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Lin Q, Dong X, Huang T, Zhou H. Care dependency in older stroke patients with comorbidities: a latent profile analysis. Front Aging Neurosci 2024; 16:1366380. [PMID: 38863785 PMCID: PMC11165196 DOI: 10.3389/fnagi.2024.1366380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 05/14/2024] [Indexed: 06/13/2024] Open
Abstract
Objectives To explore latent profiles of care dependency in older stroke patients with comorbidities and to analyze the factors influencing different latent profiles. Methods A total of 312 older ischemic stroke patients with comorbidities were included in the analysis. Latent Profile Analysis (LPA) was used to classify the participants into potential subgroups with different types of care dependency. The influencing factors of the classification of care dependency subgroups were determined using multivariate Logistic regression analysis. Results The care dependency score of older ischemic stroke patients with comorbidities was (51.35 ± 13.19), and the patients could be classified into 3 profiles, namely Universal dependency (24.0%), Moderate activity-social-learning dependency (28.0%), and Mild activity-social-learning dependency (48.0%); caregiver, BI at admission, and functional impairments were independent factors influencing care dependency (P < 0.05). Conclusion There are three latent profiles of care dependency in older ischemic stroke patients with comorbidities. According to the characteristics of various populations, medical staff are able to implement specific interventions to lower the level of dependency and further improve the quality of life of patients.
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Affiliation(s)
- Qinger Lin
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Xiaohang Dong
- Department of Neurology, Nanfang Hospital Baiyun Branch, Southern Medical University, Guangzhou, China
| | - Tianrong Huang
- Department of Neurology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Hongzhen Zhou
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
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2
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Bai X, Li Z, Cai Z, Yao M, Chen L, Wang Y. Gender differences in risk factors for ischemic stroke: a longitudinal cohort study in East China. BMC Neurol 2024; 24:171. [PMID: 38783249 PMCID: PMC11112765 DOI: 10.1186/s12883-024-03678-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 05/17/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVES Epidemiological studies of stroke and its risk factors can help develop strategies to prevent stroke. We aimed to explore the current gender-specific prevalence of stroke and associated risk factors. METHODS Data were collected using a structured precoded questionnaire designed by the Stroke Screening and Prevention Programme of the National Health and Wellness Commission Stroke Prevention and Control Project Committee, between June 2020 and November 2021. A total of 7394 residents took part in the study, 187 of whom had a stroke. The baseline information of each participant was obtained and included in this study. The chi-square test and Kruskal-Wallis tests were used to examine the relationship between these indicators and stroke, and then multivariate logistic regression was used to construct the prediction scale between different genders. RESULTS of 7394 participants,4571 (61.82%) were female. The overall prevalence of stroke patients in the study population was 2.53%, Multivariate analysis found that residence status (OR = 0.43, p = 0.002) 、HCY (OR = 0.962, p = 0.000)、Previous TIA (OR = 0.200, p = 0.002) 、Hypertension (OR = 0.33, p = 0.000) and Dyslipidemia (OR = 0.668, p = 0.028) were significant predictors of stroke. there are gender differences in the traditional risk factors for stroke, and women have more risk factors. ROC analysis confirmed the accuracy of the stroke risk model, and the AUC of the stroke risk model for the general population was 0.79 with p < 0.05. In the gender model, the female AUC was 0.796 (p < 0.05). and the male AUC was 0.786 with p < 0.05. CONCLUSION The prevalence of stroke in adults aged 40 years and above is high in eastern China were high. management of risk factors can effectively prevent the occurrence of most strokes. more attention should be paid to gender differences associated with stroke.
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Affiliation(s)
- Xinping Bai
- Department of Neurology, Fuyang People's Hospital, Anhui, 236000, People's Republic of China
| | - Zifeng Li
- Department of Neurology, Fuyang People's Hospital, Anhui, 236000, People's Republic of China
| | - Zhuo Cai
- Department of Neurology, Fuyang Hospital Affiliated to Bengbu Medical University, Anhui, 236000, People's Republic of China
| | - Mingren Yao
- Department of Neurology, Fuyang People's Hospital, Anhui, 236000, People's Republic of China
| | - Lin Chen
- Department of Neurology, Fuyang People's Hospital, Anhui, 236000, People's Republic of China
| | - Youmeng Wang
- Department of Neurology, Fuyang People's Hospital, Anhui, 236000, People's Republic of China.
- Department of Neurology, Fuyang Hospital Affiliated to Bengbu Medical University, Anhui, 236000, People's Republic of China.
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3
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Zhou X, Gao Y, Wei J, Luo J, Wang Y, Yue M, Wang B, Hong D, Chen T, Fang X. The intestinal microbiota exerts a sex-specific influence on neuroinflammation in a Parkinson's disease mouse model. Neurochem Int 2024; 173:105661. [PMID: 38157887 DOI: 10.1016/j.neuint.2023.105661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 12/17/2023] [Accepted: 12/21/2023] [Indexed: 01/03/2024]
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder characterised by chronic and progressive symptoms; it is more prevalent in men than in women. The sex-specific influence of the intestinal microbiota has been associated with some neurodegenerative diseases, but the relationship with PD is currently unclear. In this study, we treated mice with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) to establish a PD mouse model, and we utilised an antibiotic cocktail (Abx) to deplete the intestinal microbiota to evaluate the influence of the intestinal microbiota on male and female PD mice. MPTP treatment obviously caused bradykinesia and low mobility in female and male mice. Meanwhile, Abx treatment exerted a greater effect on male mice than female mice. Western blotting and immunofluorescence revealed that male mice treated with MPTP had higher expression of α-synuclein and proteins related to neuroinflammation and intestinal inflammation based on activation of glial cells and the TLR4-MyD88 signalling pathway. The sex-specific differences could be due to the different composition of the intestinal microbiota. Specifically, female mice had significantly higher abundance of Allobaculum, Turicibacter and Ruminococcus than male mice. Moreover, the abundance of the probiotic genus Bifidobacterium showed opposite trends in male and female mice. Our results indicate that the intestinal microbiota has an important effect on PD mice, especially male mice, by influencing neuroinflammation through the microbiota-gut-brain axis. In the future, there should be a focus on providing more reliable evidence for the pathogenesis and precise treatment of PD.
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Affiliation(s)
- Xiaoting Zhou
- Department of Neurology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
| | - Yuan Gao
- National Engineering Research Center for Bioengineering Drugs and the Technologies, Institution of Translational Medicine, Jiangxi Medical College, Nanchang University, Nanchang, 330031, China; Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Jing Wei
- National Engineering Research Center for Bioengineering Drugs and the Technologies, Institution of Translational Medicine, Jiangxi Medical College, Nanchang University, Nanchang, 330031, China
| | - Jie Luo
- School of Public Health, Nanchang University, Nanchang, 330031, China
| | - Yun Wang
- Department of Neurology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
| | - Mengyun Yue
- Department of Neurology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
| | - Bo Wang
- Department of Neurology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
| | - Daojun Hong
- Department of Neurology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
| | - Tingtao Chen
- National Engineering Research Center for Bioengineering Drugs and the Technologies, Institution of Translational Medicine, Jiangxi Medical College, Nanchang University, Nanchang, 330031, China.
| | - Xin Fang
- Department of Neurology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China.
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Higgins HM, Chen L, Ravare BC, Jeppson KA, Bina HT, Herson PS, Monte AA, Poisson SN, Dylla L. Response to: Acute ischemic stroke and cardioemboli: Does sex matter? Am J Emerg Med 2023; 74:170-171. [PMID: 37867013 PMCID: PMC10792528 DOI: 10.1016/j.ajem.2023.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 10/14/2023] [Indexed: 10/24/2023] Open
Affiliation(s)
- Hannah M Higgins
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, United States of America
| | - Lucia Chen
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, United States of America
| | - Brandy C Ravare
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, United States of America
| | - Kerri A Jeppson
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, United States of America
| | - Heather T Bina
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, United States of America
| | - Paco S Herson
- Department of Neurological Surgery, The Ohio State University, College of Medicine, Columbus, OH, United States of America
| | - Andrew A Monte
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, United States of America
| | - Sharon N Poisson
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, United States of America
| | - Layne Dylla
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, United States of America.
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Higgins HM, Chen L, Ravare BC, Jeppson KA, Bina HT, Herson PS, Monte AA, Poisson SN, Dylla L. Sex differences in acute ischemic stroke presentation are a matter of infarct location. Am J Emerg Med 2023; 74:95-99. [PMID: 37802001 PMCID: PMC10843056 DOI: 10.1016/j.ajem.2023.09.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 10/08/2023] Open
Abstract
INTRODUCTION Recognition of stroke by Emergency Medical Services (EMS) is critical to initiate rapid emergency department treatment. Most prehospital stroke screening tools rely heavily on presentation with the classic symptoms of facial droop, speech changes, unilateral weakness. However, women may be less likely to present with classic symptoms and may also have different distributions of stroke by anatomical location. This study seeks to determine the association between biological sex, presentation with classic symptoms, and the location of the infarcted tissue. METHODS This is a retrospective cohort study. Data from electronic health records were extracted for patients with acute ischemic stroke who presented via EMS to a single Comprehensive Stroke Center between January 1, 2018 and December 31, 2020. We used descriptive statistics characterize the cohort. Multivariable logistic regression identified factors associated with classic symptom presentation (facial droop, speech changes, and/or unilateral weakness). Biological sex, location of the infarct, stroke etiology, age and the interaction between sex and infarct location were assessed as covariates. RESULTS There were 364 (58.6%) males and 257 (41.1%) females with an acute ischemic stroke included in this study. EMS documented one or more classic symptoms in 125 (72.3%) males and 161 (67.9%) females. There were no baseline differences in infarct location or presentation with classic symptoms as documented by EMS comparing males and females. Multivariate logistic regression found no association between biological sex and presentation with classic symptoms (Odds Ratio 1.08; 95% CI 0.58 to 1.55) after controlling for age, stroke location, etiology of stroke or the interaction between sex and infarct location. Presence of an anterior circulation infarct compared to posterior circulation infarct was positively associated with a classic presentation to EMS (Odds Ratio 3.41; 95% CI 2.15 to 5.41). CONCLUSIONS This study found no difference in the frequency of patient presentation with classic stroke symptoms based on biological sex alone, nor a significant different in distribution of infarcts between males and females. Infarct location (i.e., involving the anterior circulation) was associated with a classic presentation. This suggests that the likelihood of presenting with classic stroke symptoms is not influenced by sex, but rather the location of the infarct.
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Affiliation(s)
- Hannah M Higgins
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, United States of America
| | - Lucia Chen
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, United States of America
| | - Brandy C Ravare
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, United States of America
| | - Kerri A Jeppson
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, United States of America
| | - Heather T Bina
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, United States of America
| | - Paco S Herson
- Department of Neurological Surgery, The Ohio State University, College of Medicine, Columbus, OH, United States of America
| | - Andrew A Monte
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, United States of America
| | - Sharon N Poisson
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, United States of America
| | - Layne Dylla
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, United States of America.
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Huang Y, Li Y, Pan H, Han L. Global, regional, and national burden of neurological disorders in 204 countries and territories worldwide. J Glob Health 2023; 13:04160. [PMID: 38018250 PMCID: PMC10685084 DOI: 10.7189/jogh.13.04160] [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: 11/30/2023] Open
Abstract
Background We aimed to determine the incidence and disability-adjusted life-years (DALYs) of neurological disorders worldwide from 1990 to 2019. Methods We obtained age-standardised incidence and DALY rates of neurological disorders in 204 countries and territories from 1990 to 2019 from the Global Burden of Disease (GBD) database. We determined trends stratified by age, sex, region, country, and Social Development Index (SDI) and the risk factors contributing to DALYs associated with these neurological disorders. Results The largest increases in the age-standardised incidence rates of neurological disorders in 1990-2019 occurred in four regions (East Asia: estimated annual percentage change (EAPC) = 0.19, tropical Latin America: EAPC = 0.07, Southern Latin America: EAPC = 0.03, Western Europe: EAPC = 0.03) and three countries (China: EAPC = 0.20, Ecuador: EAPC = 0.13, Italy: EAPC = 0.13). We observed the largest increases in age-standardised incidence rates for Parkinson disease, idiopathic epilepsy, and bipolar disorder, and in age-standardised DALY rates for Alzheimer disease and other dementias. High-SDI regions showed the highest EAPC for age-standardised incidence rates of Parkinson disease, depression, and motor neuron disease, and age-standardised DALY rates of neurological disorders. Conclusions There is a need to control the increase in age-standardised incidence rates of neurological disorders in East Asia, tropical Latin America, Southern Latin America, and Western Europe, particularly in China, Ecuador, and Italy.
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Affiliation(s)
- Yi Huang
- Department of Neurosurgery, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Yongan Li
- Department of Neurology, Suzhou Xiangcheng People's Hospital, Jiangsu, China
| | - Haiyan Pan
- The First Dongguan Affiliated Hospital,Guangdong Medical University
- School of Public Health, Guangdong Medical University, Dongguan, Guangdong, PR China
| | - Liyuan Han
- Center for Cardiovascular and Cerebrovascular Epidemiology and Translational Medicine, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China
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Aguiar de Sousa D, Bushnell C. Addressing the Impact of Adverse Pregnancy Outcomes on Stroke Risk in Women: A Call for Comprehensive Strategies. Stroke 2023; 54:1806-1807. [PMID: 37363946 DOI: 10.1161/strokeaha.123.043716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Affiliation(s)
- Diana Aguiar de Sousa
- Stroke Center, Lisbon Central University Hospital, Lisbon, Portugal (D.A.d.S.)
- CEEM and Institute of Anatomy, Faculdade de Medicina, Universidade de Lisboa, Portugal (D.A.d.S.)
| | - Cheryl Bushnell
- Department of Neurology, Wake Forest University School of Medicine (C.B.)
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Dafer RM. Current State of Sex and Gender Influence in Neurology. Neurol Clin 2023; 41:xiii-xvi. [PMID: 37030969 DOI: 10.1016/j.ncl.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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9
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Pavlovic A, Pekmezovic T, Mijajlovic M, Tomic G, Zidverc Trajkovic J. Is the female sex associated with an increased risk for long-term cognitive decline after the first-ever lacunar stroke? Prospective study on small vessel disease cohort. Front Neurol 2023; 13:1052401. [PMID: 36712431 PMCID: PMC9878188 DOI: 10.3389/fneur.2022.1052401] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 12/16/2022] [Indexed: 01/15/2023] Open
Abstract
Background Sex is a significant determinant of survival and functional outcome after stroke. Long-term cognitive outcome after acute lacunar stroke in the context of sex differences has been rarely reported. Methods A cohort of small vessel disease (SVD) patients presenting with first-ever acute lacunar stroke and normal cognitive status has been evaluated 4 years after the qualifying event for the presence of cognitive impairment (CI) with a comprehensive neuropsychological battery. Differences in baseline clinical and neuroimaging characteristics were compared between sexes in relation to cognitive status. Results A total of 124 female and 150 male patients were analyzed. No difference was detected between the groups regarding age (p = 0.932) or frequency of common vascular risk factors (p > 0.1 for all). At the baseline assessment, women had more disabilities compared to men with a mean modified Rankin scale (mRS) score of 2.5 (1.5 in men, p < 0.0001). Scores of white matter hyperintensities (WMH) of presumed vascular origin and a total number of lacunes of presumed vascular origin on brain MRI were higher in women compared to men (p < 0.0001 for all). As many as 64.6% of patients had CI of any severity on follow-up, women more frequently (77.4%) than men (54.0%; p < 0.0001). Univariate logistic regression analysis showed that female sex, higher NIHSS and mRS scores, presence of depression, and increasing WMH severity were associated with an increased risk for CI. Multivariate regression analysis indicated that only depression (OR 1.74, 95%CI 1.25-2.44; p = 0.001) and WMH severity (OR 1.10, 95%CI 1.03-1.17; p = 0.004) were independently associated with the CI. Conclusion At the long-term follow-up, women lacunar stroke survivors, compared to men, more frequently had CI in the presence of more severe vascular brain lesions, but this association was dependent on the occurrence of depression and severity of WMH, and could not be explained by differences in common vascular risk factors.
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Affiliation(s)
- Aleksandra Pavlovic
- Faculty of Special Education and Rehabilitation, University of Belgrade, Belgrade, Serbia,Neurology Clinic, University Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia,*Correspondence: Aleksandra Pavlovic ✉
| | - Tatjana Pekmezovic
- Faculty of Medicine, Institute of Epidemiology, University of Belgrade, Belgrade, Serbia
| | - Milija Mijajlovic
- Neurology Clinic, University Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Gordana Tomic
- Neurology Clinic, University Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Jasna Zidverc Trajkovic
- Neurology Clinic, University Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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10
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Dylla L, Higgins HM, Piper C, Poisson SN, Herson PS, Monte AA. Sex as a biological variable in determining the metabolic changes influencing acute ischemic stroke outcomes-Where is the data: A systematic review. Front Neurol 2022; 13:1026431. [PMID: 36504643 PMCID: PMC9729945 DOI: 10.3389/fneur.2022.1026431] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 10/31/2022] [Indexed: 11/25/2022] Open
Abstract
Women continue to face a greater lifetime morbidity and mortality from stroke and have been shown to respond differently to stroke treatments compared to men. Since 2016, updated National Institutes of Health (NIH) policies require research studies to consider sex as a biological variable. However, the way in which this policy affects study design, analysis, and reporting is variable, with few studies performing and reporting a subgroup analysis based on biological sex. In acute ischemic stroke, the underlying biological explanation for sex-based differences in patient outcomes and response to treatments remains understudied. We performed a systematic review of preclinical and clinical research studies that explored sex differences in the metabolic response to acute ischemic stroke as it relates to neurological outcomes. Through a literature search in Ovid Medline, Embase, and Web of Science, 1,004 potential references were identified for screening. After abstract and full-text review, we identified only two studies which assessed metabolic response to acute ischemic stroke (within 72 h of last known well) and neurological outcome [Barthel Index, modified Rankin Scale (mRS) or an equivalent in preclinical models] and reported results based on biological sex. One article was a preclinical rat model and the other a clinical cohort study. In both studies, metabolites involved in amino acid metabolism, energy metabolism, fat metabolism, or oxidative stress were identified. We review these results and link to additional articles that use metabolomics to identify metabolites differentially expressed by sex or regulated based on stroke outcomes, but not both. The results of this systematic review should not only help identify targets in need of further investigation to improve the understanding of sex differences in the pathophysiology of acute ischemic stroke, but also highlight the critical need to expand the incorporation of sex as a biological variable in acute stroke research beyond simply including both sexes and reporting the proportion of males/females in each population studied.
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Affiliation(s)
- Layne Dylla
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, United States
| | - Hannah M. Higgins
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, United States
| | - Christi Piper
- Strauss Health Sciences Library, University of Colorado School of Medicine, Aurora, CO, United States
| | - Sharon N. Poisson
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Paco S. Herson
- Department of Neurological Surgery, The Ohio State University, Columbus, OH, United States
| | - Andrew A. Monte
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, United States
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Saposnik G, Galanos LC, Guerrero R, Casagrande F, Adhamidhis E, Gao MMY, Grupper MF, Arsovska A. The World Stroke Academy: A World Stroke Organization global pathway to improve knowledge in stroke care. Int J Stroke 2022; 17:829-834. [PMID: 35195047 PMCID: PMC9483194 DOI: 10.1177/17474930221085895] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 02/17/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND The World Stroke Academy (WSA) (www.world-stroke-academy.org) is the educational platform of the World Stroke Organization (WSO). It facilitates educational activities (e.g. webinars and eLearning modules) and supports the WSO mission by providing high-quality stroke education to healthcare professionals. It provides evidence-based educational materials in a variety of formats to meet the needs of the WSO membership. AIM This article introduces the WSA, its core activities, and outlines how to access the many educational resources it offers. RESULTS The WSA offers high-quality peer reviewed stroke education material and uses outcome metrics to assess and improve the quality of medical training of healthcare professionals. This article also highlights the importance of identifying knowledge and knowledge-to-action gaps through the creation of special projects and initiatives. It describes three areas in which the WSA has carried out recent educational initiatives, namely: life after stroke, women in stroke, and stroke checklist/pre-printed stroke orders. CONCLUSION WSA material is freely available, and we would encourage the global stroke community to use, and contribute to, its resources.
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Affiliation(s)
| | | | - Rodrigo Guerrero
- Department of Neurology, Neurosurgery and Interventional Neuroradiology, Clínica Santa María, Santiago, Chile
| | | | | | | | | | - Anita Arsovska
- Urgent Neurology, Faculty of Medicine, University Clinic of Neurology, University Ss. Cyril and Methodius, Skopje, North Macedonia
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Liu X, Zhang J, Peng S, Pei M, Dai C, Wang T, Zhang P. Mediating effects of sleep duration on the association between natural menopause and stroke risk among Chinese women. Front Neurosci 2022; 16:960497. [PMID: 36033607 PMCID: PMC9403275 DOI: 10.3389/fnins.2022.960497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 07/27/2022] [Indexed: 11/24/2022] Open
Abstract
Background Sleep disturbance is commonly reported by menopausal women. Stroke risk and poor stroke outcomes in women have usually been attributed to menopause. This study aimed to investigate the mediating effect of sleep duration on relationship between menopause and risk of stroke in natural menopause women. Materials and methods A cross-sectional study was performed, and participants were recruited through a multistage, stratified, probability proportional to size sampling method in this research. The stroke risk was measured using the risk assessment form for high-risk stroke population. The average sleep duration was calculated by adding up night sleep and afternoon nap duration. Multivariate regression analysis was conducted to identify the association between menopause, sleep duration, and stroke risk. The direct and indirect effects of menopause on stroke risk were analyzed by using the sleep duration in a mediation framework. Results Perimenopause, menopause, average sleep duration, and night sleep duration were significantly associated with stroke risk (P < 0.001), after adjusting for covariates. Perimenopause and menopause were significantly related to average sleep duration (P < 0.001) and night sleep duration (P < 0.001). The average sleep duration (ab = 0.016, 95% CI: 0.003, 0.030; ab = −0.048, 95% CI: −0.070, −0.027) partially mediated the relationship between menopause and stroke risk. And night sleep duration (ab = 0.024, 95% CI: 0.009, 0.040; ab = −0.054, 95% CI: −0.077, −0.033) played a major mediating role, in which night sleep duration of ≤5 h mediated the link between both perimenopause (ab = 0.707, 95% CI: 0.392, 1.021) and menopause (ab = −0.787, 95% CI: −1.096, −0.478) and stroke risk; both night sleep duration of >8–9 h (ab = 0.079, 95% CI: 0.010, 0.193) and >9 h (ab = 0.379, 95% CI: 0.086, 0.712) had mediating effects on perimenopause and stroke risk. Conclusion A significant relationship between menopause and stroke risk factors among natural menopausal status was found in this study. The average sleep duration, especially night sleep duration, partially mediated the association between menopause and stroke risk, which is a novel insight to the progression of stroke risk in Women. Suitable prevention methods and interventions for sleep in menopausal women may reduce the risk of stroke.
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Affiliation(s)
- Xingyue Liu
- Graduate School, Shanghai University of Medicine and Health Sciences, Shanghai, China
- Graduate School, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Juhua Zhang
- Department of Integrated Traditional Chinese and Western Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Shuzhi Peng
- Graduate School, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Mengyun Pei
- Graduate School, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chunying Dai
- Department of Medicine, Kashgar Vocational and Technical College, Kashgar, China
| | - Tingting Wang
- School of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai, China
- *Correspondence: Tingting Wang,
| | - Peng Zhang
- Department of Medicine, Kashgar Vocational and Technical College, Kashgar, China
- School of Clinical Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
- Peng Zhang,
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Maxwell CJ, Maclagan LC, Harris DA, Wang X, Guan J, Marrie RA, Hogan DB, Austin PC, Vigod SN, Swartz RH, Bronskill SE. Incidence of neurological and psychiatric comorbidity over time: a population-based cohort study in Ontario, Canada. Age Ageing 2022; 51:6520504. [PMID: 35134841 DOI: 10.1093/ageing/afab277] [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: 07/08/2021] [Revised: 10/14/2021] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Comprehensive, population-based investigations of the extent and temporality of associations between common neurological and psychiatric disorders are scarce. METHODS This retrospective cohort study used linked health administrative data for Ontarians aged 40-85 years on 1 April 2002, to estimate the adjusted rate of incident dementia, Parkinson's disease (PD), stroke or mood/anxiety disorder (over 14 years) according to the presence and time since diagnosis of a prior disorder. Sex differences in the cumulative incidence of a later disorder were also examined. RESULTS The cohort included 5,283,546 Ontarians (mean age 56.2 ± 12.1 years, 52% female). The rate of dementia was significantly higher for those with prior PD (adjusted hazard ratio [adjHR] 4.05, 95% confidence interval [CI] 3.99-4.11); stroke (adjHR 2.49, CI 2.47-2.52) and psychiatric disorder (adjHR 1.79, CI 1.78-1.80). The rate of PD was significantly higher for those with prior dementia (adjHR 2.23, CI 2.17-2.30) and psychiatric disorder (adjHR 1.77, CI 1.74-1.81). The rate of stroke was significantly higher among those with prior dementia (adjHR 1.56, CI 1.53-1.58). Prior dementia (adjHR 2.36, CI 2.33-2.39), PD (adjHR 1.80, CI 1.75-1.85) and stroke (adjHR 1.47, CI 1.45-1.49) were associated with a higher rate of an incident psychiatric disorder. Generally, associations were strongest in the 6 months following a prior diagnosis and demonstrated a J-shape relationship over time. Significant sex differences were evident in the absolute risks for several disorders. CONCLUSIONS The observed nature of bidirectional associations between these neurological and psychiatric disorders indicates opportunities for earlier diagnosis and interventions to improve patient care.
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Affiliation(s)
- Colleen J Maxwell
- Schools of Pharmacy and Public Health, Sciences University of Waterloo, Waterloo, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | | | - Daniel A Harris
- ICES, Toronto, Ontario, Canada
- Public Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Ruth Ann Marrie
- Departments of Internal Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - David B Hogan
- Division of Geriatric Medicine, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Peter C Austin
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management & Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Simone N Vigod
- ICES, Toronto, Ontario, Canada
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Richard H Swartz
- ICES, Toronto, Ontario, Canada
- Department of Medicine (Neurology), Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Susan E Bronskill
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management & Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
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