Number Of Stroke Cases Research Articles

Seasonal and monthly stroke incidence in relation to weather variables: a preliminary single-centre epidemiologic study

This single-centre epidemiologic study investigated seasonal/monthly stroke incidence and stroke-related mortality in relation to weather variables, gender, age, as well as stroke subtype and stroke aetiology. The study involved 638 patients hospitalised due to stroke at the Neurology Ward with a stroke unit at the Regional Hospital in Poland, during one complete calendar year. The data collected included the date of admission to the ward, year of birth, sex, type and subtype of stroke relative to the aetiology and location within different arteries as well as mortality. The data related to wind speed, atmospheric pressure, and temperature were acquired from the archive at the weather station in Tarnów, Poland. Majority of the patients in the study group were aged 66–85 years (57.2%), and there were more women than men. Ischaemic stroke was significantly more common than haemorrhagic stroke (87 vs 13%). Large artery atherosclerosis was the predominant cause of stroke, particularly in June and October, and total anterior circulation stroke (TACS) was the most common type, particularly in January and December. The analysis showed that stroke type and aetiology, as well as weather variables such as temperature and pressure, were associated with stroke incidence and mortality rates. The findings suggest that both high and low temperatures may contribute to an increased stroke incidence, as significant differences in the number of stroke cases are observed during periods of extreme temperatures. Therefore, increased vigilance is necessary during periods of both hot and cold weather. Further research is needed to better understand these relationships and develop effective prevention strategies.

Development of a self-care guideline to prevent rehospitalization in stroke patients: a modified Delphi study

Introduction: Since 2007, the number of stroke cases in Indonesia has continued to increase. Stroke patients who have passed the acute phase of stroke still have a risk of recurrent stroke and rehospitalization. This study aimed to develop self-care guidelines to prevent the rehospitalization of stroke patients. Methods: A three-round modified Delphi study was applied to a panel of 24 experts with different fields of expertise, consisting of doctors, nurses, families, and patients. In the first round, data were collected through a literature review and semi-structured interviews. In the second and third rounds, data were collected using a survey questionnaire on a 9-point Likert scale. Results: The first round produced seven themes around self-care activities, including drug therapy, physical exercise, diet and nutrition, stress management, self-motivation, functional status screening, and control for risk factors. In the second round, all types of self-care in the first round were agreed upon for content in preparing the guidebook. The third round resulted in agreement on the guidebook that had been designed, with scores of 8 and above by 100% of the expert panel. Conclusions: The development of a self-care guidebook to prevent rehospitalization of stroke patients through a three-round Delphi study has reached a consensus among the entire panel of experts. Further research by testing guidebooks in the healthcare system is needed to determine their effectiveness in preventing re-hospitalization in stroke patients.

Predicting the risk of stroke based on machine learning

Stroke, the second largest leading cause of death among all chronic diseases, is affecting about 101 million people in the world currently. It is estimated that this number of stroke cases will increase by 2.25 by the year 2050. Considering the large number of potential patients with stroke, a mathematical model is designed to predict ones risk of having a stroke in the future based on ones basic health data using machinery methods. Using the algorithm of Logistic Regression, the model reaches an accuracy of 92.28% when predicting whether one has a stroke, the model also validates that hypertension is the leading cause of the incidence of stroke by finding out the highest correlation value among all the feature variables. People who would like to know their probability of having a stroke can use the model, then they can have some precautionary measures to lower the likelihood of happening of stroke based on the prediction given, which helps save the medical costs and overuse of medical resources. Governments can enact policies and allocate medical resources based on the predictions made by the model.

Posterior cerebral artery stroke with visual manifestation during COVID pandemic

The posterior cerebral artery (PCA) stroke represents 5% to 10% of total strokes. The number of stroke cases has increased during the Global pandemic of Covid 19. It can be challenging to diagnose PCA stroke presenting as a visual manifestation, as symptoms are nonspecific and variable over due course of time. This is more complex in patients who are not aware of their symptoms, and therefore difficult to establish a timeline of events. Mostly PCA stroke with only visual symptoms visits an ophthalmologist rather than an emergency attendee. Knowledge of the neurovascular anatomy of the brain is required to understand PCA stroke and identify the stroke’s mechanism to select appropriate therapies. In this article, we provide an overview of PCA stroke and focused on visual manifestations, diagnosis, and management of PCA stroke.

STROKE PREDICTION USING A SUPPORT VECTOR MACHINE (SVM)

Based on data from the Indonesian Ministry of Health, there has been an increase in the number of stroke cases by 3.9% from 2013 to 2018. Nationally, the number of stroke cases often occurs in groups that have an age range between 55-64 years and the least occur in the 15-24 age range. A stroke (Cerebrovascular Accident) is a condition where blood flow to the brain is suddenly interrupted or reduced. This can be caused by a blockage or rupture of blood vessels so that cells in the brain area do not get a blood supply that is full of nutrients and oxygen. Early detection is needed which aims to reduce the number of potential deaths from stroke. Stroke prediction is still a challenge in the field of medicine, one of the reasons is the volume of data on medical data which has high heterogeneity and complexity. Machine learning techniques are data analysis models that can be used to predict stroke. Various machine learning models have been proposed by previous researchers, one of which is the Support Vector Machine. This study tries to re-implement the SVM algorithm to get better performance results than previous studies. In this study, the accuracy value was 100% and ROC-AUC values were 100%. Further studies need to be carried out regarding the results obtained to reach 100%.

Stroke rates in non-anticoagulated individuals with and without atrial fibrillation and one non-sex CHA2DS2-VASc risk factor: a nationwide registry-based cohort (Atrial Fibrillation in Norway – AFNOR)

Abstract Background Stroke prevention is fundamental in the management of atrial fibrillation (AF). However, in patients with intermediate risk of stroke (CHA2DS2-VASc score 2 in women; 1 in men) the net clinical benefit of oral anticoagulant (OAC) treatment is uncertain, as the treatment effect must be carefully balanced against the potential bleeding risk. Moreover, multiple risk factors included in the CHA2DS2-VASc score increase the risk of stroke independent of AF. Purpose We aimed to compare rates of ischemic and haemorrhagic stroke between non-anticoagulated individuals with and without AF in a nationwide cohort of individuals at intermediate risk of stroke. Method We identified a cohort of non-anticoagulated Norwegian individuals with and without non-valvular AF aged ≥18 years, with one non-sex CHA2DS2-VASc risk factor linking data from the Norwegian Population Registry, Patient Registry, Prescription Database and Cause of Death Registry. AF and comorbidities were identified with minimum three-year look-back period at study start and successively during follow up. Individuals without AF entered the study at date of first registered non-sex CHA2DS2-VASc risk factor while individuals with AF entered at the first date when both AF and first CHA2DS2-VASc risk factor were registered. Individuals with and without AF were followed from study start in 2011 until occurrence of stroke, death, emigration, OAC claim, increased CHA2DS2-VASc score or end of follow-up on December 31, 2018. Rates of ischemic and haemorrhagic stroke were calculated as the number of stroke cases per 100 person-years with 95% confidence intervals (CI). Results During 2011–2018, a total of 61,762 individuals with AF at intermediate risk of stroke and no previous OAC use were identified (mean age 63.2±7.6 years (SD); 37% women). In the AF population, a total of 1,304 ischemic strokes were registered during 109,881 person-years, and 127 haemorrhagic strokes during 109,559 person-years. In the corresponding intermediate risk non-AF population, 1,099,655 individuals (mean age 59.5±10.2 years (SD); 49.5% women) were identified, with a total of 6,081 ischemic strokes during 4,037,940 person-years and 3,037 haemorrhagic strokes during 4,022,952 person-years. The rate of ischemic stroke was 1.19 (95% CI, 1.12–1.25) in AF-patients and 0.15 (95% CI, 0.15–0.15) in non-AF individuals per 100 person-years, corresponding to a rate difference of 1.04 excess stroke cases per 100 person-years in AF patients. The haemorrhagic stroke rate was 0.12 (95% CI, 0.10–0.14) in AF-patients and 0.08 (95% CI, 0.07–0.08) per 100 person-years in non-AF individuals. Similar rate differences were seen in both men and women. Conclusion In a nationwide population with one non-sex CHA2DS2-VASc risk factor and without OAC treatment, we found higher stroke rate in AF patients compared to the rest of the population without AF, with a stroke rate difference of ∼1% per year. Haemorrhagic stroke rates were generally low. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): South-Eastern Norway Regional Health Authority

Targeted vs. full population screening costs for incident atrial fibrillation and AF-related stroke for a healthy population aged 65 years in the United Kingdom.

Atrial Fibrillation (AF) is the most common sustained heart arrhythmia and a major preventable cause of stroke. Stroke accounts for a large amount of health and social care funding and over the coming years is likely to place an increasing cost burden on the wider UK health care system. We therefore need to understand how an opportunistic AF screening programme would impact on healthcare costs of AF (and AF-related stroke) for the NHS. Using UK population forecasts and prior published data we initially calculated the number of people to be screened, newly-diagnosed and treated for Atrial Fibrillation (AF), and the associated costs of such a programme for all 65 year olds and for just a 'high risk' group. The reduction in the number of stroke cases recorded and the associated cost savings were subsequently calculated, for 2020 and the projected estimates over the following decade. The number of newly diagnosed AF patients at 65 years old for the two groups (all 65 year olds and for just a 'high risk' group) would be in 6754 and 797 in 2020, rising to 9200 and 1086 in 2030, respectively. In 2020 the cost of the screening programme for the two options would be £14.3mand £1.7m.IfAF is medicated and monitored then there would be a subsequent reduction in the number of stroke cases in 2020 by 4323 or 510 depending on the group screened, with associated savings of £394.2mand £46.5m, respectively. Focussingon 2030 and should opportunistic screenings for AF be introduced at age 65, with subsequent treatment, it is predicted to reduce the number of stroke cases over the decade by 5888 if all 65 year olds are screened and 695 if just the high risk group are screened. If the number of strokes can be reduced by treating these screened AF patients, we would substantially reduce the health and social care costs of stroke by £654.6mand £77.3m, respectively. The number of newly diagnosed AF patients at age 65 will rise over the decade between 2020 and 2030. Screening and treatment of AF will substantially reduce the health and social care costs of AF-related stroke in the NHS.

Association of Brachial Ankle Pulse Wave Velocity With New Onset Stroke in Hypertensive Patients Aged Less Than 65 With Normal Fasting Glucose Among Chinese Community-Based Population.

BackgroundPrevious studies have shown an association of stroke and brachial ankle pulse wave velocity (baPWV). However, due to limitations on total population size and small numbers of stroke cases, lack of power has prevented further detection among subgroups such as age and laboratory testing.MethodsA total of 19217 participants including 660 incident stroke patients were pooled in the present study. Participants were divided to 2 groups, aged less than 65 years [56.0 (50.0, 61.0)] and aged 65 years or more [70.0 (67.0, 74.0)].ResultsAfter adjustment for demographic, anthropometric, and laboratory parameters, the incident stroke was positively associated to baPWV in the group aged less than 65 years (OR, 1.16; 95% CI, 1.05–1.28), but not in the older group aged 65 or more. When baPWV was assigned as quartiles, a significant, increased risk of new-onset stroke was found in quartiles 3-4 compared with quartile 1. In addition, the predictive value of baPWV for incident stroke was modified by fasting glucose in participants aged less than 65 years (P-interaction = 0.010). An increase in baPWV was strongly, positively associated to new-onset stroke in the subgroup of normal fasting glucose (< 5.6 mmol/L) (OR, 1.34; 95% CI, 1.15 - 1.57), but no effect was seen in the impaired fasting glucose (5.6-7.0 mmol/L) or diabetic fasting glucose (> 7.0 mmol/L) subgroups.ConclusionsIncreased baPWV was significantly associated with new-onset stroke in a hypertensive population aged less than 65 years. Particularly, it is of great importance to monitor baPWV for predicting incident stroke in “relatively healthy” hypertensive patients, i.e. aged less than 65 years with normal fasting glucose.

The Influence of Selected Meteorological Factors on the Prevalence and Course of Stroke.

Background: The objective of this study was to evaluate the impact of weather factors on stroke parameters. Methods: This retrospective study analyzed the records of stroke patients concerning the influence of meteorological conditions and moon phases on stroke parameters. Results: The study group consisted of 402 patients aged between 20 and 102; women constituted 49.8% of the subjects. Ischaemic stroke was diagnosed in 90.5% of patients and hemorrhagic stroke was diagnosed in 9.5% of patients. The highest number of hospitalizations due to stroke was observed in January (48 events); the lowest number was observed in July (23 events). There was no statistically significant correlation between the meteorological parameters on the day of onset and the preceding day of stroke and the neurological status (NIHSS) of patients. Mean air temperature on the day of stroke and the day preceding stroke was significantly lower in the group of patients discharged with a very good functional status (≤2 points in modified Rankin scale (mRS)) compared to the patients with a bad functional status (>2 points in mRS); respectively: 7.98 ± 8.01 vs. 9.63 ± 7.78; p = 0.041 and 8.13 ± 7.72 vs. 9.70 ± 7.50; p = 0.048). Humidity above 75% on the day of stroke was found to be a factor for excellent functional state (RR 1.61; p = 0.016). The total anterior circulation infarcts (in comparison with stroke in the other localization) were more frequent (70%) during a third quarter moon (p = 0.011). The following parameters had a significant influence on the number of stroke cases in relation to autumn having the lowest number of onsets: mean temperature (OR 1.019 95% CI 1.014–1.024, p < 0.000), humidity (OR 1.028, CI 1.023–1.034, p < 0.0001), wind speed (OR 0.923, 95% CI 0.909–0.937, p < 0.0001), insolation (OR 0.885, 95% CI 0.869–0.902, p < 0.0001), precipitation (OR 0.914, 95% CI 0.884–0.946, p < 0.0001). Conclusion: Air humidity and air temperature on the day of stroke onset as well as air temperature on the day preceding stroke are important for the functional status of patients in the acute disease period. A combination of the following meteorological parameters: lowered mean temperature and low sunshine, high humidity and high wind speed all increase the risk of stroke during the winter period. High humidity combined with high precipitation, low wind speed and low sunshine in the autumn period are associated with the lowest stroke incidence risk. A possible relationship between phases of the moon and the incidence requires further investigation.

Oral anticoagulation in atrial fibrillation patients at intermediate risk of stroke: a nationwide registry-based cohort (Atrial Fibrillation in Norway – AFNOR)

Abstract Background The effect of oral anticoagulants (OAC) on prevention of stroke must be carefully balanced against the potential risk of bleeding in patients with atrial fibrillation (AF). The net benefit of OAC in AF patients at intermediate risk of stroke remains unclear. Aim We aimed to determine whether the rates of ischemic and haemorrhagic stroke differ between users and non-users of OAC in a nationwide cohort of AF patients at intermediate risk of stroke. Method We investigated the association between initiation of OAC treatment and rates of ischemic and haemorrhagic stroke in a cohort of Norwegian patients with non-valvular AF aged ≥18 years with one non-sex CHA2DS2-VASc risk factor registered from 2011 to 2018, linking data from the Norwegian Population Registry, Patient Registry, Prescription Database and Cause of Death Registry. Individuals using OAC at baseline were excluded. Each individual had at least a three years look-back period for identification of their first non-sex CHA2DS2-VASc risk factor, after which they entered the study cohort and were followed until occurrence of stroke, death, emigration, higher CHA2DS2-VASc score or end of follow-up on December 31, 2018. Individuals were defined as exposed to OAC from the first redeemed prescription of OAC with a reimbursement code for AF and throughout follow-up. Rates of ischemic and haemorrhagic stroke were calculated as the number of stroke cases per 100 person-years, with 95% confidence intervals (CI). Results During 2011–2018, a total of 61,631 individuals with AF and intermediate risk of stroke were included (mean age 63,8±7,6 years (SD); 37% women), of whom 75% initiated OAC treatment. In total, 1709 ischemic strokes (405 cases in OAC users and 1304 in non-users) were registered during 214,738 person-years, and 378 haemorrhagic strokes (251 cases in OAC users and 127 in non-users) during 213,487 person-years. The rate of ischemic stroke was 0.39 (95% CI, 0.35–0.43) and 1.19 (95% CI, 1.12–1.25) per 100 person-years in OAC users and non-users, respectively. The haemorrhagic stroke rate was 0.24 (95% CI, 0.21–0-27) and 0.12 (95% CI, 0.10–0.14) per 100 person-years in OAC users and non-users, respectively. Both ischemic and haemorrhagic stroke rates were highest among those over 65 years of age (Figure 1). Conclusion In a nationwide cohort of Norwegian AF patients at intermediate risk of stroke, three out of four initiated treatment with OAC. Use of OAC was associated with a considerably lower rate of ischemic stroke compared to non-OAC use. Although haemorrhagic stroke rates were increased in the OAC-users vs. non-users, the hemorrhagic stroke rates were generally low. Funding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): Vestre Viken Health Trust Figure 1. Rates of ischemic and haemorrhagic stroke per 100 person-years in AF-patients at intermediate risk of stroke (CHA2DS2-VASc score 1 in men, score 2 in women) by OAC use during 2011 to 2018. Age corresponds to age at attainment of the first non-sex CHA2DS2-VASc risk factor.

The economic burden of stroke: a systematic review of cost of illness studies.

Stroke is one of the leading causes of morbidity and mortality worldwide. As the number of stroke cases is rising from one year to another, policymakers require data on the amount spent on stroke to enforce better financing policies for prevention, hospital care, outpatient rehabilitation services and social services. We aimed to systematically assess the economic burden of stroke at global level. Cost of stroke studies were retrieved from five databases. We retrieved the average cost per patient, where specified, or estimated it using a top-down approach. Resulting costs were grouped in two main categories: per patient per year and per patient lifetime. We extracted information from forty-six cost of illness studies. Per patient per year costs are larger in high income countries and in studies conducted from the payer perspective. The highest average per patient per year cost by country was reported in the United States ($59,900), followed by Sweden ($52,725) and Spain ($41,950). The highest per patient lifetime costs were reported in Australia ($232,100) for all identified definitions of stroke. Existing literature regarding the economic burden of stroke is concentrated in high-income settings, with very few studies conducted in South America and Africa. Published manuscripts on this topic highlight substantial methodological heterogeneity, rendering comparisons difficult or impossible, even within the same country or among studies with similar costing perspectives.

Risk factors for post stroke epilepsy

Stroke is the leading cause of death and disability in the world. The prevalence of post-stroke epilepsy increases with the increase in the number of stroke cases. Epilepsy may develop in 10% of post-stroke cases and first-diagnosed seizures may develop in 55%. Most often they occur in people who have had intracerebral or subarachnoid haemorrhage. A huge number of factors influence the development of post-stroke seizures and epilepsy. The role of some of them is not in doubt. However, in most cases, the influence of a factor remains controversial and participation in the development of post-stroke epilepsy is not fully proven. The management of post-stroke epilepsy is of great clinical importance, since patients with seizures after a stroke have a higher mortality and disability than those without seizures. Attacks worsen the quality of life of patients, can slow the recovery of functions damaged as a result of a stroke, and aggravate cognitive impairment. Social consequences of post-stroke epilepsy play an important role as well.

Workforce requirements for comprehensive ischaemic stroke care in a developing country: the case of Saudi Arabia

BackgroundIschaemic stroke care requires a co-ordinated multi-disciplinary approach to optimise patient outcomes. Current care provision in Saudi Arabia is below international recommendations, and with increasing patient numbers, variable access to new therapies, and sub-optimal co-ordination of staff, the Kingdom’s Ministry of Health has prioritised strategies to develop stroke care. Our objective was to use local epidemiological data to predict stroke incidence and to combine this with international staffing recommendations to estimate future staff requirements and their costs over a 10-year period.MethodsWe researched existing stroke services and staff availability within Saudi Arabia to establish current provision, undertook epidemiological modelling to predict stroke incidence, and used international staffing recommendations for acute and rehabilitation services to develop a care pathway to provide state-of-the-art stroke services. This information was used to determine the additional staff requirements, and their costs, across the Kingdom.ResultsOur research concluded that current staff numbers and services are inadequate to cope with the projected increase in the number of stroke cases. In order to provide acute and rehabilitation services which use the latest technologies, re-organisation of existing staff and services would be required, together with significant investment in new staff across several disciplines. An estimated additional 43.8 full-time equivalent stroke neurologists would be required, plus 53.5 full-time equivalent interventional neuroradiologists in addition to expansion of occupational therapy and psychology services. The total cost of additional staff over 10 years was estimated to be 862 390 778 Saudi Riyals ($229 970 874).ConclusionsProviding high-quality care for ischaemic stroke patients would involve significant investment in new staff in Saudi Arabia. Further research is required on the applicability of international staffing ratios to countries where there is a significant workforce gap. Nevertheless, this analysis provides a framework to inform stroke care planning and can be adapted to other regions or countries.

P5743Overweight and obesity in adolescent men in Sweden and risk of early stroke

Abstract Background Increasing numbers of stroke cases in the young are reported in many countries, potentially at least partly due to rising rates of overweight and obesity. Most data on the effect of obesity on stroke is derived from middle aged populations; there is a comparative lack of information on the effect of excessive body weight in young people. Purpose We aimed to determine whether body mass index (BMI) at age 18 predicted early stroke events among men in Sweden. Methods Population-based Swedish cohort study of conscripts (n=1,668,921; mean age at baseline, 18.3 years) who enlisted during 1968–2005. Follow-up was done through linkage to the nationwide Swedish patient and death registries. Risk of a first hospitalization for stroke (any type) during follow-up (5–46 years) was calculated with Cox proportional hazards models. Objective baseline measures of fitness and cognition were included in the models in a second set of analyses. Results During follow-up there were 12,512 first hospitalizations for stroke (mean age at diagnosis, 48.5 (SD 9.4) years, maximum 64 years). Compared with men with BMI of 18.5 to 20.0 kg/m2, men with BMI 20 to &lt;22.5 and 22.5 to &lt;25.0 kg/m2 had hazard ratios (HR) of 1.06 (1.00–1.12) and 1.23 (1.14–1.31), respectively, for hospitalization for stroke, after adjustment for age, year of conscription, comorbidities at baseline, parental education, blood pressure, IQ, muscle strength, and fitness. Those with a BMI of ≥35 kg/m2 had an HR of 3.33 (2.46–4.51) for an event before the age of 65, compared to slim men. The multiple-adjusted risk per 1-unit increase in BMI was 1.07 (95% CI, 1.06–1.08). Conclusion We found a rise in risk of early hospitalisation for stroke detectable already at normal levels of body weight at age 18, and rising to more than 3-fold in the highest weight category. Given increasing levels of body weight, and prevalence of overweight, obesity, and severe obesity in young adults, the increased incidence of stroke in the young may potentially partly be explained by rising body weight, with an obvious potential for prevention.

Improved Early Detection of Stroke By FAST Method in Kebraon Village Surabaya

Ignorance of the community about the signs and symptoms of stroke can cause delays of patients stroke be carried to the hospital. FAST (Face, Arm, Speech, Time) is an easy way to identify the symptoms of stroke, causing an increasing number of stroke cases in the community. The purpose of this research is identifying Effect of Health Education about FAST to Knowledge Early Detection of Stroke to The Cadres in Kebraon Village Surabaya.The MethodsThe Design of this research used Pre-experimental with One Group Pretest-Posttest Design approach. The Variable of independent is health education about FAST and the variable of dependent is knowledge early detection of stroke. The number population of health cadre in Kebraon Village is 164 people used Simple random sampling techniques as much as 116 respondents health cadres. The instrument used a questionnaire sheet. Data were analyzed with the Wilcoxon signed rank test.The results showed before being given health education about FAST, the knowledge of cadres majority is deficient. But after being given a health education about FAST, the knowledge of cadres majority is good. Wilcoxon signed rank test indicated the value of health education about FAST to knowledge early detection of stroke ρ = 0.000 ≤ α = 0.05. Conclusion The implication result of the this research showed an enhancement knowledge of early detection of stroke on cadres. Be expected enhancement knowledge to community about early detection of stroke with FAST.Keywords: FAST, Knowledge of Early Detection of Stroke, Cadres

Clinical Profile, Risk Factors and Outcomes in Patients with Acute Stroke-A Prospective Observational study

Background: Burden of disease in India (2005) had estimated that there had been an increase in number of stroke cases in India during the last one and a half decade by 17.05%, thus showing worrying upward trends of disease Objective: To investigate the profile, risk factors, and clinical outcomes in patients with acute stroke. Methods: The study design was prospective observational study was conducted including 65 patients aged more than 18 years admitted in medical wards from November 2017 to April 2018. Detailed clinical profile and investigations were done. Results: Total 70 patients were included in this study. There were more male percent (36.17%) than females (63.83%). The age distribution between the Male and Female and association between the age and gender is found not significant at 5% level of Significance. All patients underwent computed tomography or magnetic resonance imaging; 81% had cerebrovascular imaging.. Conclusion: In conclusion, recovery from acute stroke which found to be highly significant at 5% level of significance.

Modeling the Impact of Transcendental Meditation on Stroke Incidence and Mortality

ObjectivesMeditation has shown promise in clinical trials in reducing systolic blood pressure, one of the main risk factors for stroke. We aim to estimate the potential benefits of popularizing meditation on stroke incidence and mortality in the United States (U.S.). MethodsWe developed a dynamic population-based microsimulation model to simulate the disease progression of each individual and compute disease burden. We calibrated the microsimulation model for stroke incidence and further validated it by comparing the stroke-related mortality for each age group generated by the model with that observed in the U.S. We used the population simulation model to estimate the effects of meditation intervention on the number of stroke cases and deaths over a course of 15 years. ResultsOur results show that we could avert nearly 200,000 stroke cases and 50,000 stroke-related deaths over the course of 15 years. Our sensitivity analysis reveals that most of the benefits come from applying the intervention for individuals older than 60 years. In addition, meditation acceptance and adherence rate play a critical role in its effectiveness. ConclusionsThe practice of meditation, if properly utilized along with the regular antihypertensive medication, could substantially alleviate the burden of stroke in the U.S. In order to design an effective meditation program, policymakers may prioritize funding to the programs that aim to encourage older individuals to practice meditation.

Factors related to 6-month mortality after the first-ever stroke.

BACKGROUND AND OBJECTIVE:Stroke is the second leading cause of death worldwide and the number of stroke cases has increased remarkably over the last 20 years. This study aimed at identifying predictors of with 6-month mortality of first-ever stroke patients and the factors contributing to it in East Azerbaijan province.MATERIALS AND METHODS:A closed cohort study was carried out from April 2014 to December 2014. All cases of first-ever diagnosed stroke were included in the study. Any transient ischemic attack, silent brain infarctions, and the stroke cases which were neither associated with trauma, blood disease nor with malignancy were excluded from the study. The variables of this study include participants' demographic characteristics, stroke severity National Institutes of Health Stroke Scale (NIHSS), and stroke risk factors. Patients were followed up within 6 months. To determine the survival time, the log-rank method was applied to compare intergroup differences. The tests include the univariate and multivariate analysis Cox regression. P < 0.05 were considered as statistically significant.RESULTS:A total of 576 cases of stroke were included in this study. Average age of ischemic and hemorrhagic stroke was 70.15 ± 13.0 and 67.79 ± 12.69, respectively. Case-fatality rate (CFR) of stroke patients was 49.2 and 21.7% in hemorrhagic and ischemic stroke types, respectively. Factors contributing to stroke mortality events include the severity of stroke (NIHSS categories 15–19 and ≥20), age over 65, being female, high body mass index and hyperlipidemia. In the final model, the severity of stroke (with NIHSS 15–19 with hazard ratio (HR) 4.22 (95% confidence interval [CI] 2.36–7.56) and NIHSS ≥20 with HR 5.34 (95% CI: 2.81–10.12) and age above 65 with HR 1.61 (95% CI: 1.02–2.51) were the most important predictors of 6-month mortality.CONCLUSION:Severity of stroke by NIHSS was the most prominent factor in stroke patients' mortality. By increasing the follow-up time, a better evaluation of the predictors of mortality after stroke can be achieved.

Top 3 Behavioral Tests in Cell Therapy Studies After Stroke: Difficult to Stop a Moving Train.

Stroke is a huge burden to our society now, and this is expected to grow in the future. The recent stroke burden report in Europe predicts that there will be a 34% increase in the number of stroke cases from 2015 to 2035.1 As a result of improved acute care (eg, thrombolysis, mechanical thrombectomy), more and more patients survive after stroke, but are left with permanent disabilities. One clear unmet medical need is to enhance a functional recovery of stroke patients, and much effort is being expended in devising the so-called restorative therapies, especially those involving stem cells. However, although there is convincing experimental evidence for the benefits of cell therapy, their efficacy remains to be confirmed in human patients.2 The assessment of therapeutic efficacy of cell products in experimental stroke models relies heavily on behavioral testing. There are many behavioral outcome measures available designed to assess gross neurologic deficits, sensorimotor function, and fine skilled movements.3–6 However, there is no consensus about which tests are sensitive for detecting long-term treatment effects or, in general, if there is even an optimal study design for these kinds of stroke recovery studies. Hicks et al7 listed the most frequently used behavioral tests in 2001 to 2009 for assessing the functional outcome after cell-based therapy in experimental stroke. The top 3 were modified neurological severity score (mNSS), adhesive tape removal, and the Rotarod test. The surprising finding was that these frequently used tests most likely to yield positive treatment effects but it is far from clear whether this is because of enhanced motivation, motor learning, or compensation complicating data interpretation. Indeed, these behavioral tasks are simple, requiring minimal manpower, but are also rather likely to be affected by the compensatory strategies developed by stroke animals while completing a …

The Burden of Stroke in the Lao People's Democratic Republic

In the Lao People's Democratic Republic (Laos), stroke is ranked as the third leading cause of death, with a 9·01% mortality rate. To date, neither the prevalence nor the incidence of stroke has been recorded in Laos. This omission may be attributed to a lack of awareness among Laotians of the signs and symptoms of stroke, incomplete data, or insufficient database recording. The only risk factor for stroke that has been studied extensively is cigarette smoking; studies have found that smokers have twice the risk of stroke. Unfortunately, smoking is increasing among youths, adults, and even healthcare professionals. The Southeast Asia Tobacco Control Alliance stated that 42% of hospitalized stroke patients are smokers. Laos is one of the least developed countries in the world, and the country has only one fully trained neurologist for the growing number of stroke cases. The Laos government should seek help from international bodies, such as the World Health Organization, to monitor and rehabilitate stroke patients and prevent stroke occurrence and recurrence.