Stroke prevalence among the Turkish population in a rural area of Istanbul: A community-based study

Evaluation of Serum Secretoneurin Levels in Patients With Ischemic Stroke Who Underwent Mechanical Thrombectomy

Background Ischemic stroke is a focal or global cerebral dysfunction of vascular origin; its treatment aims to provide reperfusion. Secretoneurin is a hypoxia-sensitive biomarker found in high concentrations in brain tissue. We aim to determine secretoneurin levels in patients with ischemic stroke, examine how secretoneurin levels change in the mechanical thrombectomy group, and evaluate the correlation with disease severity and prognosis. Methods Twenty-two patients diagnosed with ischemic stroke in the emergency department underwent mechanical thrombectomy, and twenty healthy volunteers were included in the study. Serum secretoneurin levels were measured by the enzyme-linked immunosorbent assay (ELISA) method. Secretoneurin levels were measured at the 0^th hour, 12^th hour, and 5^th day in patients who underwent mechanical thrombectomy. Results Serum secretoneurin levels were found to be statistically significantly higher in the patient group (7.43 ng/mL) compared to the control group (5.90 ng/mL) (p=0.023). The secretoneurin levels of the patients who underwent mechanical thrombectomy were 7.43 ng/mL, 7.04 ng/mL, and 8.65 ng/mL, measured at the 0^th hour, 12^th hour, and 5^th day, respectively, and no significant difference was detected in all three time periods (p=0.142). Conclusion Secretoneurin appears to be a useful biomarker in the diagnosis of stroke. However, it was found that there was no prognostic value in the mechanical thrombectomy group, and it was not correlated with the severity of the disease.

Prevalence of stroke, associated risk factors and stroke related physical, mental, and economic burden in the Republic of Georgia

Introduction

We investigated the prevalence, risk factors and physical, mental, and economic consequences of ischemic Janelidze and hemorrhagic stroke in the population of the Republic of Georgia.

Materials and Methods

A population-based, cross-sectional study was conducted among 3036 adults residing in the Imereti Region of Georgia, selected using a multistage, probability proportionate-to-size, cluster sampling technique. Data were collected by medical students, using an interviewer-administered questionnaire. Diagnosis of stroke was confirmed by neurologists based on clinical examination and corroborated by documental evidence.

Results

Of the targeted 3036 subjects, 2811 (92.6%) participated, of whom 1223 (43.5%) were women. Mean age of the sample was 49.7 (SD 15.2) years. The overall prevalence of stroke was 8.9%, the prevalence of ischemic stroke - 7.8% (95% CI 6.9-8.9) and of hemorrhagic stroke - 0.7% (95% CI 0.4-1.0). Ischemic stroke was more prevalent in males, while hemorrhagic stroke was more prevalent in females. Age, smoking, hypertension, and diabetes were associated with stroke. Stroke victims were young, many of them in the fifth decade of life. Sixty-five percent of them had a modified Rankin scale of three or greater, 25% were depressed, and 85% suffered cognitive impairment.

Discussion

Stroke affected people and their families, experiencing a significant economic burden due to loss of the income and increase in out-of-pocket payment for post-stroke medical care.

Conclusion

The stroke prevalence in the Republic of Georgia is higher than in Europe and is associated with a significant physical, mental, and economic burden.

Younger age of stroke in low-middle income countries is related to healthcare access and quality

Stroke is the second leading cause of mortality globally with higher burden and younger age in low‐middle income countries (LMICs) than high‐income countries (HICs). However, it is unclear to what extent differences in healthcare access and quality (HAQ) and prevalence of risk factors between LMICs and HICs contribute to younger age of stroke in LMICs. In this systematic review, we conducted meta‐analysis of 67 articles and compared the mean age of stroke between LMICs and HICs, before and after adjusting for HAQ index. We also compared the prevalence of main stroke risk factors between HICs and LMICs. The unadjusted mean age of stroke in LMICs was significantly lower than HICs (63.1 vs. 68.6), regardless of gender (63.9 vs. 66.6 among men, and 65.6 vs. 70.7 among women) and whether data were collected in population‐ (64.7 vs. 69.5) or hospital‐based (62.6 vs. 65.9) studies (all p < 0.01). However, after adjusting for HAQ index, the difference in the mean age of stroke between LMICs and HICs was not significant (p ≥ 0.10), except among women (p = 0.048). In addition, while the median prevalence of hypertension in LMICs was 23.4% higher than HICs, the prevalence of all other risk factors was lower in LMICs than HICs. Our findings suggest a much larger contribution of HAQ to the younger mean age of stroke in LMICs, as compared with other potential factors. Additional studies on stroke care quality and accessibility are needed in LMICs.

The relationship of religious coping strategies and family harmony with caregiver burden for family members of patients with stroke

AIM

Patients with stroke experience various challenges such as motor and cognitive and sensory problems, which can increase the caregiver burden of family members in long-term care. Understanding the factors related to caregiver burden is important to develop strategies to support informal caregivers. Therefore, this study aimed to examine the relationship of religious coping strategies and family harmony to caregiver burden for family members of patients with stroke.

METHOD

The sample of this descriptive, cross-sectional study consisted of 181 family caregivers who completed the Religious Coping Scale, Burden Interview Scale, and Family Harmony Scale - Short Form. Multiple linear regression and Pearson's correlation were performed.

RESULTS

Pearson's correlation analysis indicated a significant positive relationship between caregiver burden and negative religious coping. A significant negative relationship was found of caregiver burden and family harmony with positive religious coping. Multiple regression analysis indicated that family harmony, amount of time spent on caregiving, and negative and positive religious coping were predictors of caregiver burden.

Given the significant relationship of caregiver burden and family harmony to positive religious coping, future research should integrate religious coping strategies into multidisciplinary caregiver intervention programs to reduce caregiver burden.