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Misgana S, Asemahagn MA, Atnafu DD, Anagaw TF. Incidence of stroke and its predictors among hypertensive patients in Felege Hiwot comprehensive specialized hospital, Bahir Dar, Ethiopia, a retrospective follow-up study. Eur J Med Res 2023; 28:227. [PMID: 37430339 DOI: 10.1186/s40001-023-01192-6] [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: 09/01/2022] [Accepted: 06/23/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Globally, one in three adults has hypertension, a condition that causes 51% of all deaths from stroke. Stroke is becoming a major public health problem and the most common cause of morbidity and mortality among non-communicable diseases in the world and Ethiopia. Therefore, this study assesses the incidence of stroke and its predictors among hypertensive patients in Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Ethiopia 2021. METHODS A hospital-based retrospective follow-up study design was used, simple random sampling technique was used to select 583 hypertensive patients that had follow-up registration between January 2018 and December 30th, 2020. Data were entered into Epi-data version 3.1 and exported to STATA version 14. The adjusted hazard ratio for each predictor with a 95% confidence interval was calculated using the Cox proportional hazards regression model, and a P-value ≤ 0.05 was used to denote statistical significance. RESULTS From 583 hypertensive patients 106(18.18%) [95% CI 15-20] were developed stroke. The overall incidence rate was 1 per 100 person-years (95% CI 0.79-1.19). Comorbidities (Adjusted hazard ratio(AHR): 1.88, 95% CI 1.0-3.5), stage two hypertension (AHR = 5.21, 95%CI 2.75-9.8), uncontrolled systolic blood pressure (AHR: 2, 95% CI 1.21-354), uncontrolled diastolic blood pressure (AHR:1.9, 95% CI 1.1-3.57), alcohol consumption (AHR = 2.04, 95%CI 1.2-3.49), age 45-65 (AHR = 10.25, 95%CI 7.47-11.1); and drug discontinuation (AHR = 2.05,95% CI 1.26-3.35) were independent predictors for the incidence of stroke among hypertensive patients. CONCLUSION The incidence of stroke among hypertensive patients was high and various modifiable and non-modifiable risk factors highly contributed to its incidence. This study recommends early screening of blood pressure, giving priority to comorbid patients and patients with advanced stage hypertension, and giving health education about behavioral risks and drug adherence.
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Affiliation(s)
- Solomon Misgana
- Amhara Regional Health Beauro,Bahir Dar, Bahir Dar, Ethiopia
| | - Mulusew Andualem Asemahagn
- School of Public health, College of Medicine and Health Science Bahir Dar University, Bahir Dar, Ethiopia
| | - Desta Debalkie Atnafu
- Department of Health System Management and Health Economics, School of Public health, College of Medicine and Health Science Bahir Dar University, Bahir Dar, Ethiopia
| | - Tadele Fentabil Anagaw
- Department of Health Promotion and Behavioral Science, School of Public health, College of Medicine and Health Science Bahir Dar University, 079, Bahir Dar, Ethiopia.
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Kamal FZ, Lefter R, Jaber H, Balmus IM, Ciobica A, Iordache AC. The Role of Potential Oxidative Biomarkers in the Prognosis of Acute Ischemic Stroke and the Exploration of Antioxidants as Possible Preventive and Treatment Options. Int J Mol Sci 2023; 24:ijms24076389. [PMID: 37047362 PMCID: PMC10094154 DOI: 10.3390/ijms24076389] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/27/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023] Open
Abstract
Ischemic strokes occur when the blood supply to a part of the brain is interrupted or reduced due to arterial blockage, and it often leads to damage to brain cells or death. According to a myriad of experimental studies, oxidative stress is an important pathophysiological mechanism of ischemic stroke. In this narrative review, we aimed to identify how the alterations of oxidative stress biomarkers could suggest a severity-reflecting diagnosis of ischemic stroke and how these interactions may provide new molecular targets for neuroprotective therapies. We performed an eligibility criteria-based search on three main scientific databases. We found that patients with acute ischemic stroke are characterized by increased oxidative stress markers levels, such as the total antioxidant capacity, F2-isoprostanes, hydroxynonenal, total and perchloric acid oxygen radical absorbance capacity (ORACTOT and ORACPCA), malondialdehyde (MDA), myeloperoxidase, and urinary 8-oxo-7,8-dihydro-2′-deoxyguanosine. Thus, acute ischemic stroke is causing significant oxidative stress and associated molecular and cellular damage. The assessment of these molecular markers could be useful in diagnosing ischemic stroke, finding its causes, predicting its severity and outcomes, reducing its impact on the cellular structures of the brain, and guiding preventive treatment towards antioxidant-based therapy as novel therapeutic alternatives.
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Determinants of post-stroke depression among stroke survivors at University of Gondar Hospital, Northwest Ethiopia: a case-control study. BMC Neurol 2022; 22:446. [PMID: 36456908 PMCID: PMC9714110 DOI: 10.1186/s12883-022-02982-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 11/17/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Stroke is one of the most common causes of disability among adults. Post-stroke depression (PSD) is a frequent neuropsychiatric complication in stroke patients. Despite the increasing prevalence of stroke, there is a paucity of data on PSD and its determinants among stroke survivors in developing countries like Ethiopia. We aim to assess the factors associated with PSD in survivors of stroke. METHOD A hospital-based unmatched case-control study was conducted during the period of February to July 2020 at University of Gondar Hospital among stroke survivors. Study subjects were recruited consecutively. Socio-demographic and clinical data were obtained from patients' interviews and medical record reviews. A diagnosis of PSD was made using the Patient Health Questionnaire (PHQ-9). EpiData version 3.1 was used to enter data, and SPSS version 26 was used to analyze it. Bivariate and multivariate logistic regressions were fitted to identify associated variables. The adjusted odds ratio (AOR) with 95% confidence interval (CI) and p-value 0.05 were used to determine the significance of the association. RESULT A total of 240 stroke survivors were included in the study (80 cases and 160 controls). The mean age was 60.8 years (SD ± 14.3) with an equal sex distribution. Variables statistically associated with PSD were male gender (AOR = 3.5, 95% CI: 1.64-7.46 C, P-value = 0.001), subcortical location of the largest lesion (AOR = 2.42, 95% CI: 1.06-5.56, p-value = 0.036), severity of the stroke (AOR = 52.34, 95% CI:10.64-256.87, p-value = 0.000), physical disability (AOR = 5.85. 95% CI:1.94-17.65, p-value = 0.002), previous history of stroke or transient ischemic attack (AOR = 5.90, 95% CI:2.04-17.10, p-value = 0.001) and ischemic heart disease (AOR = 9.97, 95% CI:3.4-29.22, p-value = 0.000). CONCLUSION Important factors in the occurrence of PSD in this study include prior history of stroke, physical disability, severity of the stroke, subcortical location of the lesion, male gender, and ischemic heart disease. Stroke patients with such factors need routine screening for PSD, particularly in LMICs where there is uncoordinated post-stroke care, a shortage of neurologists and mental health practitioners.
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Masuku KP, Khumalo G, Shabangu N. The effects of COVID-19 on the rehabilitation of persons with aphasia: A scoping review. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2022; 69:e1-e9. [PMID: 36073071 PMCID: PMC9452926 DOI: 10.4102/sajcd.v69i2.920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/10/2022] [Accepted: 05/12/2022] [Indexed: 11/01/2022] Open
Abstract
Background: The impact of the Coronavirus disease 2019 (COVID-19) pandemic was more pronounced on the well-being of persons with disabilities, especially in low- and middle-income countries. There is documented evidence of the rippling effects of COVID-19 on persons with disabilities. However, not much is known about the impact of COVID-19 on the rehabilitation of persons with aphasia.Objective: The scoping review explores how COVID-19 affected the rehabilitation of persons living with aphasia.Method: A scoping review was conducted using Arksey and O’Malley’s framework. A search was conducted on Science Direct, PubMed, Medline, Scopus, ProQuest and Google Scholar, to identify relevant studies published between 2019 and 2022. Data were analysed using thematic analysis.Results: Most studies regarding the effects of COVID-19 on persons living with aphasia were conducted in the United Kingdom. Five themes emerged from the data, namely, (1) negative impact on rehabilitative care, (2) telehealth and its limitations, (3) impact on social participation, (4) compromised caregiver involvement and (5) mental health challenges.Conclusions: Findings highlight the need for healthcare professionals to pursue innovative ways in which aphasia rehabilitation and conversational support programmes can be made accessible to persons with aphasia, despite the limitations brought about by a pandemic. Telerehabilitation programmes need to be tailored to the needs of persons with aphasia if they are to be successful. This study highlights the importance and need for the prioritisation of mental health services for persons with aphasia and their caregivers during a pandemic.
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Affiliation(s)
- Khetsiwe P Masuku
- Department of Speech Pathology, Faculty of Humanities, University of the Witwatersrand, Johannesburg.
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Mohamad Safiai NI, Mohamad NA, Basri H, Inche Mat LN, Hoo FK, Abdul Rashid AM, Yusof Khan AHK, Loh WC, Baharin J, Fernandez A, Samsudin IN, Mohamed MH, Ching SM, Lee KW, Ramachandran V, Pozo-Rosich P, Wan Sulaiman WA. High-frequency repetitive transcranial magnetic stimulation at dorsolateral prefrontal cortex for migraine prevention: A systematic review and meta-analysis. Cephalalgia 2022; 42:1071-1085. [PMID: 35435045 DOI: 10.1177/03331024221092423] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the efficacy of high-frequency repetitive transcranial magnetic stimulation over dorsolateral prefrontal cortex as a migraine prevention by conducting a systematic review and meta-analysis. BACKGROUND The efficacy of high-frequency repetitive transcranial magnetic stimulation over dorsolateral prefrontal cortex as preventive migraine treatment remains debatable. METHODS PubMed, Scopus, CINAHL, CENTRAL, and BioMed Central databases were searched from their inception until December 2020. Randomised trials comparing high-frequency repetitive transcranial magnetic stimulation over dorsolateral prefrontal cortex with sham for migraine prevention were included. The risk of bias was assessed using the Cochrane guidelines. Headache days, pain intensity, acute medication intake, and disability were extracted as study outcomes and the mean difference with a random-effects model was used to determine the effect size. RESULTS Meta-analysis revealed that high-frequency repetitive transcranial magnetic stimulation over dorsolateral prefrontal cortex significantly reduced acute medication intake (Mean Difference = 9.78, p = 0.02, 95%CI: 1.60, 17.96, p = 0.02) and functional disability (Mean Difference = 8.00, p < 0.05, 95%CI: 4.21, 11.79). However, no differences were found in headache days and pain intensity reduction, although there was a slight trend favouring high-frequency repetitive transcranial magnetic stimulation. CONCLUSION High-frequency repetitive transcranial magnetic stimulation over dorsolateral prefrontal cortex may be effective in reducing acute medication intake and disability. However, more studies are needed to strengthen this preliminary evidence.
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Affiliation(s)
- Nabil Izzaatie Mohamad Safiai
- Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Nur Afiqah Mohamad
- Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Hamidon Basri
- Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Liyana Najwa Inche Mat
- Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Fan Kee Hoo
- Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Anna Misyail Abdul Rashid
- Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Abdul Hanif Khan Yusof Khan
- Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Wei Chao Loh
- Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Janudin Baharin
- Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Aaron Fernandez
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Intan Nureslyna Samsudin
- Department of Pathology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Mohd Hazmi Mohamed
- Department of ORL-HNS, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Siew Mooi Ching
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.,Department of Medical Sciences, School of Medical and Live Sciences, Sunway University, Bandar Sunway, Selangor, Malaysia
| | - Kai Wei Lee
- Department of Preclinical Sciences, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kajang, Selangor, Malaysia
| | - Vasudevan Ramachandran
- Centre for Materials Engineering and Regenerative Medicine, Bharath Institute of Higher Education and Research, Selaiyur, Chennai, Tamil Nadu, India
| | - Patricia Pozo-Rosich
- Headache and Craniofacial Pain Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Headache and Neurological Pain Research Group, Vall d'Hebron Research Institute, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Wan Aliaa Wan Sulaiman
- Department of Neurology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.,Malaysian Research Institute on Ageing (MyAgeing), Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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Telemedicine in Surgical Care in Low- and Middle-Income Countries: A Scoping Review. World J Surg 2022; 46:1855-1869. [PMID: 35428920 PMCID: PMC9012517 DOI: 10.1007/s00268-022-06549-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2022] [Indexed: 12/11/2022]
Abstract
Background Access to timely and quality surgical care is limited in low- and middle-income countries (LMICs). Telemedicine, defined as the remote provision of health care using information, communication and telecommunication platforms have the potential to address some of the barriers to surgical care. However, synthesis of evidence on telemedicine use in surgical care in LMICs is lacking. Aim To describe the current state of evidence on the use and distribution of telemedicine for surgical care in LMICs. Methods This was a scoping review of published and relevant grey literature on telemedicine use for surgical care in LMICs, following the PRISMA extension for scoping reviews guideline. PubMed-Medline, Web of Science, Scopus and African Journals Online databases were searched using a comprehensive search strategy from 1 January 2010 to 28 February 2021. Results A total of 178 articles from 53 (38.7%) LMICs across 11 surgical specialties were included. The number of published articles increased from 2 in 2010 to 44 in 2020. The highest number of studies was from the World Health Organization Western Pacific region (n = 73; 41.0%) and of these, most were from China (n = 69; 94.5%). The most common telemedicine platforms used were telephone call (n = 71, 39.9%), video chat (n = 42, 23.6%) and WhatsApp/WeChat (n = 31, 17.4%). Telemedicine was mostly used for post-operative follow-up (n = 71, 39.9%), patient education (n = 32, 18.0%), provider training (n = 28, 15.7%) and provider-provider consultation (n = 16, 9.0%). Less than a third (n = 51, 29.1%) of the studies used a randomised controlled trial design, and only 23 (12.9%) reported effects on clinical outcomes. Conclusion Telemedicine use for surgical care is emerging in LMICs, especially for post-operative visits. Basic platforms such as telephone calls and 2-way texting were successfully used for post-operative follow-up and education. In addition, file sharing and video chatting options were added when a physical assessment was required. Telephone calls and 2-way texting platforms should be leveraged to reduce loss to follow-up of surgical patients in LMICs and their use for pre-operative visits should be further explored. Despite these telemedicine potentials, there remains an uneven adoption across several LMICs. Also, up to two-thirds of the studies were of low-to-moderate quality with only a few focusing on clinical effectiveness. There is a need to further adopt, develop, and validate telemedicine use for surgical care in LMICs, particularly its impact on clinical outcomes. Supplementary Information The online version contains supplementary material available at 10.1007/s00268-022-06549-2.
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Comparison of Machine Learning Methods Using Spectralis OCT for Diagnosis and Disability Progression Prognosis in Multiple Sclerosis. Ann Biomed Eng 2022; 50:507-528. [PMID: 35220529 PMCID: PMC9001622 DOI: 10.1007/s10439-022-02930-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 02/10/2022] [Indexed: 12/28/2022]
Abstract
Machine learning approaches in diagnosis and prognosis of multiple sclerosis (MS) were analysed using retinal nerve fiber layer (RNFL) thickness, measured by optical coherence tomography (OCT). A cross-sectional study (72 MS patients and 30 healthy controls) was used for diagnosis. These 72 MS patients were involved in a 10-year longitudinal follow-up study for prognostic purposes. Structural measurements of RNFL thickness were performed using different Spectralis OCT protocols: fast macular thickness protocol to measure macular RNFL, and fast RNFL thickness protocol and fast RNFL-N thickness protocol to measure peripapillary RNFL. Binary classifiers such as multiple linear regression (MLR), support vector machines (SVM), decision tree (DT), k-nearest neighbours (k-NN), Naïve Bayes (NB), ensemble classifier (EC) and long short-term memory (LSTM) recurrent neural network were tested. For MS diagnosis, the best acquisition protocol was fast macular thickness protocol using k-NN (accuracy: 95.8%; sensitivity: 94.4%; specificity: 97.2%; precision: 97.1%; AUC: 0.958). For MS prognosis, our model with a 3-year follow up to predict disability progression 8 years later was the best predictive model. DT performed best for fast macular thickness protocol (accuracy: 91.3%; sensitivity: 90.0%; specificity: 92.5%; precision: 92.3%; AUC: 0.913) and SVM for fast RNFL-N thickness protocol (accuracy: 91.3%; sensitivity: 87.5%; specificity: 95.0%; precision: 94.6%; AUC: 0.913). This work concludes that measurements of RNFL thickness obtained with Spectralis OCT have a good ability to diagnose MS and to predict disability progression in MS patients. This machine learning approach would help clinicians to have valuable information.
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Nirooei E, Kashani SMA, Owrangi S, Malekpour F, Niknam M, Moazzen F, Nowrouzi-Sohrabi P, Farzinmehr S, Akbari H. Blood Trace Element Status in Multiple Sclerosis: a Systematic Review and Meta-analysis. Biol Trace Elem Res 2022; 200:13-26. [PMID: 33611740 DOI: 10.1007/s12011-021-02621-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 01/31/2021] [Indexed: 12/17/2022]
Abstract
The aim of this meta-analysis was to investigate whether the blood concentrations of patients with multiple sclerosis (MS) are associated with those of the healthy control group in terms of trace elements including zinc (Zn), iron (Fe), manganese (Mn), magnesium (Mg), selenium (Se), and copper (Cu). A comprehensive search was performed in online databases including PubMed, Scopus, Embase, and Web of Science for studies, which have addressed trace elements in MS up to July 23, 2020. The chi-square test and I2 statistic were utilized to evaluate inter-study heterogeneity across the included studies. Weighted mean differences (WMDs) and corresponding 95% CI were considered as a pooled effect size (ES). Twenty-seven articles (or 32 studies) with a total sample comprised of 2895 participants (MS patients (n = 1567) and controls (n = 1328)) were included. Pooled results using random-effects model indicated that the levels of Zn (WMD = - 7.83 mcg/dl, 95% CI = - 12.78 to - 2.87, Z = 3.09, P = 0.002), and Fe (WMD = - 13.66 mcg/dl, 95% CI = - 23.13 to - 4.19, Z = 2.83, P = 0.005) were significantly lower in MS patients than in controls. However, it was found that levels of Mn (WMD = 0.03 mcg/dl, 95% CI = 0.01 to 0.04, Z = 2.89, P = 0.004) were significantly higher in MS patients. Yet, no significant differences were observed in the levels of Mg, Se, and Cu between both groups. This meta-analysis revealed that the circulating levels of Zn and Fe were significantly lower in MS patients and that Mn level was significantly higher than those in the control group. However, it was found that there was no significant difference between MS patients and controls with regard to levels of Mg, Se, and Cu.
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Affiliation(s)
- Elahe Nirooei
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Soroor Owrangi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Malekpour
- Family Medicine Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Niknam
- Department of Biochemistry, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Moazzen
- Department of Hematology, Faculty of Allied Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Peyman Nowrouzi-Sohrabi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Biochemistry, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Somaye Farzinmehr
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Hamed Akbari
- Department of Biochemistry, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
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Guo J, Wang J, Sun W, Liu X. The advances of post-stroke depression: 2021 update. J Neurol 2021; 269:1236-1249. [PMID: 34052887 DOI: 10.1007/s00415-021-10597-4] [Citation(s) in RCA: 97] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/02/2021] [Accepted: 05/04/2021] [Indexed: 12/13/2022]
Abstract
Post-stroke depression (PSD) is one of common and serious sequelae of stroke. Approximately, one in three stroke survivors suffered from depression after stroke. It heavily affected functional rehabilitation, which leaded to poor quality of life. What is worse, it is strongly associated with high mortality. In this review, we aimed to derive a comprehensive and integrated understanding of PSD according to recently published papers and previous classic articles. Based on the considerable number of studies, we found that within 2 years incidence of PSD has a range from 11 to 41%. Many factors contribute to the occurrence of PSD, including the history of depression, stroke severity, lesion location, and so on. Currently, the diagnosis of PSD is mainly based on the DSM guidelines and combined with various depression scales. Unfortunately, we lack a unified mechanism to explain PSD which mechanisms now involve dysregulation of hypothalamic-pituitary-adrenal (HPA) axis, increased inflammatory factors, decreased levels of monoamines, glutamate-mediated excitotoxicity, and abnormal neurotrophic response. At present, both pharmacotherapy and psychological therapies are employed in treating PSD. Although great advance has been made by researchers, there are still a lot of issues need to be addressed. Especially, the mechanism of PSD is not completely clear.
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Affiliation(s)
- Jianglong Guo
- Stroke Center and Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, People's Republic of China
| | - Jinjing Wang
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Wen Sun
- Stroke Center and Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, People's Republic of China
| | - Xinfeng Liu
- Stroke Center and Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, People's Republic of China.
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
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10
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Abdullah NA, Inman M, Moody CJ, Storr SJ, Martin SG. Cytotoxic and radiosensitising effects of a novel thioredoxin reductase inhibitor in breast cancer. Invest New Drugs 2021; 39:1232-1241. [PMID: 33768386 PMCID: PMC8426295 DOI: 10.1007/s10637-021-01106-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 03/16/2021] [Indexed: 12/24/2022]
Abstract
Radiotherapy is an effective treatment modality for breast cancer but, unfortunately, not all patients respond fully with a significant number experiencing local recurrences. Overexpression of thioredoxin and thioredoxin reductase has been reported to cause multidrug and radiation resistance - their inhibition may therefore improve therapeutic efficacy. Novel indolequinone compounds have been shown, in pancreatic cancer models, to inhibit thioredoxin reductase activity and exhibit potent anticancer activity. The present study evaluates, using in vitro breast cancer models, the efficacy of a novel indolequinone compound (IQ9) as a single agent and in combination with ionising radiation using a variety of endpoint assays including cell proliferation, clonogenic survival, enzyme activity, and western blotting. Three triple-negative breast cancer (MDA-MB-231, MDA-MB-468, and MDA-MB-436) and two luminal (MCF-7 and T47D) breast cancer cell lines were used. Results show that treatment with IQ9 significantly inhibited thioredoxin reductase activity, and inhibited cell growth and colony formation of breast cancer cells with IC50 values in the low micromolar ranges. Enhanced radiosensitivity of triple-negative breast cancer cells was observed, with sensitiser enhancement ratios of 1.20–1.43, but with no evident radiosensitisation of luminal breast cancer cell lines. IQ9 upregulated protein expression of thioredoxin reductase in luminal but not in triple-negative breast cancer cells which may explain the observed differential radiosensitisation. This study provides important evidence of the roles of the thioredoxin system as an exploitable radiobiological target in breast cancer cells and highlights the potential therapeutic value of indolequinones as radiosensitisers. ***This study was not part of a clinical trial. Clinical trial registration number: N/A
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Affiliation(s)
- Nurul A Abdullah
- Nottingham Breast Cancer Research Centre, School of Medicine, Biodiscovery Institute, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
- Present address: Biomedical Science Department, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia
| | - Martyn Inman
- School of Chemistry, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Christopher J Moody
- School of Chemistry, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Sarah J Storr
- Nottingham Breast Cancer Research Centre, School of Medicine, Biodiscovery Institute, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Stewart G Martin
- Nottingham Breast Cancer Research Centre, School of Medicine, Biodiscovery Institute, University of Nottingham, University Park, Nottingham, NG7 2RD, UK.
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Agazhe M, Eshetu D, Arsicha A, Hamato A, Petros A, Dabaro D, Yohanis N, Getahun B, Hirigo AT. Incidence and pattern of stroke among patients admitted to medical ward at Yirgalem General Hospital, Sidama Regional State, Southern-Ethiopia. SAGE Open Med 2021; 9:20503121211001154. [PMID: 33796298 PMCID: PMC7968040 DOI: 10.1177/20503121211001154] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 02/15/2021] [Indexed: 11/15/2022] Open
Abstract
Introduction: In the current days, stroke has become one of the common reasons for admission in many health care setups and becoming an alarming public health problem in Ethiopia. Hence, this study aimed to assess the incidence and associated factors of stroke among patients admitted to the medical wards in Yirgalem hospital. Methods: An institution-based retrospective cross-sectional study design was carried out from 01 January 2017, to 30 December 2019. Admitted adult patients’ medical charts were used to collect all required information using structured checklists. Data were analyzed using statistical package for social sciences (SPSS) version 20 software, and a p value < 0.05 was accepted as statistically significant. Result: From a total of 3016 admitted patients, the incidence of stroke was 3.15% (n = 95). Of the 95 stroke cases, 58.9% were males and 69.5% of them were urban dwellers. 62.1% (59/95) of the stroke patients had an ischemic stroke, whereas 37.9% (36/95) had a hemorrhagic stroke. Patients with age ⩾ 65 years, smokers, hypertension, and type-II diabetes had significantly higher ischemic stroke when compared to patients with hemorrhagic stroke (62.7% vs 30.5%, p = 0.008), (49.1% vs 11.1%, p ⩽ 0.0001), and (71.2%vs 13.9%, p < 0.0001), respectively. While patients with hypertension had a significantly higher rate of hemorrhagic stroke when compared to patients with ischemic stroke (88.9% vs 61%, p = 0.003). Conclusion: The majority of stroke patients had cardiovascular problems and hypertension. More than 44% and 34.7% of them had a history of alcoholism and smoking. Therefore, proper management of hypertension, lifestyle modification, early screening and management of strok risks and avoiding risk-full personal behaviors like smoking and alcoholism are important tools to limit or prevent stroke-related morbidity and mortality.
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Affiliation(s)
| | - Daniel Eshetu
- Department of Microbiology, Yirgalem Hospital Medical College, Yirgalem, Southern-Ethiopia
| | - Admasu Arsicha
- Yirgalem Hospital Medical College, Yirgalem, Southern-Ethiopia
| | - Assefa Hamato
- Department of Microbiology, Yirgalem Hospital Medical College, Yirgalem, Southern-Ethiopia
| | - Assefa Petros
- Yirgalem Hospital Medical College, Yirgalem, Southern-Ethiopia
| | - Desalegn Dabaro
- Yirgalem Hospital Medical College, Yirgalem, Southern-Ethiopia
| | | | - Bekalu Getahun
- Department of Ophthalmology & Optometry, College of Medicine and Health Science, Hawassa University, Hawassa, Southern-Ethiopia
| | - Agete Tadewos Hirigo
- School of Medical Laboratory Sciences, Faculty of Medicine, College of Medicine and Health Science, Hawassa University, Hawassa, Southern-Ethiopia
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