Higher Prevalence Of Stroke Research Articles

Treatment Outcome and Its Determinants among Patients Admitted to Stroke Unit of Jimma University Medical Center, Southwest Ethiopia.

Background Stroke is a public health problem in Ethiopia. Despite the high prevalence of stroke in Ethiopia, there is a paucity of data with regard to drug treatment, treatment outcome, and risk factors of poor treatment outcome of stroke. Hence, this study is aimed at assessing treatment outcome and its determinants among patients admitted to stroke unit of Jimma University Medical Center (JUMC). Methods A two-year hospital-based retrospective cross-sectional study was employed to analyze the medical records of patients admitted with stroke to stroke unit of Jimma University Medical Centre from February 1st, 2016 to March 30th, 2018. Data was entered by Epidata manager version 4.0.2 and analyzed by SPSS version 24. Multivariable logistic regression analysis with the backward stepwise approach was done to identify independent predictors of poor treatment outcome of stroke. Variables with P value less than 0.05 were considered as statically significant determinants of poor treatment outcome. Results Of 220 patients with stroke admitted to the Jimma University, 67.30% were male. Nearly two thirds (63.18%) of them had poor treatment outcomes. Dyslipidimics were administered to 60% of the patients, and the most popular antiplatelet used was aspirin, which was prescribed to 67.3% the patients. Age ≥ 65 adjusted odd ratio ((AOR): 2.56; 95% CI: 1.95-9.86, P = 0.001), presence of comorbidity (AOR: 5.25; 95% CI: 1.08-17.69, P < 0.001), admission with hemorrhagic stroke (AOR: 18.99; 95% CI: 7.05-42.07, P < 0.001), and admission to the hospital after 24 hour of stroke onset (AOR: 4.98; 95% CI: 1.09-21.91, P = 0.03) were independent predictors of poor treatment outcomes. Conclusion Substantial numbers of stroke patients had poor treatment outcomes. Elderly patients, patients diagnosed with hemorrhagic stroke, patients with comorbidity, and those with delayed hospital admission were more likely to have poor treatment outcome. Hence, frequent monitoring and care should be given for the aforementioned patients. Awareness creation on the importance of early admission should be delivered particularly for patients who have risk factors of stroke (cardiovascular diseases).

Physical Rehabilitation of Patients After Ischemic Stroke

The high prevalence of ischemic stroke and high mortality from it with increasing disability of such patients currently makes the problem of vascular diseases of the brain one of the most socially significant and requiring additional research. Conducting physical rehabilitation in post-stroke patients according to the author's scheme had a pronounced positive effect on their hematological parameters, regardless of their initial state. Wellness measures ensured in all patients who had an ischemic stroke a gradual optimization of the number of red blood cells, white blood cells and platelets in the blood. The upcoming changes created conditions for improving trophic tissue of patients, increased their overall reactivity and minimized the risk of repeated ischemic damage to brain tissue. The results suggest that the author's option of rehabilitation of post-stroke patients is highly promising in terms of ensuring adequate activation of the bone marrow regardless of the initial level of erythropoiesis, leukopoiesis and thrombocytopoiesis. This prevents anemia, weakening of resistance and thrombophilia in such patients, optimizing the general condition and significantly improving the prognosis for the disease and for life.

Vascular remodeling with violations of intracardiac hemodynamics in patients older age category, combined with the clinical-cluster, neurocognitive and biomarker heterogeneity in multifocal atherosclerosis

Study of the remodeling of the carotid arteries with violation of intracardiac hemodynamics in patients with MFA, and the estimation of the main parameters of dyslipidemia, apoptosis, and oxidative stress in patients with high vascular risk older age group (6175 years) in a Regional vascular center of Ufa. Depending on the predominant lesion of the vascular pool, patients were divided into 3 clusters by the method of hierarchical analysis of categorical variables according to the clinical manifestation of atherosclerotic lesions of the heart, brain and lower limb arteries confirmed by coronary angiography, ultrasound Doppler of the main arteries of the head and lower extremities. 96 of them were IPA with a primary lesion of the heart (1st cluster), the 96 IPA with a predominance of lesions of the carotid arteries (2nd cluster), 96 patients with ischemia of lower extremities (3rd cluster). At the hospital stage, electrocardiography, echocardiography, magnetic resonance imaging of the chest and abdomen, ultrasound of the OBP and kidneys, if necessary, ultrasound of the pelvis were performed. Determination of 8-ON-deoxyguanosine, annexin-5 (An-5) and Aan-5 in blood by ELISA was performed in all patients with MFA, as well as standard biochemical screening for lipidogram examination. We have found that most often in different combinations and with different degrees of severity according to our data are observed: Clinical manifestation of atherosclerotic heart disease (cluster 1) mainly due to its history in combination with stage III hypertension with increasing thickness of intima-media complex and stenosis of the right WASP, left ventricular dilatation, as well as a higher concentration of Aan-5IgMand LP-A as a risk factor for coronary heart disease, atherosclerosis, atherothrombosis. 2. Hemodynamically significant violations of the main arteries of the head in patients of the 2nd cluster mainly with acute ischemic cerebral circulation, in which there was a development of left ventricular hypertrophy with an increase in the size of the left atrium and the presence of atherosclerotic plaque of the right and left WASP. The higher prevalence of stroke was combined with a marked cognitive deficit among patients of cluster 2 with the lowest level of An-5, an increase in total cholesterol and low-density lipoprotein cholesterol. 3. The total severity of the condition in patients with hemodynamic ischemia with clinical manifestation of vascular lesions of the lower extremities was accompanied by a predominant increase in stable angina with FC2, lerish syndrome with occlusion of the iliac, superficial femoral arteries, the presence of insulin-independent type 2 diabetes, which in this group was established in 59.4% of cases, combined with a higher concentration of the marker of oxidative stress 8-ON-deoxyguanosine and hypertriglyceridemia. The construction of a three-cluster model in patients at high vascular risk of the elderly age category showed the interaction of cardio-carotid comorbid background on the clinical diversity of systemic vascular lesions in MFA with the development of remodeling of the main arteries and disorders of intracardiac hemodynamics associated with laboratory changes in the assessment of the main parameters of dyslipidemia, apoptosis markers, oxidative stress.

The burden of dementia and dementia due to Down syndrome, Parkinson’s disease, stroke, TBI, and HIV: An analysis for the Global Burden of Disease study 2019

AbstractBackgroundIn light of the increasing trends in the global number of individuals affected by dementia and the lack of any available disease‐modifying therapies, it is necessary to fully understand and quantify the global burden of dementia. Previous efforts to quantify the relationships between dementia and stroke, Parkinson’s disease, Down syndrome, traumatic brain injury and HIV, but these analyses have remained isolated and results have not been summarized across disease topics. We estimated the proportion of dementia due to Down syndrome, Parkinson’s disease, clinical stroke, TBI and HIV using consistent and comparable methods, in order to better understand their contribution to the prevalence of dementia.MethodThrough systematic review, we obtained data on the relative risk of dementia with each condition and found sufficient evidence to estimate relative risks for all clinical conditions except HIV. We then estimated relative risks by age using a Bayesian meta‐regression tool and calculated population attributable fractions (PAFs) using the estimates of relative risk and prevalence estimates for each condition from the Global Burden of Disease Study 2019. Finally, we multiplied these estimates by dementia prevalence to calculate the number of dementia cases attributable to each condition.ResultThe relative risk of dementia for all four conditions decreased with age. Relative risks were highest for Down syndrome, followed by Parkinson’s disease, stroke and TBI. However, due to the high prevalence of stroke, the PAF for dementia due to stroke was highest. Overall, Down syndrome, Parkinson’s disease, stroke and TBI explained 9.9% (5.9 to 16.4) of the global prevalence of dementia.ConclusionLess than 10% of dementia prevalence could be explained by Down syndrome, Parkinson’s disease, stroke and TBI. This result emphasizes the large fraction of dementia prevalence unexplained by the four diseases examined in this analysis, and highlights the need for additional epidemiologic research exploring lifestyle risk factors and further research in the basic sciences focused on elucidating intervention approaches to prevent or delay the neuropathological changes that characterize dementia.

Identifying and assessing the impact of key neighborhood-level determinants on geographic variation in stroke: a machine learning and multilevel modeling approach

BackgroundStroke is a chronic cardiovascular disease that puts major stresses on U.S. health and economy.The prevalence of stroke exhibits a strong geographical pattern at the state-level, where a cluster of southern states with a substantially higher prevalence of stroke has been called the stroke belt of the nation. Despite this recognition, the extent to which key neighborhood characteristics affect stroke prevalence remains to be further clarified.MethodsWe generated a new neighborhood health data set at the census tract level on nearly 27,000 tracts by pooling information from multiple data sources including the CDC’s 500 Cities Project 2017 data release. We employed a two-stage modeling approach to understand how key neighborhood-level risk factors affect the neighborhood-level stroke prevalence in each state of the US. The first stage used a state-of-the-art Bayesian machine learning algorithm to identify key neighborhood-level determinants. The second stage applied a Bayesian multilevel modeling approach to describe how these key determinants explain the variability in stroke prevalence in each state.ResultsNeighborhoods with a larger proportion of older adults and non-Hispanic blacks were associated with neighborhoods with a higher prevalence of stroke. Higher median household income was linked to lower stroke prevalence. Ozone was found to be positively associated with stroke prevalence in 10 states, while negatively associated with stroke in five states. There was substantial variation in both the direction and magnitude of the associations between these four key factors with stroke prevalence across the states.ConclusionsWhen used in a principled variable selection framework, high-performance machine learning can identify key factors of neighborhood-level prevalence of stroke from wide-ranging information in a data-driven way. The Bayesian multilevel modeling approach provides a detailed view of the impact of key factors across the states. The identified major factors and their effect mechanisms can potentially aid policy makers in developing area-based stroke prevention strategies.

Tree-Based Machine Learning to Identify and Understand Major Determinants for Stroke at the Neighborhood Level.

BackgroundStroke is a major cardiovascular disease that causes significant health and economic burden in the United States. Neighborhood community‐based interventions have been shown to be both effective and cost‐effective in preventing cardiovascular disease. There is a dearth of robust studies identifying the key determinants of cardiovascular disease and the underlying effect mechanisms at the neighborhood level. We aim to contribute to the evidence base for neighborhood cardiovascular health research.Methods and ResultsWe created a new neighborhood health data set at the census tract level by integrating 4 types of potential predictors, including unhealthy behaviors, prevention measures, sociodemographic factors, and environmental measures from multiple data sources. We used 4 tree‐based machine learning techniques to identify the most critical neighborhood‐level factors in predicting the neighborhood‐level prevalence of stroke, and compared their predictive performance for variable selection. We further quantified the effects of the identified determinants on stroke prevalence using a Bayesian linear regression model. Of the 5 most important predictors identified by our method, higher prevalence of low physical activity, larger share of older adults, higher percentage of non‐Hispanic Black people, and higher ozone levels were associated with higher prevalence of stroke at the neighborhood level. Higher median household income was linked to lower prevalence. The most important interaction term showed an exacerbated adverse effect of aging and low physical activity on the neighborhood‐level prevalence of stroke.ConclusionsTree‐based machine learning provides insights into underlying drivers of neighborhood cardiovascular health by discovering the most important determinants from a wide range of factors in an agnostic, data‐driven, and reproducible way. The identified major determinants and the interactive mechanism can be used to prioritize and allocate resources to optimize community‐level interventions for stroke prevention.

Temporal, geographical and demographic trends of stroke prevalence in China: a systematic review and meta-analysis.

BackgroundChina has made large efforts to reduce stroke prevalence. We aimed to systematically examine the prevalence of stroke in China over the past two decades.MethodsDatabases, including China National Knowledge Infrastructure, Wanfang, VIP, and PubMed, were systematically searched for studies published in English or Chinese that reported stroke prevalence in China during 2000–2017. Meta-analysis was conducted to estimate the pooled stroke prevalence and the variations in stroke prevalence subgroups stratified by age, gender, time period, and region.ResultsIn total, 96 papers met the inclusion criteria. Meta-analysis showed that the overall estimated national prevalence was 5.1% (5.0–5.3%) with large variations across regions: 3.1% (2.5–3.6%) in south China, 3.4% (3.0–3.8%) in southwest China, 3.6% (3.3–3.8%) in east China, 5.0% (4.7–5.4%) in central China, 5.8% (4.6–7.1%) in northwest China, 6.0% (5.0–7.0%) in northeast China, and 8.0% (7.4–8.5%) in north China. Men had a higher prevalence than women [7.3% (6.9–7.7%) vs. 5.6% (5.2–6.0%)]. Stroke prevalence increased with age, was 1.2% (1.0–1.3%), 2.9% (2.6–3.2%), 5.9% (5.2–6.5%), and 8.7% (8.0–9.5%) in the 40–49, 50–59, 60–69, and ≥70 years old groups, respectively.ConclusionsMen, people being older, or living in northern China had higher stroke prevalence. More vigorous efforts are needed in China to prevent stroke.

Normalization of Cerebral Blood Flow, Neurochemicals, and White Matter Integrity after Kidney Transplantation.

CKD is associated with abnormalities in cerebral blood flow, cerebral neurochemical concentrations, and white matter integrity. Each of these is associated with adverse clinical consequences in the non-CKD population, which may explain the high prevalence of dementia and stroke in ESKD. Because cognition improves after kidney transplantation, comparing these brain abnormalities before and after kidney transplantation may identify potential reversibility in ESKD-associated brain abnormalities. In this study of patients with ESKD and age-matched healthy controls, we used arterial spin labeling to assess the effects of kidney transplantation on cerebral blood flow and magnetic resonance spectroscopic imaging to measure cerebral neurochemical concentrations (N-acetylaspartate, choline, glutamate, glutamine, myo-inositol, and total creatine). We also assessed white matter integrity measured by fractional anisotropy (FA) and mean diffusivity (MD) with diffusion tensor imaging. We used a linear mixed model analysis to compare longitudinal, repeated brain magnetic resonance imaging measurements before, 3 months after, and 12 months after transplantation and compared these findings with those of healthy controls. Study participants included 29 patients with ESKD and 19 controls; 22 patients completed post-transplant magnetic resonance imaging. Cerebral blood flow, which was higher in patients pretransplant compared with controls (P=0.003), decreased post-transplant (P<0.001) to values in controls. Concentrations of neurochemicals choline and myo-inositol that were higher pretransplant compared with controls (P=0.001 and P<0.001, respectively) also normalized post-transplant (P<0.001 and P<0.001, respectively). FA increased (P=0.001) and MD decreased (P<0.001) post-transplant. Certain brain abnormalities in CKD are reversible and normalize with kidney transplantation. Further studies are needed to understand the mechanisms underlying these brain abnormalities and to explore interventions to mitigate them even in patients who cannot be transplanted. Cognitive Impairment and Imaging Correlates in End Stage Renal Disease, NCT01883349.

The Epidemiological and Mechanistic Understanding of the Neurological Manifestations of COVID-19: A Comprehensive Meta-Analysis and a Network Medicine Observation

Background and Purpose: The clinical characteristics and biological effects on the nervous system of infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remain poorly understood. The aim of this study is to advance epidemiological and mechanistic understanding of the neurological manifestations of coronavirus disease 2019 (COVID-19) using stroke as a case study.Methods: We performed a meta-analysis of clinical studies reporting stroke history, intensive inflammatory response and procoagulant state (C-reactive protein (CRP), Procalcitonin (PCT) and coagulation indicator (D-dimer)) in patients with COVID-19. Via network-based analysis of SARS-CoV-2 host genes and stroke-associated genes in the human protein-protein interactome, we inspected the underlying inflammatory endophenotypes between COVID-19 and stroke. Finally, we further verified the network medicine-based findings using large-scale single-cell RNA-sequencing data generated from the lymphocytic choriomeningitis virus (LCMV) infected mouse model.Results: The overall pooled prevalence of stroke history was 2.98% (95% CI, 1.89 - 4.68; I2=69.2%) in the COVID-19 population. Notably, the severe group had a higher prevalence of stroke (6.06%; 95% CI 3.80 - 9.52; I2 = 42.6%) compare to the non-severe group (1.1%, 95% CI 0.72 - 1.71; I2 = 0.0%). In addition, there were increased CRP, PCT and D-dimer in severe illness, and the pooled mean difference was 40.7mg/L (95% CI, 24.3 - 57.1), 0.07mg/L (95% CI, 0.04 - 0.10) and 0.63mg/L (95% CI, 0.28 - 0.97) respectively. Vascular cell adhesion molecule 1 (VCAM-1), dimethylarginine dimethylaminohydrolase-1 (DDAH-1), CD59 and NOTCH-3 were selected from the results of the protein-protein interactome (PPI) network analysis. Among them, VCAM-1, one of the leukocyte adhesion molecules, is suspected to play a vital role in a holistic perspective. Even though the verification using LCMV data revealed no significant change could be observed in part of virus-host genes and stroke-associated genes, suggesting the relative importance of inflammatory responses in SARS-CoV-2 infection-associated neurological manifestations.Conclusion: In this study, we identified increased vulnerability of those with a history of stroke to severe COVID-19, suggesting monotonic relationships, thus implicating causality. Some candidates underlying inflammatory responses (i.e., VCAM-1) and procoagulant pathways were preliminarily identified for neurologists in caring COVID-19 patients with cerebrovascular disease, which requires future clinical and functional validation studies.Funding Statement: This work was supported by the National Heart, Lung, and Blood Institute (R00HL138272) and the National Institute of Aging (R01AG066707).Declaration of Interests: The authors declare that they have no conflict of interest.

Economic Burden Bore by Patients and Families because of stroke: Policy Assessment

AbstractStroke to this day is still a disease that causes a high disability. In the future, it will require a prohibitive cost so that it has an impact on the socio-economic consequences for patients and their families. The price is prohibitive so that the impact on socioeconomic implications for patients and their families. Because of that, the purpose of the study is to estimate the cause of the cost that causes an economic burden from a stroke. The method that is used is a content analysis by doing a further literature review from various sources, from journal to textbook from a national level to international. Literature studies show that direct medical cost, which is rehabilitation, and nursing care cost is identified as the leading contributor to the high price of economic burden from a stroke. High costs incurred cause family to experience catastrophic financial disaster; it even impacts to drop welfare level. Social preventive action is needed to reduce the high prevalence of stroke to reduce the cost, to protect every household from financial disaster from a stroke.

Mortality rates for hip fracture patients managed surgically and conservatively in a dedicated unit in Singapore.

At our hospital, an unusually high proportion of patients and families opted for conservative management of hip fractures. This study aimed to compare the mortality rates of patients with hip fractures treated conservatively to that of operatively managed patients in a dedicated hip fracture unit. Retrospective analysis was done for patients who were treated for hip fractures between January 2015 and October 2017 in a Hip Fracture Unit at a tertiary hospital. Patients were managed non-operatively or surgically after discussion with the multi-disciplinary team. 233 patients were treated conservatively and 781 underwent operative management for hip fractures. Patients managed non-operatively had a higher inpatient, 30-day and 1-year mortality rates. Inpatient mortality was 6.01% for conservatively managed compared to 0% for operative management. 30-day mortality for conservatively managed patients was 8.58% as compared to 0% for operatively managed patients, and 1-year mortality was 33.05% as opposed to 8.96%. There was an association seen with the type of management of hip fractures and that of inpatient death (p = 0.000), death in 30days (p = 0.000) and death in 1year (p = 0.000). The type of management was a predictive factor in 1-year mortality (p = 0.000). The average number of co-morbidities in conservatively managed patients was 5.2 compared to surgically managed patients of 4.0. Conservatively managed hip patients had a higher prevalence of stroke, chronic kidney disease and ischemic heart disease. Complications during hospital stay were comparable for both groups. The mean length of hospital stay was similar for both groups. Surgical intervention for hip fractures is associated with lower inpatient, 30-day and 1-year mortality rates. However, patient co-morbidities and pre-morbid conditions should also be considered. IV.

Quantile Regression Forests to Identify Determinants of Neighborhood Stroke Prevalence in 500 Cities in the USA: Implications for Neighborhoods with High Prevalence.

Stroke exerts a massive burden on the US health and economy. Place-based evidence is increasingly recognized as a critical part of stroke management, but identifying the key determinants of neighborhood stroke prevalence and the underlying effect mechanisms is a topic that has been treated sparingly in the literature. We aim to fill in the research gaps with a study focusing on urban health. We develop and apply analytical approaches to address two challenges. First, domain expertise on drivers of neighborhood-level stroke outcomes is limited. Second, commonly used linear regression methods may provide incomplete and biased conclusions. We created a new neighborhood health data set at census tract level by pooling information from multiple sources. We developed and applied a machine learning-based quantile regression method to uncover crucial neighborhood characteristics for neighborhood stroke outcomes among vulnerable neighborhoods burdened with high prevalence of stroke. Neighborhoods with a larger share of non-Hispanic blacks, older adults, or people with insufficient sleep tended to have a higher prevalence of stroke, whereas neighborhoods with a higher socio-economic status in terms of income and education had a lower prevalence of stroke. The effects of five major determinants varied geographically and were significantly stronger among neighborhoods with high prevalence of stroke. Highly flexible machine learning identifies true drivers of neighborhood cardiovascular health outcomes from wide-ranging information in an agnostic and reproducible way. The identified major determinants and the effect mechanisms can provide important avenues for prioritizing and allocating resources to develop optimal community-level interventions for stroke prevention.

Risk Factors for Stroke in Rural Population of Telangana State of India, an Unmatched Case Control Study.

Context Stroke tops the list of causes for acquired disability among adults and is the second leading cause of death worldwide. Evidence from developed countries indicate significant decline in stroke incidence and mortality, attributable to prevention of risk factors in general population. There is limited evidence on risk factors for stroke in rural India. Aims This study aims to ascertain the risk factors for stroke in rural Telangana and provide a guide to health care providers in adopting treatment and prevention strategies. Settings and Design The study was conducted in the Moinabad mandal of Ranga Reddy District, Telangana state of India. This is a population based unmatched case–control study. Methods and Materials All the houses of Moinabad were approached by a door-to-door survey to identify cases. A total of 288 persons were enrolled in the study which included 144 cases and 144 controls. Statistical Analysis To derive age and gender adjusted odds ratios of various risk factors, binary logistic regression analysis was performed. Results The estimated crude prevalence of stroke in Moinabad mandal is 257 per lakh population. Modifiable risk factors identified were, total cholesterol, systolic blood pressure, alcohol consumption, smoking, diastolic blood pressure, low high-density lipoprotein cholesterol, and central obesity as measured by waist circumference. Nonmodifiable risk factors identified were male gender and higher age group. Conclusion The high prevalence of stroke in rural Telangana makes it an important public health challenge for the state. The identified risk factors need to be addressed at population level.

Vitamin D deficiency, cardiothoracic ratio, and long-term mortality in hemodialysis patients

Hemodialysis patients are a special group of patients with higher mortality rates. Hemodialysis patients with vitamin D deficiency {plasma levels of 25-hydroxyvitamin D [25(OH)D] below 20 ng/mL} are associated with even higher mortality rates. The prognostic importance of vitamin D deficiency in hemodialysis patients with different cardiothoracic ratios (CTRs) is still unclear. This prospective study was performed in a single hemodialysis center, and 186 patients were included. This study analyzed the prognostic importance of vitamin D deficiency in hemodialysis patients with different CTRs. Vitamin D deficiency patients had a significantly higher prevalence of stroke and diabetic mellitus than those without vitamin D deficiency. In addition, the CTR was higher in patients with vitamin D deficiency than in those without vitamin D deficiency. After multivariate logistic regression, we found that CTR was the solitary factor that was independently significantly associated with vitamin D deficiency [odds ratio: 1.07, 95% confidence internal (CI): 1.01–1.13, p = 0.02]. Additionally, vitamin D deficiency was associated with all-cause mortality in patients with higher CTR after adjustment in hierarchical regression models. In conclusion, we reported that vitamin D deficiency was independently significantly associated with a higher CTR. We additionally revealed that vitamin D deficiency was an independent predicator for all-cause mortality in higher CTR hemodialysis patients.

High prevalence of stroke but low prevalence of Vascular dementia in a memory clinic from South India (5496)

High prevalence of stroke but low prevalence of Vascular dementia in a memory clinic from South India (5496)

Prevalence of stroke survivors in Parakou in northern Benin: A door-to-door community survey

IntroductionStroke is a major public health problem with a high burden in Sub-Saharan Africa. We aimed to determine the prevalence of stroke in Titirou in Parakou. MethodsIt was a cross-sectional study using a door-to-door survey in Titirou (Parakou) from 15 march to 15 October 2016 and included 4671 adults. We did a two stages survey. In the first stage the World Health Organization (WHO) tool for the diagnosis of stroke in community was used. In the second phase all suspected cases underwent neurological exam and sometimes brain CT-scan. The WHO definition was used for the diagnosis of stroke. We recorded the socio-demographic data and the vascular risk factors. The prevalence was standardized on age according to the WHO type population. Multiple logistic regression was done to identify associated factors and estimate the adjusted prevalence ratio (aPR) and their 95% confidence interval (CI). ResultsThe mean age of the subjects was 27.7±12.9 years with a sex ratio of 0.97. After screening 161 were suspected and 54 confirmed cases, the overall prevalence of stroke in Titirou was 1.156 per 100,000 inhabitants [95% CI: 0.850 to 1.426]. The age-standardized prevalence of stroke was 3223 cases per 100,000 inhabitants. The associated factors were age (aPR 1.7 [1.5–1.9] for 10 years), history of hypertension (aPR: 64.8 [46.1–108.9]), diabetes mellitus (aPR: 4.5 [1.6–12.3]), low consumption of fruits and vegetables (aPR: 2.3 [1.2–4.4]), history of heart disease (aPR: 6.0 [2.6–13.7]), family history of stroke (PR: 4.6 [2.1–10.0]). Among the 54 subjects who had a stroke 10 were able to perform the brain CT-Scan: 40% were hemorrhagic and 60% ischemic stroke. ConclusionOur study showed a high prevalence of stroke in Titirou and suggested urgent action for prevention.

Abstract WP219: Lipoprotein Subfractions Are Associated With Stroke Among 9,795 Patients in the Field Trial

Background: In the FIELD trial, a 5-year randomized double-blind placebo-controlled trial of fenofibrate vs. placebo in 9,795 adults with type 2 diabetes (T2D), the only standard lipid parameter correlating with microvascular (renal) events was triglycerides. Given the high prevalence of stroke among diabetic patients, we explored associations between lipoprotein subfractions and risk for stroke in the FIELD trial. Methods: We performed ultracentrifugation using the vertical auto profile (VAP, Atherotech) on plasma (baseline and after 6 weeks of fenofibrate). Analyses were performed using Cox proportional hazards and logistic regression for new on-study events. Results were adjusted for gender and fenofibrate or placebo allocation. Results: HDL related analytes (HDL-C, HDL3-C, apo A1, apoA2) correlated with reduced risk for all stroke. LDL and its subfractions and Lp(a)-C did not. VLDL and its subfractions, non-HDL-C, triglycerides, apo B, apo En, various ratios incorporating apo C3, and the ratios of apoB/A1 and apoB/apoA2 all correlated with increased risk for stroke. Conclusions: VAP identifies multiple lipoprotein subclasses, apoproteins, and VAP subclass/apoprotein ratios associated with stroke. Many of these measures improved with fenofibrate therapy.

Oxidative Stress at the Crossroads of Aging, Stroke and Depression.

Epidemiologic studies have shown that in the aging society, a person dies from stroke every 3 minutes and 42 seconds, and vast numbers of people experience depression around the globe. The high prevalence and disability rates of stroke and depression introduce enormous challenges to public health. Accumulating evidence reveals that stroke is tightly associated with depression, and both diseases are linked to oxidative stress (OS). This review summarizes the mechanisms of OS and OS-mediated pathological processes, such as inflammation, apoptosis, and the microbial-gut-brain axis in stroke and depression. Pathological changes can lead to neuronal cell death, neurological deficits, and brain injury through DNA damage and the oxidation of lipids and proteins, which exacerbate the development of these two disorders. Additionally, aging accelerates the progression of stroke and depression by overactive OS and reduced antioxidant defenses. This review also discusses the efficacy and safety of several antioxidants and antidepressants in stroke and depression. Herein, we propose a crosstalk between OS, aging, stroke, and depression, and provide potential therapeutic strategies for the treatment of stroke and depression.

Non Invasive Method to Diagnose Lung Energy of the Smoking Population

Smoking is an activity where toxic content which on fire produces smoke which can be detrimental if inhaled and mixed into the blood flow. Smoking is one of the key factors for death globally. On an average masculine and feminine smoker suffer about 13.2 and 14.5 year lifetime variation when compared to non-smoking individual. Most of the individuals who smoke regularly has higher prevalence of stroke, eye cataracts and cancer of nose, lips, tongue and mouth. The fact that 22.1% of masculine smoker and 11.9% of feminine smoker has a huge risk of dying due to lung cancer before age 80. The smoking generally has a adverse effect in its later stage and the diagnosis is generally invasive. There is a need for an early and non invasive diagnosis method for finding the adverse effects of smoking. Biowell is one such non invasive device to find psycho emotional status, Energy distribution and functional status of different organ. By using GDV based energy detection and health status analysis we can differentiate the damage caused to the brain and other major parts like Lungs, Nerve and Thoracic region. Smoking populations along with non smokers are taken and energy distribution and health status are collected, analyzed to prove the efficiency of Biowell instrument as a standard diagnostic tool.

Pecularities of Arterial Hypertension Prevalence and Intervisit Variability of Blood Pressure in Khmelnytskyi Region

The objective: to carry out the comparative analysis of arterial hypertension (AH) prevalence in rural and city population of Khmelnytskyi region, and to establish the frequency of patients with high intervisit variability of blood pressure (IVBP) in rural population.Materials and methods. We carried out the analysis of prevalence of AH and its major complications (myocardial infarction and cerebrovascular accident) in rural and city population of Khmelnytskyi region in dynamics during the period 2016–2018, based on official statistical data (form 12). The IVBP was studied in a random sample of 160 rural males with uncomplicated AH. Systolic blood pressure (BP), diastolic BP and the pulse BP were measured at each visit to doctor. IVBP was assessed by the standard deviation (SD) value, calculated from the BP recordings at the four visits to doctor. We also calculated the variation coefficient as a SD/average BP ratio.Results. It was established that the prevalence of AH in the population of Khmelnytskyi region was high (39 352,5 per 100 000 inhabitants), accompanied by the higher prevalence of stroke, in comparison with average stroke prevalence inUkraine. The prevalence of AH in rural population exceeded the corresponding index in the urban population, and was characterized by considerable variations in certain rural areas. The frequency of high IVBP in rural AH males was 51,25%. The high IVBP among males was mainly caused by significant variation of systolic BP (50,62%), and high variability of diastolic BP was observed only among 12,5% of patients with AH. The lipid profile changes and hypertension-mediated organ damage (namely heart and kidneys) were more pronounced in patients with high IVBP, as compared to males with low IVBP.Conclusions. The prevalence of AH in the population of Khmelnytskyi region is high, with the higher value in rural population as compared to the city one. The prevalence of stroke in Khmelnytskyi region remains high, with the tendency to increase during the last several years. Such unfavorable dynamics could be at least partially related to the high frequency (more than 50%) of patients with AH and high IVBP.