased level of homocysteine was observed in IS patients compared to the controls (P < 0.001), especially in patients carrying the rs2666433AA genotype compared to those carrying the rs2666433 GG+GA genotypes (P < 0.001). However, no significant association between rs12128240 or rs6577555 and IS was found. Collectively, our study found the association between miR-34a polymorphisms and the risk of IS among the Chinese population. The results may provide an explanation for etiology of IS and a potential biomarker or therapeutic target for IS. HIGHLIGHTS-MiR-34a rs2666433 polymorphism was associated with an increased risk of ischemic stroke.-The level of miR-34a was significantly up-regulated in ischemic stroke patients compared with controls, and patients with rs2666433 AA genotype had a higher level miR-34a than those with GG+GA genotypes.-Furthermore, increased level of homocysteine was showed in IS patients compared to controls, and in patients carrying the rs2666433AA compared to those carrying the rs2666433 GG+GA.
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Affiliation(s)
- Gui-Jiang Wei
- Department of Cell Biology, Medical College of Guangxi University, Nanning, China
- Department of Medical Laboratory, Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Ming-Qing Yuan
- Department of Cell Biology, Medical College of Guangxi University, Nanning, China
| | - Li-He Jiang
- Department of Cell Biology, Medical College of Guangxi University, Nanning, China
| | - Yu-Lan Lu
- Department of Medical Laboratory, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
| | - Chun-Hong Liu
- Department of Medical Laboratory, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
| | - Hong-Cheng Luo
- Department of Medical Laboratory, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
| | - Hua-Tuo Huang
- Department of Medical Laboratory, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
| | - Zong-Quan Qi
- Department of Cell Biology, Medical College of Guangxi University, Nanning, China
| | - Ye-Sheng Wei
- Department of Cell Biology, Medical College of Guangxi University, Nanning, China
- Department of Medical Laboratory, Affiliated Hospital of Guilin Medical University, Guilin, China
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Xia X, Yue W, Chao B, Li M, Cao L, Wang L, Shen Y, Li X. Prevalence and risk factors of stroke in the elderly in Northern China: data from the National Stroke Screening Survey. J Neurol 2019; 266:1449-1458. [PMID: 30989368 PMCID: PMC6517347 DOI: 10.1007/s00415-019-09281-5] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 02/02/2019] [Accepted: 02/06/2019] [Indexed: 12/13/2022]
Abstract
Background The overall global burden of stroke is considerable and increasing. In China, stroke is the leading cause of death and disability. Methods For this study, we used data from the National Stroke Screening Survey in 2012 and the 2010 Chinese population from sixth National Census of Populations to calculate a standardized (by age, gender, and education) stroke prevalence. Prevalence, risk factors, and management of stroke were compared by gender, age, and site. Findings The standardized prevalence rate of survival stroke patients in study population aged 60 and older was 4.94% in total. Hypertension was the most prevalent risk factor for stroke. Compared to men, women were more likely to have diabetes, obesity, elevated low-density lipoprotein cholesterol (LDL-C), and atrial fibrillation (P < 0.05). Men were far more likely to drink and smoke than women (P < 0.05). The rates of diabetes and atrial fibrillation were substantially higher in urban than those in rural stroke survivors (P < 0.05). Rural stroke survivors exhibited higher rates of smoking and alcohol consumption than urban stroke survivors (P < 0.05). Interpretation The stroke prevalence in China is in line with median worldwide stroke prevalence. Traditional risk factors remain highly prevalent in stroke survivors, among which hypertension was the most common. Stroke prevalence rates and risk factors varied by age, sex, and sociogeological factors. Electronic supplementary material The online version of this article (10.1007/s00415-019-09281-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xiaoshuang Xia
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, 300211, China
| | - Wei Yue
- Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China
| | - Baohua Chao
- Nation Project Office of Stroke Prevention and Control, Beijing, China
| | - Mei Li
- China Stroke Data Center, Beijing, China
| | - Lei Cao
- Nation Project Office of Stroke Prevention and Control, Beijing, China
| | - Lin Wang
- Department of Geratology, The Second Hospital of Tianjin Medical University and Tianjin Geriatric Institute, Tianjin, China
| | - Ying Shen
- Department of Traditional Chinese Medicine, Beijing Xuanwu Hospital, Capital Medical University, Beijing, 100000, China.
| | - Xin Li
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, 300211, China.
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Chen PH, Kao YW, Shia BC, Lin HC, Kang JH. Adverse stroke outcomes among patients with bipolar disorder. PLoS One 2019; 14:e0213072. [PMID: 30830937 PMCID: PMC6398847 DOI: 10.1371/journal.pone.0213072] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 02/12/2019] [Indexed: 01/24/2023] Open
Abstract
Failure to deliver the standard stroke care is suspected to be a potential reason for disproportionately high mortality among patients with co-morbid bipolar disorder (BD). Few studies have explored adverse outcomes and medical care costs concurrently (as a proxy for care intensity) among patients with BD admitted for stroke. Data for this nationwide population-based study were extracted from the Taiwan National Health Insurance Research Database, on 580 patients with BD hospitalized for stroke (the study group) and a comparison group consisting of randomly selected 1740 stroke patients without BD matched by propensity scores. Conditional logistic regression was used to estimate odds ratios (OR) for adverse in-hospital outcomes between study group and comparison group. We found that stroke patients with BD had significantly lower in-hospital mortality (3.28% vs. 5.63%), acute respiratory failure (2.59% vs. 5.57%), and use of mechanical ventilation (6.55% vs. 10.23%) than the comparison group. After adjusting for geographical location, urbanization level, monthly income, hypertension, diabetes, hyperlipidemia, and coronary heart disease, the odds of in-hospital mortality, acute respiratory failure, and use of mechanical ventilation in the BD group were 0.56 (95% CI: 0.34–0.92), 0.46 (95% CI: 0.26–0.80), and 0.63 (95% CI: 0.44–0.91), respectively. No differences were found in hospitalization costs and the length of hospital stay. With comparable hospitalization costs and length of hospital stay, we concluded that stroke patients with BD had lower in-hospital mortality and serious adverse events compared to stroke patients without BD.
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Affiliation(s)
- Pao-Huan Chen
- Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-Wei Kao
- Big Data Research Center, Taipei Medical University, Taipei, Taiwan
| | - Ben-Chang Shia
- Big Data Research Center, Taipei Medical University, Taipei, Taiwan
| | - Herng-Ching Lin
- School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
- Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Jiunn-Horng Kang
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- * E-mail:
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Wu S, Chen J, Wang S, Jiang M, Wang X, Wen Y. Effect of Tai Chi Exercise on Balance Function of Stroke Patients: A Meta-Analysis. Med Sci Monit Basic Res 2018; 24:210-215. [PMID: 30504762 PMCID: PMC6289026 DOI: 10.12659/msmbr.911951] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Background Tai Chi is an ancient form of physical activity that has been shown to improve cardiovascular function, but to date there had been no comprehensive systematic review on the effect of Tai Chi exercise on balance function of patients with stroke. This study evaluated the effect of Tai Chi exercise on balance function in stroke patients. Material/Methods PubMed, Cochrane library, and China National Knowledge Information databases and the Wan Fang medical network were searched to collect the articles. The random-effects model was used to assess the effect of Tai Chi exercise on balance function of stroke patients. Results Six studies were chosen to perform the meta-analysis according to the inclusion and exclusion criteria. There were significant improvements of balance on Berg Balance Scale score (MD=4.823, 95% CI: 2.138–7.508), the standing balance with fall rates (RR=0.300, 95%CI: 0.120–0.770), functional reach test and dynamic gait index in Tai Chi intervention group compared to the control intervention group. However, the short physical performance battery for balance (SPBB) showed Tai Chi did not significantly improve the ability of balance for stroke patients (MD=0.293, 95%CI: −0.099~0.685). Conclusions Tai Chi exercise might have a significant impact in improving balance efficiency by increasing BBS score and reducing fall rate.
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Affiliation(s)
- Shouzhi Wu
- School of Public Foundation, Wannan Medical College, Wuhu, Anhui, China (mainland)
| | - Jian Chen
- Hunan Provincial People's Hospital, Changsha, Hunan, China (mainland)
| | - Shuyi Wang
- School of Laboratory Medicine, Wannan Medical College, Wuhu, Anhui, China (mainland)
| | - Mingfei Jiang
- School of Laboratory Medicine, Wannan Medical College, Wuhu, Anhui, China (mainland)
| | - Ximei Wang
- School of Laboratory Medicine, Wannan Medical College, Wuhu, Anhui, China (mainland)
| | - Yufeng Wen
- School of Laboratory Medicine, Wannan Medical College, Wuhu, Anhui, China (mainland)
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Kim BJ, Lee EJ, Kwon SU, Park JH, Kim YJ, Hong KS, Wong LKS, Yu S, Hwang YH, Lee JS, Lee J, Rha JH, Heo SH, Ahn SH, Seo WK, Park JM, Lee JH, Kwon JH, Sohn SI, Jung JM, Navarro JC, Kang DW, Kwon SU, Lee J, Kang DW, Rha JH, Park JM, Lee YS, Lee JH, Kim YJ, Hong KS, Yu KH, Sohn SI, Ahn SH, Cha JK, Park MS, Kim JS, Yoon BW, Lee BC, Nam CM, Koo JS, Nam HS, Park KY, Park JM, Lee JH, Kim DH, Rha JH, Nah HW, Lee YS, Cho YJ, Kim DE, Han MK, Lee KB, Heo SH, Heo JH, Kim BJ, Cho KH, Kim HY, Kim YD, Cho AH, Lee KY, Lee JS, Park JH, Seo WK, Kim EG, Koh IS, Choi NC, Kwon JH, Lee J, Hwang YH, Song HJ, Shin BS, Kim JT, Lee SJ, Chung PW, Kim SH, Lee JH, Shin DI, Do JK, Lee SB, Lee YB, Yoo BG, Sung SM, Jung JM, Park JW, Lee TK, Navarro JC, San Jos MCZ, Roxas A, Mallarl-Alvarez RJ, Collantes MEV, WONG LK, Fong WC, Tsoi TH, Ng PW, Lee EJ, Lee JS. Prevention of cardiovascular events in Asian patients with ischaemic stroke at high risk of cerebral haemorrhage (PICASSO): a multicentre, randomised controlled trial. Lancet Neurol 2018; 17:509-518. [DOI: 10.1016/s1474-4422(18)30128-5] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Revised: 03/22/2018] [Accepted: 03/22/2018] [Indexed: 12/18/2022]
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Shi D, Li Z, Yang J, Liu BZ, Xia H. Symptom experience and symptom burden of patients following first-ever stroke within 1 year: a cross-sectional study. Neural Regen Res 2018; 13:1907-1912. [PMID: 30233063 PMCID: PMC6183032 DOI: 10.4103/1673-5374.239440] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Symptoms that are multidimensional and concurrent should be assessed from different dimensions and managed together. Few studies have evaluated concurrent and multidimensional symptoms in patients with stroke. Most studies of stroke focused on dysfunctions and complications. We hypothesize that patients with stroke have a heavy symptom burden within 1 year. This study aimed to describe multidimensional and concurrent symptoms within 1 year after stroke. This study recruited 230 patients with stroke from the Rehabilitation Department of Xuhui District Center Hospital of Shanghai and the Shanghai Sunshine Rehabilitation Center in China from March to September 2017. The patients’ multidimensional symptom experience and symptom burden were analyzed using a self-made structured questionnaire and the influential factors for symptom burden were identified. The mean number of symptoms in patients with stroke was 11.7 ± 3.5. More than two thirds of the participants suffered from at least 10 co-occurring symptoms. Unilateral limb weakness had the highest prevalence and frequency. Participation restriction had the highest symptom dimensions of severity and distress. Lack of self-care ability (severity), memory deterioration (frequency), imbalance of body (distress), moodiness (distress), being unable to move limbs at will (distress), shoulder pain (distress), and slower response (frequency) were independent factors of the total symptom burden score. These findings can provide essential information for efficient symptom management of patients with stroke. This trial was registered with the ISRCTN registry (registration number: ISRCTN18421629).
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Affiliation(s)
- Dan Shi
- School of Nursing, Fudan University, Shanghai, China
| | - Zheng Li
- School of Nursing, Fudan University, Shanghai, China
| | - Jian Yang
- Xuhui District Center Hospital of Shanghai, Shanghai, China
| | - Bang-Zhong Liu
- Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
| | - Hui Xia
- School of Nursing, Fudan University, Shanghai, China
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Wang H, Tian Y, Guo Y, Wang Y, Lip GYH. Multiple risk factors and ischaemic stroke in the elderly Asian population with and without atrial fibrillation. Thromb Haemost 2017; 115:184-92. [DOI: 10.1160/th15-07-0577] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 07/21/2015] [Indexed: 11/05/2022]
Abstract
SummaryIschaemic stroke risk rises with the increasing cardiovascular risk factors. How atrial fibrillation (AF) incrementally contributes to the risk for ischaemic stroke with increasing age and multiple cardiovascular risk factors is unclear. In an individual patient with AF the mechanism of ischaemic stroke may be related directly to AF itself or to risk factors associated with AF. It was this study’s objective to investigate incident ischaemic stroke in relation to age and increasing cardiovascular risk factor(s), and the incremental impact of AF on stroke rates. We studied a 5 % random sampling from Chinese medical insurance data covering more than 10 million individuals, for the years 2001 to 2012. The rate of ischaemic stroke was calculated amongst the individuals with no prior history of ischaemic stroke, in relation to age groups (aged < 65, 65–74,75 years old; n = 348,431, n = 56,952, n = 20,217, respectively), and increasing risk factors using the CHA2DS2-VASc score. Among the randomly sampled 425,600 individuals with total follow-up of 1,864,232 patient-years [63.8 % male, mean age 60 years; 880 with AF, vs 424,720 non-AF], there were 13,242 (3.1 %) ischaemic strokes after 64,834 person-years follow-up. Overall, ischaemic stroke incidence (per 100 person-years) was 0.35 (95 %CI 0.34–0.35) in the non-AF population and 1.11 (0.84–1.45) with AF. The AF population age < 65 and 65–74 had higher CHA2DS2-VASc scores than the nonAF population (p< 0.001), but this was non-significant between the non-AF and AF population age75 (p=0.086). For the population age75 years, incident stroke rates were 2.07 (0.86–4.76) and 4.29 (4.08–4.51) in non-AF and AF populations, respectively. The non-AF population age65 years with2 additional comorbidities (hyper-tension, vascular disease, diabetic, or heart failure) had ischaemic stroke rates similar to an AF population with CHA2DS2-VASc4. In both non-AF and AF populations, those with CHA2DS2-VASc =1 had a 1.9 fold increase in stroke risk, and those with CHA2DS2-VASc2 had more than four-fold increased risk for stroke, compared with those with CHA2DS2-VASc=0. In conclusion, an increasing cluster of multiple cardiovascular risk factors (besides AF) contributes to a greater risk for ischaemic stroke, especially in the elderly population. If elderly and with multiple risk factors, non-AF patients may have a risk of incident ischaemic stroke that is comparable or even higher than patients with AF, suggesting that the incremental stroke risk attributable to AF is marginal in such ‘high risk’ patients.
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Li X, Xia X, Wang P, Zhang S, Liu M, Wang L. Needs and rights awareness of stroke survivors and caregivers: a cross-sectional, single-centre questionnaire survey. BMJ Open 2017; 7:e013210. [PMID: 28982805 PMCID: PMC5640053 DOI: 10.1136/bmjopen-2016-013210] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES The needs and rights awareness of stroke survivors have not been reported in China. This study investigated the needs and rights awareness of stroke survivors and caregivers in Tianjin, China. SETTING A survey launched by the World Stroke Organization was conducted in Tianjin, China. The questionnaire included demands for psychological support, treatment and care, social support and information. Stroke survivors and their caregivers were interviewed face to face for the questionnaire. Between June 2014 and February 2015, stroke survivors were invited to participate if they were more than 18 years old and had experienced a stroke. Exclusion criteria were patients who had disorders of consciousness, significant cognitive impairment, aphasia, communication difficulties or psychiatric disorders. Only caregivers who were family members of the patients were chosen. Paid caregivers were excluded. PARTICIPANTS Two hundred and forty-eight stroke survivors and 212 caregivers were enrolled. PRIMARY OUTCOME MEASURES The correlations between levels of needs and potential effect factors were analysed. Levels of different needs were compared by age, gender and time since stroke. RESULTS Among the cohort, 95.6% stroke survivors and 92.5% caregivers agreed to each question in the questionnaire. The participants prioritised the needs for psychological support (99.4%), treatment and care (98.6%), social support (98%) and information (96.2%). The total score was negatively correlated with age (r=-0.255, p<0.01). Patients below 65 years old had higher scores than those 65 years or older (p<0.01), while male patients had higher scores than female patients (p<0.01). CONCLUSIONS The needs for psychological and emotional support, individual treatment, social support and information about stroke were eagerly reported by most survivors. The Bill of Rights must be recognised by the Chinese society, providing appropriate stroke care to every patient to optimise stroke outcomes.
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Affiliation(s)
- Xin Li
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xiaoshuang Xia
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Peilu Wang
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Shuting Zhang
- Stroke Clinical Research Unit, Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Ming Liu
- Stroke Clinical Research Unit, Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Lin Wang
- Department of Geratology, The Second Hospital of Tianjin Medical University and Tianjin Geriatric Institute, Tianjin, China
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Venketasubramanian N, Yoon BW, Pandian J, Navarro JC. Stroke Epidemiology in South, East, and South-East Asia: A Review. J Stroke 2017; 19:286-294. [PMID: 29037005 PMCID: PMC5647629 DOI: 10.5853/jos.2017.00234] [Citation(s) in RCA: 168] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 09/07/2017] [Accepted: 09/14/2017] [Indexed: 11/29/2022] Open
Abstract
Asia, which holds 60% of the world’s population, comprises some developing countries which are in economic transition. This paper reviews the epidemiology of stroke in South, East and South-East Asia. Data on the epidemiology of stroke in South, East, and South-East Asia were derived from the Global Burden of Disease study (mortality, disability-adjusted life-years [DALYs] lost because of stroke), World Health Organization (vascular risk factors in the community), and publications in PubMed (incidence, prevalence, subtypes, vascular risk factors among hospitalized stroke patients). Age- and sex-standardized mortality is the lowest in Japan, and highest in Mongolia. Community-based incidence data of only a few countries are available, with the lowest rates being observed in Malaysia, and the highest in Japan and Taiwan. The availability of prevalence data is higher than incidence data, but different study methods were used for case-finding, with different age bands. For DALYs, Japan has the lowest rates, and Mongolia the highest. For community, a high prevalence of hypertension is seen in Mongolia and Pakistan; diabetes mellitus in Papua New Guinea, Pakistan, and Mongolia; hypercholesterolemia in Japan, Singapore, and Brunei; inactivity in Malaysia; obesity in Brunei, Papua New Guinea, and Mongolia; tobacco smoking in Indonesia. Hypertension is the most frequent risk factor, followed by diabetes mellitus and smoking. Ischemic stroke occurs more frequently than hemorrhagic stroke, and subarachnoid hemorrhages are uncommon. There are variations in the stroke epidemiology between countries in South, East, and South-East Asia. Further research on stroke burden is required.
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Affiliation(s)
| | - Byung Woo Yoon
- Department of Neurology, Seoul National University Hospital, Seoul, Korea
| | - Jeyaraj Pandian
- Department of Neurology, Christian Medical College, Ludhiana, India
| | - Jose C Navarro
- Neuroscience Institute, St. Luke's Medical Center, Jose R. Reyes Medical Center, Manila, Philippines
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Yu C, Wang W, Zhang Y, Wang Y, Hou W, Liu S, Gao C, Wang C, Mo L, Wu J. The Effects of Modified Constraint-Induced Movement Therapy in Acute Subcortical Cerebral Infarction. Front Hum Neurosci 2017; 11:265. [PMID: 28572764 PMCID: PMC5435756 DOI: 10.3389/fnhum.2017.00265] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 05/04/2017] [Indexed: 01/17/2023] Open
Abstract
Background: Constraint-induced movement therapy (CIMT) promotes upper extremity recovery post stroke, however, it is difficult to implement clinically due to its high resource demand and safety of the restraint. Therefore, we propose that modified CIMT (mCIMT) be used to treat individuals with acute subcortical infarction. Objective: To evaluate the therapeutic effects of mCIMT in patients with acute subcortical infarction, and investigate the possible mechanisms underlying the effect. Methods: The role of mCIMT was investigated in 26 individuals experiencing subcortical infarction in the preceding 14 days. Patients were randomly assigned to either mCIMT or standard therapy. mCIMT group was treated daily for 3 h over 10 consecutive working days, using a mitt on the unaffected arm for up to 30% of waking hours. The control group was treated with an equal dose of occupational therapy and physical therapy. During the 3-month follow-up, the motor functions of the affected limb were assessed by the Wolf Motor Function Test (WMFT) and Motor Activity Log (MAL). Altered cortical excitability was assessed via transcranial magnetic stimulation (TMS). Results: Treatment significantly improved the movement in the mCIMT group compared with the control group. The mean WMF score was significantly higher in the mCIMT group compared with the control group. Further, the appearance of motor-evoked potentials (MEPs) were significantly higher in the mCIMT group compared with the baseline data. A significant change in ipsilesional silent period (SP) occurred in the mCIMT group compared with the control group. However, we found no difference between two groups in motor function or electrophysiological parameters after 3 months of follow-up. Conclusions: mCIMT resulted in significant functional changes in timed movement immediately following treatment in patients with acute subcortical infarction. Further, early mCIMT improved ipsilesional cortical excitability. However, no long-term effects were seen.
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Affiliation(s)
- Changshen Yu
- Department of Neurorehabilitation, Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative DiseasesTianjin, China
| | - Wanjun Wang
- Department of Neurorehabilitation, Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative DiseasesTianjin, China
| | - Yue Zhang
- Department of Rehabilitation Medicine, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative DiseasesTianjin, China
| | - Yizhao Wang
- Department of Rehabilitation Medicine, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative DiseasesTianjin, China
| | - Weijia Hou
- Department of Rehabilitation Medicine, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative DiseasesTianjin, China
| | - Shoufeng Liu
- Department of Neurorehabilitation, Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative DiseasesTianjin, China
| | - Chunlin Gao
- Department of Neurorehabilitation, Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative DiseasesTianjin, China
| | - Chen Wang
- Neurological Disease Biobank, Tianjin Neurosurgical Institute, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative DiseasesTianjin, China
| | - Lidong Mo
- Neurological Disease Biobank, Tianjin Neurosurgical Institute, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative DiseasesTianjin, China
| | - Jialing Wu
- Department of Neurorehabilitation, Department of Neurology, Tianjin Huanhu Hospital, Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative DiseasesTianjin, China
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Guo Y, Wang H, Tao T, Tian Y, Wang Y, Chen Y, Lip GYH. Determinants and Time Trends for Ischaemic and Haemorrhagic Stroke in a Large Chinese Population. PLoS One 2016; 11:e0163171. [PMID: 27685332 PMCID: PMC5042494 DOI: 10.1371/journal.pone.0163171] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 09/02/2016] [Indexed: 11/19/2022] Open
Abstract
Background The clinical epidemiology of stroke has been widely investigated in Caucasian populations, but the changes over time in the proportion of ischaemic to haemorrhagic strokes is less clear, especially in the Chinese population. Aims Our objective was to study the determinants and time trends for ischaemic and haemorrhagic stroke, in relation to age, in a large Chinese population cohort. Methods Using a medical insurance database in the southwest of China from 2001 to 2012, time trends in age-adjusted ischaemic and haemorrhagic stroke incidence and the contributing risk factors associated with age were investigated. Results Among 425,901 individuals without prior stroke (52.4% male, median age 54), the rate of ischaemic stroke (per 1000 patient-years) decreased between 2002–2007, then remained broadly similar between 2008–2012. The rate of haemorrhagic stroke showed a similar trend, being approximately 1.3–1.9 from 2008–2012. Compared to patients age<65, ischaemic and haemorrhagic stroke incidences (rate, 95% confidential interval, CI) were higher in the elderly population (age <65 versus age ≥65: ischaemic: 3.64, 3.33–4.00, vs 14.33, 14.01–14.60; haemorrhagic: 1.09, 1.00–1.10 vs 2.52,2.40–2.70, respectively, both p<0.001). There were no significant differences in haemorrhagic stroke rates between the elderly and the very elderly population. Ischaemic and haemorrhagic stroke shared similar risk factors (age, hypertension, coronary artery disease (CAD), vascular disease, and diabetes mellitus) (all p<0.05). In subjects age<75 years, CAD (7.17, 4.14–12.37) and diabetes mellitus (3.27, 2.42–4.42) contributed most to the developing of haemorrhagic stroke (all p<0.001). Amongst the very elderly, vascular disease (2.24, 1.49–3.37) was an additional major risk factor for haemorrhagic stroke, together with CAD and diabetes mellitus (all p<0.001). Conclusion In this large Chinese cohort, there was an increased risk of ischaemic stroke compared to haemorrhagic stroke with ageing. CAD, vascular disease, diabetes mellitus, and hypertension were major contributors to the development of hemorrhagic stroke in the very elderly Chinese population.
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Affiliation(s)
- Yutao Guo
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Hao Wang
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Tao Tao
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Yingchun Tian
- Department of Gerontology, Second People’s Hospital, Kunming, Yunnan Province, China
| | - Yutang Wang
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Yundai Chen
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
- * E-mail: (YC); (GYHL)
| | - Gregory Y. H. Lip
- University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom
- * E-mail: (YC); (GYHL)
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Nezu T, Hosomi N, Lip GY, Aoki S, Shimomura R, Maruyama H, Yagita Y, Matsumoto M, Kobayashi S. Temporal Trends in Stroke Severity and Prior Antithrombotic Use Among Acute Ischemic Stroke Patients in Japan. Circ J 2016; 80:2033-6. [PMID: 27452200 DOI: 10.1253/circj.cj-16-0374] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Few existing stroke registries allow for evaluation of stroke severity, stroke subtype and antithrombotic usage prior to stroke onset over a given time period. The present study aimed to elucidate temporal trends in initial presenting stroke severity, stroke subtype and prior antithrombotic use over a 12-year period in a Japanese multicenter stroke registry. METHODS AND RESULTS We included 71,017 acute ischemic stroke patients (72±12 years old; 27,445 women) from the Japan Standard Stroke Registry Study (JSSRS) who were admitted to 94 hospitals between 2001 and 2012. The mean age of stroke onset increased gradually over time (P<0.001). Cardioembolic stroke patients (n=19,247) exhibited more severe NIHSS scores when compared with those with non-cardioembolic stroke (n=50,427). The proportion of cardioembolic stroke patients tended to increase over time, rising from 25.9% in 2001-2002 to 30.2% in 2011-2012 (P<0.001). Among the cardioembolic stroke patients, the frequency of prior anticoagulant use significantly increased from 15.6% in 2001-2002 to 24.8% in 2011-2012 (P<0.001). The frequency of prior antiplatelet use increased from 2001-2002 to 2007-2008 but decreased after 2007-2008. Among both cardioembolic and non-cardioembolic stroke patients, initial stroke severity at admission decreased over time, particularly after 2008. CONCLUSIONS In this Japanese study, the mean age of ischemic stroke onset increased, while the initial neurological severity at presentation decreased, over a 12-year period. (Circ J 2016; 80: 2033-2036).
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Affiliation(s)
- Tomohisa Nezu
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical & Health Sciences
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Mi T, Sun S, Du Y, Guo S, Cong L, Cao M, Sun Q, Sun Y, Qu C. Differences in the distribution of risk factors for stroke among the high-risk population in urban and rural areas of Eastern China. Brain Behav 2016; 6:e00461. [PMID: 27096105 PMCID: PMC4829046 DOI: 10.1002/brb3.461] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 02/20/2016] [Accepted: 02/28/2016] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Considering the program of screening for risk factors of stroke in Eastern China, the aim of this study was to compare the distribution differences in risk factors for stroke among the high-risk population living in urban and rural areas. METHODS A total of 231,289 residents were screened and basic information collected. Risk factors for stroke among the high-risk population were compared between the urban and rural groups. RESULTS A total of 117,776 high-risk residents from urban areas and 113,513 from rural areas were included in the analysis. The prevalence of hypertension was much higher in rural areas (73.3%) than that in urban areas (64.1%). Dyslipidemia (48.9% vs. 26.9%), sport lack (46.6% vs. 31.6%), diabetes mellitus (21.3% vs. 16.5%), and atrial fibrillation (18.7% vs. 9.8%) were more prevalent in the urban group, while smoking (26.5% vs. 28.8%), previous stroke (10.1% vs. 16.9%), and transient ischemic attack (20.9% vs. 24.6%) were less prevalent. CONCLUSION Among the population at high risk of stroke, there were significant differences in the distribution of the following risk factors between the urban and rural groups: hypertension, atrial fibrillation, dyslipidemia, lack of physical exercise, and a previous stroke.
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Affiliation(s)
- Te Mi
- Neurology DepartmentShandong Provincial Hospital Affiliated to Shandong UniversityJinanShandong250021China
| | - Shangwen Sun
- Cardio‐Cerebrovascular Control and Research CenterInstitute of Basic MedicineShandong Academy of Medical SciencesJinanShandong250062China
| | - Yifeng Du
- Neurology DepartmentShandong Provincial Hospital Affiliated to Shandong UniversityJinanShandong250021China
| | - Shougang Guo
- Neurology DepartmentShandong Provincial Hospital Affiliated to Shandong UniversityJinanShandong250021China
| | - Lin Cong
- Neurology DepartmentShandong Provincial Hospital Affiliated to Shandong UniversityJinanShandong250021China
| | - Mingfeng Cao
- Medical DepartmentShandong Provincial Hospital affiliated to Shandong UniversityJinanShandong250021China
| | - Qinjian Sun
- Neurology DepartmentShandong Provincial Hospital Affiliated to Shandong UniversityJinanShandong250021China
| | - Yi Sun
- Neurology DepartmentShandong Provincial Hospital Affiliated to Shandong UniversityJinanShandong250021China
| | - Chuanqiang Qu
- Neurology DepartmentShandong Provincial Hospital Affiliated to Shandong UniversityJinanShandong250021China
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Risk of stroke and transient ischaemic attack after herpes zoster. Clin Microbiol Infect 2016; 22:542-8. [PMID: 26992774 DOI: 10.1016/j.cmi.2016.03.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 03/01/2016] [Accepted: 03/03/2016] [Indexed: 11/22/2022]
Abstract
We assessed the association of herpes zoster (HZ) with stroke/transient ischaemic attack (TIA) in the general population according to age with controlling risk factors for stroke, using a nationwide representative cohort. The study was based on a prospective dynamic cohort consisting of 1 million Koreans representing all age groups, genders and geographical areas in the Korea Health Insurance Database. New events of stroke/TIA and HZ were identified using the diagnostic codes in the International Classification of Diseases, tenth revision. The risk for stroke/TIA after HZ was compared with HZ-free stroke/TIA individuals according to age group. A total of 766 179 adults were followed up for 11 years from 2003. The incidence of the first-diagnosed HZ cases was 9.40 per 1000 person-years, and that of the first-diagnosed stroke/TIA cases was 9.77 per 1000 person-years. The risk for stroke/TIA was higher in patients who had previous HZ episodes than in those who had never experienced HZ (incidence rate ratio 1.90; 95% CI 1.85-1.95). In addition, this risk persisted for several years after HZ. The risk of stroke/TIA after HZ gradually decreased with age; adjusted hazard ratio (HR) 2.04 in 18- to 30-year-olds, HR 1.74 in 30- to 40-year-olds, HR 1.43 in 40- to 50-year-olds, HR 1.23 in 50- to 60-year-olds, HR 1.24 in 60- to 70-year-olds, and HR 1.29 in those >70 years old, after controlling risk factors for stroke/TIA. Our findings provide evidence that HZ carries an increased risk of stroke or TIA and that the effect of HZ on stroke decreases with increasing age.
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Civelek GM, Atalay A, Turhan N. Medical complications experienced by first-time ischemic stroke patients during inpatient, tertiary level stroke rehabilitation. J Phys Ther Sci 2016; 28:382-91. [PMID: 27065523 PMCID: PMC4792978 DOI: 10.1589/jpts.28.382] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 10/30/2015] [Indexed: 12/21/2022] Open
Abstract
[Purpose] The aim of this study was to assess the medical complications in first-time
ischemic stroke patients, to identify the factors related to occurrence of complications.
[Subjects and Methods] First-time ischemic stroke patients (n=81) admitted to a tertiary
level inpatient rehabilitation center during a 5 year period were included in the study.
The attending physiatrist noted the presence of specific medical complications and
complications that required transfer to the acute care facility from patient records. The
Oxfordshire Community Stroke Project classification was used to define the clinical
subtypes of the ischemic stroke patients. The Charlson comorbidity index was used to
evaluate co-morbid conditions. Functional disability was assessed using the Functional
Independence Measure at admission and discharge. [Results] We found that 88.9% of the
patients had at least one complication. The five most common complications were urinary
tract infection (48.1%), shoulder pain (37.0%), insomnia (37.0%), depression (32.1%), and
musculoskeletal pain other than shoulder pain (32.1%) and 11.1% of patients were
transferred to acute care facility during rehabilitation period. Functional Independence
Measure scores both at admission and discharge were significantly lower in patients with
at least one complication than in patients with no complications. [Conclusion] Medical
complications are common among patients undergoing stroke rehabilitation. Close
interdisciplinary collaboration between physiatrists and other medical specialities is
necessary for optimal management.
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Affiliation(s)
- Gul Mete Civelek
- Physical Medicine and Rehabilitation Clinic, Ankara Children's Hematology Oncology Training and Research Hospital, Turkey
| | - Ayce Atalay
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Acibadem University, Faculty of Medicine, Turkey
| | - Nur Turhan
- Physical Medicine and Rehabilitation Clinic, Bayındır Hospital, Turkey
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Shi GM, Zhang YD, Geng C, Zhang YQ, Pan XD, Liu YK, Yang J, Zhou JS. Profile and 1-Year Outcome of Ischemic Stroke in East China: Nanjing First Hospital Stroke Registry. J Stroke Cerebrovasc Dis 2015; 25:49-56. [PMID: 26409718 DOI: 10.1016/j.jstrokecerebrovasdis.2015.08.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 07/11/2015] [Accepted: 08/24/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The profile and 1-year outcome after acute ischemic stroke (AIS) in Nanjing, China, is uncertain. This study aimed to investigate the profile and outcome after 1-year follow-up of AIS in East China. METHODS In a prospective cohort study, 2168 patients with AIS were recruited consecutively. The primary outcome was death or dependency defined as a modified Rankin Scale score of 3-6 at 12 months. Plausible risk factors of death or dependency, such as demographics, risk factors of cardiovascular diseases, clinical features, laboratory results, and complications after a stroke, were selected from available variables to perform multivariable logistic regression analyses. RESULTS Eight hundred thirty-seven (38.6%) patients died or suffered from dependency. Multivariate logistic regression analysis showed that age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.03-1.05), history of diabetes mellitus (OR, 1.50; 95% CI, 1.10-2.04), prior stroke (OR, 2.08; 95% CI, 1.51-2.87), National Institutes of Health Stroke Scale (NIHSS) score (OR, 23.06; 95% CI, 14.24-37.34), estimated glomerular filtration rate (OR, 1.65; 95% CI, 1.02-2.66), pulmonary infection (OR, 2.98; 95% CI, 2.17-4.09), and gastrointestinal bleeding (OR, 7.81; 95% CI, 2.76-22.09) were significantly and independently associated with higher rates of mortality or disability (all P values < .05). Male gender (P values < .001) was the only factor associated with lower mortality or disability. CONCLUSIONS The main dominating predictors for death or dependency were older age, female gender, diabetes mellitus, prior stroke, NIHSS score, estimated glomerular filtration rate, pulmonary infection, and gastrointestinal bleeding.
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Affiliation(s)
- Guo-Mei Shi
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Ying-Dong Zhang
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Cong Geng
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Yu-Qiao Zhang
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xi-Ding Pan
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Yu-Kai Liu
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Jie Yang
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
| | - Jun-Shan Zhou
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
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Epidemiological Characteristics of Hypertension in the Elderly in Beijing, China. PLoS One 2015; 10:e0135480. [PMID: 26295836 PMCID: PMC4546586 DOI: 10.1371/journal.pone.0135480] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 07/22/2015] [Indexed: 12/12/2022] Open
Abstract
Background/Objectives The prevalence rate of hypertension increases significantly with the aging society, and hypertension is obviously becoming a major health care concern in China. The aim of the study was to explore the epidemiological characteristics of hypertension in the elderly and to provide a basis for the prevention of hypertension. Design 3-cross sectional studies in 2000, 2004, and 2007, respectively. Setting Beijing, China. Participants A group of 2,832, 1,828, and 2,277 elderly residents aged ≥60 years were included this study in 2000, 2004, and 2007, respectively. Intervention None. Measurements Statistical sampling techniques included cluster, stratification, and random selection. Trained staff used a comprehensive geriatric assessment questionnaire and a standard survey instrument to complete the assessments. During the person-to-person interviews, the participants’ demographic characteristics, living conditions, and health status were collected, and their blood pressure was measured. Results The prevalence rates (69.2%, 61.9%, and 56.0%) of hypertension and the control rates (22.6%, 16.7%, and 21.5%) lowered annually, while the awareness rates (43.7%, 55.8%, and 57.6%) of the treatment elevated annually in 2000, 2004, and 2007, respectively. There was no increase in the control rates for males (26.2%, 16.7%, and 20.8%), younger participants (28.0%, 18.4%, and 21.0%), and rural residents (19.5%, 9.6%, and 13.4%) in 2000, 2004, and 2007, respectively. Conclusions Our study findings indicated that the prevalence of hypertension is high in rural elderly participants, while the rates of awareness, treatment, and control were low. This suggests that effective public measures need to be developed to improve the prevention and control of hypertension.
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Chen BL, Guo JB, Liu MS, Li X, Zou J, Chen X, Zhang LL, Yue YS, Wang XQ. Effect of Traditional Chinese Exercise on Gait and Balance for Stroke: A Systematic Review and Meta-Analysis. PLoS One 2015; 10:e0135932. [PMID: 26291978 PMCID: PMC4546302 DOI: 10.1371/journal.pone.0135932] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 07/29/2015] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE A systematic review is conducted to determine the effect of traditional Chinese exercise for patients with stroke. METHODS Studies are obtained from PubMed, Embase, Cochrane Library, EBSCO, Web of Science, and CNKI. Only randomized controlled trials were left to evaluate the effects of traditional Chinese exercise for patients with stroke, and with no limits on study data or language. The primary outcome was the Berg balance score (BBS), Functional walking scale. And a random-effects model was used to calculate the pooled mean difference (MD) with 95% confidence interval (CI). RESULTS A total of 9 studies on 820 participants conform to the inclusion criteria, whereas eight studies on 704 participants are used as data sources for the meta-analysis, all trials were published between 2004 and 2013. The BBS indicates that the efficacy of traditional Chinese exercise on balance of patients with stroke is better than that of other training or no training in short term [MD (95%CI) = 11.85 [5.41, 18.30], P < 0.00001]. And the short physical performance battery, Functional walking scale, limit of stability were observed significant differences on balance (p<0.05) and gait (p<0.05) between traditional Chinese exercise and other exercises or no exercise. In addition, there is an article showed that some other form (physiotherapy exercises focused on balance) significantly improved balance ability for stroke patients compared to tai chi chuan practice (Berg test = 0.01, Romberg, and standing on one leg). CONCLUSION In our meta analysis, the positive findings of this study suggest traditional Chinese exercise has beneficial effects on the balance ability in short term. However, we drew the conclusion according to the extreme heterogeneity, and evidence of better quality and from a larger sample size is required. Because of the inconsistent outcomes, there are short of enough good evidence for patients with stroke to prove the effects of traditional Chinese exercise on gait. SYSTEMATIC REVIEW REGISTRATION http://www.crd.york.ac.uk/PROSPERO PROSPERO registration number: CRD42013006474.
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Affiliation(s)
- Bing-Lin Chen
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Jia-Bao Guo
- Second School of Clinical Medical, Nanjing University of Chinese Medicine, Nanjing, China
| | - Ming-Shuo Liu
- Bulloch Academy, Statesboro, United States of America
| | - Xin Li
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Jun Zou
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Xi Chen
- Kinesiology and Exercise Science, Shanghai University of Sport, Shanghai, China
| | - Ling-Li Zhang
- Kinesiology and Exercise Science, Shanghai University of Sport, Shanghai, China
| | - Yu-Shan Yue
- Second School of Clinical Medical, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xue-Qiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
- * E-mail:
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Bueno-de-Mesquita HB. Noncommunicable Diseases of Major Public Health Interest and Prevention. Asia Pac J Public Health 2015; 27:110S-115S. [PMID: 26155799 DOI: 10.1177/1010539515594445] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Noncommunicable diseases (NCDs; mainly cancer, cardiovascular diseases, diabetes, and chronic respiratory diseases) are now responsible for more than 35 million deaths per annum in the world; more than 80% of these deaths occur in low- and middle-income countries. Dramatic worldwide changes in lifestyle and in the prevalence and incidence of major chronic diseases lends credence to the causative role of modifiable risk factors. For the elucidation of modifiable risk factors, large-scale prospective cohort studies with biobanks often combined in consortia are of paramount importance. Associations between selected risk factors and development of NCDs will be reviewed. In addition to the contribution of treatment, even larger proportions of NCDs can be prevented had risk factors been reduced to the optimum levels or eliminated. Individual-based approaches should be complemented by administrative regulations.
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Affiliation(s)
- H Bas Bueno-de-Mesquita
- National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands School of Public Health, Imperial College London, London, UK University Medical Centre Utrecht, Utrecht, Netherlands University of Malaya, Kuala Lumpur, Malaysia
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Association Between TRAF6 Gene Polymorphisms and Susceptibility of Ischemic Stroke in Southern Chinese Han Population. J Mol Neurosci 2015; 57:386-92. [PMID: 25999280 DOI: 10.1007/s12031-015-0580-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 05/11/2015] [Indexed: 10/23/2022]
Abstract
The tumor necrosis factor receptor-associated factor 6 (TRAF6) gene encodes a protein that acts downstream of the Toll-like receptor (TLR) pathway. TLRs activate inflammatory cascades and mediate inflammatory injury after cerebral ischemia. However, the role of TFAR6 gene polymorphisms in ischemic stroke (IS) remains unknown. This study aims to investigate the associations of TRAF6 gene polymorphisms with susceptibility to IS and IS-related quantitative traits in Southern Chinese Han population. A total of 816 IS cases and 816 age- and gender-matched controls were included. Two variants of the TRAF6 gene (rs5030411 and rs5030416) were genotyped using the Sequenom MassARRAY iPLEX platform. Our study showed that rs5030416 was significantly associated with increased susceptibility to IS in the additive model [ORadj 1.25(1.04-1.51), P adj = 0.019, P Bc = 0.038] and dominant model [ORadj 1.23(1.04-1.60), P adj = 0.021, P Bc = 0.042] after adjusting by age and sex and applying a Bonferroni correction. No significant association was found between rs5030411 and IS susceptibility (all P > 0.05). The haplotype rs5030416 (allele C)-rs5030411 (allele C) was significantly associated with IS susceptibility (P adj = 0.015). Moreover, a significant association of rs5030411 with TC levels in IS patients under the additive model [β 0.16(0.01-0.30), P adj = 0.034] and recessive model [β 0.45(0.12-0.78), P adj = 0.007] was observed after adjustment by age and sex. This association remained statistically significant under the recessive model (P Bc = 0.042) after Bonferroni correction. Our results suggest that TRAF6 gene polymorphisms may be involved in the pathogenesis of IS.
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Chang WH, Sohn MK, Lee J, Kim DY, Lee SG, Shin YI, Oh GJ, Lee YS, Joo MC, Han EY, Kim YH. Korean Stroke Cohort for functioning and rehabilitation (KOSCO): study rationale and protocol of a multi-centre prospective cohort study. BMC Neurol 2015; 15:42. [PMID: 25886039 PMCID: PMC4376073 DOI: 10.1186/s12883-015-0293-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Accepted: 02/26/2015] [Indexed: 11/13/2022] Open
Abstract
Background Development of a long-term stroke care plan requires serial assessment of long-term patient function and consideration of caregiver mood. However, to date, few comprehensive cohort studies have included both stroke patients and caregivers. Methods/Design KOSCO is a large, multi-centre prospective cohort study for all acute first-ever stroke patients admitted to participating hospitals in nine distinct areas of Korea. This study is designed as a 10-year, longitudinal follow-up investigating the residual disabilities, activity limitations, and quality of life issues arising in patients suffering from first-ever stroke. The main objectives of this study are to identify the factors that influence residual disability and long-term quality of life. The secondary objectives of this study are to determine the risk of mortality and recurrent vascular events in patients with acute first-ever stroke. We will investigate longitudinal health behaviors and patterns of healthcare utilization, including stroke rehabilitation care. We will also investigate the long-term health status, mood, and quality of life in stroke patient caregivers. In addition, we will identify baseline and ongoing characteristics that are associated with our secondary outcomes. Discussion KOSCO is a prospective, multi-centre, 10-year longitudinal follow-up study investigating the residual disabilities, activity limitations, and quality of life issues arising in patients suffering from first-ever stroke.
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Affiliation(s)
- Won Hyuk Chang
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul, 135-710, Republic of Korea.
| | - Min Kyun Sohn
- Department of Rehabilitation Medicine, School of Medicine, Chungnam National University, 282 Munhwa-ro, Jung-gu, Daejeon, 301-721, Republic of Korea.
| | - Jongmin Lee
- Department of Rehabilitation Medicine, Konkuk University School of Medicine, 120-1 Neungdong-ro, Hwayang-dong, Gwangjin-gu, Seoul, 143-729, Republic of Korea.
| | - Deog Young Kim
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
| | - Sam-Gyu Lee
- Department of Physical and Rehabilitation Medicine, Chonnam National University Medical School, 42 Jebong-ro, Donggu, Gwangju, 501-757, Republic of Korea.
| | - Yong-Il Shin
- Department of Rehabilitation Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Republic of Korea.
| | - Gyung-Jae Oh
- Department of Preventive Medicine, Wonkwang University School of Medicine, 895 Muwang-ro, Iksan, Jeonlabuk-do, 570-711, Republic of Korea.
| | - Yang-Soo Lee
- Department of Rehabilitation Medicine, Kyungpook National University School of Medicine, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu, 700-721, Republic of Korea.
| | - Min Cheol Joo
- Department of Rehabilitation Medicine, Wonkwang University School of Medicine, 895 Muwang-ro, Iksan, Jeonlabuk-do, 570-711, Republic of Korea.
| | - Eun Young Han
- Department of Rehabilitation Medicine, Jeju National University Hospital, University of Jeju School of Medicine, 15 Aran 13-gil, Jeju, 690-767, Republic of Korea.
| | - Yun-Hee Kim
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul, 135-710, Republic of Korea.
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Venketasubramanian N, Chang HM, Chan BPL, Young SH, Kong KH, Tang KF, Ang YH, Ahmad A, Chow KY. Countrywide Stroke Incidence, Subtypes, Management and Outcome in a Multiethnic Asian Population: The Singapore Stroke Registry — Methodology. Int J Stroke 2015; 10:767-9. [DOI: 10.1111/ijs.12472] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 01/12/2015] [Indexed: 10/23/2022]
Abstract
Rationale Because of its rapidly-growing and aging populations, the global burden of stroke will be felt most strongly in Asia. Data from Asia are scarce. Even rarer are data from multiethnic populations. Aim The Singapore Stroke Registry is a countrywide registry of risk factors, stroke subtypes, management and outcome of incident and recurrent stroke in multiethnic Singapore. Methods and design Using a cold-pursuit design, potential subjects are identified from medical claims, hospital discharge summaries and death certificates. Standardized methods are used for case ascertainment and data recording by trained staff into standardized case report forms. All ages and both genders are included. Study outcome Stroke incidence, subtypes and mortality will be calculated. Trend data will be obtained. Inter-ethnic differences will be explored. Discussion The Registry has many features of an ‘ideal’ incidence study. Previously unavailable countrywide data on an Asian population will be acquired. The unique data on inter-ethnic differences will help fill knowledge gaps in stroke epidemiology.
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Affiliation(s)
| | - Hui Meng Chang
- Department of Neurology, National Neuroscience Institute — Singapore General Hospital Campus, Singapore
| | | | - Sherry H. Young
- Department of Rehabilitation Medicine, Changi General Hospital, Singapore
| | - Keng He Kong
- Department of Rehabilitation Medicine, Tan Tock Seng Hospital, Singapore
| | - Kok Foo Tang
- Tang Neurology and Medical Clinic, Mt Elizabeth Hospital, Singapore
| | - Yan Hoon Ang
- Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore
| | - Aftab Ahmad
- Department of Medicine, Alexandra Hospital, Singapore
| | - Khuan Yew Chow
- National Registry of Disease Office, Health Promotion Board, Singapore
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