1
|
Scheper V, Seitz AK, Kübler H, Kocot A, Kalogirou C, Schwinger M. A Propensity Score-Based Comparison regarding Renal, Functional, and Surgical Outcome of Continent Cutaneous Urinary Diversions in Patients with Benign Chronic Bladder Diseases and Patients with Bladder Cancer. Urol Int 2024:1-8. [PMID: 39154646 DOI: 10.1159/000540950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 08/07/2024] [Indexed: 08/20/2024]
Abstract
INTRODUCTION Continent cutaneous urinary diversion post-cystectomy is an established approach addressing both oncological and functional indications. However, there is a noticeable gap of evidence when it comes to comparing outcomes between these indications, especially concerning the technique of Mainz pouch I (MPI). This study aimed to close the gap by analyzing the long-term functional and renal outcomes of patients with MPI after cystectomy due to both benign and malign bladder pathologies. METHODS In this retrospective study, we examined 173 patients, who underwent MPI surgery between 2000 and 2022. Patients were categorized into a study group (benign conditions, n = 26) and a control group (bladder cancer, n = 52) using propensity score matching. Clinical demographics, surgical outcomes, and functional/renal parameters were analyzed using unpaired t tests and χ2 tests. RESULTS Patients undergoing cystectomy with MPI due to benign bladder pathologies were significantly younger and had a lower comorbidity burden compared to those with bladder cancer. In contrast to a significantly higher incidence of chemotherapy in the oncological cohort, the long-term renal function was comparable between both populations. Surgical outcomes, revisions, and postoperative complications did not differ significantly between both groups. Nearly 90% of patients in both groups showed full continence. CONCLUSION This study demonstrates the efficacy and safety of MPI surgery in both benign and malignant conditions, proving favorable long-term renal and functional outcomes.
Collapse
Affiliation(s)
- Vincent Scheper
- Department of Urology and Pediatric Urology, Julius Maximilians University Medical Center of Würzburg, Würzburg, Germany
| | - Anna Katharina Seitz
- Department of Urology and Pediatric Urology, Julius Maximilians University Medical Center of Würzburg, Würzburg, Germany
| | - Hubert Kübler
- Department of Urology and Pediatric Urology, Julius Maximilians University Medical Center of Würzburg, Würzburg, Germany
| | - Arkadius Kocot
- Department of Urology and Pediatric Urology, Julius Maximilians University Medical Center of Würzburg, Würzburg, Germany
| | - Charis Kalogirou
- Department of Urology and Pediatric Urology, Julius Maximilians University Medical Center of Würzburg, Würzburg, Germany
| | - Marcel Schwinger
- Department of Urology and Pediatric Urology, Julius Maximilians University Medical Center of Würzburg, Würzburg, Germany
| |
Collapse
|
2
|
Prevalence of Stroke in the Elderly: A Systematic Review and Meta-Analysis. INTERDISCIPLINARY NEUROSURGERY 2023. [DOI: 10.1016/j.inat.2023.101746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
|
3
|
Kallen V, Tahir M, Bedard A, Bongers B, van Riel N, van Meeteren N. Aging and Allostasis: Using Bayesian Network Analytics to Explore and Evaluate Allostatic Markers in the Context of Aging. Diagnostics (Basel) 2021; 11:diagnostics11020157. [PMID: 33494482 PMCID: PMC7912325 DOI: 10.3390/diagnostics11020157] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/06/2021] [Accepted: 01/18/2021] [Indexed: 12/30/2022] Open
Abstract
Allostatic load reflects the cumulative strain on organic functions that may gradually evolve into overt disease. Our aim was to evaluate the allostatic parameters in the context of aging, and identify the parameters that may be suitable for an allostatic load index for elderly people (>60 years). From previously published studies, 11 allostatic (bio)markers could be identified that sustain sufficient variability with aging to capture meaningful changes in health status. Based on reported statistics (prevalence of a biomarker and its associated outcome, and/or an odds/risk ratio relating these two), seven of these could be adopted in a Bayesian Belief Network (BBN), providing the probability of “disturbed” allostasis in any given elder. Additional statistical analyses showed that changes in IL-6 and BMI contributed the most to a “disturbed” allostasis, indicating their prognostic potential in relation to deteriorating health in otherwise generally healthy elderly. In this way, and despite the natural decline in variance that irrevocably alters the prognostic relevance of most allostatic (bio)markers with aging, it appeared possible to outline an allostatic load index specifically for the elderly. The allostatic parameters here identified might consequently be considered a useful basis for future quantitative modelling in the context of (healthy) aging.
Collapse
Affiliation(s)
- Victor Kallen
- Department of Microbiology & Systems Biology, Netherlands Organization for Applied Scientific Research (TNO), P.O. Box 360, 3700 AJ Zeist, The Netherlands; (M.T.); (A.B.)
- The Physical Activity and Nutrition INfluences In Ageing (PANINI) Consortium: School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (B.B.); (N.v.R.); (N.v.M.)
- Correspondence:
| | - Muhammad Tahir
- Department of Microbiology & Systems Biology, Netherlands Organization for Applied Scientific Research (TNO), P.O. Box 360, 3700 AJ Zeist, The Netherlands; (M.T.); (A.B.)
- The Physical Activity and Nutrition INfluences In Ageing (PANINI) Consortium: School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (B.B.); (N.v.R.); (N.v.M.)
| | - Andrew Bedard
- Department of Microbiology & Systems Biology, Netherlands Organization for Applied Scientific Research (TNO), P.O. Box 360, 3700 AJ Zeist, The Netherlands; (M.T.); (A.B.)
| | - Bart Bongers
- The Physical Activity and Nutrition INfluences In Ageing (PANINI) Consortium: School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (B.B.); (N.v.R.); (N.v.M.)
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism/Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Natal van Riel
- The Physical Activity and Nutrition INfluences In Ageing (PANINI) Consortium: School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (B.B.); (N.v.R.); (N.v.M.)
- Department of Biomedical Engineering, Eindhoven University of Technology, P.O. Box 513, 5300 Eindhoven, The Netherlands
| | - Nico van Meeteren
- The Physical Activity and Nutrition INfluences In Ageing (PANINI) Consortium: School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (B.B.); (N.v.R.); (N.v.M.)
- Health~Holland, Top Sector Life Sciences and Health, Wilhelmina van Pruisenweg 104, 2595 AN The Hague, The Netherlands
- Erasmus Medical Center, Department of Anesthesiology, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| |
Collapse
|
4
|
Yan S, Gan Y, Li L, Jiang H, Song F, Yin X, Chen L, Fu W, Wang X, Li W, Shu C, Hu S, Wang C, Yue W, Yan F, Wang L, Lv C, Wang Z, Lu Z. Sex differences in risk factors for stroke: A nationwide survey of 700,000 Chinese Adults. Eur J Prev Cardiol 2019; 27:323-327. [PMID: 30823863 DOI: 10.1177/2047487319831483] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Shijiao Yan
- Department of Social Medicine and Health Management, Huazhong University of Science and Technology, China
| | - Yong Gan
- Department of Social Medicine and Health Management, Huazhong University of Science and Technology, China
| | - Liqing Li
- School of Economics and Management, Jiangxi Science and Technology Normal University, China
| | - Heng Jiang
- Centre for Alcohol Policy Research, La Trobe University, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - Fujian Song
- Norwich Medical School, University of East Anglia, UK
| | - Xiaoxv Yin
- Department of Social Medicine and Health Management, Huazhong University of Science and Technology, China
| | - Liwu Chen
- Center for Health Policy Analysis and Rural Health Research, University of Nebraska Medical Center, USA
| | - Wenning Fu
- Department of Social Medicine and Health Management, Huazhong University of Science and Technology, China
| | - Xiaojun Wang
- Department of Social Medicine and Health Management, Huazhong University of Science and Technology, China
| | - Wenzhen Li
- Department of Social Medicine and Health Management, Huazhong University of Science and Technology, China
| | - Chang Shu
- Administration of Surgery Office, Huazhong University of Science and Technology, China
| | - Sai Hu
- Department of Social Medicine and Health Management, Huazhong University of Science and Technology, China
| | - Chao Wang
- Department of Social Medicine and Health Management, Huazhong University of Science and Technology, China
| | - Wei Yue
- Department of Neurology, Tianjin Huanhu Hospital, China
| | - Feng Yan
- Department of Neurosurgery, Xuanwu Hospital, China
| | - Longde Wang
- National Health Commission of the People's Republic of China, China
| | - Chuanzhu Lv
- Department of Emergency, The Second Affiliated Hospital of Hainan Medical University, China.,Emergency and Trauma College, Hainan Medical University, China
| | - Zhihong Wang
- Department of Neurosurgery, Shenzhen Second People's Hospital, China
| | - Zuxun Lu
- Department of Social Medicine and Health Management, Huazhong University of Science and Technology, China
| |
Collapse
|
5
|
Türk Börü Ü, Kulualp AŞ, Tarhan ÖF, Bölük C, Duman A, Zeytin Demiral G, Güçlü Altun İ, Taşdemir M. Stroke prevalence among the Turkish population in a rural area of Istanbul: A community-based study. SAGE Open Med 2018; 6:2050312118797565. [PMID: 30202524 PMCID: PMC6122242 DOI: 10.1177/2050312118797565] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 08/07/2018] [Indexed: 12/22/2022] Open
Abstract
Background The population-based information on the prevalence of stroke from rural areas of Middle East countries including Turkey is unknown. Our aim is to evaluate the prevalence of stroke in those ⩾18 years in the Turkish population in a rural area of Istanbul. Methods A cross-sectional door-to-door study was conducted in a rural area of Istanbul between 1 March and 30 March 2013. A research protocol recommended by World Health Organization for developing countries was used. Each screening teams consisted of one neurologist, one local nurse, and five surveyors. Teams were trained about the survey and questionnaire. The patients, who claimed to have suffered a stroke, were examined, and the diagnosis was confirmed by a neurologist on site. The findings and medical records were documented. Results In total, 2906 people ⩾18 years were screened. 50 stroke cases were detected. 80% of those were found to have had an ischemic stroke, 14% of those were hemorrhagic cases, and 6% of those had an unclassified stroke type. The overall prevalence rate in those ⩾ 18 years was 1.7%. The male/female ratio was 0.92. Young (<45) stroke prevalence was found to be 0.6%. Conclusion This study was the first of its kind to show the stroke prevalence among Turkish population ⩾ 18 years in a rural area of Istanbul. When compared to other studies which investigate people ⩾45 years from Turkey, the result (in the same age group) was moderate high. The male/female ratio was low compared to many other studies.
Collapse
Affiliation(s)
- Ülkü Türk Börü
- Department of Neurology, Dr. Lütfi Kırdar Kartal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | | | - Ömer Faruk Tarhan
- Department of Neurology, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Cem Bölük
- Department of Neurology, Dr. Lütfi Kırdar Kartal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Arda Duman
- Department of Neurology, Maltepe State Hospital, Istanbul, Turkey
| | | | - İlknur Güçlü Altun
- Department of Neurology, Dr. Lütfi Kırdar Kartal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Mustafa Taşdemir
- Department of Public Health, Istanbul Medeniyet University, Istanbul, Turkey
| |
Collapse
|
6
|
Argüeso-Armesto RM, Pérez-Castro TR, Díaz-Díaz JL, Rodríguez-González A, Ameneiros-Lago ME, Del Alamo-Alonso A, de Toro-Santos JM, Fernández-Catalina PÁ, Pena-Seijo M, Díaz-Peromingo JA, Pose-Reino A, Názara-Otero CA, Vázquez-Freire MR, Escobar-Seoane L, Gordo-Fraile P, Castellanos-Rodríguez MDM, Rodríguez-Fernández JÁ, Muñiz J. Rationale, design and preliminary results of the GALIPEMIAS study (prevalence and lipid control of familial dyslipidemia in Galicia, northwest Spain). Int J Clin Pract 2018; 72:e13243. [PMID: 33685033 DOI: 10.1111/ijcp.13243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 07/15/2018] [Indexed: 11/29/2022] Open
Abstract
AIMS There is little information on the familial nature of dyslipidemias in the Spanish population. This knowledge could have potential diagnostic and treatment implications. The objective of the GALIPEMIAS study was to determine the prevalence of familial dyslipidemia in Galicia, as well as determine the degree of lipid control in the participants. Prevalence of atherosclerotic cardiovascular disease (ASCVD) was also estimated. This paper presents the design, methodology and selected preliminary results. METHODOLOGY A cross-sectional study was performed in the population aged ≥18 years using cluster sampling and then random sampling. A sample of 1000 subjects was calculated and divided into three sequential phases with a specific methodology for each one. Phase I: selection of subjects from the general population and collection of informed consent documents; Phase II: collection of data from the digital clinical history to select subjects with dyslipidemia according to study criteria; Phase III: personal interview, blood analysis, family tree, and definitive diagnosis of dyslipidemia. Prevalence of different diseases and active medication was analysed. Corrected prevalence (to the reference population) of different risk factors and ASCVD was estimated. RESULTS Phase I participation was 89.5%. We extracted complete information from 93% of the participants (Phase II). According to the study's own criteria, 56.5% (n = 527) of the participants had some form of dyslipidemia and almost 33.7% of them had familial dyslipidemia with autosomal dominant inherit pattern. The corrected prevalence of ASCVD was 5.1% (95% CI 3.1-7.2). CONCLUSIONS Dyslipidemia was the most prevalent cardiovascular risk factor in our population with an autosomal dominant inheritance pattern in one out of every three dyslipidemia cases. Approximately, 5.1% of the sample population aged ≥18 has suffered an episode of ACVD.
Collapse
Affiliation(s)
| | - Teresa-Rosalia Pérez-Castro
- Universidade da Coruña, Grupo de Investigación Cardiovascular (GRINCAR), Instituto Universitario de Ciencias de la Salud e Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain
| | - José Luis Díaz-Díaz
- Servicio Galego de Saúde, Servicio de Medicina Interna, Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - Avelino Rodríguez-González
- Servicio Galego de Saúde, Servicio de Medicina Interna, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, Spain
| | | | | | - José Manuel de Toro-Santos
- Servicio Galego de Saúde, Servicio de Medicina Interna, Complexo Hospitalario Universitario de Ourense, Ourense, Spain
| | | | - Marta Pena-Seijo
- Servicio Galego de Saúde, Santiago de Compostela, A Coruña, Spain
| | - Jose Antonio Díaz-Peromingo
- Servicio Galego de Saúde, Medicina Interna, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, A Coruña, Spain
| | - Antonio Pose-Reino
- Servicio Galego de Saúde, Medicina Interna, Complexo Hospitalario de Santiago, Santiago de Compostela, A Coruña, Spain
| | | | | | | | - Pedro Gordo-Fraile
- Servicio Galego de Saúde, Medicina Interna, Hospital da Costa, Burela, Lugo, Spain
| | | | | | - Javier Muñiz
- Universidade da Coruña, Grupo de Investigación Cardiovascular (GRINCAR), Instituto Universitario de Ciencias de la Salud e Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain
| |
Collapse
|
7
|
Köseoğlu Toksoy C, Bölük C, Türk Börü Ü, Akın S, Yılmaz AY, Coşkun Duman S, Taşdemir M. Stroke Prevalence in a Coastal Town on the Black Sea Coast in Turkey: Community Based Study. Neurol Res Int 2018; 2018:8246123. [PMID: 30057814 PMCID: PMC6051058 DOI: 10.1155/2018/8246123] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 05/29/2018] [Accepted: 06/10/2018] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND This study aims to determine the stroke prevalence in Akçakoca which is a rural area in Turkey. METHODS The study was designed as a cross-sectional, door-to-door survey. The stroke questionnaire was completed by a trained team in the presence of the participants according to their answers. Based on the screenings, patients who had been diagnosed with stroke previously were reexamined by a neurologist and determined the prevalence values, risk factors, and stroke types. RESULTS A total of 3750 people over 44 years old were reached in the screenings. It was determined that 83 people had previously suffered a stroke. The prevalence rate of stroke in those above 44 years was found to be 2.2 (98% confidence level and ± 2% margin of error). 70 (84.3%) patients had suffered an ischemic stroke while 12 (14.5%) had suffered a hemorrhagic stroke. Male/female ratio was 1.1. CONCLUSION The results of this study give the prevalence rate of stroke among the Turkish population living in a rural area. Due to a lack of other similar studies, it is impossible to make any data comparison. However, the results of this study help shed light on the stroke prevalence rate.
Collapse
Affiliation(s)
- Cansu Köseoğlu Toksoy
- Gaziosmanpaşa Taksim Training and Research Hospital, Department of Neurology, Istanbul, Turkey
| | - Cem Bölük
- University of Health Sciences, Dr. Lütfi Kırdar Kartal Training and Research Hospital, Department of Neurology, Istanbul, Turkey
| | - Ülkü Türk Börü
- University of Health Sciences, Dr. Lütfi Kırdar Kartal Training and Research Hospital, Department of Neurology, Istanbul, Turkey
| | - Seydahmet Akın
- University of Health Sciences, Dr. Lütfi Kırdar Kartal Training and Research Hospital, Department of Internal Medicine, Istanbul, Turkey
| | | | - Sanem Coşkun Duman
- University of Health Sciences, Dr. Lütfi Kırdar Kartal Training and Research Hospital, Department of Neurology, Istanbul, Turkey
| | - Mustafa Taşdemir
- Istanbul Medeniyet University, Department of Public Health, Istanbul, Turkey
| |
Collapse
|
8
|
Padir Şensöz N, Türk Börü Ü, Bölük C, Bilgiç A, Öztop Çakmak Ö, Duman A, Taşdemir M. Stroke epidemiology in Karabük city Turkey: Community based study. eNeurologicalSci 2017; 10:12-15. [PMID: 29736423 PMCID: PMC5933997 DOI: 10.1016/j.ensci.2017.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 12/20/2017] [Indexed: 11/30/2022] Open
Abstract
Introduction Stroke has been projected to increase in developing countries like Turkey. Information about the prevalence of stroke may uncover the etiology of stroke and overcome its impact burden. However, data is limited due to a lack of studies based in Turkey and neighboring regions. We aimed to investigate the prevalence and risk factors of stroke in the Turkish city of Karabük and to pave the way for future epidemiological studies in Turkey. Methods The study was designed as a cross-sectional, door-to-door survey. The questionnaire was completed by a trained team in the presence of the participants according to their answers. Patients who had been diagnosed with stroke prior to the survey were re-examined by a neurologist. Results 3131 persons who were above 44 years old were screened. 129 of them were found to have had a stroke previously. The prevalence rate of stroke above 44 years was found to be 4.12% (98% confidence level and ± 2% margin of error). 72.1% of stroke patients had hypertension. Male/female ratio was 0.72. Conclusion This study showed a high prevalence rate of stroke in Karabük Turkey with a low male/female ratio when compared to other studies.
Collapse
Affiliation(s)
- Nilay Padir Şensöz
- University of Health Sciences, Dr. Lütfi Kırdar Kartal Research and Training Hospital, Department of Neurology, Istanbul, Turkey
| | - Ülkü Türk Börü
- University of Health Sciences, Dr. Lütfi Kırdar Kartal Research and Training Hospital, Department of Neurology, Istanbul, Turkey
| | - Cem Bölük
- University of Health Sciences, Dr. Lütfi Kırdar Kartal Research and Training Hospital, Department of Neurology, Istanbul, Turkey
| | - Adnan Bilgiç
- Eregli State Hospital, Department of Neurology, Eregli, Turkey
| | | | - Arda Duman
- Maltepe State Hospital, Department of Neurology, Istanbul, Turkey
| | - Mustafa Taşdemir
- Istanbul Medeniyet University, Department of Public Health, Istanbul, Turkey
| |
Collapse
|
9
|
Gan Y, Wu J, Zhang S, Li L, Yin X, Gong Y, Herath C, Mkandawire N, Zhou Y, Song X, Zeng X, Li W, Liu Q, Shu C, Wang Z, Lu Z. Prevalence and risk factors associated with stroke in middle-aged and older Chinese: A community-based cross-sectional study. Sci Rep 2017; 7:9501. [PMID: 28842623 PMCID: PMC5572736 DOI: 10.1038/s41598-017-09849-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 08/01/2017] [Indexed: 11/09/2022] Open
Abstract
Although the prevalence of stroke and its risk factors has been widely reported in some Western countries, information on essential stroke parameters is lacking in China, the most populous nation. A community-based cross-sectional study with 8,018 Chinese adults aged ≥40 years was used to determine the prevalence of stroke and associated risk factors. Within the screened population, the prevalence of stroke was 2.21% for both sexes, 1.60% for females, and 3.18% for males. Prevalence increased with age in both sexes (P < 0.0001). In a multivariable model, factors significantly associated with stroke were increasing age (odds ratio [OR] = 1.87, 95% CI: 1.58-2.24), male gender (OR = 2.03, 95% CI: 1.42-2.90), family history of stroke (OR = 4.33, 95% CI: 2.89-6.49), history of hyperlipidemia (OR = 1.87, 95% CI 1.31-2.68), history of hypertension (OR = 1.47, 95% CI 1.02-2.12), and physical inactivity (OR = 1.74, 95% CI: 1.16-2.59). The findings indicate that stroke prevalence in middle-aged and older Chinese adults is higher in males than in females, and increases with age in both sexes. Population-based public health intervention programs and policies targeting hyperlipidemia and hypertension control and encouragement of physical activity should be highly prioritized for middle-aged and older adults in Shenzhen, China.
Collapse
Affiliation(s)
- Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jiang Wu
- Bao'an Central Hospital of Shenzhen, Shenzhen, Guangdong, China
| | - Shengchao Zhang
- Bao'an Central Hospital of Shenzhen, Shenzhen, Guangdong, China
| | - Liqing Li
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Department of Management, School of Economics and Management, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China
| | - Xiaoxv Yin
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yanhong Gong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chulani Herath
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Naomie Mkandawire
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yanfeng Zhou
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xingyue Song
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaozhou Zeng
- Bao'an Central Hospital of Shenzhen, Shenzhen, Guangdong, China
| | - Wenzhen Li
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qiaoyan Liu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chang Shu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhihong Wang
- Department of Neurosurgery, Shenzhen Second People's Hospital, Shenzhen University, Shenzhen, Guangdong, China.
| | - Zuxun Lu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| |
Collapse
|
10
|
Almazán-Isla J, Comín-Comín M, Alcalde-Cabero E, Ruiz C, Franco E, Magallón R, Damián J, de Pedro-Cuesta J, Larrosa-Montañes LA. Disability, support and long-term social care of an elderly Spanish population, 2008-2009: an epidemiologic analysis. Int J Equity Health 2017; 16:4. [PMID: 28068988 PMCID: PMC5223489 DOI: 10.1186/s12939-016-0498-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 12/12/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Though poorly known, relationships between disability, need of help (dependency) and use of social services are crucial aspects of public health. The objective of this study was to describe the links between disability, officially assessed dependency, and social service use by an industrial population, and identify areas of inequity. METHODS We took advantage of a door-to-door survey conducted in the Cinco Villas district, Spain, in 2008-2009, which provided data on disability, morbidity, and service use among 1216 residents aged ≥50 years, and officially assessed dependency under the 2006 Dependency Act (OAD). Using logistic regression, we combined data collected at homes/residences on 625 disability screened-positive participants, and administrative information on degree of OAD and benefits at date of visit. RESULTS Based on 163 disabled persons, the prevalence of residential/community-care users was 13.4% overall, with 6.0% being market-provided, 2.5% supported by the 2006 Act, and 4.9% supported by other public funds. Of 111 OAD applicants, 30 had been assigned an OAD degree; in 29 cases this was the highest OAD degree, with 12 receiving direct support for residential care and 17 receiving home care. Compared to unassessed dependency, the highest OAD degree was linked to residential care (OR and 95% CI) 12.13 (3.86-38.16), declared non-professional care 10.99 (1.28-94.53), and publicly-funded, non-professional care 26.30 (3.36-205.88). In contrast, 43 persons, 58% of the severely/extremely disabled, community-dwelling sample population, 81% of whom were homebound, including 10 persons with OAD but no implemented service plan, made no use of any service, and of these, 40% lacked a non-professional carer. CONCLUSIONS Formal service use in the Cinco Villas district attained ratios observed for established welfare systems but the publicly-funded proportion was lower. The 2006 Act had a modest, albeit significant, impact on support for non-professional carers and residential care, coexisting with a high prevalence of non-use of social services by severely disabled persons.
Collapse
Affiliation(s)
- J Almazán-Isla
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Neurodegenerative Diseases (Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas - CIBERNED), Ministry of Science and Innovation, Madrid, Spain
| | - M Comín-Comín
- School of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - E Alcalde-Cabero
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Neurodegenerative Diseases (Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas - CIBERNED), Ministry of Science and Innovation, Madrid, Spain
| | - C Ruiz
- School of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - E Franco
- School of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - R Magallón
- School of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - J Damián
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Neurodegenerative Diseases (Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas - CIBERNED), Ministry of Science and Innovation, Madrid, Spain
| | - J de Pedro-Cuesta
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain. .,Consortium for Biomedical Research in Neurodegenerative Diseases (Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas - CIBERNED), Ministry of Science and Innovation, Madrid, Spain.
| | - L A Larrosa-Montañes
- Department of Social Services and Family, Aragon Regional Authority, Zaragoza, Spain
| | | |
Collapse
|
11
|
Brea A, Laclaustra M, Martorell E, Pedragosa A. [Epidemiology of cerebrovascular disease in Spain]. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS 2013; 25:211-7. [PMID: 24238835 DOI: 10.1016/j.arteri.2013.10.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 10/23/2013] [Indexed: 11/17/2022]
Abstract
In Spain, cerebrovascular disease (CVD) is a very common cause of morbidity and hospitalization. They are the second leading cause of mortality in the general population, and the first in women. They also constitute a very high social spending, which is estimated to increase in coming years, due to the aging of our population. Data from the Hospital Morbidity Survey of the National Statistics Institute recorded, in 2011, 116,017 strokes and 14,933 transient ischemic attacks, corresponding, respectively, to an incidence of 252 and 32 events per 100,000 people. In 2002, the cost of hospitalization for each stroke was estimated at €3,047. The amount of total cost health care throughout the life of a stroke patient is calculated at €43,129. Internationally, the direct costs of stroke constitute 3% of national health spending, this being similar amount in different countries around us. Hypertension was the cardiovascular risk factor (CVRF) more prevalent in both ischemic and hemorrhagic strokes, followed by dyslipidemia and diabetes mellitus. Peripheral arterial disease and hypertension were more frequently associated with atherothrombotic events, atrial fibrillation with cardioembolic strokes, and obesity and high blood pressure to lacunar infarcts. In Spain, as showing several studies, we are far from optimal control of CVRF, especially in secondary prevention of stroke. According to the ICTUSCARE study, achieving recommended values was 17.6% in the case of hypertension, 29.8% in LDL-cholesterol, 74.9% of smoking, and 50.2% in diabetes mellitus. In this review, we analyze in detail the epidemiology, prevention and costs originated by CVD.
Collapse
Affiliation(s)
- Angel Brea
- Unidad de Lípidos, Servicio de Medicina Interna, Hospital San Pedro, Logroño, España.
| | - Martín Laclaustra
- Departamento de Epidemiología, Aterotrombosis e Imagen, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, España
| | | | - Angels Pedragosa
- Servei d'Urgències Mèdiques, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, España
| |
Collapse
|
12
|
Almazán-Isla J, Comín-Comín M, Damián J, Alcalde-Cabero E, Ruiz C, Franco E, Martín G, Larrosa-Montañés LA, de Pedro-Cuesta J. Analysis of disability using WHODAS 2.0 among the middle-aged and elderly in Cinco Villas, Spain. Disabil Health J 2013; 7:78-87. [PMID: 24411511 DOI: 10.1016/j.dhjo.2013.08.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 08/06/2013] [Accepted: 08/11/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND The prevalence of disability, as defined by the International Classification of Functioning, Disability and Health (ICF), among the middle-aged and elderly population is poorly known. OBJECTIVE To determine disability prevalence in a resident population sample aged ≥50 years, in the Cinco Villas district, Spain, from June 2008 through June 2009. METHODS We used the WHODAS 2.0 36-item questionnaire to quantify the prevalence of disability, globally and by domain, together with a 13-item combined measure of three domains, Getting around, Self-care and Life activities, claimed to reflect the need of integrated services. In addition, we performed exploratory analyses of the relationship between disability and different variables using ordinal logistic regression. RESULTS Disability was detected by global WHODAS score in 604 of a total of 1214 persons, i.e., a prevalence of 49.8% 95% CI (46.9-52.5), with the corresponding figures for mild, moderate, severe, and extreme disability being 26.8%, 16.0%, 7.6% and 0.1%, respectively. Disability increased with age, was higher among women, and for specific domains. Prevalence of severe/extreme disability among women vs. men was as follows: Getting around, 26.8% vs. 12.1%; Life activities, 25.2% vs. 6.8%; and Self-care, 9.5% vs. 6.0%. Disability was more frequent among subjects diagnosed with dementia, chronic liver disease, severe mental disease, and stroke. The abovementioned 13-item measure yielded prevalence figures for disability levels quite similar to those obtained using 36-item scores. CONCLUSIONS For the first time, this study furnishes detailed disability prevalence figures and data on associated variables in a middle-aged and elderly Western population.
Collapse
Affiliation(s)
- J Almazán-Isla
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Neurodegenerative Diseases (Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas - CIBERNED), Ministry of Science and Innovation, Madrid, Spain
| | - M Comín-Comín
- School of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - J Damián
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Neurodegenerative Diseases (Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas - CIBERNED), Ministry of Science and Innovation, Madrid, Spain
| | - E Alcalde-Cabero
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Neurodegenerative Diseases (Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas - CIBERNED), Ministry of Science and Innovation, Madrid, Spain
| | - C Ruiz
- School of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - E Franco
- School of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - G Martín
- School of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - L A Larrosa-Montañés
- Department of Social Services and Family, Aragon Regional Authority, Zaragoza, Spain
| | - J de Pedro-Cuesta
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Neurodegenerative Diseases (Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas - CIBERNED), Ministry of Science and Innovation, Madrid, Spain.
| | | |
Collapse
|
13
|
Oncel C, Tokgöz F, Bozkurt AI, Erdoğan C. Prevalence of cerebrovascular disease: a door-to-door survey in West Anatolia. Neurol Sci 2013; 35:373-7. [PMID: 23975522 DOI: 10.1007/s10072-013-1521-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 08/07/2013] [Indexed: 01/06/2023]
Abstract
The aim of this study was to demonstrate the prevalence of cerebrovascular disease (CVD), and its relation to age, education, gender, and other risk factors in the city of Denizli, Turkey. The study was performed between 2010 and 2011 in the city center, where 138,000 inhabitants >45 years were included in the research. 2,441 inhabitants were selected by cluster sampling method. A specific questionnaire about CVD was employed during the interview. We inquired about patient's age, gender, and educational history. If there was suspicion of CVD, cranial imaging was performed, and recent medical records were re-evaluated. The mean age was 58 ± 10.1 (45-100) among 2,441 in this study. Of those, 1,257 (51.5 %) participants were female and 1,184 (48.5 %) were male. We found the prevalence of CVD to be 0.9 % with 0.68 % among males and 1.21 % among females (p = 0.023). The mean age of subjects with CVD was 72.4 ± 8.1 (56-86) years. CVD was found to increase with age (p = 0.001), but was lower than reported rates in other European countries; however, it was similar to that of Mediterranean countries. CVD was detected more frequently in women than men. This finding differed from other studies, but was first to evaluate the prevalence of CVD in Turkey.
Collapse
Affiliation(s)
- Cağatay Oncel
- Department of Neurology, Pamukkale University Medical Faculty, Denizli, Turkey,
| | | | | | | |
Collapse
|
14
|
Prevalence and risk factors for stroke in an adult population in a rural community in the Niger Delta, south-south Nigeria. J Stroke Cerebrovasc Dis 2013; 23:505-10. [PMID: 23721622 DOI: 10.1016/j.jstrokecerebrovasdis.2013.04.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 04/10/2013] [Indexed: 11/21/2022] Open
Abstract
Sub-Saharan Africa is experiencing an epidemiologic transition with stroke contributing to the disease burden. However, community-based stroke prevalence studies are sparse. This study aimed to determine the prevalence of stroke in a rural population in the Niger Delta region in south-south Nigeria and to describe known risk factors for stroke among them. A door-to-door stroke prevalence study was conducted in 2008 among randomly selected adults of 18 years or older in rural Kegbara-Dere community in Rivers State, south-south Nigeria. We administered a modified screening tool by the World Health Organization, a stroke-specific questionnaire, and conducted a physical/neurological examination (on persons screening positive) in 3 stages of assessments. The crude prevalence of stroke was 8.51/1000 (95% confidence interval [CI] = 3.9-16.1) representing 9 of 1057 participants. The age-adjusted prevalence was 12.3/1000 using the US Population 2000. Men had higher unadjusted prevalence than women (12.9/1000 versus 5.1/1000) but were not at more risk (unadjusted relative risk = .99; 95% CI = .98-1.00). Stroke prevalence increased with age (Mantel-Haenszel χ(2) P = .00). Hypertension (blood pressure ≥140/90 mm Hg) was present in all stroke cases and diabetes mellitus (fasting blood sugar >126 mg/dL) in 1 person, but none had hypercholesterolemia, obesity (body mass index >30 kg/m(2)), or a history of alcohol intake or smoking. Stroke prevalence was found to be high, commoner among men and the elderly population, and likely to be predisposed by hypertension, in rural south-south Nigeria. The need to conduct follow-up studies on the burden and outcomes of stroke among this study population is acknowledged.
Collapse
|
15
|
Casado A, Secades JJ, Ibarz R, Herdman M, Brosa M. Cost-effectiveness of citicoline versus conventional treatment in acute ischemic stroke. Expert Rev Pharmacoecon Outcomes Res 2012; 8:151-7. [PMID: 20528404 DOI: 10.1586/14737167.8.2.151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In the framework of an integral assessment (effectiveness and cost) of the use of neuroprotection in stroke, a cost-effectiveness study was conducted to compare the potential advantages of citicoline with conventional therapy (without neuroprotection or placebo) in patients with acute ischemic stroke. The literature was searched for systematic reviews and meta-analyses evaluating the effectiveness of citicoline versus placebo in the hospital setting and during 12 weeks after discharge from hospital. Data on the use of resources were obtained from a panel of experts of four acute-care teaching hospitals in Spain. The study was performed from the perspective of the Spanish National Health System. Two meta-analyses were included (Cochrane Stroke Review Group and a pooling analysis). Treatment with citicoline resulted in 99 or 50 more patients recovered per 1000 patients treated (depending on selection criteria of the Cochrane study and the pooled analysis), with average cost savings between euro101.2 and euro126.4 per patient treated of the type of those included in the Cochrane study. In patients with acute ischemic stroke, treatment with placebo was more expensive and less effective in the scenarios of inpatient care and inpatient plus outpatient care after discharge from the hospital.
Collapse
|
16
|
Clua-Espuny JL, Piñol-Moreso JL, Panisello-Tafalla A, Lucas-Noll J, Gil-Guillen VF, Orozco-Beltran D, Queralt-Tomas ML. [Ebrictus study. Functional results, survival, and potential years of life lost after the first stroke]. Aten Primaria 2012; 44:223-31. [PMID: 21959094 PMCID: PMC7025231 DOI: 10.1016/j.aprim.2011.04.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Revised: 03/30/2011] [Accepted: 04/04/2011] [Indexed: 11/21/2022] Open
Abstract
AIM To determine the mortality, degree of dependence, survival, and years of life lost (YLL) after first episode of stroke. DESIGN Cohort study. LOCATION Community based register. PARTICIPANTS A total of 553 subjects between 15-90 years with a first episode of definitive or transitory stroke were recruited between 01/04/2006 and 31/03/2008. MEASUREMENTS The analyses were performed with the use of time-to-event methods, according to the intention-to-treat principle. The level of dependency was assessed according to the Barthel Scale one year after stroke; YLL (1-70 years) from the mean life expectancies at birth; survival analysis by Kaplan-Meier's curves, bivariate analysis comparing the variables between patients who had survived and those who died, and Cox's multivariate. RESULTS The mean age was 73.3 (±11.6 years. The mean time of follow-up was 29.7 ± 13,4 months, during which 26.6% of the patients died. The mean Barthel score fell by >20%, particularly among women. There was moderate or greater dependence in 41.5% (95%CI 30.6-52.8%) of the subjects. The overall accumulative probability of survival was 0.96 (95% CI 0.94-0.97) in the first month and 0.69 (95% CI 0.65-0.72) in the fourth year. The thrombolytic treatment showed a protective effect on mortality, particularly among the women. The main predictive variables were, history of recurrent cardiovascular event (RR 6.7, 95% CI 2.2-21.7) and aging (RR 1.08, 95% CI 1.01-1.2). The average YLL was 11.5/10000/year SD7.2, and higher among men. CONCLUSION There are differences in functional outcome, mortality, and potential years of life lost by gender. A new cardiovascular event is an independent prognostic factor of survival.
Collapse
Affiliation(s)
- J L Clua-Espuny
- Especialista en Medicina de Familia y Comunitaria, Equipo de Atención Primaria Tortosa, Servicio de Atención Primaria Terres de l'Ebre, Institut Català de la Salut, España.
| | | | | | | | | | | | | |
Collapse
|
17
|
Abe IM, Lotufo PA, Goulart AC, Benseñor IM. Stroke Prevalence in a Poor Neighbourhood of SãO Paulo, Brazil: Applying a Stroke Symptom Questionnaire. Int J Stroke 2011; 6:33-9. [DOI: 10.1111/j.1747-4949.2010.00538.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background Brazil has one of the highest stroke mortality rates in the world, these rates are most endemic in the poor. We verified the prevalence of stroke in a deprived neighbourhood in the city of São Paulo, Brazil and compared it with other surveys worldwide. Methods A questionnaire with six questions concerning limb and facial weakness, articulation, sensory disturbances, impaired vision, and past diagnosis of stroke was completed door-to-door in a well-defined area of 15 000 people. Questionnaires were considered positive when a participant answered two or more questions about stroke symptoms or the presence of stroke being confirmed by a physician, or at least three questions in the positive, even if not confirmed by a doctor. Results Of the 4496 individuals over 35-years old living in the area, 243 initially screened positive for stroke. The age-adjusted prevalence rate for men was 4·6% (95% confidence interval 3·5–5·7). For women, the prevalence rate was 6·5% (95% confidence interval 5·5–7·5); when considering only one question, the rate was 4·8% (95% confidence interval 3·9–5·7). The most commonly reported symptoms were limb weakness and sensory disturbances. Hypertension and heart disease were the conditions most commonly associated with previous stroke. Conclusion Stroke prevalence rates were higher in this poor neighbourhood compared with other surveys.
Collapse
Affiliation(s)
- Ivana M. Abe
- School of Medicine, University of São Paulo, Sao Paulo, Brazil
| | - Paulo A. Lotufo
- School of Medicine, University of São Paulo, Sao Paulo, Brazil
- Hospital Universitário, University of São Paulo, Sao Paulo, Brazil
| | - Alessandra C. Goulart
- Hospital Universitário, University of São Paulo, Sao Paulo, Brazil
- Hospital das Clínicas, University of São Paulo, Sao Paulo, Brazil
| | - Isabela M. Benseñor
- School of Medicine, University of São Paulo, Sao Paulo, Brazil
- Hospital Universitário, University of São Paulo, Sao Paulo, Brazil
- Hospital das Clínicas, University of São Paulo, Sao Paulo, Brazil
| |
Collapse
|
18
|
|
19
|
Murie-Fernández M, Irimia P, Martínez-Vila E, John Meyer M, Teasell R. Neuro-rehabilitation after stroke. NEUROLOGÍA (ENGLISH EDITION) 2010. [DOI: 10.1016/s2173-5808(10)70036-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
|
20
|
Alzamora MT, Forés R, Baena-Díez JM, Pera G, Toran P, Sorribes M, Vicheto M, Reina MD, Sancho A, Albaladejo C, Llussà J. The peripheral arterial disease study (PERART/ARTPER): prevalence and risk factors in the general population. BMC Public Health 2010; 10:38. [PMID: 20529387 PMCID: PMC2835682 DOI: 10.1186/1471-2458-10-38] [Citation(s) in RCA: 132] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2009] [Accepted: 01/27/2010] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The early diagnosis of atherosclerotic disease is essential for developing preventive strategies in populations at high risk and acting when the disease is still asymptomatic. A low ankle-arm index is a good marker of vascular events and may be diminished without presenting symptomatology (silent peripheral arterial disease). The aim of the study is to know the prevalence and associated risk factors of peripheral arterial disease in the general population. METHODS We performed a cross-sectional, multicentre, population-based study in 3786 individuals >49 years, randomly selected in 28 primary care centres in Barcelona (Spain). Peripheral arterial disease was evaluated using the ankle-arm index. Values < 0.9 were considered as peripheral arterial disease. RESULTS The prevalence (95% confidence interval) of peripheral arterial disease was 7.6% (6.7-8.4), (males 10.2% (9.2-11.2), females 5.3% (4.6-6.0); p < 0.001).Multivariate analysis showed the following risk factors: male sex [odds ratio (OR) 1.62; 95% confidence interval 1.01-2.59]; age OR 2.00 per 10 years (1.64-2.44); inability to perform physical activity [OR 1.77 (1.17-2.68) for mild limitation to OR 7.08 (2.61-19.16) for breathless performing any activity]; smoking [OR 2.19 (1.34-3.58) for former smokers and OR 3.83 (2.23-6.58) for current smokers]; hypertension OR 1.85 (1.29-2.65); diabetes OR 2.01 (1.42-2.83); previous cardiovascular disease OR 2.19 (1.52-3.15); hypercholesterolemia OR 1.55 (1.11-2.18); hypertriglyceridemia OR 1.55 (1.10-2.19). Body mass index > or =25 Kg/m2 OR 0.57 (0.38-0.87) and walking >7 hours/week OR 0.67 (0.49-0.94) were found as protector factors. CONCLUSIONS The prevalence of peripheral arterial disease is low, higher in males and increases with age in both sexes. In addition to previously described risk factors we found a protector effect in physical exercise and overweight.
Collapse
Affiliation(s)
- María Teresa Alzamora
- Primary Healthcare Centre Riu Nord-Riu Sud, Institut Català de Salut, Santa Coloma de Gramenet, Spain.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Bermejo Pareja F, Martínez Salio A, Díaz-Guzmán J. [Information about vascular diseases (cardiac and cerebral) in Spain]. Med Clin (Barc) 2009; 133:683-4. [PMID: 19361815 DOI: 10.1016/j.medcli.2008.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2008] [Accepted: 11/11/2008] [Indexed: 11/26/2022]
|
22
|
Abstract
BACKGROUND AND PURPOSE Epidemiological studies, mainly based on Western European surveys, have shown that stroke is more common in men than in women. In recent years, sex-specific data on stroke incidence, prevalence, subtypes, severity and case-fatality have become available from other parts of the world. The purpose of this article is to give a worldwide review on sex differences in stroke epidemiology. METHODS We searched PubMed, tables-of-contents, review articles, and reference lists for community-based studies including information on sex differences. In some areas, such as secular trends, ischemic subtypes and stroke severity, noncommunity-based studies were also reviewed. Male/female ratios were calculated. RESULTS We found 98 articles that contained relevant sex-specific information, including 59 incidence studies from 19 countries and 5 continents. The mean age at first-ever stroke was 68.6 years among men, and 72.9 years among women. Male stroke incidence rate was 33% higher and stroke prevalence was 41% higher than the female, with large variations between age bands and between populations. The incidence rates of brain infarction and intracerebral hemorrhage were higher among men, whereas the rate of subarachnoidal hemorrhage was higher among women, although this difference was not statistically significant. Stroke tended to be more severe in women, with a 1-month case fatality of 24.7% compared with 19.7% for men. CONCLUSIONS Worldwide, stroke is more common among men, but women are more severely ill. The mismatch between the sexes is larger than previously described.
Collapse
Affiliation(s)
- Peter Appelros
- Department of Neurology, Orebro University Hospital, Orebro, Sweden.
| | | | | |
Collapse
|
23
|
Stroke in Spain: Epidemiologic Incidence and Patterns; A Health Sentinel Network Study. J Stroke Cerebrovasc Dis 2009; 18:11-6. [DOI: 10.1016/j.jstrokecerebrovasdis.2008.06.010] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2008] [Revised: 05/19/2008] [Accepted: 06/09/2008] [Indexed: 11/20/2022] Open
|
24
|
Rodríguez-Artalejo F, Guallar-Castillón P, Villar Álvarez F, Banegas JR. Análisis crítico y propuestas de mejora de los sistemas de información sobre enfermedades cardiovasculares en España. Med Clin (Barc) 2008. [DOI: 10.1016/s0025-7753(08)72264-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
25
|
Danesi M, Okubadejo N, Ojini F. Prevalence of stroke in an urban, mixed-income community in Lagos, Nigeria. Neuroepidemiology 2007; 28:216-23. [PMID: 17851261 DOI: 10.1159/000108114] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The burden of cerebrovascular disease in developing countries is projected to be on the rise. However, data on the current epidemiology of stroke in Africa are sparse. METHODS Using a 3-staged method, we conducted a door-to-door study of stroke in an urban, mixed-income community in Lagos, Nigeria. We used a modification of the WHO protocol in the first stage, a stroke-specific questionnaire in the second stage and neurological examination of all persons screening positive for stroke in the third stage. We also examined an equal number of stroke-negative persons. RESULTS Overall, the crude prevalence rate of stroke in urban Nigeria was 1.14/1,000 (males: 1.51; females: 0.69). The age-adjusted prevalence rates per 1,000 (adjusted to the USA population 2000) in mid-decade strata showed a trend of increasing prevalence with advancing age as follows: 35-44 years = 0.009, 45-54 years = 0.33, 55-64 years = 0.71, 65-74 years = 0.98, 75-84 years = 2.04 and >85 years = 0.74. CONCLUSIONS Stroke prevalence rates in urban Nigeria are lower than those in most developed countries. The lower rates may be related to lower incidence and higher stroke mortality in developing countries.
Collapse
Affiliation(s)
- Mustapha Danesi
- Neurology Unit, Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria
| | | | | |
Collapse
|