Pub Date : 2025-01-08DOI: 10.1016/j.jstrokecerebrovasdis.2025.108228
A Zepeski , BA Faine , M Ghannam , HM Olalde , L Wendt , A Naidech , NM Mohr , EC Leira
Background
Intracranial hemorrhage (ICH) is a complication of oral anticoagulation and is associated with significant morbidity and mortality. Clinical need exists for biomarkers to measure anticoagulation in patients with factor Xa inhibitor-associated ICH to assess the hemostatic effect of reversal agents. This study explored the utility of thromboelastography (TEG) to assess anticoagulation in emergency department (ED) patients who received activated prothrombin complex concentrate (aPCC) reversal for factor Xa-inhibitor-associated ICH.
Methods
This was a prospective, single-center, cohort study in a convenient sample of adult patients presenting to the ED with acute factor Xa-associated ICH. Exclusion criteria included pregnancy, incarceration, polytrauma, hepatic failure, or other known coagulopathic conditions. TEG samples were collected prior to anticoagulation reversal, as well as at 30-minutes, 12-hours, and 24-hours post-reversal. Only patients who received aPCC reversal were included in the final analysis.
Results
Pre-reversal TEG was collected on 10 participants prior to aPCC administration. A significant decrease in TEG R-time was observed at 30 minutes post-aPCC reversal (Beta = -0.91, p = 0.035). R-time increased at 12- and 24-hours post-aPCC reversal to baseline levels. Significant changes were not observed in K-time, clot strength, maximum amplitude, or coagulation index.
Conclusions
TEG R-time decreases acutely after anticoagulation reversal with aPCC and rebounds at 12- and 24-hours post-reversal. TEG R-time may serve as a potential sensitive biomarker of the residual anticoagulation activity of factor Xa inhibitors in patients with ICH that undergo anticoagulation reversal with aPCCs.
{"title":"Thromboelastography may assess the effect of anticoagulation reversal in intracranial hemorrhage","authors":"A Zepeski , BA Faine , M Ghannam , HM Olalde , L Wendt , A Naidech , NM Mohr , EC Leira","doi":"10.1016/j.jstrokecerebrovasdis.2025.108228","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108228","url":null,"abstract":"<div><h3>Background</h3><div>Intracranial hemorrhage (ICH) is a complication of oral anticoagulation and is associated with significant morbidity and mortality. Clinical need exists for biomarkers to measure anticoagulation in patients with factor Xa inhibitor-associated ICH to assess the hemostatic effect of reversal agents. This study explored the utility of thromboelastography (TEG) to assess anticoagulation in emergency department (ED) patients who received activated prothrombin complex concentrate (aPCC) reversal for factor Xa-inhibitor-associated ICH.</div></div><div><h3>Methods</h3><div>This was a prospective, single-center, cohort study in a convenient sample of adult patients presenting to the ED with acute factor Xa-associated ICH. Exclusion criteria included pregnancy, incarceration, polytrauma, hepatic failure, or other known coagulopathic conditions. TEG samples were collected prior to anticoagulation reversal, as well as at 30-minutes, 12-hours, and 24-hours post-reversal. Only patients who received aPCC reversal were included in the final analysis.</div></div><div><h3>Results</h3><div>Pre-reversal TEG was collected on 10 participants prior to aPCC administration. A significant decrease in TEG R-time was observed at 30 minutes post-aPCC reversal (Beta = -0.91, p = 0.035). R-time increased at 12- and 24-hours post-aPCC reversal to baseline levels. Significant changes were not observed in K-time, clot strength, maximum amplitude, or coagulation index.</div></div><div><h3>Conclusions</h3><div>TEG R-time decreases acutely after anticoagulation reversal with aPCC and rebounds at 12- and 24-hours post-reversal. TEG R-time may serve as a potential sensitive biomarker of the residual anticoagulation activity of factor Xa inhibitors in patients with ICH that undergo anticoagulation reversal with aPCCs.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 3","pages":"Article 108228"},"PeriodicalIF":2.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-08DOI: 10.1016/j.jstrokecerebrovasdis.2025.108232
Matija Zupan , Janja Pretnar Oblak , Senta Frol
{"title":"Letter to the editor, regarding “Iatrogenic cerebral amyloid angiopathy: Two case reports to explore clinical heterogeneity and pathological patterns” recently published by Vera-Cáceres and colleagues","authors":"Matija Zupan , Janja Pretnar Oblak , Senta Frol","doi":"10.1016/j.jstrokecerebrovasdis.2025.108232","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108232","url":null,"abstract":"","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 3","pages":"Article 108232"},"PeriodicalIF":2.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-07DOI: 10.1016/j.jstrokecerebrovasdis.2024.108197
Katherine Sewell PhD , Tamara Tse PhD , Leonid Churilov PhD , Thomas Linden PhD , Sheila Crewther PhD , Henry Ma PhD , Stephen M. Davis MD , Geoffrey A. Donnan MD , Leeanne M. Carey PhD
Objectives
Knowledge of the trajectory of post-stroke depression is important to identify high-risk patients, develop precise management programs and enhance prognosis. We aimed to characterise the course of depressive symptoms within the first year post-stroke and to evaluate associations with time.
Materials and Methods
Depressive symptoms were measured using the Montgomery-Åsberg Depression Rating Scale (MADRS) within the first week, and at 3 and 12 months post-stroke. Scores were dichotomised into symptoms ‘present’ (MADRS ≥ 7) or ‘absent’ (MADRS < 7). The course of depressive symptoms within individuals was mapped and categorised using a trajectory diagram. The association between time and the presence of depressive symptoms was investigated using random effects logistic regression. Logistic regression was also used to assess the likelihood of participants having depressive symptoms later, given their status at earlier time points.
Results
Of 142 ischaemic stroke survivors included for analysis, almost half (47.9%) experienced a change in depressive symptom status over time. Depressive symptoms were common at each timepoint (35-43%), although an association between time and frequency of depressive symptoms was not evident. Stroke survivors with depressive symptoms at 3 months were more likely to have depressive symptoms at 12 months, compared to those without symptoms at 3 months.
Conclusion
Our findings provide evidence for a dynamic trajectory of depressive symptoms in individuals in the first year post-stroke. The importance of repeated screening for depression is highlighted, though most necessary at 3 months post-stroke.
{"title":"Trajectory of depressive symptoms in a longitudinal stroke cohort","authors":"Katherine Sewell PhD , Tamara Tse PhD , Leonid Churilov PhD , Thomas Linden PhD , Sheila Crewther PhD , Henry Ma PhD , Stephen M. Davis MD , Geoffrey A. Donnan MD , Leeanne M. Carey PhD","doi":"10.1016/j.jstrokecerebrovasdis.2024.108197","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108197","url":null,"abstract":"<div><h3>Objectives</h3><div>Knowledge of the trajectory of post-stroke depression is important to identify high-risk patients, develop precise management programs and enhance prognosis. We aimed to characterise the course of depressive symptoms within the first year post-stroke and to evaluate associations with time.</div></div><div><h3>Materials and Methods</h3><div>Depressive symptoms were measured using the Montgomery-Åsberg Depression Rating Scale (MADRS) within the first week, and at 3 and 12 months post-stroke. Scores were dichotomised into symptoms ‘present’ (MADRS ≥ 7) or ‘absent’ (MADRS < 7). The course of depressive symptoms within individuals was mapped and categorised using a trajectory diagram. The association between time and the presence of depressive symptoms was investigated using random effects logistic regression. Logistic regression was also used to assess the likelihood of participants having depressive symptoms later, given their status at earlier time points.</div></div><div><h3>Results</h3><div>Of 142 ischaemic stroke survivors included for analysis, almost half (47.9%) experienced a change in depressive symptom status over time. Depressive symptoms were common at each timepoint (35-43%), although an association between time and frequency of depressive symptoms was not evident. Stroke survivors with depressive symptoms at 3 months were more likely to have depressive symptoms at 12 months, compared to those without symptoms at 3 months.</div></div><div><h3>Conclusion</h3><div>Our findings provide evidence for a dynamic trajectory of depressive symptoms in individuals in the first year post-stroke. The importance of repeated screening for depression is highlighted, though most necessary at 3 months post-stroke.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 3","pages":"Article 108197"},"PeriodicalIF":2.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.jstrokecerebrovasdis.2024.108165
Linshan Pan , Yongjun Peng , Lihua Jiang
Background
The correlation between the prognostic nutritional index (PNI) and the risk of stroke has become a hot spot within the medical research community. The available evidence from a large sample regarding the correlation between PNI and stroke is inadequate. There is also a need for more research analysis from national surveys.
Objective
The principal goal of this research is to improve our understanding of the relationship between PNI and the risk of stroke. This study also intends to investigate the potential synergistic influence of PNI on stroke in combination with other interacting variables.
Methods
A cross-sectional study was conducted with 35,549 participants selected from the National Health and Nutrition Examination Survey (NHANES) 2005–2018 cycle. Information was gathered from all participants regarding the following: lymphocyte count, albumin levels, stroke occurrence, age, sex, race/ethnicity, education level, poverty income ratio (PIR), marital status, body mass index (BMI), smoking habits, drinking status, physical activity measured in total metabolic equivalents (PA_total_MET), diabetes status, glycohemoglobin levels, total cholesterol, direct high-density lipoprotein cholesterol(direct HDL-cholesterol), hypertension, and coronary heart disease. Curve fitting, subgroup analysis, and multifactor weighted logistic regression analysis were used to examine the relationship between PNI and stroke.
Results
The overall prevalence of stroke was found to be 3.9%, PNI quartile 4(Q4) had an increased prevalence of stroke than quartile 1, 2, and 3(Q1,2,3). Our research suggested a negative association between PNI and the risk of stroke, as indicated by the odds ratio (OR=0.98) with a 95% confidence interval (CI=0.97∼0.99) and a p-value <0.05 (P=0.005), even after adjusting for all confounders. Subsequent subgroup analysis indicated a significant difference in the impact of PNI on stroke between individuals with different body mass index(BMI) levels (p for interaction = 0.02).
Conclusion
Our findings underscore that lower PNI in US adults is associated with an increased stroke risk, shedding light on a potential interrelationship between nutrition, inflammatory parameters, and stroke.
{"title":"Association between prognostic nutritional index and stroke: A nationally representative cross-sectional study from NHANES","authors":"Linshan Pan , Yongjun Peng , Lihua Jiang","doi":"10.1016/j.jstrokecerebrovasdis.2024.108165","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108165","url":null,"abstract":"<div><h3>Background</h3><div>The correlation between the prognostic nutritional index (PNI) and the risk of stroke has become a hot spot within the medical research community. The available evidence from a large sample regarding the correlation between PNI and stroke is inadequate. There is also a need for more research analysis from national surveys.</div></div><div><h3>Objective</h3><div>The principal goal of this research is to improve our understanding of the relationship between PNI and the risk of stroke. This study also intends to investigate the potential synergistic influence of PNI on stroke in combination with other interacting variables.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted with 35,549 participants selected from the National Health and Nutrition Examination Survey (NHANES) 2005–2018 cycle. Information was gathered from all participants regarding the following: lymphocyte count, albumin levels, stroke occurrence, age, sex, race/ethnicity, education level, poverty income ratio (PIR), marital status, body mass index (BMI), smoking habits, drinking status, physical activity measured in total metabolic equivalents (PA_total_MET), diabetes status, glycohemoglobin levels, total cholesterol, direct high-density lipoprotein cholesterol(direct HDL-cholesterol), hypertension, and coronary heart disease. Curve fitting, subgroup analysis, and multifactor weighted logistic regression analysis were used to examine the relationship between PNI and stroke.</div></div><div><h3>Results</h3><div>The overall prevalence of stroke was found to be 3.9%, PNI quartile 4(Q4) had an increased prevalence of stroke than quartile 1, 2, and 3(Q1,2,3). Our research suggested a negative association between PNI and the risk of stroke, as indicated by the odds ratio (OR=0.98) with a 95% confidence interval (CI=0.97∼0.99) and a p-value <0.05 (P=0.005), even after adjusting for all confounders. Subsequent subgroup analysis indicated a significant difference in the impact of PNI on stroke between individuals with different body mass index(BMI) levels (p for interaction = 0.02).</div></div><div><h3>Conclusion</h3><div>Our findings underscore that lower PNI in US adults is associated with an increased stroke risk, shedding light on a potential interrelationship between nutrition, inflammatory parameters, and stroke.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 1","pages":"Article 108165"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.jstrokecerebrovasdis.2024.108168
Changxing Liu , Zhirui Zhang , Tianwei Meng , Chengjia Li , Boyu Wang , Xulong Zhang
Background
While cardiovascular disease is linked to abnormal lipid metabolism, the relationship between NHHR (non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio), a new lipid metric, and cardiovascular disease in middle-aged and older adults in China is still unclear.
Methods
This cohort study, based on a population sample, examined the incidence of cardiovascular disease (CVD) events, including stroke and heart disease. It utilized self-reported diagnoses from the study's inception and during Wave 4, involving 9259 participants from the China Health and Retirement Longitudinal Study (CHARLS). The research employed restricted cubic spline models and multivariate logistic regression to investigate possible non-linear relationships. Additionally, subgroup analyses were conducted to assess the influence of socio-demographic factors on the outcomes.
Result
During the seven-year follow-up period, 1,139 participants developed CVD, including 742 cases of heart problems and 582 strokes. In Model 3, it was observed that for each unit increase in the highest NHHR group, the risk of developing CVD increased by 98%, the risk of stroke increased by 48%, and the risk of heart problems increased by 115%. Subgroup analyses indicated that this correlation was more pronounced among individuals under 60 years of age and those with hypertension.
Conclusions
According to the current study, elevated NHHR ratio is an important risk factor for CVD in middle-aged and elderly Chinese. Early intervention in patients with higher NHHR ratios may help to further reduce the incidence of CVD.
{"title":"Cross-sectional analysis of non-HDL/HDL cholesterol ratio as a marker for cardiovascular disease risk in middle-aged and older adults: Evidence from the CHARLS study","authors":"Changxing Liu , Zhirui Zhang , Tianwei Meng , Chengjia Li , Boyu Wang , Xulong Zhang","doi":"10.1016/j.jstrokecerebrovasdis.2024.108168","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108168","url":null,"abstract":"<div><h3>Background</h3><div>While cardiovascular disease is linked to abnormal lipid metabolism, the relationship between NHHR (non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio), a new lipid metric, and cardiovascular disease in middle-aged and older adults in China is still unclear.</div></div><div><h3>Methods</h3><div>This cohort study, based on a population sample, examined the incidence of cardiovascular disease (CVD) events, including stroke and heart disease. It utilized self-reported diagnoses from the study's inception and during Wave 4, involving 9259 participants from the China Health and Retirement Longitudinal Study (CHARLS). The research employed restricted cubic spline models and multivariate logistic regression to investigate possible non-linear relationships. Additionally, subgroup analyses were conducted to assess the influence of socio-demographic factors on the outcomes.</div></div><div><h3>Result</h3><div>During the seven-year follow-up period, 1,139 participants developed CVD, including 742 cases of heart problems and 582 strokes. In Model 3, it was observed that for each unit increase in the highest NHHR group, the risk of developing CVD increased by 98%, the risk of stroke increased by 48%, and the risk of heart problems increased by 115%. Subgroup analyses indicated that this correlation was more pronounced among individuals under 60 years of age and those with hypertension.</div></div><div><h3>Conclusions</h3><div>According to the current study, elevated NHHR ratio is an important risk factor for CVD in middle-aged and elderly Chinese. Early intervention in patients with higher NHHR ratios may help to further reduce the incidence of CVD.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 1","pages":"Article 108168"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.jstrokecerebrovasdis.2024.108218
Linrong He , Ruolan Lei , Shuangyang Li , Xiaoying Zhao , Xinying He , Xinyue Yang , Ping Liu , Dechou Zhang , Yu Jiang
Objective
Hirudin has shown potential in promoting angiogenesis and providing neuroprotection in ischemic stroke; however, its therapeutic role in promoting cerebrovascular angiogenesis remains unclear. In this study, we aimed to investigate whether hirudin exerts neuroprotective effects by promoting angiogenesis through the regulation of the Wnt/β-catenin signaling pathway.
Methods
An in vitro model of glucose and oxygen deprivation/reperfusion (OGD/R) was established using rat brain microvascular endothelial cells (BMECs). The effects of hirudin on OGD/R cell viability were assessed using the cell counting kit-8 (CCK-8) assay. The angiogenic potential of hirudin was evaluated using Transwell and tube formation assays. In vivo, a middle cerebral artery occlusion/reperfusion (MCAO/R) model was created in rats. The neuroprotective effects of hirudin were assessed using the modified neurological severity score (mNSS), Hematoxylin and eosin (H&E) staining, 2,3,5-Triphenyltetrazolium chloride (TTC) staining, and immunofluorescence staining. Dickkopf-1 (DKK1), a specific inhibitor of this pathway, was introduced in order to investigate the role of the Wnt/β-catenin pathway. The effects of hirudin on the Wnt/β-catenin pathway were examined through immunohistochemistry, western blotting, and reverse transcription quantitative polymerase chain reaction (RT-qPCR).
Results
Hirudin significantly improved BMEC survival and enhanced both cell migration and tube formation in the OGD/R model. In the MCAO/R model, hirudin reduced the mNSS score, alleviated pathological damage, decreased infarction volume, and increased the expression of key angiogenic factors, including CD34, vascular endothelial growth factor (VEGF), and angiopoietin-2 (Ang-2). In addition, hirudin activated the Wnt/β-catenin pathway, leading to elevated levels of Wnt3a and β-catenin.
Conclusion
Hirudin has substantial neuroprotective effects associated with the promotion of angiogenesis in the ischemic penumbra. This mechanism is mediated by the regulation of the Wnt/β-catenin pathway.
{"title":"Hirudin promotes cerebral angiogenesis and exerts neuroprotective effects in MCAO/R rats by activating the Wnt/β-catenin pathway","authors":"Linrong He , Ruolan Lei , Shuangyang Li , Xiaoying Zhao , Xinying He , Xinyue Yang , Ping Liu , Dechou Zhang , Yu Jiang","doi":"10.1016/j.jstrokecerebrovasdis.2024.108218","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108218","url":null,"abstract":"<div><h3>Objective</h3><div>Hirudin has shown potential in promoting angiogenesis and providing neuroprotection in ischemic stroke; however, its therapeutic role in promoting cerebrovascular angiogenesis remains unclear. In this study, we aimed to investigate whether hirudin exerts neuroprotective effects by promoting angiogenesis through the regulation of the Wnt/β-catenin signaling pathway.</div></div><div><h3>Methods</h3><div>An in vitro model of glucose and oxygen deprivation/reperfusion (OGD/R) was established using rat brain microvascular endothelial cells (BMECs). The effects of hirudin on OGD/R cell viability were assessed using the cell counting kit-8 (CCK-8) assay. The angiogenic potential of hirudin was evaluated using Transwell and tube formation assays. In vivo, a middle cerebral artery occlusion/reperfusion (MCAO/R) model was created in rats. The neuroprotective effects of hirudin were assessed using the modified neurological severity score (mNSS), Hematoxylin and eosin (H&E) staining, 2,3,5-Triphenyltetrazolium chloride (TTC) staining, and immunofluorescence staining. Dickkopf-1 (DKK1), a specific inhibitor of this pathway, was introduced in order to investigate the role of the Wnt/β-catenin pathway. The effects of hirudin on the Wnt/β-catenin pathway were examined through immunohistochemistry, western blotting, and reverse transcription quantitative polymerase chain reaction (RT-qPCR).</div></div><div><h3>Results</h3><div>Hirudin significantly improved BMEC survival and enhanced both cell migration and tube formation in the OGD/R model. In the MCAO/R model, hirudin reduced the mNSS score, alleviated pathological damage, decreased infarction volume, and increased the expression of key angiogenic factors, including CD34, vascular endothelial growth factor (VEGF), and angiopoietin-2 (Ang-2). In addition, hirudin activated the Wnt/β-catenin pathway, leading to elevated levels of Wnt3a and β-catenin.</div></div><div><h3>Conclusion</h3><div>Hirudin has substantial neuroprotective effects associated with the promotion of angiogenesis in the ischemic penumbra. This mechanism is mediated by the regulation of the Wnt/β-catenin pathway.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 3","pages":"Article 108218"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.jstrokecerebrovasdis.2024.108043
Muhammad Saad MBBS , Maria Saleem MBBS , Umar Maqbool MBBS , Fareeha Khan MBBS , Maleeha Saleem MBBS , Eman Alamgir MBBS , Salvia Qazi MBBS , Haram Rehman MBBS , Aleena Arshad Ali BDS , Arfa Ahmed Assad MBBS , Aasma Javed MBBS , Qais Bin Abdul Ghaffar MBBS , Ammad Adeel MBBS , Faheemullah Khan MD , Adarsh Raja MBBS
Background
One of the most prevalent causes of morbidity and death is cerebrovascular disease in the US. The manifestations and pathophysiology of cerebrovascular disease are significantly impacted by ageing and determine the quality of one's late life. However, contemporary mortality trends in cerebrovascular disease and comparison to older adults of different gender, race, and geographic disparities have not been fully examined. A thorough comprehension of these correlations and current cerebrovascular disease death patterns can impact medical treatment and strategies.
Objective
We examined the mortality trends according to gender, race, and geographical disparities in cerebrovascular disease among older adults, using mortality data (1999 - 2020) from the Centers for Disease Control and Prevention WONDER database
Methods
This research study aims to analyze disparities in cerebrovascular disease among senior citizens in the United States. The analysis has considered factors such as gender, race, and geographical variations over 21 years from 1999 to 2020. Mortality data obtained from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database has been utilized for this retrospective cohort analysis, focusing on individuals aged 75 and above.
Results
From 1999 to 2020, there were 3,813,729 deaths related to Cerebrovascular disease in older adults, demonstrating a declining trend (AAPC=). Males (880.6) had slightly higher AAMRs than females (866.7). Non-Hispanic (NH) Black (1050) had higher AAMRs than NH whites (880.8) followed by NH American Indians (699.7), Hispanic (673.2), and NH Asians (669.3). AAMRs also varied by region with the Midwest (922) having the highest AAMRs followed by the South (918.2), West (884.3), and Northeast (744). Among states, Tennessee had the highest AAMRs (1076.3), whereas New York had the lowest (609.7).
Conclusion
These results indicate a significant decline in cerebrovascular disease-related mortality among older adults from 1999 to 2020, highlighting improvements in healthcare and preventive measures over the two decades. Despite the overall decrease, elderly females had more deaths, elderly males had a higher AAMR, non-Hispanic blacks had the highest AAMR, and the Midwest and non-metropolitan areas had higher mortality burdens. The recent uptick in mortality rates from 2018 to 2020 underscores the need for ongoing public health efforts to address cerebrovascular diseases, particularly targeting vulnerable populations and high-risk regions.
{"title":"Trends in cerebrovascular disease-related mortality among older adults in the United States from 1999 to 2020: An analysis of gender, race/ethnicity, and geographical disparities","authors":"Muhammad Saad MBBS , Maria Saleem MBBS , Umar Maqbool MBBS , Fareeha Khan MBBS , Maleeha Saleem MBBS , Eman Alamgir MBBS , Salvia Qazi MBBS , Haram Rehman MBBS , Aleena Arshad Ali BDS , Arfa Ahmed Assad MBBS , Aasma Javed MBBS , Qais Bin Abdul Ghaffar MBBS , Ammad Adeel MBBS , Faheemullah Khan MD , Adarsh Raja MBBS","doi":"10.1016/j.jstrokecerebrovasdis.2024.108043","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108043","url":null,"abstract":"<div><h3>Background</h3><div>One of the most prevalent causes of morbidity and death is cerebrovascular disease in the US. The manifestations and pathophysiology of cerebrovascular disease are significantly impacted by ageing and determine the quality of one's late life. However, contemporary mortality trends in cerebrovascular disease and comparison to older adults of different gender, race, and geographic disparities have not been fully examined. A thorough comprehension of these correlations and current cerebrovascular disease death patterns can impact medical treatment and strategies.</div></div><div><h3>Objective</h3><div>We examined the mortality trends according to gender, race, and geographical disparities in cerebrovascular disease among older adults, using mortality data (1999 - 2020) from the Centers for Disease Control and Prevention WONDER database</div></div><div><h3>Methods</h3><div>This research study aims to analyze disparities in cerebrovascular disease among senior citizens in the United States. The analysis has considered factors such as gender, race, and geographical variations over 21 years from 1999 to 2020. Mortality data obtained from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database has been utilized for this retrospective cohort analysis, focusing on individuals aged 75 and above.</div></div><div><h3>Results</h3><div>From 1999 to 2020, there were 3,813,729 deaths related to Cerebrovascular disease in older adults, demonstrating a declining trend (AAPC=). Males (880.6) had slightly higher AAMRs than females (866.7). Non-Hispanic (NH) Black (1050) had higher AAMRs than NH whites (880.8) followed by NH American Indians (699.7), Hispanic (673.2), and NH Asians (669.3). AAMRs also varied by region with the Midwest (922) having the highest AAMRs followed by the South (918.2), West (884.3), and Northeast (744). Among states, Tennessee had the highest AAMRs (1076.3), whereas New York had the lowest (609.7).</div></div><div><h3>Conclusion</h3><div>These results indicate a significant decline in cerebrovascular disease-related mortality among older adults from 1999 to 2020, highlighting improvements in healthcare and preventive measures over the two decades. Despite the overall decrease, elderly females had more deaths, elderly males had a higher AAMR, non-Hispanic blacks had the highest AAMR, and the Midwest and non-metropolitan areas had higher mortality burdens. The recent uptick in mortality rates from 2018 to 2020 underscores the need for ongoing public health efforts to address cerebrovascular diseases, particularly targeting vulnerable populations and high-risk regions.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 1","pages":"Article 108043"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.jstrokecerebrovasdis.2024.108117
Xiaoqin Huang, Li Chen
{"title":"Corrigendum to “Spontaneous Neuronal Plasticity in the Contralateral Motor Cortex and Corticospinal Tract after Focal Cortical Infarction in Hypertensive Rats” [J Stroke Cerebrovasc Dis,2020 Dec;29(12):105235/Manuscript NO:JSCVD-D-20-00162]","authors":"Xiaoqin Huang, Li Chen","doi":"10.1016/j.jstrokecerebrovasdis.2024.108117","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108117","url":null,"abstract":"","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 1","pages":"Article 108117"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.jstrokecerebrovasdis.2024.108164
Fábio Pereira , Sergi Bermúdez i Badia , Rúben Ornelas , Mónica S. Cameirão
Here we present a study that explores the feasibility, user engagement, and usability of an interactive system that involves the use of tangible objects with various shapes and properties to interact with virtual tasks designed for upper limb rehabilitation following a stroke. We evaluated five different types of interaction modalities, including three grasps modalities (power grasp, lateral grasp and tripod grasp) and two strength modalities. These were tested using five basic game-like tasks with a total of 20 stroke patients. High levels of enjoyment were reported, and the system overall was considered feasible. The usability mean score (63.3) was acceptable for a system still in development. Enabling the use of tangibles during serious games in rehabilitation settings can enhance the transfer of learning to real-world situations.
{"title":"Feasibility, usability and engagement of a tangible interface for upper limb rehabilitation after stroke","authors":"Fábio Pereira , Sergi Bermúdez i Badia , Rúben Ornelas , Mónica S. Cameirão","doi":"10.1016/j.jstrokecerebrovasdis.2024.108164","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2024.108164","url":null,"abstract":"<div><div>Here we present a study that explores the feasibility, user engagement, and usability of an interactive system that involves the use of tangible objects with various shapes and properties to interact with virtual tasks designed for upper limb rehabilitation following a stroke. We evaluated five different types of interaction modalities, including three grasps modalities (power grasp, lateral grasp and tripod grasp) and two strength modalities. These were tested using five basic game-like tasks with a total of 20 stroke patients. High levels of enjoyment were reported, and the system overall was considered feasible. The usability mean score (63.3) was acceptable for a system still in development. Enabling the use of tangibles during serious games in rehabilitation settings can enhance the transfer of learning to real-world situations.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 1","pages":"Article 108164"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号