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Sample records for animal stroke studies

  1. Obtaining Human Ischemic Stroke Gene Expression Biomarkers from Animal Models: A Cross-species Validation Study.

    Science.gov (United States)

    Wang, Yingying; Cai, Yunpeng

    2016-01-01

    Recent studies have revealed the systematic altering of gene expression in human peripheral blood during the early stages of ischemic stroke, which suggests a new potential approach for the rapid diagnosis or prediction of stroke onset. Nevertheless, due to the difficulties of collecting human samples during proper disease stages, related studies are rather restricted. Many studies have instead been performed on manipulated animal models for investigating the regulation patterns of biomarkers during different stroke stages. An important inquiry is how well the findings of animal models can be replicated in human cases. Here, a method is proposed based on PageRank scores of miRNA-mRNA interaction network to select ischemic stroke biomarkers derived from rat brain samples, and biomarkers are validated with two human peripheral blood gene expression datasets. Hierarchical clustering results revealed that the achieved biomarkers clearly separate the blood gene expression of stroke patients and healthy people. Literature searches and functional analyses further validated the biological significance of these biomarkers. Compared to the traditional methods, such as differential expression, the proposed approach is more stable and accurate in detecting cross-species biomarkers with biological relevance, thereby suggesting an efficient approach of re-using gene biomarkers obtained from animal-model studies for human diseases. PMID:27407070

  2. Publication bias in reports of animal stroke studies leads to major overstatement of efficacy.

    Directory of Open Access Journals (Sweden)

    Emily S Sena

    2010-03-01

    Full Text Available The consolidation of scientific knowledge proceeds through the interpretation and then distillation of data presented in research reports, first in review articles and then in textbooks and undergraduate courses, until truths become accepted as such both amongst "experts" and in the public understanding. Where data are collected but remain unpublished, they cannot contribute to this distillation of knowledge. If these unpublished data differ substantially from published work, conclusions may not reflect adequately the underlying biological effects being described. The existence and any impact of such "publication bias" in the laboratory sciences have not been described. Using the CAMARADES (Collaborative Approach to Meta-analysis and Review of Animal Data in Experimental Studies database we identified 16 systematic reviews of interventions tested in animal studies of acute ischaemic stroke involving 525 unique publications. Only ten publications (2% reported no significant effects on infarct volume and only six (1.2% did not report at least one significant finding. Egger regression and trim-and-fill analysis suggested that publication bias was highly prevalent (present in the literature for 16 and ten interventions, respectively in animal studies modelling stroke. Trim-and-fill analysis suggested that publication bias might account for around one-third of the efficacy reported in systematic reviews, with reported efficacy falling from 31.3% to 23.8% after adjustment for publication bias. We estimate that a further 214 experiments (in addition to the 1,359 identified through rigorous systematic review; non publication rate 14% have been conducted but not reported. It is probable that publication bias has an important impact in other animal disease models, and more broadly in the life sciences.

  3. PET studies of stroke

    International Nuclear Information System (INIS)

    PET already has been helpful in ischemic stroke disease. It has given us new data on physiological events occurring after a stroke; PET indices of blood flow and metabolism have provided the basis for staging the severity of tissue injury and predicting outcome, and PET has shown alterations in tissue function in response to therapy. Experience with PET in hemorrhagic disease is more limited, but initial results suggest a useful role for PET in the evaluation of nontraumatic intracranial hemorrhage as well [Ackerman et al., 1983a]. This brief review discusses general problems in the study of stroke disease using PET and then the contribution of PET to the stroke field

  4. Association between acute statin therapy, survival, and improved functional outcome after ischemic stroke: the North Dublin Population Stroke Study.

    LENUS (Irish Health Repository)

    2011-04-01

    Statins improve infarct volume and neurological outcome in animal stroke models. We investigated the relationship between statin therapy and ischemic stroke outcome in the North Dublin Population Stroke Study.

  5. Large Animal Stroke Models vs. Rodent Stroke Models, Pros and Cons, and Combination?

    Science.gov (United States)

    Cai, Bin; Wang, Ning

    2016-01-01

    Stroke is a leading cause of serious long-term disability worldwide and the second leading cause of death in many countries. Long-time attempts to salvage dying neurons via various neuroprotective agents have failed in stroke translational research, owing in part to the huge gap between animal stroke models and stroke patients, which also suggests that rodent models have limited predictive value and that alternate large animal models are likely to become important in future translational research. The genetic background, physiological characteristics, behavioral characteristics, and brain structure of large animals, especially nonhuman primates, are analogous to humans, and resemble humans in stroke. Moreover, relatively new regional imaging techniques, measurements of regional cerebral blood flow, and sophisticated physiological monitoring can be more easily performed on the same animal at multiple time points. As a result, we can use large animal stroke models to decrease the gap and promote translation of basic science stroke research. At the same time, we should not neglect the disadvantages of the large animal stroke model such as the significant expense and ethical considerations, which can be overcome by rodent models. Rodents should be selected as stroke models for initial testing and primates or cats are desirable as a second species, which was recommended by the Stroke Therapy Academic Industry Roundtable (STAIR) group in 2009. PMID:26463926

  6. The Use of Animal Models for Stroke Research: A Review

    OpenAIRE

    Juliana B Casals; Pieri, Naira CG; Feitosa, Matheus LT; Ercolin, Anna CM; Roballo, Kelly CS; Barreto, Rodrigo SN; Bressan, Fabiana F; Daniele S. Martins; Maria A. Miglino; Carlos E. Ambrósio

    2011-01-01

    Stroke has been identified as the second leading cause of death worldwide. Stroke is a focal neurologic deficit caused by a change in cerebral circulation. The use of animal models in recent years has improved our understanding of the physiopathology of this disease. Rats and mice are the most commonly used stroke models, but the demand for larger models, such as rabbits and even nonhuman primates, is increasing so as to better understand the disease and its treatment. Although the basic mech...

  7. Animal Models of Ischemic Stroke. Part Two: Modeling Cerebral Ischemia

    OpenAIRE

    Bacigaluppi, Marco; Comi, Giancarlo; Dirk M Hermann

    2010-01-01

    Animal models of stroke provide an essential tool for the understanding of the complex cellular and molecular pathophysiology of stroke and for testing novel recanalyzing, neuroprotective, neuroregenerative or anti- inflammatory drugs in pre- clinical setting. Since the first description of the distal occlusion of the middle cerebral artery (MCA) in rats, different techniques and methods to induce focal and global ischemia of the brains have been developed and optimized. The different models,...

  8. EFFECTS OF MULBERRY FRUIT POWDER IN ANIMAL MODEL OF STROKE

    Directory of Open Access Journals (Sweden)

    Pratchaya Kaewkaen

    2012-01-01

    Full Text Available Stroke is the leading cause of death and the important cause of disability worldwide. Presently, the effectiveness of therapeutic strategy is still very limited. Based on the role neuroprotective effect of substance possessing antioxidant effect previously reported, we hypothesized mulberry fruit a substance possessing anti-oxidant activity, might be able to protect against cognitive impairment induced by stroke or cerebral ischemia. Male Wistar rats were orally given mulberry fruit powder at doses of 2,10 and 50 mg kg-1 BW at a periods of 7 days before and 21 days after induced Middle Cerebral Artery Occlusion (MCAO. The animals were determined spatial memory using Morris water maze test, motor performance was determined using neurological score and the sensory performance was also determined using hot plate test every 7 days before and after the operation until the end of experiment. In addition, the density of survival neurons was determined using cresyl violet stain. The results showed that the significant improvement of mulberry fruits in healthy condition after single dose and 7 days of MCAO at dose 2 and10 mg kg-1 BW. In cognitive deficit condition, mulberry fruits can exert neuroprotective at dose 10 and 50 mg kg-1 BW after 21 days MCAO. Moreover, the significant change of sensory recovery was observed at 50 mg kg-1 BW after MCAO 7 days. The mulberry fruits significantly improved the density of survival neurons in CA2 and CA3 of hippocampus after 21 days of MCAO. All results in this study suggested that mulberry fruit had high potential to be developed as novel preventive and therapeutic strategy against stroke condition. However, precise underlying mechanism is still required further investigation.

  9. Neuroserpin polymorphisms and stroke risk in a biracial population: the stroke prevention in young women study

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    Stern Barney J

    2007-10-01

    Full Text Available Abstract Background Neuroserpin, primarily localized to CNS neurons, inhibits the adverse effects of tissue-type plasminogen activator (tPA on the neurovascular unit and has neuroprotective effects in animal models of ischemic stroke. We sought to evaluate the association of neuroserpin polymorphisms with risk for ischemic stroke among young women. Methods A population-based case-control study of stroke among women aged 15–49 identified 224 cases of first ischemic stroke (47.3% African-American and 211 age-matched control subjects (43.1% African-American. Neuroserpin single nucleotide polymorphisms (SNPs chosen through HapMap were genotyped in the study population and assessed for association with stroke. Results Of the five SNPs analyzed, the A allele (frequency; Caucasian = 0.56, African-American = 0.42 of SNP rs6797312 located in intron 1 was associated with stroke in an age-adjusted dominant model (AA and AT vs. TT among Caucasians (OR = 2.05, p = 0.023 but not African-Americans (OR = 0.71, p = 0.387. Models adjusting for other risk factors strengthened the association. Race-specific haplotype analyses, inclusive of SNP rs6797312, again demonstrated significant associations with stroke among Caucasians only. Conclusion This study provides the first evidence that neuroserpin is associated with early-onset ischemic stroke among Caucasian women.

  10. Anemia Boosts Stroke Death Risk, Study Finds

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_160476.html Anemia Boosts Stroke Death Risk, Study Finds Blood condition ... 2016 (HealthDay News) -- Older stroke victims suffering from anemia -- a lack of red blood cells -- may have ...

  11. Translational Hurdles in Stroke Recovery Studies.

    Science.gov (United States)

    Jolkkonen, Jukka; Kwakkel, Gert

    2016-08-01

    Emerging understanding of brain plasticity has opened new avenues for the treatment of stroke. The promising preclinical evidence with neuroprotective drugs has not been confirmed in clinical trials, thus nowadays, researchers, pharmaceutical companies, and funding bodies hesitate to initiate these expensive trials with restorative therapies. Since many of the previous failures can be traced to low study quality, a number of guidelines such as STAIR and STEPS were introduced to rectify these shortcomings. However, these guidelines stem from the study design for neuroprotective drugs and one may question whether they are appropriate for restorative approaches, which rely heavily on behavioral testing. Most of the recovery studies conducted in stroke patients have been small-scale, proof-of-concept trials. Consequently, the overall effect sizes of pooled phase II trials have proved unreliable and unstable in most meta-analyses. Although the methodological quality of trials in humans is improving, most studies still suffer from methodological flaws and do not meet even the minimum of evidence-based standards for reporting randomized controlled trials. The power problem of most phase II trials is mostly attributable to a lack of proper stratification with robust prognostic factors at baseline as well as the incorrect assumption that all patients will exhibit the same proportional amount of spontaneous neurological recovery poststroke. In addition, most trials suffer from insufficient treatment contrasts between the experimental and control arm and the outcomes have not been sufficiently responsive to detect small but clinically relevant changes in neurological impairments and activities. This narrative review describes the main factors that bias recovery studies, both in experimental animals and stroke patients. PMID:27000881

  12. Experimental animal models and inflammatory cellular changes in cerebral ischemic and hemorrhagic stroke

    OpenAIRE

    Yan, Tao; Chopp, Michael; Chen, Jieli

    2015-01-01

    Stroke, including cerebral ischemia, intracerebral hemorrhage, and subarachnoid hemorrhage, is the leading cause of long-term disability and death worldwide. Animal models have greatly contributed to our understanding of the risk factors and the pathophysiology of stroke, as well as the development of therapeutic strategies for its treatment. Further development and investigation of experimental models, however, are needed to elucidate the pathogenesis of stroke and to enhance and expand nove...

  13. Animal models of ischemic stroke and their application in clinical research

    OpenAIRE

    Fluri F; Schuhmann MK; Kleinschnitz C

    2015-01-01

    Felix Fluri, Michael K Schuhmann, Christoph KleinschnitzDepartment of Neurology, University Clinic Wuerzburg, Wuerzburg, GermanyAbstract: This review outlines the most frequently used rodent stroke models and discusses their strengths and shortcomings. Mimicking all aspects of human stroke in one animal model is not feasible because ischemic stroke in humans is a heterogeneous disorder with a complex pathophysiology. The transient or permanent middle cerebral artery occlusion (MCAo) model is ...

  14. A CLINICAL STUDY OF STROKE IN YOUNG

    Directory of Open Access Journals (Sweden)

    Kumbha Thulasi Ram

    2015-02-01

    Full Text Available NTRIDUCTION : Stroke is one of the important causes of morbidity and mortality all over the world. Incidence of stroke steadily increases with age. Experts are concerned of the emerging stroke epidemic in India. Stroke affecting the young has potentially devastating consequence son the individual and his family. Certain risk factors are unique to the young. I t needs more studies for identification and modification of risk factors. The study aims to evaluate clinical features, risk factors, etiology and mortality of stroke in young patients. METHODS : 74 young patients satisfying the inclusion criteria were included in this study. A detailed history was taken from young stroke patients, systemic examination and required investigations were done. Data was collected in standardized proforma and analysed. RESULTS: Stroke in young accounts for 7.95% of stroke cases of all age groups. The mean age of the patients was 34.66 ± 7.48 years. Among 74 patients, 47(63.51% were male and 27(36.49% were female. Seizures, decreased consciousness, speech involvement and motor deficit were observed in 33.78%, 44.59%, 22.97% and 100% of cases respectively. 82.43% patients had ischemic and 17.57% patients had hemorrhagic stroke. Among ischemic stroke, large artery atherosclerosis was 16.21%, tuberculous meningoencephalitis with vasculitis was 16.21%, lacunar stroke was 10.81%, CVT was 10.81% and cardio embolic stroke was 6.76%. Smoking (59.45%, alcoholism (58.10%, hypertension (43.24%, coronary artery disease (8.10%, diabetes mellitus (10.81%, elevated total cholesterol (25.67%, elevated low density lipo proteins (22.97%, elevated triglycerides (27.02% and low HDL (22.97% were important risk factors. Carotid doppler was abnormal in 9.45% of patients. 6.76% patients had mitral stenosis in echocardiogram. Low protein C and protein S were found in 1.35% of patients. Eight (10.81% patients died during the hospital stay. INTERPRETATION AND CONCLUSIONS: The major risk

  15. The Christchurch earthquake stroke incidence study.

    Science.gov (United States)

    Wu, Teddy Y; Cheung, Jeanette; Cole, David; Fink, John N

    2014-03-01

    We examined the impact of major earthquakes on acute stroke admissions by a retrospective review of stroke admissions in the 6 weeks following the 4 September 2010 and 22 February 2011 earthquakes. The control period was the corresponding 6 weeks in the previous year. In the 6 weeks following the September 2010 earthquake there were 97 acute stroke admissions, with 79 (81.4%) ischaemic infarctions. This was similar to the 2009 control period which had 104 acute stroke admissions, of whom 80 (76.9%) had ischaemic infarction. In the 6 weeks following the February 2011 earthquake, there were 71 stroke admissions, and 61 (79.2%) were ischaemic infarction. This was less than the 96 strokes (72 [75%] ischaemic infarction) in the corresponding control period. None of the comparisons were statistically significant. There was also no difference in the rate of cardioembolic infarction from atrial fibrillation between the study periods. Patients admitted during the February 2011 earthquake period were less likely to be discharged directly home when compared to the control period (31.2% versus 46.9%, p=0.036). There was no observable trend in the number of weekly stroke admissions between the 2 weeks leading to and 6 weeks following the earthquakes. Our results suggest that severe psychological stress from earthquakes did not influence the subsequent short term risk of acute stroke, but the severity of the earthquake in February 2011 and associated civil structural damages may have influenced the pattern of discharge for stroke patients.

  16. Stroke and nutrition: A review of studies

    Directory of Open Access Journals (Sweden)

    Mehdi Foroughi

    2013-01-01

    Conclusions : Adherence to Mediterranean diet or DASH diet and increasing the consumption of antioxidant, vitamins, potassium, calcium food sources, vegetables, fruits, and whole grains intake can lower the risk of stroke. Healthy diet is effective in reducing risk of stroke, however, more studies need to be carried out in this area.

  17. Different strokes for different folks: the rich diversity of animal models of focal cerebral ischemia

    OpenAIRE

    Howells, David W.; Michelle J Porritt; Rewell, Sarah S J; O'Collins, Victoria; Sena, Emily S.; van der Worp, H. Bart; Traystman, Richard J; Macleod, Malcolm R.

    2010-01-01

    No single animal model is able to encompass all of the variables known to affect human ischemic stroke. This review highlights the major strengths and weaknesses of the most commonly used animal models of acute ischemic stroke in the context of matching model and experimental aim. Particular emphasis is placed on the relationships between outcome and underlying vascular variability, physiologic control, and use of models of comorbidity. The aim is to provide, for novice and expert alike, an o...

  18. Hyperglycemia decreases expression of 14-3-3 proteins in an animal model of stroke.

    Science.gov (United States)

    Jeon, Seong-Jun; Sung, Jin-Hee; Koh, Phil-Ok

    2016-07-28

    Diabetes is a severe metabolic disorder and a major risk factor for stroke. Stroke severity is worse in patients with diabetes compared to the non-diabetic population. The 14-3-3 proteins are a family of conserved acidic proteins that are ubiquitously expressed in cells and tissues. These proteins are involved in many cellular processes including metabolic pathways, signal transduction, protein trafficking, protein synthesis, and cell cycle control. This study investigated 14-3-3 proteins expression in the cerebral cortex of animals with diabetes, cerebral ischemic injury and a combination of both diabetes and cerebral ischemic injury. Diabetes was induced by intraperitoneal injection of streptozotocin (40mg/kg) in adult male rats. After 4 weeks of treatment, middle cerebral artery occlusion (MCAO) was performed for the induction of focal cerebral ischemia and cerebral cortex tissue was collected 24h after MCAO. We confirmed that diabetes increases infarct volume following MCAO compared to non-diabetic animals. In diabetic animals with MCAO injury, reduction of 14-3-3 β/α, 14-3-3 ζ/δ, 14-3-3 γ, and 14-3-3 ε isoforms was detected. The expression of these proteins was significantly decreased in diabetic animals with MCAO injury compared to diabetic-only and MCAO-only animals. Moreover, Western blot analysis ascertained the decreased expression of 14-3-3 family proteins in diabetic animals with MCAO injury, including β/α, ζ/δ, γ, ε, τ, and η isoforms. These results show the changes of 14-3-3 proteins expression in streptozotocin-induced diabetic animals with MCAO injury. Thus, these findings suggest that decreases in 14-3-3 proteins might be involved in the regulation of 14-3-3 proteins under the presence of diabetes following MCAO. PMID:27177727

  19. Family history and stroke outcome in a bi-ethnic, population-based stroke surveillance study

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    Uchino Ken

    2005-10-01

    Full Text Available Background The genetic epidemiology of ischemic stroke remains relatively unstudied, and information about the genetic epidemiology of ischemic stroke in populations with significant minority representation is currently unavailable. Methods The Brain Attack Surveillance in Corpus Christi project (BASIC is a population-based stroke surveillance study conducted in the bi-ethnic community of Nueces County, Texas, USA. Completed ischemic strokes were identified among patients 45 years or older seen at hospitals in the county between January 1, 2000 – December 31, 2002. A random sample of ischemic stroke patients underwent an in-person interview and detailed medical record abstraction (n = 400. Outcomes, including initial stroke severity (NIH stroke scale, age at stroke onset, 90-day mortality and functional outcome (modified Rankin scale ≥2, were studied for their association with family history of stroke among a first degree relative using multivariable logistic and linear regression. A chi-square test was used to test the association between family history of stroke and ischemic stroke subtype. Results The study population was 53.0% Mexican American and 58.4% female. Median age was 73.2 years. Forty percent reported a family history of stroke among a first degree relative. Family history of stroke was borderline significantly associated with stroke subtype (p = 0.0563. Family history was associated with poor functional outcome in the multivariable model (OR = 1.87; 95% CI: 1.14–3.09. Family history was not significantly related to initial stroke severity, age at stroke onset, or 90-day mortality. Conclusion Family history of stroke was related to ischemic stroke subtype and to functional status at discharge. More research is needed to understand whether stroke subtype would be a useful selection criterion for genetic association studies and to hypothesize about a possible genetic link to recovery following ischemic stroke.

  20. Seizures after stroke : a prospective clinical study.

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    Dhanuka A

    2001-01-01

    Full Text Available Stroke is one of the most common causes of epilepsy in elderly. However, there have been very few prospective studies to define the incidence, pattern and outcome of seizures in stroke. Most studies are based on retrospective analysis of hospital records. Hence, we planned this prospective study to see the clinical, radiological and electroencephalographic characteristics of seizures in stroke and their outcome, from a north Indian tertiary care centre. Over a span of approximately 6 years, 269 consecutive patients with stroke were studied and followed up. Thirty-five (13% of these developed seizures, primarily related to stroke, during mean follow up period of 15.9 months. Twenty of these had infarctions while 15 had haemorrhages. Involvement of the cortical region was seen in most of the patients with seizures. In these patients, 86% of the lesions involved cortical areas exclusively or in addition to subcortical areas on CT scan of the brain. Twenty-seven (77% developed early seizures, two third of them had immediate post-stroke seizures. None of the patients with early onset seizures developed recurrent seizures or epilepsy, while 50% of late onset seizures developed epilepsy. No specific EEG pattern was found in those who later developed epilepsy. In the present study, early onset seizures after stroke were rather common and did not affect outcome and did not recur even when not treated with anti-epileptics. Late onset seizures were less common but were associated with recurrent seizures.

  1. Small-animal PET imaging of the type 1 and type 2 cannabinoid receptors in a photothrombotic stroke model

    International Nuclear Information System (INIS)

    Recent ex vivo and pharmacological evidence suggests involvement of the endocannabinoid system in the pathophysiology of stroke, but conflicting roles for type 1 and 2 cannabinoid receptors (CB1 and CB2) have been suggested. The purpose of this study was to evaluate CB1 and CB2 receptor binding over time in vivo in a rat photothrombotic stroke model using PET. CB1 and CB2 microPET imaging was performed at regular time-points up to 2 weeks after stroke using [18F]MK-9470 and [11C]NE40. Stroke size was measured using MRI at 9.4 T. Ex vivo validation was performed via immunostaining for CB1 and CB2. Immunofluorescent double stainings were also performed with markers for astrocytes (GFAP) and macrophages/microglia (CD68). [18F]MK-9470 PET showed a strong increase in CB1 binding 24 h and 72 h after stroke in the cortex surrounding the lesion, extending to the insular cortex 24 h after surgery. These alterations were consistently confirmed by CB1 immunohistochemical staining. [11C]NE40 did not show any significant differences between stroke and sham-operated animals, although staining for CB2 revealed minor immunoreactivity at 1 and 2 weeks after stroke in this model. Both CB1+ and CB2+ cells showed minor immunoreactivity for CD68. Time-dependent and regionally strongly increased CB1, but not CB2, binding are early consequences of photothrombotic stroke. Pharmacological interventions should primarily aim at CB1 signalling as the role of CB2 seems minor in the acute and subacute phases of stroke. (orig.)

  2. Small-animal PET imaging of the type 1 and type 2 cannabinoid receptors in a photothrombotic stroke model

    Energy Technology Data Exchange (ETDEWEB)

    Vandeputte, Caroline; Casteels, Cindy; Koole, Michel; Gerits, Anneleen [KU Leuven, Division of Nuclear Medicine, Leuven (Belgium); KU Leuven, Molecular Small Animal Imaging Center, MoSAIC, Leuven (Belgium); Struys, Tom [Hasselt University, Laboratory of Histology, Biomedical Research Institute, Hasselt (Belgium); KU Leuven, Biomedical NMR Unit, Leuven (Belgium); Veghel, Daisy van; Evens, Nele; Bormans, Guy [KU Leuven, Molecular Small Animal Imaging Center, MoSAIC, Leuven (Belgium); KU Leuven, Laboratory of Radiopharmacy, Leuven (Belgium); Dresselaers, Tom; Himmelreich, Uwe [KU Leuven, Molecular Small Animal Imaging Center, MoSAIC, Leuven (Belgium); KU Leuven, Biomedical NMR Unit, Leuven (Belgium); Lambrichts, Ivo [Hasselt University, Laboratory of Histology, Biomedical Research Institute, Hasselt (Belgium); Laere, Koen van [KU Leuven, Division of Nuclear Medicine, Leuven (Belgium); KU Leuven, Molecular Small Animal Imaging Center, MoSAIC, Leuven (Belgium); UZ Leuven, Division of Nuclear Medicine, Leuven (Belgium)

    2012-11-15

    Recent ex vivo and pharmacological evidence suggests involvement of the endocannabinoid system in the pathophysiology of stroke, but conflicting roles for type 1 and 2 cannabinoid receptors (CB{sub 1} and CB{sub 2}) have been suggested. The purpose of this study was to evaluate CB{sub 1} and CB{sub 2} receptor binding over time in vivo in a rat photothrombotic stroke model using PET. CB{sub 1} and CB{sub 2} microPET imaging was performed at regular time-points up to 2 weeks after stroke using [{sup 18}F]MK-9470 and [{sup 11}C]NE40. Stroke size was measured using MRI at 9.4 T. Ex vivo validation was performed via immunostaining for CB{sub 1} and CB{sub 2}. Immunofluorescent double stainings were also performed with markers for astrocytes (GFAP) and macrophages/microglia (CD68). [{sup 18}F]MK-9470 PET showed a strong increase in CB{sub 1} binding 24 h and 72 h after stroke in the cortex surrounding the lesion, extending to the insular cortex 24 h after surgery. These alterations were consistently confirmed by CB{sub 1} immunohistochemical staining. [{sup 11}C]NE40 did not show any significant differences between stroke and sham-operated animals, although staining for CB{sub 2} revealed minor immunoreactivity at 1 and 2 weeks after stroke in this model. Both CB{sub 1} {sup +} and CB{sub 2} {sup +} cells showed minor immunoreactivity for CD68. Time-dependent and regionally strongly increased CB{sub 1}, but not CB{sub 2}, binding are early consequences of photothrombotic stroke. Pharmacological interventions should primarily aim at CB{sub 1} signalling as the role of CB{sub 2} seems minor in the acute and subacute phases of stroke. (orig.)

  3. Illuminating the Effects of Stroke on the Diabetic Brain: Insights From Imaging Neural and Vascular Networks in Experimental Animal Models.

    Science.gov (United States)

    Reeson, Patrick; Jeffery, Andrew; Brown, Craig E

    2016-07-01

    Type 1 diabetes is known to cause circulatory problems in the eyes, heart, and limbs, and the brain is no exception. Because of the insidious effects of diabetes on brain circulation, patients with diabetes are two to four times more likely to have an ischemic stroke and are less likely to regain functions that are lost. To provide a more mechanistic understanding of this clinically significant problem, imaging studies have focused on how stroke affects neural and vascular networks in experimental models of type 1 diabetes. The emerging picture is that diabetes leads to maladaptive changes in the cerebrovascular system that ultimately limit neuronal rewiring and recovery of functions after stroke. At the cellular and systems level, diabetes is associated with abnormal cerebral blood flow in surviving brain regions and greater disruption of the blood-brain barrier. The abnormal vascular responses to stroke can be partly attributed to aberrant vascular endothelial growth factor (VEGF) signaling because genetic or pharmacological inhibition of VEGF signaling can mitigate vascular dysfunction and improve stroke recovery in diabetic animals. These experimental studies offer new insights and strategies for optimizing stroke recovery in diabetic populations. PMID:27329953

  4. Preclinical models of stroke in aged animals with or without comorbidities: role of neuroinflammation.

    Science.gov (United States)

    Buga, A-M; Di Napoli, Mario; Popa-Wagner, A

    2013-12-01

    Age is the principal nonmodifiable risk factor for stroke. Over the past 10 years, suitable models for stroke in aged rats have been established. At genetic and cellular level there are significant differences in behavioral, cytological and genomics responses to injury in old animals as compared with the young ones. Behaviorally, the aged rats have the capacity to recover after cortical infarcts albeit to a lower extent than the younger counterparts. Similarly, the increased vulnerability of the aged brain to stroke, together with a decreased interhemisphere synchrony after stroke, assessed by different experimental methods (MRI, fMRI, in vivo microscopy, EEG) leads to unfavorable recovery of physical and cognitive functions in aged people and may have a prognostic value for the recovery of stroke patients. Furthermore, in elderly, comorbidities like diabetes or arterial hypertension are associated with higher risk of stroke, increased mortality and disability, and poorer functional status and quality of life. Aging brain reacts strongly to ischemia-reperfusion injury with an early inflammatory response. The process of cellular senescence can be an important additional contributor to chronic post-stroke by creating a "primed" inflammatory environment in the brain. Overall, these pro-inflammatory reactions promote early scar formation associated with tissue fibrosis and reduce functional recovery. A better understanding of molecular factors and signaling pathways underlying the contribution of comorbidities to stroke-induced pathological sequelae, may be translated into successful treatment or prevention therapies for age-associated diseases which would improve lifespan and quality of life.

  5. Suicide after a stroke: a population study

    DEFF Research Database (Denmark)

    Teasdale, T W; Engberg, A W

    2001-01-01

    STUDY OBJECTIVE: To establish whether there are increased rates of suicide after a stroke and the degree to which any increase is related to gender, age at stroke, diagnosis, duration of hospitalisation, and time since stroke. DESIGN: Cross linkage of national registers for hospitalisations...... cases of suicide were identified. MAIN RESULTS: Annual incidence rates, both observed and expected, together with standardised mortality ratios (SMR) were computed based on annual population and suicide statistics, stratified by age and gender. The overall annual incidence rate of suicide in the cohort.......76) for patients under 50 years of age group and were least for patients 80 years or older (1.3; 0.95, 1.79). There was no clear relation to stroke diagnosis. Suicides were negatively related to duration of hospitalisation, being lowest for those hospitalised for more than three months (0.88; 0.65, 1...

  6. Changes in chronotype after stroke: A pilot study

    Directory of Open Access Journals (Sweden)

    Thomas eKantermann

    2015-01-01

    Full Text Available This study aimed to elucidate associations between stroke onset and severity as well as chronotype (phase of entrainment and internal time of stroke. Fifty-six first-ever ischemic stroke patients participated in a cross-sectional study assessing chronotype (mid-sleep on work-free days corrected for sleep deficit on workdays; MSFsc by applying the Munich ChronoType Questionnaire (MCTQ. The MCTQ was completed twice, on average 68 ± 24 (SD days post stroke and retrospectively for the time before stroke. To assess the impact of stroke in relation to internal time, InTstroke was calculated as MSFsc minus local time of stroke. Stroke severity was assessed via the standard clinical National Institute Health Stroke Scale (NIHSS and modified Ranking Scale (mRS, both at hospital admission and discharge. Overall, most strokes occurred between noon and midnight. There was no significant association between MSFsc and stroke onset. MSFsc changed significantly after stroke, especially in patients with more severe strokes. Changes in MSFsc varied with InTstroke – the earlier the internal time of a stroke relative to MSFsc-before-stroke, the more MSFsc advanced after stroke. In addition, we provide first evidence that MSFsc changes varied between stroke locations. Larger trials are needed to confirm these findings.

  7. FACTOR V LEIDEN AND ISCHEMIC STROKE RISK: THE GENETICS OF EARLY ONSET STROKE (GEOS) STUDY

    Science.gov (United States)

    Hamedani, Ali G.; Cole, John W.; Cheng, Yuching; Sparks, Mary J.; O'Connell, Jeffrey R.; Stine, Oscar C.; Wozniak, Marcella A.; Stern, Barney J.; Mitchell, Braxton D.; Kittner, Steven J.

    2011-01-01

    Background and Purpose Factor V Leiden (FVL) has been associated with ischemic stroke in children, but not in adults. Although the FVL mutation is associated with increased risk for venous thrombosis, its association with ischemic stroke in young adults remains uncertain. Therefore, we examined the association between FVL and ischemic stroke in participants of the Genetics of Early Onset Stroke (GEOS) Study. Methods A population-based case-control study identified 354 women and 476 men aged 15–49 years with first-ever ischemic stroke, and 907 controls. Participant-specific data included vascular risk factors, FVL genotype and, for cases, the ischemic stroke subtype by modified TOAST criteria. Logistic regression was used to calculate odds ratios for the entire population and for subgroups stratified by risk factors and ischemic stroke subtype. Results The frequency of the FVL mutation was similar between ischemic stroke patients (3.6%, 95% CI: 2.5%–5.1%) and non-stroke controls (3.8%, 95% CI: 2.7%–5.2%). This frequency did not change significantly when cases were restricted to patients with stroke of undetermined etiology (4.1%, 95% CI: 2.6%–6.4%). Conclusions Among young adults, we found no evidence for an association between Factor V Leiden and either all ischemic stroke or the subgroup with stroke of undetermined etiology. PMID:22100829

  8. Short- and long-term prognosis for very old stroke patients. The Copenhagen Stroke Study

    DEFF Research Database (Denmark)

    Kammersgaard, Lars Peter; Jørgensen, H S; Reith, J;

    2004-01-01

    BACKGROUND AND PURPOSE: The very old are expected to become a growing part of the stroke population in the industrialised part of the world. The aims of this study were to evaluate clinical characteristics of patients aged 85 years or more at stroke onset and to investigate very old age as an ind...... and rehabilitation after stroke.......BACKGROUND AND PURPOSE: The very old are expected to become a growing part of the stroke population in the industrialised part of the world. The aims of this study were to evaluate clinical characteristics of patients aged 85 years or more at stroke onset and to investigate very old age...... as an independent predictor of short- and long-term outcome. METHODS: In the community-based Copenhagen Stroke Study we recorded admission clinical characteristics in 1197 consecutive stroke patients. Patients were stratified according to age groups on admission. Follow-up was performed at a mean of 7 years after...

  9. Magnetic Resonance Imaging of Cerebral Blood Flow in Animal Stroke Models

    OpenAIRE

    Shen, Qiang; Duong, Timothy Q.

    2016-01-01

    Perfusion could provide useful information on metabolic and functional status of tissue and organs. This review summarizes the most commonly used perfusion measurement methods: dynamic susceptibility weighted contrast (DSC) and arterial spin labeling (ASL) and their applications in experimental stroke. Some new developments of CBF techniques in animal models are also discussed.

  10. Long Sleep Duration and Risk of Ischemic Stroke and Hemorrhagic Stroke: the Kailuan Prospective Study

    Science.gov (United States)

    Song, Qiaofeng; Liu, Xiaoxue; Zhou, Wenhua; Wang, Ling; Zheng, Xiang; Wang, Xizhu; Wu, Shouling

    2016-01-01

    The objective of this study was to examine the relationship between sleep duration and ischemic and hemorrhagic stroke in a community-based cohort. The current analysis included 95,023 Chinese participants who were free of stroke at the baseline survey (2006–2007). Cox proportional hazards models were used to calculate hazard ratios (HRs) and their confidence intervals (CIs) for stroke, according to sleep duration. After a mean follow-up period of 7.9 years, 3,135 participants developed stroke (2,504 ischemic stroke and 631 hemorrhagic stroke). The full adjusted hazard ratio (95% CI) of total stroke (with 6–8 hours of night sleep being considered for the reference group) for individuals reporting greater than 8 hours was 1.29 (1.01–1.64). More significant association between long sleep duration and total stroke was found in the elderly (HR, 1.47; 95% CI, 1.05–2.07). Compared with participants getting 6–8 hours of sleep, only women who reported sleeping more than 8 hours per night were associated with hemorrhagic stroke (HR, 3.58; 95% CI, 1.28–10.06). This study suggested that long sleep duration might be a potential predictor/ marker for total stroke, especially in the elderly. And long sleep duration increased the risk of hemorrhagic stroke only in women. PMID:27633270

  11. Stroke

    Science.gov (United States)

    ... emergency. Strokes happen when blood flow to your brain stops. Within minutes, brain cells begin to die. There are two kinds ... blocks or plugs a blood vessel in the brain. The other kind, called hemorrhagic stroke, is caused ...

  12. Sex Differences in Stroke Survival: 10-Year Follow-up of the Copenhagen Stroke Study Cohort

    DEFF Research Database (Denmark)

    Andersen, Morten Nonboe; Andersen, Klaus Kaae; Kammersgaard, Lars Peter;

    2005-01-01

    -up period. Predictors of death were identified using a Cox proportional hazards model. RESULTS: Of 999 patients, 559 (56%) were women and 440 (44%) were men. Women were older (77.0 v 70.9 years; P strokes (Scandinavian Stroke Scale: 36.1 v 40.5; P Age-adjusted risk......), and 17.4% versus 18.7% (10-year), respectively. Adjusting for age, stroke severity, stroke type, and risk factors, women had a higher probability of survival at 1 year (hazard ratio 1.47, 95% confidence interval 1.10-2.00); 5 years (hazard ratio 1.47, 95% confidence interval 1.23-1.76); and 10 years......BACKGROUND: Although diverging, most studies show that sex has no significant influence on stroke survival. METHODS: In a Copenhagen, Denmark, community all patients with stroke during March 1992 to November 1993 were registered on hospital admission. Stroke severity was measured using...

  13. Hemorrhagic stroke in the Stroke Prevention by Aggressive Reduction in Cholesterol Levels study

    DEFF Research Database (Denmark)

    Goldstein, L.B.; Amarenco, P.; Szarek, M.;

    2008-01-01

    risk was higher in those having a hemorrhagic stroke as the entry event (HR 5.65, 95% CI 2.82 to 11.30, p age (10 y increments, HR 1.42, 95% CI 1.16 to 1.74, p = 0.001). There were no statistical interactions between these factors......: Hemorrhagic stroke was more frequent in those treated with atorvastatin, in those with a hemorrhagic stroke as an entry event, in men, and increased with age. Those with Stage 2 hypertension at the last visit prior to the hemorrhagic stroke were also at increased risk. Treatment did not disproportionately......BACKGROUND: In the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) study, atorvastatin 80 mg/day reduced the risk of stroke in patients with recent stroke or TIA. Post hoc analysis found this overall benefit included an increase in the numbers of treated patients having...

  14. Sex differences in stroke survival: 10-year follow-up of the Copenhagen stroke study cohort

    DEFF Research Database (Denmark)

    Andersen, Morten Nonboe; Andersen, Klaus Kaae; Kammersgaard, Lars Peter;

    2005-01-01

    -up period. Predictors of death were identified using a Cox proportional hazards model. RESULTS: Of 999 patients, 559 (56%) were women and 440 (44%) were men. Women were older (77.0 v 70.9 years; P strokes (Scandinavian Stroke Scale: 36.1 v 40.5; P Age-adjusted risk......), and 17.4% versus 18.7% (10-year), respectively. Adjusting for age, stroke severity, stroke type, and risk factors, women had a higher probability of survival at 1 year (hazard ratio 1.47, 95% confidence interval 1.10-2.00); 5 years (hazard ratio 1.47, 95% confidence interval 1.23-1.76); and 10 years......BACKGROUND: Although diverging, most studies show that sex has no significant influence on stroke survival. METHODS: In a Copenhagen, Denmark, community all patients with stroke during March 1992 to November 1993 were registered on hospital admission. Stroke severity was measured using...

  15. Poststroke epilepsy in the Copenhagen stroke study: incidence and predictors

    DEFF Research Database (Denmark)

    Kammersgaard, Lars Peter; Olsen, Tom Skyhøj

    2005-01-01

    a cohort of 1197 consecutively and prospectively admitted patients with stroke. Patients were followed up for 7 years. We defined PSE as recurrent epileptic seizures with onset after stroke and requiring antiepileptic prophylaxis. PSE was related to clinical factors (age, sex, onset stroke severity, lesion...... patients with stroke within 7 years after stroke. Age, intracerebral hemorrhage, lesion size, increasing stroke severity, and early seizures are independent predictors of PSE.......Poststroke epilepsy (PSE) is a feared complication after stroke and is reported in 3% to 5% of stroke survivors. In this study we sought to identify incidence and predictors of PSE in an unselected stroke population with a follow-up period of 7 years. The study was community-based and comprises...

  16. The study of emotional presentation after stroke

    Institute of Scientific and Technical Information of China (English)

    Qijia Shi; Donghang Li

    2000-01-01

    Abstract: 30 stroke cases were studied in field of their emotional facts. linear related statistics showed the negative relation between the age, disease onset MMSE and ADL with SDS, SSRI drugs and Psychothcrapy should bc useful for prohibiting sever functional retardation.

  17. Animal Models in Studying Cerebral Arteriovenous Malformation

    Directory of Open Access Journals (Sweden)

    Ming Xu

    2015-01-01

    Full Text Available Brain arteriovenous malformation (AVM is an important cause of hemorrhagic stroke. The etiology is largely unknown and the therapeutics are controversial. A review of AVM-associated animal models may be helpful in order to understand the up-to-date knowledge and promote further research about the disease. We searched PubMed till December 31, 2014, with the term “arteriovenous malformation,” limiting results to animals and English language. Publications that described creations of AVM animal models or investigated AVM-related mechanisms and treatments using these models were reviewed. More than 100 articles fulfilling our inclusion criteria were identified, and from them eight different types of the original models were summarized. The backgrounds and procedures of these models, their applications, and research findings were demonstrated. Animal models are useful in studying the pathogenesis of AVM formation, growth, and rupture, as well as in developing and testing new treatments. Creations of preferable models are expected.

  18. Changes in chronotype after stroke : a pilot study

    NARCIS (Netherlands)

    Kantermann, Thomas; Meisel, Andreas; Fitzthum, Katharina; Penzel, Thomas; Fietze, Ingo; Ulm, Lena

    2014-01-01

    This study aimed to elucidate associations between stroke onset and severity as well as chronotype (phase of entrainment) and internal time of stroke. Fifty-six first-ever ischemic stroke patients participated in a cross-sectional study assessing chronotype (mid-sleep on work-free days corrected for

  19. Determinants of depression in chronic stroke : A prospective cohort study

    NARCIS (Netherlands)

    van de Port, Ingrid G. L.; Kwakkel, Gert; Bruin, Margje; Lindeman, Eline

    2007-01-01

    Purpose. The aim of the study was to identify factors that are significantly related to depression in chronic stroke patients. Methods. Prospective cohort study of stroke patients admitted for rehabilitation. A total of 165 first ever stroke patients over 18 years of age were assessed at one and thr

  20. Short- and long-term prognosis for very old stroke patients. The Copenhagen Stroke Study

    DEFF Research Database (Denmark)

    Kammersgaard, Lars Peter; Jørgensen, H S; Reith, J;

    2004-01-01

    BACKGROUND AND PURPOSE: The very old are expected to become a growing part of the stroke population in the industrialised part of the world. The aims of this study were to evaluate clinical characteristics of patients aged 85 years or more at stroke onset and to investigate very old age...... as an independent predictor of short- and long-term outcome. METHODS: In the community-based Copenhagen Stroke Study we recorded admission clinical characteristics in 1197 consecutive stroke patients. Patients were stratified according to age groups on admission. Follow-up was performed at a mean of 7 years after...... stroke onset. By way of multiple logistic regression and survival analyses very old age was independently related to short- and long-term mortality and nursing home placement independent of other clinical characteristics. RESULTS: 16% of patients were 85 years or older at the time of stroke onset. More...

  1. Survival after stroke. Risk factors and determinants in the Copenhagen Stroke Study

    DEFF Research Database (Denmark)

    Kammersgaard, Lars Peter

    2010-01-01

    The eight papers included in this doctoral thesis were made during my position as a clinical research assistant at the Department of Neurology, Bispebjerg Hospital. All papers are based on the Copenhagen Stroke Study, which comprises a cohort of 1197 patients with acute stroke admitted to a single...... stroke unit and recruited from a well-defined area in Copenhagen, Denmark. This thesis focuses on the survival after stroke in relation to several baseline clinical characteristics and risk factors for cardiovascular disease. The thesis comes in three sections with regard to whether factors or clinical...

  2. Effect of pre-stroke statin use on stroke severity and early functional recovery: a retrospective cohort study

    OpenAIRE

    Choi, Jay Chol; Lee, Ji Sung; Park, Tai Hwan; Cho, Yong-Jin; Park, Jong-Moo; Kang, Kyusik; Lee, Kyung Bok; Lee, Soo-Joo; Ko, Youngchai; Lee, Jun; Kim, Joon-Tae; Yu, Kyung-Ho; Lee, Byung-Chul; Cha, Jae-Kwan; Kim, Dae-Hyun

    2015-01-01

    Background Experimental studies suggest that pre-stroke statin treatment has a dual effect of neuroprotection during ischemia and neurorestoration after ischemic injury. The aim of this study was to evaluate the effect of pre-stroke statin use on initial stroke severity and early clinical outcome. Methods We used a prospective database enrolling patients with acute ischemic stroke from 12 hospitals in Korea between April 2008 and January 2012. Primary endpoint was the initial stroke severity ...

  3. Survival after stroke. Risk factors and determinants in the Copenhagen Stroke Study

    DEFF Research Database (Denmark)

    Kammersgaard, Lars Peter

    2010-01-01

    stroke unit and recruited from a well-defined area in Copenhagen, Denmark. This thesis focuses on the survival after stroke in relation to several baseline clinical characteristics and risk factors for cardiovascular disease. The thesis comes in three sections with regard to whether factors or clinical...... definitions of the intensity of exposure. Smoking is uniformly associated with a poorer survival after stroke. Stroke unit treatment improves both short- and longterm survival regardless of stroke type, severity, age, and cardiovascular risk factor profile.......-based surveys is emphasized. For factors such as sex, and most cardiovascular risk factors further studies are necessary to clarify the relation to survival because studies disagree. Conclusions from studies of the relation between survival and alcohol intake are still debatable, mostly because of diverging...

  4. Study and Analysis of Six Stroke Engine

    Directory of Open Access Journals (Sweden)

    B. Ramya

    2014-09-01

    Full Text Available Six Stroke engine, the name itself indicates a cycle of six strokes out of which two are useful power strokes. According to its mechanical design, the six-stroke engine with external and internal combustion and double flow is similar to the actual internal reciprocating combustion engine. However, it differentiates itself entirely, due to its thermodynamic cycle and a modified cylinder head with two supplementary chambers: combustion and an air heating chamber, both independent from the cylinder. In this the cylinder and the combustion chamber are separated which gives more freedom for design analysis. In addition to the two valves in the four stroke engine two more valves are incorporated which are operated by a piston arrangement. The Six Stroke is thermodynamically more efficient because the change in volume of the power stroke is greater than the intake stroke and the compression stroke. The main advantages of six stroke engine includes reduction in fuel consumption by 40%, two power strokes in the six stroke cycle, dramatic reduction in pollution, adaptability to multi fuel operation. Six stroke engine’s adoption by the automobile industry would have a tremendous impact on the environment and world economy .

  5. Sleep Duration and the Risk of Mortality From Stroke in Japan: The Takayama Cohort Study

    OpenAIRE

    Toshiaki Kawachi

    2016-01-01

    Background: Few studies have assessed the associations between sleep duration and stroke subtypes. We examined whether sleep duration is associated with mortality from total stroke, ischemic stroke, and hemorrhagic stroke in a population-based cohort of Japanese men and women. Methods: Subjects included 12 875 men and 15 021 women aged 35 years or older in 1992, who were followed until 2008. The outcome variable was stroke death (ischemic stroke, hemorrhagic stroke, and total stroke). R...

  6. Stroke

    International Nuclear Information System (INIS)

    The advent of computed tomography (CT) in the early 1970s greatly facilitated the diagnosis and management of stroke and added significantly to our understanding of the pathophysiologic brain alterations it causes in humans. With CT it is now possible for the first time to noninvasively and reliably diagnose and distinguish between stroke resulting from cerebral infraction and that resulting from cerebral hemorrhage. In addition, other brain lesions that at times may clinically present as stroke-like syndromes, such as primary or metastatic brain tumor, brain abscess, or subdural hematoma, can usually be clearly differentiated by the CT examination. In most instances it is no longer necessary to perform cerebral angiography to exclude a possible surgical lesion in patients in whom the clinical diagnosis of stroke may have been in doubt

  7. Companion animal adoption study.

    Science.gov (United States)

    Neidhart, Laura; Boyd, Renee

    2002-01-01

    To better understand the outcomes of companion animal adoptions, Bardsley & Neidhart Inc. conducted a series of 3 surveys over a 1-year period with dog and cat owners who had adopted their pet through either a (a) Luv-A-Pet location, (b) Adopt-a-thon, or (c) traditional shelter. This article suggests opportunities to improve owners' perceptions of their pets and the adoption process through (a) providing more information before adoption about pet health and behaviors, (b) providing counseling to potential adopters to place pets appropriately, and (c) educating adopters to promote companion animal health and retention. Results demonstrate that the pet's relationship to the family unit, such as where the pet sleeps and how much time is spent with the pet, is related to the amount of veterinary care the companion animal receives, and to long-term retention. Satisfaction and retention are attributed to the pet's personality, compatibility, and behavior, rather than demographic differences among adopters or between adoption settings. The age of the companion animal at adoption, the intended recipient, and presence of children in the home also play a role. Health problems were an issue initially for half of all adopted pets, but most were resolved within 12 months. Roughly one fourth of adopters who no longer have their companion animal said their pet died. Characteristics of pets that died support the contention that spaying and neutering profoundly affects a companion animal's life span. Although retention is similar for dogs and cats, mortality is higher among cats in the first year after adoption. PMID:12578739

  8. Progesterone in experimental permanent stroke: a dose-response and therapeutic time-window study.

    Science.gov (United States)

    Wali, Bushra; Ishrat, Tauheed; Won, Soonmi; Stein, Donald G; Sayeed, Iqbal

    2014-02-01

    Currently, the only approved treatment for ischaemic stroke is tissue plasminogen activator, a clot-buster. This treatment can have dangerous consequences if not given within the first 4 h after stroke. Our group and others have shown progesterone to be beneficial in preclinical studies of stroke, but a progesterone dose-response and time-window study is lacking. We tested male Sprague-Dawley rats (12 months old) with permanent middle cerebral artery occlusion or sham operations on multiple measures of sensory, motor and cognitive performance. For the dose-response study, animals received intraperitoneal injections of progesterone (8, 16 or 32 mg/kg) at 1 h post-occlusion, and subcutaneous injections at 6 h and then once every 24 h for 7 days. For the time-window study, the optimal dose of progesterone was given starting at 3, 6 or 24 h post-stroke. Behavioural recovery was evaluated at repeated intervals. Rats were killed at 22 days post-stroke and brains extracted for evaluation of infarct volume. Both 8 and 16 mg/kg doses of progesterone produced attenuation of infarct volume compared with the placebo, and improved functional outcomes up to 3 weeks after stroke on locomotor activity, grip strength, sensory neglect, gait impairment, motor coordination and spatial navigation tests. In the time-window study, the progesterone group exhibited substantial neuroprotection as late as 6 h after stroke onset. Compared with placebo, progesterone showed a significant reduction in infarct size with 3- and 6-h delays. Moderate doses (8 and 16 mg/kg) of progesterone reduced infarct size and improved functional deficits in our clinically relevant model of stroke. The 8 mg/kg dose was optimal in improving motor, sensory and memory function, and this effect was observed over a large therapeutic time window. Progesterone shows promise as a potential therapeutic agent and should be examined for safety and efficacy in a clinical trial for ischaemic stroke. PMID:24374329

  9. Animal Models in Studying Cerebral Arteriovenous Malformation

    OpenAIRE

    Ming Xu; Hongzhi Xu; Zhiyong Qin

    2015-01-01

    Brain arteriovenous malformation (AVM) is an important cause of hemorrhagic stroke. The etiology is largely unknown and the therapeutics are controversial. A review of AVM-associated animal models may be helpful in order to understand the up-to-date knowledge and promote further research about the disease. We searched PubMed till December 31, 2014, with the term “arteriovenous malformation,” limiting results to animals and English language. Publications that described creations of AVM animal ...

  10. Systematic review and stratified meta-analysis of the efficacy of carnosine in animal models of ischemic stroke

    OpenAIRE

    Davis, C.K.; Laud, P J; Bahor, Z.; Rajanikant, G.K.; Majid, A

    2016-01-01

    Carnosine is a naturally occurring pleotropic dipeptide which influences multiple deleterious mechanisms that are activated during stroke. Numerous published studies have reported that carnosine has robust efficacy in ischemic stroke models. To further evaluate these data, we have conducted a systematic review and meta-analysis of published studies. We included publications describing in vivo models of ischemic stroke where the neuroprotective efficacy of carnosine was being evalu...

  11. Pattern of hospitalized-stroke patients in ASEAN countries an ASNA stroke epidemiological study

    Directory of Open Access Journals (Sweden)

    Jusuf Misbach

    2001-03-01

    Full Text Available To better understanding the demographic characteristics, admission time, clinical pattern, risk factors, stroke type, length of stay, and discharge outcome of hospitalized acute stroke patients in ASEAN member countries, ASEAN   Neurological Association (ASNA formed a Standing Commiltee for Stroke in 1996 and this is the first ASNA Stroke Epidemiological Study using the same stroke protocol. This prospective hospital based study was conducted in seven ASEAN countries (Brunei, Indonesia, Malaysia, Philippines, Singapore, Thailand, and Vietnam by participating neurologists from October 1996 to March 1997. Of the 3723 consecutive hospitalized stroke patients (2030 males and 1660 females from 44 participating hospitals in this study ie Brunei (n=53, Indonesia (n=2065, Malaysia (n=300,Philippines (n=545,Singapore (n=232, Thailand (n=244 and Vietnam (n=284, the mean age was 59.0 ± 13,8 years 16% of patients were younger than 45 years and 37% of patients were older than 65 years. There were no significant differences in age at onset among stroke subjects except in Vietnam (younger and Singapore (older. The sex distribution showed a slight higher prevalence of women in Singapore and in the age group > 64 years. The mean adrnission time was 41.5 ± 87.0 hours, 19% of patients were admitted within 3 hours, 29% within 6 hours and 66% more than 6 hours (delayed admission especially in Malaysia and Singapore (80% and 77% respectively. Motor disability was the most prevalent clinical feature in all countries and carotid bruit was the rarest (1%. Hypertension was the most common risk factor (68% in all countries, followed by TIA (35%, smoking, diabetes mellitus, ischnemic heart disease and hypercholesterolemia. CT scan was performed on 76% of subjects. The diagnostic classification was non lacunar anterior circulation (32%, lacunar infarction (14%, hemorrhagic stroke (26%, SAH (4%. Mean length of stay was 11.4 ± 11.8 days. Most of the patients

  12. [Current registry studies of acute ischemic stroke].

    Science.gov (United States)

    Veltkamp, R; Jüttler, E; Pfefferkorn, T; Purrucker, J; Ringleb, P

    2012-10-01

    Study registries offer the opportunity to evaluate the effects of new therapies or to observe the consequences of new treatments in clinical practice. The SITS-MOST registry confirmed the validity of findings from randomized trials on intravenous thrombolysis concerning safety and efficacy in the clinical routine. Current study registries concerning new interventional thrombectomy techniques suggest a high recanalization rate; however, the clinical benefit can only be evaluated in randomized, controlled trials. Similarly, the experiences of the BASICS registry on basilar artery occlusion have led to the initiation of a controlled trial. The benefit of hemicraniectomy in malignant middle cerebral artery infarction has been demonstrated by the pooled analysis of three randomized trials. Numerous relevant aspects are currently documented in the DESTINY-R registry. Finally, the recently started RASUNOA registry examines diagnostic and therapeutic aspects of ischemic and hemorrhagic stroke occurring during therapy with new oral anticoagulants.

  13. STUDY OF RISK FACTORS AND CLINICAL PROFILE OF ACUTE STROKE

    Directory of Open Access Journals (Sweden)

    Tomar

    2014-05-01

    Full Text Available `INTRODUCTION: Stroke is the third leading cause of death in developed countries after cardiovascular disease and cancer. In India Community Surveys have shown a crude prevalence rate for hemiplegia 200 per 1, 00, 000 population. It accounts for nearly 1.5% of all urban admissions, 4.5 % of all medical and about 20% of neurological cases. AIMS AND OBJECTIVE: Identification of risk factors and evaluation of clinical profile of acute stroke. MATERIAL AND METHOD: INCLUSION CRITERIA: Cases of acute stoke admitted in SGMH hospital were selected for the study. EXCLUSION CRITERIA: Brain injury cases, infective, neoplastic cases producing stroke were excluded. RESULTS: Stroke was more common in male, 58 % patients were male and 42% patients were female. It was more common in 5th and 6th decade. Most common etiology was infarction. Most common risk factor was hypertension followed by smoking. In addition to limb weakness, headache and vomiting were most common presenting symptoms followed by convulsion. These symptoms were more common in hemorrhagic stroke. Right sided hemiplegia was more common than left sided. Middle cerebral artery was involved in majority of cases in atherothrombotic stroke whereas basal ganglion was most common site of bleed in hemorrhagic stroke. Coma and mortality were more in hemorrhagic stroke. CONCLUSION: The risk factors and clinical profile of acute stroke in India are similar to that of Western countries. Common risk factors are hypertension, smoking, diabetes mellitus and hyperlipidemia

  14. Animal Studies of Addictive Behavior

    OpenAIRE

    Vanderschuren, Louk J. M. J.; Ahmed, Serge H.

    2013-01-01

    It is increasingly recognized that studying drug taking in laboratory animals does not equate to studying genuine addiction, characterized by loss of control over drug use. This has inspired recent work aimed at capturing genuine addiction-like behavior in animals. In this work, we summarize empirical evidence for the occurrence of several DSM-IV-like symptoms of addiction in animals after extended drug use. These symptoms include escalation of drug use, neurocognitive deficits, resistance to...

  15. Effects of a Web-Based Stroke Education Program on Recurrence Prevention Behaviors among Stroke Patients: A Pilot Study

    Science.gov (United States)

    Kim, Jae-Il; Lee, Sook; Kim, Jung-Hee

    2013-01-01

    The effectiveness of methods to prevent stroke recurrence and of education focusing on learners' needs has not been fully explored. The aims of this study were to assess the effects of such interventions among stroke patients and their primary caregivers and to evaluate the feasibility of a web-based stroke education program. The participants were…

  16. Animal Studies of Human Hazards

    OpenAIRE

    Rosen, L. A.

    1988-01-01

    Animals have provided a surrogate for the study of human health. This has been particularly important in the definition of the effects of pollutants generated in our society. Electromagnetic fields provide an example of the use of animals as models. A review of the animal model literature provides the following information in response to three basic toxicologic elements in defining whether electromagnetic fields are a hazard: 1. Various scientific committees have determined that, in general, ...

  17. Sleep characteristics of individuals with chronic stroke: a pilot study

    Directory of Open Access Journals (Sweden)

    Al-Dughmi M

    2015-10-01

    Full Text Available Mayis Al-Dughmi,1 Alham Al-Sharman,2 Suzanne Stevens,3 Catherine F Siengsukon1 1Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, USA; 2Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan; 3Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA Abstract: Changes in sleep characteristics in individuals with chronic stroke are not well described, particularly compared with healthy individuals. Therefore, the aim of this pilot study was to explore the sleep characteristics in individuals with chronic stroke compared to age- and sex-matched controls. Sixteen individuals with chronic stroke and ten age- and sex-matched controls underwent two nights of polysomnographic recording. The sleep characteristics of interest included total sleep time, sleep efficiency, and percent time, as well as time in minutes spent in stages N1, N2, and N3 and stage R sleep. The individuals with chronic stroke spent less percent time in stage N3 compared with controls (P=0.048. No significant differences in the other sleep characteristics were found between the stroke and control groups. Individuals with chronic stroke present with altered stage N3 sleep compared with healthy controls. These alterations in stage N3 sleep might be a sign of neuronal dysfunction and may impact recovery following stroke. A larger scale study is needed to confirm these findings. Keywords: sleep characteristics, sleep, chronic stroke, polysomnography

  18. STROKE IN YOUNG ADULTS: A RETROSPECTIVE STUDY OF 68 CASES

    Directory of Open Access Journals (Sweden)

    M. H. Harirchian

    2006-06-01

    Full Text Available Numerous etiologies are responsible for cases of stroke in young adults. This study reviews the causes of two types of stroke (ischemic and intracerebral hemorrhage in young adults aged 15 to 40years, admitted to our center (a tertiary care center from 1997 to 2002. The purpose of this study is to determine the relative frequency of causes of stroke in young adults and compare this with published data in the literature. Using the codes 46.0 to 46.8 of the International Classification of Diseases- 10th Edition (ICD-10, cases were identified from the records of the stroke patients admitted in Imam Khomeini Hospital and the data were collected from their files using a comprehensive questionnaire. Forty-two cases of ischemic stroke (62% and 26 cases of intracerebral hemorrhage (38% were identified. The leading cause of ischemic stroke was cardioembolism (38.1%, followed by atherosclerosis in 5 cases (11.9%. Among cardiac causes infarction was attributable to consequences of rheumatic heart disease in 8 cases. In 3 cases a cessation or decrease in dose of warfarin was followed directly by an ischemic stroke. The most leading cause of intracerebral hemorrhage was hypertension (30.8%. Other causes were anticoagulant therapy, intratumoral hemorrhage, aplastic anemia, leukemia, arteriovenous malformations, and chronic active hepatitis. In conclusion, cardioembolism and hypertension were the most leading causes of ischemic and hemorrhagic stroke in young adults admitted in our hospital.

  19. Study Links Sleep Problems to Stroke Risk, Recovery

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_160229.html Study Links Sleep Problems to Stroke Risk, Recovery Treating sleep difficulties ... research suggests. The review of 29 previously published studies found that sleep disorders such as insomnia and sleep apnea are ...

  20. Early carotid endarterectomy after a nondisabling stroke: a prospective study.

    Science.gov (United States)

    Ricco, J B; Illuminati, G; Bouin-Pineau, M H; Demarque, C; Camiade, C; Blecha, L; Neau, J P

    2000-01-01

    On the recommendation of several studies, carotid endarterectomy (CEA) should be delayed for at least 6 weeks in patients suffering an acute nondisabling stroke. Our objective was to determine if these patients could be safely operated on earlier, thus decreasing the risk of a recurrent stroke prior to surgery. This prospective study, carried out from January 1990 to December 1997, included 72 consecutive patients having a nondisabling hemispheric stroke with severe ipsilateral carotid stenosis (NASCET 70-99%). All patients underwent CEA within 15 days of stroke onset. Patients were considered to have a nondisabling hemispheric stroke if (1) symptoms of hemispheric ischemia persisted longer than 24 hr and (2) the resulting deficit caused no major impairment in their everyday activities. All patients were examined by a neurologist prior to carotid angiography and contrast CT scan. Hemorrhage seen on the initial CT scan eliminated the patient from the study. If the CT scan with contrast injection was negative, patients underwent magnetic resonance imaging. CEA was performed under general anesthesia with intraluminal shunting. All patients had a postoperative duplex scan and yearly follow-up by a neurologist and a surgeon, with a duplex scan of the carotid arteries. Mean follow-up was 53 months. Our study shows that CEA can be performed relatively safely within 15 days following an acute nondisabling stroke. The arbitrary 6-week delay for CEA may unnecessarily expose patients with high-grade stenosis to a recurrent stroke, which could be prevented by earlier surgery. PMID:10629271

  1. Neuroprotective effect of a new synthetic aspirin-decursinol adduct in experimental animal models of ischemic stroke.

    Directory of Open Access Journals (Sweden)

    Bing Chun Yan

    Full Text Available Stroke is the second leading cause of death. Experimental animal models of cerebral ischemia are widely used for researching mechanisms of ischemic damage and developing new drugs for the prevention and treatment of stroke. The present study aimed to comparatively investigate neuroprotective effects of aspirin (ASA, decursinol (DA and new synthetic aspirin-decursinol adduct (ASA-DA against transient focal and global cerebral ischemic damage. We found that treatment with 20 mg/kg, not 10 mg/kg, ASA-DA protected against ischemia-induced neuronal death after transient focal and global ischemic damage, and its neuroprotective effect was much better than that of ASA or DA alone. In addition, 20 mg/kg ASA-DA treatment reduced the ischemia-induced gliosis and maintained antioxidants levels in the corresponding injury regions. In brief, ASA-DA, a new synthetic drug, dramatically protected neurons from ischemic damage, and neuroprotective effects of ASA-DA may be closely related to the attenuation of ischemia-induced gliosis and maintenance of antioxidants.

  2. Animal studies of addictive behavior.

    Science.gov (United States)

    Vanderschuren, Louk J M J; Ahmed, Serge H

    2013-04-01

    It is increasingly recognized that studying drug taking in laboratory animals does not equate to studying genuine addiction, characterized by loss of control over drug use. This has inspired recent work aimed at capturing genuine addiction-like behavior in animals. In this work, we summarize empirical evidence for the occurrence of several DSM-IV-like symptoms of addiction in animals after extended drug use. These symptoms include escalation of drug use, neurocognitive deficits, resistance to extinction, increased motivation for drugs, preference for drugs over nondrug rewards, and resistance to punishment. The fact that addiction-like behavior can occur and be studied in animals gives us the exciting opportunity to investigate the neural and genetic background of drug addiction, which we hope will ultimately lead to the development of more effective treatments for this devastating disorder.

  3. Animal studies of addictive behavior.

    Science.gov (United States)

    Vanderschuren, Louk J M J; Ahmed, Serge H

    2013-04-01

    It is increasingly recognized that studying drug taking in laboratory animals does not equate to studying genuine addiction, characterized by loss of control over drug use. This has inspired recent work aimed at capturing genuine addiction-like behavior in animals. In this work, we summarize empirical evidence for the occurrence of several DSM-IV-like symptoms of addiction in animals after extended drug use. These symptoms include escalation of drug use, neurocognitive deficits, resistance to extinction, increased motivation for drugs, preference for drugs over nondrug rewards, and resistance to punishment. The fact that addiction-like behavior can occur and be studied in animals gives us the exciting opportunity to investigate the neural and genetic background of drug addiction, which we hope will ultimately lead to the development of more effective treatments for this devastating disorder. PMID:23249442

  4. Non-convulsive status epilepticus after ischemic stroke: a hospital-based stroke cohort study.

    Science.gov (United States)

    Belcastro, Vincenzo; Vidale, Simone; Gorgone, Gaetano; Pisani, Laura Rosa; Sironi, Luigi; Arnaboldi, Marco; Pisani, Francesco

    2014-11-01

    To evaluate in the setting of a stroke unit ward the usefulness of a prolonged (>6 h) video-EEG recording (PVEEG) in identifying non-convulsive status epilepticus (NCSE) in patients with an acute ischemic stroke. Predictors of NCSE were also evaluated. Patients with an acute ischemic stroke, referred to our unit, were included in this prospective observational study. A PVEEG recording was implemented after stroke in all patients during the first week: (a) promptly in those exhibiting a clear or suspected epileptic manifestation; (b) at any time during the routine activity in the remaining patients. After the first week, a standard EEG/PVEEG recording was hooked up only in presence of an evident or suspected epileptic manifestation or as control of a previous epileptic episode. NCSE was identified in 32 of the 889 patients (3.6 %) included in the study. It occurred early (within the first week) in 20/32 (62.5 %) patients and late in the remaining 12. Diagnosis was made on the basis of a specific clinical suspect (n = 19, 59.4 %) or without any suspect (n = 13, 40.6 %). In a multivariate analysis, a significant association of NCSE was observed with NIHSS score, infarct size and large atherothrombotic etiology. NCSE is not a rare event after an acute ischemic stroke and a delayed diagnosis could worsen patient prognosis. Since NCSE can be difficult to be diagnosed only on clinical grounds, implementation of a prompt PVEEG should be kept available in a stroke unit whenever a patient develop signs, although subtle, consistent with NCSE.

  5. Post stroke rehabilitation based on SMART goals: a case study

    Directory of Open Access Journals (Sweden)

    Amir-ur Rehman

    2014-02-01

    Full Text Available Post stroke rehabilitation has been consistently reported in physiotherapy as being difficult to manage and limiting to rehabilitation outcome. It is reported that the first few months post stroke are crucial for rehabilitation to reach a maximum potential. However, after this period further recovery is unlikely. Specific, measurable, achievable, realistic, and time-framed (SMART goals are used for goal setting for rehabilitation. They can provide coordination between a multidisciplinary team to develop a plan for the individual needs of patients. This case study explored the use of SMART goals, which are often not used in a rehabilitation setting due to being time-consuming and difficult to create. This case report provides the first evidence that SMART goals may serve as a powerful tool for rehabilitation following stroke. The case study illustrates the clinical role of physiotherapists in the management of a patient with stroke. [J Exp Integr Med 2014; 4(1.000: 71-73

  6. STUDY OF C-REACTIVE PROTEIN IN ACUTE ISCHEMIC STROKE

    Directory of Open Access Journals (Sweden)

    Medhini

    2014-06-01

    Full Text Available : Ischemic stroke is the 3rd leading cause of death after AMI and cancer. Stroke is also the leading cause of hospital admission causing disability. The study was based on 100 patients with ischemic stroke admitted to the JJM Medical College, Davangere. This study was done to estimate the role of C-reactive protein as a marker of acute inflammation following ischemic stroke and also to determine, its prognostic role, by assessing the functional outcome of patient using modified Barthel index scoring (ADL. Patients with CRP 6 mg/dl suffered severe disease with poor functional outcome. P value <0.05, significant, suggests CRP is a good tool for prognostic indicator

  7. Thrombotic stroke in the anesthetized monkey (Macaca mulatta): characterization by MRI - A pilot study

    International Nuclear Information System (INIS)

    The lack of a relevant stroke model in large nonhuman primates hinders the development of innovative diagnostic/therapeutic approaches concerned with this cerebrovascular disease. Our objective was to develop a novel and clinically relevant model of embolic stroke in the anesthetized monkey that incorporates readily available clinical imaging techniques and that would allow the possibility of drug delivery including strategies of reperfusion. Thrombin was injected into the lumen of the middle cerebral artery (MCA) in 12 anesthetized (sevoflurane) male rhesus macaques (Macaca mulatta). Sequential MRI studies (including angiography, FLAIR, PWI, DWI, and gadolinium-enhanced T1W imaging) were performed in a 3 T clinical MRI. Physiological and biochemical parameters were monitored throughout the investigations. Once standardized, the surgical procedure induced transient occlusion of the middle cerebral artery in all operated animals. All animals studied showed spontaneous reperfusion, which occurred some time between 2 h and 7 days post-ictus. Eighty percent of the studied animals showed diffusion/perfusion mismatch. The ischemic lesions at 24 h spared both superficial and profound territories of the MCA. Some animals presented hemorrhagic transformation at 7 days post-ictus. In this study, we developed a pre-clinically relevant model of embolic stroke in the anesthetized nonhuman primate. (authors)

  8. Study on three-dimensional freehand stroke creation

    Directory of Open Access Journals (Sweden)

    Cuixian Xuan

    2015-05-01

    Full Text Available The automotive frames that can be created consciously with three-dimensional freehand strokes are quite important and useful in the early stage of automotive styling. However, all the strokes are drawn on the screen in two-dimensional. This study focuses on the creation of three-dimensional freehand strokes by applying the interpolation algorithm in two orthogonal planes, the projection algorithm and the resultant matrix algorithm. The fitting algorithms of strokes have been developed as the bridges between the traditional two-dimensional sketching and three-dimensional digital modeling. The stylists could use the digital tablet and pen to sketch the frames or outlines of a vehicle in three-dimensional space and then those could be used for establishing the automotive surfaces in any engineering software.

  9. Clinical Study on Evolutionary Stroke Treated by Defibrase

    Institute of Scientific and Technical Information of China (English)

    YANG Zhi; JIANG Xiandi

    2000-01-01

    Objective Evolutionary stroke is one common and important subgroup of acute ischemic stroke with nerve damage symptoms evolutionarily heaving. There is not effective methods clinically to stop its development. This article aims to study the feasibility and effectiveness of Defibrase therapy on evolutionary stroke through observing curative effect of evolutionary stroke treated by defibrase therapy and analyze and compare with that of treated by routine medicine. Methods Select 52 evolutionary stroke cases 8 hours to 5 days after stroke and divide them into treatment group(28 cases):treated by 250ml saline intravenous transfusion with 10u Defibrase,once per day,after 3 successive days switch to routine treatmcnt, and control group(24 cases):receive routine treatment. Both groups have not found significant difference in age and severity through X2 inspection,and are comparable both in case history and complication accumulation.The curative effect is evaluated 10 days and 20 days after treatment respectively.Results 10 days after treatment, in treatment group total efficiency is 63%,in control group that is 36%;20 days after treatment,in treatment group total efficiency is 82% and that in control group is 53%.Both have significant difference(P<0.01).No untoward effect such as hemorrhage occurs to both groups.Discussion and Conclutions In general speaking.within 6 hours after ischmic stroke is the optimum time to conduct thrombus-dissolution,but for evolutionary stroke the situation is still developing within several hours and even several days after stroke,that is to say thrombus is still developing or ischemia half dark band is changing to irreversible .Therefore evolutionary stroke itself is the indication of needing thrombus dissolution.Volume urokinase thrombus-dissolving therapy is easy to superven serious complication such as intracrainial hemorrhage. Insertion treatment is not matured enough limited to equipment,infarct position and curative effect. Defibrase

  10. Linking stroke mortality with air pollution, income, and greenness in northwest Florida: an ecological geographical study

    OpenAIRE

    Rao K Ranga; Liebens Johan; Hu Zhiyong

    2008-01-01

    Abstract Background Relatively few studies have examined the association between air pollution and stroke mortality. Inconsistent and inclusive results from existing studies on air pollution and stroke justify the need to continue to investigate the linkage between stroke and air pollution. No studies have been done to investigate the association between stroke and greenness. The objective of this study was to examine if there is association of stroke with air pollution, income and greenness ...

  11. Systematic Review and Meta-Analysis of the Efficacy of Interleukin-1 Receptor Antagonist in Animal Models of Stroke: an Update.

    Science.gov (United States)

    McCann, Sarah K; Cramond, Fala; Macleod, Malcolm R; Sena, Emily S

    2016-10-01

    Interleukin-1 receptor antagonist (IL-1 RA) is an anti-inflammatory protein used clinically to treat rheumatoid arthritis and is considered a promising candidate therapy for stroke. Here, we sought to update the existing systematic review and meta-analysis of IL-1 RA in models of ischaemic stroke, published in 2009, to assess efficacy, the range of circumstances in which efficacy has been tested and whether the data appear to be confounded due to reported study quality and publication bias. We included 25 sources of data, 11 of which were additional to the original review. Overall, IL-1 RA reduced infarct volume by 36.2 % (95 % confidence interval 31.6-40.7, n = 76 comparisons from 1283 animals). Assessments for publication bias suggest 30 theoretically missing studies which reduce efficacy to 21.9 % (17.3-26.4). Efficacy was higher where IL-1 RA was administered directly into the ventricles rather than peripherally, and studies not reporting allocation concealment during the induction of ischaemia reported larger treatment effects. The preclinical data supporting IL-1 RA as a candidate therapy for ischaemic stroke have improved. The reporting of measures to reduce the risk of bias has improved substantially in this update, and studies now include the use of animals with relevant co-morbidities. PMID:27526101

  12. Post-Stroke Mortality, Stroke Severity, and Preadmission Antipsychotic Medicine Use – A Population-Based Cohort Study

    DEFF Research Database (Denmark)

    Prior, Anders; Laursen, Thomas Munk; Larsen, Karen Kjær;

    2014-01-01

    severity, length of hospital stay, and 30-day post-stroke mortality using logistic regression analysis, survival analysis, and propensity score matching. Results: Current users of antipsychotics had a higher risk of severe or very severe stroke on The Scandinavian Stroke Scale than never users...... of antipsychotics (adjusted odds ratios, 1.43; 95% CI, 1.29–1.58). Current users were less likely to be discharged from hospital within 30 days of admission than never users (probability of non-discharge, 27.0% vs. 21.9%). Antipsychotics was associated with an increased 30-day post-stroke mortality among current......Background and Purpose: It has been suggested that antipsychotic medication may be neuroprotective and may reduce post-stroke mortality, but studies are few and ambiguous. We aimed to investigate the post-stroke effects of preadmission antipsychotic use. Methods: We conducted a nationwide...

  13. Determination of Vascular Reactivity of Middle Cerebral Arteries from Stroke and Spinal Cord Injury Animal Models Using Pressure Myography.

    Science.gov (United States)

    Anwar, Mohammad A; Eid, Ali H

    2016-01-01

    Stroke and other neurovascular derangements are main causes of global death. They, along with spinal cord injuries, are responsible for being the principal cause of disability due to neurological and cognitive problems. These problems then lead to a burden on scarce financial resources and societal care facilities as well as have a profound effect on patients' families. The mechanism of action in these debilitating diseases is complex and unclear. An important component of these problems arises from derangement of blood vessels, such as blockage due to clotting/embolism, endothelial dysfunction, and overreactivity to contractile agents, as well as alteration in endothelial permeability. Moreover, the cerebro-vasculature (large vessels and arterioles) is involved in regulating blood flow by facilitating auto-regulatory processes. Moreover, the anterior (middle cerebral artery and the surrounding region) and posterior (basilar artery and its immediate locality) regions of the brain play a significant role in triggering the pathological progression of ischemic stroke particularly due to inflammatory activity and oxidative stress. Interestingly, modifiable and non-modifiable cardiovascular risk factors are responsible for driving ischemic and hemorrhagic stroke and spinal cord injury. There are different stroke animal models to examine the pathophysiology of middle cerebral and basilar arteries. In this context, arterial myography offers an opportunity to determine the etiology of vascular dysfunction in these diseases. Herein, we describe the technique of pressure myography to examine the reactivity of cerebral vessels to contractile and vasodilator agents and a prelude to stroke and spinal cord injury. PMID:27604741

  14. Post-stroke mortality, stroke severity, and preadmission antipsychotic medicine use--a population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Anders Prior

    Full Text Available BACKGROUND AND PURPOSE: It has been suggested that antipsychotic medication may be neuroprotective and may reduce post-stroke mortality, but studies are few and ambiguous. We aimed to investigate the post-stroke effects of preadmission antipsychotic use. METHODS: We conducted a nationwide, population-based cohort study of 81,143 persons admitted with stroke in Denmark from 2003-2010. Using Danish health care databases, we extracted data on preadmission use of antipsychotics and confounding factors. We examined the association between current, former, and never use of antipsychotics and stroke severity, length of hospital stay, and 30-day post-stroke mortality using logistic regression analysis, survival analysis, and propensity score matching. RESULTS: Current users of antipsychotics had a higher risk of severe or very severe stroke on The Scandinavian Stroke Scale than never users of antipsychotics (adjusted odds ratios, 1.43; 95% CI, 1.29-1.58. Current users were less likely to be discharged from hospital within 30 days of admission than never users (probability of non-discharge, 27.0% vs. 21.9%. Antipsychotics was associated with an increased 30-day post-stroke mortality among current users (adjusted mortality rate ratios, 1.42; 95% CI, 1.29-1.55, but not among former users (adjusted mortality rate ratios, 1.05; 95% CI, 0.98-1.14. CONCLUSIONS: Preadmission use of antipsychotics was associated with a higher risk of severe stroke, a longer duration of hospital stay, and a higher post-stroke mortality, even after adjustment for known confounders. Antipsychotics play an important role in the treatment of many psychiatric conditions, but our findings do not support the hypothesis that they reduce stroke severity or post-stroke mortality.

  15. Stroke Experiences in Weblogs: A Feasibility Study of Sex Differences

    Science.gov (United States)

    Koh, Sukjin; Gordon, Andrew S; Wienberg, Christopher; Sood, Sara O; Morley, Stephanie

    2014-01-01

    Background Research on cerebral stroke symptoms using hospital records has reported that women experience more nontraditional symptoms of stroke (eg, mental status change, pain) than men do. This is an important issue because nontraditional symptoms may delay the decision to get medical assistance and increase the difficulty of correct diagnosis. In the present study, we investigate sex differences in the stroke experience as described in stories on weblogs. Objective The goal of this study was to investigate the feasibility of using the Internet as a source of data for basic research on stroke experiences. Methods Stroke experiences described in blogs were identified by using StoryUpgrade, a program that searches blog posts using a fictional prototype story. In this study, the prototype story was a description of a stroke experience. Retrieved stories coded by the researchers as relevant were used to update the search query and retrieve more stories using relevance feedback. Stories were coded for first- or third-person narrator, traditional and nontraditional patient symptoms, type of stroke, patient sex and age, delay before seeking medical assistance, and delay at hospital and in treatment. Results There were 191 relevant stroke stories of which 174 stories reported symptoms (52.3% female and 47.7% male patients). There were no sex differences for each traditional or nontraditional stroke symptom by chi-square analysis (all Ps>.05). Type of narrator, however, affected report of traditional and nontraditional symptoms. Female first-person narrators (ie, the patient) were more likely to report mental status change (56.3%, 27/48) than male first-person narrators (36.4%, 16/44), a marginally significant effect by logistic regression (P=.056), whereas reports of third-person narrators did not differ for women (27.9%, 12/43) and men (28.2%, 11/39) patients. There were more reports of at least 1 nontraditional symptom in the 92 first-person reports (44.6%, 41/92) than

  16. Impact of Libido at 2 Weeks after Stroke on Risk of Stroke Recurrence at 1-Year in a Chinese Stroke Cohort Study

    Institute of Scientific and Technical Information of China (English)

    Jing-Jing Li; Huai-Wu Yuan; Chun-Xue Wang; Ben-Yan Luo; Jie Ruan; Ning Zhang; Yu-Zhi Shi

    2015-01-01

    Background:There were few studies on the relation between changes in libido and incidence of stroke recurrence.The aim of this study was to investigate the relationship between libido decrease at 2 weeks after stroke and recurrent stroke at 1-year.Methods:It is a multi-centered,prospective cohort study.The 14th item of the Hamilton Depression Rating Scale-17 was used to evaluate changes of libido in poststroke patients at 2 weeks.Stroke recurrence was defined as an aggravation of former neurological functional deficit,new local or overall symptoms,or stroke diagnosed at re-admission.Results:Among 2341 enrolled patients,1757 patients had completed follow-up data,533 (30.34%) patients had decreased libido at 2 weeks,and 166 (9.45%) patients had recurrent stroke at 1-year.Multivariate logistic regression analysis showed that,compared with patients with normal libido,the odds ratio (OR) of recurrent stroke in patients with decreased libido was reduced by 41% (OR =0.59,95% confidence interval [CI]:0.40-0.87).The correlation was more prominent among male patients (OR =0.52,95% CI:0.31-0.85) and patients of≥60 years of age (OR =0.57,95% CI:0.35-0.93).Conclusions:One out of three stroke patients in mainland China has decreased libido at 2 weeks after stroke.Decreased libido is a protective factor for stroke recurrence at 1-year,which is more prominent among older male patients.

  17. Family History and Functional Outcome in Korean Stroke Patients: A Preliminary Study

    OpenAIRE

    Park, Hee Jung; Kim, Tae Uk; Hyun, Jung Keun; Kim, Jung Yoon

    2015-01-01

    Objective To investigate the association of family history of stroke with functional outcomes in stroke patients in Korea. Methods A case-control study was conducted. A total of 170 patients who were admitted to a rehabilitation unit were included. Risk factors for stroke such as age, sex, diabetes mellitus, hypertension, atrial fibrillation, smoking, high blood cholesterol and homocysteine level, obesity, and family history of stroke were taken into account. Stroke subtypes were the followin...

  18. Neuroprotection for Stroke: Current Status and Future Perspectives

    OpenAIRE

    Christoph Kleinschnitz; Sutherland, Brad A; Jens Minnerup; Buchan, Alastair M.

    2012-01-01

    Neuroprotection aims to prevent salvageable neurons from dying. Despite showing efficacy in experimental stroke studies, the concept of neuroprotection has failed in clinical trials. Reasons for the translational difficulties include a lack of methodological agreement between preclinical and clinical studies and the heterogeneity of stroke in humans compared to homogeneous strokes in animal models. Even when the international recommendations for preclinical stroke research, the Stroke Academi...

  19. Improving Balance in Subacute Stroke Patients: A Randomized Controlled Study

    Science.gov (United States)

    Goljar, Nika; Burger, Helena; Rudolf, Marko; Stanonik, Irena

    2010-01-01

    The aim of the study was to compare the efficacy of balance training in a balance trainer, a newly developed mechanical device for training balance, with conventional balance training in subacute stroke patients. This was a randomized controlled study. Fifty participants met the inclusion criteria and 39 finished the study. The participants were…

  20. Mortality study for a decade: ischemic stroke in the elderly.

    Directory of Open Access Journals (Sweden)

    Javier J. García Zacarías

    2014-09-01

    Full Text Available Cerebrovascular diseases are among the top three causes of death in Cuba and the world, about 80 % of these patients belong to Ischemic Stroke. The objective of this paper is to describe the clinical and developmental profile of patients who died of Ischemic Stroke. A descriptive, prospective research, cross- sectional study was made, the sample included all deaths from ischemic stroke at the University Hospital "Camilo Cienfuegos" Sancti Spiritus, between January 1st, 2001 and December 31, 2010, and persons over 60 years of age with necropsy performed. Atherothrombotic stroke was the most frequent category, the highest mortality rates were observed in persons over 80 years of age and in females, hypertension, ischemic heart disease and transient ischemic attack were the main significant medical history; most patients were admitted in the stroke unit and died in Middle Progressive Care, cerebral edema and intracranial hypertension and hypostatic bronchopne umonia were complications and specific main causes of most frequent death. Value of cerebral edema and hypostatic bronchopneumonia as clinical complications and causes of death in patients investigated is confirmed.

  1. Moving with music for stroke rehabilitation: a sonification feasibility study.

    Science.gov (United States)

    Scholz, Daniel S; Rhode, Sönke; Großbach, Michael; Rollnik, Jens; Altenmüller, Eckart

    2015-03-01

    Gross-motor impairments are common after stroke, but efficacious and motivating therapies for these impairments are scarce. We present a novel musical sonification therapy especially designed to retrain gross-motor functions. Four stroke patients were included in a clinical pre-post feasibility study and were trained with our sonification training. Patients' upper-extremity functions and their psychological states were assessed before and after training. The four patients were subdivided into two groups, with both groups receiving 9 days of musical sonification therapy (music group, MG) or a sham sonification training (control group, CG). The only difference between these training protocols was that, in the CG, no sound was played back. During the training the patients initially explored the acoustic effects of their arm movements, and at the end of the training the patients played simple melodies by moving their arms. The two patients in the MG improved in nearly all motor function tests after the training. They also reported in the stroke impact scale, which assesses well-being, memory, thinking, and social participation, to be less impaired by the stroke. The two patients in the CG did benefit less from the movement training. Taken together, musical sonification may be a promising therapy for impairments after stroke.

  2. Optimizing muscle power after stroke: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Stavric Verna A

    2012-09-01

    Full Text Available Abstract Background Stroke remains a leading cause of disability worldwide and results in muscle performance deficits and limitations in activity performance. Rehabilitation aims to address muscle dysfunction in an effort to improve activity and participation. While muscle strength has an impact on activity performance, muscle power has recently been acknowledged as contributing significantly to activity performance in this population. Therefore, rehabilitation efforts should include training of muscle power. However, little is known about what training parameters, or load, optimize muscle power performance in people with stroke. The purpose of this study was to investigate lower limb muscle power performance at differing loads in people with and without stroke. Methods A cross-sectional study design investigated muscle power performance in 58 hemiplegic and age matched control participants. Lower limb muscle power was measured using a modified leg press machine at 30, 50 and 70% of one repetition maximum (1-RM strength. Results There were significant differences in peak power between involved and uninvolved limbs of stroke participants and between uninvolved and control limbs. Peak power was greatest when pushing against a load of 30% of 1RM for involved, uninvolved and control limbs. Involved limb peak power irrespective of load (Mean:220 ± SD:134 W was significantly lower (p  Conclusions Significant power deficits were seen in both the involved and uninvolved limbs after stroke. Maximal muscle power was produced when pushing against lighter loads. Further intervention studies are needed to determine whether training of both limbs at lighter loads (and higher velocities are preferable to improve both power and activity performance after stroke.

  3. Disability pensions in relation to stroke: a population study

    DEFF Research Database (Denmark)

    Teasdale, T W; Engberg, A W

    2002-01-01

    days, the proportion ultimately awarded a disability pension rises to over 80%. CONCLUSIONS: The results show high levels of disability pensions awards to relatively young stroke patients probably reflecting pessimism concerning ability to return to employment in such patients. More recent development......PRIMARY OBJECTIVE: This study aimed to establish prevalence levels of disability pensions among stroke patients within a national population. RESEARCH DESIGN: From a Danish National register of hospitalizations, 72 673 patients were identified who had a discharge diagnosis of stroke between...... the years 1979-1993 inclusive and were of pensionable age during that period. These patients were then screened in registers for death during the period 1979-1993 and for the award of disability pensions between the years 1979-1995. A total of 19476 (27%) patients had received a pension at some level. MAIN...

  4. Ischemic Stroke

    OpenAIRE

    Eleni Dokoutsidou; Konstantina Antoniou

    2009-01-01

    Stroke is currently the third leading cause of death, ranking after heart disease and cancer and causes 10% of deaths, worldwide.Aim: The aim of the present study was to review the literature about the types of stroke and the risk factors for ischemic stroke.The methodoly that was followed included bibliography review from the both the research and the review literature of Greek and international data base which referred to ischemic stroke.Results: Stroke, according to its’ underlying etio...

  5. Novel Methods to Study Aphasia Recovery after Stroke

    DEFF Research Database (Denmark)

    Hartwigsen, Gesa; Siebner, Hartwig R

    2013-01-01

    The neural mechanisms that support aphasia recovery are not yet fully understood. It has been argued that the functional reorganization of language networks after left-hemisphere stroke may engage perilesional left brain areas as well as homologous right-hemisphere regions. In this chapter, we...... that language recovery after stroke may integrate left- as well as right-hemisphere brain regions to a different degree over the time course of recovery. Although the results of these preliminary studies provide some evidence that noninvasive brain stimulation may promote aphasia recovery, the reported effect...

  6. Functional recovery in aging mice after experimental stroke

    OpenAIRE

    Manwani, Bharti; Liu, Fudong; Xu, Yan; Persky, Rebecca; Li, Jun; McCullough, Louise D.

    2011-01-01

    Aging is a non modifiable risk factor for stroke. Since not all strokes can be prevented, a major emerging area of research is the development of effective strategies to enhance functional recovery after stroke. However, in the vast majority of pre-clinical stroke studies, the behavioral tests used to assess functional recovery have only been validated for use in young animals, or are designed for rats. Mice are increasingly utilized in stroke models but well validated behavioral tests design...

  7. Use of Occupational Performance Coaching for stroke survivors (OPC-Stroke in late rehabilitation: A descriptive case study

    Directory of Open Access Journals (Sweden)

    Danika Belliveau

    2016-04-01

    Full Text Available Background: Stroke is a leading cause of disability in adults. Following stroke, 60% of people report needing help with everyday activities, and 80% report having very few meaningful activities. These restrictions often continue for years. This study explored the efficacy of Occupational Performance Coaching for stroke survivors (OPC-Stroke on the participation level of adults in the later stage of stroke rehabilitation. Method: A descriptive case study design was used. One participant in the later stages of rehabilitation was recruited. Outcome measures for participation, goal performance and satisfaction, and emotional well-being were administered pre and postintervention to observe for direction of change. A semi-structured interview was carried out postintervention to explore the participant’s experiences of the intervention. Results: The participant who took part in the study reported improvement with his goal performance and satisfaction. However, the level of participation did not improve and emotional well-being decreased. Qualitative data revealed an appreciation of the intervention and a recommendation of the intervention for others. Conclusion: OPC-Stroke was valued by the participant and shows promise for improving goal performance and satisfaction. Further research is necessary to determine the potential efficacy of OPC-Stroke in later stages of rehabilitation.

  8. Animal Rights - a critical study

    OpenAIRE

    Nordin, Ingemar

    2001-01-01

    Do animals have rights similar to humans? In the philosophical debate concerning this question there have been two major ethical approaches. One of them is Peter Singer’s utilitarian theory, and the other is Tom Regan’s theory of animal rights. In this work these arguments for animal rights are extensively presented and discussed. Contrary to Singer and Regan, it is argued that there are ethically relevant biological distinctions between non-human animals and all humans. Although there are st...

  9. Ischemic Stroke

    Science.gov (United States)

    ... can help you. Learn more What Is Stroke? Hemorrhagic Stroke Ischemic Stroke What is TIA? Stroke Facts Recognizing ... Stroke Survey Faces of Stroke What is stroke? Hemorrhagic stroke Ischemic stroke What is TIA? Stroke facts I ...

  10. Stroke and Long-Term Exposure to Outdoor Air Pollution From Nitrogen Dioxide A Cohort Study

    DEFF Research Database (Denmark)

    Andersen, Zorana Jovanovic; Kristiansen, Luise Cederkvist; Andersen, Klaus K.;

    2012-01-01

    Background and Purpose-Years of exposure to tobacco smoke substantially increase the risk for stroke. Whether long-term exposure to outdoor air pollution can lead to stroke is not yet established. We examined the association between long-term exposure to traffic-related air pollution and incident...... and fatal stroke in a prospective cohort study.Methods-We followed 57 053 participants of the Danish Diet, Cancer and Health cohort in the Hospital Discharge Register for the first-ever hospital admission for stroke (incident stroke) between baseline (1993-1997) and 2006 and defined fatal strokes as death...

  11. Improved late survival and disability after stroke with therapeutic anticoagulation for atrial fibrillation: a population study.

    LENUS (Irish Health Repository)

    Hannon, Niamh

    2011-09-01

    Although therapeutic anticoagulation improves early (within 1 month) outcomes after ischemic stroke in hospital-admitted patients with atrial fibrillation, no information exists on late outcomes in unselected population-based studies, including patients with all stroke (ischemic and hemorrhagic).

  12. Associations between stroke mortality and weekend working by stroke specialist physicians and registered nurses: prospective multicentre cohort study.

    Directory of Open Access Journals (Sweden)

    Benjamin D Bray

    2014-08-01

    Full Text Available BACKGROUND: Observational studies have reported higher mortality for patients admitted on weekends. It is not known whether this "weekend effect" is modified by clinical staffing levels on weekends. We aimed to test the hypotheses that rounds by stroke specialist physicians 7 d per week and the ratio of registered nurses to beds on weekends are associated with mortality after stroke. METHODS AND FINDINGS: We conducted a prospective cohort study of 103 stroke units (SUs in England. Data of 56,666 patients with stroke admitted between 1 June 2011 and 1 December 2012 were extracted from a national register of stroke care in England. SU characteristics and staffing levels were derived from cross-sectional survey. Cox proportional hazards models were used to estimate hazard ratios (HRs of 30-d post-admission mortality, adjusting for case mix, organisational, staffing, and care quality variables. After adjusting for confounders, there was no significant difference in mortality risk for patients admitted to a stroke service with stroke specialist physician rounds fewer than 7 d per week (adjusted HR [aHR] 1.04, 95% CI 0.91-1.18 compared to patients admitted to a service with rounds 7 d per week. There was a dose-response relationship between weekend nurse/bed ratios and mortality risk, with the highest risk of death observed in stroke services with the lowest nurse/bed ratios. In multivariable analysis, patients admitted on a weekend to a SU with 1.5 nurses/ten beds had an estimated adjusted 30-d mortality risk of 15.2% (aHR 1.18, 95% CI 1.07-1.29 compared to 11.2% for patients admitted to a unit with 3.0 nurses/ten beds (aHR 0.85, 95% CI 0.77-0.93, equivalent to one excess death per 25 admissions. The main limitation is the risk of confounding from unmeasured characteristics of stroke services. CONCLUSIONS: Mortality outcomes after stroke are associated with the intensity of weekend staffing by registered nurses but not 7-d/wk ward rounds by stroke

  13. One-Month to 10-Year Survival in the Copenhagen Stroke Study

    DEFF Research Database (Denmark)

    Andersen, Klaus Kaae; Olsen, Tom Skyhøj

    2011-01-01

    We studied the association of stroke severity with survival from 1 month to 10 years after stroke and explored how stroke severity interacts with other prognostic indicators with time. The study is based on 999 stroke patients from the community-based Copenhagen Stroke Study (mean age, 74.3 ± 11.......5% of the variance was explained for the endpoints of 1 month, 1 year, 5 years, and 10 years, respectively. When SSS was left out of the model, the corresponding values were 6.9%, 13.3%, 29.0%, and 35.1%. Factors significantly associated with survival were SSS at 1 month; SSS, age, diabetes, and stroke type at 1...... year; SSS, age, sex, previous stroke, other complicating diseases, diabetes, smoking, and atrial fibrillation at 5 years; and SSS, age, sex, other complicating diseases, and diabetes at 10 years. Our data suggest that stroke severity is significantly associated with short-term and long-term survival...

  14. Clinical profile of acute hemorrhagic stroke patients: a study in tertiary care hospital in Northern India

    OpenAIRE

    Omkar P. Baidya; Sunita Tiwari; Kauser Usman

    2014-01-01

    Background: Acute hemorrhagic stroke, a subtype of acute stroke is one of the leading cause of death and major cause of morbidity and mortality throughout the world. The incidence of acute hemorrhagic stroke is increasing with gradual increase in obesity, diabetes mellitus, hyperlipidemia, hypertension and various cardiac problems. This study had been conducted with an objective to study the risk factors and clinical presentation of acute hemorrhagic stroke patients in north-Indian population...

  15. Predicting mobility outcome one year after stroke: a prospective cohort study.

    NARCIS (Netherlands)

    Port, I.G. van de; Kwakkel, G.; Schepers, V.P.; Lindeman, E.

    2006-01-01

    OBJECTIVE: To develop a prognostic model to predict mobility outcome one year post-stroke. DESIGN: Prospective cohort study in patients with a first-ever stroke admitted for inpatient rehabilitation. PATIENTS: A total of 217 patients with stroke (mean age 58 years) following inpatient rehabilitation

  16. Self-management: challenges for allied healthcare professionals in stroke rehabilitation--a focus group study

    NARCIS (Netherlands)

    Satink, T.J.; Cup, E.H.; Swart, B.J.M. de; Sanden, M.W. van der

    2015-01-01

    PURPOSE: Self-management has become an important concept in stroke rehabilitation. This study explored allied healthcare professionals' (AHPs) perceptions and beliefs regarding the self-management of stroke survivors and their knowledge and skills regarding stroke self-management interventions. METH

  17. Ethical considerations in animal studies

    OpenAIRE

    Ghasemi, Mehdi; Dehpour, Ahmad Reza

    2009-01-01

    Scientists undoubtedly owe their great advance and knowledge in biomedical research to millions of animals which they use every year in often-times extremely painful and distressing scientific procedures. One of the important issues in scientific research is to consider ethics in animal experimentation. Since this is a crucial issue in the modern era of medical research, in this paper, we have provided some guidelines (most of which have been adopted from Guidelines for Ethical Conduct in the...

  18. A Family History of Stroke Is Associated with Increased Intima-Media Thickness in Young Ischemic Stroke - The Norwegian Stroke in the Young Study (NOR-SYS)

    Science.gov (United States)

    Øygarden, Halvor; Fromm, Annette; Sand, Kristin Modalsli; Kvistad, Christopher Elnan; Eide, Geir Egil; Thomassen, Lars; Naess, Halvor; Waje-Andreassen, Ulrike

    2016-01-01

    Background and Purpose Positive family history (FH+) of cardiovascular disease (CVD) is a risk factor for own CVD. We aimed to analyze the effect of different types of FH (stroke, coronary heart disease (CHD), peripheral artery disease (PAD) on carotid intima-media thickness (cIMT) in young and middle-aged ischemic stroke patients. Methods First-degree FH of CVD was assessed in ischemic stroke patients ≤ 60y using a standardized interview. Carotid ultrasound was performed and far wall cIMT in three carotid artery segments was registered, representing the common carotid (CCA-IMT), carotid bifurcation (BIF-IMT) and the internal carotid artery (ICA-IMT). Measurements were compared between FH+ and FH negative groups and stepwise backward regression analyses were performed to identify factors associated with increased cIMT. Results During the study period 382 patients were enrolled, of which 262 (68%) were males and 233 (61%) reported FH of CVD. Regression analyses adjusting for risk factors revealed age as the most important predictor of cIMT in all segments. The association between FH+ and cIMT was modified by age (p = 0.014) and was significant only regarding ICA-IMT. FH+ was associated with increased ICA-IMT in patients aged < 45y (p = 0.001), but not in patients ≥ 45y (p = 0.083). The association with ICA-IMT was present for a FH of stroke (p = 0.034), but not a FH+ of CHD or PAD. Conclusions FH of stroke is associated with higher ICA-IMT in young ischemic stroke patients. Subtyping of cardiovascular FH is important to investigate heredity in young ischemic stroke patients. Trial Registration ClinicalTrials.gov NCT01597453 PMID:27504830

  19. Management of acute stroke: impact of registration studies.

    Science.gov (United States)

    Adams, Harold P

    2010-09-01

    Stroke is a life-threatening or life-changing disease that is expensive in health care costs and lost productivity. Stroke also is a leading cause of human suffering. While the risk of stroke may be reduced with advances in prevention, recent advances in acute care can limit the consequences of stroke. In particular, the success of reperfusion therapies including intra-arterial interventions and intravenous administration of thrombolytic agents means that some patients with stroke may be cured. Still, the time window for effective treatment of stroke is relatively short. As a result, modern stroke management requires the close collaboration of the public, health care providers, administrators, insurance companies, and the government. Potential strategies to extend modern stroke care to as many patients as possible include 1) educational programs to train community emergency medical service personnel and physicians, 2) development of stroke care plans at community hospitals, 3) an integrated community-comprehensive stroke center program based on consultation, and telemedicine. The goal is to have a highly integrated approach to provide emergency treatment of the stroke that provides key emergency treatment, including intravenous administration of thrombolytic medications, at a community hospital (primary stroke center) with evacuation to a comprehensive stroke center that has resources and expertise that are not available in the primary stroke center. Taiwan is an ideal location for the development of such regional stroke programs.

  20. [Influence of pineal hormone melatonin on behavioral disturbances and neurological status of animals after hemorrhagic stroke].

    Science.gov (United States)

    Arushanian, E B; Naumov, S S

    2011-01-01

    Experimental hemorrhagic stroke causes behavior and locomotor activity with memory impairment and neurological disturbances in rats. These shifts are weaker in the evening hours than after morning testing. The repeated administration of the pineal gland hormone melatonin (melaxen) during one week significantly decreases behavior and neurological deficits as well as pathomorphological signs in the lesion focus. The normalizing effect of the hormone is more distinct in the evening.

  1. Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Eleni Dokoutsidou

    2009-05-01

    Full Text Available Stroke is currently the third leading cause of death, ranking after heart disease and cancer and causes 10% of deaths, worldwide.Aim: The aim of the present study was to review the literature about the types of stroke and the risk factors for ischemic stroke.The methodoly that was followed included bibliography review from the both the research and the review literature of Greek and international data base which referred to ischemic stroke.Results: Stroke, according to its’ underlying etiology, can be classified into two major categories, ischemic and hemorrhagic. 20% of stroke are of hemorrhagic type, whereas 80% are of ischemic type. Although, ischemic stroke is the most common type, its’ etiology differs. Ischemic stroke is categorized in thrombotic, embolic, lacunar, unknown etiology, transient and due to systematic low blood pressure. In the literature is cited that risk factors for stroke are classified in non-modifiable and modifiable. Non-modifiable risk factors are age, gender, ethnicity and heredity. The most important modifiable risk factors for stroke are high blood pressure and atrial fibrillation. Other modifiable risk factors include high blood cholesterol levels, diabetes mellitus, cigarette smoking (active and passive, carotid artery stenosis, heavy alcohol consumption, drug abuse, lack of physical activity, obesity and unhealthy diet.Conclusions: As it is supported by published evidence, ischemic stroke is of higher incidence compared to hemorrhagic stroke. Risk factor modification remains as the principal aspect of care for ischemic stroke prevention.

  2. No difference in stroke knowledge between Korean adherents to traditional and western medicine – the AGE study: an epidemiological study

    Directory of Open Access Journals (Sweden)

    Eun Su-Yong

    2006-06-01

    Full Text Available Abstract Background Effective stroke intervention and risk reduction depend on the general public's awareness and knowledge of stroke. In Korea, where both traditional Oriental medicine and Western medicine are practiced, estimates of the general public's awareness and knowledge of stroke are poor. The present study sought to describe the inception cohort of the Ansan Geriatric Study (AGE study and to determine baseline stroke awareness and preferred medical treatment for stroke in this Korean sample. Methods A total of 2,767 subjects selected randomly from the Ansan Geriatric Study in South Korea were questioned about stroke. Their answers were compared with their sociodemographic data and other variables. Results Only 44.8% of participants correctly identified stroke as a vascular disease in the human brain. Sudden numbness or weakness was the most frequently identified stroke warning sign (60.2%. Hypertension (66.7% and mental stress (62.2% were most frequently identified as stroke risk factors. The contributions of diabetes mellitus and cardiovascular disease to stroke were underestimated; they were identified as risk factors by 28.3% and 18.6% of participants, respectively. The predictors for poor knowledge of stroke warning signs and risk factors were similar irrespective of preference for Western or Oriental medical treatment, and included those with lower levels of education and inaccurate definition of stroke. Television and radio (40.3% were the most frequent sources of stroke information for both groups. Conclusion This study shows that knowledge of stroke is similar among Koreans with preferences for either Western or Oriental medical treatment and that misunderstandings about stroke are common among the Korean elderly. In order to prevent and manage stroke effectively, public health education regarding basic concepts of stroke is necessary. This should target those with a lower level of education and a misunderstanding of the

  3. Sleep Duration and the Risk of Mortality From Stroke in Japan: The Takayama Cohort Study

    Directory of Open Access Journals (Sweden)

    Toshiaki Kawachi

    2016-04-01

    Full Text Available Background: Few studies have assessed the associations between sleep duration and stroke subtypes. We examined whether sleep duration is associated with mortality from total stroke, ischemic stroke, and hemorrhagic stroke in a population-based cohort of Japanese men and women. Methods: Subjects included 12 875 men and 15 021 women aged 35 years or older in 1992, who were followed until 2008. The outcome variable was stroke death (ischemic stroke, hemorrhagic stroke, and total stroke. Results: During follow-up, 611 stroke deaths (354 from ischemic stroke, 217 from hemorrhagic stroke, and 40 from undetermined stroke were identified. Compared with 7 h of sleep, ≥9 h of sleep was significantly associated with an increased risk of total stroke and ischemic stroke mortality after controlling for covariates. Hazard ratios (HRs and 95% confidence intervals (CIs were 1.51 (95% CI, 1.16–1.97 and 1.65 (95% CI, 1.16–2.35 for total stroke mortality and ischemic stroke mortality, respectively. Short sleep duration (≤6 h of sleep was associated with a decreased risk of mortality from total stroke (HR 0.77; 95% CI, 0.59–1.01, although this association was of borderline significance (P = 0.06. The trends for total stroke and ischemic stroke mortality were also significant (P < 0.0001 and P = 0.0002, respectively. There was a significant risk reduction of hemorrhagic stroke mortality for ≤6 h of sleep as compared with 7 h of sleep (HR 0.64; 95% CI, 0.42–0.98; P for trend = 0.08. The risk reduction was pronounced for men (HR 0.31; 95% CI, 0.16–0.64. Conclusions: Data suggest that longer sleep duration is associated with increased mortality from total and ischemic stroke. Short sleep duration may be associated with a decreased risk of mortality from hemorrhagic stroke in men.

  4. Stroke awareness in Denmark

    DEFF Research Database (Denmark)

    Truelsen, Thomas; Krarup, Lars-Henrik

    2010-01-01

    This is the first study to examine the awareness of major stroke symptoms and stroke risk factors among the general population in Denmark. Early recognition of stroke warning signs and means of reducing stroke occurrence could improve the treatment and prevention of stroke.......This is the first study to examine the awareness of major stroke symptoms and stroke risk factors among the general population in Denmark. Early recognition of stroke warning signs and means of reducing stroke occurrence could improve the treatment and prevention of stroke....

  5. Animal models for microbicide studies

    OpenAIRE

    Veazey, Ronald S.; Shattock, Robin J.; Klasse, Per Johan; Moore, John P.

    2012-01-01

    There have been encouraging recent successes in the development of safe and effective topical microbicides to prevent vaginal or rectal HIV-1 transmission, based on the use of anti-retroviral drugs. However, much work remains to be accomplished before a microbicide becomes a standard element of prevention science strategies. Animal models should continue to play an important role in pre-clinical testing, with emphasis on safety, pharmacokinetic and efficacy testing.

  6. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study)

    DEFF Research Database (Denmark)

    O'Donnell, Martin J; Xavier, Denis; Liu, Lisheng;

    2010-01-01

    BACKGROUND: The contribution of various risk factors to the burden of stroke worldwide is unknown, particularly in countries of low and middle income. We aimed to establish the association of known and emerging risk factors with stroke and its primary subtypes, assess the contribution of these risk...... factors to the burden of stroke, and explore the differences between risk factors for stroke and myocardial infarction. METHODS: We undertook a standardised case-control study in 22 countries worldwide between March 1, 2007, and April 23, 2010. Cases were patients with acute first stroke (within 5 days...... an alternate definition of hypertension was used (history of hypertension or blood pressure >160/90 mm Hg), the combined PAR was 90.3% (85.3-93.7) for all stroke. These risk factors were all significant for ischaemic stroke, whereas hypertension, smoking, waist-to-hip ratio, diet, and alcohol intake were...

  7. Studies using multiple vaccinated animals

    International Nuclear Information System (INIS)

    The serological responses in vaccinated and multiple vaccinated cattle against non-structural proteins (NSP) of foot-and-mouth disease (FMD) virus were measured using four commercially available assays. Vaccines were concentrated using polyethylene glycol to contain higher antigenic payloads that those routinely used. Animals received up to five doses of polyvalent oil vaccines over six months, administered by the intra-muscular route on d 0, 90, 130, 160 and 200. Serum samples were taken 30-40 d after each vaccination. At 60 d post vaccination the antibody response to each of the vaccine strains showed high levels of antibodies against structural proteins that correlated with protection against challenge above 81%. The detection of antibodies against NSP was made with two ELISAs using expressed 3ABC as antigen; one ELISA using peptides from 3B and an enzyme-immunotransfer blot assay (EITB). Locally produced ELISA-3ABC reagents and agar gel immunodiffusion using VIAA, were also evaluated. After four doses of vaccine, animals were negative in all the assays. After the fifth immunization, two of seventeen animals were reactive in one ELISA kit, but these samples proved negative by confirmatory tests. Antibodies against NSP were not detected in primo-vaccinated cattle used for potency tests using three batches of standard vaccine. The principle of the NSP ELISA as screening test for large sero surveys in South America is established and this paper emphasises the importance using vaccines that have no demonstrated interference with NSP ELISAs and the advantages of reducing the number of false-positives that would require further confirmation by other assays. (author)

  8. Mixed Stroke

    Institute of Scientific and Technical Information of China (English)

    HuangRuxun(黄如训); Zeng Jinsheng(曾进胜)

    2000-01-01

    evolution of stroke very well and has very high incidence. it Is a good animal model of MS. conclusions It is essential to list MS as a type of stroke singly. Valuing and studying MS are im ponant for the whole fieid studying pathogenesis. prophylaxis and treatment of stoke.

  9. Knowledge of stroke risk factors among primary care patients with previous stroke or TIA: a questionnaire study

    Directory of Open Access Journals (Sweden)

    Strender Lars-Erik

    2010-06-01

    Full Text Available Abstract Background Survivers of stroke or transient ischaemic attacks (TIA are at risk of new vascular events. Our objective was to study primary health care patients with stroke/TIA regarding their knowledge about risk factors for having a new event of stroke/TIA, possible associations between patient characteristics and patients' knowledge about risk factors, and patients' knowledge about their preventive treatment for stroke/TIA. Methods A questionnaire was distributed to 240 patients with stroke/TIA diagnoses, and 182 patients (76% responded. We asked 13 questions about diseases/conditions and lifestyle factors known to be risk factors and four questions regarding other diseases/conditions ("distractors". The patients were also asked whether they considered each disease/condition to be one of their own. Additional questions concerned the patients' social and functional status and their drug use. The t-test was used for continuous variables, chi-square test for categorical variables, and a regression model with variables influencing patient knowledge was created. Results Hypertension, hyperlipidemia and smoking were identified as risk factors by nearly 90% of patients, and atrial fibrillation and diabetes by less than 50%. Few patients considered the distractors as stroke/TIA risk factors (3-6%. Patients with a family history of cardiovascular disease, and patients diagnosed with carotid stenosis, atrial fibrillation or diabetes, knew these were stroke/TIA risk factors to a greater extent than patients without these conditions. Atrial fibrillation or a family history of cardiovascular disease was associated with better knowledge about risk factors, and higher age, cerebral haemorrhage and living alone with poorer knowledge. Only 56% of those taking anticoagulant drugs considered this as intended for prevention, while 48% of those taking platelet aggregation inhibitors thought this was for prevention. Conclusions Knowledge about hypertension

  10. Pain following stroke: a population-based follow-up study.

    Directory of Open Access Journals (Sweden)

    Henriette Klit

    Full Text Available BACKGROUND AND PURPOSE: Chronic pain is increasingly recognized as a consequence of stroke. This study aimed to describe the prevalence and pain types of new onset chronic pain ("novel pain" in patients with stroke compared with a randomly selected reference group from the general population and to identify factors associated with pain development in stroke patients. METHODS: In a population-based follow-up design, development of chronic pain after stroke was assessed by a questionnaire sent to consecutive stroke patients, registered in a Danish national stroke database, two years after their stroke. A randomly selected sex- and age-matched reference group from the same catchment area received a similar questionnaire about development of new types of chronic pain in the same time period. A total of 608 stroke patients and 519 reference subjects were included in the study. RESULTS: Development of novel pain was reported by 39.0% of stroke patients and 28.9% of reference subjects (OR 1.57, CI 1.21-2.04, and was associated with low age and depression in a multivariate model. Daily intake of pain medication for novel pain was reported by 15.3% and 9.4% of the stroke and reference population, respectively. Novel headache, shoulder pain, pain from increased muscle stiffness, and other types of novel pain were more common in stroke patients, whereas joint pain was equally common in the two groups. CONCLUSIONS: Development of chronic pain is more common in stroke patients compared with sex- and age-matched reference subjects. Evaluation of post-stroke pain should be part of stroke follow-up.

  11. Book review: animal studies: an introduction

    OpenAIRE

    Hui Lee, Jia

    2013-01-01

    Animal studies seeks to understand how humans study and conceive of other-than-human animals, and how these conceptions have changed over time, across cultures, and across different ways of thinking. This interdisciplinary introduction to the field foregrounds the realities of nonhuman animals, and is compelling and comprehensive, writes Jia Hui Lee. Paul Waldau convincingly argues for a deeper and more meaningful engagement with the world, and students of all social science disciplines shoul...

  12. Poststroke depression and risk of recurrent stroke at 1 year in a Chinese cohort study.

    Directory of Open Access Journals (Sweden)

    Huai Wu Yuan

    Full Text Available BACKGROUND: Studies show that poststroke depression (PSD increases mortality risk at 1 year. However, whether PSD increases the risk of recurrent stroke at 1 year remains unclear. This study was to investigate whether PSD at 2 weeks following a stroke could increase risk of recurrent stroke at 1 year. METHODS AND RESULTS: This was a multi-centered prospective cohort study. A total of 2306 patients with acute stroke were enrolled in our study. PSD was diagnosed according to the criteria set by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV. The outcomes of recurrent stroke were followed up via face-to-face or phone interview. A total of 1713 patients had complete follow-up data, with 481 (28.1% cases of PSD and 158 (9.2% cases of cumulative recurrent stroke at 1 year. Multivariate logistic regression analysis showed a 49% increase of OR of recurrent stroke at 1 year in patients with PSD, compared to patients without PSD following a stroke (OR=1.49, 95%CI: 1.03-2.15. There was no significant correlation between anti-depressant drugs and the risk of recurrent stroke at 1 year following a stroke (OR=1.96, 95%: CI 0.95-4.04. CONCLUSIONS: Based on the DSM-IV diagnostic criteria, nearly 3 out of 10 hospitalized stroke patients in China were diagnosed with PSD at 2 weeks following a stroke. PSD is associated with a higher risk of recurrent stroke at 1 year. Our study did not find benefit of anti-depressant drugs in reducing such risk.

  13. Declining Patient Functioning and Caregiver Burden/Health: The Minnesota Stroke Survey-Quality of Life after Stroke Study

    Science.gov (United States)

    Nelson, Melissa M.; Smith, Maureen A.; Martinson, Brian C.; Kind, Amy; Luepker, Russell V.

    2008-01-01

    Purpose: Caregivers of stroke patients may adapt to changes in patient functioning over time. If adaptation occurs, then caregiver burden and health may be influenced more by worsening in patient functioning than by static levels of functioning. This study examines the relationship between patients' baseline and changes in functioning and…

  14. Transient isolated brainstem symptoms preceding posterior circulation stroke: a population-based study

    Science.gov (United States)

    Paul, Nicola LM; Simoni, Michela; Rothwell, Peter M

    2013-01-01

    Summary Background Transient isolated brainstem symptoms (eg, isolated vertigo, dysarthria, diplopia) are not consistently classified as transient ischaemic attacks (TIAs) and data for prognosis are limited. If some of these transient neurological attacks (TNAs) are due to vertebrobasilar ischaemia, then they should be common during the days and weeks preceding posterior circulation strokes. We aimed to assess the frequency of TNAs before vertebrobasilar ischaemic stroke. Methods We studied all potential ischaemic events during the 90 days preceding an ischaemic stroke in patients ascertained within a prospective, population-based incidence study in Oxfordshire, UK (Oxford Vascular Study; 2002–2010) and compared rates of TNA preceding vertebrobasilar stroke versus carotid stroke. We classified the brainstem symptoms isolated vertigo, vertigo with non-focal symptoms, isolated double vision, transient generalised weakness, and binocular visual disturbance as TNAs in the vertebrobasilar territory; atypical amaurosis fugax and limb-shaking as TNAs in the carotid territory; and isolated slurred speech, migraine variants, transient confusion, and hemisensory tingling symptoms as TNAs in uncertain territory. Findings Of the 1141 patients with ischaemic stroke, vascular territory was categorisable in 1034 (91%) cases, with 275 vertebrobasilar strokes and 759 carotid strokes. Isolated brainstem TNAs were more frequent before a vertebrobasilar stroke (45 of 275 events) than before a carotid stroke (10 of 759; OR 14·7, 95% CI 7·3–29·5, p<0·0001), particularly during the preceding 2 days (22 of 252 before a vertebrobasilar stroke vs two of 751 before a carotid stroke, OR 35·8, 8·4–153·5, p<0·0001). Of all 59 TNAs preceding (median 4 days, IQR 1–30) vertebrobasilar stroke, only five (8%) fulfilled the National Institute of Neurological Disorders and Stroke (NINDS) criteria for TIA. The other 54 cases were isolated vertigo (n=23), non-NINDS binocular visual

  15. Cardiovascular risk factors and 5-year mortality in the Copenhagen Stroke Study

    DEFF Research Database (Denmark)

    Kammersgaard, Lars Peter; Olsen, Tom Skyhøj

    2005-01-01

    analyses, adjustment for other factors and especially age revealed the lethal effect of smoking, while the positive effect of alcohol disappeared. More focus on secondary preventive measures, such as anticoagulation for AF, smoking cessation, and proper treatment of diabetes may significantly improve long...... population. METHODS: We studied 905 ischemic stroke patients from the community-based Copenhagen Stroke Study. Patients had a CT scan and stroke severity was measured by the Scandinavian Stroke Scale on admission. A comprehensive evaluation was performed by a standardized medical examination...... by Cox proportional hazards analyses adjusted for age, gender, stroke severity, and risk factor profile. RESULTS: In Kaplan-Meier analyses atrial fibrillation (AF), ischemic heart disease, diabetes, and previous stroke were associated with increased mortality, while smoking and alcohol intake were...

  16. Socioeconomic status and stroke prevalence in Morocco: results from the Rabat-Casablanca study.

    Directory of Open Access Journals (Sweden)

    Thomas Engels

    Full Text Available BACKGROUND: Stroke is a growing public health concern in low- and middle- income countries. Improved knowledge about the association between socioeconomic status and stroke in these countries would enable the development of effective stroke prevention and management strategies. This study presents the association between socioeconomic status and the prevalence of stroke in Morocco, a lower middle-income country. METHODS: Data on the prevalence of stroke and stroke-related risk factors were collected during a large population-based survey. The diagnosis of stroke in surviving patients was confirmed by neurologists while health, demographic, and socioeconomic characteristics of households were collected using structured questionnaires. We used Multiple Correspondence Analysis to develop a wealth index based on characteristics of the household dwelling as well as ownership of selected assets. We used logistic regressions controlling for multiple variables to assess the statistical association between socioeconomic status and stroke. FINDINGS: Our results showed a significant association between household socioeconomic status and the prevalence of stroke. This relationship was non-linear, with individuals from both the poorest (mainly rural and richest (mainly urban households having a lower prevalence of stroke as compared to individuals with medium wealth level. The latter belonged mainly to urban households with a lower socioeconomic status. When taking into account the urban population only, we observed that a third of poorest households experienced a significantly higher prevalence of stroke compared to the richest third (OR = 2.06; CI 95%: 1.09; 3.89. CONCLUSION: We conclude that individuals from the most deprived urban households bear a higher risk of stroke than the rest of the population in Morocco. This result can be explained to a certain extent by the higher presence of behavioral risk factors in this specific category of the population

  17. Prevalence of self-reported stroke and disability in the French adult population: a transversal study.

    Directory of Open Access Journals (Sweden)

    Alexis Schnitzler

    Full Text Available In France, the prevalence of stroke and the level of disability of stroke survivors are little known. The aim of this study was to evaluate functional limitations in adults at home and in institutions, with and without self-reported stroke. A survey named "the Disability Health survey" was carried out in people's homes (DHH and in institutions (DHI. Medical history and functional level (activities-of-daily-living, ADL and instrumented-activities-of-daily-living IADL were collected through interviews. The modified Rankin score (mRS and the level of dependence and disability were compared between participants with and without stroke. 33896 subjects responded. The overall prevalence of stroke was 1.6% (CI95% [1.4%-1.7%]. The mRS was over 2 for 34.4% of participants with stroke (28.7% of participants at home and 87.8% of participants in institutions versus respectively 3.9%, 3.1% and 71.6% without stroke. Difficulty washing was the most frequently reported ADL for those with stroke (30.6% versus 3% for those without stroke. Difficulty with ADL and IADL increased with age but the relative risk was higher below the age of 60 (17 to 25 than over 85 years (1.5 to 2.2, depending on the ADL. In the overall population, 22.6% of those confined to bed or chair reported a history of stroke. These results thus demonstrate a high national prevalence of stroke. Older people are highly dependent, irrespective of stroke history and the relative risk of dependence in young subjects with a history of stroke is high compared with those without.

  18. Stroke awareness in Denmark

    DEFF Research Database (Denmark)

    Truelsen, Thomas; Krarup, Lars-Henrik

    2010-01-01

    This is the first study to examine the awareness of major stroke symptoms and stroke risk factors among the general population in Denmark. Early recognition of stroke warning signs and means of reducing stroke occurrence could improve the treatment and prevention of stroke....

  19. A forced running wheel system with a microcontroller that provides high-intensity exercise training in an animal ischemic stroke model

    Energy Technology Data Exchange (ETDEWEB)

    Chen, C.C. [Department of Electrical Engineering, National Cheng-Kung University, Tainan, Taiwan (China); Chang, M.W. [Department of Electrical Engineering, Southern Taiwan University of Science and Technology, Tainan, Taiwan (China); Chang, C.P. [Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan (China); Chan, S.C.; Chang, W.Y.; Yang, C.L. [Department of Electrical Engineering, National Cheng-Kung University, Tainan, Taiwan (China); Lin, M.T. [Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan (China)

    2014-08-15

    We developed a forced non-electric-shock running wheel (FNESRW) system that provides rats with high-intensity exercise training using automatic exercise training patterns that are controlled by a microcontroller. The proposed system successfully makes a breakthrough in the traditional motorized running wheel to allow rats to perform high-intensity training and to enable comparisons with the treadmill at the same exercise intensity without any electric shock. A polyvinyl chloride runway with a rough rubber surface was coated on the periphery of the wheel so as to permit automatic acceleration training, and which allowed the rats to run consistently at high speeds (30 m/min for 1 h). An animal ischemic stroke model was used to validate the proposed system. FNESRW, treadmill, control, and sham groups were studied. The FNESRW and treadmill groups underwent 3 weeks of endurance running training. After 3 weeks, the experiments of middle cerebral artery occlusion, the modified neurological severity score (mNSS), an inclined plane test, and triphenyltetrazolium chloride were performed to evaluate the effectiveness of the proposed platform. The proposed platform showed that enhancement of motor function, mNSS, and infarct volumes was significantly stronger in the FNESRW group than the control group (P<0.05) and similar to the treadmill group. The experimental data demonstrated that the proposed platform can be applied to test the benefit of exercise-preconditioning-induced neuroprotection using the animal stroke model. Additional advantages of the FNESRW system include stand-alone capability, independence of subjective human adjustment, and ease of use.

  20. A forced running wheel system with a microcontroller that provides high-intensity exercise training in an animal ischemic stroke model

    International Nuclear Information System (INIS)

    We developed a forced non-electric-shock running wheel (FNESRW) system that provides rats with high-intensity exercise training using automatic exercise training patterns that are controlled by a microcontroller. The proposed system successfully makes a breakthrough in the traditional motorized running wheel to allow rats to perform high-intensity training and to enable comparisons with the treadmill at the same exercise intensity without any electric shock. A polyvinyl chloride runway with a rough rubber surface was coated on the periphery of the wheel so as to permit automatic acceleration training, and which allowed the rats to run consistently at high speeds (30 m/min for 1 h). An animal ischemic stroke model was used to validate the proposed system. FNESRW, treadmill, control, and sham groups were studied. The FNESRW and treadmill groups underwent 3 weeks of endurance running training. After 3 weeks, the experiments of middle cerebral artery occlusion, the modified neurological severity score (mNSS), an inclined plane test, and triphenyltetrazolium chloride were performed to evaluate the effectiveness of the proposed platform. The proposed platform showed that enhancement of motor function, mNSS, and infarct volumes was significantly stronger in the FNESRW group than the control group (P<0.05) and similar to the treadmill group. The experimental data demonstrated that the proposed platform can be applied to test the benefit of exercise-preconditioning-induced neuroprotection using the animal stroke model. Additional advantages of the FNESRW system include stand-alone capability, independence of subjective human adjustment, and ease of use

  1. A Comprehensive Study of Underground Animals Habitat

    Science.gov (United States)

    Klokov, A. V.; Zapasnoy, A. S.; Mironchev, A. S.; Yakubov, V. P.; Shipilova, S. S.

    2016-01-01

    This paper describes a method of studying the natural habitats of underground animals by the example of zokor. The purpose of the research is to find habitation of animals using unmanned aircraft and investigate networks of tunnels and burrows with ground penetrating radar "OKO-2". Geolocation data were processed by techniques developed by the authors.

  2. Post-stroke epilepsy in young adults: a long-term follow-up study

    OpenAIRE

    Arntz, R.M.; Rutten-Jacobs, L.C.A.; Maaijwee, N.A.M.M.; Schoonderwaldt, H.C.; Dorresteijn, L.D.A.; Dijk, E.J. van; de Leeuw, F E

    2013-01-01

    BACKGROUND: Little is known about the incidence and risk of seizures after stroke in young adults. Especially in the young seizures might dramatically influence prognosis and quality of life. We therefore investigated the long-term incidence and risk of post-stroke epilepsy in young adults with a transient ischemic attack (TIA), ischemic stroke (IS) or intracerebral hemorrhage (ICH). METHODS AND FINDINGS: We performed a prospective cohort study among 697 consecutive patients with a first-ever...

  3. Correlative study between neuron-specific enolase and blood sugar level in ischemic stroke patients

    OpenAIRE

    Aparna Pandey; Kiran Saxena; Meena Verma; Anuradha Bharosay

    2011-01-01

    Background: A study to investigate the level of the neurobiochemical marker, Neuron-Specific Enolase (NSE), at the time of admission and its correlation with the blood sugar level in ischemic stroke patients. Patients and Methods: We investigated 90 patients with complete stroke who were admitted to the Stroke Unit of the Department of Neurology at Sri Aurobindo Institute of Medical Sciences. NSE was measured with commercially available quantitative ‘sandwich’ enzyme-linked immunosorbent assa...

  4. Natural history of TPA-untreated minor stroke in the North Dublin population stroke study

    LENUS (Irish Health Repository)

    Marnane, M

    2011-05-01

    Introduction: Current guidelines recommend caution when considering emergency tissue plasminogen activator (tPA) therapy for patients with minor neurological deficits. However few data exist regarding the “natural history” (without tPA) of stroke in unselected population-based cohorts. We sought to evaluate the risk of long term disability in “minor stroke” patients.\\r\

  5. Animal models for the study of arterial hypertension

    Indian Academy of Sciences (India)

    Waleska C Dornas; Marcelo E Silva

    2011-09-01

    Hypertension is one of the leading causes of disability or death due to stroke, heart attack and kidney failure. Because the etiology of essential hypertension is not known and may be multifactorial, the use of experimental animal models has provided valuable information regarding many aspects of the disease, which include etiology, pathophysiology, complications and treatment. The models of hypertension are various, and in this review, we provide a brief overview of the most widely used animal models, their features and their importance.

  6. Stroke service in the Netherlands: an exploratory study on effectiveness, patient satisfaction and utilisation of healthcare

    Directory of Open Access Journals (Sweden)

    H. Rosendal

    2002-03-01

    Full Text Available Objective: To assess whether shared care for stroke patients results in better patient outcome, higher patient satisfaction and different use of healthcare services. Design: Prospective, comparative cohort study. Setting: Two regions in the Netherlands with different healthcare models for stroke patients: a shared care model (stroke service and a usual care setting. Patients: Stroke patients with a survival rate of more than six months, who initially were admitted to the Stroke Service of the University Hospital Maastricht (experimental group in the second half of 1997 and to a middle sized hospital in the western part of the Netherlands between March 1997 and March 1999 (control group. Main outcome measures: Functional health status according to the SIP-68, EuroQol, Barthel Index and Rankin Scale, patient satisfaction and use of healthcare services. Results: In total 103 patients were included in this study: 58 in the experimental group and 45 in the control group. Six months after stroke, 64% of the surviving patients in the experimental group had returned home, compared to 42% in the control group (p Conclusions: The Stroke Service Maastricht resulted in a higher number of patients who returned home after stroke, but not in a better health status. Since patients in the usual care group received a higher volume of healthcare in the period of rehabilitation, the Stroke Service Maastricht might be more efficient.

  7. EXPERIMENTAL HEMORRHAGIC STROKE: SEARCH FOR A BETTER MODEL

    OpenAIRE

    Yabluchanskiy, Andriy; Sawle, Philip; Homer-Vanniasinkam, Shervanthi; Green, Colin; Motterlini, Roberto

    2010-01-01

    Hemorrhagic stroke is one of the least studied problems in the modern neurology. Development of the treatment leads to examination of the pathophysiology of the process, which mainly can be performed in animal models. Recent years few animal model of the hemorrhagic stroke have been proposed. In this review we discuss the differences and benefits of the existing models in the compliance with the process that take place in human patients with hemorrhagic stroke.

  8. Five-year prognosis after mild to moderate ischemic stroke by stroke subtype: a multi-clinic registry study.

    Directory of Open Access Journals (Sweden)

    Yumei Lv

    Full Text Available BACKGROUND AND PURPOSE: Mild to moderate ischemic stroke is a common presentation in the outpatient setting. Among the various subtypes of stroke, lacunar infarction (LI is generally very common. Currently, little is known about the long-term prognosis and factors associated with the prognosis between LI and non-LI. This study aims to compare the risk of death and acute cardiovascular events between patients with LI and non-LI, and identify potential risk factors associated with these outcomes. METHODS: A total of 710 first-ever ischemic stroke patients (LI: 474, non-LI: 263 from 18 clinics were recruited consecutively from 2003 to 2004. They were prospectively followed-up until the end of 2008. Hazard ratios and 95% confidence intervals were calculated using multivariable Cox proportional hazards regression. RESULTS: After a 5-year follow up, 54 deaths and 96 acute cardiovascular events occurred. Recurrent stroke was the most common cause of death (19 cases, 35.18% and new acute cardiovascular events (75 cases, 78.13%. There were no significant differences between patients with LI and non-LI in their risks of death, new cardiovascular events, and recurrent stroke after adjusting for age, sex, hypertension, diabetes, cardiac diseases, body mass index, dyslipidemia, smoking, alcohol consumption, ADL dependence, and depressive symptoms. Among the modifiable risk factors, diabetes, hypertension, ADL dependency, and symptoms of depression were independent predictors of poor outcomes in patients with LI. In non-LI patients, however, no modifiable risk factors were detected for poor outcomes. CONCLUSION: Long-term outcomes did not differ significantly between LI and non-LI patients. Detecting and managing vascular risk factors and depression as well as functional rehabilitation may improve the prognoses of LI patients.

  9. Stroke Risk among Patients with Type 2 Diabetes Mellitus in Zhejiang: A Population-Based Prospective Study in China

    Directory of Open Access Journals (Sweden)

    Lihua Guo

    2016-01-01

    Full Text Available Objective. This study aimed to explore the incidence of stroke and stroke subtypes among patients with type 2 diabetes mellitus (T2DM based on the long-term surveillance data in Zhejiang, China, during 2007 to 2013. Materials and Methods. During January 1, 2007, and December 31, 2013, a total of 327,268 T2DM and 307,984 stroke patients were registered on Diabetes and Stroke Surveillance System, respectively. Stroke subtypes were classified according to standard definitions of subarachnoid hemorrhage, intracerebral hemorrhage, and ischemic stroke. The incidence of stroke and stroke subtypes was calculated by standardized incidence ratio (SIRs with 95% confidence intervals (CIs compared with general population. Results. The incidence of stroke and stroke subtypes among patients with T2DM was significantly higher than in general population. Stroke risk was found significantly increased with an SIR of 3.87 (95% CI 3.76–3.99 and 3.38 (95% CI 3.27–3.48 in females and males, respectively. The excess risk of stroke was mainly attributable to the significantly higher risk of cerebral infarctions with the risk for T2DM being four times that for general population. Conclusions. The relationship between stroke and T2DM was strong, especially in female. The incidence of stroke and stroke subtypes among patients with T2DM was up to 3-fold higher than in general population in Zhejiang province, especially the subtype of cerebral infarctions.

  10. Susceptibility to deterioration of mobility long-term after stroke: a prospective cohort study.

    NARCIS (Netherlands)

    Port, I.G. van de; Kwakkel, G.; Wijk, I. van; Lindeman, E.

    2006-01-01

    BACKGROUND AND PURPOSE: The aim of the present study was to identify clinical determinants able to predict which individuals are susceptible to deterioration of mobility from 1 to 3 years after stroke. METHODS: Prospective cohort study of stroke patients consecutively admitted for inpatient rehabili

  11. Stroke Mortality, Clinical Presentation and Day of Arrival: The Atherosclerosis Risk in Communities (ARIC Study

    Directory of Open Access Journals (Sweden)

    Emily C. O'Brien

    2011-01-01

    Full Text Available Background. Recent studies report that acute stroke patients who present to the hospital on weekends have higher rates of 28-day mortality than similar patients who arrive during the week. However, how this association is related to clinical presentation and stroke type has not been systematically investigated. Methods and Results. We examined the association between day of arrival and 28-day mortality in 929 validated stroke events in the ARIC cohort from 1987–2004. Weekend arrival was defined as any arrival time from midnight Friday until midnight Sunday. Mortality was defined as all-cause fatal events from the day of arrival through the 28th day of followup. The presence or absence of thirteen stroke signs and symptoms were obtained through medical record review for each event. Binomial logistic regression was used to estimate odds ratios and 95% confidence intervals (OR; 95% CI for the association between weekend arrival and 28-day mortality for all stroke events and for stroke subtypes. The overall risk of 28-day mortality was 9.6% for weekday strokes and 10.1% for weekend strokes. In models controlling for patient demographics, clinical risk factors, and event year, weekend arrival was not associated with 28-day mortality (0.87; 0.51, 1.50. When stratified by stroke type, weekend arrival was not associated with increased odds of mortality for ischemic (1.17, 0.62, 2.23 or hemorrhagic (0.37; 0.11, 1.26 stroke patients. Conclusions. Presence or absence of thirteen signs and symptoms was similar for weekday patients and weekend patients when stratified by stroke type. Weekend arrival was not associated with 28-day all-cause mortality or differences in symptom presentation for strokes in this cohort.

  12. Correlative study between neuron-specific enolase and blood sugar level in ischemic stroke patients

    Directory of Open Access Journals (Sweden)

    Aparna Pandey

    2011-01-01

    Full Text Available Background: A study to investigate the level of the neurobiochemical marker, Neuron-Specific Enolase (NSE, at the time of admission and its correlation with the blood sugar level in ischemic stroke patients. Patients and Methods: We investigated 90 patients with complete stroke who were admitted to the Stroke Unit of the Department of Neurology at Sri Aurobindo Institute of Medical Sciences. NSE was measured with commercially available quantitative ′sandwich′ enzyme-linked immunosorbent assay kits obtained from R and D Systems. Hyperglycemia was defined as blood glucose concentration ≥ 7 mmol / L, and measured using the glucose oxidase method immediately. Results: Significantly increased NSE and lipid profile levels were found in ischemic stroke patients as compared to the control. Hyperglycemic ischemic stroke patients had increased levels of NSE, lipid profile, and National Institute of Health stroke scale scores (NIHSS score compared to normoglycemic ischemic stroke patients. In addition the serum NSE level of hyperglycemic stroke patients was also positively correlated with the blood sugar level (r = 0.734 P < 0.001. Conclusions: Hyperglycemia predicts an increased risk of poor outcome after ischemic stroke and it is reflected by a significantly increased level of Neuron-Specific Enolase.

  13. Bias During the Evaluation of Animal Studies?

    Directory of Open Access Journals (Sweden)

    Andrew Knight

    2012-02-01

    Full Text Available My recent book entitled The Costs and Benefits of Animal Experiments seeks to answer a key question within animal ethics, namely: is animal experimentation ethically justifiable? Or, more precisely, is it justifiable within the utilitarian cost:benefit framework that fundamentally underpins most regulations governing animal experimentation? To answer this question I reviewed more than 500 scientific publications describing animal studies, animal welfare impacts, and alternative research, toxicity testing and educational methodologies. To minimise bias I focused primarily on large-scale systematic reviews that had examined the human clinical and toxicological utility of animal studies. Despite this, Dr. Susanne Prankel recently reviewed my book in this journal, essentially accusing me of bias. However, she failed to provide any substantive evidence to refute my conclusions, let alone evidence of similar weight to that on which they are based. Those conclusions are, in fact, firmly based on utilitarian ethical reasoning, informed by scientific evidence of considerable strength, and I believe they are robust.

  14. Bias During the Evaluation of Animal Studies?

    Science.gov (United States)

    Knight, Andrew

    2012-01-01

    My recent book entitled The Costs and Benefits of Animal Experiments seeks to answer a key question within animal ethics, namely: is animal experimentation ethically justifiable? Or, more precisely, is it justifiable within the utilitarian cost:benefit framework that fundamentally underpins most regulations governing animal experimentation? To answer this question I reviewed more than 500 scientific publications describing animal studies, animal welfare impacts, and alternative research, toxicity testing and educational methodologies. To minimise bias I focused primarily on large-scale systematic reviews that had examined the human clinical and toxicological utility of animal studies. Despite this, Dr. Susanne Prankel recently reviewed my book in this journal, essentially accusing me of bias. However, she failed to provide any substantive evidence to refute my conclusions, let alone evidence of similar weight to that on which they are based. Those conclusions are, in fact, firmly based on utilitarian ethical reasoning, informed by scientific evidence of considerable strength, and I believe they are robust. PMID:26486779

  15. Acute hospital, community, and indirect costs of stroke associated with atrial fibrillation: population-based study.

    LENUS (Irish Health Repository)

    Hannon, Niamh

    2014-10-30

    No economic data from population-based studies exist on acute or late hospital, community, and indirect costs of stroke associated with atrial fibrillation (AF-stroke). Such data are essential for policy development, service planning, and cost-effectiveness analysis of new therapeutic agents.

  16. Treatment and rehabilitation on a stroke unit improves 5-year survival. A community-based study

    DEFF Research Database (Denmark)

    Jørgensen, H S; Kammersgaard, L P; Nakayama, H;

    1999-01-01

    We have previously reported a marked reduction in mortality up to 1 year after treatment and rehabilitation on a stroke unit versus on general neurological and medical wards in unselected stroke patients. In the present study we wanted to test the hypothesis that this mortality-reducing effect...

  17. Exploring the Feasibility and Efficacy of a Telehealth Stroke Self-Management Programme: A Pilot Study

    OpenAIRE

    Huijbregts, Maria P.J.; McEwen, Sara; Taylor, Denise

    2009-01-01

    Purpose: Moving On after STroke (MOST) is an established self-management programme for persons with stroke and their care partners. Through 18 sessions over 9 weeks, each including discussion and exercise, participants learn about goal-setting, problem-solving, exercise, and community-reintegration skills. This study was undertaken to evaluate the feasibility and efficacy of telehealth delivery of MOST.

  18. Variation in fibrinogen FGG and FGA genes and risk of stroke: the Rotterdam Study.

    Science.gov (United States)

    Cheung, Elim Y L; Bos, Michiel J; Leebeek, Frank W G; Koudstaal, Peter J; Hofman, Albert; de Maat, Moniek P M; Breteler, Monique M B

    2008-08-01

    Haplotypes of the fibrinogen gamma and alpha (FGG and FGA) genes are associated with the structure of the fibrin network and may therefore influence the risk of stroke. We investigated the relationship between common variation in these genes with ischemic and haemorrhagic stroke. The study was based on 6,275 participants of the prospective population-based Rotterdam Study who at baseline (1990-1993) were aged 55 years or over, free from stroke, and had successful assessment of at least one FGG or FGA single nucleotide polymorphisms (SNP). Common haplotypes were estimated using seven tagging SNPs across a 30 kb region containing the FGG and FGA genes. Follow-up for incident stroke was complete until January 1, 2005. Associations between constructed haplotypes and risk of stroke were estimated with an age- and sex-adjusted logistic regression model. We observed 668 strokes, of which 393 were ischemic and 62 haemorrhagic, during a median follow-up time of 10.1 years. FGG + FGA haplotype 3 (H3) was associated with an increased risk of ischemic stroke (odds ratio [OR] 1.36, 95% confidence interval [CI] 1.09-1.69) and the risk estimate for hemorrhagic stroke was 0.71 (95% CI 0.46-1.09) compared to the most frequent H1. The FGG and FGA genes were not associated with stroke or its subtypes when analyzed separately. In conclusion, risk of ischemic stroke was higher in FGG + FGA H3 than in H1. The results suggested that an opposite association may exist for haemorrhagic stroke.

  19. Animal Models for the Study of Osteomyelitis

    OpenAIRE

    Patel, Mitul; Rojavin, Yuri; Jamali, Amir A.; Wasielewski, Samantha J.; Salgado, Christopher J.

    2009-01-01

    Osteomyelitis is an acute or chronic inflammatory process of the bone and its related structures secondary to an infection with pyogenic organisms. Because of the variety in disease presentations and pathophysiology of osteomyelitis, it is very difficult to evaluate in clinical studies. Therefore, animal models have been created for in vivo experimentation. A PubMed and OVID search was performed on March 31, 2008, using keywords osteomyelitis, animal model (rabbit, rat, mouse, avian, dog, she...

  20. Animal models for the study of tendinopathy

    OpenAIRE

    Warden, S. J.

    2006-01-01

    Tendinopathy is a common and significant clinical problem characterised by activity‐related pain, focal tendon tenderness and intratendinous imaging changes. Recent histopathological studies have indicated the underlying pathology to be one of tendinosis (degeneration) as opposed to tendinitis (inflammation). Relatively little is known about tendinosis and its pathogenesis. Contributing to this is an absence of validated animal models of the pathology. Animal models of tendinosis represent po...

  1. SALGOT - Stroke Arm Longitudinal study at the University of Gothenburg, prospective cohort study protocol

    Directory of Open Access Journals (Sweden)

    Lundgren-Nilsson Åsa

    2011-05-01

    Full Text Available Abstract Background Recovery patterns of upper extremity motor function have been described in several longitudinal studies, but most of these studies have had selected samples, short follow up times or insufficient outcomes on motor function. The general understanding is that improvements in upper extremity occur mainly during the first month after the stroke incident and little if any, significant recovery can be gained after 3-6 months. The purpose of this study is to describe the recovery of upper extremity function longitudinally in a non-selected sample initially admitted to a stroke unit with first ever stroke, living in Gothenburg urban area. Methods/Design A sample of 120 participants with a first-ever stroke and impaired upper extremity function will be consecutively included from an acute stroke unit and followed longitudinally for one year. Assessments are performed at eight occasions: at day 3 and 10, week 3, 4 and 6, month 3, 6 and 12 after onset of stroke. The primary clinical outcome measures are Action Research Arm Test and Fugl-Meyer Assessment for Upper Extremity. As additional measures, two new computer based objective methods with kinematic analysis of arm movements are used. The ABILHAND questionnaire of manual ability, Stroke Impact Scale, grip strength, spasticity, pain, passive range of motion and cognitive function will be assessed as well. At one year follow up, two patient reported outcomes, Impact on Participation and Autonomy and EuroQol Quality of Life Scale, will be added to cover the status of participation and aspects of health related quality of life. Discussion This study comprises a non-selected population with first ever stroke and impaired arm function. Measurements are performed both using traditional clinical assessments as well as computer based measurement systems providing objective kinematic data. The ICF classification of functioning, disability and health is used as framework for the selection of

  2. Correlation study on cystatin C and ischemic stroke

    Directory of Open Access Journals (Sweden)

    CHEN Rong-bo

    2013-06-01

    Full Text Available Objective To investigate the relationship between serum cystatin C (Cys C and patients with acute ischemic stroke. Methods The clinical and laboratory data of 115 patients with acute ischemic stroke and 110 controls were recorded and analyzed. Results The serum Cys C levels of patients in ischemic stroke group [(1.15 ± 0.34 mg/L] were higher than that of the control group [(0.99 ± 0.25 mg/L]. The difference between two groups was significant after correction of age and cardiovascular risk factors (t = ? 3.889, P = 0.000. It was found that age, Cys C, homocysteine (Hcy, type 2 diabetes mellitus [hemoglobin A1c (HbA1c, fructosamine (FRU], smoking, alcohol consumption, hypertension and intima-media thickness (IMT were risk factors for ischemic stroke on univariate Logistic regression analysis. The difference of serum Cys C level between the patients and controls was significant (P = 0.000, but through covariance analysis, after adjusted other risk factors, it was not significant (P = 0.875. Conclusion The serum Cys C levels of patients in ischemic stroke group is higher than the control group. It can be used as an indicator in the acute phase of ischemic stroke. The elevation of serum Cys C is a risk factor for ischemic stroke, but not an independent risk factor.

  3. Association of selenoprotein S gene polymorphism with ischemic stroke in a Chinese case-control study.

    Science.gov (United States)

    Li, Xiao-Xia; Guan, Hong-Jun; Liu, Jian-Ping; Guo, Yu-Peng; Yang, Yong; Niu, Ying-Ying; Yao, Li-Yan; Yang, Yin-Dong; Yue, Hong-Yu; Meng, Li-Li; Cui, Xin-Yu; Yang, Xiao-Wei; Gao, Jin-Xiao

    2015-03-01

    Previous studies showed that selenoprotein S (SELS) was associated with a range of inflammatory markers, and its gene expression was influenced by a polymorphism in the promoter region. The genetic basis of the ischemic stroke has now been largely determined, so the aim of the study was to examine the role of SELS genetic variants in the ischemic stroke risk in a Chinese population. We conducted a case-control study with 239 ischemic stroke patients and 240 controls. Two single-nucleotide polymorphisms (SNPs) in SELS genes were analyzed for association with the risk of ischemic stroke in the Chinese Han population. No evidence of ischemic stroke association was observed with the SNP rs34713741. Interestingly, the strongest evidence showed that SELS SNP rs4965814 was associated with ischemic stroke (P hazard ratio: 2.43(1.03-5.75)]; a similar trend was also found in men carrying the TC genotype of rs4965814 [hazard ratio: 1.81(1.06-3.08)]. SNP rs4965814 of SELS may affect the susceptibility to ischemic stroke. Understanding the inflammatory mechanisms of ischemic stroke may give new therapeutic targets to pharmacologists. PMID:25390504

  4. Length of Hospital Stay After Stroke: A Korean Nationwide Study

    Science.gov (United States)

    2016-01-01

    Objective To investigate the length of hospital stay (LOS) after stroke using the database of the Korean Health Insurance Review & Assessment Service. Methods We matched the data of patients admitted for ischemic stroke onset within 7 days in the Departments of Neurology of 12 hospitals to the data from the database of the Korean Health Insurance Review & Assessment Service. We recruited 3,839 patients who were hospitalized between January 2011 and December 2011, had a previous modified Rankin Scale of 0, and no acute hospital readmission after discharge. The patients were divided according to the initial National Institute of Health Stroke Scale score (mild, ≤5; moderate, >5 and ≤13; severe, >13); we compared the number of hospitals that admitted patients and LOS after stroke according to severity, age, and sex. Results The mean LOS was 115.6±219.0 days (median, 19.4 days) and the mean number of hospitals was 3.3±2.1 (median, 2.0). LOS was longer in patients with severe stroke (mild, 65.1±146.7 days; moderate, 223.1±286.0 days; and severe, 313.2±336.8 days). The number of admitting hospitals was greater for severe stroke (mild, 2.9±1.7; moderate, 4.3±2.6; and severe, 4.5±2.4). LOS was longer in women and shorter in patients less than 65 years of age. Conclusion LOS after stroke differed according to the stroke severity, sex, and age. These results will be useful in determining the appropriate LOS after stroke in the Korean medical system.

  5. Tea consumption and risk of stroke: a dose-response meta-analysis of prospective studies

    Institute of Scientific and Technical Information of China (English)

    Li SHEN; Liu-guang SONG; Hong MA; Chun-na JIN; Jian-an WANG; Mei-xiang XIANG

    2012-01-01

    Objective:To determine the association between tea consumption and the risk of stroke.Methods:We searched the PubMed database from January 1966 to March 2012 and reviewed reference lists of retrieved articles to identify relevant studies.Studies were included if they reported relative risks (RRs) and corresponding 95% confidence intervals (CIs) of stroke with respect to three or more categories of tea consumption.A random-effects model was used to combine the study-specific risk estimates.Results:Fourteen studies,consisting of 513 804 participants with a median follow-up of 11.5 years,were included in this meta-analysis.We observed a modest but statistically significant inverse association between tea consumption and risk of stroke.An increase of three cups/d in tea consumption was associated with a 13% decreased risk of stroke (RR 0.87; 95% CI,0.81-0.94).The decreased risk of stroke with tea consumption was consistent among most subgroups.Based on the three studies that provided results for stroke subtypes,tea consumption was also inversely associated with the risk of ischemic stroke (RR 0.76; 95% CI,0.69-0.84),but not cerebral hemorrhage (RR 0.96; 95% CI,0.82-1.11 ) or subarachnoid hemorrhage (RR 0.81 ; 95% CI,0.57-1.16).Conclusions:Tea consumption is associated with a decreased risk of stroke,particularly ischemic stroke.More well-designed,rigorously conducted studies are needed in order to make confident conclusions about the association between tea consumption and stroke subtypes.

  6. Protocol and methodology of the Stroke in Young Fabry Patients (sifap1) study: a prospective multicenter European study of 5,024 young stroke patients aged 18-55 years.

    LENUS (Irish Health Repository)

    Rolfs, Arndt

    2011-01-01

    Stroke in the young has not been thoroughly investigated with most previous studies based on a small number of patients from single centers. Furthermore, recent reports indicate that Fabry disease may be a significant cause for young stroke. The primary aim of our study was to determine the prevalence of Fabry disease in young stroke patients, while the secondary aim was to describe patterns of stroke in young patients.

  7. Specific imaging of inflammation with the 18 kDa translocator protein ligand DPA-714 in animal models of epilepsy and stroke.

    Directory of Open Access Journals (Sweden)

    Denise Harhausen

    Full Text Available Inflammation is a pathophysiological hallmark of many diseases of the brain. Specific imaging of cells and molecules that contribute to cerebral inflammation is therefore highly desirable, both for research and in clinical application. The 18 kDa translocator protein (TSPO has been established as a suitable target for the detection of activated microglia/macrophages. A number of novel TSPO ligands have been developed recently. Here, we evaluated the high affinity TSPO ligand DPA-714 as a marker of brain inflammation in two independent animal models. For the first time, the specificity of radiolabeled DPA-714 for activated microglia/macrophages was studied in a rat model of epilepsy (induced using Kainic acid and in a mouse model of stroke (transient middle cerebral artery occlusion, tMCAO using high-resolution autoradiography and immunohistochemistry. Additionally, cold-compound blocking experiments were performed and changes in blood-brain barrier (BBB permeability were determined. Target-to-background ratios of 2 and 3 were achieved in lesioned vs. unaffected brain tissue in the epilepsy and tMCAO models, respectively. In both models, ligand uptake into the lesion corresponded well with the extent of Ox42- or Iba1-immunoreactive activated microglia/macrophages. In the epilepsy model, ligand uptake was almost completely blocked by pre-injection of DPA-714 and FEDAA1106, another high-affinity TSPO ligand. Ligand uptake was independent of the degree of BBB opening and lesion size in the stroke model. We provide further strong evidence that DPA-714 is a specific ligand to image activated microglia/macrophages in experimental models of brain inflammation.

  8. Pediatric Stroke

    Science.gov (United States)

    ... News About Neurology Image Library Search The Internet Stroke Center Patients & Families About Stroke Stroke Diagnosis Stroke ... communicate with your child’s doctor. Symptoms of a Stroke Stroke is an injury to part of the ...

  9. Prevalence of patent foramen ovale in ischemic stroke in Italy: the SISIFO study.

    Science.gov (United States)

    Consoli, Domenico; Paciaroni, Maurizio; Aguggia, Marco; Melis, Maurizio; Malferrari, Giovanni; Vidale, Simone; Cerrato, Paolo; Sacco, Simona; Gandolfo, Carlo; Bovi, Paolo; Serrati, Carlo; Del Sette, Massimo; Cavallini, Anna; Diomedi, Marina; Postorino, Paolo; Ricci, Stefano

    2014-06-01

    Patent foramen ovale (PFO) is a common congenital anatomical defect in the general population with a mean prevalence of 20 %. Transcranial Doppler sonography and echocardiography, both with infusion of agitated saline as an echo contrast, have been introduced for the diagnosis of PFO. Transesophageal echocardiography is considered the gold standard. Several studies have suggested an association between cryptogenetic stroke and PFO, but the role of this condition as a risk factor for stroke is still debated. The aims of this prospective multicentre study are the evaluation of PFO prevalence in the whole ischemic stroke population and the identification of a stroke recurrence profile risk in patients with PFO. All consecutive patients admitted for acute ischemic stroke and with a confirmed diagnosis at discharge are eligible cases for the study. Demographic and vascular risk factors are registered. Clinical severity is summarized by the National Institute of Health stroke scale. Echocardiographic and transcranial studies are performed in each patient to detect the presence of PFO. Prevalence of PFO will be calculated with 95 % CIs. Univariate analysis will be performed to detect the correlation of PFO with different registered factors and multivariable analysis with PFO as independent variable. The present study should contribute to better identify the role of PFO in ischemic stroke risk and recurrence-related events. Qualifying findings of the study are represented by the high number of enrolled patients, the prospective methodology of the study and the presence of secondary instrumental endpoints.

  10. Lung function and risk of fatal and non-fatal stroke. The Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Truelsen, T; Prescott, E; Lange, P;

    2001-01-01

    adjustment for potential confounders: sex, age, smoking, inhalation, body mass index, systolic blood pressure, triglycerides, physical activity in leisure time, education, diabetes mellitus, and antihypertensive treatment. RESULTS: We found an inverse association between FEV1 and risk of first-time stroke....... For each 10% decrease in FEV1 in percentage of expected, the relative risk (RR) increased 1.05 (95% CI : 1.00-1.09, P = 0.03). This represents an approximately 30% higher risk of stroke in the group of people with the lowest lung function as compared to the group with the highest lung function...... function groups. CONCLUSIONS: This study shows that reduced lung function measured in percentage of predicted FEV1 is a predictor of first-time stroke and fatal stroke independent of smoking and inhalation. The high risk of fatal first-ever stroke in the group of people with low lung function may...

  11. [Stroke mortality in Poland--role of observational studies based on computer databases].

    Science.gov (United States)

    Mazurek, Maciej

    2005-01-01

    Stroke is a leading cause of death worldwide and remains one of the major public health problems. Most European countries have experienced declines in stroke mortality in contrast to central and eastern European countries including Poland. The World Health Organization Data Bank is an invaluable source of information especially for mortality trends. Stroke mortality in Poland and some problems with accuracy of ICD coding for the identification of patients with acute stroke are discussed. Computerized databases are increasingly being used to identify patients with acute stroke for epidemiological, quality of care, and cost studies. More accurate methods of collecting and analysis of the data should be implemented to gain more information from these bases. PMID:16425791

  12. Animal models for studying penile hemodynamics

    Institute of Scientific and Technical Information of China (English)

    HiroyaMizusawa; OsamuIshizuka

    2002-01-01

    Animal models for the study of erectile function monitoring the changes in intracavernous pressure(ICP)during penile erection was reviewed.The development of new modwls using small commercially-available experimen-tal animals,rats and mice,in the last edcade facilitated in vivo investigation of erectile physiology.The technique enabled to evaluate even subtle erectile responses by analyzing ICPand systemic blood pressure,Moreover,the method has been well improved and studies using conscious animal models without the influence of any drug or anesthesia are more appropriate in exploring the precise physiological and pharmacological mechanisms in erection.Also,more natural and physiological sexual arousal instead of electrical or pharmacological stimulation is desirable in most of the studies.This article reviewed the development of ICPstudies in rats and mice.

  13. Screening Education And Recognition in Community pHarmacies of Atrial Fibrillation to prevent stroke in an ambulant population aged ≥65 years (SEARCH-AF stroke prevention study): a cross-sectional study protocol

    OpenAIRE

    Lowres, Nicole; Freedman, Saul Benedict; Redfern, Julie; McLachlan, Andrew; Krass, Ines; Bennett, Alexandra; Briffa, Thomas; Bauman, Adrian; Neubeck, Lis

    2012-01-01

    Background Atrial fibrillation (AF) is associated with a high risk of stroke and may often be asymptomatic. AF is commonly undiagnosed until patients present with sequelae, such as heart failure and stroke. Stroke secondary to AF is highly preventable with the use of appropriate thromboprophylaxis. Therefore, early identification and appropriate evidence-based management of AF could lead to subsequent stroke prevention. This study aims to determine the feasibility and impact of a community ph...

  14. Experimental studies for the development of a new method for stroke volume measuring using X-ray videodensitometry

    International Nuclear Information System (INIS)

    Quantitative videodensitometry was studied with a view to its possible application as a new, non-invasive method of measuring cardiac stroke volume. To begin with, the accuracy of roentgen volumetric measurements was determined. After this, blood volume variations were measured by densitometry in five animal experiments. The findings were compared with the volumes measured by a flowmeter in the pulmonary artery. The total stroke volume was found to be proportional to the difference between the maximum and mean densitometric volume. A comparison between videodensitometry and other non-invasive methods showed that, in a stable circulatory system, the results of videodensitometry are equally reliable as, or even more reliable than, those of the conventional methods. (orig./MG)

  15. A biochemical marker panel in MRI-proven hyperacute ischemic stroke-a prospective study

    Directory of Open Access Journals (Sweden)

    Knauer Carolin

    2012-03-01

    Full Text Available Abstract Background Computer tomography (CT is still the fastest and most robust technique to rule out ICH in acute stroke. However CT-sensitivity for detection of ischemic stroke in the hyperacute phase is still relatively low. Moreover the validity of pure clinical judgment is diminished by several stroke imitating diseases (mimics. The "Triage® Stroke Panel", a biochemical multimarker assay, detects Brain Natriuretic Peptide (BNP, D-Dimers (DD, Matrix-Metalloproteinase-9 (MMP-9, and S100B protein and promptly generates a Multimarkerindex of these values (MMX. This index has been licensed for diagnostic purposes as it might increase the validity of the clinical diagnosis to differentiate between stroke imitating diseases and true ischemic strokes. Our aim was to prove whether the panel is a reliable indicating device for the diagnosis of ischemic stroke in a time window of 6 h to fasten the pre- and intrahospital pathway to fibrinolysis. Methods We investigated all consecutive patients admitted to our stroke unit during a time period of 5 months. Only patients with clinical investigation, blood sample collection and MRI within six hours from symptom onset were included. Values of biochemical markers were analyzed according to the results of diffusion weighted MR-imaging. In addition MMX-values in ischemic strokes were correlated with the TOAST-criteria. For statistical analysis the SAS Analyst software was used. Correlation coefficients were analyzed and comparison tests for two or more groups were performed. Statistical significance was assumed in case of p Results In total 174 patients were included into this study (n = 100 strokes, n = 49 mimics, n = 25 transitoric ischemic attacks. In patients with ischemic strokes the mean NIHSS was 7.6 ± 6.2, while the mean DWI-lesion volume was 20.6 ml (range 186.9 to 4.2 ml. According to the MMX or the individual markers there was no statistically significant difference between the group of ischemic

  16. Functional recovery in aging mice after experimental stroke.

    Science.gov (United States)

    Manwani, Bharti; Liu, Fudong; Xu, Yan; Persky, Rebecca; Li, Jun; McCullough, Louise D

    2011-11-01

    Aging is a non-modifiable risk factor for stroke. Since not all strokes can be prevented, a major emerging area of research is the development of effective strategies to enhance functional recovery after stroke. However, in the vast majority of pre-clinical stroke studies, the behavioral tests used to assess functional recovery have only been validated for use in young animals, or are designed for rats. Mice are increasingly utilized in stroke models but well validated behavioral tests designed for rats are not necessarily reproducible in mice. We examined a battery of behavioral tests to evaluate functional recovery in an aging murine model of stroke. We found that the vertical pole, hanging wire and open field can accurately assess acute behavioral impairments after stroke in both young and aging male mice, but animals recover rapidly on these tasks. The corner test can accurately and repeatedly differentiate stroke from sham animals up to 30 days post stroke and can be performed reliably in aging mice. Aging male mice had significantly worse behavioral impairment compared to young male mice in the first two weeks after stroke but eventually recovered to the same degree as young mice. In contrast, chronic infarct size, as measured by ipsilateral cerebral atrophy, was significantly lower in aging male mice compared to young male mice. Reactive gliosis, formation of glial scar, and an enhanced innate immune response was seen in the aging brain and may contribute to the delayed behavioral recovery seen in the aging animals.

  17. STUDY OF RENAL FUNCTION TESTS IN PATIEN TS OF ACUTE HAEMORRHAGIC STROKE

    Directory of Open Access Journals (Sweden)

    Aditya Vardhan

    2015-05-01

    Full Text Available OBJECTIVE: To study renal function tests in patients with acute haemorrhagic stroke and to find association of abnormal renal function with adverse outcome in patients with acute haemorrhagic stroke . MATERIAL AND METHODS: The study was conducted at Darbhanga Medical College & Hospital , Laheriasarai , Darbhanga during the period from January 2012 to September 2013 . This was an observational study . A total of 100 patients presenting with acute haemorrhagic stroke admitted to the hospital or reporting in OPD/Emergency for stroke were included in this study after having taken written informed consent . Cases were selected by random sampling . OBSERVATION: Out of 100 patients with acute haemorrhagic stroke 92 patients had intracerebral haemorrhage and 8 patie nts had subarachnoid haemorrhage . Patients were divided into two groups on the basis of estimated glomerular filtration rate ( eGFR . Group A ( eGFR > 60 ml/min/1 . 73 m 2 BSA comprised of 71% of total stroke patients and group B ( eGFR 98umol/L and 15 ( 68 . 60% patients had blood urea >6 . 8mmol/L . CONCLUSION: This study clearly indicated that renal dysfunction as evidenced by ( a eGFR 98umol/L & c Blood urea >6 . 8mmol/L , are not only an important risk factor for acute haemorrhagic stroke but are also an independent predictor of mortality within 30 days of presentation .

  18. Measures of Adiposity and Risk of Stroke in China: A Result from the Kailuan Study

    OpenAIRE

    Wang, Anxin; Wu, Jianwei; Zhou, Yong; Guo, Xiuhua; Luo, Yanxia; Wu, Shouling; Zhao, Xingquan

    2013-01-01

    Objective The objective of this study was to explore the association between adiposity and risk of incident stroke among men and women. Methods We studied the relationship between adiposity and stroke among 94,744 participants (18–98 years old) in the Kailuan study. During a follow-up of 4 years, 1,547 ischemic or hemorrhagic strokes were recorded. Measurements of adiposity included body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHpR), and waist-to-height ratio (WHtR). H...

  19. Increased risk of ischemic stroke in cervical cancer patients: a nationwide population-based study

    International Nuclear Information System (INIS)

    Increased risk of ischemic stroke has been validated for several cancers, but limited study evaluated this risk in cervical cancer patients. Our study aimed to evaluate the risk of ischemic stroke in cervical cancer patients. The study analyzed data from the 2003 to 2008 National Health Insurance Research Database (NHIRD) provided by the National Health Research Institutes in Taiwan. Totally, 893 cervical cancer patients after radiotherapy and 1786 appendectomy patients were eligible. The Kaplan-Meier method and the Cox proportional hazards model were used to assess the risk of ischemic stroke. The 5-year cumulative risk of ischemic stroke was significantly higher for the cervical cancer group than for the control group (7.8% vs 5.1%; p <0.005). The risk of stroke was higher in younger (age <51 years) than in older (age ≥51 years) cervical cancer patients (HR = 2.73, p = 0.04; HR = 1.37, p = 0.07) and in patients with more than two comorbid risk factors (5 years cumulative stroke rate of two comorbidities: 15% compared to no comorbidities: 4%). These study demonstrated cervical cancer patients had a higher risk of ischemic stroke than the general population, especially in younger patients. Strategies to reduce this risk should be assessed

  20. Diffusion and perfusion correlates of the {sup 18}F-MISO PET lesion in acute stroke: pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Alawneh, Josef A.; Marrapu, S.T.; Jensen-Kondering, Ulf; Morris, Rhiannon S.; Jones, P.S. [University of Cambridge, Stroke Research Group, Department of Clinical Neurosciences, Cambridge (United Kingdom); Moustafa, Ramez R. [University of Cambridge, Stroke Research Group, Department of Clinical Neurosciences, Cambridge (United Kingdom); Ain Shams University, Department of Neurology, Cairo (Egypt); Aigbirhio, Franklin I.; Fryer, Tim D.; Carpenter, T.A. [University of Cambridge, Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, Cambridge (United Kingdom); Warburton, Elizabeth A. [University of Cambridge, Stroke Research Group, Department of Clinical Neurosciences, Cambridge (United Kingdom); Stroke Unit, Addenbrooke' s Hospital, Cambridge (United Kingdom); Baron, Jean-Claude [University of Cambridge, Stroke Research Group, Department of Clinical Neurosciences, Cambridge (United Kingdom); Universite Paris Descartes, INSERM U894, Centre Hospitalier Sainte-Anne, Paris (France)

    2014-04-15

    Mapping the ischaemic penumbra in acute stroke is of considerable clinical interest. For this purpose, mapping tissue hypoxia with {sup 18}F-misonidazole (FMISO) PET is attractive, and is straightforward compared to {sup 15}O PET. Given the current emphasis on penumbra imaging using diffusion/perfusion MR or CT perfusion, investigating the relationships between FMISO uptake and abnormalities with these modalities is important. According to a prospective design, three patients (age 54-81 years; admission NIH stroke scale scores 16-22) with an anterior circulation stroke and extensive penumbra on CT- or MR-based perfusion imaging successfully completed FMISO PET, diffusion-weighted imaging and MR angiography 6-26 h after stroke onset, and follow-up FLAIR to map the final infarction. All had persistent proximal occlusion and a poor outcome despite thrombolysis. Significant FMISO trapping was defined voxel-wise relative to ten age-matched controls and mapped onto coregistered maps of the penumbra and irreversibly damaged ischaemic core. FMISO trapping was present in all patients (volume range 18-119 ml) and overlapped mainly with the penumbra but also with the core in each patient. There was a significant (p ≤ 0.001) correlation in the expected direction between FMISO uptake and perfusion, with a sharp FMISO uptake bend around the expected penumbra threshold. FMISO uptake had the expected overlap with the penumbra and relationship with local perfusion. However, consistent with recent animal data, our study suggests FMISO trapping may not be specific to the penumbra. If confirmed in larger samples, this preliminary finding would have potential implications for the clinical application of FMISO PET in acute ischaemic stroke. (orig.)

  1. Relationship between C-reactive protein and stroke: a large prospective community based study.

    Directory of Open Access Journals (Sweden)

    Yanfang Liu

    Full Text Available Previous studies have suggested that C-reactive protein (CRP was associated with risk of stroke. There were few studies in Asian population, or on stroke subtypes other than ischemic stroke. We thus investigated the relationship between CRP and the risks of all stroke and its subtypes in a Chinese adult population.In the current study, we included 90,517 Chinese adults free of stroke and myocardial infarction at baseline (June 2006 to October 2007 in analyses. Strokes were classified as ischemic stroke (IS, intracranial heamorrhage (ICH and subarachnoid heamorrhage (SAH. High-sensitivity CRP (hs-CRP were categorized into three groups: 3 mg/L. Cox proportional hazards regression was used to calculate the association between hs-CRP concentrations and all stroke, as well as its subtypes.During a median follow-up time of 49 months, we documented 1,472 incident stroke cases. Of which 1,049 (71.3% were IS, 383 (26.0% were ICH, and 40 (2.7% were SAH. After multivariate adjustment, hs-CRP concentrations ≥1 mg/L were associated with increased risks of all stroke (hs-CRP 1-3 mg/L: hazard ratio (HR 1.17, 95% confidential interval (CI 1.03-1.33; hs-CRP>3 mg/L: HR 1.25, 95% CI 1.07-1.46 and IS (hs-CRP 1-3 mg/L: HR 1.17, 95% CI 1.01-1.36; hs-CRP>3 mg/L: HR 1.33, 95% CI 1.11-1.60, but not with ICH and SAH. Subgroup analyses showed that higher hs-CRP concentration was more prone to be a risk factor for all stroke and IS in non-fatal stroke, male and hypertensive participants.We found that higher hs-CRP concentrations were associated with a higher risk of IS, particularly for non-fatal stroke, male and hypertensive subjects. In contrast, we did not observe significant associations between hs-CRP and ICH/SAH.

  2. Risk of Stroke in Patients With Spontaneous Pneumothorax: A Nationwide, Population-Based Study.

    Science.gov (United States)

    Cheng, Ching-Yuan; Yeh, Diana Yu-Wung; Lin, Cheng-Li; Kao, Chia-Hung

    2016-04-01

    The association between spontaneous pneumothorax (SP) and stroke has not been reported, and this study aimed to explore this association. We used the National Health Insurance Research Database for conducting a nationwide, population-based, retrospective cohort study of patients newly hospitalized for SP from 2000 to 2010. A total of 2541 patients with newly diagnosed SP were included and compared with patients without SP. We observed that patients with SP were at higher risk for developing stroke, with an adjusted hazard ratio (HR) of 1.56. In addition, these patients had a significantly higher risk of hemorrhagic stroke (adjusted HR = 2.22) than of ischemic stroke (adjusted HR = 1.48). The risk of stroke was the highest in the initial 4 months after hospitalization for SP (adjusted HR = 3.41, 95% confidence interval = 1.98-5.87). In conclusion, our study revealed a correlation between stroke and a history of SP, and the risk of stroke after SP was time sensitive. PMID:27100423

  3. Risk of Stroke in Patients With Spontaneous Pneumothorax: A Nationwide, Population-Based Study.

    Science.gov (United States)

    Cheng, Ching-Yuan; Yeh, Diana Yu-Wung; Lin, Cheng-Li; Kao, Chia-Hung

    2016-04-01

    The association between spontaneous pneumothorax (SP) and stroke has not been reported, and this study aimed to explore this association. We used the National Health Insurance Research Database for conducting a nationwide, population-based, retrospective cohort study of patients newly hospitalized for SP from 2000 to 2010. A total of 2541 patients with newly diagnosed SP were included and compared with patients without SP. We observed that patients with SP were at higher risk for developing stroke, with an adjusted hazard ratio (HR) of 1.56. In addition, these patients had a significantly higher risk of hemorrhagic stroke (adjusted HR = 2.22) than of ischemic stroke (adjusted HR = 1.48). The risk of stroke was the highest in the initial 4 months after hospitalization for SP (adjusted HR = 3.41, 95% confidence interval = 1.98-5.87). In conclusion, our study revealed a correlation between stroke and a history of SP, and the risk of stroke after SP was time sensitive.

  4. Lower Ipsilateral Hippocampal Integrity after Ischemic Stroke in Young Adults: A Long-Term Follow-Up Study

    NARCIS (Netherlands)

    Schaapsmeerders, P.; Tuladhar, A.M.; Maaijwee, N.A.M.M.; Rutten-Jacobs, L.C.A.; Arntz, R.M.; Schoonderwaldt, H.C.; Dorresteijn, L.D.A.; Dijk, E.J. van; Kessels, R.P.C.; Leeuw, H.F. de

    2015-01-01

    Background and purpose Memory impairment after stroke is poorly understood as stroke rarely occurs in the hippocampus. Previous studies have observed smaller ipsilateral hippocampal volumes after stroke compared with controls. Possibly, these findings on macroscopic level are not the first occurrenc

  5. Lower Ipsilateral Hippocampal Integrity after Ischemic Stroke in Young Adults: A Long-Term Follow-Up Study

    NARCIS (Netherlands)

    Schaapsmeerders, P.; Tuladhar, A.M.; Maaijwee, N.A.M.M.; Rutten-Jacobs, L.C.A.; Arntz, R.M.; Schoonderwaldt, H.C.; Dorresteijn, L.D.; Dijk, E.J. van; Kessels, R.P.C.; Leeuw, F.E. de

    2015-01-01

    BACKGROUND AND PURPOSE: Memory impairment after stroke is poorly understood as stroke rarely occurs in the hippocampus. Previous studies have observed smaller ipsilateral hippocampal volumes after stroke compared with controls. Possibly, these findings on macroscopic level are not the first occurren

  6. A COMPAR A TIVE STUDY OF SELECTIVE INDICATOR PROFILES IN PATIENTS WITH ISCHEMIC STROKE AND HEMORRHAGIC STROKE

    OpenAIRE

    Narayanaswamy; Ravi; Nagarjun

    2015-01-01

    BACKGROUND: In Urban India, stroke accounts for 1% mortality in all hospital admissions. The pathogenic role of increased plasma fibrinogen level in causing stroke has been recently reinforced. It was therefore of interest to measure plasma fibrinogen level in patients with ischemic and hemorrhagic stroke and to compare it with lipid profile....

  7. Effect of vitamin C supplementation on stroke recovery: A case-control study

    OpenAIRE

    Rabadi, Meheroz H; Kristal, Bruce S.

    2007-01-01

    Background and purpose: Epidemiological studies have associated increased dietary intake of antioxidants (vitamin C, E, and β-carotene) in preventing and decreasing the extent of ischemic brain injury. The effect of vitamin C supplementation on functional recovery after stroke has not been studied. Method: In this retrospective, case-control study of 23 patients with ischemic stroke taking vitamin C were identified and matched for age, sex, onset to admission, and admission total functional i...

  8. Sickness absence and return to work among Japanese stroke survivors: a 365-day cohort study

    OpenAIRE

    Endo, Motoki; Sairenchi, Toshimi; Kojimahara, Noriko; Haruyama, Yasuo; Sato, Yasuto; Kato, Rika; Yamaguchi, Naohito

    2016-01-01

    Objectives The objective of this study was to investigate the cumulative return to work (RTW) rate and to clarify the predictors of the time to full-time RTW (full RTW) and resignation among Japanese stroke survivors, within the 365-day period following their initial day of sickness absence due to stroke. Setting This study was based on tertiary prevention of occupational health in large-scaled Japanese companies of various industries. Participants The participants in this study were 382 Japa...

  9. SERUM CREATINE KINASE MB IN ISCHAEMIC STROKE: A CASE CONTROL STUDY

    Directory of Open Access Journals (Sweden)

    Preethi

    2016-06-01

    Full Text Available AIM To estimate CK-MB levels in ischaemic stroke patients and know its correlation in stroke patients. OBJECTIVES Serum creatine kinase-MB, other cardiac enzymes (CK, SGOT, uric acid, lipid profile, fasting blood glucose, and blood pressure was recorded. CT scan and ECG were also considered for the study. The aim of study was to determine serum creatine kinase-MB and the vascular risk factors for ischaemic stroke in a series of patients with an ischaemic stroke and to compare them with a series of controls of same age. METHODS Fifty (50 consecutive patients with ischaemic stroke were compared with thirty (30 healthy controls of same age. Vascular risk factors were recorded and serum creatine kinase-MB was determined in all of them. RESULTS There was modest rise of CK-MB in initial stages of stroke as compared with controls. The increase in CK-MB among cases is highly significant with a P value of <0.001. CONCLUSION The modest rise in serum CK-MB, which have recorded in the initial stages of stroke suggest that acute myocardial involvement is a common complication than is generally recognized. It is more likely that acute myocardial dysfunction is a consequence rather than a cause of acute cerebrovascular lesion.

  10. Accuracy of the detection of infratentorial stroke lesions using perfusion CT: an experimenter-blinded study

    Energy Technology Data Exchange (ETDEWEB)

    Lee, In Hyouk; Kim, Myung Soon; Kim, Young Ju; Lee, Myeong Sub [Yonsei University, Department of Radiology, Wonju College of Medicine, Wonju (Korea, Republic of); You, Joshua H. [Center for Health, Wellness, Fitness, Prevention, and Healing Across the Life Span, Department of Physical Therapy, Graduate School of Rehabilitation Science, Yonsei University, Center for Movement Impairment Solutions, Wonju City (Korea, Republic of); Lee, Ji Yong [Yonsei University, Department of Neurology, Wonju College of Medicine, Wonju (Korea, Republic of); Whang, Kum [Yonsei University, Department of Neurosurgery, Wonju College of Medicine, Wonju (Korea, Republic of)

    2010-12-15

    Although perfusion CT (PCT) for the detection of supratentorial stroke is well established, there is a dearth of evidence of its effectiveness in the detection of infratentorial stroke. Hence, this study compared sensitivity, specificity, and accuracy of PCT maps between infratentorial and supratentorial stroke lesions. One hundred patients with acute stroke who had successfully undergone near whole-brain PCT with the toggling table technique and follow-up MRI were included. Wilcoxon Mann-Whitney test was performed at P < 0.01. There was no significant statistical difference in the accuracy (91.79% vs. 93.23% in regional cerebral blood volume; 92.26% vs. 95.31% in regional cerebral blood flow; 89.17% vs. 92.71% in mean transit time; 89.76% vs. 92.19% in time to peak; P > 0.01 in all PCT maps) between supratentorial and infratentorial stroke. Also, there was no remarkable difference in both sensitivity and specificity of PCT maps. This was the first study to investigate the accuracy of PCT with the toggling table technique in detection of infratentorial stroke lesions. Clinically, PCT is highly reliable and accurate in detecting infratentorial stroke lesions. (orig.)

  11. Post-stroke cognitive dysfunctions: A clinical and neuroimaging study

    Directory of Open Access Journals (Sweden)

    Andrei Yuryevich Emelin

    2013-01-01

    Full Text Available Clinical, neuropsychological, and neuroimaging examinations were made in 65 patients (52 men and 13 women aged 65.6±10.1 years who had experienced ischemic stroke. Cognitive impairments (CI were heterogeneous; regulatory functions, attention, and counting were most significantly affected in moderate CI. In mild dementia, mainly poor attention and regulatory dysfunctions were added by clearly-cut impairments of memory, orientation, and visual-spatial function. Brain atrophy, white matter changes, and small focal gray matter damages along with focal post-stroke changes were revealed by neuroimaging in most patients. It was found that besides the volume and location of a damage focus, the signs of impaired integrated mental activity of the brain, regulatory dysfunctions in particular, should be a necessary condition for the verification of post-stroke CI.

  12. Trends in stroke incidence. The Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Truelsen, T; Prescott, E; Grønbaek, M;

    1997-01-01

    at least one of the two first examinations as well as the total cohort including nonresponders. Subjects between 45 and 84 years of age were followed from March 1, 1976 until March 1, 1993. Changes in age-specific stroke incidence were calculated by means of Poisson regression analysis. RESULTS......: For subjects aged 45 to 64 years, no significant trends were observed, with an annual incidence rate ratio of 1.00 (95% confidence interval [CI], 0.97 to 1.03) and 1.04 (95% CI, 0.99 to 1.08) for men and women, respectively. In subjects aged 65 to 84 years a significant decrease in stroke incidence was found...... there has been a decline in incidence of stroke in men and women aged 65 to 84 years that was significant only in men, whereas no changes were found for persons aged 45 to 64 years....

  13. Epilepsy after stroke

    DEFF Research Database (Denmark)

    Olsen, T S; Høgenhaven, H; Thage, O

    1987-01-01

    Development of epilepsy was studied prospectively in a group of 77 consecutive stroke patients. Included were stroke patients less than 75 years old admitted within the first 3 days after the stroke. Excluded were patients with subarachnoid hemorrhage, vertebrobasilar stroke, and patients...

  14. Little change of modifiable risk factors 1 year after stroke: a pilot study

    DEFF Research Database (Denmark)

    Hornnes, Nete; Larsen, Klaus; Boysen, Gudrun

    2010-01-01

    Recurrent stroke accounts for about 25% of admissions for acute stroke. For the prevention of recurrent cerebro and cardiovascular disease, stroke patients are advised to change modifiable stroke risk factors before discharge from stroke units.......Recurrent stroke accounts for about 25% of admissions for acute stroke. For the prevention of recurrent cerebro and cardiovascular disease, stroke patients are advised to change modifiable stroke risk factors before discharge from stroke units....

  15. Circle drawing as evaluative movement task in stroke rehabilitation: an explorative study

    Directory of Open Access Journals (Sweden)

    Rietman Johan S

    2011-03-01

    Full Text Available Abstract Background The majority of stroke survivors have to cope with deficits in arm function, which is often measured with subjective clinical scales. The objective of this study is to examine whether circle drawing metrics are suitable objective outcome measures for measuring upper extremity function of stroke survivors. Methods Stroke survivors (n = 16 and healthy subjects (n = 20 drew circles, as big and as round as possible, above a table top. Joint angles and positions were measured. Circle area and roundness were calculated, and synergistic movement patterns were identified based on simultaneous changes of the elevation angle and elbow angle. Results Stroke survivors had statistically significant lower values for circle area, roundness and joint excursions, compared to healthy subjects. Stroke survivors moved significantly more within synergistic movement patterns, compared to healthy subjects. Strong correlations between the proximal upper extremity part of the Fugl-Meyer scale and circle area, roundness, joint excursions and the use of synergistic movement patterns were found. Conclusions The present study showed statistically significant differences in circle area, roundness and the use of synergistic movement patterns between healthy subjects and stroke survivors. These circle metrics are strongly correlated to stroke severity, as indicated by the proximal upper extremity part of the FM score. In clinical practice, circle area and roundness can give useful objective information regarding arm function of stroke survivors. In a research setting, outcome measures addressing the occurrence of synergistic movement patterns can help to increase understanding of mechanisms involved in restoration of post stroke upper extremity function.

  16. Stroke propensity is increased under atrial fibrillation hemodynamics: a simulation study.

    Directory of Open Access Journals (Sweden)

    Hyo Won Choi

    Full Text Available Atrial fibrillation (AF is the most common sustained dysfunction in heart rhythm clinically and has been identified as an independent risk factor for stroke through formation and embolization of thrombi. AF is associated with reduced cardiac output and short and irregular cardiac cycle length. Although the effect of AF on cardiac hemodynamic parameters has been reported, it remains unclear how the hemodynamic perturbations affect the potential embolization of blood clots to the brain that can cause stroke. To understand stroke propensity in AF, we performed computer simulations to describe trajectories of blood clots subject to the aortic flow conditions that represent normal heart rhythm and AF. Quantitative assessment of stroke propensity by blood clot embolism was carried out for a range of clot properties (e.g., 2-6 mm in diameter and 0-0.8 m/s ejection speed under normal and AF flow conditions. The simulations demonstrate that the trajectory of clot is significantly affected by clot properties as well as hemodynamic waveforms which lead to significant variations in stroke propensity. The predicted maximum difference in stroke propensity in the left common carotid artery was shown to be about 60% between the normal and AF flow conditions examined. The results suggest that the reduced cardiac output and cycle length induced by AF can significantly increase the incidence of carotid embolism. The present simulations motivate further studies on patient-specific risk assessment of stroke in AF.

  17. Linking stroke mortality with air pollution, income, and greenness in northwest Florida: an ecological geographical study

    Directory of Open Access Journals (Sweden)

    Rao K Ranga

    2008-05-01

    Full Text Available Abstract Background Relatively few studies have examined the association between air pollution and stroke mortality. Inconsistent and inclusive results from existing studies on air pollution and stroke justify the need to continue to investigate the linkage between stroke and air pollution. No studies have been done to investigate the association between stroke and greenness. The objective of this study was to examine if there is association of stroke with air pollution, income and greenness in northwest Florida. Results Our study used an ecological geographical approach and dasymetric mapping technique. We adopted a Bayesian hierarchical model with a convolution prior considering five census tract specific covariates. A 95% credible set which defines an interval having a 0.95 posterior probability of containing the parameter for each covariate was calculated from Markov Chain Monte Carlo simulations. The 95% credible sets are (-0.286, -0.097 for household income, (0.034, 0.144 for traffic air pollution effect, (0.419, 1.495 for emission density of monitored point source polluters, (0.413, 1.522 for simple point density of point source polluters without emission data, and (-0.289,-0.031 for greenness. Household income and greenness show negative effects (the posterior densities primarily cover negative values. Air pollution covariates have positive effects (the 95% credible sets cover positive values. Conclusion High risk of stroke mortality was found in areas with low income level, high air pollution level, and low level of exposure to green space.

  18. Effects of a Public Education Campaign on the Association Between Knowledge of Early Stroke Symptoms and Intention to Call an Ambulance at Stroke Onset: The Acquisition of Stroke Knowledge (ASK) Study

    Science.gov (United States)

    Nishikawa, Tomofumi; Okamura, Tomonori; Nakayama, Hirofumi; Miyamatsu, Naomi; Morimoto, Akiko; Toyoda, Kazunori; Suzuki, Kazuo; Toyota, Akihiro; Hata, Takashi; Yamaguchi, Takenori

    2016-01-01

    Background An immediate ambulance call offers the greatest opportunity for acute stroke therapy. Effectively using ambulance services requires strengthening the association between knowledge of early stroke symptoms and intention to call an ambulance at stroke onset, and encouraging the public to use ambulance services. Methods The present study utilized data from the Acquisition of Stroke Knowledge (ASK) study, which administered multiple-choice, mail-in surveys regarding awareness of early stroke symptoms and response to a stroke attack before and after a 2-year stroke education campaign in two areas subject to intensive and moderate intervention, as well as in a control area, in Japan. In these three areas, 3833 individuals (1680, 1088 and 1065 participants in intensive intervention, moderate intervention, and control areas, respectively), aged 40 to 74 years, who responded appropriately to each survey were included in the present study. Results After the intervention, the number of correctly identified symptoms significantly associated with intention to call an ambulance (P < 0.05) increased (eg, from 4 to 5 correctly identified symptoms), without increasing choice of decoy symptoms in the intensive intervention area. Meanwhile, in other areas, rate of identification of not only correct symptoms but also decoy symptoms associated with intention to call an ambulance increased. Furthermore, the association between improvement in the knowledge of stroke symptoms and intention to call an ambulance was observed only in the intensive intervention area (P = 0.009). Conclusions Our results indicate that intensive interventions are useful for strengthening the association between correct knowledge of early stroke symptoms and intention to call an ambulance, without strengthening the association between incorrect knowledge and intention to call an ambulance. PMID:26441211

  19. Inaugurating the Study of Animal Metacognition

    OpenAIRE

    Smith, J. David

    2010-01-01

    Metacognition—the ability to monitor and control one’s own cognition—is a sophisticated ability that reveals humans’ reflective mind and consciousness. Researchers have begun to explore whether animals share humans’ metacognitive capacity. This article reprises the original study that explored metacognition across species. A captive dolphin performed an auditory pitch-discrimination task using High/Low discrimination responses and an Uncertainty response with which he could decline to complet...

  20. Proper housing conditions in experimental stroke studies – special emphasis on environmental enrichment

    Directory of Open Access Journals (Sweden)

    Satu eMering

    2015-03-01

    Full Text Available Environmental enrichment provides laboratory animals with novelty and extra space, allowing different forms of multisensory stimulation ranging from social grouping to enhanced motor activity. At the extreme end of the spectrum, one can have a super-enriched environment. Environmental enrichment is believed to result in improved cognitive and sensorimotor functions both in naïve rodents and in animals with brain lesions such as those occurring after a stroke. Robust behavioral effects in animals which have suffered a stroke are probably related not only to neuronal plasticity in the perilesional cortex but also in remote brain areas. There is emerging evidence to suggest that testing restorative therapies in an enriched environment can maximize treatment effects, e.g., the perilesional milieu seems to be more receptive to concomitant pharmacotherapy and/or cell therapy. This review provides an updated overview on the effect of an enriched environment in stroke animals from the practical points to be considered when planning experiments to the mechanisms explaining why combined therapies can contribute to behavioral improvement in a synergistic manner.

  1. Stroke Treatments

    Science.gov (United States)

    ... T. Quiz 5 Things to Know About Stroke Stroke Treatments A stroke occurs when a vessel in ... Busting Clots to Save Lives Hemorrhagic Stroke Treatment Stroke Prevention The good news is that 80 percent ...

  2. The Development of Animal Welfare in Finland and How People Perceive Animal Welfare : Case Study: Animals in Tourism: Zoos

    OpenAIRE

    Laatu, Suvi

    2013-01-01

    The aim of the thesis was to study how Finnish people perceive animal welfare in general and how they feel about animals in tourism purposes, more specifically in zoos. The thesis also contains information about Finnish animal legislation and how animal welfare has developed over time. The target group for the research was people who have visited zoos recently. The interviewed people were from different age groups. The theoretical framework consists of the following topics: people’s relations...

  3. Why do we study animal toxins?

    Science.gov (United States)

    Zhang, Yun

    2015-07-18

    Venom (toxins) is an important trait evolved along the evolutionary tree of animals. Our knowledges on venoms, such as their origins and loss, the biological relevance and the coevolutionary patterns with other organisms are greatly helpful in understanding many fundamental biological questions, i.e., the environmental adaptation and survival competition, the evolution shaped development and balance of venoms, and the sophisticated correlations among venom, immunity, body power, intelligence, their genetic basis, inherent association, as well as the cost-benefit and trade-offs of biological economy. Lethal animal envenomation can be found worldwide. However, from foe to friend, toxin studies have led lots of important discoveries and exciting avenues in deciphering and fighting human diseases, including the works awarded the Nobel Prize and lots of key clinic therapeutics. According to our survey, so far, only less than 0.1% of the toxins of the venomous animals in China have been explored. We emphasize on the similarities shared by venom and immune systems, as well as the studies of toxin knowledge-based physiological toxin-like proteins/peptides (TLPs). We propose the natural pairing hypothesis. Evolution links toxins with humans. Our mission is to find out the right natural pairings and interactions of our body elements with toxins, and with endogenous toxin-like molecules. Although, in nature, toxins may endanger human lives, but from a philosophical point of view, knowing them well is an effective way to better understand ourselves. So, this is why we study toxins. PMID:26228472

  4. Mixed Stroke

    Institute of Scientific and Technical Information of China (English)

    黄如训; 曾进胜

    2000-01-01

    Purpose To summarize the chnical, autoptic and animal experimental dala of stroke, propose the concept of mixed stroke (MS) and demonstrate the enoiogy, pathogenesis, clinical mainfestations, prophylaxis and treatment of MS Background At present. stroke still is classified in the national and international academic fields as two main groups: hemorrhage and ischema In fact, thc cerebral vascular disease with hemorrhage forus and ischema focus at the same time is not rare moreover, this type of stroke has special etiology, pathogenesis and clinical manifestations. But it is always made a main dagnosis and neglected the other nature of coexistent focus on either clinical or pathological diagnosis according to traditional classification of stroke Data sources and methods Mort of pablished originsl articles about MS in our department and laboralory wcre reviewed. Resulta The clinical autoptic and animal experimental dats all prcved that hemorrhage and infarction could occur in the course of a stroke simultaneously or in suecession during a short time, which demonstrated the existence of MS It was found clinically that MS patients all had the hustory of hypcrtension and in the autoptic data the MS patients dying of stroke all had typical hypertensive changes in the heart and kidney. and had hypertensive arteriosclerosis in the cerebral arteriole and small artery. MS was cas lily thdueed in stroke-prone renovascular hypertensivc rats This kind of rats are free from genetic deficiency and arc not affected by senile factor, so their cerebral vascular foci are mainly induced by the single factor -hypertension. TThese indicate definitely that hypertensive cerebral vascular lesion is the basis inducing MS. The main lesions of hypertensive cerebral arteriole and small artery were hyalinosis and fibrinoid of the walls, and the formation of microaneurysms or hyperplasla of iniernal and external layers The math lcsions of hypertensive cerebral capillaries were increasing vascular

  5. Fatal stroke after the death of a sibling: a nationwide follow-up study from Sweden.

    Directory of Open Access Journals (Sweden)

    Mikael Rostila

    Full Text Available BACKGROUND: Although less studied than other types of familial losses, the loss of a sibling could be a potential trigger of stroke as it represents a stressful life event. We studied the association between loss of a sibling and fatal stroke up to 18 years since bereavement. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a follow-up study between 1981 and 2002, based on register data covering the total population of Swedes aged 40-69 years (n = 1,617,010. An increased risk of fatal stroke (1.31 CI: 1.05, 1.62 was found among women who had experienced the loss of a sibling. No increase in the overall mortality risk was found in men (1.11 CI: 0.92, 1.33. An elevated risk in the short term (during the second and third half-year after the death was found among both men and women, whereas longer-term elevation in risk was found primarily for women. Both external (1.47 CI: 1.00, 2.17 and not external (1.26 CI: 1.00, 1.60 causes of sibling death showed associations among women. In men, an association was found only if the sibling also died from stroke (1.78 CI: 1.00, 3.17. However, among women, we found an increased risk of stroke mortality if the sibling died from causes other than stroke (1.30 CI: 1.04, 1.62. CONCLUSIONS/SIGNIFICANCE: The findings suggest an increased risk of dying from stroke mortality after the death of a sibling, and that bereavement affects particularly women. It is important for health care workers to follow bereaved siblings and recognize potential changes of stress-levels and health related behaviours that could lead to risk of stroke.

  6. Quality of care and mortality among patients with stroke - A nationwide follow-up study

    DEFF Research Database (Denmark)

    Ingeman, A.; Pedersen, Lars; Hundborg, Heidi Holmager;

    2008-01-01

    National Indicator Project, a quality improvement initiative with participation of all Danish hospital departments caring for patients with stroke, we identified 29,573 patients hospitalized with stroke between January 13, 2003 and October 31, 2005. Quality of care was measured in terms of 7 specific......-response relationship between the number of quality of care criteria met and mortality; the lowest mortality rate was found among patients whose care met all criteria compared with patients whose care failed to meet any criteria (ie, adjusted 30-day mortality rate ratios: 0.45, 95% confidence interval: 0.24-0.66). When......Background: The relationship between process and outcome measures among patients with stroke is unclear. Objectives: To examine the association between quality of care and mortality among patients with stroke in a nationwide population-based follow-up study. Methods: Using data from The Danish...

  7. [Results of the multicenter prospective study of cerebrolysin safety and efficacy in acute stroke].

    Science.gov (United States)

    Skwortsova, V I; Stakhovskaia, L V; Shamalov, N A; Kerbikov, O B

    2006-01-01

    The multicenter prospective study of cerebrolysin safety and efficacy included 277 patients with ischemic stroke aged 55-85 years, who received therapy within 12 h from the disease development. Cerebrolysin was used in dosage 10 ml daily along with concomitant standard basic treatment during 10 days after stroke onset in 138 patients. A control group comprised 139 patients who received basic treatment only. A quantitative analysis of the dynamics of neurological deficit revealed the accelerated improvement by NIHSS score, modified Rankin score and Barthel index in the cerebrolysin group on days 10 and 28 (pcerebrolysin within the first 3h after stroke onset comparing to those treated within 6-12h. The trial demonstrated cerebrolysin safety and good tolerability in treatment of ischemic stroke in the carotid artery territory as well as its favorable clinical effect.

  8. Lower Risk of Stroke after Deformity Surgery: Long Term Benefit Demonstrated by a National Cohort Study

    Directory of Open Access Journals (Sweden)

    Liang-Chung Huang

    2015-10-01

    Full Text Available Objectives: This study aimed to investigate the long-term risk of stroke in adult patients with spinal deformity. Specifically, the study addressed the possible protective effect of surgery for spinal deformity against stroke. Methods: Using the National Health Insurance Research Database (NHIRD, a monopolistic national database in Taiwan, this retrospective cohort study analyzed the incidence of stroke in patients with adult spinal deformity (ASD in a 11-year period. A total of 13,503 patients, between 55 and 75 years old, were identified for the diagnosis of ASD. The patients were grouped into two: the surgical group (n = 10,439 who received spinal fusion surgery, and the control group (n = 2124 who received other medical treatment. The incidence rates of all subsequent cerebrovascular accidents, including ischemic and hemorrhagic strokes, were calculated. Hazard ratios for stroke were calculated use a full cohort and a propensity score matched cohort. Adjustments for co-morbidities that may predispose to stroke, including hypertension, diabetes mellitus, arrhythmia and coronary heart disease were conducted. Kaplan-Meier and Cox regression analyses were performed to compare the risk of stroke between the two groups. Results: During the total observation period of 50,450 person-years, the incidence rate of stroke in the surgical group (15.55 per 1000 person-years was significantly lower than that of the control group (20.89 per 1000 person-years, p < 0.001. Stroke was more likely to occur in the control group than in the surgical group (crude hazard ratio 1.34, p < 0.001; adjusted HR 1.28, p < 0.001, by a propensity score matched model. Conclusions: In this national cohort of more than 13,000 ASD patients covering 10 years, stroke was approximately 25% less likely to happen in patients who underwent spinal fusion surgery than those who received medical management. Therefore, spinal fusion surgery may provide a protective effect against stroke

  9. Pivotal Roles of Monocytes/Macrophages in Stroke

    Directory of Open Access Journals (Sweden)

    Tsuyoshi Chiba

    2013-01-01

    Full Text Available Stroke is an important issue in public health due to its high rates both of morbidity and mortality, and high rate of disability. Hypertension, cardiovascular disease, arterial fibrillation, diabetes mellitus, smoking, and alcohol abuse are all risk factors for stroke. Clinical observations suggest that inflammation is also a direct risk factor for stroke. Patients with stroke have high levels of inflammatory cytokines in plasma, and immune cells, such as macrophages and T-lymphocytes, are noted within stroke lesions. These inflammatory events are considered as a result of stroke. However, recent studies show that plasma levels of inflammatory cytokines or soluble adhesion molecules are high in patients without stroke, and anti-inflammatory therapy is effective at reducing stroke incidence in not only animal models, but in humans as well. Statins have been shown to decrease the stroke incidence via anti-inflammatory effects that are both dependent and independent of their cholesterol-lowering effects. These reports suggest that inflammation might directly affect the onset of stroke. Microglial cells and blood-derived monocytes/macrophages play important roles in inflammation in both onset and aggravation of stroke lesions. We review the recent findings regarding the role of monocytes/macrophages in stroke.

  10. Mineral Metabolism Markers Are Associated with Myocardial Infarction and Hemorrhagic Stroke but Not Ischemic Stroke in Hemodialysis Patients: A Longitudinal Study.

    Directory of Open Access Journals (Sweden)

    Miho Tagawa

    Full Text Available The associations between phosphate, calcium, and intact parathyroid hormone (PTH levels and composite cardiovascular end points have been studied. This study examined the associations of these markers with myocardial infarction (MI and stroke separately.This is a longitudinal study on 65,849 hemodialysis patients from the Japan Renal Data Registry. Patients with prior events at baseline were excluded. Predictors were phosphate, albumin-corrected calcium, intact PTH, and calcium times phosphate product levels. Outcome was the first episode of MI or stroke during a 1-year observation period. Data were analyzed using multiple logistic regression analyses, adjusted for potential confounders.There were 1,048, 651, and 2,089 events of incident MI, hemorrhagic, and ischemic stroke, respectively. Incident MI was associated with phosphate levels ≥6.5 mg/dL (odds ratio 1.49; confidence interval 1.23-1.80 compared with phosphate levels of 4.7-5.4 mg/dL and intact PTH levels>500 pg/mL (1.35; 1.03-1.79 compared with intact PTH levels of 151-300 pg/mL. Higher albumin-corrected calcium level was positively associated with MI (p = 0.04 by trend analysis. Hemorrhagic stroke was associated only with intact PTH levels>500 pg/mL (1.54; 1.10-2.17. Incident ischemic stroke had no association with phosphate, calcium, or intact PTH levels. The association of calcium times phosphate product with outcomes was essentially the same pattern as that of phosphate and outcomes.MI was associated with phosphate, calcium, and intact PTH levels, whereas hemorrhagic stroke was associated only with intact PTH. Ischemic stroke was not associated with any of them. The potential distinct beneficial effect on MI and stroke by managing bone and mineral disease should be investigated in future studies.

  11. Efficacy and safety of a TIA/stroke electronic support tool (FASTEST trial: Study protocol

    Directory of Open Access Journals (Sweden)

    Ranta Annemarei

    2012-10-01

    Full Text Available Abstract Background Strokes are a common cause of adult disability and mortality worldwide. Transient ischaemic attacks (TIA are associated with a high risk of subsequent stroke, and rapid intervention has the potential to reduce stroke burden. This study will assess a novel electronic decision support (EDS tool to allow general practitioners (GPs to implement evidence-based care rapidly without full reliance on specialists. Methods/design This is a cluster randomized controlled trial comparing TIA/stroke management of GPs with access to the EDS tool versus usual care. The intervention period is 12 months with a 3-month follow-up period for individual patients. Primary outcomes consist of stroke within 90 days of presenting event and adherence to the New Zealand national TIA guideline. Discussion A positive study will provide strong evidence for widespread implementation of this tool in practice and has the potential to improve key outcomes for patients and reduce the burden of stroke. Trial registration Australia New Zealand Clinical Trials Registry ACTRN12611000792921

  12. Animal imaging studies of potential brain damage

    Science.gov (United States)

    Gatley, S. J.; Vazquez, M. E.; Rice, O.

    To date, animal studies have not been able to predict the likelihood of problems in human neurological health due to HZE particle exposure during space missions outside the Earth's magnetosphere. In ongoing studies in mice, we have demonstrated that cocaine stimulated locomotor activity is reduced by a moderate dose (120 cGy) of 1 GeV 56Fe particles. We postulate that imaging experiments in animals may provide more sensitive and earlier indicators of damage due to HZE particles than behavioral tests. Since the small size of the mouse brain is not well suited to the spatial resolution offered by microPET, we are now repeating some of our studies in a rat model. We anticipate that this will enable us to identify imaging correlates of behavioral endpoints. A specific hypothesis of our studies is that changes in the metabolic rate for glucose in striatum of animals will be correlated with alterations in locomotor activity. We will also evaluate whether the neuroprotective drug L-deprenyl reduces the effect of radiation on locomotor activity. In addition, we will conduct microPET studies of brain monoamine oxidase A and monoamine oxidase B in rats before and at various times after irradiation with HZE particles. The hypothesis is that monoamine oxidase A, which is located in nerve terminals, will be unchanged or decreased after irradiation, while monoamine oxidase B, which is located in glial cells, will be increased after irradiation. Neurochemical effects that could be measured using PET could in principle be applied in astronauts, in terms of detecting and monitoring subtle neurological damage that might have occurred during long space missions. More speculative uses of PET are in screening candidates for prolonged space missions (for example, for adequate reserve in critical brain circuits) and in optimizing medications to treat impairments after missions.

  13. Etiologic Classification in Ischemic Stroke

    OpenAIRE

    Hakan Ay

    2011-01-01

    Ischemic stroke is an etiologically heterogenous disorder. Classification of ischemic stroke etiology into categories with discrete phenotypic, therapeutic, and prognostic features is indispensible to generate consistent information from stroke research. In addition, a functional classification of stroke etiology is critical to ensure unity among physicians and comparability among studies. There are two major approaches to etiologic classification in stroke. Phenotypic systems define subtypes...

  14. Sleep characteristics of individuals with chronic stroke: a pilot study

    OpenAIRE

    Al-Dughmi M; Al-Sharman A; Stevens S; Siengsukon CF

    2015-01-01

    Mayis Al-Dughmi,1 Alham Al-Sharman,2 Suzanne Stevens,3 Catherine F Siengsukon1 1Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, USA; 2Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan; 3Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA Abstract: Changes in sleep characteristics in individuals with chronic stroke are not well described, particularly...

  15. CHARACTERISTICS OF PATIENTS WITH CEREBRAL STROKE OR TRANSIENT ISCHEMIC ATTACK, INCLUDED INTO THE LIS-2 REGISTER (LYUBERTSY STUDY OF MORTALITY IN PATIENTS AFTER STROKE

    Directory of Open Access Journals (Sweden)

    S. Yu. Martsevich

    2015-01-01

    Full Text Available Aim. To provide final data on the three-year period of the inclusion of patients; to give most accurate "portrait" of patients hospitalized with a brain stroke within the framework of the LIS-2 register (Lyubertsy study of mortality in patients after stroke.Material and methods. All patients (n=960 admitted to the Lyubertsy district hospital №2 with stroke for the period from 01.2009 to 12.2011 were included into the study.Results. Men accounted for 37.5%, women - 62.5%, mean age was 71.1±9.8 years. The history of hypertension was present in 833 patients (86.8%, atrial fibrillation in 252 (26.8% patients, 199 (20.7% patients had previously undergone stroke. In-hospital mortality was 21.6% (207 patients had died; mean age 72.9±9.8 years. Low frequency of the antihypertensive therapy (34.5%, lipid-lowering therapy (0.7%, antiplatelet agents (5.7%, anticoagulation therapy prescription in patients with atrial fibrillation was detected.Conclusion. Insufficient assignment of drugs with a proven effect on the prognosis in patients with risk factors prior to the development of the reference stroke draws attention. High incidence of recurrent strokes indicates an underactive secondary prevention.

  16. Cortical thickness estimation in longitudinal stroke studies: A comparison of 3 measurement methods.

    Science.gov (United States)

    Li, Qi; Pardoe, Heath; Lichter, Renee; Werden, Emilio; Raffelt, Audrey; Cumming, Toby; Brodtmann, Amy

    2015-01-01

    There is considerable controversy about the causes of cognitive decline after stroke, with evidence for both the absence and coexistence of Alzheimer pathology. A reduction in cortical thickness has been shown to be an important biomarker for the progression of many neurodegenerative diseases, including Alzheimer's disease (AD). However, brain volume changes following stroke are not well described. Cortical thickness estimation presents an ideal way to detect regional and global post-stroke brain atrophy. In this study, we imaged a group of patients in the first month after stroke and at 3 months. We compared three methods of estimating cortical thickness on unmasked images: one surface-based (FreeSurfer) and two voxel-based methods (a Laplacian method and a registration method, DiRecT). We used three benchmarks for our analyses: accuracy of segmentation (especially peri-lesional performance), reproducibility, and biological validity. We found important differences between these methods in cortical thickness values and performance in high curvature areas and peri-lesional regions, but similar reproducibility metrics. FreeSurfer had less reliance on manual boundary correction than the other two methods, while reproducibility was highest in the Laplacian method. A discussion of the caveats for each method and recommendations for use in a stroke population is included. We conclude that both surface- and voxel-based methods are valid for estimating cortical thickness in stroke populations.

  17. A PRELIMINARY STUDY ON EFFECTIVENESS OF CONVENTIONAL AND SYMMETRICAL WEIGHT TRAINING IN STROKE PATIENTS TO PREVENT FALLS

    Directory of Open Access Journals (Sweden)

    Abbas Divan Mohaideen

    2014-04-01

    Full Text Available Introduction: Stroke is the leading cause of disability in the elderly and significant source of disability. In the stroke patients the occurrence of fall is one of the essential factors hindering the rehabilitation process. Asymmetrical weight bearing is the major cause for frequent falls in stroke patients. Materials & Methods: In this study 15 patients subjected to Symmetrical weight bearing along with conventional stroke training in Experimental group. Other 15 patients subjected to conventional stroke training alone in control group. After 3 months of training period the pre and post test values of frequency of falls were compared. Results: As per the study results the mean difference of reduced number of falls in experimental group was 5.8 and the mean difference of reduced number of falls in control group was 2.86. The calculated value of experimental group was 31.8 whereas in control group 14.3. Discussion: Stroke patients can be trained easily with conventional weight training exercise which is highly beneficial. Further study can be done with huge number of stroke patients. Conclusion: The study concluded that the number of falls in stroke cases were reduced significantly by using symmetrical weight training exercise and conventional stroke training compared to conventional stroke training alone

  18. Krill Products: An Overview of Animal Studies

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    Lena Burri

    2015-05-01

    Full Text Available Many animal studies have been performed with krill oil (KO and this review aims to summarize their findings and give insight into the mechanism of action of KO. Animal models that have been used in studies with KO include obesity, depression, myocardial infarction, chronic low-grade and ulcerative inflammation and are described in detail. Moreover, studies with KO in the form of krill powder (KP and krill protein concentrate (KPC as a mix of lipids and proteins are mentioned and compared to the effects of KO. In addition, differences in tissue uptake of the long-chain omega-3 polyunsaturated fatty acids eicosapentaenoic acid (EPA and docosahexaenoic acid (DHA, when delivered in either phospholipid or triglyceride form, are addressed and the differential impact the delivery form has on gene expression profiles is explained. In our outlook, we try to highlight the potential of KO and KP supplementation in clinical settings and discuss health segments that have a high potential of showing krill product specific health benefits and warrant further clinical investigations.

  19. Prevalence of post-stroke cognitive impairment in china: a community-based, cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Yanji Qu

    Full Text Available International hospital-based studies have indicated a high risk of cognitive impairment after stroke, evidence from community-based studies in China is scarce. To determine the prevalence of post-stroke cognitive impairment (PSCI and its subtypes in stroke survivors residing in selected rural and urban Chinese communities, we conducted a community-based, cross-sectional study in 599 patients accounting for 48% of all stroke survivors registered in the 4 communities, who had suffered confirmed strokes and had undergone cognitive assessments via the Montreal Cognitive Assessment (MoCA, Mini-Mental State Examination (MMSE, and Hachinski Ischemia Scale (HIS. Detection of PSCI was based on scores in these neuropsychological scales. Factors potentially impacting on occurrence of PSCI were explored by comparing demographic characteristics, stroke features, and cardiovascular risk factors between patients with and without PSCI. The overall prevalence of PSCI was 80.97% (95%CI: 77.82%-84.11%, while that of non-dementia PSCI (PSCI-ND and post-stroke vascular dementia (PSD was 48.91% (95%CI: 44.91%-52.92% and 32.05% (95%CI: 28.32%-35.79%, respectively. Prior stroke and complications during the acute phase were independent risk factors for PSCI. The risk of recurrent stroke survivors having PSCI was 2.7 times higher than for first-episode survivors, and it was 3 times higher for those with complications during the acute phase than for those without. The higher prevalence of PSCI in this study compared with previous Chinese studies was possibly due to the combined effects of including rural stroke survivors, a longer period from stroke onset, and different assessment methods. There is an urgent need to recognize and prevent PSCI in stroke patients, especially those with recurrent stroke and complications during the acute phase.

  20. Gingivitis and periodontitis as a risk factor for stroke: A case-control study in the Iranian population

    OpenAIRE

    Maryam Alsadat Hashemipour; Afsaneh Jahanshahi Afshar; Roya Borna; Behnas Seddighi; Amin Motamedi

    2013-01-01

    Background: Periodontitis and gingivitis are one of the most infectious diseases in human. Several studies have been carried out on dependence of periodontitis and stroke. The aim of this study was to investigate the gingivitis and periodontitis as a risk factor for stroke in Iranian population. Materials and Methods: A case-control study was conducted on 100 patients suffering from stroke as case group, and 100 hospitalized patients as control group. The case group included 42 males and ...

  1. What Do Stroke Patients Look for in Game-Based Rehabilitation: A Survey Study.

    Science.gov (United States)

    Hung, Ya-Xuan; Huang, Pei-Chen; Chen, Kuan-Ta; Chu, Woei-Chyn

    2016-03-01

    Stroke is one of the most common causes of physical disability, and early, intensive, and repetitive rehabilitation exercises are crucial to the recovery of stroke survivors. Unfortunately, research shows that only one third of stroke patients actually perform recommended exercises at home, because of the repetitive and mundane nature of conventional rehabilitation exercises. Thus, to motivate stroke survivors to engage in monotonous rehabilitation is a significant issue in the therapy process. Game-based rehabilitation systems have the potential to encourage patients continuing rehabilitation exercises at home. However, these systems are still rarely adopted at patients' places. Discovering and eliminating the obstacles in promoting game-based rehabilitation at home is therefore essential. For this purpose, we conducted a study to collect and analyze the opinions and expectations of stroke patients and clinical therapists. The study is composed of 2 parts: Rehab-preference survey - interviews to both patients and therapists to understand the current practices, challenges, and expectations on game-based rehabilitation systems; and Rehab-compatibility survey - a gaming experiment with therapists to elaborate what commercial games are compatible with rehabilitation. The study is conducted with 30 outpatients with stroke and 19 occupational therapists from 2 rehabilitation centers in Taiwan. Our surveys show that game-based rehabilitation systems can turn the rehabilitation exercises more appealing and provide personalized motivation for various stroke patients. Patients prefer to perform rehabilitation exercises with more diverse and fun games, and need cost-effective rehabilitation systems, which are often built on commodity hardware. Our study also sheds light on incorporating the existing design-for-fun games into rehabilitation system. We envision the results are helpful in developing a platform which enables rehab-compatible (i.e., existing, appropriately

  2. What Do Stroke Patients Look for in Game-Based Rehabilitation: A Survey Study.

    Science.gov (United States)

    Hung, Ya-Xuan; Huang, Pei-Chen; Chen, Kuan-Ta; Chu, Woei-Chyn

    2016-03-01

    Stroke is one of the most common causes of physical disability, and early, intensive, and repetitive rehabilitation exercises are crucial to the recovery of stroke survivors. Unfortunately, research shows that only one third of stroke patients actually perform recommended exercises at home, because of the repetitive and mundane nature of conventional rehabilitation exercises. Thus, to motivate stroke survivors to engage in monotonous rehabilitation is a significant issue in the therapy process.Game-based rehabilitation systems have the potential to encourage patients continuing rehabilitation exercises at home. However, these systems are still rarely adopted at patients' places. Discovering and eliminating the obstacles in promoting game-based rehabilitation at home is therefore essential.For this purpose, we conducted a study to collect and analyze the opinions and expectations of stroke patients and clinical therapists. The study is composed of 2 parts: Rehab-preference survey - interviews to both patients and therapists to understand the current practices, challenges, and expectations on game-based rehabilitation systems; and Rehab-compatibility survey - a gaming experiment with therapists to elaborate what commercial games are compatible with rehabilitation. The study is conducted with 30 outpatients with stroke and 19 occupational therapists from 2 rehabilitation centers in Taiwan.Our surveys show that game-based rehabilitation systems can turn the rehabilitation exercises more appealing and provide personalized motivation for various stroke patients. Patients prefer to perform rehabilitation exercises with more diverse and fun games, and need cost-effective rehabilitation systems, which are often built on commodity hardware. Our study also sheds light on incorporating the existing design-for-fun games into rehabilitation system. We envision the results are helpful in developing a platform which enables rehab-compatible (i.e., existing, appropriately selected

  3. Association between ischemic stroke and iron-deficiency anemia: a population-based study.

    Directory of Open Access Journals (Sweden)

    Yen-Liang Chang

    Full Text Available BACKGROUND: Very little is known about the relationship between non-sickle cell anemia and stroke. The purpose of this study is to evaluate the association of iron-deficiency anemia (IDA with stroke based on a nationwide coverage database in Taiwan. METHODS: The case-control study subjects were obtained from the Taiwanese Longitudinal Health Insurance Database 2000. We included 51,093 subjects with stroke as cases and randomly selected 153,279 controls (3 controls per case in this study.Separate conditional logistic regression analyses were used to calculate the odds ratio (OR for having been previously diagnosed with IDA between cases and controls.We further analyzed the association between stroke and IDA by stroke subtype. RESULTS: Results showed that 3,685 study subjects (1.81% had been diagnosed with IDA prior to the index date; of those subjects, 1,268 (2.48% were cases and 2,417 (1.58% were controls (p<0.001. Conditional logistic regression shows that the OR of having previously received an IDA diagnosis among cases was 1.49 (95% CI: 1.39~1.60; p < 0.01 that of controls after adjusting for monthly income, geographic region, hypertension, diabetes, coronary heart disease, atrial fibrillation, heart failure, hyperlipidemia, tobacco use disorder, and alcohol abuse/alcohol dependency syndrome. Furthermore, the adjusted OR of prior IDA for cases with ischemic stroke was found to be 1.45 (95% CI: 1.34~1.58 compared to controls. However, we did not find any significant relationship between IDA and subarachnoid/intracerebral hemorrhage even adjusting for other confounding factors (OR=1.17, 95% CI=0.97~1.40. CONCLUSION: There is a significant association between prior IDA and ischemic stroke.

  4. Demographic and geographic vascular risk factor differences in European young adults with ischemic stroke: the 15 cities young stroke study

    NARCIS (Netherlands)

    Putaala, J.; Yesilot, N.; Waje-Andreassen, U.; Pitkaniemi, J.; Vassilopoulou, S.; Nardi, K.; Odier, C.; Hofgart, G.; Engelter, S.; Burow, A.; Mihalka, L.; Kloss, M.; Ferrari, J.; Lemmens, R.; Coban, O.; Haapaniemi, E.; Maaijwee, N.; Rutten-Jacobs, L.; Bersano, A.; Cereda, C.; Baron, P.; Borellini, L.; Valcarenghi, C.; Thomassen, L.; Grau, A.J.; Palm, F.; Urbanek, C.; Tuncay, R.; Durukan-Tolvanen, A.; Dijk, E.J. van; Leeuw, F.E. de; Thijs, V.; Greisenegger, S.; Vemmos, K.; Lichy, C.; Bereczki, D.; Csiba, L.; Michel, P.; Leys, D.; Spengos, K.; Naess, H.; Bahar, S.Z.; Tatlisumak, T.

    2012-01-01

    BACKGROUND AND PURPOSE: We compared among young patients with ischemic stroke the distribution of vascular risk factors among sex, age groups, and 3 distinct geographic regions in Europe. METHODS: We included patients with first-ever ischemic stroke aged 15 to 49 years from existing hospital- or pop

  5. A STUDY ON EFFECTIVENESS OF TREADMILL EXERCISE TRAINING IN GAIT PARAMETERS OF CHRONIC STROKE CASES

    Directory of Open Access Journals (Sweden)

    Abbas Divan Mohaideen

    2014-04-01

    Full Text Available Introduction: Stroke is the leading cause of death and the most common cause of disability. This study determined the effects of Treadmill Aerobic Exercise on spatial and temporal gait parameters among stroke patients. Materials & Methods: In this study, Thirty -nine subjects with hemiparetic stroke underwent Treadmill Aerobic Exercise four times weekly for six months from December 2006 to June 2007. This study has taken place in Department of Physical therapy and Rehabilitation, GSN multi Specialty hospital and research Centre, Hyderabad, India. We measured the spatial and temporal gait parameters of the subjects before and after Treadmill Aerobic Exercise training by the means of 30-foot timed walks, 6 minute distance walks with usual assistive devices and 8metre instrumented walkway without assistive devices. Pre and post training results were compared and contrast. Results: This study results that the Treadmill Aerobic Exercise improved 30-foot walks by 17% and 6 minute walk by 23%. Unassisted walking velocity increased 22%, stride length increased 13% and cadence increased 7%. Paretic and non-paretic step lengths increased significantly, and respective step times increased significantly. Discussion: Large study should be done with treadmill exercise training along with other skills for the better results to improve the gait parameters in chronic stroke cases. Conclusion: This study shows the evidence for positive changes in spatial and temporal gait parameters of subjects with stroke after Treadmill Aerobic Exercise.

  6. Cultural Consumer and Copyright: A Case Study of Anime Fansubbing

    OpenAIRE

    Lee, H. K.

    2011-01-01

    This article aims at discussing copyright and its infringement from the consumers’ perspective by examining ‘anime fansubbing’. Anime fansubbing refers to the practice in which avid anime (Japanese animation) fans copy anime, translate Japanese to another language, and subtitle and release a subtitled version on the Internet to share it with other fans, without permission from the copyright holder. The case study of English fansubbing of anime shows that this activity has been guided by fansu...

  7. Differences in videofluoroscopic swallowing study (VFSS) findings according to the vascular territory involved in stroke.

    Science.gov (United States)

    Kim, Seo Yeon; Kim, Tae Uk; Hyun, Jung Keun; Lee, Seong Jae

    2014-08-01

    Dysphagia affects up to half of stroke patients and increases the risk of pneumonia and fatal outcomes. In order to assess swallowing difficulty, videofluoroscopic swallowing study (VFSS) has traditionally been the gold standard. The purpose of this study was to compare the patterns of post-stroke swallowing difficulties according to the vascular territories involved in the stroke. One hundred and three patients who were diagnosed with first ischemic stroke by brain magnetic resonance imaging and had swallowing difficulty were included in this study. Location of the stroke was classified into three groups: territorial anterior infarcts (TAI) (n = 62), territorial posterior infarcts (TPI) (n = 19) and white matter disease (WMD) (n = 22). Oral cavity residue existed significantly in the TAI group more than in any other groups (P = 0.017). The WMD group showed more residue in the valleculae (P = 0.002) and the TPI group showed more residue in the pyriform sinuses (P = 0.001). The oral transit time, pharyngeal delay time and pharyngeal transit time did not show significant differences among the groups with swallowing of both thick and thin liquids. Penetration and aspiration were more frequent in the TPI group (P swallowing of both thick and thin liquids. The results suggest that TAI is more related to oral phase dysfunction and TPI is more related to pharyngeal dysfunction. In ischemic stroke, patterns of swallowing difficulty may differ according to the vascular territory involved and this should be considered in the management of post-stroke dysphagia.

  8. Lower Ipsilateral Hippocampal Integrity after Ischemic Stroke in Young Adults: A Long-Term Follow-Up Study.

    Directory of Open Access Journals (Sweden)

    Pauline Schaapsmeerders

    Full Text Available Memory impairment after stroke is poorly understood as stroke rarely occurs in the hippocampus. Previous studies have observed smaller ipsilateral hippocampal volumes after stroke compared with controls. Possibly, these findings on macroscopic level are not the first occurrence of structural damage and are preceded by microscopic changes that may already be associated with a worse memory function. We therefore examined the relationship between hippocampal integrity, volume, and memory performance long after first-ever ischemic stroke in young adults.We included all consecutive first-ever ischemic stroke patients, without hippocampal strokes or recurrent stroke/TIA, aged 18-50 years, admitted to our academic hospital between 1980 and 2010. One hundred and forty-six patients underwent T1 MPRAGE, DTI scanning and completed the Rey Auditory Verbal Learning Test and were compared with 84 stroke-free controls. After manual correction of hippocampal automatic segmentation, we calculated mean hippocampal fractional anisotropy (FA and diffusivity (MD.On average 10 years after ischemic stroke, lesion volume was associated with lower ipsilateral hippocampal integrity (p0.05.Patients with average ipsilateral hippocampal volume could already have lower ipsilateral hippocampal integrity, although at present with no attendant worse memory performance compared with patients with high hippocampal integrity. Longitudinal studies are needed to investigate whether a low hippocampal integrity after stroke might lead to exacerbated memory decline with increasing age.

  9. Lifetime risk of stroke and impact of hypertension: estimates from the adult health study in Hiroshima and Nagasaki.

    Science.gov (United States)

    Takahashi, Ikuno; Geyer, Susan M; Nishi, Nobuo; Ohshita, Tomohiko; Takahashi, Tetsuya; Akahoshi, Masazumi; Fujiwara, Saeko; Kodama, Kazunori; Matsumoto, Masayasu

    2011-05-01

    Very few reports have been published on lifetime risk (LTR) of stroke by blood pressure (BP) group. This study included participants in the Radiation Effects Research Foundation Adult Health Study who have been followed up by biennial health examinations since 1958. We calculated the LTR of stroke for various BP-based groups among 7847 subjects who had not been diagnosed with stroke before the index age of 55 years using cumulative incidence analysis adjusting for competing risks. By 2003, 868 subjects had suffered stroke (512 (58.9%) were women and 542 (62.4%) experienced ischemic stroke). BP was a significant factor in determining risk of stroke for men and women, with distributions of cumulative risk for stroke significantly different across BP groups. The LTR of all-stroke for normotension (systolic BP/diastolic BP 160/100 mm Hg) were 13.8-16.9-25.8-25.8% in men and 16.0-19.9-24.0-30.5% in women, respectively (P bomb survivor subjects experienced stroke over their lifetime from the age of 55 years. Long-term stroke risks were elevated in those with hypertension (> 140/90 mm Hg) at any of the index ages of 45, 55, 65 and 75 years. PMID:21326305

  10. Impact of Diet on Mortality From Stroke: Results From the U.S. Multiethnic Cohort Study

    Science.gov (United States)

    Sharma, Sangita; Cruickshank, J Kennedy; Green, Deborah M; Vik, Shelly; Tome, Anne; Kolonel, Laurence N

    2016-01-01

    Objectives Stroke is the fourth leading cause of death in the United States and stroke mortality rates vary by ethnicity. The purpose of this study was to examine the associations between food group consumption and risk of death from stroke among 5 ethnic groups in the United States. Methods The Multiethnic Cohort includes >215,000 participants, the majority of whom are African American, Native Hawaiian, Japanese American, Latino, and Caucasian men and women recruited by mail survey in Hawaii and Los Angeles in 1993–1996. Deaths from stroke were identified by linkage to the state death files and the U.S. National Death Index. Diet was assessed using a validated food frequency questionnaire. Associations were examined using multivariable Cox proportional hazards models, stratified by ethnicity and gender. Results A total of 860 deaths from stroke were identified among the cohort participants. Vegetable intake was associated with a significant reduction in risk for fatal stroke among African American women (relative risk [RR] = 0.60; 95% CI: 0.36–0.99). Among Japanese American women only, high fruit intake was significantly associated with a risk reduction for stroke mortality (RR = 0.43; 95% confidence interval [CI]: 0.22–0.85), whereas meat intake increased risk (RR = 2.36; 95% CI: 1.31–4.26). Among men, a significant reduction in stroke mortality was observed among Native Hawaiians (RR = 0.26; 95% CI: 0.07–0.95). After pooling the data for the ethnic groups, the findings support an elevated risk for high meat intake among women overall (RR = 1.56; 95% CI: 1.12–2.16); no significant effects of dietary intake on risk for fatal stroke were observed among men. Conclusions Although some variations were observed for the associations between diet and stroke mortality among ethnic groups, the findings suggest that these differences are not substantial and may be due to dietary intake of specific food subgroups. Additional investigations including dietary

  11. High incidence of diabetes after stroke in young adults and risk of recurrent vascular events: the FUTURE study

    OpenAIRE

    Rutten-Jacobs, L.C.A.; Keurlings, P.A.; Arntz, R.M.; Maaijwee, N.A.M.M.; Schoonderwaldt, H.C.; Dorresteijn, L.D.A.; Vlugt, M.J. van der; Dijk, E.J. van; de Leeuw, F E

    2014-01-01

    BACKGROUND: Diabetes diagnosed prior to stroke in young adults is strongly associated with recurrent vascular events. The relevance of impaired fasting glucose (IFG) and incidence of diabetes after young stroke is unknown. We investigated the long-term incidence of diabetes after young stroke and evaluated the association of diabetes and impaired fasting glucose with recurrent vascular events. METHODS: This study was part of the FUTURE study. All consecutive patients between January 1, 1980, ...

  12. Cfd Studies of Two Stroke Petrol Engine Scavenging

    OpenAIRE

    S Gavudhama Karunanidhi,; NithinV S

    2014-01-01

    This project deals with the numerical analysis of 2 stroke engine scavenging in two cases. One with an existing condition (Flat headed pistons) and another with a new design (Dome headed piston) .The numerical analysis is done with help of CFD software ANSYS FLUENT 14.5. Here, the modeling of engine piston with flat headed type and with dome headed types was done in workbench. In ANSYS FLUENT after the geometrical design, for the dynamic motion meshing is used and set up speci...

  13. Spontaneous ischaemic stroke in dogs

    DEFF Research Database (Denmark)

    Gredal, Hanne Birgit; Skerritt, G. C.; Gideon, P.;

    2013-01-01

    Translation of experimental stroke research into the clinical setting is often unsuccessful. Novel approaches are therefore desirable. As humans, pet dogs suffer from spontaneous ischaemic stroke and may hence offer new ways of studying genuine stroke injury mechanisms.......Translation of experimental stroke research into the clinical setting is often unsuccessful. Novel approaches are therefore desirable. As humans, pet dogs suffer from spontaneous ischaemic stroke and may hence offer new ways of studying genuine stroke injury mechanisms....

  14. Body Mass Index and Stroke

    DEFF Research Database (Denmark)

    Andersen, Klaus Kaae; Olsen, Tom Skyhøj

    2013-01-01

    Although obesity is associated with excess mortality and morbidity, mortality is lower in obese than in normal weight stroke patients (the obesity paradox). Studies now indicate that obesity is not associated with increased risk of recurrent stroke in the years after first stroke. We studied the ...... the association between body mass index (BMI) and stroke patient's risk of having a history of previous stroke (recurrent stroke)....

  15. Sex Disparities in Stroke

    DEFF Research Database (Denmark)

    Dehlendorff, Christian; Andersen, Klaus Kaae; Olsen, Tom Skyhøj

    2015-01-01

    between 2003 and 2012 (N=79 617), and the Danish Register of Causes of Death. Information was available on age, sex, marital status, stroke severity, stroke subtype, socioeconomic status, and cardiovascular risk profile. We studied only deaths due to the index stroke, with the assumption that death.......5%) or 1 month (6.9%), respectively. After the age of 60 years, women had more severe strokes than men. Up to ages in the mid-60s, no difference in the risk of death from stroke was seen between the 2 sexes. For people aged >65 years, however, the risk gradually became greater in men than in women...... and significantly so (>15%) from the mid-70s (adjusted for age, marital status, stroke severity, stroke subtype, socioeconomic status, and cardiovascular risk factors). Results were essentially the same when analyzing deaths within 1 week, 1 month and ischemic and hemorrhagic stroke separately. CONCLUSIONS: Stroke...

  16. Stroke-prone renovascular hypertensive rats

    Institute of Scientific and Technical Information of China (English)

    曾进胜; 贷如训; 苏镇培

    2000-01-01

    Purpose To summarized the methods for establishment, characteristics of vascular lesions in brain and heart and thc application of stroke-pronc renovascular hypertensive rats (RHRSP). Background Spontaneously hypcrtensivc rats (STR) and subtypes of SH R, especially stroke-prone spontaneously hypertensive rats (SHRSP) are considered as most important animal models at present for the studies of hypertension and its complications in heart and brain, evcn SHRSP arc considered as thc unique animal model in which prcvention of stroke can be studied cxperimentally Howcver, the applications of SHR and SHRSP are limited because of the effects of genetic deficits and thc difficulties with breeding Theretore, most of the researches on experimental stroke have been performed on the animal models with normotcnsion and normal structure of cerebral vessels. In fact, there are great differences in structure of cerebrovesscls, autoregulation of cerebral blood flow and extent of lesions in brain tissue, even the reaction to the medication after ischemia between the animals with extcnsive arteriosclerosis and with normal cerebral blood vessels. Obviously, thc relevancc of experimental stroke on normal animals to the stroke on cerebral arteriosclerotic patients clinically remains dubious. Data sources and methods Most published original articles about RHRSP in our laboratory were reviewed Results After the renal arteries were constricted bilaterally with ring-shape silver clips, the stroke-prone rcnovascular hypertensive rats were established. Hypertension was produced in all RHRSP(100%).The peak of blood pressure in RHRSP reached 29.1 ±3.0kPa. The lesions of cerebral arteries and arterioles and the damage of cerebral capillary structure by hypertension were observed in the RHRSP. The incidence of spontaneous stroke was 56.4% with in 40 weeks after the renal artery constriction. Left ventricular hypertrophy and small coronary arterial lesions in myocardium were discovered in all

  17. A blended user centred design study for wearable haptic gait rehabilitation following hemiparetic stroke

    Directory of Open Access Journals (Sweden)

    Theodoros Georgiou

    2015-12-01

    Full Text Available Restoring mobility and rehabilitation of gait are high priorities for post-stroke rehabilitation. Cueing using metronomic rhythmic sensory stimulation has been shown to improve gait, but most versions of this approach have used auditory and visual cues. In contrast, we developed a prototype wearable system for rhythmic cueing based on haptics, which was shown to be highly effective in an early pilot study. In this paper we describe a follow-up study with four stroke survivors to inform design, and to identify issues and requirements for such devices to be used in home-based or out-door settings. To this end, we present a blended user-centred design study of a wearable haptic gait rehabilitation system. This study draws on the combined views of physiotherapists, nurses, interaction designers and stroke survivors. Many of the findings were unanticipated, identifying issues outside the scope of initial designs, with important implications for future design and appropriate use.

  18. A pilot study of rivastigmine in the treatment of delirium after stroke: A safe alternative

    Directory of Open Access Journals (Sweden)

    Jansen Ben PW

    2008-09-01

    Full Text Available Abstract Background Delirium is a common disorder in the early phase of stroke. Given the presumed cholinergic deficiency in delirium, we tested treatment with the acetylcholinesterase inhibitor rivastigmine. Methods This pilot study was performed within an epidemiological study. In 527 consecutive stroke patients presence of delirium was assessed during the first week with the confusion assessment method. Severity was scored with the delirium rating scale (DRS. Sixty-two patients developed a delirium in the acute phase of stroke. Only patients with a severe and persistent delirium (defined as a DRS of 12 or more for more than 24 hours were enrolled in the present study. In total 26 fulfilled these criteria of whom 17 were treated with orally administered rivastigmine with a total dose between 3 and 12 mg a day. Eight patients could not be treated because of dysphagia and one because of early discharge. Results No major side effects were recorded. In 16 patients there was a considerable decrease in severity of delirium. The mean DRS declined from 14.8 on day one to 8.5 after therapy and 5.6 after tapering. The mean duration of delirium was 6.7 days (range; 2–17. Conclusion Rivastigmine is safe in stroke patients with delirium even after rapid titration. In the majority of patients the delirium improved after treatment. A randomized controlled trial is needed to establish the usefulness of rivastigmine in delirium after stroke. Trial registration Nederlands Trial Register NTR1395

  19. Relationship of Self-Rated Health to Stroke Incidence and Mortality in Older Individuals with and without a History of Stroke: A Longitudinal Study of the MRC Cognitive Function and Ageing (CFAS Population.

    Directory of Open Access Journals (Sweden)

    Nahal Mavaddat

    Full Text Available Poor self-rated health (SRH has been associated with increased risk of death and poor health outcomes even after adjusting for confounders. However its' relationship with disease-specific mortality and morbidity has been less studied. SRH may also be particularly predictive of health outcomes in those with pre-existing conditions. We studied whether SRH predicts new stroke in older people who have never had a stroke, or a recurrence in those with a prior history of stroke.MRC CFAS I is a multicentre cohort study of a population representative sample of people in their 65th year and older. A comprehensive interview at baseline included questions about presence of stroke, self-rated health and functional disability. Follow-up at 2 years included self-report of stroke and stroke death obtained from death certificates. Multiple logistical regression determined odds of stroke at 2 years adjusting for confounders including disability and health behaviours. Survival analysis was performed until June 2014 with follow-up for up to 13 years.11,957 participants were included, of whom 11,181 (93.8% had no history of stroke and 776 (6.2% one or more previous strokes. Fewer with no history of stroke reported poor SRH than those with stroke (5 versus 21%. In those with no history of stroke, poor self-rated health predicted stroke incidence (OR 1.5 (1.1-1.9, but not stroke mortality (OR 1.2 (0.8-1.9 at 2 years nor for up to 13 years (OR 1.2(0.9-1.7. In those with a history of stroke, self-rated health did not predict stroke incidence (OR 0.9(0.6-1.4, stroke mortality (OR 1.1(0.5-2.5, or survival (OR 1.1(0.6-2.1.Poor self-rated health predicts risk of stroke at 2 years but not stroke mortality among the older population without a previous history of stroke. SRH may be helpful in predicting who may be at risk of developing a stroke in the near future.

  20. Animal models for HCV and HBV studies

    Directory of Open Access Journals (Sweden)

    Isabelle Chemin

    2007-02-01

    develop fulminant hepatitis, acute hepatitis, or chronic liver disease after adoptive transfer, and others spontaneously develop hepatocellular carcinoma (HCC. Among HCV transgenic mice, most develop no disease, but acute hepatitis has been observed in one model, and HCC in another. Although mice are not susceptible to HBV and HCV, their ability to replicate these viruses and to develop liver diseases characteristic of human infections provides opportunities to study pathogenesis and develop novel therapeutics In the search for the mechanism of hepatocarcinogenesis in hepatitis viral infection, two viral proteins, the core protein of hepatitis C virus (HCV and the HBx protein of hepatitis B virus (HBV, have been shown to possess oncogenic potential through transgenic mouse studies, indicating the direct involvement of the hepatitis viruses in hepatocarcinogenesis.

    This may explain the very high frequency of HCC in patients with HCV or HBV infection.

    Chimpanzees remain the only recognized animal model for the study of hepatitis C virus (HCV. Studies performed in chimpanzees played a critical role in the discovery of HCV and are continuing to play an essential role in defining the natural history of this important human pathogen. In the absence of a reproducible cell culture system, the infectivity titer of HCV challenge pools can be determined only in chimpanzees.

    Recent studies in chimpanzees have provided new insight into the nature of host immune responses-particularly the intrahepatic responses-following primary and secondary experimental HCV infections. The immunogenicity and efficacy of vaccine candidates against HCV can be tested only in chimpanzees. Finally, it would not have been possible to demonstrate

  1. Ischemic Stroke

    Science.gov (United States)

    A stroke is a medical emergency. There are two types - ischemic and hemorrhagic. Ischemic stroke is the most common type. It is usually ... are at risk for having a more serious stroke. Symptoms of stroke are Sudden numbness or weakness ...

  2. A systematic review and meta-analysis of erythropoietin in experimental stroke

    OpenAIRE

    Jerndal, Mikael; Forsberg, Kalle; Sena, Emily S.; Macleod, Malcolm R.; O'Collins, Victoria E; Linden, Thomas; Nilsson, Michael; Howells, David W.

    2010-01-01

    Erythropoietin (EPO) has shown promise as a neuroprotectant in animal models of ischemic stroke. EPO is thought not only to protect neurons from cell death, but also to promote regeneration after stroke. Here, we report a systematic review and meta-analysis of the efficacy of EPO in animal models of focal cerebral ischemia. Primary outcomes were infarct size and neurobehavioral outcome. Nineteen studies involving 346 animals for infarct size and 425 animals for neurobehavioral outcome met our...

  3. A systematic review and meta-analysis of erythropoietin in experimental stroke

    OpenAIRE

    Jerndal, Mikael; Forsberg, Kalle; Sena, Emily S.; Macleod, Malcolm R.; O'Collins, Victoria E; Linden, Thomas; Nilsson, Michael; Howells, David W.

    2009-01-01

    Erythropoietin (EPO) has shown promise as a neuroprotectant in animal models of ischemic stroke. EPO is thought not only to protect neurons from cell death, but also to promote regeneration after stroke. Here, we report a systematic review and meta-analysis of the efficacy of EPO in animal models of focal cerebral ischemia. Primary outcomes were infarct size and neurobehavioral outcome. Nineteen studies involving 346 animals for infarct size and 425 animals for neurobehavioral outcome met our...

  4. Modifiable etiological factors and the burden of stroke from the Rotterdam study: a population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Michiel J Bos

    2014-04-01

    Full Text Available BACKGROUND: Stroke prevention requires effective treatment of its causes. Many etiological factors for stroke have been identified, but the potential gain of effective intervention on these factors in terms of numbers of actually prevented strokes remains unclear because of the lack of data from cohort studies. We assessed the impact of currently known potentially modifiable etiological factors on the occurrence of stroke. METHODS AND FINDINGS: This population-based cohort study was based on 6,844 participants of the Rotterdam Study who were aged ≥55 y and free from stroke at baseline (1990-1993. We computed population attributable risks (PARs for individual risk factors and for risk factors in combination to estimate the proportion of strokes that could theoretically be prevented by the elimination of etiological factors from the population. The mean age at baseline was 69.4 y (standard deviation 6.3 y. During follow-up (mean follow-up 12.9 y, standard deviation 6.3 y, 1,020 strokes occurred. The age- and sex-adjusted combined PAR of prehypertension/hypertension, smoking, diabetes mellitus, atrial fibrillation, coronary disease, and overweight/obesity was 0.51 (95% CI 0.41-0.62 for any stroke; hypertension and smoking were the most important etiological factors. C-reactive protein, fruit and vegetable consumption, and carotid intima-media thickness in combination raised the total PAR by 0.06. The PAR was 0.55 (95% CI 0.41-0.68 for ischemic stroke and 0.70 (95% CI 0.45-0.87 for hemorrhagic stroke. The main limitations of our study are that our study population comprises almost exclusively Caucasians who live in a middle and high income area, and that risk factor awareness is higher in a study cohort than in the general population. CONCLUSIONS: About half of all strokes are attributable to established causal and modifiable factors. This finding encourages not only intervention on established etiological factors, but also further study of less

  5. CONTRAST ADVERSE EFFECT STUDY OF ASPIRIN AND CLOPIDOGREL IN STROKE PATIENTS USING COMBINATION AND INDIVIDUAL MEDICATION

    Directory of Open Access Journals (Sweden)

    V.S. Giri Prasad

    2012-11-01

    Full Text Available Ischemia and hemorrhage are the conditions which may lead to stroke. As stroke is a medical emergency, treated with medications such as aspirin, clopidogrel and dipyridamole. In the present study the combination and individual adverse effects of aspirin and clopidogrel medication were studied. The study during was around nine months in one of the private hospital at Hyderabad, Andhra Pradesh, India. Adverse effects evaluation was based on WHO guide lines and Naranjo’s Algorithm. Total 69 stroke patients were taken in to studies. 46 (66.66% were males and 23 (33.33% were females. The number of ischemic stroke patients was 39(56.5% and hemorrhage stroke was 30(43.4%. Among 41 patients, 19 patients was on Aspirin (46.34%, 10 patients was on clopidogral (24.34% and 12 patients was on combinations medication (29.26%. Adverse effects reported among the antiplatelate users were 6 patients. Among these 6 patients 4 patients were observed with upper gastrointestinal bleeding (UGI the overall percentage was 66.66% and 2 patients were observed with Vomiting, the overall percentage was 33.33%. In this study, the relative risk reduction for secondary stroke prevention was 37% with use of a combination of extended- release dipyridamole and aspirin. Importantly, the risk of major bleeding attributable to the combination therapy was no greater than that seen with aspirin alone. The benefit of clopidogrel over aspirin for the prevention of vascular events was a relative risk reduction of 8.7%.In addition, there was less major bleeding in the clopidogrel group, yielding a relative net benefit of about 10%. This study revels clopidogrel is the safe drug when compared with Aspirin and as well as combination therapy.

  6. Lower Ipsilateral Hippocampal Integrity after Ischemic Stroke in Young Adults: A Long-Term Follow-Up Study

    OpenAIRE

    Schaapsmeerders, P.; Tuladhar, A.M.; Maaijwee, N.A.M.M.; Rutten-Jacobs, L.C.A.; Arntz, R.M.; Schoonderwaldt, H.C.; Dorresteijn, L.D.A.; Dijk, E.J. van; Kessels, R.P.C.; Leeuw, H.F. de

    2015-01-01

    BACKGROUND AND PURPOSE: Memory impairment after stroke is poorly understood as stroke rarely occurs in the hippocampus. Previous studies have observed smaller ipsilateral hippocampal volumes after stroke compared with controls. Possibly, these findings on macroscopic level are not the first occurrence of structural damage and are preceded by microscopic changes that may already be associated with a worse memory function. We therefore examined the relationship between hippocampal integrity, vo...

  7. Lack of Association between Stroke and Left Atrial Out-Pouching Structures: Results of a Case-Control Study

    OpenAIRE

    Ko, Ji Young; Kim, Young Dae; Hong, Yoo Jin; Lee, Hye-Jeong; Hur, Jin; Choi, Byoung Wook; Heo, Ji Hoe; Kim, Young Jin

    2013-01-01

    Background and Purpose Clinical significance of out-pouching structures of the left atrium (LA) as potential embolic sources remains unclear. We sought to evaluate the association between stroke and LA out-pouching structures. Methods A case-control study was conducted to assess the prevalence of LA out-pouching structures in subjects with and without stroke. Case subjects were 270 stroke patients who had undergone cardiac CT. Control subjects were 270 age- and sex-matched patients without a ...

  8. Can readmission after stroke be prevented? Results of a randomized clinical study: a postdischarge follow-up service for stroke survivors

    DEFF Research Database (Denmark)

    Andersen, H E; Schultz-Larsen, K; Kreiner, S;

    2000-01-01

    that the effect of intervention was strongest for patients with a prolonged inpatient rehabilitation. CONCLUSIONS: Readmission is common among disabled stroke survivors. Follow-up intervention after discharge seems to be a way of preventing readmission, especially for patients with long inpatient rehabilitation.......BACKGROUND AND PURPOSE: About 50% of stroke survivors are discharged to their homes with lasting disability. Knowledge, however, of the importance of follow-up services that targets these patients is sparse. The purpose of the present study was to evaluate 2 models of follow-up intervention after...... discharge. The study hypothesis was that intervention could reduce readmission rates and institutionalization and prevent functional decline. We report the results regarding readmission. METHODS: This randomized study included 155 stroke patients with persistent impairment and disability who, after...

  9. Greek stroke score, Siriraj score and allen score in clinical diagnosis of intracerebral hemorrhage and infarct: Validation and comparison study

    Directory of Open Access Journals (Sweden)

    Soman Aamod

    2004-10-01

    Full Text Available AIM: To compare Greek stroke score with available previous two stroke scores for the diagnosis of cerebral ischemia and hemorrhage in acute stroke patients, and validate the Greek stroke score. SETTING: A tertiary hospital in India. MATERIALS AND METHODS: In a prospective study acute stroke patients were evaluated with Greek stroke score, Allen score and Siriraj stroke score. Comparability (Kappa Statistics and validity (sensitivity, specificity, negative predictive value and positive predictive value of the Greek stroke score and previous scores were tested. RESULT: Out of the 91 patients enrolled in the study, 47 patients had cerebral infarction and 44 patients had hemorrhage by CT scan. Allen score was uncertain / equivocal in 39 patients, Siriraj Stroke score in 22 and Greek stroke score in 47 patients. Sensitivity, Specificity, positive predictive value, negative predictive value for Allen score were 0.5(95% CI:0.34,0.58, 0.94(95% CI:0.86,0.98, 0.81(95% CI:0.56,0.95, 0.78(95% CI: 0.71,0.81 for Siriraj score were 0.75(95% CI: 0.63,0.84, 0.81(95% CI: 0.71,0.89, 0.77(95% CI: 0.65,0.86, 0.78(95% CI 0.69,0.86 and for Greek Score were 0.42(95% CI: 0.23,0.53, 0.93(95% CI: 0.87,0.98, 0.71(95% CI:0.39,0.91, 0.81(95% CI:0.75,0.85 respectively. Greek stroke score was compared with previous scores using kappa statistics which revealed substantial strength of agreement between the Allen Score for certain results. CONCLUSION: The overall comparability of Greek stroke score and Allen score was better as compared to Greek stroke score and Siriraj stroke score. Greek Stroke score was more specific in diagnosing hemorrhage as compared to Siriraj score. However, all these stroke scores lack accuracy hence could not be applied safely to guide the physician in management of stroke.

  10. Secondary prevention of stroke in atrial fibrillation, use of apixaban: ARISTOTLE, AVERROES studies

    Directory of Open Access Journals (Sweden)

    V.A. Parfenov

    2014-01-01

    Full Text Available Ischemic stroke (IS prevention in non-valvular atrial fibrillation (NVAF patients who already had IS or Transient Ischemic Attack (TIA is the actual problem of up-to-date neurology. The article analyses methods of IS secondary prevention in AF, particularly usage of vitamin Kantagonist – warfarin and new oral anticoagulants: inhibitors of Xa factor (apixaban, rivaroxaban and direct thrombin inhibiror – dabigatran.Presented results ARISTOTLE study, where have defined preference apixaban vs warfarin, and AVEEROES study, where have shown preference apixaban vs ASA in AF patients. It was noted that apixaban demonstrated superiority vs warfarin in all of the 3 key outcomes:stroke/systemic embolism prevention, including recurrent, major bleeding reducing, reduction in all-cause mortality. Optimization of secondary stroke prevention in AF patients can lead to substantial reduction of morbidity and mortality in our country.

  11. White matter structure and clinical characteristics of stroke patients: A diffusion tensor MRI study.

    Science.gov (United States)

    Ueda, Ryo; Yamada, Naoki; Kakuda, Wataru; Abo, Masahiro; Senoo, Atsushi

    2016-03-15

    Fractional anisotropy has been used in many studies that examined post-stroke changes in white matter. This study was performed to clarify cerebral white matter changes after stroke using generalized fractional anisotropy (GFA). White matter structure was visualized using diffusion tensor imaging in 72 patients with post-stroke arm paralysis. Exercise-related brain regions were examined in cerebral white matter using GFA. The relationship between GFA and clinical characteristics was examined. Overall, the mean GFA of the lesioned hemisphere was significantly lower than that of the non-lesioned hemisphere (Pparalysis of the dominant hand were significantly different from those of patients with paralysis of the nondominant hand in Brodmann areas 4 and 6 of the non-lesioned hemisphere and Brodmann area 4 of the lesioned hemisphere (Pbrain region, age at onset of paralysis, and paralysis of the dominant or non-dominant hand. PMID:26783693

  12. Supporting Treatment decision making to Optimise the Prevention of STROKE in Atrial Fibrillation: The STOP STROKE in AF study. Protocol for a cluster randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Gattellari Melina

    2012-07-01

    Full Text Available Abstract Background Suboptimal uptake of anticoagulation for stroke prevention in atrial fibrillation has persisted for over 20 years, despite high-level evidence demonstrating its effectiveness in reducing the risk of fatal and disabling stroke. Methods The STOP STROKE in AF study is a national, cluster randomised controlled trial designed to improve the uptake of anticoagulation in primary care. General practitioners from around Australia enrolling in this ‘distance education’ program are mailed written educational materials, followed by an academic detailing session delivered via telephone by a medical peer, during which participants discuss patient de-identified cases. General practitioners are then randomised to receive written specialist feedback about the patient de-identified cases either before or after completing a three-month posttest audit. Specialist feedback is designed to provide participants with support and confidence to prescribe anticoagulation. The primary outcome is the proportion of patients with atrial fibrillation receiving oral anticoagulation at the time of the posttest audit. Discussion The STOP STROKE in AF study aims to evaluate a feasible intervention via distance education to prevent avoidable stroke due to atrial fibrillation. It provides a systematic test of augmenting academic detailing with expert feedback about patient management. Trial registration Australian Clinical Trials Registry Registration Number: ACTRN12611000076976.

  13. Playing piano can improve upper extremity function after stroke: case studies.

    Science.gov (United States)

    Villeneuve, Myriam; Lamontagne, Anouk

    2013-01-01

    Music-supported therapy (MST) is an innovative approach that was shown to improve manual dexterity in acute stroke survivors. The feasibility of such intervention in chronic stroke survivors and its longer-term benefits, however, remain unknown. The objective of this pilot study was to estimate the short- and long-term effects of a 3-week piano training program on upper extremity function in persons with chronic stroke. A multiple pre-post sequential design was used, with measurements taken at baseline (week0, week3), prior to (week6) and after the intervention (week9), and at 3-week follow-up (week12). Three persons with stroke participated in the 3-week piano training program that combined structured piano lessons to home practice program. The songs, played on an electronic keyboard, involved all 5 digits of the affected hand and were displayed using a user-friendly MIDI program. After intervention, all the three participants showed improvements in their fine (nine hole peg test) and gross (box and block test) manual dexterity, as well as in the functional use of the upper extremity (Jebsen hand function test). Improvements were maintained at follow-up. These preliminary results support the feasibility of using an MST approach that combines structured lessons to home practice to improve upper extremity function in chronic stroke. PMID:23533954

  14. Playing Piano Can Improve Upper Extremity Function after Stroke: Case Studies

    Directory of Open Access Journals (Sweden)

    Myriam Villeneuve

    2013-01-01

    Full Text Available Music-supported therapy (MST is an innovative approach that was shown to improve manual dexterity in acute stroke survivors. The feasibility of such intervention in chronic stroke survivors and its longer-term benefits, however, remain unknown. The objective of this pilot study was to estimate the short- and long-term effects of a 3-week piano training program on upper extremity function in persons with chronic stroke. A multiple pre-post sequential design was used, with measurements taken at baseline (week0, week3, prior to (week6 and after the intervention (week9, and at 3-week follow-up (week12. Three persons with stroke participated in the 3-week piano training program that combined structured piano lessons to home practice program. The songs, played on an electronic keyboard, involved all 5 digits of the affected hand and were displayed using a user-friendly MIDI program. After intervention, all the three participants showed improvements in their fine (nine hole peg test and gross (box and block test manual dexterity, as well as in the functional use of the upper extremity (Jebsen hand function test. Improvements were maintained at follow-up. These preliminary results support the feasibility of using an MST approach that combines structured lessons to home practice to improve upper extremity function in chronic stroke.

  15. Animals

    International Nuclear Information System (INIS)

    The radionuclides of most concern with respect to contamination of animals after a nuclear accident are radioiodine, radiocaesium and radiostrontium (ICRP 30, 1979). Of the other significant anthropogenic radionuclides likely to be released in most accidents, only small proportions of that ingested will be absorbed in an animals gut, and the main animal products, milk and meat, will not normally be contaminated to a significant extent. Animal products will mostly be contaminated as a result of ingestion of contaminated feed and possibly, but to a much lesser extent, from inhalation (for radioiodine only). Direct external contamination of animals is of little or no consequence in human food production. Radioiodine and radiostrontium are important with respect to contamination of milk; radiocaesium contaminates both milk and meat. The physical and chemical form of a radionuclide can influence its absorption in the animal gut. For example, following the Chernobyl accident radiocaesium incorporated into vegetation by root uptake was more readily absorbed than that associated with the original deposit. The transfer of radiocaesium and radiostrontium to animals will be presented both as transfer coefficients and aggregated transfer coefficients. For most animal meat products, only radiocaesium is important as other radionuclides do not significantly contaminate muscle. Farm animal products are the most important foodstuff determining radiocaesium intake by the average consumer in the Nordic countries. The major potential source of radioiodine and radiostrontium to humans is milk and milk products. Of the different species, the smaller animals have the highest transfer of radiocaesium from fodder to meat and milk. (EG)

  16. A prospective cohort study of stroke characteristics, care, and mortality in a hospital stroke registry in Vietnam

    OpenAIRE

    Tirschwell David L; Ton Thanh G N; Ly Kiet A; Van Ngo Quang; Vo Tung T; Pham Chien Hung; Longstreth William T; Fitzpatrick Annette L

    2012-01-01

    Abstract Background As low and middle-income countries such as Vietnam experience the health transition from infectious to chronic diseases, the morbidity and mortality from stroke will rise. In line with the recommendation of the Institute of Medicine’s report on “Promoting Cardiovascular Health in the Developing World” to “improve local data”, we sought to investigate patient characteristics and clinical predictors of mortality among stroke inpatients at Da Nang Hospital in Vietnam. Methods...

  17. Cfd Studies of Two Stroke Petrol Engine Scavenging

    Directory of Open Access Journals (Sweden)

    S Gavudhama Karunanidhi,

    2014-07-01

    Full Text Available This project deals with the numerical analysis of 2 stroke engine scavenging in two cases. One with an existing condition (Flat headed pistons and another with a new design (Dome headed piston .The numerical analysis is done with help of CFD software ANSYS FLUENT 14.5. Here, the modeling of engine piston with flat headed type and with dome headed types was done in workbench. In ANSYS FLUENT after the geometrical design, for the dynamic motion meshing is used and set up species transport model also. At first the scavenging effect of flat headed piston is analyzed. Later the simulation of piston with dome headed type was also checked. Analyzing the variations from each and selected the best method for scavenging. Finally the scavenging efficiency is calculated for both type arrangements.

  18. Factors affecting burden on caregivers of stroke survivors: Population-based study in Mumbai (India

    Directory of Open Access Journals (Sweden)

    Madhumita Bhattacharjee

    2012-01-01

    Full Text Available Background: Caring for stroke patients leads to caregiver (CG strain. The aims of this study are to identify factors related to increased CG burden in stroke survivors in a census-defined population and to assess the relationship between patient characteristics and CG stress. Materials and Methods: In a prospective population-based study, 223 first ever stroke (FES were identified over a 1-year period. At 28 days, 127 (56.9% were alive and 79 (35% died, and 17 were lost to follow-up. One hundred and eleven CGs of 127 FES survivors agreed to participate. The level of stress was assessed by two scales: Oberst Caregiving Burden Scale (OCBS and the Caregivers Strain Index (CSI in CGs of survivors with mild stroke Modified Rankin Scale (MRS 1-2 and in those with significant disability (MRS 3-5. Results: The mean age of CGs was 45.6 years, approximately 22 years younger than that of the patients (67.5 years. Eighty-nine (80% of the CGs were females and only 22 (20% were males. Urinary incontinence (P=0.000008, morbidity at 28 days by MRS (P=0.0051, female gender (P=0.0183 and moderate to severe neurological deficit by National Institute of Health Stroke Scale (NIHSS on admission (P=0.0254 were factors in FES cases leading to major CGs stress. CG factors responsible for major stress were long caregiving hours (P≤0.000001, anxiety (P≤0.000001, disturbed night sleep ( P≤0.000001, financial stress (P=0.0000108, younger age (P=0.0021 and CGs being daughter-in-laws (P=0.012. Conclusion: Similar studies using uniform methodologies would help to identify factors responsible for major CG stress. Integrated stroke rehabilitation services should address CG issues to local situations and include practical training in simple nursing skills and counseling sessions to help reduce CG burden.

  19. Is visuospatial hemineglect really a determinant of postural control following stroke? An acute-phase study.

    NARCIS (Netherlands)

    Nes, I.J.W. van; Linden, S. van der; Hendricks, H.T.; Kuijk, A.A. van; Rulkens, M.; Verhagen, W.I.; Geurts, A.C.H.

    2009-01-01

    OBJECTIVE: The purpose of this study was to determine the independent contribution of visuospatial hemineglect to impaired postural control in the acute phase (<2 weeks) of stroke compared with other possible clinical and biological determinants. METHODS: This study was conducted in 4 hospitals i

  20. Self-reported stress and risk of stroke: the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Truelsen, Thomas; Nielsen, Naja; Boysen, Gudrun;

    2003-01-01

    BACKGROUND AND PURPOSE: Lay people often mention stress as one of the most important risk factors for stroke. Stress might trigger a cerebrovascular event directly or could be associated with higher levels of blood pressure or an unfavorable lifestyle. To examine these possibilities, we analyzed...... the association between self-reported stress frequency and intensity and risk of stroke. METHODS: Data from the second examination, 1981 to 1983, of participants in the Copenhagen City Heart Study were analyzed with Cox regression after a mean of 13 years of follow-up. A total of 5604 men and 6970 women were...... included, and 929 first-ever strokes occurred, of which 207 (22%) were fatal within 28 days after onset of symptoms. The stress frequency categories were never/hardly ever, monthly, weekly, or daily. The stress intensity categories were never/hardly ever, light, moderate, or high. RESULTS: Subjects...

  1. High Sensitivity C-reactive Protein Levels in Acute Ischemic Stroke and Subtypes: A study from a Tertiary Care Center

    Directory of Open Access Journals (Sweden)

    Jaydip Ray Chaudhuri

    2013-07-01

    Full Text Available Background: Stroke is a heterogeneous disease with several risk factors. High sensitivity C-reactive protein (hsCRP is a marker for cardiovascular and cerebrovascular diseases. Recent studies have shown that high hsCRP level is a risk factor for ischemic stroke. The objective of our study was to investigate the association of high hsCRP(> 3 mg/L levels with ischemic stroke and its subtypes in Indian patients.Methods: We recruited 210 consecutive acute stroke patients and 150 age and sex matched controls. Stroke patients were admitted within 72 hours of onset, at Yashoda Hospital, Hyderabad, India. The study period was from January 2011 to December 2012. All patients underwent tests as per standard protocol for stroke workup. Serum hsCRP level was assessed in all stroke patients and controls on the day of admission.Results: The mean hsCRP was significantly higher in stroke patients (3.8 ± 2.5 than controls (1.8 ± 1.5 (P < 0.001. High hsCRP had higher frequency in stroke patients 130 (61.9% compared to controls 10 (6.6%, P < 0.001. High hsCRP level was more prevalent in the stroke subtypes of cardioembolic stroke (83.3% and large artery atherosclerosis (72%. High hsCRP level was significantly associated with hypercholesterolemia (P = 0.001, age(P = 0.01, and mortality (0.04. After adjustment of regression analysis it was observed that high level hsCRP is independently associated with acute ischemic stroke (Odds 4.5; 95% CI: 2.5-12.2; especially the stroke subtypes of cardioembolic stroke, (odds ratio 3.4, 95% CI: 1.9-10.5 and large artery atherosclerosis (odds ratio 2.1, 95% CI: 1.5-3.8.Conclusion: High hsCRP level is strongly associated with and an independent predictor of acute ischemic stroke. The association was found in all ischemic stroke subtypes.

  2. Modeling of in hospital mortality determinants in myocardial infarction patients, with and without stroke: A national study in Iran

    Directory of Open Access Journals (Sweden)

    Ali Ahmadi

    2016-01-01

    Full Text Available Background: The data and determinants of mortality due to stroke in myocardial infarction (MI patients are unknown. This study was conducted to evaluate the differences in risk factors for hospital mortality among MI patients with and without stroke history. Materials and Methods: This study was a retrospective, cohort study; 20,750 new patients with MI from April, 2012 to March, 2013 were followed up and their data were analyzed according to having or not having the stroke history. Stroke and MI were defined based on the World Health Organization′s definition. The data were analyzed by logistic regression in STATA software. Results: Of the 20,750 studied patients, 4293 had stroke history. The prevalence of stroke in the studied population was derived 20.96% (confidence interval [CI] 95%: 20.13-21.24. Of the patients, 2537 (59.1% had ST-elevation MI (STEMI. Mortality ratio in patients with and without stroke was obtained 18.8% and 10.3%, respectively. The prevalence of risk factors in MI patients with and without a stroke is various. The adjusted odds ratio of mortality in patients with stroke history was derived 7.02 (95% CI: 5.42-9 for chest pain resistant to treatment, 2.39 (95% CI: 1.97-2.9 for STEMI, 3.02 (95% CI: 2.5-3.64 for lack of thrombolytic therapy, 2.2 (95% CI: 1.66-2.91 for heart failure, and 2.17 (95% CI: 1.6-2.9 for ventricular tachycardia. Conclusion: With regards to the factors associated with mortality in this study, it is particularly necessary to control the mortality in MI patients with stroke history. More emphasis should be placed on the MI patients with the previous stroke over those without in the interventions developed for prevention and treatment, and for the prevention of avoidable mortalities.

  3. The Effect of Repetitive Rhythmic Precision Grip Task-Oriented Rehabilitation in Chronic Stroke Patients: A Pilot Study

    Science.gov (United States)

    Dispa, Delphine; Lejeune, Thierry; Thonnard, Jean-Louis

    2013-01-01

    Most chronic stroke patients present with difficulty in the manipulation of objects. The aim of this study was to test whether an intensive program of precision grip training could improve hand functioning of patients at more than 6 months after a stroke. This was a cross-over study; hence, at inclusion, the patients were randomly divided into two…

  4. The sensitivity of CT and rCBF-studies for the pathology of strokes

    International Nuclear Information System (INIS)

    A localized pathology of the cerebral circulation or cerebral metabolism and the morphology of the brain tissue can be visualized by the use of new techniques in radiology and nuclear medicine: measurements of rCBF by radioactive diffusible isotopes, of the densitiy of the brain tissue, by CT, and of the cerebral metabolism regionally by positron-emission tomography. Having studied 475 stroke patients par rCBF measurements and 335 by CT we think it useful to compare the value of these two methods in revealing information on the pathology underlying focal disorders of brain functions due to stroke. (orig./VJ)

  5. Population-based study of central post-stroke pain in Rimini district, Italy

    Directory of Open Access Journals (Sweden)

    Raffaeli W

    2013-09-01

    Full Text Available William Raffaeli,1 Cristina E Minella,2 Francesco Magnani,3 Donatella Sarti3 1ISAL Foundation, Institute for Research on Pain, Torre Pedrera, Rimini, Italy 2Pain Therapy Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy 3Department of Pain Therapy and Palliative Care, Infermi Hospital, Rimini, Italy Abstract: Central post-stroke pain (CPSP is still an underestimated complication of stroke, resulting in impaired quality of life and, in addition to the functional and cognitive consequences of stroke, the presence of CPSP may be associated with mood disorders, such as depression, anxiety, and sleep disturbances. This type of pain may also impair activities of daily living and further worsen quality of life, negatively influencing the rehabilitation process. The prevalence of CSPS in the literature is highly variable (1%–12% according to different studies, and this variability could be influenced by selection criteria and the different ethnic populations being investigated. With this scenario in mind, we performed a population-based study to assess the prevalence of CPSP and its main features in a homogeneous health district (Rimini, Italy, including five hospitals for a total population of 329,970 inhabitants. From 2008 to 2010, we selected 1,494 post-stroke patients and were able to interview 660 patients, 66 (11% of whom reported pain with related tactile and thermal hyperesthesia, accompanied by needle puncture, tingling, swelling, and pressure sensations. Patients reported motor impairment and disability, which influenced their working ability, rehabilitation, and social life. Despite this severe pain state, there was a high percentage of patients who did not receive adequate treatment for pain. Keywords: stroke, central post-stroke pain, disability

  6. Exploratory Cohort Study of Associations between Serum C - Reactive Protein and Fatigue after Stroke.

    Directory of Open Access Journals (Sweden)

    Simiao Wu

    Full Text Available Post-stroke fatigue is a common and distressing problem but little is known about its biological mechanisms. This cohort study was to investigate associations between C-reactive protein (CRP and fatigue after stroke.Patients were assessed at one, six and 12 months after their stroke onset, with the Fatigue Assessment Scale, a case definition of post-stroke fatigue, Hospital Anxiety and Depression Scale, and daily step counts. Blood samples were collected at each assessment and the CRP level was determined by a standard CRP immunoassay. Cross-sectional associations between CRP and fatigue at each time point were determined by Pearson correlation coefficient and independent-samples t-test. Whether CRP levels at one month predict fatigue scores at six and 12 months was explored by multiple linear regression, with anxiety, depression, and daily step counts as covariates.Sixty-five patients (mean age 67 years, 65% men were included: 61 at one month, 49 at six months, and 41 at 12 months. CRP levels and fatigue scores were not associated at one month (p = 0.88 or 12 months (p = 0.56, but weakly associated at six months (r = 0.27, p = 0.04; however, this association was no longer significant (p = 0.14 after controlling for the effects of covariates. The CRP level was not associated with the fulfilment of case definition of post-stroke fatigue at any time points (all p > 0.05. The CRP level at one month was not a significant predictor for fatigue levels at either six months (p = 0.93 or 12 months (p = 0.78.There is insufficient evidence for the association between CRP and PSF in stroke patients. Future studies with larger sample sizes and controlling for potential confounders are needed to investigate whether this association exists.

  7. Exploratory Cohort Study of Associations between Serum C - Reactive Protein and Fatigue after Stroke

    Science.gov (United States)

    Wu, Simiao; Duncan, Fiona; Anderson, Niall H.; Kuppuswamy, Annapoorna; Macloed, Malcolm R.; Mead, Gillian E.

    2015-01-01

    Background and Aim Post-stroke fatigue is a common and distressing problem but little is known about its biological mechanisms. This cohort study was to investigate associations between C-reactive protein (CRP) and fatigue after stroke. Methods Patients were assessed at one, six and 12 months after their stroke onset, with the Fatigue Assessment Scale, a case definition of post-stroke fatigue, Hospital Anxiety and Depression Scale, and daily step counts. Blood samples were collected at each assessment and the CRP level was determined by a standard CRP immunoassay. Cross-sectional associations between CRP and fatigue at each time point were determined by Pearson correlation coefficient and independent-samples t-test. Whether CRP levels at one month predict fatigue scores at six and 12 months was explored by multiple linear regression, with anxiety, depression, and daily step counts as covariates. Results Sixty-five patients (mean age 67 years, 65% men) were included: 61 at one month, 49 at six months, and 41 at 12 months. CRP levels and fatigue scores were not associated at one month (p = 0.88) or 12 months (p = 0.56), but weakly associated at six months (r = 0.27, p = 0.04); however, this association was no longer significant (p = 0.14) after controlling for the effects of covariates. The CRP level was not associated with the fulfilment of case definition of post-stroke fatigue at any time points (all p > 0.05). The CRP level at one month was not a significant predictor for fatigue levels at either six months (p = 0.93) or 12 months (p = 0.78). Conclusions There is insufficient evidence for the association between CRP and PSF in stroke patients. Future studies with larger sample sizes and controlling for potential confounders are needed to investigate whether this association exists. PMID:26599129

  8. ASSOCIATION OF DIABETES MELLITUS WITH STROKE: A HOSPITAL-BASED CASE-CONTROL STUDY

    Directory of Open Access Journals (Sweden)

    Manoj Kumar

    2016-07-01

    Full Text Available Stroke is a major cause of mortality and morbidity worldwide. Globally, stroke is the second leading cause of death above the age of 60 years and the fifth leading cause of death in people aged 15-59 years old. In addition to specific complications of diabetes mellitus like nephropathy, retinopathy, etc., some other non-specific complications, notably coronary artery disease and stroke are also increasing in frequency in diabetic patients. MATERIALS AND METHODS This was a case-control study conducted from Feb-2016 to Apr-2016 (3 months. Study was done among stroke patients aged 20 years and above hospitalized in TMMC and RC, Moradabad, UP, Age and gender matched control subjects were selected among neurologically healthy people who were admitted for other ailments in this hospital. Sample size was 312 people containing 156 cases and 156 controls. Statistical analysis was done using Med Calc Version 12.7.5.0 software. Chi-square test was used as test of significance and p value less than 0.05 was considered as significant. OBSERVATION Male:Female ratio among the cases and control was 1.51:1. Mean age of cases and controls were 51.30±11.13 and 51.93±14.60. Out of 156 cases, 77 (49.36% were suffering from Diabetes mellitus, while only 46 (29.48% controls were having diabetes mellitus. P value was 0.0003, which is highly significant. CONCLUSION In the present hospital-based case-control study, diabetes mellitus was found to be a significant risk factor in patients with stroke. Risk factor assessment is an important step towards better understanding of pathogenesis, prevention and control of stroke. RECOMMENDATIONS Physicians caring for patients at risk for stroke should be vigilant for diabetes as well as other concurrent stroke risk factors like hypertension, dyslipidaemia, heart diseases, etc., that tend to cluster with diabetes. Lifestyle modification and non-pharmacological as well as pharmacological interventions for the modifiable risk

  9. Bias During the Evaluation of Animal Studies?

    OpenAIRE

    Andrew Knight

    2012-01-01

    Simple Summary Animal experimentation evokes strong emotional responses in people on both sides of the debate surrounding its ethical status. However, the true level of its usefulness to society may only be discerned by careful examination of reliable scientific evidence. My recent book, The Costs and Benefits of Animal Experiments, reviewed more than 500 relevant scientific publications. Recently in this journal, however, a reviewer essentially accused me of bias. Yet the conclusions of my b...

  10. Animals

    Energy Technology Data Exchange (ETDEWEB)

    Skuterud, L.; Strand, P. [Norwegian Radiation Protection Authority (Norway); Howard, B.J. [Inst. of Terrestrial Ecology (United Kingdom)

    1997-10-01

    The radionuclides of most concern with respect to contamination of animals after a nuclear accident are radioiodine, radiocaesium and radiostrontium (ICRP 30, 1979). Of the other significant anthropogenic radionuclides likely to be released in most accidents, only small proportions of that ingested will be absorbed in an animals gut, and the main animal products, milk and meat, will not normally be contaminated to a significant extent. Animal products will mostly be contaminated as a result of ingestion of contaminated feed and possibly, but to a much lesser extent, from inhalation (for radioiodine only). Direct external contamination of animals is of little or no consequence in human food production. Radioiodine and radiostrontium are important with respect to contamination of milk; radiocaesium contaminates both milk and meat. The physical and chemical form of a radionuclide can influence its absorption in the animal gut. For example, following the Chernobyl accident radiocaesium incorporated into vegetation by root uptake was more readily absorbed than that associated with the original deposit. The transfer of radiocaesium and radiostrontium to animals will be presented both as transfer coefficients and aggregated transfer coefficients. For most animal meat products, only radiocaesium is important as other radionuclides do not significantly contaminate muscle. Farm animal products are the most important foodstuff determining radiocaesium intake by the average consumer in the Nordic countries. The major potential source of radioiodine and radiostrontium to humans is milk and milk products. Of the different species, the smaller animals have the highest transfer of radiocaesium from fodder to meat and milk. (EG). 68 refs.

  11. A prospective cohort study of stroke mortality and arsenic in drinking water in Bangladeshi adults

    Science.gov (United States)

    2014-01-01

    Background Arsenic in drinking water causes increased coronary artery disease (CAD) and death from CAD, but its association with stroke is not known. Methods Prospective cohort study with arsenic exposure measured in well water at baseline. 61074 men and women aged 18 years or older on January 2003 were enrolled in 2003. The cohort was actively followed for an average of 7 years (421,754 person-years) through December 2010. Based on arsenic concentration the population was categorized in three groups and stroke mortality HR was compared to the referent. The risk of stroke mortality Hazard Ratio (HR) and 95% Confidence Interval was calculated in relation to arsenic exposure was estimated by Cox proportional hazard models with adjustment for potential confounders. Results A total of 1033 people died from stroke during the follow-up period, accounting for 23% of the total deaths. Multivariable adjusted HRs (95% confidence interval) for stroke for well water arsenic concentrations <10, 10-49, and ≥50 μg/L were 1.0 (reference), 1.20 (0.92 to 1.57), and 1.35 (1.04 to 1.75) respectively (Ptrend=0.00058). For men, multivariable adjusted HRs (95%) for well water arsenic concentrations <10, 10-49, and ≥50 μg/L were 1.0 (reference), 1.12 (0.78 to 1.60), and 1.07 (0.75 to 1.51) respectively (Ptrend=0.45) and for women 1.0 (reference),1.31 (0.87 to 1.98), and 1.72 (1.15 to 2.57) respectively (Ptrend=0.00004). Conclusion The result suggests that arsenic exposure was associated with increased stroke mortality risk in this population, and was more significant in women compared to men. PMID:24548416

  12. Effects of electroacupuncture on recent stroke inpatients with incomplete bladder emptying: a preliminary study

    Directory of Open Access Journals (Sweden)

    Yu KW

    2012-11-01

    Full Text Available Kuo-Wei Yu,1,* Chien-Lin Lin,1,2 Chun-Chuang Hung,3 Eric Chieh-Lung Chou,4 Yueh-Ling Hsieh,5 Te-Mao Li,2,3,* Li-Wei Chou1,2,61Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan; 2School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; 3Graduate Institute of Acupuncture Science, China Medical University, Taichung, Taiwan; 4Department of Urology, China Medical University Hospital, Taichung, Taiwan; 5Department of Physical Therapy, China Medical University, Taichung, Taiwan; 6Acupuncture Research Center, China Medical University, Taichung, Taiwan*These authors contributed equally to this workBackground: Incomplete bladder emptying (IBE is defined as having a postvoid residual (PVR urine volume greater than 100 mL for 2 consecutive days. IBE is common in stroke patients and could necessitate indwelling or intermittent catheterization. The condition is correlated with urinary tract infections, which could impede rehabilitation progress and increase medical costs. Treatment for patients with IBE includes bladder retraining, biofeedback, medication, and botulinum toxin injection, but none of these interventions are completely effective.Methods: All patients with acute stroke who were admitted to the rehabilitation ward between August 2010 and April 2011 were included in the study and their PVR urine volume was checked. Electroacupuncture (EA; 1 Hz, 15 minutes was performed on the acupoints Sanyinjiao (SP6, Ciliao (BL32, and Pangguangshu (BL28 of stroke patients with IBE for a total of ten treatments (five times a week for 2 weeks. Bladder diaries, which included the spontaneous voiding and PVR urine volumes, were recorded during the course of treatment.Results: The presence of IBE was not related to sex, history of diabetes mellitus, stroke type (hemorrhagic or ischemic, or stroke location (P > 0.05. Among the 49 patients in the study, nine (18% had IBE

  13. Cognitive Deficits Associated with Acquired Amusia after Stroke: A Neuropsychological Follow-Up Study

    Science.gov (United States)

    Sarkamo, Teppo; Tervaniemi, Mari; Soinila, Seppo; Autti, Taina; Silvennoinen, Heli M.; Laine, Matti; Hietanen, Marja

    2009-01-01

    Recent evidence on amusia suggests that our ability to perceive music might be based on the same neural resources that underlie other higher cognitive functions, such as speech perception and spatial processing. We studied the neural correlates of acquired amusia by performing extensive neuropsychological assessments on 53 stroke patients with a…

  14. Effectiveness of a Care Coordination Model for Stroke Survivors: A Randomized Study

    Science.gov (United States)

    Claiborne, Nancy

    2006-01-01

    This study evaluated the effectiveness of systematically integrating biopsychosocial interventions with coordinated delivery of care for outpatients recovering from stroke. Care coordination coordinates resources across the health care system and routinely addresses the psychological and social risks affecting patient outcomes, while monitoring…

  15. Efficiency of a Care Coordination Model: A Randomized Study with Stroke Patients

    Science.gov (United States)

    Claiborne, Nancy

    2006-01-01

    Objectives: This study investigated the efficiency of a social work care coordination model for stroke patients. Care coordination addresses patient care and treatment resources across the health care system to reduce risk, improve clinical outcomes, and maximize efficiency. Method: A randomly assigned, pre-post experimental design measured…

  16. Transfer of training effects in stroke patients with apraxia: an exploratory study.

    NARCIS (Netherlands)

    Geusgens, C.; Heugten, C. van; Donkervoort, M.; Ende, E. van den; Jolles, J.; Heuvel, W. van den

    2006-01-01

    The goal of the present study was to examine the transfer of the effects of cognitive strategy training for stroke patients with apraxia from trained to non-trained tasks. In strategy training, the occurrence of transfer is expected as the training programme is aimed, not at relearning specific task

  17. The right hemisphere is dominant in organization of visual search-A study in stroke patients

    NARCIS (Netherlands)

    Ten Brink, Antonia F.; Biesbroek, Matthijs; Kuijf, Hugo J.; Van der Stigchel, Stefan; Oort, Quirien; Visser-Meily, Johanna M A; Nijboer, Tanja C W

    2016-01-01

    Cancellation tasks are widely used for diagnosis of lateralized attentional deficits in stroke patients. A disorganized fashion of target cancellation has been hypothesized to reflect disturbed spatial exploration. In the current study we aimed to examine which lesion locations result in disorganize

  18. Rationale and design of INTERSTROKE: a global case-control study of risk factors for stroke

    DEFF Research Database (Denmark)

    O'Donnell, M; Serpault, Damien Xavier; Diener, C;

    2010-01-01

    Stroke is a major global health problem. It is the third leading cause of death and the leading cause of adult disability. INTERHEART, a global case-control study of acute myocardial infarction in 52 countries (29,972 participants), identified nine modifiable risk factors that accounted for >90% ...

  19. Pharmacogenetic effects of 'candidate gene complexes' on stroke in the GenHAT study

    DEFF Research Database (Denmark)

    Sørensen, Izel F; Vazquez, Ana I; Irvin, Marguerite R;

    2014-01-01

    OBJECTIVE: The aim of this study was to investigate whether there is a genotype-by-treatment interaction in patients experiencing stroke and treated with one of three antihypertensive drugs, that is chlorthalidone, amlodipine, or lisinopril. PARTICIPANTS AND METHODS: A population of 436 African...

  20. Measuring disabilities in stroke patients with apraxia: a validation study of an observational method.

    NARCIS (Netherlands)

    Heugten, C.M. van; Dekker, J.; Deelman, B.G.; Dijk, A.J. van; Stehmann-Saris, F.C.; Kinebanian, A.

    2000-01-01

    The objective of the present study was to determine the clinical and construct validity of the assessment of disabilities in stroke patients with apraxia. Disabilities were assessed by means of observation of activities of daily living (ADL), such as washing the face and upper body and putting on a

  1. Measuring disabilities in stroke patients with apraxia : A validation study of an observational method

    NARCIS (Netherlands)

    van Heugten, CM; Dekker, J; Deelman, BG; van Dijk, AJ; Stehmann-Saris, FC; Kinebanian, A

    2000-01-01

    The objective of the present study was to determine the clinical and construct validity of the assessment of disabilities in stroke patients with apraxia. Disabilities were assessed by means of observation of activities of daily living (ADL), such as washing the face and upper body and putting on a

  2. Cessation of smoking after first-ever stroke: a follow-up study

    DEFF Research Database (Denmark)

    Bak, Søren; Sindrup, Søren Hein; Alslev, Torben;

    2002-01-01

    and at follow-up were included in the present study. Among 198 patients (38.7%) who were current smokers on admission, 43 patients (21.7%) gave up smoking within 6 months of suffering a stroke. Sex, functional status, and sociodemographic characteristics were independently associated with persistent smoking...

  3. Restoration of weight-shifting capacity in patients with postacute stroke: a rehabilitation cohort study.

    NARCIS (Netherlands)

    Haart, M. de; Geurts, A.C.H.; Dault, M.C.; Nienhuis, B.; Duysens, J.E.J.

    2005-01-01

    OBJECTIVES: To identify and interrelate recovery characteristics of voluntary weight shifting after stroke and to examine whether the assessment of weight shifting adds information about balance recovery compared with the assessment of quiet standing. DESIGN: Exploratory study using an inception coh

  4. Assessment of Visuospatial Neglect in Stroke Patients Using Virtual Reality: A Pilot Study

    Science.gov (United States)

    Jannink, Michiel J. A.; Aznar, Miguel; de Kort, Alexander Cornelis; van de Vis, Wim; Veltink, Peter; van der Kooij, Herman

    2009-01-01

    One of the neuropsychological deficits that can result from a stroke is the neglect phenomenon. Neglect has traditionally been assessed with paper-and-pencil tasks, which are administered within the reaching space of a person. The purpose of this explorative study is to investigate whether it is possible to assess neglect in the extrapersonal…

  5. Assessment of visuospatial neglect in stroke patients using virtual reality: a pilot study.

    NARCIS (Netherlands)

    Jannink, Michiel J.A.; Aznar, Miguel; Kort, de Alexander Cornelis; Vis, van de Wim; Veltink, Peter; Kooij, van der Herman

    2009-01-01

    One of the neuropsychological deficits that can result from a stroke is the neglect phenomenon. Neglect has traditionally been assessed with paper-and-pencil tasks, which are administered within the reaching space of a person. The purpose of this explorative study is to investigate whether it is pos

  6. Recovery of slow-5 oscillations in a longitudinal study of ischemic stroke patients

    Science.gov (United States)

    La, C.; Nair, V.A.; Mossahebi, P.; Stamm, J.; Birn, R.; Meyerand, M.E.; Prabhakaran, V.

    2016-01-01

    Functional networks in resting-state fMRI are identified by characteristics of their intrinsic low-frequency oscillations, more specifically in terms of their synchronicity. With advanced aging and in clinical populations, this synchronicity among functionally linked regions is known to decrease and become disrupted, which may be associated with observed cognitive and behavioral changes. Previous work from our group has revealed that oscillations within the slow-5 frequency range (0.01–0.027 Hz) are particularly susceptible to disruptions in aging and following a stroke. In this study, we characterized longitudinally the changes in the slow-5 oscillations in stroke patients across two different time-points. We followed a group of ischemic stroke patients (n = 20) and another group of healthy older adults (n = 14) over two visits separated by a minimum of three months (average of 9 months). For the stroke patients, one visit occurred in their subacute window (10 days to 6 months after stroke onset), the other took place in their chronic window (> 6 months after stroke). Using a mid-order group ICA method on 10-minutes eyes-closed resting-state fMRI data, we assessed the frequency distributions of a component's representative time-courses for differences in regards to slow-5 spectral power. First, our stroke patients, in their subacute stage, exhibited lower amplitude slow-5 oscillations in comparison to their healthy counterparts. Second, over time in their chronic stage, those same patients showed a recovery of those oscillations, reaching near equivalence to the healthy older adult group. Our results indicate the possibility of an eventual recovery of those initially disrupted network oscillations to a near-normal level, providing potentially a biomarker for stroke recovery of the cortical system. This finding opens new avenues in infra-slow oscillation research and could serve as a useful biomarker in future treatments aimed at recovery. PMID:27077023

  7. Recovery of slow-5 oscillations in a longitudinal study of ischemic stroke patients

    Directory of Open Access Journals (Sweden)

    C. La

    2016-01-01

    Full Text Available Functional networks in resting-state fMRI are identified by characteristics of their intrinsic low-frequency oscillations, more specifically in terms of their synchronicity. With advanced aging and in clinical populations, this synchronicity among functionally linked regions is known to decrease and become disrupted, which may be associated with observed cognitive and behavioral changes. Previous work from our group has revealed that oscillations within the slow-5 frequency range (0.01–0.027 Hz are particularly susceptible to disruptions in aging and following a stroke. In this study, we characterized longitudinally the changes in the slow-5 oscillations in stroke patients across two different time-points. We followed a group of ischemic stroke patients (n = 20 and another group of healthy older adults (n = 14 over two visits separated by a minimum of three months (average of 9 months. For the stroke patients, one visit occurred in their subacute window (10 days to 6 months after stroke onset, the other took place in their chronic window (>6 months after stroke. Using a mid-order group ICA method on 10-minutes eyes-closed resting-state fMRI data, we assessed the frequency distributions of a component's representative time-courses for differences in regards to slow-5 spectral power. First, our stroke patients, in their subacute stage, exhibited lower amplitude slow-5 oscillations in comparison to their healthy counterparts. Second, over time in their chronic stage, those same patients showed a recovery of those oscillations, reaching near equivalence to the healthy older adult group. Our results indicate the possibility of an eventual recovery of those initially disrupted network oscillations to a near-normal level, providing potentially a biomarker for stroke recovery of the cortical system. This finding opens new avenues in infra-slow oscillation research and could serve as a useful biomarker in future treatments aimed at recovery.

  8. Socioeconomic status and stroke incidence in the US elderly: the role of risk factors in the EPESE study.

    NARCIS (Netherlands)

    Avendano, Mauricio; Kawachi, Ichiro; Lenthe, Frank J van; Boshuizen, Hendriek C; Mackenbach, Johan P; Bos, G A M van den; Fay, Martha E; Berkman, Lisa F

    2006-01-01

    BACKGROUND AND PURPOSE: This study assesses the effect of socioeconomic status on stroke incidence in the elderly, and the contribution of risk factors to stroke disparities. METHODS: Data comprised a sample of 2812 men and women aged 65 years and over from the New Haven cohort of the Established Po

  9. Socioeconomic status and stroke incidence in the US elderly - The role of risk factors in the EPESE study

    NARCIS (Netherlands)

    M. Avendano; I. Kawachi; F. van Lenthe; H.C. Boshuizen; J.P. Mackenbach; G.A.M. van den Bos; M.E. Fay; L.F. Berkman

    2006-01-01

    Background and Purpose - This study assesses the effect of socioeconomic status on stroke incidence in the elderly, and the contribution of risk factors to stroke disparities. Methods - Data comprised a sample of 2812 men and women aged 65 years and over from the New Haven cohort of the Established

  10. Longitudinal robustness of variables predicting independent gait following severe middle cerebral artery stroke: a prospective cohort study.

    NARCIS (Netherlands)

    Kollen, B.; Kwakkel, G.; Lindeman, E.

    2006-01-01

    OBJECTIVE: To determine within the first 10 weeks post onset the most robust variables in the prediction of recovery of independent gait at six months post stroke. DESIGN: A prospective cohort study. SUBJECTS: One hundred and one first ever ischaemic middle cerebral artery stroke patients. None of t

  11. Predicting sickness impact profile at six months after stroke: further results from the European multi-center CERISE study

    NARCIS (Netherlands)

    Stummer, C.A.; Verheyden, G.; Putman, K.; Jenni, W.; Schupp, W.; Wit, L. De

    2015-01-01

    PURPOSE: To develop prognostic models and equations for predicting participation at six months after stroke. METHODS: This European prospective cohort study recruited 532 consecutive patients from four rehabilitation centers. Participation was assessed at six months after stroke with the Sickness Im

  12. Five-year mortality and related prognostic factors after inpatient stroke rehabilitation : A European multi-centre study

    NARCIS (Netherlands)

    L. de Wit (Liesbet); K. Putman (Koen); H. Devos (Hannes); N. Brinkmann (Nadine); E. Dejaeger (Eddy); W. de Weerdt (Willy); W. Jenni (Walter); N. Lincoln (Nadina); B. Schuback (Birgit); W. Schupp (Wilfried); E.M.E.H. Lesaffre (Emmanuel)

    2012-01-01

    textabstractObjective: To determine 5-year mortality and its association with baseline characteristics and functional status 6 months post-stroke for patients who received inpatient rehabilitation. Design: A prospective rehabilitation-based cohort study. Subjects: A total of 532 consecutive stroke p

  13. The Right Supramarginal Gyrus Is Important for Proprioception in Healthy and Stroke-Affected Participants: A Functional MRI Study

    OpenAIRE

    Ben-Shabat, Ettie; Matyas, Thomas A.; Pell, Gaby S; Brodtmann, Amy; Carey, Leeanne M.

    2015-01-01

    Human proprioception is essential for motor control, yet its central processing is still debated. Previous studies of passive movements and illusory vibration have reported inconsistent activation patterns related to proprioception, particularly in high-order sensorimotor cortices. We investigated brain activation specific to proprioception, its laterality, and changes following stroke. Twelve healthy and three stroke-affected individuals with proprioceptive deficits participated. Propriocept...

  14. Ocular Fundus Photography as a Tool to Study Stroke and Dementia.

    Science.gov (United States)

    Cheung, Carol Y; Chen, Christopher; Wong, Tien Y

    2015-10-01

    Although cerebral small vessel disease has been linked to stroke and dementia, due to limitations of current neuroimaging technology, direct in vivo visualization of changes in the cerebral small vessels (e.g., cerebral arteriolar narrowing, tortuous microvessels, blood-brain barrier damage, capillary microaneurysms) is difficult to achieve. As the retina and the brain share similar embryological origin, anatomical features, and physiologic properties with the cerebral small vessels, the retinal vessels offer a unique and easily accessible "window" to study the correlates and consequences of cerebral small vessel diseases in vivo. The retinal microvasculature can be visualized, quantified and monitored noninvasively using ocular fundus photography. Recent clinic- and population-based studies have demonstrated a close link between retinal vascular changes seen on fundus photography and stroke and dementia, suggesting that ocular fundus photography may provide insights to the contribution of microvascular disease to stroke and dementia. In this review, we summarize current knowledge on retinal vascular changes, such as retinopathy and changes in retinal vascular measures with stroke and dementia as well as subclinical makers of cerebral small vessel disease, and discuss the possible clinical implications of these findings in neurology. Studying pathologic changes of retinal blood vessels may be useful for understanding the etiology of various cerebrovascular conditions; hence, ocular fundus photography can be potentially translated into clinical practice.

  15. A Comparative Study on the Positive Lightning Return Stroke Electric Fields in Different Meteorological Conditions

    Directory of Open Access Journals (Sweden)

    Chin-Leong Wooi

    2015-01-01

    Full Text Available Positive cloud-ground lightning is considerably more complex and less studied compared to the negative lightning. This paper aims to measure and characterize the significant parameters of positive return strokes electric field, namely, the zero-to-peak rise time, 10–90% rise time, slow front duration, fast transition rise time (10–90%, zero-crossing time, and opposite polarity overshoot relative to peak. To the best of the authors’ knowledge, this is the first time such detailed characteristics of positive lightning in Malaysia are thoroughly analyzed. A total of 41 positive lightning flashes containing 48 return strokes were analyzed. The average multiplicity is 1.2 strokes per flash. The majority of positive lightning was initiated from the primary positive charge rather than as a byproduct of in-cloud discharges. The cumulative probability distribution of rise time parameters, opposite polarity overshoot relative to peak, and slow front amplitude relative to peak are presented. A comparison between studies in four countries representing tropic, subtropic, and temperate regions was also carried out. Measured parameters in Florida, Sweden, and Japan are generally lower than those in Malaysia. Positive lightning occurrences in tropical regions should be further studied and analyzed to improve our current understanding on positive return strokes.

  16. GHRH treatment: studies in an animal model.

    Science.gov (United States)

    Shakutsui, S; Abe, H; Chihara, K

    1989-01-01

    This study examined the effects of chronic deletion of circulating growth hormone-releasing (GHRH) and/or somatostatin (SRIF) on normal growing male rats, as well as the effects of exogenous GHRH (1-29)NH2 and/or SMS 201-995 administration on the growth of rats with hypothalamic ablation. Passive immunization with anti-rat GHRH goat gamma-globulin (GHRH-Ab) for 3 weeks caused a marked decrease in the levels of pituitary GH mRNA and severe growth failure. Treatment with anti-SRIF goat gamma-globulin (SRIF-Ab) for 3 weeks produced a more modest decrease in GH mRNA levels in the pituitary and a slight but significant inhibition of normal somatic growth. Hypothalamic ablation produced a marked decrease in the level of mRNA in the pituitary. Chronic continuous administration of GHRH (1-29)NH2 stimulated pituitary GH synthesis, elevated serum levels of insulin-like growth factor I and increased body weight gain in rats with hypothalamic ablation treated with replacement doses of cortisone, testosterone and L-thyroxine. Combined treatment with GHRH (1-29)NH2 and SMS 201-995 appeared to promote the effect of GHRH on pituitary GH release and somatic growth in these animals. The results suggest that continuous administration of GHRH will be useful in the treatment of children with growth retardation resulting from hypothalamic disorders. In children with combined GHRH and somatostatin deficiencies, the addition of somatostatin to a GHRH treatment regimen may produce better results. PMID:2568726

  17. Stroke Statistics in Korea: Part II Stroke Awareness and Acute Stroke Care, A Report from the Korean Stroke Society and Clinical Research Center For Stroke

    OpenAIRE

    Hong, Keun-Sik; Bang, Oh Young; Kim, Jong S.; Heo, Ji Hoe; Yu, Kyung-Ho; Bae, Hee-Joon; Kang, Dong-Wha; Lee, Jin Soo; Kwon, Sun U.; Oh, Chang Wan; Lee, Byung-Chul; Yoon, Byung-Woo

    2013-01-01

    The aim of the current Part II of Stroke Statistics in Korea is to summarize nationally representative data on public awareness, pre-hospital delay, thrombolysis, and quality of acute stroke care in a single document. The public's knowledge of stroke definition, risk factors, warning signs, and act on stroke generally remains low. According to studies using open-ended questions, the correct definition of stroke was recognized in less than 50%, hypertension as a stroke risk factor in less than...

  18. Stroke and plasma markers of milk fat intake – a prospective nested case-control study

    Directory of Open Access Journals (Sweden)

    Weinehall Lars

    2009-05-01

    Full Text Available Abstract Background Dairy products are high in saturated fat and are traditionally a risk factor for vascular diseases. The fatty acids 15:0 and 17:0 of plasma lipids are biomarkers of milk fat intake. The aim of the present study was to evaluate the risk of a first-ever stroke in relation to the plasma milk fat biomarkers. Methods A prospective case-control study was nested within two population based health surveys in Northern Sweden. Among 129 stroke cases and 257 matched controls, plasma samples for fatty acid analyses were available in 108 cases and 216 control subjects. Proportions of 15:0 and 17:0 of plasma lipids, weight, height, blood lipids, blood pressures, and lifestyle data were employed in conditional logistic regression modelling. Results The proportions of fatty acids 17:0 and 15:0+17:0 of total plasma phospholipids were significantly higher in female controls than cases, but not in men. 17:0 and 15:0+17:0 were significantly and inversely related to stroke in the whole study sample as well as in women. The standardised odds ratio (95% CI in women to have a stroke was 0.41 (0.24–0.69 for 17:0 in plasma phospholipids. Adjustment for traditional cardiovascular risk factors, physical activity and diet had marginal effects on the odds ratios. A similar, but non-significant, trend was seen in men. Conclusion It is hypothesised that dairy or milk fat intake may be inversely related to the risk of a first event of stroke. The intriguing results of this study should be interpreted with caution. Follow up studies with greater power, and where intakes are monitored both by dietary recordings and fatty acid markers are needed.

  19. STUDY OF ECG AND ECHOCARDIOGRAPHIC ABNORMALITIES IN STROKE PATIENTS AND ITS PROGNOSTIC SIGNIFICANCE

    Directory of Open Access Journals (Sweden)

    Tomar

    2014-03-01

    Full Text Available BACKGROUND: Stroke is common life threatening disorder. It is the third leading cause of death in developed countries after cardiovascular disease and cancer. OBJECTIVE: 1.To study ECG and 2D echocardiographic changes in different types of strokes. 2. To know whether such changes have any prognostic significance. MATERIAL AND METHOD: The material of study comprised of 100 Patient admitted in a Medical College & associated Hospital of central India, from May 2009 to Sept. 2011. RESULTS: Abnormal ECG changes were more common among hemorrhagic patients (78.12% compared to infarct patients (67.64%. 2D echo abnormalities were more common among hemorrhage group (75% than in infarct (44.12%. None of the ECG changes had much significance on mortality and was statistically insignificant (p>0.05 while LV dysfunction showed significant mortality in stroke patients and was statistically significant (p<0.001. CONCLUSION: ECG abnormalities in stroke patients do not have any prognostic significance, while LV dysfunction had prognostic significance in predicting mortality.

  20. Incidence of stroke and coronary heart disease in the adult health study sample, 1958 - 78

    International Nuclear Information System (INIS)

    Approximately 16,000 study subjects in the Adult Health Study sample who had received examination at least once during the 20 years (1958 - 78) in Hiroshima or Nagasaki and were found to have neither stroke nor coronary heart disease (CHD) at the initial examination were studied for the incidence of stroke and CHD and the relationship of these to atomic bomb radiation exposure. Their secular trends were also studied. Findings suggestive of a relationship between stroke and radiation exposure among Hiroshima females were first discovered for the years 1969 - 73, that is, 24 - 28 years after A-bomb exposure. In general, this association is supported by the present analysis. Stroke incidence continued to decrease during the present report's period of observation. Analysis by type showed that cerebral infarction and cerebral hemorrhage both decreased, but the decrease of the latter is especially remarkable. The trend to decrease is observed in both sexes and in both cities. A relationship between CHD and radiation exposure was, as noted for stroke, first observed only in Hiroshima females for the years 1969 - 73, but from this analysis it appears that the trend began earlier and the association is getting stronger with the passage of time. Analysis by type showed myocardial infarction (MI), but not angina pectoris, to be related to radiation exposure. The incidence rate for CHD, especially for MI, was almost constant during the observation period, it being 1.2/1,000 person-years on the average. Comparing by sex, the incidence rate was constant in males. In females, the pattern varied with time. There appear to be no between-city differences in secular trends - essentially constant. (author)

  1. Neural interface of mirror therapy in chronic stroke patients: A functional magnetic resonance imaging study

    Directory of Open Access Journals (Sweden)

    Ashu Bhasin

    2012-01-01

    Full Text Available Background: Recovery in stroke is mediated by neural plasticity. Neuro-restorative therapies improve recovery after stroke by promoting repair and function. Mirror neuron system (MNS has been studied widely in humans in stroke and phantom sensations. Materials and Methods: Study subjects included 20 patients with chronic stroke and 10 healthy controls. Patients had clinical disease-severity scores, functional magnetic resonance imaging (fMRI and diffuse tensor imaging (DTI at baseline, 8 and at 24 weeks. Block design with alternate baseline and activation cycles was used with a total of 90 whole brain echo planar imaging (EPI measurements (timed repetition (TR = 4520 ms, timed echo (TE = 44 ms, slices = 31, slice thickness = 4 mm, EPI factor 127, matrix = 128 × 128, FOV = 230 mm. Whole brain T1-weighted images were acquired using 3D sequence (MPRage with 120 contiguous slices of 1.0 mm thickness. The mirror therapy was aimed via laptop system integrated with web camera, mirroring the movement of the unaffected hand. This therapy was administered for 5 days in a week for 60-90 min for 8 weeks. Results: All the patients showed statistical significant improvement in Fugl Meyer and modified Barthel Index (P < 0.05 whereas the change in Medical Research Council (MRC power grade was not significant post-therapy (8 weeks. There was an increase in the laterality index (LI of ipsilesional BA 4 and BA 6 at 8 weeks exhibiting recruitment and focusing principles of neural plasticity. Conclusions: Mirror therapy simulated the "action-observation" hypothesis exhibiting recovery in patients with chronic stroke. Therapy induced cortical reorganization was also observed from our study.

  2. Studying Biotechnological Methods Using Animations: The Teacher's Role

    Science.gov (United States)

    Yarden, Hagit; Yarden, Anat

    2011-12-01

    Animation has great potential for improving the way people learn. A number of studies in different scientific disciplines have shown that instruction involving computer animations can facilitate the understanding of processes at the molecular level. However, using animation alone does not ensure learning. Students sometimes miss essential features when they watch only animations, mainly due to the cognitive load involved. Moreover, students seem to attribute a great deal of authority to the computer and may develop misconceptions by taking animations of abstract concepts too literally. In this study, we attempted to explore teachers' perceptions concerning the use of animations in the classroom while studying biotechnological methods, as well as the teachers' contribution to the enactment of animations in class. Thirty high-school biotechnology teachers participated in a professional development workshop, aimed at investigating how teachers plan for and support learning with animation while studying biotechnological methods in class. From that sample, two teachers agreed to participate in two case studies aimed at characterizing teachers' contribution to the enactment of animations in class while studying biotechnological methods. Our findings reveal marked teacher contribution in the following three aspects: establishing the "hands-on" point of view, helping students deal with the cognitive load that accompanies the use of animation, and implementing constructivist aspects of knowledge construction while studying using animations.

  3. STUDY ON SURGE ARRESTER PERFORMANCE DUE TO LIGHTNING STROKE IN 20 KV DISTRIBUTION LINES

    Directory of Open Access Journals (Sweden)

    Agung Warsito

    2012-02-01

    Full Text Available Electric energy has been transmiting from power station to end user with transmission and distribution lines.Lightning strokes are problems that occure in transmission and distribution lines and make them fault when theelectric energy were transmited. Surge Diverter or Lightning Arrester has been installing to reduce these faults.In this paper the simulation of lightning stroke and lightning arrester performance on distribution lines 20 kVwere done using EMTP (Electromagnetic Transient Program. Some parameters such us impuls voltage andincreasing voltage on distribution line was inverstigated. As case study in this simulation, Mojosongo 1 mainfeeder 20 kV three phase lines were used.The simulation results show that the lightning stroke 20 kA in By1-61-61E-84-9I on S phase at 0,1 ms, makevoltage on S phase was increased about 1,3054 MV. For R phase and T phase will increase of induced voltagewere 0.79539 MV and 0.80484 MV. We also show the performance of MOV Arrester (Metal Oxide Varistor inovercoming lightning stroke trouble, where arrester can decrease voltage up to 15.198 kV on S phase, while atR phase and T phase arrester can decrease voltage up to 11.375 kV and 13.616 kV.

  4. What's new in stroke? The top 10 studies of 2009-2011: part II.

    Science.gov (United States)

    Hart, Robert G; Oczkowski, Wiesław J

    2011-06-01

    Five studies published between 2009 and 2011 are reviewed that importantly inform stroke prevention for patients with atrial fibrillation (AF) or with cervical carotid artery stenosis. Two large, phase III randomized trials tested novel oral anticoagulants for stroke prevention in patients with AF: the direct thrombin inhibitor dabigatran 150 mg twice daily was superior to adjusted-dose warfarin (RE-LY trial) and the direct factor Xa inhibitor apixaban was far superior to aspirin in patients deemed unsuitable for warfarin (AVERROES trial). For both novel anticoagulants, major bleeding rates were similar to the comparator treatment. Clopidogrel plus aspirin was more efficacious than aspirin alone for prevention of stroke in patients with AF deemed unsuitable for warfarin, but major bleeding was significantly increased with dual antiplatelet therapy (ACTIVE A trial). Two large randomized trials (CREST, ICSS) provide the best available data on the short-term risks of carotid artery stenting vs. endarterectomy. In both trials, periprocedural stroke was more frequent with stenting than with endarterectomy, but the increased risk was largely confined to patients >70 years old. For younger patients, periprocedural risks were comparable with stenting or endarterectomy, but long-term outcomes are required to assess the relative merits of the two procedures.

  5. ENGAGE: Guided Activity-Based Gaming in Neurorehabilitation after Stroke: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Ann Reinthal

    2012-01-01

    Full Text Available Introduction. Stroke is a leading cause of disability in healthy adults. The purpose of this pilot study was to assess the feasibility and outcomes of a novel video gaming repetitive practice paradigm, (ENGAGE enhanced neurorehabilitation: guided activity-based gaming exercise. Methods. Sixteen individuals at least three months after stroke served as participants. All participants received concurrent outpatient therapy or took part in a stroke exercise class and completed at least 500 minutes of gaming. Primary baseline and posttest outcome measures included the Wolf motor function test (WMFT and the Fugl-Meyer assessment (FMA. ENGAGE uses a game selection algorithm providing focused, graded activity-based repetitive practice that is highly individualized and directed. The Wilcoxon signed ranks test was used to determine statistical significance. Results. There were improvements in the WMFT (=0.003 and the FMA (=0.002 that exceeded established values of minimal clinically important difference. Conclusions. ENGAGE was feasible and an effective adjunct to concurrent therapy after stroke.

  6. A study on regional cerebral circulation in stroke patients with aphasia

    International Nuclear Information System (INIS)

    To study the pathophysiology of aphasia due to cerebral stroke, regional cerebral blood flow (rCBF) was measured by the 133Xe clearance method and the volume of low density area (LDA) was estimated on the basis of computerized tomography in 43 thrombotic (24 aphasia and 19 non-aphasia), 30 hemorrhagic (16 aphasia and 14 non-aphasia) and 6 non-stroke cases. 1) In the healthy hemisphere, rCBF showed no significant difference between aphasia and non-aphasia in both thrombotic and hemorrhagic cases. In the affected hemisphere, thrombotic cases showed significantly decreased rCBF in aphasic cases as compared to non-aphasic, however, hemorrhagic cases revealed no difference. 2) LDA volume showed no significant difference between aphasia and non-aphasia in cerebral thrombosis, however, LDA volume in non-aphasia was smaller than that in aphasia in cerebral hemorrage. 3) Significant differences in the pathophysiology of aphasia due to cerebral stroke were recognized between cerebral thrombosis and cerebral hemorrhage. Such differences should be taken into consideration in the management and treatment of aphasia caused by cerebral stroke. (author)

  7. Hemispheric activation during planning and execution phases in reaching post stroke: a consort study.

    Science.gov (United States)

    Fang, Yin; Daly, Janis J; Hansley, Jeff; Yao, Wan X; Yang, Qi; Sun, Jiayang; Hvorat, Ken; Pundik, Svetlana; Yue, Guang H

    2015-01-01

    Enhanced activation in the non-lesion hemisphere in stroke patients was widely observed during movement of the affected upper limb, but its functional role related to motor planning and execution is still unknown.This study was to characterize the activation in the non-lesion hemisphere during movement planning and execution by localizing sources of high-density electroencephalography (EEG) signal and estimating the source strength (current density [A/m]).Ten individuals with chronic stroke and shoulder/elbow coordination deficits and 5 healthy controls participated in the study.EEG (64 channels) was recorded from scalp electrodes while the subjects performed a reach task involving shoulder flexion and elbow extension of the affected (patients) or dominant (controls) upper extremity. Sources of the EEG were obtained and analyzed at 17 time points across movement preparation and execution phases. A 3-layer boundary element model was overlaid and used to identify the brain activation sources. A distributed current density model, low-resolution electromagnetic tomography (LORETA) L1 norm method, was applied to the data pre-processed by independent component analysis.Subjects with stroke had stronger source strength in the sensorimotor cortices during the movement compared with the controls. Their contralesional/lesional activation ratio (CTLR) for the primary motor cortices was significantly higher than that of the controls during the movement-planning phase, but not during the execution phase. The CTLR was higher in planning than in the execution phase in the stroke group.Excessive contralesional motor cortical activation appears to be more related to movement preparation rather than execution in chronic stroke.

  8. Use of 3-D magnetic resonance electrical impedance tomography in detecting human cerebral stroke: a simulation study

    Institute of Scientific and Technical Information of China (English)

    GAO Nuo; ZHU Shan-an; HE Bin

    2005-01-01

    We have developed a new three dimensional (3-D) conductivity imaging approach and have used it to detect human brain conductivity changes corresponding to acute cerebral stroke. The proposed Magnetic Resonance Electrical Impedance Tomography (MREIT) approach is based on the J-Substitution algorithm and is expanded to imaging 3-D subject conductivity distribution changes. Computer simulation studies have been conducted to evaluate the present MREIT imaging approach.Simulations of both types of cerebral stroke, hemorrhagic stroke and ischemic stroke, were performed on a four-sphere head model Simulation results showed that the correlation coefficient (CC) and relative error (RE) between target and estimated conductivity distributions were 0.9245±0.0068 and 8.9997%±0.0084%, for hemorrhagic stroke, and 0.6748±0.0197 and 8.8986%±0.0089%,for ischemic stroke, when the SNR (signal-to-noise radio) of added GWN (Gaussian White Noise) was 40. The convergence characteristic was also evaluated according to the changes of CC and RE with different iteration numbers. The CC increases and RE decreases monotonously with the increasing number of iterations. The present simulation results show the feasibility of the proposed 3-D MREIT approach in hemorrhagic and ischemic stroke detection and suggest that the method may become a useful alternative in clinical diagnosis of acute cerebral stroke in humans.

  9. Intravenous thrombolytic therapy for acute ischemic stroke (A pilot study in China)

    Institute of Scientific and Technical Information of China (English)

    Qingtang CHEN, MD

    2000-01-01

    Objective: This paper is the results of an open clinical trial, and also a pilot study of a 5-year National Project “Clinical study of thrombolytic therapy for iscbemic stroke within 6 hours of onset” (19962000). The purpose of this pilot study is to evaluate the efficacy and safety of intravenously administered thrombolytic therapy for isehemic stroke (mostly within 6 hours and partly within 12 hours of onset), using urokinase, produced by Tian Pu Pharmaceutical Company, China. The second phase of this clinical trial, a multicenter, randomized, double blind, placebo-controlled study will be finished by the end of the year 2000. Patients and Methods: The inclusion criteria of this study included 1. The age was between 35 and 80. 2. The time window should be controlled within 6 hours from the onset. If it was an evolved stroke, the consciousness of the patient was clear or only mild drowsy, and the CT scan didn't show any low density area, the time window could be controlled within 12 houri. 3. The clinical features indicated a carotid territory stroke. 4. CT scan demonstrated no intracranial bleeding or low density area, not including the old lacunes not related to this stroke. 5. The blood pressure should be controlled under 180/100 mmHg. 6 The consciousness of the patient should be clear, or mild drowsy. 7. The severity of the paralytic limbs was between 0 and 3 degrees (with a scale of 0~5degree). 8. An informed consent was required. The patients were assigned to receive the treatment with urokinase (UK) 1.0-l.5million U given over 30 minutes. After UK infusion, 500 ml of low molecular weight dextran will be continued daily for l0 days. 24h after UK infusion, 300 mg aspirin daily will be administered for 10days, andthen l00mgof aspirin daily for 80 days. The neurological deficit was measured by European Stroke Scale (ESS) and was recorded before therapy and at 2h, ld, 3d, 7d, 14d, 30d, and 90d after therapy. Results: The results revealed that 409 cases

  10. The incidence and relative risk of stroke among patients with bipolar disorder: a seven-year follow-up study.

    Directory of Open Access Journals (Sweden)

    Hung-Chi Wu

    Full Text Available OBJECTIVE: This study aimed to estimate the incidence and relative risk of stroke and post-stroke all-cause mortality among patients with bipolar disorder. METHODS: This study identified a study population from the National Health Insurance Research Database (NHIRD between 1999 and 2003 that included 16,821 patients with bipolar disorder and 67,284 age- and sex-matched control participants without bipolar disorder. The participants who had experienced a stroke between 1999 and 2003 were excluded and were randomly selected from the NHIRD. The incidence of stroke (ICD-9-CM code 430-438 and patient survival after stroke were calculated for both groups using data from the NIHRD between 2004 and 2010. A Cox proportional-hazards model was used to compare the seven-year stroke-free survival rate and all-cause mortality rate across the two cohorts after adjusting for confounding risk factors. RESULTS: A total of 472 (2.81% patients with bipolar disorder and 1,443 (2.14% controls had strokes over seven years. Patients with bipolar disorder were 1.24 times more likely to have a stroke (95% CI = 1.12-1.38; p<0.0001 after adjusting for demographic characteristics and comorbid medical conditions. In addition, 513 (26.8% patients who had a stroke died during the follow-up period. The all-cause mortality hazard ratio for patients with bipolar disorder was 1.28 (95% CI = 1.06-1.55; p = 0.012 after adjusting for patient, physician and hospital variables. CONCLUSIONS: The likelihood of developing a stroke was greater among patients with bipolar disorder than controls, and the all-cause mortality rate was higher among patients with bipolar disorder than controls during a seven-year follow-up period.

  11. Why do we study animal toxins?

    OpenAIRE

    Zhang, Yun

    2015-01-01

    Venom (toxins) is an important trait evolved along the evolutionary tree of animals. Our knowledges on venoms, such as their origins and loss, the biological relevance and the coevolutionary patterns with other organisms are greatly helpful in understanding many fundamental biological questions, i.e., the environmental adaptation and survival competition, the evolution shaped development and balance of venoms, and the sophisticated correlations among venom, immunity, body power, intelligence,...

  12. Feasibility and efficacy of thrombolysis in acute ischemic stroke: A study from National Institute of Neurological and Allied Sciences, Kathmandu, Nepal

    OpenAIRE

    Lekhjung Thapa; Shikher Shrestha; Pratyush Shrestha; Suman Bhattarai; D N Gongal; Devkota, U P

    2016-01-01

    Background: Stroke is the major cause of morbidity and mortality worldwide. The number of stroke patients receiving recombinant tissue plasminogen activator (rt-PA), also known as Alteplase, in the developing world is extremely low. We aim to study the feasibility and efficacy of thrombolysis for the 1st time in our country. Materials and Methods: In this retrospective study (July 2012-August 2015), acute ischemic stroke patients who were thrombolyzed within 3 h of stroke onset were included....

  13. A COMPARATIVE STUDY OF LIPID PROFILE IN ISCHEMIC STROKE BETWEEN DIAB ETIC AND NON DIABETIC PATIENTS AT TERTIARY CARE CENTRE

    Directory of Open Access Journals (Sweden)

    Jeetendrakumar

    2015-04-01

    Full Text Available BACKGROUND: Dyslipidemia is one of the cardiovascular risk factors, but the association with stroke is not as strong as with heart disease. Diabetic patients who suffered a stroke have hypertension and dyslipidemia in a higher percentage than non - diabetes patients. OBJECTIVES: 1. To compare the lipid profile in ischemic stroke patients among type 2 diabetes mellitus patients and non - diabetic patients in tertiary care hospi tal. METHODS: This study was conducted in Department of General medicine, ESIC - MC & PGIMSR, Rajajinagar, Bangalore. 60 ischemic stroke patients were included in the study, among which 30 type 2 diabetes patients and 30 non diabetes patients were included i n the study. Fasting blood glucose, postprandinal blood sugar, Glycosylated hemoglobin (HbA1c and fasting lipid profile are measured both in diabetic and non - diabetic groups. RESULTS: 60 cases of stroke were studied to compare the lipid profile in diabeti c and non - diabetic patients. The mean serum triglyceride level and mean VLDL cholesterol level in diabetic stroke patients is (365 . 16+49 . 9 and (70 . 3+11 . 42 was significantly higher than in non - diabetic stroke patients is (162 . 16+17 . 33 and ( 33 . 49+4 . 64 r espectively. The mean serum HDL cholesterol level in diabetic stroke patients (22 . 33+3 . 75 was significantly lower than in non - diabetic stroke patients (44 . 7+12 . 41. There was no significant difference in the mean values of serum total and LDL cholesterol levels in diabetic (191 . 63 + 14 . 9 & 100+19 . 62 and non - diabetic (186 . 53+19 . 47 & 96 . 4+8 . 7 stroke patients. Thus the present study showed that diabetic patients with stroke had a significantly higher triglycerides and significantly lower HDL cholesterol level s. The total and LDL cholesterol levels were similar in both groups. CONCLUSION: In conclusion, the present study showed that diabetic patients with stroke had a significantly higher triglycerides and significantly lower

  14. Upper Limb Outcome Measures Used in Stroke Rehabilitation Studies: A Systematic Literature Review

    Science.gov (United States)

    Santisteban, Leire; Térémetz, Maxime; Bleton, Jean-Pierre; Baron, Jean-Claude; Maier, Marc A.; Lindberg, Påvel G.

    2016-01-01

    Background Establishing which upper limb outcome measures are most commonly used in stroke studies may help in improving consensus among scientists and clinicians. Objective In this study we aimed to identify the most commonly used upper limb outcome measures in intervention studies after stroke and to describe domains covered according to ICF, how measures are combined, and how their use varies geographically and over time. Methods Pubmed, CinHAL, and PeDRO databases were searched for upper limb intervention studies in stroke according to PRISMA guidelines and477 studies were included. Results In studies 48different outcome measures were found. Only 15 of these outcome measures were used in more than 5% of the studies. The Fugl-Meyer Test (FMT)was the most commonly used measure (in 36% of studies). Commonly used measures covered ICF domains of body function and activity to varying extents. Most studies (72%) combined multiple outcome measures: the FMT was often combined with the Motor Activity Log (MAL), the Wolf Motor Function Test and the Action Research Arm Test, but infrequently combined with the Motor Assessment Scale or the Nine Hole Peg Test. Key components of manual dexterity such as selective finger movements were rarely measured. Frequency of use increased over a twelve-year period for the FMT and for assessments of kinematics, whereas other measures, such as the MAL and the Jebsen Taylor Hand Test showed decreased use over time. Use varied largely between countries showing low international consensus. Conclusions The results showed a large diversity of outcome measures used across studies. However, a growing number of studies used the FMT, a neurological test with good psychometric properties. For thorough assessment the FMT needs to be combined with functional measures. These findings illustrate the need for strategies to build international consensus on appropriate outcome measures for upper limb function after stroke. PMID:27152853

  15. Animals

    Institute of Scientific and Technical Information of China (English)

    杨光

    2000-01-01

    The largest animal ever to live on the earth is the blue whale(蓝鲸)It weighs about 80 tons--more than 24 elephants. It is more than 30 metres long. A newborn baby whale weighs as much as a big elephant.

  16. Hemorrhagic Stroke

    Science.gov (United States)

    A stroke is a medical emergency. There are two types - ischemic and hemorrhagic. Hemorrhagic stroke is the less common type. It happens when ... an artery wall that breaks open. Symptoms of stroke are Sudden numbness or weakness of the face, ...

  17. Stroke Rehabilitation

    Science.gov (United States)

    A stroke can cause lasting brain damage. People who survive a stroke need to relearn skills they lost because of ... them relearn those skills. The effects of a stroke depend on which area of the brain was ...

  18. Preventing stroke

    Science.gov (United States)

    Stroke - prevention; CVA - prevention; cerebral vascular accident - prevention; TIA - prevention, transient ischemic attack - prevention ... A stroke occurs when the blood supply is cut off to any part of the brain. A stroke is ...

  19. Study on the Prevalence and Corelation of Carotid Atherosclerosis in Stroke Patients

    Institute of Scientific and Technical Information of China (English)

    Wei Hua; Wang Yongjun; Yah Zhenying

    2000-01-01

    Objective To assess the prevalence and severity of carotid atherosclerosis in stroke patients and the risk factors of carotid atherosclerosis. Methods Two hundred fifty-one ischemic stroke patients,46 ccrcbral hemorrhagc patients and 96 control subjects were entercd into this study. Sonographic assessment of the extracranial carotid arteries was performed in all patients. Diametcr. IMT, plaques and percentage ratio of lumen stenosis were observcd. Results (1)The prevalence of carotid plaqucs was prominent in stroke patients than the control subjects(63.0%vs 36.5%). (2)The prevalencc of lumen stenosis>50% in ischemic stroke patients was higher than the cerebral hemorrhage patients and control subjects (15.6% vs 4.3%. 2.1%).(3) The prevalence of severe carotid artery stcnosis(>75%) was promincnt in aged 61~70 years old patients.(4)Our data revealed 30% of the cortical infarction subgroup, 17.5%of the subcortical infarction subgroup, 17% of the lacunar infarction subgroup,8% of the vcrtibral-basilar artery infarction subgroup.2.8% of thc CT normal subgroup possessed carotid stcnosis >50%. (5)Age, diabetes mellitus and ApoAl(inversely) were independent predictors of the extracranial carotid atherosclcrosis. Discusssion (Ⅰ)There is close relation between extracraniai carotid atherosclerosis and ischemic cerebrovascular disease.(2)The extent of serious carotid artery stcnosis in aged patients was lower.(3)Thc severity of extracranial carotid artery atherosclerosis was prominent in patients with conical infarction. Conclusion There is a high prevalence of extracranial carotid atherosclerosis in Chinese stroke patients.

  20. Study protocol: home-based telehealth stroke care: a randomized trial for veterans

    Directory of Open Access Journals (Sweden)

    McGee-Hernandez Nancy

    2010-06-01

    Full Text Available Abstract Background Stroke is one of the most disabling and costly impairments of adulthood in the United States. Stroke patients clearly benefit from intensive inpatient care, but due to the high cost, there is considerable interest in implementing interventions to reduce hospital lengths of stay. Early discharge rehabilitation programs require coordinated, well-organized home-based rehabilitation, yet lack of sufficient information about the home setting impedes successful rehabilitation. This trial examines a multifaceted telerehabilitation (TR intervention that uses telehealth technology to simultaneously evaluate the home environment, assess the patient's mobility skills, initiate rehabilitative treatment, prescribe exercises tailored for stroke patients and provide periodic goal oriented reassessment, feedback and encouragement. Methods We describe an ongoing Phase II, 2-arm, 3-site randomized controlled trial (RCT that determines primarily the effect of TR on physical function and secondarily the effect on disability, falls-related self-efficacy, and patient satisfaction. Fifty participants with a diagnosis of ischemic or hemorrhagic stroke will be randomly assigned to one of two groups: (a TR; or (b Usual Care. The TR intervention uses a combination of three videotaped visits and five telephone calls, an in-home messaging device, and additional telephonic contact as needed over a 3-month study period, to provide a progressive rehabilitative intervention with a treatment goal of safe functional mobility of the individual within an accessible home environment. Dependent variables will be measured at baseline, 3-, and 6-months and analyzed with a linear mixed-effects model across all time points. Discussion For patients recovering from stroke, the use of TR to provide home assessments and follow-up training in prescribed equipment has the potential to effectively supplement existing home health services, assist transition to home and

  1. Stroke burden and stroke care system in Asia

    OpenAIRE

    Suwanwela, Nijasri C.; Niphon Poungvarin; the Asian Stroke Advisory Panel

    2016-01-01

    Background: Stroke is a major cause of death and disability. Asia is the largest and mostly populated continent of the world. The Asian Stroke Advisory Panel (ASAP) consists of stroke neurologists from 12 different countries in 13 Asian regions. It has been established for 17 years, and holds regular meetings for reviewing the stroke activities in Asia. It also helps in conducting several multinational research projects. This study is one of the ASAP projects and aims to explore stroke care s...

  2. SYRCLE's risk of bias tool for animal studies

    OpenAIRE

    C R Hooijmans; Rovers, M M; Vries, R.B.M. de; Leenaars, M.; Ritskes-Hoitinga, M.; Langendam, M.W.

    2014-01-01

    BACKGROUND: Systematic Reviews (SRs) of experimental animal studies are not yet common practice, but awareness of the merits of conducting such SRs is steadily increasing. As animal intervention studies differ from randomized clinical trials (RCT) in many aspects, the methodology for SRs of clinical trials needs to be adapted and optimized for animal intervention studies. The Cochrane Collaboration developed a Risk of Bias (RoB) tool to establish consistency and avoid discrepancies in assessi...

  3. Symptoms of Insomnia and Sleep Duration and Their Association with Incident Strokes: Findings from the Population-Based MONICA/KORA Augsburg Cohort Study.

    Directory of Open Access Journals (Sweden)

    A Katharina Helbig

    Full Text Available To examine the relationship between symptoms of insomnia and sleep duration and incident total (non-fatal plus fatal strokes, non-fatal strokes, and fatal strokes in a large cohort of men and women from the general population in Germany.In four population-based MONICA (monitoring trends and determinants in cardiovascular disease/KORA (Cooperative Health Research in the Region of Augsburg surveys conducted between 1984 and 2001, 17,604 men and women (aged 25 to 74 years were asked about issues like sleep, health behavior, and medical history. In subsequent surveys and mortality follow-ups, incident stroke cases (cerebral hemorrhage, ischemic stroke, transient ischemic attack, unknown stroke type were gathered prospectively until 2009. Sex-specific hazard ratios (HR and their 95% confidence intervals (CI were estimated using sequential Cox proportional hazards regression models.During a mean follow-up of 14 years, 917 strokes (710 non-fatal strokes and 207 fatal strokes were observed. Trouble falling asleep and difficulty staying asleep were not significantly related to any incident stroke outcome in either sex in the multivariable models. Among men, the HR for the association between short (≤5 hours and long (≥10 hours daily sleep duration and total strokes were 1.44 (95% CI: 1.01-2.06 and 1.63 (95% CI: 1.16-2.29, after adjustment for basic confounding variables. As for non-fatal strokes and fatal strokes, in the analyses adjusted for age, survey, education, physical activity, alcohol consumption, smoking habits, body mass index, hypertension, diabetes, and dyslipidemia, the increased risks persisted, albeit somewhat attenuated, but no longer remained significant. Among women, in the multivariable analyses the quantity of sleep was also not related to any stroke outcome.In the present study, symptoms of insomnia and exceptional sleep duration were not significantly predictive of incident total strokes, non-fatal strokes, and fatal strokes in

  4. ANIMALS

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Mammals(哺乳动物)Mammals are the world's most dominant(最占优势的)animal.They are extremely(非常)diverse(多种多样的)creatures(生物,动物)that include(包括)the biggest ever animal (the blue whale鲸,which eats up to 6 tons every day),the smallest(leaf-nosed bat小蹄蝠) and the laziest(sloth树獭,who spends 80% of their time sleeping).There are over 4,600 kinds of mammals and they live in very different environments(环境)—oceans(海洋),rivers,the jungle(丛林),deserts,and plains(平原).

  5. Feasibility study of an integrated stroke self-management programme : a cluster-randomised controlled trial

    OpenAIRE

    Jones, Fiona; Gage, Heather; Drummond, Avril; Bhalla, Ajay; Grant, Robert; Lennon, Sheila; McKevitt, Christopher; Riazi, Afsane; Liston, Matthew

    2016-01-01

    OBJECTIVES: To test the feasibility of conducting a controlled trial into the effectiveness of a self-management programme integrated into stroke rehabilitation. DESIGN: A feasibility cluster-randomised design was utilised with stroke rehabilitation teams as units of randomisation. SETTING: Community-based stroke rehabilitation teams in London. PARTICIPANTS: 78 patients with a diagnosis of stroke requiring community based rehabilitation. INTERVENTION: The interv...

  6. STUDY OF ANAEMIA AS AN INDIVIDUAL RISK FACTOR IN CVA : ISCHEMIC STROKE

    Directory of Open Access Journals (Sweden)

    Prabhu

    2015-07-01

    Full Text Available To identify anaemia as an individual risk factor in CVA patients , in rural population , Chidambaram. In our study a total of 50 patients were identified in a 3 month non - invasive prospective observational study. The risk factors such as anaemia , diabetes , hypertension , smoking and alcohol consumption , were compared. In our study out of 41 males and 9 females the incidence rate of anaemia was found to be more in males than females. Microcytic Hypochromic anaemia and Dimorphic anaemia are the common types of anaemia identified. The stroke incidence rate was found to be more in hypertensive patients , secondary to anaemia and equal in both alcoholic and non - alcoholic patients. Anaemia was found to be the most common risk factor for stroke followed by hypertension in rural population.

  7. Registration of acute stroke

    DEFF Research Database (Denmark)

    Wildenschild, Cathrine; Mehnert, Frank; Thomsen, Reimar Wernich;

    2013-01-01

    BACKGROUND: The validity of the registration of patients in stroke-specific registries has seldom been investigated, nor compared with administrative hospital discharge registries. The objective of this study was to examine the validity of the registration of patients in a stroke-specific registry...... (The Danish Stroke Registry [DSR]) and a hospital discharge registry (The Danish National Patient Registry [DNRP]). METHODS: Assuming that all patients with stroke were registered in either the DSR, DNRP or both, we first identified a sample of 75 patients registered with stroke in 2009; 25 patients...... in the DSR, 25 patients in the DNRP, and 25 patients registered in both data sources. Using the medical record as a gold standard, we then estimated the sensitivity and positive predictive value of a stroke diagnosis in the DSR and the DNRP. Secondly, we reviewed 160 medical records for all potential stroke...

  8. Isolated insular strokes and plasma MR-proANP levels are associated with newly diagnosed atrial fibrillation: a pilot study.

    Directory of Open Access Journals (Sweden)

    Karl Frontzek

    Full Text Available INTRODUCTION: In this study, we assessed the relationship of insular strokes and plasma MR-proANP levels with newly diagnosed atrial fibrillation (NDAF. METHODS: This study is based on a prospective acute stroke cohort (http://www.clinicaltrials.gov, NCT00390962. Patient eligibility was dependent on the diagnosis of acute ischemic stroke, absence of previous stroke based on past medical history and MRI, no history of AF and congestive heart failure (cohort A and, additionally, no stroke lesion size ≥ 20 mL (sub-cohort A*. AF, the primary endpoint, was detected on 24-hour electrocardiography and/or echocardiography. Involvement of the insula was assessed by two experienced readers on MRI blinded to clinical data. MR-proANP levels were obtained through a novel sandwich immunoassay. Logistic-regression-models were fitted to estimate odds ratios for the association of insular strokes and MR-proANP with NDAF. The discriminatory accuracy of insular strokes and MR-proANP was assessed by a model-wise comparison of the area under the receiver-operating-characteristics-curve (AUC with known predictors of AF. RESULTS: 104 (cohort A and 83 (cohort A* patients fulfilled above-mentioned criteria. Patients with isolated insular strokes had a 10.7-fold higher odds of NDAF than patients with a small ischemic stroke at any other location. The AUC of multivariate logistic regression models for the prediction of NDAF improved significantly when adding stroke location and MR-proANP levels. Moreover, MR-proANP levels remained significantly elevated throughout the acute hospitalization period in patients with NDAF compared to those without. CONCLUSIONS: Isolated insular strokes and plasma MR-proANP levels on admission are independent predictors of NDAF and significantly improve the prediction accuracy of identifying patients with NDAF compared to known predictors including age, the NIHSS and lesion size. To accelerate accurate diagnosis and enhance secondary

  9. Comparative Evaluation of Stroke Triage Algorithms for Emergency Medical Dispatchers (MeDS: Prospective Cohort Study Protocol

    Directory of Open Access Journals (Sweden)

    Bloom Evan

    2011-01-01

    Full Text Available Abstract Background Stroke is a major cause of death and leading cause of disability in the United States. To maximize a stroke patient's chances of receiving thrombolytic treatment for acute ischemic stroke, it is important to improve prehospital recognition of stroke. However, it is known from published reports that emergency medical dispatchers (EMDs using Card 28 of the Medical Priority Dispatch System protocols recognize stroke poorly. Therefore, to improve EMD's recognition of stroke, the National Association of Emergency Medical Dispatchers recently designed a new diagnostic stroke tool (Cincinnati Stroke Scale -CSS to be used with Card 28. The objective of this study is to determine whether the addition of CSS improves diagnostic accuracy of stroke triage. Methods/Design This prospective experimental study will be conducted during a one-year period in the 911 call center of Santa Clara County, CA. We will include callers aged ≥ 18 years with a chief complaint suggestive of stroke and second party callers (by-stander or family who are in close proximity to the patient and can administer the tool ≥ 18 years of age. Life threatening calls will be excluded from the study. Card 28 questions will be administered to subjects who meet study criteria. After completion of Card 28, CSS tool will be administered to all calls. EMDs will record their initial assessment of a cerebro-vascular accident (stroke after completion of Card 28 and their final assessment after completion of CSS. These assessments will be compared with the hospital discharge diagnosis (ICD-9 codes recorded in the Office of Statewide Health Planning and Development (OSHPD database after linking the EMD database and OSHPD database using probabilistic linkage. The primary analysis will compare the sensitivity of the two stroke protocols using logistic regression and generalizing estimating equations to account for clustering by EMDs. To detect a 15% difference in sensitivity

  10. Barriers and enablers to implementing multiple stroke guideline recommendations: a qualitative study

    OpenAIRE

    McCluskey, Annie; Vratsistas-Curto, Angela; Schurr, Karl

    2013-01-01

    Background Translating evidence into practice is an important final step in the process of evidence-based practice. Medical record audits can be used to examine how well practice compares with published evidence, and identify evidence-practice gaps. After providing audit feedback to professionals, local barriers to practice change can be identified and targetted with focussed behaviour change interventions. This study aimed to identify barriers and enablers to implementing multiple stroke gui...

  11. Relationship between dressing and motor function in stroke patients: a study with partial correlation analysis

    OpenAIRE

    Fujita, Takaaki; Sato, Atsushi; Yamamoto, Yuichi; Yamane, Kazuhiro; Otsuki, Koji; Tsuchiya, Kenji; Tozato, Fusae

    2015-01-01

    [Purpose] The aim of the present study was to elucidate which motor functions are most or more important for dressing performance before and after rehabilitation. [Subjects] Seventy-nine first episode stroke patients in a hospital convalescent rehabilitation ward. [Methods] The relationships between motor function of the affected upper and lower limbs, unaffected side function, trunk function, balance, cognitive function, and independence level in dressing were examined at admission and disch...

  12. Neighbourhood Environment and Stroke: A Follow-Up Study in Sweden

    OpenAIRE

    Tsuyoshi Hamano; Naomi Kawakami; Xinjun Li; Kristina Sundquist

    2013-01-01

    BACKGROUND: In recent years, research on the association between physical environments and cardiovascular disease outcomes has gained momentum with growing attention being paid to Geographic Information Systems (GIS). This nationwide study is the first to examine the effect of neighbourhood physical environments on individual-level stroke, using GIS-based measures of neighbourhood availability of potentially health-damaging (fast food restaurants and pubs/bars) and health-promoting (physical ...

  13. Stroke, Vascular Dementia, and Alzheimer's Disease: Molecular Links.

    Science.gov (United States)

    Vijayan, Murali; Reddy, P Hemachandra

    2016-09-01

    Stroke is a brain disease that occurs when blood flow stops, resulting in reduced oxygen supply to neurons. Stroke occurs at any time and at any age, but increases after the age of 55. It is the second leading cause of death and the third leading cause of disability-adjusted, life-years. The pathophysiology of ischemic stroke is complex and recent molecular, cellular, and animal models and postmortem brain studies have revealed that multiple cellular changes have been implicated, including oxidative stress/mitochondrial dysfunction, inflammatory responses, micro RNA alterations, and marked changes in brain proteins. These cellular changes provide new information for developing therapeutic strategies for ischemic stroke treatment. Research also revealed that stroke increases with a number of modifiable factors and most strokes can be prevented and/or controlled through pharmacological or surgical interventions and lifestyle changes. Ischemic stroke is the major risk factor for vascular dementia and Alzheimer's disease. This review summarizes the latest research findings on stroke, including causal factors and molecular links between stroke and vascular disease/Alzheimer's disease. PMID:27567871

  14. Long-Term Survival after Stroke: 30 Years of Follow-Up in a Cohort, the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Boysen, G.; Marott, J.L.; Gronbaek, M.;

    2009-01-01

    died before the end of 2007. The National Register of Causes of Death provided cause of death. Survival in stroke patients was compared with survival in participants in the Copenhagen City Heart Study who did not suffer a stroke, and with survival in the general Danish population. Cox regression...... analyses adjusting for age and gender were used to compare survival in six consecutive 4-year periods starting with 1978-1982. Results: Of 2,051 patients with first-ever stroke 1,801 died during follow-up. Causes of death were cerebrovascular disease in 37%, other cardiovascular diseases in 28%, cancer...

  15. Differences in Rheobase and Chronaxie between the Paretic and Non-Paretic Sides of Hemiplegic Stroke Patients: a Pilot Study.

    Science.gov (United States)

    Lee, Won-Deok; Kim, Ju-Hyun; Lee, Jeong-Uk; Kim, Mee-Young; Lee, Lim-Kyu; Yang, Seung-Min; Jeon, Hye-Joo; Lee, Tae-Hyun; Kim, Junghwan

    2013-06-01

    [Purpose] Rheobase and chronaxie are used to confirm muscle degeneration. For stroke patients, however, the uses of rheobase and chronaxie in determining paretic side muscle degeneration is not yet fully understood. Thus, in this study, we examined the electrical properties of the quadriceps muscles of stroke patients' paretic side and compared them with their respective values on the non-paretic side. [Method] The subjects were six stroke patients (three females, three males). The pad of an electrical stimulator was applied to the vastus lateralis and vastus medialis regions to measure rheobase and chronaxie until the contractive muscle response to electrical stimulation became visible. [Result] Rheobase was significantly increased on the paretic side compared to that of the non-paretic side of hemiplegic stroke patients. Furthermore, chronaxie was significantly increased on the paretic side compared to the non-paretic side of hemiplegic stroke patients. [Conclusion] These results suggest that stroke affects the sensitivity of skeletal muscle contraction. Therefore, this data may contribute to our understanding of the muscle status of stroke patients.

  16. Cardiovascular risk factors and 5-year mortality in the Copenhagen Stroke Study

    DEFF Research Database (Denmark)

    Kammersgaard, Lars Peter; Olsen, Tom Skyhøj

    2005-01-01

    BACKGROUND: The treatment of cardiovascular risk factors has improved over the recent years and may have improved survival. The aim of this study was to investigate the up-to-date prognostic significance of cardiovascular risk factors for 5-year survival in a large unselected ischemic stroke...... and questionnaire for cardiovascular risk factors, age, and sex. Follow-up was performed 5 years after stroke, and data on mortality were obtained for all, except 6, who had left the country. Five-year mortality was calculated by the Kaplan-Meier procedure and the influence of multiple predictors was analyzed...... associated with decreased mortality. No association was found for hypertension or intermittent claudication. In the final Cox proportional hazard model predictors of 5-year mortality were AF (hazard ratio, HR 1.4; 95% CI 1.1-1.7), diabetes (HR 1.3; 95% CI 1.0-1.6), smoking (HR 1.2; 95% CI 1...

  17. Psoriasis and risk of atrial fibrillation and ischaemic stroke: a Danish Nationwide Cohort Study

    DEFF Research Database (Denmark)

    Ahlehoff, Ole; Gislason, Gunnar H; Jørgensen, Casper H;

    2011-01-01

    AimsPsoriasis is a chronic inflammatory disease and inflammation contributes to the pathogenesis of atrial fibrillation (AF) and ischaemic stroke. We therefore investigated the risk of these endpoints in patients with psoriasis.Methods and resultsCohort study of the entire Danish population...... followed from 1997 to 2006 by individual-level-linkage of nationwide prospectively recorded registers. Multivariable Poisson's regression and sensitivity analyses were used to assess the psoriasis-related risk of AF and ischaemic stroke. A total of 36 765 patients with mild psoriasis and 2793 with severe...... psoriasis were compared with 4 478 926 individuals, i.e. the reference population. In patients with mild psoriasis, the adjusted rate ratios (RRs) for AF were 1.50 (1.21-1.86) and 1.16 (1.08-1.24) in patients aged...

  18. Increased risk of stroke in hypertensive women using hormone therapy: analyses based on the Danish Nurse Study

    DEFF Research Database (Denmark)

    Løkkegaard, Ellen; Jovanovic, Zorana; Heitmann, Berit L;

    2003-01-01

    BACKGROUND: Recent randomized clinical trials suggest an increased risk of stroke with hormone therapy (HT), whereas observational studies have suggested mixed results. Differences in design, definitions of HT exposure, and stroke outcome may explain these discrepancies. Little attention has been...... paid to identifying subgroups of women who are particularly sensitive to HT. OBJECTIVES: To investigate the risk of various stroke outcomes among women using HT based primarily on estradiol-17beta (unopposed or combined with norethisterone acetate) and to assess the potential modifying effect...... by presence of risk factors for stroke. DESIGN: Prospective cohort study. SETTING: In 1993, the Danish Nurse Study was established, and questionnaires on lifestyle and HT use were sent to all Danish nurses older than 44 years, of whom 19,898 (85.8%) replied. PARTICIPANTS: Postmenopausal women (n = 13...

  19. Conductive Education as a Method of Stroke Rehabilitation: A Single Blinded Randomised Controlled Feasibility Study

    Directory of Open Access Journals (Sweden)

    Judith Bek

    2016-01-01

    Full Text Available Background. Conductive Education for stroke survivors has shown promise but randomised evidence is unavailable. This study assessed the feasibility of a definitive randomised controlled trial to evaluate efficacy. Methods. Adult stroke survivors were recruited through local community notices. Those completing the baseline assessment were randomised using an online program and group allocation was independent. Intervention group participants received 10 weekly 1.5-hour sessions of Conductive Education at the National Institute of Conductive Education in Birmingham, UK. The control group participants attended two group meetings. The study evaluated the feasibility of recruitment procedures, delivery of the intervention, retention of participants, and appropriateness of outcome measures and data collection methods. Independent assessments included the Barthel Index, the Stroke Impact Scale, the Timed Up and Go test, and the Hospital Anxiety and Depression Scale. Results. Eighty-two patients were enrolled; 77 completed the baseline assessment (46 men, mean age 62.1 yrs. and were randomised. 70 commenced the intervention (n=37 or an equivalent waiting period (n=33. 32/37 completed the 10-week training and 32/33 the waiting period. There were no missing items from completed questionnaires and no adverse events. Discussion. Recruitment, intervention, and assessment methods worked well. Transport issues for intervention and assessment appointments require review. Conclusion. A definitive trial is feasible. This trial is registered with ISRCTN84064492.

  20. Analysis of acute ischemic stroke presenting classic lacunar syndrome. A study by diffusion-weighted MRI

    Energy Technology Data Exchange (ETDEWEB)

    Terai, Satoshi; Ota, Kazuki; Tamaki, Kinya [Hakujyuji Hospital, Fukuoka (Japan)

    2002-03-01

    We retrospectively assessed the pathophysiological features of acute ischemic stroke presenting ''classic'' lacunar syndrome by using diffusion-weighted imaging (DWI). Subjects were 16 patients who were admitted to our hospital within 24 hours of stroke onset and underwent DWI examination on admission. These were divided into three categorical groups; pure motor hemiplegia (PMH) in 8, sensorimotor stroke (SMS) in 7, and dysarthria-clumsy hand syndrome (DCHS) in 1. The fresh responsible lesions were identified by DWI in the perforating territory in 7 patients with PMH and 7 with SMS. Four (one had two possible response lesions; pons and corona radiata) and five patients in the respective groups were diagnosed as lacunar infarction on admission (the largest dimension of the lesion measuring smaller than 15 mm). On the contralateral side to the neurological symptoms, DWI revealed high intensities in cortex, subcortical white matter, and anterior and posterior border zones in the remaining one patient with PMH and in the precentral arterial region in one with DCHS. They were diagnosed as atherothrombotic infarction resulting from the occlusion of the internal carotid artery and cerebral embolism due to atrial fibrillation, respectively. Three patients with PMH showed progressive deterioration after admission and follow-up DWI study in an acute stage revealed enlargement of heir ischemic lesions. The present study suggests that DWI is a useful imaging technique for diagnosis of clinical categories and observation for pathophsiological alteration in the acute ischemic stroke patients with ''classic'' lacunar syndrome. Our results also indicate a necessity to be aware that various types of fresh ischemic lesions other than a single lacune might possibly be developing in cases with this syndrome. (author)

  1. Poststroke Epilepsy Is Associated With a High Mortality After a Stroke at Young Age: Follow-Up of Transient Ischemic Attack and Stroke Patients and Unelucidated Risk Factor Evaluation Study

    NARCIS (Netherlands)

    Arntz, R.M.; Rutten-Jacobs, L.C.A.; Maaijwee, N.A.M.M.; Schoonderwaldt, H.C.; Dorresteijn, L.D.; Dijk, E.J. van; Leeuw, F.E. de

    2015-01-01

    BACKGROUND AND PURPOSE: Poststroke epilepsy is a common complication after a young stroke. We investigated the association between poststroke epilepsy and mortality. METHODS: We performed a prospective cohort study among 631 patients with a first-ever transient ischemic attack or ischemic stroke, ag

  2. Poor Long-Term Functional Outcome After Stroke Among Adults Aged 18 to 50 Years: Follow-Up of Transient Ischemic Attack and Stroke Patients and Unelucidated Risk Factor Evaluation (FUTURE) Study

    NARCIS (Netherlands)

    Synhaeve, N.E.; Arntz, R.M.; Maaijwee, N.A.M.M.; Rutten-Jacobs, L.C.A.; Schoonderwaldt, H.C.; Dorresteijn, L.D.A.; Kort, P.L.M. de; Dijk, E.J. van; Leeuw, F.E. de

    2014-01-01

    BACKGROUND AND PURPOSE: Stroke in young adults has a dramatic effect on life; therefore, we investigated the long-term functional outcome after transient ischemic attack, ischemic stroke, or intracerebral hemorrhage in adults aged 18 to 50 years. METHODS: We studied 722 young patients with first-eve

  3. Feasibility and safety of inducing modest hypothermia in awake patients with acute stroke through surface cooling

    DEFF Research Database (Denmark)

    Kammersgaard, L P; Rasmussen, B H; Jørgensen, Henrik Stig;

    2000-01-01

    Hypothermia reduces neuronal damage in animal stroke models. Whether hypothermia is neuroprotective in patients with acute stroke remains to be clarified. In this case-control study, we evaluated the feasibility and safety of inducing modest hypothermia by a surface cooling method in awake patients...

  4. How to calculate sample size in animal studies?

    OpenAIRE

    Jaykaran Charan; N D Kantharia

    2013-01-01

    Calculation of sample size is one of the important component of design of any research including animal studies. If a researcher select less number of animals it may lead to missing of any significant difference even if it exist in population and if more number of animals selected then it may lead to unnecessary wastage of resources and may lead to ethical issues. In this article, on the basis of review of literature done by us we suggested few methods of sample size calculations for animal s...

  5. Preliminary study on the relationship between insulin resistance and stroke during acute stage

    International Nuclear Information System (INIS)

    Objective: To explore whether there are insulin resistance (IR) in the patients with stroke and the relationship between IR and the patients' condition and prognosis. Method: Fasting plasma glucose (FPG), fasting serum insulin and cortisol levels were determined in 30 patients with cerebral infarction, 31 patients with cerebral hemorrhage and 28 normal adults. The insulin sensitivity index (ISI) was calculated and the result was analyzed by linear correlation with the score of neurologic impairment and the size of lesions. Results: The study showed that the levels of FPG, FINS and cortisol of the patients with stroke were significantly higher than those of the control group (p < 0.001); ISI in patient was significantly lower than that in control group (p < 0.001). There were als significant deference in FPG, FINS levels and ISI between the mild group and moderate as well as severe groups of stroke (p < 0.001, p < 0.01, p < 0.05). ISI was negatively also correlated with area of infarction and volume of haemorrhage (r = -0.372, r -0.406, p < 0.05). It was also negatively correlated with the score of neurologic impairment (r = -0.321, p < 0.05). The mortality rate and the disability rate in moderate and severe groups were higher than those in mild group. Conclusion: There were presence of IR in the patients with stroke. The insulin level and IR during acute stage were correlated with patients condition and prognosis. It was suggested that insulin should be used to treat the patients with presence of IR (high plasma glucose level and low ISI)

  6. Association between Carotid Artery Stenosis and Cognitive Impairment in Stroke Patients: A Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Wei Yue

    Full Text Available To investigate potential associations between carotid artery stenosis and cognitive impairment among patients with acute ischemic stroke and to provide important clinical implications. We measured the degree of carotid artery stenosis and recorded the Mini-Mental State Examination score (MMSE at admission in 3116 acute ischemic stroke patients. The association between carotid stenosis and cognitive impairment assessed by MMSE was tested using multivariate regression analysis. Other clinical variables of interest were also studied. After adjusting for age, gender, education level, marriage, alcohol use, tobacco use, physical activity, hypertension, diabetes, hypercholesterolemia, atrial fibrillation, myocardial infarction and NIHSS (National Institutes of Health Stroke Scale score, we found that participants with high-grade stenosis of the carotid artery had a higher likelihood of cognitive impairment compared to those without carotid artery stenosis (OR = 1.49, 95%CI: 1.05-2.11, p<0.001. Left common carotid artery stenosis was associated with cognitive impairment in the univariate analysis, although this effect did not persist after adjustment for the NIHSS score. Cognitive impairment was associated with high-grade stenosis of the right carotid artery.

  7. Nurses’ Empowerment in Self-Care Education to Stroke Patients: An Action Research Study

    Science.gov (United States)

    Aslani, Zahra; Alimohammadi, Nasrollah; Taleghani, Fariba; Khorasani, Parvaneh

    2016-01-01

    ABSTRACT Background: Self-care needs are major problems among stroke patients. Nurses can support them through interventions such as education, a change in their attitude and emphasis on their remaining abilities. However, research has shown some weak points in the quality of care given to these patients. So the aim of this study was to improve the nurses’ practice in self-care education to stroke patients. Methods: The findings of evaluation phase showed that during action research, approaching the nurses’ empowerment in self-care education to stroke patients has been set in motion. The nursing practice improvement, knowledge based practice, nurses’ attitude change, ability to respond against routinization, and motivation promotion emphasize the success of change process. Facilitators and barriers of educating patients are acknowledged by the participants as a factor influencing the continuation of change. Results: The lack of nurses’ educating performance skills was overcome using action research and changes were made to improve the performance of nurses. Conclusions: The lack of nurses’ educating performance skills was overcome using action research and changes were made to improve the performance of nurses. PMID:27713896

  8. Effect of vitamin C supplementation on stroke recovery: A case-control study

    Directory of Open Access Journals (Sweden)

    Meheroz H Rabadi

    2007-04-01

    Full Text Available Meheroz H Rabadi1, Bruce S Kristal2,31Burke Rehabilitation Hospital, an affiliate of Weill Medical College of Cornell Medical College, White Plains, NY, USA; 2Burke Medical Research Institute, an affiliate of Weill Medical College of Cornell Medical College, White Plains, NY, USA; 3Department of Neuroscience, Cornell University Medical College, White Plains, NY, USABackground and purpose: Epidemiological studies have associated increased dietary intake of antioxidants (vitamin C, E, and β-carotene in preventing and decreasing the extent of ischemic brain injury. The effect of vitamin C supplementation on functional recovery after stroke has not been studied. Method: In this retrospective, case-control study of 23 patients with ischemic stroke taking vitamin C were identified and matched for age, sex, onset to admission, and admission total functional independence measure (TFIM with 23 patients with ischemic stroke not taking Vitamin C supplementation. Vitamin C 1000 mg daily was prescribed on admission to our unit mainly to patients who were undernourished (defined as significant weight loss and/or 90% or less ideal body weight for age and sex and those with pressure sores. The outcome measures were: change in the TFIM, FIM-Cognition (FIM-Cog, and FIM-Motor sub-scores, discharge disposition, and length of stay (LOS.Results: The change in TFIM (20 ± 13 standard deviation [SD] vs. 26 ± 6, p = 0.20, FIM-Cog (3 ± 3 SD vs. 4 ± 5, p = 0.41, FIM-Motor (15 ± 11 SD vs. 20 ± 13, p = 0.21 sub-scores were less in the vitamin C treated group, but these differences did not reach statistical significance. Similarly, no significant differences were found in LOS (21 ± 9 SD vs. 23 ± 9, p = 0.59, and discharge disposition (home/institution (9/10 vs. 13/9, p = 0.60 between the vitamin C and the control groups.Conclusion: This study suggests vitamin C supplementation did not enhance functional recovery in undernourished ischemic stroke patients

  9. Death as a result of heat stroke in a vehicle: an adult case in winter confirmed with reconstruction and animal experiments.

    Science.gov (United States)

    Ng'walali, P M; Kibayashi, K; Yonemitsu, K; Ohtsu, Y; Tsunenari, S

    1998-12-01

    A 54-year-old man was found dead in the driver's seat of his vehicle on a winter's day. Investigations of the vehicle revealed that the engine was running, and the car heater was left on with the maximum temperature and velocity. The body was found excessively sweating. Rectal temperature of the body was 43 degrees C at 10 h post mortem. In autopsy, several superficial skin burns were observed on the face, the shoulders and the legs. The lungs were heavily congested and hemorrhagic. The liver showed typical alcohol-induced micronodular cirrhosis. The alcohol concentrations were 0.17% in the blood of both the left and the right heart, 0.17% in the femoral-vein blood, 0.21% in the bladder urine and 0.34% in the gastric contents. A reconstruction experiment demonstrated that the temperature inside the vehicle rose rapidly and reached 50-58 degrees C in 3 h. Animal experiments showed that the temperature threshold for rats to succumb to heat was between 40 and 45 degrees C. This case shows that heat stroke in a vehicle can occur in adults with chronic diseases or alcoholism, such as in this particular case, even in the winter. PMID:15335516

  10. A study on risk factors and lipid profile pattern in patients of stroke in Osmania General Hospital, Hyderabad, India

    Directory of Open Access Journals (Sweden)

    Ravala Siddeswari

    2015-11-01

    Results: A total of 100 patients were studied. There were 72 males and 28 females. Patients with age 60 years were 33, with a mean age of 57.6 +/- 12.15. Out of 100 patients, 82 had ischemic stroke and 18 had hemorrhagic stroke. In this study, patients with high LDL were 21, with mean LDL of 93.28 +/- 38.26, high total cholesterol were 20, with a mean of 151.73 +/- 47.65, low HDL cholesterol in 66, with mean of 35.29 +/- 11.26, high triglycerides in 8, with a mean of 119.43 +/- 58.09. Dyslipidemia (LDL>130; TC>200; HDL2 risk factors were found in 23. There were 6 deaths. Conclusions: In the present study common risk factors observed were male sex, mean age of 40-60 years and hypertension. Dyslipidemia as per ATP III guidelines was present in 14% of stroke patients. Most of the patients were having low HDL (<40 mg/dL which is a risk factor for stroke. This study enlightens the role of HDL in development of stroke which is having a protective role in preventing stroke. [Int J Res Med Sci 2015; 3(11.000: 3337-3341

  11. Acute hemorrhagic stroke in young adults-a study in a tertiary-care hospital of North India

    OpenAIRE

    Baidya, Omkar Prasad; Tiwari, Sunita; Usman, Kauser

    2015-01-01

    Objectives: To see the risk factors, clinical presentations and radiological profile of acute hemorrhagic stroke in young subjects in a tertiary-care hospital of North India.Methods: This study was carried out among 50 acute hemorrhagic stroke patients (clinically and radiologically confirmed) irrespective of sex within the age group of 15-45 years admitted to Department of Medicine after getting clearance from Institutional Ethical Committee (IEC). A proforma for each of the acute hemorrhagi...

  12. Paramedic Initiated Lisinopril For Acute Stroke Treatment (PIL-FAST: study protocol for a pilot randomised controlled trial

    Directory of Open Access Journals (Sweden)

    McColl Elaine

    2011-06-01

    Full Text Available Abstract Background High blood pressure during acute stroke is associated with poorer stroke outcome. Previous trials have failed to show benefit from lowering blood pressure but treatment may have been commenced too late to be effective. The earliest that acute stroke treatments could be initiated is during contact with the emergency medical services (paramedics. However, experience of pre-hospital clinical trials is limited and logistical challenges are likely to be greater than for trials performed in other settings. We report the protocol for a pilot randomised controlled trial of paramedic initiated blood pressure lowering treatment for hypertension in acute stroke. Methods Trial Design: Double blind parallel group external pilot randomised controlled trial. Setting: Participant recruitment and initial treatment by North East Ambulance Service research trained paramedics responding to the emergency call. Continued treatment in three study hospitals. Participants: Target is recruitment of 60 adults with acute arm weakness due to suspected stroke (within 3 hours of symptom onset and hypertension (systolic BP>160 mmHg. Intervention: Lisinopril 5-10 mg (intervention group, matched placebo (control group, daily for 7 days. Randomisation: Study medication contained within identical pre-randomised "trial packs" carried by research trained paramedics. Outcomes: Study feasibility (recruitment rate, compliance with data collection and clinical data to inform the design of a definitive randomised controlled trial (blood pressure monitoring, National Institute of Health Stroke Scale, Barthel ADL Index, Modified Rankin Scale, renal function. Discussion This pilot study is assessing the feasibility of a randomised controlled trial of paramedic initiated lisinopril for hypertension early after the onset of acute stroke. The results will inform the design of a definitive RCT to evaluate the effects of very early blood pressure lowering in acute stroke

  13. Epidemiological study of incidence and risk factors of Ischemic stroke subtypes according to Trial of ORG 10172 in acute stroke treatment criteria: A 3 years, hospital-based study

    Directory of Open Access Journals (Sweden)

    Pushpendra Nath Renjen

    2015-01-01

    Full Text Available Background and Purpose: The purpose of this study was to determine the incidence and risk factor of ischemic stroke subtypes by a mechanism-based classification scheme (Trial of ORG 10172 in Acute Stroke Treatment [TOAST]. Materials and Methods: This study was conducted in Indraprastha Apollo Hospital, New Delhi, between 01/01/2004 and 31/12/2006. Out of 361 admitted stroke patients, 244 (67.59% ischemic stroke patients were analyzed retrospectively for incidence and modifiable risk factors for stroke in our region. The cause of ischemic stroke was classified according to the TOAST criteria. Results: Out of 244 patients 165 (67.6% were male and 79 (32.4% were female, the mean age at the time of stroke was 57.1 years, the incidence of different risk factors were as follows: 139 (56.9%, odds ratio 2.71 hypertensive, 85 (34.8%, odds ratio 2.4 diabetics, 95 (38.9%, odds ratio 3.12 smokers, 58 (23.7%, odds ratio 5.34 dyslipidemics, 44 (18.0%, odds ratio 1.43 coronary artery disease (CAD patients, 14 (5.7%, odds ratio 1.22 patients have the transient ischemic stroke in the past, 13 (5.3%, odds ratio 1.43 were given the history of atrial fibrillation. The incidence rates of ischemic stroke subtypes were as follows: Determined causes; large artery atherosclerosis 141 (57.7%, lacunes 18 (7.7%, cardio-embolism 11 (4.5%, hypercoagulable state 8 (3.2%, un-determined causes; atherosclerosis and/or lacunes 25 (10.2%, embolism and/or two more (hypercoagulable state/CAD possible causes 7 (2.8%, negative evaluation in 34 (13.9% patients. Ischemic stroke subtype according to the TOAST criteria was a significant predictor for long-term survival. Conclusions: Our data indicate that large vessel disease is a major cause, and the hypertension, diabetes, smoking, hyperlipidemia are the most common risk factors for Ischemic stroke.

  14. Population-based study of ABCD2 score, carotid stenosis, and atrial fibrillation for early stroke prediction after transient ischemic attack: the North Dublin TIA study.

    LENUS (Irish Health Repository)

    Sheehan, Orla C

    2010-05-01

    Transient ischemic attack (TIA) etiologic data and the ABCD(2) score may improve early stroke risk prediction, but studies are required in population-based cohorts. We investigated the external validity of the ABCD(2) score, carotid stenosis, and atrial fibrillation for prediction of early recurrent stroke after TIA.

  15. A study on clinical profile of stroke in young and elderly in GMERS Medical College and Hospital, Gandhinagar, Gujarat

    Directory of Open Access Journals (Sweden)

    Chirayu V. Vaidya

    2014-08-01

    Full Text Available Background: The cerebrovascular stroke is one of the leading causes of morbidity and mortality in adult life. Indian studies have shown a stroke prevalence of 471.58/100000 population. Stroke mostly occurs in elderly people. Risk factors for stroke differ between young and elderly patients. The aim was to study the clinical presentation, risk factors, types, topography as per CT scan findings in and #8804;45 years and >45 years patients from GMERS medical college and hospital Gandhinagar. Methods: This is a retrospective study of all new patients managed for stroke in the medical ward of GMERS medical college and hospital, Gandhinagar, Gujarat from January1, 2012 to December 31, 2013. Results: Incidence of stroke in elderly ( and #8805;45 years was than young (<45 years patients with male predominance in both the groups. Most common clinical presentation from both age groups was hemiplegia (75% in young vs. 72.1% in elderly. Common risk factors in were HT and past h/o CVD (25% and smoking (16.6% in young and HT (37.1%, dyslipidemia and smoking (14.3% in elderly. Most common type of stroke in both age groups was ischemic (83.3% in young vs. 73.2% in elderly, followed by Hemorrhagic. Common sites of hemorrhage in young and elderly were lobar and thalamoganglionic. Most common infarction site in both age groups is MCA territory. Conclusion: The cerebrovascular stroke was more in elderly with hypertension and smoking was the most common risk factor in both age groups and most common type was ischemic. [Int J Res Med Sci 2014; 2(4.000: 1446-1452

  16. Predictors of functional level and quality of life at 6 months after a first-ever stroke: the KOSCO study.

    Science.gov (United States)

    Chang, Won Hyuk; Sohn, Min Kyun; Lee, Jongmin; Kim, Deog Young; Lee, Sam-Gyu; Shin, Yong-Il; Oh, Gyung-Jae; Lee, Yang-Soo; Joo, Min Cheol; Han, Eun Young; Kang, Chung; Kim, Yun-Hee

    2016-06-01

    Predicting functional outcome and quality of life (QOL) is critical to the treatment of patients with stroke. The purpose of this study was to analyze the factors influencing functional status and QOL of stroke patients 6 months after a first-ever stroke. This study was an interim analysis of the Korean Stroke Cohort for Functioning and Rehabilitation Study, designed to include 10 years of follow-up for first-ever stroke patients. This study analyzed data from 2857 patients who completed face-to-face assessments with the functional independence measurement (FIM) and Euro Quality of Life-5D (EQ-5D) at 6 months after stroke onset. A multivariate regression analysis was used to analyze factors that potentially influenced FIM and EQ-5D results at 6 months after stroke. Of the patients in this study, 80.1 % suffered from ischemic stroke and 19.9 % experienced hemorrhagic stroke. The independent predictors of functional independency measured by FIM at 6 months after stroke were age, initial stroke severity, duration of hospitalization, and functional level at discharge in terms of motor, ambulation, and language. For QOL measured by EQ-5D at 6 months after stroke, age, duration of hospitalization, and motor function at discharge were significant predictors. In conclusion, proper treatment to achieve maximal functional gain at discharge may be an important factor in improving functional independency and QOL in chronic stage stroke survivors. These results provide useful information for establishing comprehensive and systematic care for stroke patients. PMID:27113602

  17. CITICOLIN IN THE TREATMENT OF STROKE AND VASCULAR COGNITIVE DISORDERS

    Directory of Open Access Journals (Sweden)

    Vladimir Anatol'evich Parfenov

    2009-01-01

    Full Text Available Citicolin (ceraxon is used as a neuroprotector in the treatment of acute stroke and vascular cognitive disorders. Experimental animal studies have demonstrated that citicolin reduces the extent of cerebral infarct and increases the degree of functional recovery. A few clinical trials have provided evidence for the efficacy of intravenous or oral citicolin used within the first 24 hours of ischemic stroke or cerebral hemorrhage in recovery of neurological functions. Citicolin is effective in memory and behavioral disorders in elderly patients with chronic cerebrovascular diseases. The use of citicolin has been found to be safe in stroke and vascular cognitive disorders

  18. Increased risk of ischemic stroke in young patients with ankylosing spondylitis: a population-based longitudinal follow-up study.

    Directory of Open Access Journals (Sweden)

    Chia-Wei Lin

    Full Text Available BACKGROUND: Prospective data on the association between ischemic stroke and ankylosing spondylitis (AS in the young are sparse. The purpose of this population-based, age- and sex-matched longitudinal follow-up study was to investigate the risk of developing ischemic stroke in young patients with AS. METHODS: A total of 4562 patients aged 18- to 45-year-old with at least two ambulatory visits in 2001 with a principal diagnosis of AS were enrolled in the AS group. The non-AS group consisted of 22810 age- and sex-matched, randomly sampled subjects without AS. The two-year ischemic stroke-free survival rate for each group were calculated using the Kaplan-Meier method. Cox proportional hazards regression analysis was used to estimate the hazard ratio of ischemic stroke after adjusting for demographic and clinical covariates. RESULTS: During follow-up, 21 patients in the AS group and 53 in the non-AS group developed ischemic stroke. The ischemic stroke-free survival rate over the 2 year follow-up was lower in the AS group than the non-AS group (p = 0.0021. The crude hazard ratio of ischemic stroke for the AS group was 1.98 (95% CI, 1.20-3.29; p = 0.0079 and the adjusted hazard ratio after controlling for demographic and comorbid medical disorders was 1.93 (95% CI, 1.16-3.20; p = 0.0110. CONCLUSION: Our study showed an increased risk of developing ischemic stroke in young patients with AS.

  19. Functional, cognitive and psychological outcomes, and recurrent vascular events in Pakistani stroke survivors: a cross sectional study

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    Khan Maria

    2012-02-01

    Full Text Available Abstract Background There is little direct data describing the outcomes and recurrent vascular morbidity and mortality of stroke survivors from low and middle income countries like Pakistan. This study describes functional, cognitive and vascular morbidity and mortality of Pakistani stroke survivors discharged from a dedicated stroke center within a nonprofit tertiary care hospital based in a multiethnic city with a population of more than 20 million. Methods Patients with stroke, aged > 18 years, discharged alive from a tertiary care centre were contacted via telephone and a cross sectional study was conducted. All the discharges were contacted. Patients or their legal surrogate were interviewed regarding functional, cognitive and psychological outcomes and recurrent vascular events using standardized, pretested and translated scales. A verbal autopsy was carried out for patients who had died after discharge. Stroke subtype and risk factors data was collected from the medical records. Subdural hemorrhages, traumatic ICH, subarachnoid hemorrhage, iatrogenic stroke within hospital and all other diagnoses that presented like stroke but were subsequently found not to have stroke were also excluded. Composites were created for functional outcome variable and depression. Data were analyzed using logistic regression. Results 309 subjects were interviewed at a median of 5.5 months post discharge. 12.3% of the patients had died, mostly from recurrent vascular events or stroke complications. Poor functional outcome defined as Modified Rankin Score (mRS of > 2 and a Barthel Index (BI score of p = 0.01, moderate to severe dementia (Adj-OR-19.1, p p = 0.02 and multiple post stroke complications (Adj-OR-3.6, p = 0.02 were independent predictors of poor functional outcome. Cognitive outcomes were poor in 42% and predictors of moderate to severe dementia were depression (Adj-OR-6.86, p p = 0.01, presence of bed sores (Adj-OR-17.13, p = 0.01 and history of

  20. Traditional Chinese Medicine Decreases the Stroke Risk of Systemic Corticosteroid Treatment in Dermatitis: A Nationwide Population-Based Study

    Science.gov (United States)

    Tsai, Kao-Sung; Yen, Chia-Sung; Wu, Po-Yuan; Chiang, Jen-Huai; Shen, Jui-Lung; Yang, Chung-Hsien; Chen, Huey-Yi; Chen, Yung-Hsiang; Chen, Wen-Chi

    2015-01-01

    Epidemiological studies have shown a strong association between dermatitis and stroke. Systemic corticosteroid, the mainstay treatment for dermatitis, could enhance the atherosclerotic process. Traditional Chinese Medicine (TCM) has been used for dermatitis to decrease the side effects of corticosteroid. However, the different stroke risk in dermatitis patients treated with systemic corticosteroid or TCM remains unclear. This study identified 235,220 dermatitis patients and same comorbidity matched subjects between 2000 and 2009 from database of NHRI in Taiwan. The two cohorts were followed until December 31, 2011. The primary outcome of interest was new diagnosis of stroke. The crude hazard ratio (HR) for future stroke among dermatitis patients treated with systemic corticosteroid was 1.40 (95% CI, 1.34–1.45; P < 0.0001) and TCM was 1.09 (95% CI, 1.05–1.13; P < 0.0001). The log-rank test showed a higher cumulative incidence of ischemic stroke in the patient treated with only systemic corticosteroid group than that treated with systemic corticosteroid and TCM, only TCM, and neither systemic corticosteroid nor TCM in the matched cohort during the follow-up period (P < 0.0001). We demonstrated that patients treated with systemic corticosteroid had an increased risk of stroke and that the risk probably decreased by TCM treatment. PMID:26508980

  1. Traditional Chinese Medicine Decreases the Stroke Risk of Systemic Corticosteroid Treatment in Dermatitis: A Nationwide Population-Based Study

    Directory of Open Access Journals (Sweden)

    Kao-Sung Tsai

    2015-01-01

    Full Text Available Epidemiological studies have shown a strong association between dermatitis and stroke. Systemic corticosteroid, the mainstay treatment for dermatitis, could enhance the atherosclerotic process. Traditional Chinese Medicine (TCM has been used for dermatitis to decrease the side effects of corticosteroid. However, the different stroke risk in dermatitis patients treated with systemic corticosteroid or TCM remains unclear. This study identified 235,220 dermatitis patients and same comorbidity matched subjects between 2000 and 2009 from database of NHRI in Taiwan. The two cohorts were followed until December 31, 2011. The primary outcome of interest was new diagnosis of stroke. The crude hazard ratio (HR for future stroke among dermatitis patients treated with systemic corticosteroid was 1.40 (95% CI, 1.34–1.45; P<0.0001 and TCM was 1.09 (95% CI, 1.05–1.13; P<0.0001. The log-rank test showed a higher cumulative incidence of ischemic stroke in the patient treated with only systemic corticosteroid group than that treated with systemic corticosteroid and TCM, only TCM, and neither systemic corticosteroid nor TCM in the matched cohort during the follow-up period (P<0.0001. We demonstrated that patients treated with systemic corticosteroid had an increased risk of stroke and that the risk probably decreased by TCM treatment.

  2. A genome-wide association study identifies a gene network of ADAMTS genes in the predisposition to pediatric stroke.

    Science.gov (United States)

    Arning, Astrid; Hiersche, Milan; Witten, Anika; Kurlemann, Gerhard; Kurnik, Karin; Manner, Daniela; Stoll, Monika; Nowak-Göttl, Ulrike

    2012-12-20

    Pediatric stroke is a rare but highly penetrant disease with a strong genetic background. Although there are an increasing number of genome-wide association studies (GWASs) for stroke in adults, such studies for stroke of pediatric onset are lacking. Here we report the results of the first GWAS on pediatric stroke using a large cohort of 270 family-based trios. GWAS was performed using the Illumina 370 CNV single nucleotide polymorphisms array and analyzed using the transmission disequilibrium test as implemented in PLINK. An enrichment analysis was performed to identify additional true association signals among lower P value signals and searched for cumulatively associated genes within protein interaction data using dmGWAS. We observed clustering of association signals in 4 genes belonging to one family of metalloproteinases at high (ADAMTS12, P = 2.9 × 10(-6); ADAMTS2, P = 8.0 × 10(-6)) and moderate (ADAMTS13, P = 9.3 × 10(-4); ADAMTS17, P = 8.5 × 10(-4)) significance levels. Over-representation and gene-network analyses highlight the importance of the extracellular matrix in conjunction with members of the phosphoinositide and calcium signaling pathways in the susceptibility for pediatric stroke. Associated extracellular matrix components, such as ADAMTS proteins, in combination with misbalanced coagulation signals as unveiled by gene network analysis suggest a major role of postnatal vascular injury with subsequent thrombus formation as the leading cause of pediatric stroke. PMID:22990015

  3. Predictors of Poststroke Health-Related Quality of Life in Nigerian Stroke Survivors: A 1-Year Follow-Up Study

    Directory of Open Access Journals (Sweden)

    Ashiru Mohammad Hamza

    2014-01-01

    Full Text Available This study aims to identify the predictors in the different aspects of the health-related quality of life (HRQoL and to measure the changes of functional status over time in a cohort of Nigerian stroke survivors. A prospective observational study was conducted in three hospitals of Kano state of Nigeria where stroke survivors receive rehabilitation. The linguistic-validated Hausa versions of the stroke impact scale 3.0, modified Rankin scale, Barthel index and Beck depression inventory scales were used. Paired samples t-test was used to calculate the amount of changes that occur over time and the forward stepwise linear regression model was used to identify the predictors. A total of 233 stroke survivors were surveyed at 6 months, and 93% (217/233 were followed at 1 year after stroke. Functional disabilities were significantly reduced during the recovery phase. Motor impairment, disability, and level of depression were independent predictors of HRQoL in the multivariate regression analysis. The involvement of family members as caregivers is the key factor for those survivors with improved functional status. Thus, to enhance the quality of poststroke life, it is proposed that a holistic stroke rehabilitation service and an active involvement of family members are established at every possible level.

  4. Reviewing existing knowledge prior to conducting animal studies.

    Science.gov (United States)

    Knight, Andrew

    2008-12-01

    Highly polarised viewpoints about animal experimentation have often prevented agreement. However, important common ground between advocates and opponents was demonstrated within a discussion forum hosted at www.research-methodology.org.uk in July-August 2008, by the independent charity, SABRE Research UK. Agreement existed that many animal studies have methodological flaws - such as inappropriate sample sizes, lack of randomised treatments, and unblinded outcome assessments - that may introduce bias and limit statistical validity. There was also agreement that systematic reviews of the human utility of animal models yield the highest quality of evidence, as their reliance on methodical and impartial methods to select significant numbers of animal studies for review, serves to minimise bias. Unfortunately, disagreement remained that animal experimental licence applications should reference systematic reviews of existing studies, before approval. The UK Medical Research Council requires that researchers planning human clinical trials must reference such reviews of related previous work. Existing knowledge is thereby fully and appropriately utilised, and redundant experimentation is avoided. However, objections were raised that a similar requirement would interfere with animal experimental licensing, because, to date, there have been very few systematic reviews of animal studies. In fact, the relative dearth of such reviews is a matter of considerable concern, and may partially explain the very poor human success rates of drugs that appear safe and/or efficacious in animal trials. Nevertheless, the disturbing number of human trials which have proceeded concurrently with, or prior to, animal studies, or have continued despite equivocal evidence of efficacy in animals, clearly demonstrate that many researchers fail to conduct adequate prior reviews of existing evidence. Where neither sufficient primary studies, nor systematic reviews of such studies, exist, for citation

  5. Association of dementia with death after ischemic stroke: A two-year prospective study

    Science.gov (United States)

    Gao, Chang-Yue; Lian, Yan; Zhang, Meng; Zhang, Li-Li; Fang, Chuan-Qing; Deng, Juan; Li, Jing; Xu, Zhi-Qiang; Zhou, Hua-Dong; Wang, Yan-Jiang

    2016-01-01

    The association between dementia and the risk of death after ischemic stroke was investigated. Neurological, neuropsychological and functional assessments were evaluated in 619 patients with acute ischemic stroke. Dementia was diagnosed at admission and at three months after stroke onset. The patients were scheduled for a two-year follow-up after the index stroke. The Kaplan-Meier survival and Cox proportional hazards regression analyses were used to estimate the cumulative proportion of survival, and the association between dementia and risk of death after stroke. In total, 146 patients (23.6%) were diagnosed with dementia after stroke. The cumulative proportion of surviving cases was 49.3% in patients with dementia after a median follow-up of 21.2±5.6 months, and 92.5% in patients without dementia. Multivariate analysis revealed that dementia (HR, 7.21; 95% CI, 3.85–13.49) was associated with death, independent of age, atrial fibrillation, previous stroke and NIH stroke scale. In conclusion, the mortality rate is increased in stroke patients with dementia. Dementia is an important risk factor for death after stroke, independent of age, atrial fibrillation, previous stroke, and the severity of the stroke.

  6. [Cerebellar stroke].

    Science.gov (United States)

    Paradowski, Michał; Zimny, Anna; Paradowski, Bogusław

    2015-01-01

    Cerebellar stroke belongs to a group of rare diseases of vascular origin. Cerebellum, supplied by three pairs of arteries (AICA, PICA, SCA) with many anastomoses between them is less susceptible for a stroke, especially ischemic one. Diagnosis of the stroke in this region is harder due to lower sensibility of commonly used CT of the head in case of stroke suspicion. The authors highlight clinical symptoms distinguishing between vascular territories or topographical locations of the stroke, diagnostic procedures, classical and surgical treatment, the most common misdiagnoses are also mentioned. The authors suggest a diagnostic and therapeutic algorithm development, including rtPA treatment criteria for ischemic cerebellar stroke. PMID:26181157

  7. Study protocol of the YOU CALL - WE CALL TRIAL: impact of a multimodal support intervention after a "mild" stroke

    Directory of Open Access Journals (Sweden)

    Bravo Gina

    2010-01-01

    Full Text Available Abstract Background More than 60% of new strokes each year are "mild" in severity and this proportion is expected to rise in the years to come. Within our current health care system those with "mild" stroke are typically discharged home within days, without further referral to health or rehabilitation services other than advice to see their family physician. Those with mild stroke often have limited access to support from health professionals with stroke-specific knowledge who would typically provide critical information on topics such as secondary stroke prevention, community reintegration, medication counselling and problem solving with regard to specific concerns that arise. Isolation and lack of knowledge may lead to a worsening of health problems including stroke recurrence and unnecessary and costly health care utilization. The purpose of this study is to assess the effectiveness, for individuals who experience a first "mild" stroke, of a sustainable, low cost, multimodal support intervention (comprising information, education and telephone support - "WE CALL" compared to a passive intervention (providing the name and phone number of a resource person available if they feel the need to - "YOU CALL", on two primary outcomes: unplanned-use of health services for negative events and quality of life. Method/Design We will recruit 384 adults who meet inclusion criteria for a first mild stroke across six Canadian sites. Baseline measures will be taken within the first month after stroke onset. Participants will be stratified according to comorbidity level and randomised to one of two groups: YOU CALL or WE CALL. Both interventions will be offered over a six months period. Primary outcomes include unplanned use of heath services for negative event (frequency calendar and quality of life (EQ-5D and Quality of Life Index. Secondary outcomes include participation level (LIFE-H, depression (Beck Depression Inventory II and use of health services for

  8. The Potential of Adaptive Design in Animal Studies

    OpenAIRE

    Arshad Majid; Ok-Nam Bae; Jessica Redgrave; Dawn Teare; Ali Ali; Daniel Zemke

    2015-01-01

    Clinical trials are the backbone of medical research, and are often the last step in the development of new therapies for use in patients. Prior to human testing, however, preclinical studies using animal subjects are usually performed in order to provide initial data on the safety and effectiveness of prospective treatments. These studies can be costly and time consuming, and may also raise concerns about the ethical treatment of animals when potentially harmful procedures are involved. Adap...

  9. Stroke risk perception among participants of a stroke awareness campaign

    Directory of Open Access Journals (Sweden)

    Heuschmann Peter U

    2007-03-01

    Full Text Available Abstract Background Subjective risk factor perception is an important component of the motivation to change unhealthy life styles. While prior studies assessed cardiovascular risk factor knowledge, little is known about determinants of the individual perception of stroke risk. Methods Survey by mailed questionnaire among 1483 participants of a prior public stroke campaign in Germany. Participants had been informed about their individual stroke risk based on the Framingham stroke risk score. Stroke risk factor knowledge, perception of lifetime stroke risk and risk factor status were included in the questionnaire, and the determinants of good risk factor knowledge and high stroke risk perception were identified using logistic regression models. Results Overall stroke risk factor knowledge was good with 67–96% of the participants recognizing established risk factors. The two exceptions were diabetes (recognized by 49% and myocardial infarction (57%. Knowledge of a specific factor was superior among those affected by it. 13% of all participants considered themselves of having a high stroke risk, 55% indicated a moderate risk. All major risk factors contributed significantly to the perception of being at high stroke risk, but the effects of age, sex and education were non-significant. Poor self-rated health was additionally associated with high individual stroke risk perception. Conclusion Stroke risk factor knowledge was high in this study. The self perception of an increased stroke risk was associated with established risk factors as well as low perception of general health.

  10. Animal models of post stroke depression and its observations%脑卒中后抑郁的动物模型及其观测指标研究进展

    Institute of Scientific and Technical Information of China (English)

    李伟; 张春红; 黄武言

    2015-01-01

    研究显示脑卒中后抑郁(PSD)的发病机制主要分为两大类:即“原发性内源性学说”和“反应性机制学说”。原发性内源性学说即 PSD 的生物学机制,反应性机制学说认为 PSD 是社会心理生物因素综合作用的结果。临床主要从药物、针灸、康复训练、心理干预、音乐、低能量激光、重复经颅刺激等方面进行治疗。现基础研究显示先制备缺血性、出血性脑卒中动物模型,再联合慢性刺激复合可制备成 PSD 模型,其行为学与神经功能评定等方面的研究表明 PSD 动物存在快感消失、学习及记忆受损、行为绝望,神经功能受损较重等。%The present study shows that PSD pathogenesis is mainly divided into two categories :the biological mecha-nisms of primary endogenous theory namely the PSD,reactive mechanism theory of PSD is a result of the combined ac-tion of biological factors of social psychology. The clinical treatment methods are mainly drugs,acupuncture,rehabili-tation training,psychological intervention,music,low energy laser,repeat the cranial stimulation and so on. Now basic research shows that ischemic stroke and hemorrhagic stroke should be first established,and then combined with chronic stimulation of compound into PSD model. The behavioral and neurological assessment study shows the PSD animals pleasure disappeared,learning and memory impairment,behavioral despair,nerve function damaged heavily. This article mainly reviews the domestic animal models of PSD and its observations in recent 10 years.

  11. A Study on Impact of Anime on Tourism in Japan : A Case of "Anime Pilgrimage"

    OpenAIRE

    Okamoto, Takeshi

    2009-01-01

    Recently, in Japan, some of anime fans make "Anime Pilgrimage" which is a kind of tourist behavior. People making an "Anime Pilgrimage" are called "Anime Pilgrims". Some cases of "Anime Pilgrimage" evolve into movement of regional development. In these cases "Anime Pilgrims" collaborate with local residents spontaneously, hold an event and make souvenir or goods. The objective of this paper is to clarify characteristics of "Anime Pilgrim" using questionnaire survey and face-to-face interviews.

  12. Animals

    OpenAIRE

    Draheim, Megan M.; Patterson, Katheryn W.; Rockwood, Larry L.; Gregory A. Guagnano; E. Christien M. Parsons

    2013-01-01

    Simple Summary Understanding the public’s attitudes towards urban wildlife is an important step towards creating management plans, increasing knowledge and awareness about wildlife, and fostering coexistence between people and wildlife. Using undergraduate college students in the Washington, D.C. metropolitan area (where coyotes are a recent arrival), this study examined attitudes towards coyotes and coyote management methods. Amongst other findings, we found differences in opinion between ke...

  13. Pre-stroke use of beta-blockers does not affect ischaemic stroke severity and outcome

    NARCIS (Netherlands)

    De Raedt, S.; Haentjens, P.; De Smedt, A.; Brouns, R.; Uyttenboogaart, Maarten; Luijckx, G. J.; De Keyser, J.

    2012-01-01

    Background and purpose: It is unclear whether pre-stroke beta-blockers use may influence stroke outcome. This study evaluates the independent effect of pre-stroke use of beta-blockers on ischaemic stroke severity and 3 months functional outcome. Methods: Pre-stroke use of beta-blockers was investiga

  14. Book review. An animal is not a human, or is it. Review of animals and society: an Introduction to human-animal studies by Margo DeMello

    OpenAIRE

    McBride, E. A.

    2013-01-01

    Reviews the book Animals and Society: An Introduction to Human-Animal Studies by Margo DeMello. This book provides an accessible introduction to the diversity of ways in which animals influence how humans think and act, both through our direct, or indirect, relations with actual animals themselves or our symbolic representations of them. The content ranges across and within disciplines as disparate as literature studies, ethology, and social and cognitive psychology. DeMello links the multid...

  15. DEVELOPMENT OF CLINICAL STUDIES ON ACUPUNCTURE TREATMENT OF SHOULDER PAIN IN PATIENTS WITH WIND STROKE

    Institute of Scientific and Technical Information of China (English)

    粟胜勇; 周恩华; 李扬帆; 邓柏颖

    2004-01-01

    In the present paper, the authors review some new results of acupuncture treatment of shoulder pain in stroke patients from ① application of filiform needle with different needling manipulations, ② selection and combination of acupoints, and ③ some special needling methods including point-injection. Generally, if acupuncture therapy is used in combination with other rehabilitation methods, the therapeutic effect of shoulder-pain-relief will be much better. Regarding the acupoint selection, both local acupoints and those of the yang meridians are primarily used in clinical practice. Further studies on treating shoulder pain of hemiplegia based upon the basic theory of TCM are necessary.

  16. Study and design of the scavenging ports of 2-stroke engine

    OpenAIRE

    Esteban Serna, Fernando

    2005-01-01

    En este trabajo titulado: “Study and Design of the Scavenging Ports of 2- Stroke Engine” se abordó el estudio y diseño de la geometría de las lumbreras y los conductos de admisión y escape que gobiernan el proceso de barrido de los motores de dos tiempos usando técnicas de modelización del flujo de los gases basados en programas de dinámica de fluidos computacional (CFD). Este trabajo de investigación es el resultado del “Diplomarbeit” o “título de trabajo” realizado en el “...

  17. Inflammatory Disequilibrium in Stroke.

    Science.gov (United States)

    Petrovic-Djergovic, Danica; Goonewardena, Sascha N; Pinsky, David J

    2016-06-24

    Over the past several decades, there have been substantial advances in our knowledge of the pathophysiology of stroke. Understanding the benefits of timely reperfusion has led to the development of thrombolytic therapy as the cornerstone of current management of ischemic stroke, but there remains much to be learned about mechanisms of neuronal ischemic and reperfusion injury and associated inflammation. For ischemic stroke, novel therapeutic targets have continued to remain elusive. When considering modern molecular biological techniques, advanced translational stroke models, and clinical studies, a consistent pattern emerges, implicating perturbation of the immune equilibrium by stroke in both central nervous system injury and repair responses. Stroke triggers activation of the neuroimmune axis, comprised of multiple cellular constituents of the immune system resident within the parenchyma of the brain, leptomeninges, and vascular beds, as well as through secretion of biological response modifiers and recruitment of immune effector cells. This neuroimmune activation can directly impact the initiation, propagation, and resolution phases of ischemic brain injury. To leverage a potential opportunity to modulate local and systemic immune responses to favorably affect the stroke disease curve, it is necessary to expand our mechanistic understanding of the neuroimmune axis in ischemic stroke. This review explores the frontiers of current knowledge of innate and adaptive immune responses in the brain and how these responses together shape the course of ischemic stroke. PMID:27340273

  18. Population-based 5-year follow-up study in Taiwan of dementia and risk of stroke.

    Directory of Open Access Journals (Sweden)

    Mu-En Liu

    Full Text Available BACKGROUND: This study estimates the risk of stroke within 5 years of newly diagnosed dementia among elderly persons aged 65 and above. We examined the relationship between antipsychotic usage and development of stroke in patients with dementia. METHODS: We conducted a nationwide 5-year population-based study using data retrieved from the Longitudinal Health Insurance Database 2005 (LHID2005 in Taiwan. The study cohort comprised 2243 patients with dementia aged ≥65 years who had at least one inpatient service claim or at least 2 ambulatory care claims, whereas the comparison cohort consisted of 6714 randomly selected subjects (3 for every dementia patient and were matched with the study group according to sex, age, and index year. We further classified dementia patients into 2 groups based on their history of antipsychotic usage. A total of 1450 patients were classified into the antipsychotic usage group and the remaining 793 patients were classified into the non-antipsychotic usage group. Cox proportional-hazards regressions were performed to compute the 5-year stroke-free survival rates after adjusting for potentially confounding factors. RESULTS: The dementia patients have a 2-fold greater risk of developing stroke within 5 years of diagnosis compared to non-dementia age- and sex-matched subjects, after adjusting for other risk factors (95% confidence interval (CI = 2.58-3.08; P<.001. Antipsychotic usage among patients with dementia increases risk of stroke 1.17-fold compared to patients without antipsychotic treatment (95% CI = 1.01-1.40; P<.05. CONCLUSIONS: Dementia may be an independent risk factor for stroke, and the use of antipsychotics may further increase the risk of stroke in dementia patients.

  19. Stroke: Overview

    Science.gov (United States)

    ... NICHD Research Information Clinical Trials Resources and Publications Stroke: Overview Skip sharing on social media links Share this: Page Content Stroke is a leading cause of disability and death ...

  20. Know Stroke

    Science.gov (United States)

    ... Home Current Issue Past Issues Special Section Know Stroke Past Issues / Summer 2007 Table of Contents For ... D. Director, National Institute of Neurological Disorders and Stroke Photo courtesy of NIH/NINDS Welcome to this ...

  1. Factors affecting rate of stroke-related death in elderly male military population A 23-year cohort study of 1 268 cases in Xi'an, China

    Institute of Scientific and Technical Information of China (English)

    Yanhua Li; Yu Sun; Xiaoyong Sai; Yao He; Qiang Wu; Yongping Yan; Ke Men; Liangshou Li

    2011-01-01

    The study is the first long-term cohort study examining stroke and its subtypes among a population of Chinese elderly male retired military veterans. We reported on a 23-year cohort study examining stroke in 1 268 elderly male patients living in Xi'an, China since 1987. The stroke-related mortality rate in this cohort was 361.50/1 × 106 per year. Cerebral hemorrhage was the dominant cause of death, with 28 cases of fatal cerebral infarction and 49 cases of fatal cerebral hemorrhage among 77 stroke-related deaths. Independent risk factors for stroke mortality included age, blood pressure, smoking, body mass index, family history of hypertension, past medical history of stroke, hypertension and hyperlipidemia. Among them, ischemic stroke mortality correlated with age, smoking, family history of hypertension and past medical history of stroke, while hemorrhagic stroke was related to blood pressure, body mass index and past medical history of hypertension. Our results indicated that maintaining appropriate levels of blood pressure and body mass, smoking cessation and prevention of hyperlipidemia can reduce the risk of stroke-related death in elderly males who are retired from military service.

  2. Development of experimental animals for studies of radiation effects. Contribution to the studies of the team for laboratory animal development

    International Nuclear Information System (INIS)

    Author's team for the title purpose in National Institute of Radiological Sciences (NIRS) mainly handles the reproductive physiology and embryonic technology to meet the researchers' needs. For developing gene-modified animals, the system is established for freeze-storing the ovum of those animals based on techniques of the micro-manipulation for external handling of ovum, in vitro fertilization (IVF) and early embryo culture. For preparing transgenic and/or knockout mice, embryos of 2-8 cell stages are usually freeze-stored. IVF/implanting fertilized ovum systems are also run for requests for storing the gene-modified ova and for supplying quickly many (up to about 100) animals. Techniques for freeze-storing unfertilized ova are to be established within this year. As well, the team is conducting the practical studies for the animals like genetic diagnoses of diseases and for the rapid supply of animals in accordance to research needs. (S.I.)

  3. Comparative study of DSC-PWI and 3D-ASL in ischemic stroke patients.

    Science.gov (United States)

    Zhang, Shui-xia; Yao, Yi-hao; Zhang, Shun; Zhu, Wen-jie; Tang, Xiang-yu; Qin, Yuan-yuan; Zhao, Ling-yun; Liu, Cheng-xia; Zhu, Wen-zhen

    2015-12-01

    The purpose of this study was to quantitatively analyze the relationship between three dimensional arterial spin labeling (3D-ASL) and dynamic susceptibility contrast-enhanced perfusion weighted imaging (DSC-PWI) in ischemic stroke patients. Thirty patients with ischemic stroke were included in this study. All subjects underwent routine magnetic resonance imaging scanning, diffusion weighted imaging (DWI), magnetic resonance angiography (MRA), 3D-ASL and DSC-PWI on a 3.0T MR scanner. Regions of interest (ROIs) were drawn on the cerebral blood flow (CBF) maps (derived from ASL) and multi-parametric DSC perfusion maps, and then, the absolute and relative values of ASL-CBF, DSC-derived CBF, and DSC-derived mean transit time (MTT) were calculated. The relationships between ASL and DSC parameters were analyzed using Pearson's correlation analysis. Receiver operative characteristic (ROC) curves were performed to define the thresholds of relative value of ASL-CBF (rASL) that could best predict DSC-CBF reduction and MTT prolongation. Relative ASL better correlated with CBF and MTT in the anterior circulation with the Pearson correlation coefficients (R) values being 0.611 (P1.0 were 75.7%, 89.2% and 87.8% respectively. ASL-CBF map has better linear correlations with DSC-derived parameters (DSC-CBF and MTT) in anterior circulation in ischemic stroke patients. Additionally, when rASL is lower than 0.585, it could predict DSC-CBF decrease with moderate accuracy. If rASL values range from 0.585 to 0.952, we just speculate the prolonged MTT.

  4. A Comparative Study Between Modified Starch and Xanthan Gum Thickeners in Post-Stroke Oropharyngeal Dysphagia.

    Science.gov (United States)

    Vilardell, N; Rofes, L; Arreola, V; Speyer, R; Clavé, P

    2016-04-01

    Thickeners are used in post-stroke oropharyngeal dysphagia (OD) as a compensatory therapeutic strategy against aspirations. To compare the therapeutic effects of modified starch (MS) and xanthan gum (XG) thickeners on swallow safety and efficacy in chronic post-stroke OD patients using clinical and videofluoroscopic (VFS) assessment. Patients were studied by clinical assessment (volume-viscosity swallow test, V-VST) and VFS using 3 volumes (5, 10, 20 mL) and 3 viscosities (liquid, nectar and spoon thick), comparing MS and XG. We studied 122 patients (46MS, 76XG). (A) V-VST showed that both thickeners similarly improved safety of swallow. Prevalence of safe swallowing significantly increased with enhanced viscosity (P < 0.001 vs liquid), MS: 47.83 % at liquid, 84.93 % at nectar and 92.96 % at spoon thick; XG: 55.31 % at liquid, 77.78 % at nectar and 97.84 % at spoon thick. Patients on MS reported higher prevalence of pharyngeal residue at spoon-thick viscosities. (B) VFS: increasing bolus viscosity with either thickener increased prevalence of safe swallows (P < 0.001 vs liquid), MS: 30.25 % liquid, 61.07 % nectar and 92.64 % spoon thick; XG: 29.12 % liquid, 71.30 % nectar and 89.91 % spoon thick. Penetration-aspiration scale score was significantly reduced with increased viscosity with both thickeners. MS increased oral and pharyngeal residues at nectar and spoon-thick viscosities but XG did not. Timing of airway protection mechanisms and bolus velocity were not affected by either thickener. Increasing bolus viscosity with MS and XG thickeners strongly and similarly improved safety of swallow in chronic post-stroke OD by a compensatory mechanism; in contrast only MS thickeners increased oropharyngeal residue. PMID:26607158

  5. Animal subjectivity: a study into philosophy and theory of animal experience.

    NARCIS (Netherlands)

    Lijmbach, S.E.E.M.

    1998-01-01

    For many people, laypeople as well as animal scientists and philosophers, animal welfare involves animal feelings. Scientifically, however, animal feelings are problematic. In the concluding remarks of a conference about the welfare of domestic animals in 1994, for example, two questions for further

  6. GAPs in the study of zoo and wild animal welfare.

    Science.gov (United States)

    Goulart, Vinícius D; Azevedo, Pedro G; van de Schepop, Joanna A; Teixeira, Camila P; Barçante, Luciana; Azevedo, Cristiano S; Young, Robert J

    2009-11-01

    To investigate the science of animal welfare for zoo and wild animals in the period from 1966 to 2007, we conducted a bibliometric analysis of abstracts downloaded from The Web of Science((c)) database using the keyword combination "Animal welfare, Zoo* and wild" in the topic field. In total we downloaded 1,125 abstracts, which were classified into the following categories: year of publication; environment of the study (e.g., zoo) or theoretical; area of knowledge (e.g., conservation in situ); number of experimental animals used; species; addresses of authors; taxonomic classification; publication language; journal name; number of citations received. Since 1990, there has been a rapid increase in the number of articles published in this area of animal welfare. One worrying result was that published articles were predominately of a theoretical nature (58.65%, N=563). Most of the articles were published by authors either in Europe (47.43%, N=480) or North America (37.65%, N=381) and written in English (87.71%, N=971). The majority of experimental studies were conducted with mammals (75.92%, N=391), and had small sample sizes (N=7 for zoo-based studies). In terms of impact factor (IF), the journals in this study had a median factor equivalent to that for the area of biological sciences (median IF=1.013). Little knowledge cross-over from farm animal welfare was found (only four articles) in this study. In conclusion, zoo and wild animal welfare as a science may benefit from a greater interaction with farm animal welfare.

  7. Intravenous grafts of amniotic fluid-derived stem cells induce endogenous cell proliferation and attenuate behavioral deficits in ischemic stroke rats.

    Directory of Open Access Journals (Sweden)

    Naoki Tajiri

    Full Text Available We recently reported isolation of viable rat amniotic fluid-derived stem (AFS cells [1]. Here, we tested the therapeutic benefits of AFS cells in a rodent model of ischemic stroke. Adult male Sprague-Dawley rats received a 60-minute middle cerebral artery occlusion (MCAo. Thirty-five days later, animals exhibiting significant motor deficits received intravenous transplants of rat AFS cells or vehicle. At days 60-63 post-MCAo, significant recovery of motor and cognitive function was seen in stroke animals transplanted with AFS cells compared to vehicle-infused stroke animals. Infarct volume, as revealed by hematoxylin and eosin (H&E staining, was significantly reduced, coupled with significant increments in the cell proliferation marker, Ki67, and the neuronal marker, MAP2, in the dentate gyrus (DG [2] and the subventricular zone (SVZ of AFS cell-transplanted stroke animals compared to vehicle-infused stroke animals. A significantly higher number of double-labeled Ki67/MAP2-positive cells and a similar trend towards increased Ki67/MAP2 double-labeling were observed in the DG and SVZ of AFS cell-transplanted stroke animals, respectively, compared to vehicle-infused stroke animals. This study reports the therapeutic potential of AFS cell transplantation in stroke animals, possibly via enhancement of endogenous repair mechanisms.

  8. Studying extinct animals using three-dimensional visualization, scanning, animation, and prototyping

    Science.gov (United States)

    Chapman, Ralph E.; Andersen, Arthur; Wilcox, Brian

    2003-05-01

    Technology provides an important means for studying the biology of extinct animals. Skeletons of these species must be constructed virtually by scanning in data for individual bones and building virtual models for each. These then are used to produce prototypes of each of the bones at varying scales, allowing the construction of a starter skeleton configuration and the analysis of movement along each joint. The individual virtual bones are then assembled into a starter virtual skeleton using digitized landmark points on the starter physical skeleton to help place them in three-dimensional space. This virtual skeleton is then modified and improved by analyzing the movement at each joint, using the prototype bones. Once this is done, the movement is constrained further by doing animations of the whole skeleton and noting areas of impossible overlap between bones and unreasonable movement. The problems are corrected and new animations attempted until the movement is perfected. This provides a means for understanding locomotion and mastication in these extinct animals.

  9. Recovery mechanisms of somatosensory function in stroke patients: implications of brain imaging studies

    Institute of Scientific and Technical Information of China (English)

    Sung Ho Jang

    2013-01-01

    Somatosensory dysfunction is associated with a high incidence of functional impairment and safety in patients with stroke.With developments in brain mapping techniques,many studies have addressed the recovery of various functions in such patients.However,relatively little is known about the mechanisms of recovery of somatosensory function.Based on the previous human studies,a review of 11 relevant studies on the mechanisms underlying the recovery of somatosensory function in stroke patients was conducted based on the following topics:(1) recovery of an injured somatosensory pathway,(2) peri-lesional reorganization,(3) contribution of the unaffected somatosensory cortex,(4) contribution of the secondary somatosensory cortex,and (5)mechanisms of recovery in patients with thalamic lesions.We believe that further studies in this field using combinations of diffusion tensor imaging,functional neuroimaging,and magnetoencephalography are needed.In addition,the clinical significance,critical period,and facilitatory strategies for each recovery mechanism should be clarified.

  10. Progress in Studies of Geomagnetic Navigation of Animals

    Institute of Scientific and Technical Information of China (English)

    Tian Lanxiang; Pan Yongxin; Lin Wei; Wang Yinan; Zhang Shuyi

    2005-01-01

    @@ The geomagnetic field may play a key role in orientation and navigation of many long-distance migratory animals. Taking homing and migrating birds as examples, this paper reviews recent progress in studies of geomagnetic "compass" of animals.Moreover, we propose to address two aspects in future geomagnetic orientation research: ( 1 ) what are the true components of the "map"? (2) What are the magneto-receptors and which brain areas acquire and process the geomagnetic field information ?

  11. Recovering after stroke

    Science.gov (United States)

    Stroke rehabilitation; Cerebrovascular accident - rehabilitation; Recovery from stroke; Stroke - recovery; CVA - recovery ... WHERE TO LIVE AFTER A STROKE Most people will need stroke ... after they leave the hospital. Stroke rehab will help you ...

  12. Efficacy of mirror therapy in subacute stroke: A case-control study

    Directory of Open Access Journals (Sweden)

    Deo Rishi Tripathi

    2016-04-01

    Full Text Available Context: The effect of mirror visual illusions on brain activity has been investigated in a number of studies. Motor imagery can be defined as the covert cognitive process of imagining a movement of your own body (-part without actually moving that body (-part. Aims: Our aim was to investigate whether mirror therapy is effective at short-term (at 4wk and long-term (at 6month intervals on motor recovery, spasticity, and hand-related functioning of patients with subacute stroke. Methods and Material: The study recruited 40 patients suffering from sub-acute stroke with a male: female ratio of 27:8 of mean age 48.42years (age range 23-70 years. Mirror therapy was given in OPD setting over 5 weekly doses. Both the mirror group and control group participated in a conventional stroke rehabilitation program, 6 days a week, 2 to 3 hours a day with therapist in hospital and 1 hour at home for 4 weeks and follow-up at 6 months . The conventional program consists of neuro-developmental facilitation techniques, physiotherapy, occupational therapy, and speech therapy (if needed. For the same period, the mirror group received an additional 30 minutes of mirror therapy program per day. Statistical analysis used. Results: The mirror therapy treatment compared to the control group showed significant improvement at 4 weeks re-assessment from baseline assessment on hand functioning in Brunnstorm, Action Research Arm test and Functional Independence Measures. The mirror therapy treatment compared to the control group at 6-months of follow up reassessment from 4 weeks assessment showed moderate but insignificant improvement in the Brunnstorm and Action Research Arm test and significant improvement in Functional Independence Measures. Conclusion: In our group of subacute stroke patients, hand function improved more after mirror therapy in addition to a conventional rehabilitation program compared with a control treatment directly after 4 weeks of treatment and at the

  13. TO STUDY PERFORMANCE OF TWO STROKE ENGINE WITH MODIFIED INTAKE SYSTEM

    Directory of Open Access Journals (Sweden)

    BISHAKHA

    2012-08-01

    Full Text Available The two stroke engine was developed to obtain a greater output from the same size of engine. The engine mechanism eliminates the valve arrangement making it mechanically simpler. Theoretically a two stroke engine develops twice the power of a comparable four stroke engine, thus making it more compact. Getting air into an engine is the key to making power and there are many ways to increase the air flow into the engine. There are such forced induction, nitrous system, better port and valve shapes to improve flow. But for this study the technique that has been selected were the better port size. The claims that this where the harnessing the inertia of the airs velocity to better fill the cylinders. Modification in intake port is made. Also use of different fuel metering jets is used for different A/F mixtures. At various throttle positions and with torque and speed as input,performance parameters of engine are calculated. Based on the results various performance curves are plotted. The objective of the project is to determine how much power improvement with the modification in intake system in compared to the original intake system. Modification to the engine without additional system attach tothe engine operation were the best solution to have an optimum engine operation in term of torque and horsepower. To optimize the power and intake port flow produce by the engine modification were through avery limited value. The value is limited due to the restricted area of the engine production by the manufacturer.Hence modification must be planned carefully as over modification of the inlet port can end up with a device slower than its stock counterpart.

  14. The right hemisphere is dominant in organization of visual search-A study in stroke patients.

    Science.gov (United States)

    Ten Brink, Antonia F; Matthijs Biesbroek, J; Kuijf, Hugo J; Van der Stigchel, Stefan; Oort, Quirien; Visser-Meily, Johanna M A; Nijboer, Tanja C W

    2016-05-01

    Cancellation tasks are widely used for diagnosis of lateralized attentional deficits in stroke patients. A disorganized fashion of target cancellation has been hypothesized to reflect disturbed spatial exploration. In the current study we aimed to examine which lesion locations result in disorganized visual search during cancellation tasks, in order to determine which brain areas are involved in search organization. A computerized shape cancellation task was administered in 78 stroke patients. As an index for search organization, the amount of intersections of paths between consecutive crossed targets was computed (i.e., intersections rate). This measure is known to accurately depict disorganized visual search in a stroke population. Ischemic lesions were delineated on CT or MRI images. Assumption-free voxel-based lesion-symptom mapping and region of interest-based analyses were used to determine the grey and white matter anatomical correlates of the intersections rate as a continuous measure. The right lateral occipital cortex, superior parietal lobule, postcentral gyrus, superior temporal gyrus, middle temporal gyrus, supramarginal gyrus, inferior longitudinal fasciculus, first branch of the superior longitudinal fasciculus (SLF I), and the inferior fronto-occipital fasciculus, were related to search organization. To conclude, a clear right hemispheric dominance for search organization was revealed. Further, the correlates of disorganized search overlap with regions that have previously been associated with conjunctive search and spatial working memory. This suggests that disorganized visual search is caused by disturbed spatial processes, rather than deficits in high level executive function or planning, which would be expected to be more related to frontal regions. PMID:26876010

  15. Shutting down sensorimotor interferences after stroke: A proof-of-principle SMR neurofeedback study

    Directory of Open Access Journals (Sweden)

    Johanna Louise Reichert

    2016-07-01

    Full Text Available Introduction: Neurofeedback training aims at learning self-regulation of brain activity underlying cognitive, emotional or physiological functions. Despite of promising investigations on neurofeedback as a tool for cognitive rehabilitation in neurological diseases, such as after stroke, there is still a lack of research on feasibility and efficiency of neurofeedback in this field. Methods: The present study aimed at investigating behavioral and electrophysiological effects of 10 sessions of sensorimotor rhythm (SMR neurofeedback in a 74-year-old stroke patient (UG20. Based on previous results in healthy young participants, we hypothesized that SMR neurofeedback leads to a decrease in sensorimotor interferences and improved stimulus processing, reflected by changes in event-related potentials and electrophysiological coherence. To assess whether UG20 benefited from the training as much as healthy persons of a similar age, a healthy control group of N = 10 elderly persons was trained as well. Before and after neurofeedback training, participants took part in a multichannel EEG measurement conducted during a nonverbal and a verbal learning task. Results: Both UG20 and the healthy controls were able to regulate their SMR activity during neurofeedback training. Moreover, in a nonverbal learning task, changes in event-related potentials and coherence were observed after training: UG20 showed a better performance in the nonverbal learning task and a higher P3 amplitude after training than before, and coherence between central and parietal electrodes decreased after training. The control group also showed a behavioral improvement in the nonverbal learning task and tendencies for higher P3 amplitudes and decreased central-parietal coherence after training. Single-case analyses indicated that the changes observed in UG20 were not smaller than the changes in healthy controls. Conclusions: Neurofeedback can be successfully applied in a stroke patient and in

  16. Randomized, Placebo-Controlled, Double-Blind Pilot Study of D-Cycloserine in Chronic Stroke

    Directory of Open Access Journals (Sweden)

    Andrew J. Butler

    2015-01-01

    Full Text Available Stroke is a leading cause of death and disability in the USA. Up to 60% of patients do not fully recover despite intensive physical therapy treatment. N-Methyl-D-aspartate receptors (NMDA-R have been shown to play a role in synaptic plasticity when activated. D-Cycloserine promotes NMDA receptor function by binding to receptors with unoccupied glycine sites. These receptors are involved in learning and memory. We hypothesized that D-cycloserine, when combined with robotic-assisted physiotherapy (RAP, would result in greater gains compared with placebo + RAP in stroke survivors. Participants (n=14 were randomized to D-cycloserine plus RAP or placebo plus RAP. Functional, cognitive, and quality-of-life measures were used to assess recovery. There was significant improvement in grip strength of the affected hand within both groups from baseline to 3 weeks (95% confidence interval for mean change, 3.95 ± 2.96 to 4.90 ± 3.56 N for D-cycloserine and 5.72 ± 3.98 to 8.44 ± 4.90 N for control. SIS mood domain showed improvement for both groups (95% confidence interval for mean change, 72.6 ± 16.3 to 82.9 ± 10.9 for D-cycloserine and 82.9 ± 13.5 to 90.3 ± 9.9 for control. This preliminary study does not provide evidence that D-cycloserine can provide greater gains in learning compared with placebo for stroke survivors.

  17. Animal subjectivity: a study into philosophy and theory of animal experience.

    OpenAIRE

    Lijmbach, S.E.E.M.

    1998-01-01

    For many people, laypeople as well as animal scientists and philosophers, animal welfare involves animal feelings. Scientifically, however, animal feelings are problematic. In the concluding remarks of a conference about the welfare of domestic animals in 1994, for example, two questions for further research were proposed: (1) What is the nature of feelings? and (2) Why is it not possible to measure the occurrence of feelings in animals directly? This book intends to give a philosophical and ...

  18. Bilateral common carotid artery ultrasound for prediction of incident strokes using intima-media thickness and external diameter: an observational study

    OpenAIRE

    Eigenbrodt, Marsha L.; Evans, Gregory W.; Rose, Kathryn M; Bursac, Zoran; Tracy, Richard E.; Mehta, Jawahar L.; Couper, David J

    2013-01-01

    Background External common carotid artery (CCA) diameter and intima-media thickness (IMT) are independently associated with incident stroke and other cardiovascular events. Arterial geometry such as large IMT and large diameter may reflect vulnerable plaques and so impact stroke risk. Finally, arterial changes that exist bilaterally may increase stroke risk. Method We studied middle-aged men and women (n=7276) from a prospective observational study who had right (R) and left (L) CCA IMT and e...

  19. Carotid intima-media thickness and apolipoproteins in patients of ischemic stroke in a rural hospital setting in central India: A cross-sectional study

    OpenAIRE

    Jyoti Jain; Tejal Lathia; Om Prakash Gupta; Vishakha Jain

    2012-01-01

    Context: Carotid intima-media thickness (CIMT) and apolipoproteins have been found as a risk factor for ischemic stroke . Objective: The objective was to study the carotid intima-media thickness, apolipoproteins, and their relation in patients of ischemic stroke in central rural India. Settings and Design: A cross-sectional study was performed in a rural hospital in central India. Materials and Methods: In all patients of ischemic stroke proven by computerized tomography (CT), CIMT, apolipopr...

  20. Increased risk of ischemic stroke after hyperosmolar hyperglycemic state: a population-based follow-up study.

    Directory of Open Access Journals (Sweden)

    Jen-Yu Wang

    Full Text Available BACKGROUND: Although much attention has been focused on the association between chronic hyperglycemia and cerebrovascular diseases in type 2 diabetes mellitus (DM patients, there is no data regarding the risk of ischemic stroke after a hyperosmolar hyperglycemic state (HHS attack. The objective of this study was to investigate the risk of ischemic stroke in type 2 DM patients after an HHS attack. METHODS: From 2004 to 2008, this retrospective observational study was conducted on a large cohort of Taiwanese using Taiwan's National Health Insurance Research Database (NHIRD. We identified 19,031 type 2 DM patients who were discharged with a diagnosis of HHS and 521,229 type 2 DM patients without an HHS diagnosis. Using the propensity score generated from logistic regression models, conditional on baseline covariates, we matched 19,031 type 2 DM patients with an HHS diagnosis with the same number from the comparison cohort. The one-year cumulative rate for ischemic stroke was estimated using the Kaplan-Meier method. After adjusting covariates, Cox proportional hazard regression was used to compute the adjusted one-year rate of ischemic stroke. RESULTS: Of the patients sampled, 1,810 (9.5% of the type 2 DM patients with HHS and 996 (5.2% of the comparison cohort developed ischemic stroke during the one-year follow-up period. After adjusting for covariates, the adjusted HR for developing ischemic stroke during the one-year follow-up period was 1.8 (95% C.I., 1.67 to 1.95, P<0.001 for type 2 DM patients with HHS compared with those without HHS. CONCLUSION: Although DM is a well-recognized risk factor for atherosclerosis, type 2 DM patients that have suffered a HHS attacks are at an increased risk of developing ischemic stroke compared with those without HHS.

  1. The short- and long-term risk of stroke after herpes zoster - a nationwide population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Nandini Sreenivasan

    Full Text Available BACKGROUND AND OBJECTIVE: Varicella zoster virus (VZV is known to cause VZV vasculopathy, which may be associated with stroke. A recent study found an increased risk of stroke within one year of herpes zoster. We aimed to investigate the short and long-term effects of herpes zoster on the risk of stroke. METHODS: Using Danish national registers, we constructed a cohort consisting of all Danish adults ≥18 years old between 1995 and 2008 (n = 4.6 million; person-years of follow-up = 52.9 million. Individual-level information on prescriptions for herpes zoster antiviral treatment and diagnoses of stroke was obtained from national registers. We compared the risk of stroke in persons who had received the specific dosage of acyclovir for herpes zoster with persons who had never received antiviral treatment by Poisson regression. RESULTS: During follow-up, 2.5% received treatment for herpes zoster and 5.0% were diagnosed with stroke. Individuals who had received medication had a 127% (95% CI 83-182% increased risk the first two weeks, 17% (CI 9-24% between two weeks and one year, and 5% (2-9% after the first year. The increased risk was greatest in the youngest age group (<40. To control for healthcare-seeking behaviour, we conducted parallel analyses investigating the risk of selected fractures after herpes zoster and found no similar increased risks. CONCLUSIONS: This large nationwide cohort study found an increased risk of stroke after treatment for herpes zoster. Although the short-term risk was particularly high, we cannot rule out the possibility of a small but important long-term risk.

  2. High-field small animal magnetic resonance oncology studies

    Science.gov (United States)

    Bokacheva, Louisa; Ackerstaff, Ellen; LeKaye, H. Carl; Zakian, Kristen; Koutcher, Jason A.

    2014-01-01

    This review focuses on the applications of high magnetic field magnetic resonance imaging (MRI) and spectroscopy (MRS) to cancer studies in small animals. High-field MRI can provide information about tumor physiology, the microenvironment, metabolism, vascularity and cellularity. Such studies are invaluable for understanding tumor growth and proliferation, response to treatment and drug development. The MR techniques reviewed here include 1H, 31P, chemical exchange saturation transfer imaging and hyperpolarized 13C MRS as well as diffusion-weighted, blood oxygen level dependent contrast imaging and dynamic contrast-enhanced MRI. These methods have been proven effective in animal studies and are highly relevant to human clinical studies.

  3. Recovery After Stroke: Recurrent Stroke

    Science.gov (United States)

    ... who have had transient ischemic attacks (TIAs) or mini- strokes. TIAs are brief episodes of stroke-like ... exerts on blood vessel walls as your heart pumps. The second, diastolic blood pressure, is the measurement ...

  4. Slacklining and stroke: A rehabilitation case study considering balance and lower limb weakness.

    Science.gov (United States)

    Gabel, Charles P; Rando, Natalie; Melloh, Markus

    2016-08-18

    To ascertain the effectiveness of slacklining as a supplementary therapy for elderly stroke patients who are functionally non-progressing. This case study involved an 18-mo prospective observation of the management of an 87-year-old female stroke-patient of the left hemisphere with reduced balance, reduced lower limb muscular activation, hypertonia, and concurrent postural deficits. This entailed the initial acute care phase through to discharge to home and 18-mo final status in her original independent living setting. The introduction of slacklining as an adjunct therapy was made 12 mo post incident. Slacklining involves balance retention on a tightened band where external environmental changes cause a whole-body dynamic response to retain equilibrium. It is a complex neuromechanical task enabling individualized self-developed response strategies to be learned and adapted. This facilitates the innate process of balance retention, lower-limb and core muscle activation, and stable posture through a combination of learned motor skills and neurological system down regulation. Individuals adopt and follow established sequential motor learning stages where the acquired balance skills are achieved in a challenging composite-chain activity. Slacklining could be considered an adjunct therapy for lower limb stroke rehabilitation where function is compromised due to decreased muscle recruitment, decreased postural control and compromised balance. Initial inpatient rehabilitation involved one-month acute-care, one-month rehabilitation, and one-month transitional care prior to home discharge. A further six months of intensive outpatient rehabilitation was provided with five hourly sessions per week including:supervised and self-managed hydrotherapy, plus one individual and two group falls' prevention sessions. These were supported by daily home exercises. At 12 mo post incident, recovery plateaued, then regressed following three falls. Rehabilitation was subsequently modified

  5. Slacklining and stroke: A rehabilitation case study considering balance and lower limb weakness.

    Science.gov (United States)

    Gabel, Charles P; Rando, Natalie; Melloh, Markus

    2016-08-18

    To ascertain the effectiveness of slacklining as a supplementary therapy for elderly stroke patients who are functionally non-progressing. This case study involved an 18-mo prospective observation of the management of an 87-year-old female stroke-patient of the left hemisphere with reduced balance, reduced lower limb muscular activation, hypertonia, and concurrent postural deficits. This entailed the initial acute care phase through to discharge to home and 18-mo final status in her original independent living setting. The introduction of slacklining as an adjunct therapy was made 12 mo post incident. Slacklining involves balance retention on a tightened band where external environmental changes cause a whole-body dynamic response to retain equilibrium. It is a complex neuromechanical task enabling individualized self-developed response strategies to be learned and adapted. This facilitates the innate process of balance retention, lower-limb and core muscle activation, and stable posture through a combination of learned motor skills and neurological system down regulation. Individuals adopt and follow established sequential motor learning stages where the acquired balance skills are achieved in a challenging composite-chain activity. Slacklining could be considered an adjunct therapy for lower limb stroke rehabilitation where function is compromised due to decreased muscle recruitment, decreased postural control and compromised balance. Initial inpatient rehabilitation involved one-month acute-care, one-month rehabilitation, and one-month transitional care prior to home discharge. A further six months of intensive outpatient rehabilitation was provided with five hourly sessions per week including:supervised and self-managed hydrotherapy, plus one individual and two group falls' prevention sessions. These were supported by daily home exercises. At 12 mo post incident, recovery plateaued, then regressed following three falls. Rehabilitation was subsequently modified

  6. Brain plasticity and stroke recovery

    OpenAIRE

    Laaksonen, Kristina

    2012-01-01

    Brain plasticity and stroke recovery Recovery from stroke is based on the capability of the brain to reorganize its structure and function after lesion. An acute stroke triggers a cascade of time-dependent metabolic and physiological reactions, which enable changes in the organization and function of widespread cortical regions. A wide range of studies, using various functional imaging methods, have thrown light on the reorganizational changes after stroke. However, less is known about t...

  7. Pilot study to test effectiveness of video game on reaching performance in stroke.

    Science.gov (United States)

    Acosta, Ana Maria; Dewald, Hendrik A; Dewald, Jules P A

    2011-01-01

    Robotic systems currently used in upper-limb rehabilitation following stroke rely on some form of visual feedback as part of the intervention program. We evaluated the effect of a video game environment (air hockey) on reaching in stroke with various levels of arm support. We used the Arm Coordination Training 3D system to provide variable arm support and to control the hockey stick. We instructed seven subjects to reach to one of three targets covering the workspace of the impaired arm during the reaching task and to reach as far as possible while playing the video game. The results from this study showed that across subjects, support levels, and targets, the reaching distances achieved with the reaching task were greater than those covered with the video game. This held even after further restricting the mapped workspace of the arm to the area most affected by the flexion synergy (effectively forcing subjects to fight the synergy to reach the hockey puck). The results from this study highlight the importance of designing video games that include specific reaching targets in the workspace compromised by the expression of the flexion synergy. Such video games would also adapt the target location online as a subject's success rate increases. PMID:21674392

  8. Pilot study to test effectiveness of video game on reaching performance in stroke

    Directory of Open Access Journals (Sweden)

    Ana Maria Acosta, PhD;

    2011-05-01

    Full Text Available Robotic systems currently used in upper-limb rehabilitation following stroke rely on some form of visual feedback as part of the intervention program. We evaluated the effect of a video game environment (air hockey on reaching in stroke with various levels of arm support. We used the Arm Coordination Training 3D system to provide variable arm support and to control the hockey stick. We instructed seven subjects to reach to one of three targets covering the workspace of the impaired arm during the reaching task and to reach as far as possible while playing the video game. The results from this study showed that across subjects, support levels, and targets, the reaching distances achieved with the reaching task were greater than those covered with the video game. This held even after further restricting the mapped workspace of the arm to the area most affected by the flexion synergy (effectively forcing subjects to fight the synergy to reach the hockey puck. The results from this study highlight the importance of designing video games that include specific reaching targets in the workspace compromised by the expression of the flexion synergy. Such video games would also adapt the target location online as a subject’s success rate increases.

  9. The Influence of Dynamic Orthosis Training on Upper Extremity Function after Stroke: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Rodrigo Cappato de Araújo

    2014-01-01

    Full Text Available The goal of this study was to assess the use of a dynamic orthosis on upper extremity function in chronic stroke patients. A case series approach was utilized, with provision of a training program (3x/week, 50 minutes/session for 8 weeks and employment of a dynamic orthosis. Six volunteers with persistent hemiparesis due to a single, unilateral stroke performed task-oriented movements with the aid of a dynamic orthosis. Tests were administered before and after training. Functional capacity was assessed using the TEMPA (Test d'Évaluation des Membres Supérieurs de Personnes Âgées test. The Wilcoxon test was used for pre-training and post-training comparisons of TEMPA scores. The volunteers showed significant improvement of upper extremity function in the performance of a bilateral task (p = 0.01 and three unilateral tasks (p = 0.04. This pilot study suggests that the dynamic orthosis associated with the performance of functional tasks can have positive outcomes regarding the improvement of functional capacity of upper extremity.

  10. Stroke and Episodic Memory Disorders

    Science.gov (United States)

    Lim, Chun; Alexander, Michael P.

    2009-01-01

    Memory impairments are common after stroke, and the anatomical basis for impairments may be quite variable. To determine the range of stroke-related memory impairment, we identified all case reports and group studies through the Medline database and the Science Citation Index. There is no hypothesis about memory that is unique to stroke, but there…

  11. Non-stenotic intracranial arteries have atherosclerotic changes in acute ischemic stroke patients: a 3T MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Woo Jin; Choi, Hyun Seok; Jang, Jinhee; Sung, Jinkyeong; Jung, So-Lyung; Ahn, Kook-Jin; Kim, Bum-soo [The Catholic University of Korea, Department of Radiology, Seoul St. Mary' s Hospital, College of Medicine, Seoul (Korea, Republic of); Kim, Tae-Won; Koo, Jaseong [The Catholic University of Korea, Department of Neurology, College of Medicine, Seoul (Korea, Republic of); Shin, Yong Sam [The Catholic University of Korea, Department of Neurosurgery, College of Medicine, Seoul (Korea, Republic of)

    2015-10-15

    The aim of this study is to evaluate the degree of atherosclerotic changes in intracranial arteries by assessing arterial wall thickness using T1-weighted 3D-turbo spin echo (3D-TSE) and time-of-flight MR angiography (TOF-MRA) in patients with acute ischemic stroke as compared with unaffected controls. Thirty-three patients with acute ischemic stroke and 36 control patients were analyzed. Acute ischemic stroke patients were divided according to TOAST classification. At both distal internal carotid arteries and basilar artery without stenosis, TOF-MRA was used to select non-stenotic portion of assessed arteries. 3D-TSE was used to measure the area including the lumen and wall (Area{sub Outer}) and luminal area (Area{sub Inner}). The area of the vessel wall (Area{sub VW}) of assessed intracranial arteries and the ratio index (RI) of each patient were determined. Area{sub Inner}, Area{sub Outer}, Area{sub VW}, and RI showed good inter-observer reliability and excellent intra-observer reliability. Area{sub Inner} did not significantly differ between stroke patients and controls (P = 0.619). However, Area{sub Outer}, Area{sub VW}, and RI were significantly larger in stroke patients (P < 0.001). The correlation coefficient between Area{sub Inner} and Area{sub Outer} was higher in the controls (r = 0.918) than in large vessel disease patients (r = 0.778). RI of large vessel disease patients was significantly higher than that of normal control, small vessel disease, and cardioembolic groups. In patients with acute ischemic stroke, wall thickening and positive remodeling are evident in non-stenotic intracranial arteries. This change is more definite in stroke subtype that is related to atherosclerosis than that in other subtypes which are not. (orig.)

  12. Neuroprotection for Stroke: Current Status and Future Perspectives

    Directory of Open Access Journals (Sweden)

    Christoph Kleinschnitz

    2012-09-01

    Full Text Available Neuroprotection aims to prevent salvageable neurons from dying. Despite showing efficacy in experimental stroke studies, the concept of neuroprotection has failed in clinical trials. Reasons for the translational difficulties include a lack of methodological agreement between preclinical and clinical studies and the heterogeneity of stroke in humans compared to homogeneous strokes in animal models. Even when the international recommendations for preclinical stroke research, the Stroke Academic Industry Roundtable (STAIR criteria, were followed, we have still seen limited success in the clinic, examples being NXY-059 and haematopoietic growth factors which fulfilled nearly all the STAIR criteria. However, there are a number of neuroprotective treatments under investigation in clinical trials such as hypothermia and ebselen. Moreover, promising neuroprotective treatments based on a deeper understanding of the complex pathophysiology of ischemic stroke such as inhibitors of NADPH oxidases and PSD-95 are currently evaluated in preclinical studies. Further concepts to improve translation include the investigation of neuroprotectants in multicenter preclinical Phase III-type studies, improved animal models, and close alignment between clinical trial and preclinical methodologies. Future successful translation will require both new concepts for preclinical testing and innovative approaches based on mechanistic insights into the ischemic cascade.

  13. The obesity paradox in stroke

    DEFF Research Database (Denmark)

    Andersen, Klaus Kaae; Olsen, Tom Skyhøj

    2015-01-01

    . Data include age, gender, civil status, stroke severity, computed tomography, and cardiovascular risk factors. Patients were followed up to 9·8 years (median 2·6 years). We used Cox regression models to compare risk of death and readmission for recurrent stroke in the four body mass index groups......BACKGROUND: Although associated with excess mortality and morbidity, obesity is associated with lower mortality after stroke. The association between obesity and risk of recurrent stroke is unclear. AIMS: The study aims to investigate the association in stroke patients between body mass index...... and risk of death and readmission for recurrent stroke. METHODS: An administrative Danish quality-control registry designed to collect a predefined dataset on all hospitalized stroke patients in Denmark 2000–2010 includes 45 615 acute first-ever stroke patients with information on body mass index in 29 326...

  14. The Potential of Adaptive Design in Animal Studies

    Directory of Open Access Journals (Sweden)

    Arshad Majid

    2015-10-01

    Full Text Available Clinical trials are the backbone of medical research, and are often the last step in the development of new therapies for use in patients. Prior to human testing, however, preclinical studies using animal subjects are usually performed in order to provide initial data on the safety and effectiveness of prospective treatments. These studies can be costly and time consuming, and may also raise concerns about the ethical treatment of animals when potentially harmful procedures are involved. Adaptive design is a process by which the methods used in a study may be altered while it is being conducted in response to preliminary data or other new information. Adaptive design has been shown to be useful in reducing the time and costs associated with clinical trials, and may provide similar benefits in preclinical animal studies. The purpose of this review is to summarize various aspects of adaptive design and evaluate its potential for use in preclinical research.

  15. The Potential of Adaptive Design in Animal Studies.

    Science.gov (United States)

    Majid, Arshad; Bae, Ok-Nam; Redgrave, Jessica; Teare, Dawn; Ali, Ali; Zemke, Daniel

    2015-01-01

    Clinical trials are the backbone of medical research, and are often the last step in the development of new therapies for use in patients. Prior to human testing, however, preclinical studies using animal subjects are usually performed in order to provide initial data on the safety and effectiveness of prospective treatments. These studies can be costly and time consuming, and may also raise concerns about the ethical treatment of animals when potentially harmful procedures are involved. Adaptive design is a process by which the methods used in a study may be altered while it is being conducted in response to preliminary data or other new information. Adaptive design has been shown to be useful in reducing the time and costs associated with clinical trials, and may provide similar benefits in preclinical animal studies. The purpose of this review is to summarize various aspects of adaptive design and evaluate its potential for use in preclinical research. PMID:26473839

  16. Autoimmune Responses to Brain Following Stroke

    OpenAIRE

    Becker, Kyra

    2012-01-01

    This review provides a synthesis of the work done by our laboratory that demonstrates the presence of cellular immune responses directed towards brain antigens in animals following experimental stroke as well as in patients following ischemic stroke. These responses include both antigenspecific Th1(+) responses, which are associated with worse stroke outcome, and antigen-specific Treg responses, which are associated with better stroke outcome. The likelihood of developing a detrimental Th1(+)...

  17. The relation between oxidative stress parameters, ischemic stroke,and hemorrhagic stroke

    OpenAIRE

    İçme, Ferhat; EREL, ÖZCAN; AVCİ, AKKAN; SATAR, SALİM; Gülen, Müge; Acehan, Selen

    2015-01-01

    Background/aim: The aims of this study were to investigate the significance of oxidative stress parameters in the pathogenesis of ischemic stroke and hemorrhagic stroke and to investigate their effects on stroke severity using the National Institutes of Health Stroke Scale (NIHSS). Materials and methods: A total of 92 patients, including 74 with ischemic stroke and 18 with hemorrhagic stroke, and 75 volunteers were enrolled in the study. Total oxidant status (TOS), total antioxidant status (...

  18. Frequency of risk factors of cerebral infarction in stroke patients. a study of 100 cases in naseer teaching hospital, peshawar

    International Nuclear Information System (INIS)

    To study the risk factors of cerebral infarction in stroke patients. It is a descriptive hospital based study conducted at the Department of Medicine, Naseer Teaching Hospital, Peshawar from January 2005 to December 2005. One hundred patients of stroke with cerebral infarction confirmed on C.T. scan brain and more than twenty years of age were included. Risk factors for cerebral infarction were defined in terms of hypertension, diabetes mellitus, ischemic heart disease, smoking, dyslipidaemia, TIAs (transient ischemic attacks), carotid artery stenosis and family history of stroke. Data of 100 cases with cerebral infarction was recorded. Most of the patients had more than one risk factors for cerebral infarction. hypertension was commonest risk factor (55%), smoking (30%), ischemic heart disease (34%), diabetes mellitus) (26%), hyperlipedaemia (30%), atrial fibrillation (25%), carotid artery stenosis (27%), obesity (15%) and family history of stroke (12%). 39% of patients had physical inactivity. Males were slightly predominant than females (51% vs 49%) and mean age was 50 years. females were rather older with mean age of 53 years. Cerebral infarction accounts for 80% to 85% of cases of stroke, which is a common neurological disorder. It increases a burden of disability and misery for patients and their families. Most of the risk factors of cerebral infarction are modifiable, its prevention should be the main cause of concern for the community. (author)

  19. Apolipoprotein E polymorphism and acute ischemic stroke: a diffusion- and perfusion-weighted magnetic resonance imaging study.

    Science.gov (United States)

    Liu, Yawu; Laakso, Mikko P; Karonen, Jari O; Vanninen, Ritva L; Nuutinen, Juho; Soimakallio, Seppo; Aronen, Hannu J

    2002-11-01

    Diffusion- and perfusion-weighted magnetic resonance imaging (MRI) was used to study the putative effects of apolipoprotein E (ApoE) polymorphism in stroke. Thirty-one patients with acute stroke, comparative for age and gender were scanned, nine of whom were ApoE allele epsilon 4 carriers. Initially, less than 24 hours from the onset of stroke, the epsilon 4 carriers had significantly smaller volumes of hypoperfusion on relative cerebral blood volume map (P = 0.001), and smaller infarct volumes (P = 0.008) compared with the noncarriers. By day 8, this difference in the infarct volumes had disappeared, suggesting relatively enhanced infarct growth. On average, the total infarct volume increased 145% of the initial infarct volume in the epsilon 4 carriers, and 84% in the noncarriers. There were strong correlations between the imaging findings and clinical status initially and with the outcome 3 months after the stroke in the epsilon 4 noncarriers, but, with a single exception at acute phase, a lack thereof in the epsilon 4 carriers. These patterns were virtually similar in a subgroup of patients with middle cerebral artery stroke. These data support the hypothesis of increased general vulnerability of the brain in the epsilon 4 carriers. Thus, the effects of ApoE polymorphism should be accounted for when interpreting diffusion- and perfusion-weighted MRI studies, particularly if predicting lesion growth. PMID:12439291

  20. Dimensions of post-stroke fatigue: a two-year follow-up study

    DEFF Research Database (Denmark)

    Christensen, Doris; Johnsen, Soeren Paaske; Watt, Torquil;

    2008-01-01

    , was reported by 59% (95% CI: 51-66%), 44% (95% CI: 36-51%), 38% (95% CI: 31-46%), and 40% (95% CI: 32-48%) of stroke patients 10 days, 3 months, 1 year, and 2 years following hospitalization for stroke, respectively. Post-stroke fatigue levels decreased after three months and remained stable throughout......-time stroke admitted to acute stroke units at the Aarhus University Hospital, Denmark. A reference group of 1,069 persons was sampled from the general population. Fatigue was assessed using the Multidimensional Fatigue Inventory (MFI-20) covering five scales of fatigue (General Fatigue, Physical Fatigue......, Reduced Activity, Reduced Motivation, and Mental Fatigue). RESULTS: Compared to the general population, stroke patients reported higher levels of Physical Fatigue. Minor or no differences were found for the other fatigue scales. Pathological fatigue, defined as a score >or=12 on the General Fatigue scale...

  1. Gait improvement after treadmill training in ischemic stroke survivors A critical review of functional MRI studies

    Institute of Scientific and Technical Information of China (English)

    Xiang Xiao; Dongfeng Huang; Bryan O'Young

    2012-01-01

    Stroke survivors often present with abnormal gait, movement training can improve the walking performance post-stroke, and functional MRI can objectively evaluate the brain functions before and after movement training. This paper analyzes the functional MRI changes in patients with ischemic stroke after treadmill training with voluntary and passive ankle dorsiflexion. Functional MRI showed that there are some changes in some regions of patients with ischemic stroke including primary sensorimotor cortex, supplementary motor area and cingulate motor area after treadmill training. These findings suggest that treadmill training likely improves ischemic stroke patients' lower limb functions and gait performance and promotes stroke recovery by changing patients' brain plasticity; meanwhile, the novel treadmill training methods can better training effects.

  2. Does the ‘diffusion of innovations’ model enrich understanding of research use? Case studies of the implementation of thrombolysis services for stroke

    OpenAIRE

    Boaz, Annette; Baeza, Juan; Fraser, Alec

    2016-01-01

    Objectives: To test the applicability of the model of diffusion of innovations as an analytical framework to explore the implementation of evidence based thrombolysis services for stroke patients. Methods: Four empirical case studies of the implementation of evidence into stroke services in England and Sweden. Data were drawn from 95 semi structured interviews with a range of clinical and managerial staff within four hospitals, working in stroke units, emergency medicine, radiology, the ambul...

  3. Functional versus Nonfunctional Rehabilitation in Chronic Ischemic Stroke: Evidences from a Randomized Functional MRI Study

    Directory of Open Access Journals (Sweden)

    Maristela C. X. Pelicioni

    2016-01-01

    Full Text Available Motor rehabilitation of stroke survivors may include functional and/or nonfunctional strategy. The present study aimed to compare the effect of these two rehabilitation strategies by means of clinical scales and functional Magnetic Resonance Imaging (fMRI. Twelve hemiparetic chronic stroke patients were selected. Patients were randomly assigned a nonfunctional (NFS or functional (FS rehabilitation scheme. Clinical scales (Fugl-Meyer, ARA test, and modified Barthel and fMRI were applied at four moments: before rehabilitation (P1 and immediately after (P2, 1 month after (P3, and three months after (P4 the end of rehabilitation. The NFS group improved significantly and exclusively their Fugl-Meyer scores at P2, P3, and P4, when compared to P1. On the other hand, the FS group increased significantly in Fugl-Meyer at P2, when compared to P1, and also in their ARA and Barthel scores. fMRI inspection at the individual level revealed that both rehabilitation schemes most often led to decreased activation sparseness, decreased activity of contralesional M1, increased asymmetry of M1 activity to the ipsilesional side, decreased perilesional activity, and decreased SMA activity. Increased M1 asymmetry with rehabilitation was also confirmed by Lateralization Indexes. Our clinical analysis revealed subtle differences between FS and NFS.

  4. Improving adherence to medication in stroke survivors (IAMSS: a randomised controlled trial: study protocol

    Directory of Open Access Journals (Sweden)

    Johnston Marie

    2010-02-01

    Full Text Available Abstract Background Adherence to therapies is a primary determinant of treatment success, yet the World Health Organisation estimate that only 50% of patients who suffer from chronic diseases adhere to treatment recommendations. In a previous project, we found that 30% of stroke patients reported sub-optimal medication adherence, and this was associated with younger age, greater cognitive impairment, lower perceptions of medication benefits and higher specific concerns about medication. We now wish to pilot a brief intervention aimed at (a helping patients establish a better medication-taking routine, and (b eliciting and modifying any erroneous beliefs regarding their medication and their stroke. Methods/Design Thirty patients will be allocated to a brief intervention (2 sessions and 30 to treatment as usual. The primary outcome will be adherence measured over 3 months using Medication Event Monitoring System (MEMS pill containers which electronically record openings. Secondary outcomes will include self reported adherence and blood pressure. Discussion This study shall also assess uptake/attrition, feasibility, ease of understanding and acceptability of this complex intervention. Trial Registration Current Controlled Trials ISRCTN38274953

  5. Accelerometer measurement of upper extremity movement after stroke: a systematic review of clinical studies.

    Science.gov (United States)

    Noorkõiv, Marika; Rodgers, Helen; Price, Christopher I

    2014-10-09

    The aim of this review was to identify and summarise publications, which have reported clinical applications of upper limb accelerometry for stroke within free-living environments and make recommendations for future studies. Data was searched from MEDLINE, Scopus, IEEExplore and Compendex databases. The final search was 31st October 2013. Any study was included which reported clinical assessments in parallel with accelerometry in a free-living hospital or home setting. Study quality is reflected by participant numbers, methodological approach, technical details of the equipment used, blinding of clinical measures, whether safety and compliance data was collected. First author screened articles for inclusion and inclusion of full text articles and data extraction was confirmed by the third author. Out of 1375 initial abstracts, 8 articles were included. All participants were stroke patients. Accelerometers were worn for either 24 hours or 3 days. Data were collected as summed acceleration counts over a specified time or as the duration of active/inactive periods. Activity in both arms was reported by all studies and the ratio of impaired to unimpaired arm activity was calculated in six studies. The correlation between clinical assessments and accelerometry was tested in five studies and significant correlations were found. The efficacy of a rehabilitation intervention was assessed using accelerometry by three studies: in two studies both accelerometry and clinical test scores detected a post-treatment difference but in one study accelerometry data did not change despite clinical test scores showing motor and functional improvements. Further research is needed to understand the additional value of accelerometry as a measure of upper limb use and function in a clinical context. A simple and easily interpretable accelerometry approach is required.

  6. Energy expenditure in chronic stroke patients playing Wii Sports: A pilot study

    OpenAIRE

    Stam Henk J; Streur-Kranenburg Marjolein F; Ribbers Gerard M; Hurkmans Henri L; van den Berg-Emons Rita J

    2011-01-01

    Abstract Background Stroke is one of the leading causes of long-term disability in modern western countries. Stroke survivors often have functional limitations which might lead to a vicious circle of reduced physical activity, deconditioning and further physical deterioration. Current evidence suggests that routine moderate- or vigorous-intensity physical activity is essential for maintenance and improvement of health among stroke survivors. Nevertheless, long-term participation in physical a...

  7. Studies to inform the methods for Cochrane systematic reviews of diagnostic accuracy in stroke medicine

    OpenAIRE

    Brazzelli, Miriam

    2011-01-01

    Background A variety of tests are used in clinical practice to help the diagnostic process and so improve patient care. Many aspects of stroke management depend on accurate and rapid diagnosis. Brain imaging, including CT or MRI, is necessary to identify the location and extent of the cerebral lesion, and to determine the pathological type of stroke and its likely cause. Current treatments - such as thrombolysis - for ischaemic stroke have increased the need for clear eviden...

  8. Where are we in the study of animal emotions?

    Science.gov (United States)

    de Vere, Amber J; Kuczaj, Stan A

    2016-09-01

    The study of emotion is rife with debate over issues as fundamental as how to define emotion, and such disputes are particularly common in the nonhuman animal emotion literature. Here, we seek to address some of these issues, especially in terms of how they relate to animal research. Definitional issues are prevalent; clear definitions are often not given of crucial terms, including 'emotion,' and even where provided, such terms may be used inconsistently throughout a single paper. Further disagreement over the structure of emotions, and the nature of conscious experiences involved, leads to consistent differences in authors' criteria for emotions. We concur with those who believe that animals experience emotions and believe that animal emotions should be studied in their own right, not only as they compare to those of humans. We also propose several avenues for future research that we believe will further our understanding of animal emotions. First, the use of multiple measurement methods to assess emotional responses is most likely to provide the information necessary to distinguish between various states and opens the field to more research in harder-to-study species, such as marine mammals. Second, researchers should also endeavor to increase the range of emotions studied, particularly positive ones, in order to move toward a more balanced range of studied states. Finally, we believe that several aspects of personality research would prove beneficial to the study of animal emotions, particularly the distinction between trait and state emotion and the use of the rating method. WIREs Cogn Sci 2016, 7:354-362. doi: 10.1002/wcs.1399 For further resources related to this article, please visit the WIREs website. PMID:27327075

  9. Dairy Intake and Coronary Heart Disease or Stroke – a population-based cohort study in the Netherlands

    OpenAIRE

    Dalmeijer, G.W.; Struijk, E.A.; van, der Schouw, Yvonne T.; Soedamah-Muthu, S. S.; W M M Verschuren; Geleijnse, J M

    2013-01-01

    AIM: This study aimed to investigate the relationship between total dairy intake and dairy subtypes (high-fat dairy, low-fat dairy, milk and milk products, cheese and fermented dairy) with incident coronary heart disease (CHD) and stroke. METHODS: EPIC-NL is a prospective cohort study among 33,625 Dutch men and women. At baseline (1993-1997), dairy intake was measured with a validated food frequency questionnaire (FFQ). The incidence of both fatal and non-fatal CHD and stroke was obtained by ...

  10. Correlates of Post-Stroke Brain Plasticity, Relationship to Pathophysiological Settings and Implications for Human Proof-of-Concept Studies.

    Science.gov (United States)

    Sanchez-Mendoza, Eduardo H; Hermann, Dirk Matthias

    2016-01-01

    The promotion of neurological recovery by enhancing neuroplasticity has recently obtained strong attention in the stroke field. Experimental studies support the hypothesis that stroke recovery can be improved by therapeutic interventions that augment neuronal sprouting. However plasticity responses of neurons are highly complex, involving the growth and differentiation of axons, dendrites, dendritic spines and synapses, which depend on the pathophysiological setting and are tightly controlled by extracellular and intracellular signals. Thorough mechanistic insights are needed into how neuronal plasticity is influenced by plasticity-promoting therapies in order not to risk the success of future clinical proof-of-concept studies. PMID:27547178

  11. Association of Cytomegalovirus End-Organ Disease with Stroke in People Living with HIV/AIDS: A Nationwide Population-Based Cohort Study.

    Directory of Open Access Journals (Sweden)

    Yung-Feng Yen

    Full Text Available Cytomegalovirus (CMV infection might increase the risk of cardiovascular event. However, data on the link between incident stroke and co-infections of CMV and human immunodeficiency virus (HIV are limited and inconsistent. This nationwide population-based cohort study analyzed the association of CMV end-organ disease and stroke among people living with HIV/AIDS (PLWHA.From January 1, 1998, this study identified adult HIV individuals with and without CMV end-organ disease in the Taiwan National Health Insurance Research Database. All patients were observed for incident stroke and were followed until December 31, 2012. Time-dependent analysis was used to evaluate associations of CMV end-organ disease with stroke.Of the 22,581 PLWHA identified (439 with CMV end-organ disease and 22,142 without CMV end-organ disease, 228 (1.01% had all-cause stroke during a mean follow-up period of 4.85 years, including 169 (0.75% with ischemic stroke and 59 (0.26% with hemorrhagic stroke. After adjusting for age, sex, comorbidities, opportunistic infections after HIV diagnosis, and antiretroviral treatment, CMV end-organ disease was found to be an independent risk factor for incident all-cause stroke (adjusted hazard ratio [AHR], 3.07; 95% confidence interval [CI], 1.70 to 5.55. When stroke type was considered, CMV end-organ disease was significantly positively associated with the risk of ischemic stroke (AHR, 3.14; 95% CI, 1.49 to 6.62 but not hemorrhagic stroke (AHR, 2.52; 95% CI, 0.64 to 9.91.This study suggested that CMV end-organ disease was an independent predictor of ischemic stroke among PLWHA.

  12. Does short-term whole-body vibration training affect arterial stiffness in chronic stroke? A preliminary study.

    Science.gov (United States)

    Yule, Christie E; Stoner, Lee; Hodges, Lynette D; Cochrane, Darryl J

    2016-03-01

    [Purpose] Previous studies have shown that stroke is associated with increased arterial stiffness that can be diminished by a program of physical activity. A novel exercise intervention, whole-body vibration (WBV), is reported to significantly improve arterial stiffness in healthy men and older sedentary adults. However, little is known about its efficacy in reducing arterial stiffness in chronic stroke. [Subjects and Methods] Six participants with chronic stroke were randomly assigned to 4 weeks of WBV training or control followed by cross-over after a 2-week washout period. WBV intervention consisted of 3 sessions of 5 min intermittent WBV per week for 4 weeks. Arterial stiffness (carotid arterial stiffness, pulse wave velocity [PWV], pulse and wave analysis [PWA]) were measured before/after each intervention. [Results] No significant improvements were reported with respect to carotid arterial stiffness, PWV, and PWA between WBV and control. However, carotid arterial stiffness showed a decrease over time following WBV compared to control, but this was not significant. [Conclusion] Three days/week for 4 weeks of WBV seems too short to elicit appropriate changes in arterial stiffness in chronic stroke. However, no adverse effects were reported, indicating that WBV is a safe and acceptable exercise modality for people with chronic stroke.

  13. The cost effectiveness of an early transition from hospital to nursing home for stroke patients: design of a comparative study

    Directory of Open Access Journals (Sweden)

    Limburg Martien

    2010-05-01

    Full Text Available Abstract Background As the incidence of stroke has increased, its impact on society has increased accordingly, while it continues to have a major impact on the individual. New strategies to further improve the quality, efficiency and logistics of stroke services are necessary. Early discharge from hospital to a nursing home with an adequate rehabilitation programme could help to optimise integrated care for stroke patients. The objective is to describe the design of a non-randomised comparative study evaluating early admission to a nursing home, with multidisciplinary assessment, for stroke patients. The study is comprised of an effect evaluation, an economic evaluation and a process evaluation. Methods/design The design involves a non-randomised comparative trial for two groups. Participants are followed for 6 months from the time of stroke. The intervention consists of a redesigned care pathway for stroke patients. In this care pathway, patients are discharged from hospital to a nursing home within 5 days, in comparison with 12 days in the usual situation. In the nursing home a structured assessment takes place, aimed at planning adequate rehabilitation. People in the control group receive the usual care. The main outcome measures of the effect evaluation are quality of life and daily functioning. In addition, an economic evaluation will be performed from a societal perspective. A process evaluation will be carried out to evaluate the feasibility of the intervention as well as the experiences and opinions of patients and professionals. Discussion The results of this study will provide information about the cost effectiveness of the intervention and its effects on clinical outcomes and quality of life. Relevant strengths and weaknesses of the study are addressed in this article. Trial registration Current Controlled Trails ISRCTN58135104

  14. Study of exon 12 polymorphism of the human thromboxane synthase (CYP5A1) gene in Egyptian stroke patients

    International Nuclear Information System (INIS)

    Thromboxane synthase (CYP5A1) catalyzes the conversion of prostaglandin H2 to thromboxane A2, a potent mediator of platelet aggregation, vasoconstriction and bronchoconstriction. It has been implicated in the patho-physiological process of a variety of diseases, such as atherosclerosis, myocardial infarction, stroke and asthma. On the basis of the hypothesis that variations of the CYP5A1 gene may play an important role in human diseases, we performed screening for the prevalence of exon12 polymorphism of the human Thromboxane synthase (CYP5A1) gene among Egyptian normal and stroke patients. Using sequence-specific PCR, we examined the allelic prevalence in 70 Egyptian patients with ischemic strokes and in 70 controls. In addition, we compared the CYP5A1 allelic prevalence in 30 patients with stroke recurrence despite Aspirin use, in comparison with patients who have not experienced recurrent stroke while taking Aspirin. The frequencies of the CYP5A1*9 mutant (substitution of guanine by adenine near the heme-binding catalytic domain) and of the wild-type allele were 0.197(19.7%) and 0.803 (80.3%) respectively; they did not differ significantly between stroke patients and controls. The CYP5A1*9 mutant was significantly more prevalent among stroke patients with history of previous cerebrovascular attacks; even after adjusting for the common risk factors for cardiovascular disease (odds ratio (OR)1.73, 95%, confidence interval ( CI) 1.10-2.73; p=0.017). Among stroke patients, the presence of the CYP5A1 wild type allele was more frequent among the hypertensives (OR 1.68, 95% CI, 1.01-2.79; p=0.045), and less frequent among the diabetics (OR 0.55, 95%, CI 0.36-0.84; p=0.006). Also among stroke patients, the CYP5A1*9 mutant was significantly more prevalent among those, who failed secondary Aspirin prophylaxis compared to those with successful secondary Aspirin prophylaxis (OR 1.49, 95%, CI 1.06-2.11). This study provides evidence for high prevalence of the CYP5A1*9 mutant

  15. Relative effects of statin therapy on stroke and cardiovascular events in men and women: secondary analysis of the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Study

    DEFF Research Database (Denmark)

    Goldstein, L.B.; Amarenco, P.; Lamonte, M.;

    2008-01-01

    similarly benefited from randomization to statin treatment. METHODS: The effect of sex on treatment-related reductions in stroke and other cardiovascular outcomes were analyzed with Cox regression modeling testing for sex by treatment interactions. RESULTS: Women (n=1908) constituted 40% of the SPARCL study...... (207.0+/-0.54 versus 218.9+/-0.67 mg/dL) and LDL-C levels (132+/-0.45 versus 134+/-0.57 mg/dL) than women. Use of antithrombotics and antihypertensives were similar. After prespecified adjustment for region, entry event, time since event, and age, there were no sex by treatment interactions...... for the combined risk of nonfatal and fatal stroke (treatment Hazard Ratio, HR=0.84, 95% CI 0.68, 1.02 in men versus HR=0.84, 95% CI 0.63, 1.11 in women; treatment x sex interaction P=0.99), major cardiac events (HR=0.61, 95% CI 0.42, 0.87 in men versus HR=0.76, 95% CI 0.48, 1.21 in women; P=0.45), major...

  16. Physical exercise training and neurovascular unit in ischemic stroke.

    Science.gov (United States)

    Wang, X; Zhang, M; Feng, R; Li, W B; Ren, S Q; Zhang, J; Zhang, F

    2014-06-20

    Physical exercise could exert a neuroprotective effect in both clinical studies and animal experiments. A series of related studies have indicated that physical exercise could reduce infarct volume, alleviate neurological deficits, decrease blood-brain barrier dysfunction, promote angiogenesis in cerebral vascular system and increase the survival rate after ischemic stroke. In this review, we summarized the protective effects of physical exercise on neurovascular unit (NVU), including neurons, astrocytes, pericytes and the extracellular matrix. Furthermore, it was demonstrated that exercise training could decrease the blood-brain barrier dysfunction and promote angiogenesis in cerebral vascular system. An awareness of the exercise intervention benefits pre- and post stroke may lead more stroke patients and people with high-risk factors to accept exercise therapy for the prevention and treatment of stroke. PMID:24780769

  17. Epidemiologic Study of Cardinal Risk Factors of Stroke in Patients who Referred to Farshchian Hospital of Hamadan during 2014-2015

    Directory of Open Access Journals (Sweden)

    Sh. Mazaheri

    2016-01-01

    Full Text Available Introduction & Objective: Stroke is the third cause of death in developed countries and the most common neurologic disease resulting in disability. Nowadays, several risk factors for stroke are recognized properly. Life style and risk factors such as hypertension and diabetes are different among various cultures and countries. This study was designed to evaluate strokes epidemiology and their cardinal risk factors in patients who referred to Farshchian hospital of Hamedan during 2014-2015. Material & Methods: In this cross sectional-descriptive study 684 files of patients hospitalized in neurology ward of Farshchian hospital has been evaluated whose diagnosis was confirmed by clinical signs and CT scan study during 2014-15. Their information was derived to complete the check list including age, sex, location and cardinal risk factors such as history of past stroke, hypertension, diabetes mellitus, smoking, dyslipidemia and history of cardiac diseases. Corresponding data were analyzed by SPSS 16 software. Result: Of 684 patients, 355 individuals (51.9% were males and 329 individuals (48.1% were females, of whom 547 cases (79.97% had ischemic stroke and 137 cases (20.03 % had hemorrhagic stroke. The mean age for women, (67.83 years, were meaningfully more than that of men (64.18 years, (P=0.0002, and the group age of 60 to 69 years with 29.68 percent had the most abundant cases of strokes overall. 396 individuals (57.89% were urban and 288 individuals (42.11% were rural. 245 individuals (35.82% had previous stroke and 294 individuals (42.98% had familial history of stroke. The most frequent risk factors were hypertension with 54.24 percent, cardiac diseases with 35.38 percent, smoking with 29.68 percent, diabetes type 2 with 19.01 percent and dyslipidemia with 18.42 percent in order of abundance. The relation between cardiac disease and urbanity was meaningful (P=0.02, and in hemorrhagic stroke, prevalence of hypertension was significantly higher

  18. Concise review: Preclinical studies on human cell-based therapy in rodent ischemic stroke models: where are we now after a decade?

    Science.gov (United States)

    Leong, Wai Khay; Lewis, Martin D; Koblar, Simon A

    2013-06-01

    Stroke, a debilitating brain insult, afflicts millions of individuals globally each year. In the last decade, researchers have investigated cell-based therapy as an alternative strategy to improve neurological outcome following stroke. This concise review critically examines preclinical reports using human adult and fetal stem/progenitor cells in rodent models of ischemic stroke. As we enter the second decade of study, we should aim to optimize our collective likelihood to translational success for stroke victims worldwide. We advocate international consensus recommendations be developed for future preclinical research. PMID:23390084

  19. Animal venom studies: Current benefits and future developments

    Institute of Scientific and Technical Information of China (English)

    Yuri; N; Utkin

    2015-01-01

    Poisonous organisms are represented in many taxa, including kingdom Animalia. During evolution, animals have developed special organs for production and injection of venoms. Animal venoms are complex mixtures, compositions of which depend on species producing venom. The most known and studied poisonous terrestrial animals are snakes, scorpions and spiders. Among marine animals, these are jellyfishes, anemones and cone snails. The toxic substances in the venom ofthese animals are mainly of protein and peptide origin. Recent studies have indicated that the single venom may contain up to several hundred different components producing diverse physiological effects. Bites or stings by certain poisonous species result in severe envenomations leading in some cases to death. This raises the problem of bite treatment. The most effective treatment so far is the application of antivenoms. To enhance the effectiveness of such treatments, the knowledge of venom composition is needed. On the other hand, venoms contain substances with unique biological properties, which can be used both in basic science and in clinical applications. The best example of toxin application in basic science is α-bungarotoxin the discovery of which made a big impact on the studies of nicotinic acetylcholine receptor. Today compositions of venom from many species have already been examined. Based on these data, one can conclude that venoms contain a large number of individual components belonging to a limited number of structural types. Often minor changes in the amino acid sequence give rise to new biological properties. Change in the living conditions of poisonous animals lead to alterations in the composition of venoms resulting in appearance of new toxins. At the same time introduction of new methods of proteomics and genomics lead to discoveries of new compounds, which may serve as research tools or as templates for the development of novel drugs. The application of these sensitive and

  20. Prognostic value of trans-thoracic echocardiography in patients with acute stroke and atrial fibrillation: findings from the RAF study.

    Science.gov (United States)

    Paciaroni, Maurizio; Agnelli, Giancarlo; Falocci, Nicola; Caso, Valeria; Becattini, Cecilia; Marcheselli, Simona; Rueckert, Christina; Pezzini, Alessandro; Poli, Loris; Padovani, Alessandro; Csiba, Laszló; Szabó, Lilla; Sohn, Sung-Il; Tassinari, Tiziana; Abdul-Rahim, Azmil H; Michel, Patrik; Cordier, Maria; Vanacker, Peter; Remillard, Suzette; Alberti, Andrea; Venti, Michele; Acciarresi, Monica; D'Amore, Cataldo; Mosconi, Maria Giulia; Scoditti, Umberto; Denti, Licia; Orlandi, Giovanni; Chiti, Alberto; Gialdini, Gino; Bovi, Paolo; Carletti, Monica; Rigatelli, Alberto; Putaala, Jukka; Tatlisumak, Turgut; Masotti, Luca; Lorenzini, Gianni; Tassi, Rossana; Guideri, Francesca; Martini, Giuseppe; Tsivgoulis, Georgios; Vadikolias, Kostantinos; Liantinioti, Chrissoula; Corea, Francesco; Del Sette, Massimo; Ageno, Walter; De Lodovici, Maria Luisa; Bono, Giorgio; Baldi, Antonio; D'Anna, Sebastiano; Sacco, Simona; Carolei, Antonio; Tiseo, Cindy; Imberti, Davide; Zabzuni, Dorjan; Doronin, Boris; Volodina, Vera; Consoli, Domenico; Galati, Franco; Pieroni, Alessio; Toni, Danilo; Monaco, Serena; Baronello, Mario Maimone; Barlinn, Kristian; Pallesen, Lars-Peder; Kepplinger, Jessica; Bodechtel, Ulf; Gerber, Johannes; Deleu, Dirk; Melikyan, Gayane; Ibrahim, Faisal; Akhtar, Naveed; Lees, Kennedy R

    2016-02-01

    Anticoagulant therapy is recommended for the secondary prevention of stroke in patients with atrial fibrillation (AF). T he identification of patients at high risk for early recurrence, which are potential candidates to prompt anticoagulation, is crucial to justify the risk of bleeding associated with early anticoagulant treatment. The aim of this study was to evaluate in patients with acute ischemic stroke and AF the association between findings at trans-thoracic echocardiography (TTE) and 90 days recurrence. In consecutive patients with acute ischemic stroke and AF, TTE was performed within 7 days from hospital admission. Study outcomes were recurrent ischemic cerebrovascular events (stroke or TIA) and systemic embolism. 854 patients (mean age 76.3 ± 9.5 years) underwent a TTE evaluation; 63 patients (7.4%) had at least a study outcome event. Left atrial thrombosis was present in 11 patients (1.3%) among whom 1 had recurrent ischemic event. Left atrial enlargement was present in 548 patients (64.2%) among whom 51 (9.3%) had recurrent ischemic events. The recurrence rate in the 197 patients with severe left atrial enlargement was 11.7%. On multivariate analysis, the presence of atrial enlargement (OR 2.13; 95% CI 1.06-4.29, p = 0.033) and CHA2DS2-VASc score (OR 1.22; 95% CI 1.04-1.45, p = 0.018, for each point increase) were correlated with ischemic recurrences. In patients with AF-associated acute stroke, left atrial enlargement is an independent marker of recurrent stroke and systemic embolism. The risk of recurrence is accounted for by severe atrial enlargement. TTE-detected left atrial thrombosis is relatively uncommon. PMID:26566907

  1. Dairy Intake and Coronary Heart Disease or Stroke – a population-based cohort study in the Netherlands

    NARCIS (Netherlands)

    Dalmeijer, G.W.; Struijk, E.A.; Schouw, van der Y.T.; Soedamah-Muthu, S.S.; Verschuren, W.M.M.; Geleijnse, J.M.

    2013-01-01

    AIM: This study aimed to investigate the relationship between total dairy intake and dairy subtypes (high-fat dairy, low-fat dairy, milk and milk products, cheese and fermented dairy) with incident coronary heart disease (CHD) and stroke. METHODS: EPIC-NL is a prospective cohort study among 33,625 D

  2. Publication Bias in Reports of Animal Stroke Studies Leads to Major Overstatement of Efficacy

    NARCIS (Netherlands)

    Sena, Emily S.; van der Worp, H. Bart; Bath, Philip M. W.; Howells, David W.; Macleod, Malcolm R.

    2010-01-01

    The consolidation of scientific knowledge proceeds through the interpretation and then distillation of data presented in research reports, first in review articles and then in textbooks and undergraduate courses, until truths become accepted as such both amongst "experts'' and in the public understa

  3. Rural Stroke Caregivers: A Qualitative Study of the Positive and Negative Response to the Caregiver Role.

    Science.gov (United States)

    Johnson, P D

    1998-01-01

    Caregivers are often referred to as the "hidden patients." Rarely has caregiving research focused on the positive aspects of caregiving. The purpose of this study was to investigate the lived experiences of caregivers of stroke survivors who have been in the caregiver role for at least 6 months poststroke. The conceptual framework was based on a combination of Lazarus' stress and coping theory and Weiner's attribution theory. A qualitative cross-sectional design was employed. It involved a sample of 10 caregivers from a rural county in Wyoming. A total of 24 categories were identified and five themes emerged: (1) a sense of loyalty; (2) acceptance; (3) a sense of "feeling good"; (4) satisfaction is associated with helping others; and (5) burden is associated with lifestyle change. Participants in this study reported several positive outcomes as well as some negative outcomes in regard to their role as caregivers.

  4. Early infection and prognosis after acute stroke

    DEFF Research Database (Denmark)

    Kammersgaard, L P; Jørgensen, H S; Reith, J;

    2001-01-01

    Infection is a frequent complication in the early course of acute stroke and may adversely affect stroke outcome. In the present study, we investigate early infection developing in patients within 3 days of admission to the hospital and its independent relation to recovery and stroke outcome. In...... addition, we identify predictors for early infections, infection subtypes, and their relation to initial stroke severity....

  5. The Socio-economic Impact of Stroke on Households in Livingstone District, Zambia: A Cross-sectional Study

    OpenAIRE

    Mapulanga, M; Nzala, S; Mweemba, C

    2014-01-01

    Background: Stroke is the leading cause of adult disability. Stroke, which affects mostly the productive age group, leaves about 65% of its victims disabled, leads to increased loss of manpower both at individual and national levels. Little is known about the socio-economic burden of the disease in terms of its impacts on the individual, family and community both directly and indirectly in Sub-Sahara Africa region and Zambia at large. Aim: The study was aimed at assessing the socio-economic i...

  6. Field Research Studying Whales in an Undergraduate Animal Behavior Laboratory

    Science.gov (United States)

    MacLaren, R. David; Schulte, Dianna; Kennedy, Jen

    2012-01-01

    This work describes a new field research laboratory in an undergraduate animal behavior course involving the study of whale behavior, ecology and conservation in partnership with a non-profit research organization--the Blue Ocean Society for Marine Conservation (BOS). The project involves two weeks of training and five weekend trips on whale watch…

  7. An Exploratory Study of Apache Middle School Students' Computer Animation.

    Science.gov (United States)

    Stokrocki, Mary; Buckpitt, Marcia

    The paper describes a participant observation study of a 3 week summer art program for Apache middle school students on the White Mountain Reservation. Computer art skills, specifically animation using a menu-driven computer paint program, were the focus of the investigation. Because it was in the context of a summer program, instruction was…

  8. Chronic kidney disease itself is a causal risk factor for stroke beyond traditional cardiovascular risk factors: a nationwide cohort study in Taiwan.

    Directory of Open Access Journals (Sweden)

    Yi-Chun Chen

    Full Text Available BACKGROUND: Cardiovascular disease (CVD is a leading cause of mortality and morbidity in patients with chronic kidney disease (CKD. In Taiwan, CVD is dominated by strokes but there is no robust evidence for a causal relationship between CKD and stroke. This study aimed to explore such causal association. METHODS: We conducted a nationwide retrospective cohort study based on the Taiwan National Health Insurance Research Database from 2004 to 2007. Each patient identified was individually tracked for a full three years from the index admission to identify those in whom any type of stroke developed. The study cohort consisted of patients hospitalized with a principal diagnosis of CKD and no traditional cardiovascular risk factors at baseline (n = 1393 and an age-matched control cohort of patients hospitalized for appendectomies (n = 1393, a surrogate for the general population. Cox proportional hazard regression and propensity score model were used to compare the three-year stroke-free survival rate of the two cohorts after adjustment for possible confounding factors. RESULTS: There were 256 stroke patients, 156 (11.2% in the study cohort and 100 (7.2% in the control cohort. After adjusting for covariates, patients with primary CKD had a 1.94-fold greater risk for stroke (95% CI, 1.45-2.60; p<0.001 based on Cox regression and a 1.68-fold greater risk for stroke (95% CI, 1.25-2.25; p = 0.001 based on propensity score. This was still the case for two cohorts younger than 75 years old and without traditional cardiovascular risk factors. CONCLUSIONS: This study of Taiwanese patients indicates that CKD itself is a causal risk factor for stroke beyond the traditional cardiovascular risk factors. Primary CKD patients have higher risk for stroke than the general population and all CKD patients, irrespective of the presence or severity of traditional cardiovascular risk factors, should be made aware of the stroke risk and monitored for stroke prevention.

  9. Energy expenditure in chronic stroke patients playing Wii Sports: A pilot study

    NARCIS (Netherlands)

    H.L.P. Hurkmans (Henri); G.M. Ribbers (Gerard); M.F. Streur-Kranenburg (Marjolein); H.J. Stam (Henk); R.J.G. van den Berg-Emons (Rita)

    2011-01-01

    textabstractBackground: Stroke is one of the leading causes of long-term disability in modern western countries. Stroke survivors often have functional limitations which might lead to a vicious circle of reduced physical activity, deconditioning and further physical deterioration. Current evidence s

  10. Ultrasonographic and clinical study of post-stroke painful hemiplegic shoulder

    Directory of Open Access Journals (Sweden)

    Rania E. Mohamed

    2014-12-01

    Conclusion: Ultrasonography is an essential method in evaluation of post-stroke PHS. However, the U/S grades were not correlated with the stages of motor recovery. Avoiding overuse of the unaffected shoulder will be helpful for prevention of shoulder injuries following hemiplegic stroke.

  11. Stroke Patients Communicating Their Healthcare Needs in Hospital: A Study within the ICF Framework

    Science.gov (United States)

    O'Halloran, Robyn; Worrall, Linda; Hickson, Louise

    2012-01-01

    Background: Previous research has identified that many patients admitted into acute hospital stroke units have communication-related impairments such as hearing, vision, speech, language and/or cognitive communicative impairment. However, no research has identified how many patients in acute hospital stroke units have difficulty actually…

  12. Fibrinogen γ′ in ischemic stroke: A case-control study

    NARCIS (Netherlands)

    E.Y.L. Cheung (Elim); S.U. de Willige; H.L. Vos (Hans); F.W.G. Leebeek (Frank); D.W.J. Dippel (Diederik); R.M. Bertina (Rogier); M.P.M. de Maat (Moniek)

    2008-01-01

    textabstractBACKGROUND AND PURPOSE - To determine the contribution of fibrinogen γ′ levels and FGG haplotypes to ischemic stroke. METHODS - Associations between fibrinogen γ′ levels, fibrinogen γ′/total fibrinogen ratio, and FGG haplotypes with the risk of ischemic stroke were determined in 124 case

  13. Prehospital Unassisted Assessment of Stroke Severity Using Telemedicine A Feasibility Study

    NARCIS (Netherlands)

    Van Hooff, Robbert-Jan; Cambron, Melissa; Van Dyck, Rita; De Smedt, Ann; Moens, Maarten; Espinoza, Alexis Valenzuela; Van de Casseye, Rohny; Convents, Andre; Hubloue, Ives; De Keyser, Jacques; Brouns, Raf

    2013-01-01

    Background and Purpose We evaluated the feasibility and the reliability of remote stroke severity quantification in the prehospital setting using the Unassisted TeleStroke Scale (UTSS) via a telestroke ambulance system and a fourth-generation mobile network. Methods The technical feasibility and the

  14. Red cell distribution width in relation to incidence of stroke and carotid atherosclerosis: a population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Martin Söderholm

    Full Text Available Increased red cell distribution width (RDW has been related to poor prognosis in patients with cardiovascular disease, and is a predictor of cardiovascular mortality in the general population. The purpose of the present study was to investigate if RDW is associated with increased incidence of stroke and its subtypes in individuals from the general population.Red cell distribution width was measured in 26,879 participants (16,561 women and 10,318 men aged 45-73 years without history of coronary events or stroke, from the population-based Malmö Diet and Cancer Study. Incidences of total stroke and stroke subtypes over a mean follow-up of 15.2 years were calculated in relation to sex-specific quartiles of RDW. The presence of carotid plaque and intima-media thickness, as assessed by ultrasound, was studied in relation to RDW in a randomly selected subcohort (n = 5,309.Incidences of total stroke (n = 1,869 and cerebral infarction (n = 1,544 were both increased in individuals with high RDW. Hazard ratios (HRs in the highest compared to the lowest quartile were 1.31 for total stroke (95% confidence interval [CI]: 1.11-1.54, p for trend = 0.004 and 1.32 for cerebral infarction (95% CI: 1.10-1.58, p for trend = 0.004 after adjustment for stroke risk factors and hematological parameters. The adjusted HR for intracerebral hemorrhage (n = 230 was 1.44 (95% CI: 0.90-2.30 and the HR for subarachnoid hemorrhage (n = 75 was 0.94 (95% CI: 0.43-2.07, in the highest compared to the lowest quartile of RDW. Red cell distribution width was positively associated with intima-media thickness of the common carotid artery (p for trend = 0.011.Red cell distribution width in the highest quartile was associated with increased incidence of total stroke and cerebral infarction. There was no significant association between RDW and incidence of intracerebral or subarachnoid hemorrhage.

  15. Modifiable Etiological Factors and the Burden of Stroke from the Rotterdam Study: A Population-Based Cohort Study

    NARCIS (Netherlands)

    M.J. Bos (Michiel); P.J. Koudstaal (Peter Jan); A. Hofman (Albert); M.A. Ikram (Arfan)

    2014-01-01

    textabstractBackground:Stroke prevention requires effective treatment of its causes. Many etiological factors for stroke have been identified, but the potential gain of effective intervention on these factors in terms of numbers of actually prevented strokes remains unclear because of the lack of da

  16. Circulating MicroRNAs as Biomarkers of Acute Stroke

    Directory of Open Access Journals (Sweden)

    Sugunavathi Sepramaniam

    2014-01-01

    Full Text Available MicroRNAs have been identified as key regulators of gene expression and thus their potential in disease diagnostics, prognosis and therapy is being actively pursued. Deregulation of microRNAs in cerebral pathogenesis has been reported to a limited extent in both animal models and human. Due to the complexity of the pathology, identifying stroke specific microRNAs has been a challenge. This study shows that microRNA profiles reflect not only the temporal progression of stroke but also the specific etiologies. A panel of 32 microRNAs, which could differentiate stroke etiologies during acute phase was identified and verified using a customized TaqMan Low Density Array (TLDA. Furthermore we also found 5 microRNAs, miR-125b-2*, -27a*, -422a, -488 and -627 to be consistently altered in acute stroke irrespective of age or severity or confounding metabolic complications. Differential expression of these 5 microRNAs was also observed in rat stroke models. Hence, their specificity to the stroke pathology emphasizes the possibility of developing these microRNAs into accurate and useful tools for diagnosis of stroke.

  17. Effect of beta-blocker therapy on the risk of infections and death after acute stroke--a historical cohort study.

    Directory of Open Access Journals (Sweden)

    Ilko L Maier

    Full Text Available BACKGROUND: Infections are a frequent cause for prolonged hospitalization and increased mortality after stroke. Recent studies revealed a stroke-induced depression of the peripheral immune system associated with an increased susceptibility for infections. In a mice model for stroke, this immunosuppressive effect was reversible after beta-blocker administration. The aim of our study was to investigate the effect of beta-blocker therapy on the risk of infections and death after stroke in humans. METHODS: 625 consecutive patients with ischemic or hemorrhagic stroke, admitted to a university hospital stroke unit, were included in this historical cohort study. The effect of beta-blocker therapy on post-stroke pneumonia, urinary tract infections and death was investigated using multivariable Poisson and Cox regression models. RESULTS: 553 (88.3% patients were admitted with ischemic stroke, the remaining 72 (11.7% had a hemorrhagic stroke. Median baseline NIHSS was 8 (IQR 5-16 points. 301 (48.2% patients received beta-blocker therapy. There was no difference in the risk of post-stroke pneumonia between patients with and without beta-blocker therapy (Rate Ratio = 1.00, 95%CI 0.77-1.30, p = 0.995. Patients with beta-blocker therapy showed a decreased risk for urinary tract infections (RR = 0.65, 95%CI 0.43-0.98, p = 0.040. 7-days mortality did not differ between groups (Hazard Ratio = 1.36, 95%CI 0.65-2.77, p = 0.425, while patients with beta-blocker therapy showed a higher 30-days mortality (HR = 1.93, 95%CI 1.20-3.10, p = 0.006. CONCLUSIONS: Beta-blocker therapy did not reduce the risk for post-stroke pneumonia, but significantly reduced the risk for urinary tract infections. Different immune mechanisms underlying both diseases might explain these findings that need to be confirmed in future studies.

  18. Methylenetetrahydrofolate reductase gene A1298C polymorphism in pediatric stroke--case-control and family-based study.

    Science.gov (United States)

    Balcerzyk, Anna; Niemiec, Paweł; Kopyta, Ilona; Emich-Widera, Ewa; Pilarska, Ewa; Pienczk-Ręcławowicz, Karolina; Kaciński, Marek; Wendorff, Janusz; Żak, Iwona

    2015-01-01

    Moderate hyperhomocysteinemia is one of the risk factors of pediatric stroke. Methylenetetrahydrofolate reductase (MTHFR) is an important enzyme, which regulates homocysteine metabolism, and some polymorphisms of gene encoding this enzyme are associated with a decreased activity of the enzyme. The aim of the study was to assess an association between the A1298C polymorphism and pediatric stroke. We also evaluated a possible synergistic effect of A1298C and C677T polymorphisms of this gene. The study group consisted of 88 children after ischemic stroke, 142 of their parents and 111 controls. The A1298C polymorphism was genotyped using the restriction fragment length polymorphism method. We used 2 study designs: a case-control model and a family-based association test. The Statistica 7.1 and EpiInfo 6 softwares were used in all analyses. We did not observe any statistically significant differences either in the transmission of the A allele in the family-based test or in the frequency of the A allele in the patients group compared with the controls. We also did not notice any significant additive or synergistic effects between the A1298C and C677T polymorphisms. An analysis of the results obtained in this study and a critical review of previously published studies indicate that the A1298C polymorphism of the MTHFR gene is not related to ischemic stroke in children. PMID:25440348

  19. Estimating the lifetime economic burden of stroke according to the age of onset in South Korea: a cost of illness study

    Directory of Open Access Journals (Sweden)

    Suh Hae Sun

    2011-08-01

    Full Text Available Abstract Background The recently-observed trend towards younger stroke patients in Korea raises economic concerns, including erosion of the workforce. We compared per-person lifetime costs of stroke according to the age of stroke onset from the Korean societal perspective. Methods A state-transition Markov model consisted of three health states ('post primary stroke event', 'alive post stroke', and 'dead' was developed to simulate the natural history of stroke. The transition probabilities for fatal and non-fatal recurrent stroke by age and gender and for non-stroke causes of death were derived from the national epidemiologic data of the Korean Health Insurance Review and Assessment Services and data from the Danish Monitoring Trends in Cardiovascular Disease study. We used an incidence-based approach to estimate the long-term costs of stroke. The model captured stroke-related costs including costs within the health sector, patients' out-of-pocket costs outside the health sector, and costs resulting from loss of productivity due to morbidity and premature death using a human capital approach. Average insurance-covered costs occurring within the health sector were estimated from the National Health Insurance claims database. Other costs were estimated based on the national epidemiologic data and literature. All costs are presented in 2008 Korean currency values (Korean won = KRW. Results The lifetime costs of stroke were estimated to be: 200.7, 81.9, and 16.4 million Korean won (1,200 KRW is approximately equal to one US dollar for men who suffered a first stroke at age 45, 55 and 65 years, respectively, and 75.7, 39.2, and 19.3 million KRW for women at the same age. While stroke occurring among Koreans aged 45 to 64 years accounted for only 30% of the total disease incidence, this age group incurred 75% of the total national lifetime costs of stroke. Conclusions A higher lifetime burden and increasing incidence of stroke among younger Koreans

  20. Memory Profiles after Unilateral Paramedian Thalamic Stroke Infarction: A Comparative Study

    Directory of Open Access Journals (Sweden)

    Antonio Carota

    2015-01-01

    Full Text Available We performed extensive neuropsychological assessment of two male patients (matched for age and educational level with similar (localization and size unilateral paramedian ischemic thalamic lesions (AB on the left and SD on the right. Both patients showed severe memory impairments as well as other cognitive deficits. In comparison to SD, AB showed severe impairment of executive functions and a more severe deficit of episodic/anterograde memory, especially in the verbal modality. The findings of this single case study suggest the possibility that the profile and severity of the executive dysfunction are determinant for the memory deficits and depend on from the side of the lesion. In addition to a material-side-specific (verbal versus visual deficit hypothesis, the differential diencephalo-prefrontal contributions in mnestic-processing, in case of paramedian thalamic stroke, might also be explained in terms of their stage-specificity (encoding versus retrieval.

  1. [Obesity Paradox and Stroke].

    Science.gov (United States)

    Baumgartner, Ralf; Oesch, Lisa; Sarikaya, Hakan

    2016-07-01

    The obesity paradox suggests that overweight and obese patients of older age may have higher survival rates after stroke as compared to normalweight patients. However, the results need a cautious interpretation due to selection bias, treatment bias and different patients’ characteristics. Moreover, randomized studies that prove a benefit of weight reduction are still lacking. As obesity is an independet risk factor for stroke, weight reduction should still be recommended in overweight patients. Randomized-controlled studies are needed to prove the effect of weight reduction on morbidity and mortality after stroke. PMID:27381308

  2. [A complex study of the movement biomechanics in patients with post-stroke hemiparesis].

    Science.gov (United States)

    Skvortsov, D V; Bulatova, M A; Kovrazhkina, E A; Suvorov, A Iu; Ivanova, G E; Skvortsova, V I

    2012-01-01

    The authors present results of a pilot study on biomechanics of non-cyclic movements of the human consequent verticalization in the ontogenesis of patients with post-stroke hemiparesis (10 patients in the acute stage of cerebral stroke) and 10 healthy volunteers without neurologic and orthopedic pathology. Some movements of therapeutic exercises Balance (a model of ontogenetic kinesitherapy) have been selected for the study. Cinematic parameters have been recorded using a system of motion 3D video analysis, a kinematic model was build in accordance to standard protocols. The skin (native and straightened) electromyogram (EMG) was recorded synchronously with kinematic data using 16-channel electromyography from the following pairs of muscles: mm. sternocleido-mastoideus, trapezius (горизонтальная порция), biceps brachii, triceps brachii, rectus femoris, adductor magnus. Major differences in the EMG picture between patients and controls were: 1) the EMG "monotony" with the involvement of multiple additional muscles in locomotions with the prevalence of the peculiar "tonic" muscle activity (low amplitudes without distinct peaks), stretching along the whole cycle of movement. In controls, EMG demonstrated variability and had mostly "phasic" character with distinct 1 or 2 peaks; 2) the asymmetry of EMG profile in symmetric movements. i.e. when performed simultaneously from the right and from the left sides. The latter feature may be considered as predictive because it was never found in healthy people. It allows to identify objectively weak muscles even in the absence of visible parethis during the routine neurological examination.

  3. Atrial Septal Aneurysm and Patent Foramen Ovale as Risk Factors for Cryptogenic Stroke in Patients Less Than 55 Years of Age: A Study using Transesophageal Echocardiography

    Science.gov (United States)

    Cabanes, L.; Mas, J. L.; Cohen, A.; Amarenco, P.; Cabanes, P. A.; Oubary, P.; Chedru, F.; Guerin, F.; Bousser, M. G.; deRecondo, J.

    1993-01-01

    Background and Purpose: An association between atrial septal aneurysm and embolic events has been suggested. Atrial septal aneurysm has been shown to be associated with patent foramen ovale and,.in some reports, with mitral valve prolapse. These two latter cardiac disorder; have been identified as potential risk factors for ischemic stroke. The aim of this prospective study was to assess the role of atrial septal aneurysm as an independent risk factor for stroke, especially for cryptogenic stroke. Methods: We studied the prevalence of atrial septal aneurysm, patent foramen ovale, and mitral valve prolapse in 100 consecutive patients aneurysm and patent foramen ovale relied on transesophageal echocardiography with a contrast study and that of mitral valve prolapse, on two-dimensional transthoracic echocardiography. Results: Stepwise logistic regression analysis showed that atrial septal aneurysm (odds ratio, 4.3; 95% confidence interval, 1.3 to 14.6; P=.01) and patent foramen ovale (odds ratio, 3.9; 95% confidence interval, 1.5 to 10; P=.003) but not mitral valve prolapse were significantly associated with the diagnosis of cryptogenic stroke. The stroke odds of a patient with both atrial septal aneurysm and patent foramen ovale were 33.3 times (95% confidence interval, 4.1 to 270) the stroke odds of a patient with neither of these cardiac disorders. For a patient with atrial septal aneurysm of >lo-mm excursion, the stroke odds were approximately 8 times the stroke odds of a patient with atrial septal aneurysm of aneurysm and patent foramen ovale are both significantly associated with cryptogenic stroke and that their association has a marked synergistic effect. Atrial septal aneurysms of >lo-mm excursion are associated with a higher risk of stroke. (Stroke. 1993;24:1865-1873.) KEY WORDS aneurysm echocardiography foramen ovale, patent mitral valve prolapse o young adults

  4. Intravenous thrombolysis in acute ischaemic stroke: from trial exclusion criteria to clinical contraindications. An international Delphi study

    NARCIS (Netherlands)

    M. Dirks (Maaike); L.W. Niessen (Louis Wilhelmus); C.L. Franke (Cees); R.J. van Oostenbrugge (Robert Jan); D.W.J. Dippel (Diederik); P.J. Koudstaal (Peter Jan)

    2007-01-01

    textabstractOBJECTIVE: Several studies indicate that only a small proportion of patients with acute ischaemic stroke are treated with intravenous thrombolysis. Indications and contraindications for this treatment are usually based on the inclusion and exclusion criteria of randomised clinical trials

  5. Thrombolysis in Acute Ischemic Stroke : A Simulation Study to Improve Pre-and in-Hospital Delays in Community Hospitals

    NARCIS (Netherlands)

    Lahr, Maarten M.H.; van der Zee, Durk-Jouke; Vroomen, Patrick C. A. J.; Luijckx, Gert-Jan; Buskens, Erik

    2013-01-01

    Background: Various studies demonstrate better patient outcome and higher thrombolysis rates achieved by centralized stroke care compared to decentralized care, i.e. community hospitals. It remains largely unclear how to improve thrombolysis rate in decentralized care. The aim of this simulation stu

  6. Risk factors for perinatal arterial ischaemic stroke in full-term infants : a case-control study

    NARCIS (Netherlands)

    Harteman, Johanna C.; Groenendaal, Floris; Kwee, Anneke; Welsing, Paco M. J.; Benders, Manon J. N. L.; de Vries, Linda S.

    2012-01-01

    Objective The incidence of perinatal arterial ischaemic stroke (PAIS) is about 1 in 2300 live births. Evidence about the aetiology is still lacking. The aim of this study was to identify maternal, perinatal and neonatal risk factors for symptomatic PAIS in full-term infants. Methods Each full-term i

  7. How can we improve the pre-clinical development of drugs for stroke?

    NARCIS (Netherlands)

    Sena, Emily; van der Worp, H. Bart; Howells, David; Macleod, Malcolm

    2007-01-01

    The development of stroke drugs has been characterized by success in animal studies and subsequent failure in clinical trials. Animal studies might have overstated efficacy, or clinical trials might have understated efficacy; in either case we need to better understand the reasons for failure. Techn

  8. Statin Therapy and Outcome After Ischemic Stroke: Systematic Review and Meta-Analysis of Observational Studies and Randomized Trials.

    LENUS (Irish Health Repository)

    2013-01-03

    Background-Although experimental data suggest that statin therapy may improve neurological outcome after acute cerebral ischemia, the results from clinical studies are conflicting. We performed a systematic review and meta-analysis investigating the relationship between statin therapy and outcome after ischemic stroke. METHODS: The primary analysis investigated statin therapy at stroke onset (prestroke statin use) and good functional outcome (modified Rankin score 0 to 2) and death. Secondary analyses included the following: (1) acute poststroke statin therapy (≤72 hours after stroke), and (2) thrombolysis-treated patients. RESULTS: The primary analysis included 113 148 subjects (27 studies). Among observational studies, statin treatment at stroke onset was associated with good functional outcome at 90 days (pooled odds ratio [OR], 1.41; 95% confidence interval [CI], 1.29-1.56; P<0.001), but not 1 year (OR, 1.12; 95% CI, 0.9-1.4; P=0.31), and with reduced fatality at 90 days (pooled OR, 0.71; 95% CI, 0.62-0.82; P<0.001) and 1 year (OR, 0.80; 95% CI, 0.67-0.95; P=0.01). In the single randomized controlled trial reporting 90-day functional outcome, statin treatment was associated with good outcome (OR, 1.5; 95% CI, 1.0-2.24; P=0.05). No reduction in fatality was observed on meta-analysis of data from 3 randomized controlled trials (P=0.9). In studies of thrombolysis-treated patients, an association between statins and increased fatality at 90 days was observed (pooled OR, 1.25; 95% CI, 1.02-1.52; P=0.03, 3 studies, 4339 patients). However, this association was no longer present after adjusting for age and stroke severity in the largest study (adjusted OR, 1.14; 95% CI, 0.90-1.44; 4012 patients). CONCLUSIONS: In the largest meta-analysis to date, statin therapy at stroke onset was associated with improved outcome, a finding not observed in studies restricted to thrombolysis-treated patients. Randomized trials of statin therapy in acute ischemic stroke are needed.

  9. Hyponatremia in stroke

    Directory of Open Access Journals (Sweden)

    Sheikh Saleem

    2014-01-01

    Full Text Available Introduction: Hyponatremia is a common electrolyte disorder encountered in patients of neurological disorders which is usually either due to inappropriate secretion of Antidiuretic hormone (SIADH or cerebral salt wasting syndrome (CSWS. We conducted this study in a tertiary care hospital to determine the incidence and etiology of hyponatremia in patients of stroke admitted in the hospital. Materials and Methods: It was a prospective study done over a period of two years that included established cases of stroke diagnosed on the basis of clinical history, examination and neuroimaging. 1000 stoke patients were evaluated for hyponatremia (serum sodium <130 meq/l. The data was analysed using Chi-square test using SPSS (Statistical package for social science software. Results: Out of 1000 patients, 353 patients had hyponatremia. Out of this 353 patients, 238 (67% had SIADH and 115 (33% had CSWS. SIADH was seen in 83 patients who had ischemic stroke and 155 patients of hemorrhagic stroke. CSWS was found in 38 patients with ischemic stroke and 77 patients with hemorrhagic stroke. Statistical analysis revealed that hyponatremia significantly affects the outcome of stroke especially when it is due to CSWS rather than SIADH. Conclusion: Incidence of hyponatremia in our study population was 35%. In patients of hyponatremia 67% were having SIADH and 33% were having CSWS. Overall hyponatremia affected the outcome of stroke especially when caused by CSWS. Therefore close monitoring of serum sodium must be done in all patients who are admitted with stroke and efforts must be made to determine the cause of hyponatremia, in order to properly manage such patients thereby decreasing the mortality rate.

  10. Hyponatremia in stroke

    Science.gov (United States)

    Saleem, Sheikh; Yousuf, Irfan; Gul, Azhara; Gupta, Satish; Verma, Sawan

    2014-01-01

    Introduction: Hyponatremia is a common electrolyte disorder encountered in patients of neurological disorders which is usually either due to inappropriate secretion of Antidiuretic hormone (SIADH) or cerebral salt wasting syndrome (CSWS). We conducted this study in a tertiary care hospital to determine the incidence and etiology of hyponatremia in patients of stroke admitted in the hospital. Materials and Methods: It was a prospective study done over a period of two years that included established cases of stroke diagnosed on the basis of clinical history, examination and neuroimaging. 1000 stoke patients were evaluated for hyponatremia (serum sodium <130 meq/l). The data was analysed using Chi-square test using SPSS (Statistical package for social science) software. Results: Out of 1000 patients, 353 patients had hyponatremia. Out of this 353 patients, 238 (67%) had SIADH and 115 (33%) had CSWS. SIADH was seen in 83 patients who had ischemic stroke and 155 patients of hemorrhagic stroke. CSWS was found in 38 patients with ischemic stroke and 77 patients with hemorrhagic stroke. Statistical analysis revealed that hyponatremia significantly affects the outcome of stroke especially when it is due to CSWS rather than SIADH. Conclusion: Incidence of hyponatremia in our study population was 35%. In patients of hyponatremia 67% were having SIADH and 33% were having CSWS. Overall hyponatremia affected the outcome of stroke especially when caused by CSWS. Therefore close monitoring of serum sodium must be done in all patients who are admitted with stroke and efforts must be made to determine the cause of hyponatremia, in order to properly manage such patients thereby decreasing the mortality rate. PMID:24753660

  11. Stroke and atrial fibrillation: is stroke prevention treatment appropriate beforehand?

    OpenAIRE

    DEPLANQUE, D; Corea, F; Arquizan, C; Parnetti, L.; Mas, J.; Gallai, V.; Leys, D; the, S

    1999-01-01

    OBJECTIVE—To undertake a pilot study before conducting a large European multicentre prospective study, to determine the proportion of patients with atrial fibrillation who were not receiving antithrombotic treatment before stroke onset, and their characteristics.
DESIGN AND PATIENTS—The stroke in atrial fibrillation ensemble (SAFE) I study was an observational study conducted in 213 patients with atrial fibrillation consecutively admitted in 1997 to three European centres for an acute stroke ...

  12. Self-rated health, symptoms of depression and general symptoms at 3 and 12 months after a first-ever stroke: a municipality-based study in Sweden

    Directory of Open Access Journals (Sweden)

    Hassler Ejda

    2007-10-01

    Full Text Available Abstract Background Self-rated health is an important indicator of quality of life as well as a good predictor of future health. The purpose of the study was to follow up the self-rated health and the prevalence of symptoms of depression and general symptoms in a population of first-ever stroke patients 3 and 12 months after stroke. Methods All patients surviving their first-ever stroke and residing in Nacka municipality in Stockholm County Council were included using a multiple overlapping search strategy during an 18-month period (n = 187. Our study group comprised the 145 patients who survived the first 3 months after stroke. Three and 12 months after their stroke, the patients were assessed regarding self-rated health and general symptoms using parts of the Göteborg Quality of Life Instrument (GQLI, and regarding symptoms of depression using the Montgomery Asberg Depression Scale (MADRS-S. Results Self-rated health was rated as very good or rather good by 62% at 3 months after stroke and by 78% at 12 months after stroke. More than half of the patients suffered from symptoms of depression, with no significant improvement at 12 months. The most common general symptoms at 3 months after stroke were fatigue, sadness, pain in the legs, dizziness and irritability. Fatigue and sadness were still common at 12 months. Twelve months after stroke the prevalences of crying easily, irritability, impaired concentration, nausea and loss of weight were significantly lower. Conclusion The majority of patients rated their health as rather good or very good at 3 and 12 months after stroke. However, the majority suffered from fatigue and from symptoms of depression after both 3 and 12 months. In continued care of stroke survivors, it is important to consider the fact that many patients who rate their health as good may nevertheless have symptoms of depression, and some of them may benefit from anti-depressive treatment.

  13. 5-year survival and rehospitalization due to stroke recurrence among patients with hemorrhagic or ischemic strokes in Singapore

    OpenAIRE

    Sun, Yan; Lee, Sze Haur; Heng, Bee Hoon; Chin, Vivien S

    2013-01-01

    Background Stroke is the 4th leading cause of death and 1st leading cause of disability in Singapore. However the information on long-term post stroke outcomes for Singaporean patients was limited. This study aimed to investigate the post stroke outcomes of 5-year survival and rehospitalization due to stroke recurrence for hemorrhagic and ischemic stroke patients in Singapore. The outcomes were stratified by age, ethnic group, gender and stroke types. The causes of death and stroke recurrence...

  14. Outcome Determinants of Stroke in a Brazilian Primary Stroke Center

    Directory of Open Access Journals (Sweden)

    Gustavo W. Kuster

    2014-01-01

    Full Text Available Background. Stroke mortality in Brazil is one of the highest among Western countries. Nonetheless, stroke outcome determinants are still poorly known in this country. In this study we evaluate outcome determinants of stroke in a primary stroke center in São Paulo, Brazil. Methods. We evaluated demographic, clinical, and outcome data of patients with ischemic stroke (IS, transient ischemic attack (TIA, and intracerebral hemorrhage (ICH admitted at “Hospital Paulistano,” São Paulo, Brazil. In-hospital mortality and functional outcome determinants were assessed. Univariate and binary logistic regression analysis were performed. Results. Three hundred forty-one patients were included in the study, 52.2% being male with 66.8±15.7 years. The stroke type distribution was IS: 59.2%, TIA: 29.6%, and ICH: 11.1%. ICH was associated with greater severity and poorer functional outcome. The determinants of poorer functional outcome were higher NIHSS, lower Glasgow score, and lower oxygen saturation level. The most important mortality determinant was the presence of visual symptoms. Conclusions. The stroke mortality and stroke outcome determinants found in the present study do not remarkably differ from studies carried out in developed countries. Stroke prognosis studies are crucial to better understand the high burden of stroke in Brazil.

  15. Clinical study on microembolic signals monitored by transcranial Doppler ultrasonography in acute ischemic stroke

    Directory of Open Access Journals (Sweden)

    Qi-wu XU

    2016-06-01

    Full Text Available Objective To explore the correlation between microembolic signals (MES in middle cerebral artery (MCA and the occurrence of acute ischemic stroke and also evaluate the clinical effect of single and dual antiplatlet therapy.  Methods A total of 129 cases with acute ischemic stroke were tested by transcranial Doppler (TCD ultrasonography to detect MES. Univariate and multivariate Logistic regression analysis were adopted to analyze and screen the positive risk factors for MES. Medication effects and prognosis were evaluated by treatment of aspirin and combination therapy of aspirin and clopidogrel. Results Among 129 patients, 42 patients (32.56% were detected MES positive. According to Logistic regression analysis, hyperlipidemia was the independent risk factor of patients with MES positive (OR = 0.335, 95%CI: 0.147-0.764; P = 0.009. After antiplatelet treatment, the disappearence rate of MES was higher in the dual-therapy treatment group than that in the monotherapy group ( χ2 = 16.701, P = 0.000. The NIHSS score decreased significantly after 14 d of treatment in both groups (P = 0.000. The decrease of NIHSS score in dual-therapy group was more than that in monotherapy group (P = 0.025. It proves the effectiveness of antiplatelet treatment and the advantage of dual antiplatelet is superior to single antiplatelet.  Conclusions This study demonstrated that hyperlipidemia is the independent risk factor for MES positive detected by TCD and dual-therapy can inhibit the formation of MES and improve the recent prognosis. DOI: 10.3969/j.issn.1672-6731.2016.06.009

  16. Immunotoxicology of arc welding fume: worker and experimental animal studies.

    Science.gov (United States)

    Zeidler-Erdely, Patti C; Erdely, Aaron; Antonini, James M

    2012-01-01

    Arc welding processes generate complex aerosols composed of potentially hazardous metal fumes and gases. Millions of workers worldwide are exposed to welding aerosols daily. A health effect of welding that is of concern to the occupational health community is the development of immune system dysfunction. Increased severity, frequency, and duration of upper and lower respiratory tract infections have been reported among welders. Specifically, multiple studies have observed an excess mortality from pneumonia in welders and workers exposed to metal fumes. Although several welder cohort and experimental animal studies investigating the adverse effects of welding fume exposure on immune function have been performed, the potential mechanisms responsible for these effects are limited. The objective of this report was to review both human and animal studies that have examined the effect of welding fume pulmonary exposure on local and systemic immune responses. PMID:22734811

  17. Therapeutic hypothermia for acute stroke

    DEFF Research Database (Denmark)

    Olsen, Tom Skyhøj; Weber, Uno Jakob; Kammersgaard, Lars Peter

    2003-01-01

    Experimental evidence and clinical experience show that hypothermia protects the brain from damage during ischaemia. There is a growing hope that the prevention of fever in stroke will improve outcome and that hypothermia may be a therapeutic option for the treatment of stroke. Body temperature...... is directly related to stroke severity and outcome, and fever after stroke is associated with substantial increases in morbidity and mortality. Normalisation of temperature in acute stroke by antipyretics is generally recommended, although there is no direct evidence to support this treatment. Despite its...... obvious therapeutic potential, hypothermia as a form of neuroprotection for stroke has been investigated in only a few very small studies. Therapeutic hypothermia is feasible in acute stroke but owing to serious side-effects--such as hypotension, cardiac arrhythmia, and pneumonia--it is still thought...

  18. Relationship between functional connectivity and motor function assessment in stroke patients with hemiplegia: a resting-state functional MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Ye; Wang, Li; Zhang, Jingna; Sang, Linqiong; Li, Pengyue; Qiu, Mingguo [Third Military Medical University, Department of Medical Imaging, College of Biomedical Engineering, Chongqing (China); Liu, Hongliang; Yan, Rubing [Third Military Medical University, Department of Rehabilitation, Southwest Hospital, Chongqing (China); Yang, Jun; Wang, Jian [Third Military Medical University, Department of Radiology, Southwest Hospital, Chongqing (China)

    2016-05-15

    Resting-state functional magnetic resonance imaging (fMRI) has been used to examine the brain mechanisms of stroke patients with hemiplegia, but the relationship between functional connectivity (FC) and treatment-induced motor function recovery has not yet been fully investigated. This study aimed to identify the brain FC changes in stroke patients and study the relationship between FC and motor function assessment using the resting-state fMRI. Seventeen stroke patients with hemiplegia and fifteen healthy control subjects (HCSs) were recruited in this study. We compared the FC between the ipsilesional primary motor cortex (M1) and the whole brain of the patients with the FC of the HCSs and studied the FC changes in the patients before and after conventional rehabilitation and motor imagery therapy. Additionally, correlations between the FC change and motor function of the patients were studied. Compared to the HCSs, the FC in the patient group was significantly increased between the ipsilesional M1 and the ipsilesional inferior parietal cortex, frontal gyrus, supplementary motor area (SMA), and contralesional angular and decreased between the ipsilesional M1 and bilateral M1. After the treatment, the FC between the ipsilesional M1 and contralesional M1 increased while the FC between the ipsilesional M1 and ipsilesional SMA and paracentral lobule decreased. A statistically significant correlation was found between the FC change in the bilateral M1 and the Fugl-Meyer assessment (FMA) score change. Our results revealed an abnormal motor network after stroke and suggested that the FC could serve as a biomarker of motor function recovery in stroke patients with hemiplegia. (orig.)

  19. Relationship between functional connectivity and motor function assessment in stroke patients with hemiplegia: a resting-state functional MRI study

    International Nuclear Information System (INIS)

    Resting-state functional magnetic resonance imaging (fMRI) has been used to examine the brain mechanisms of stroke patients with hemiplegia, but the relationship between functional connectivity (FC) and treatment-induced motor function recovery has not yet been fully investigated. This study aimed to identify the brain FC changes in stroke patients and study the relationship between FC and motor function assessment using the resting-state fMRI. Seventeen stroke patients with hemiplegia and fifteen healthy control subjects (HCSs) were recruited in this study. We compared the FC between the ipsilesional primary motor cortex (M1) and the whole brain of the patients with the FC of the HCSs and studied the FC changes in the patients before and after conventional rehabilitation and motor imagery therapy. Additionally, correlations between the FC change and motor function of the patients were studied. Compared to the HCSs, the FC in the patient group was significantly increased between the ipsilesional M1 and the ipsilesional inferior parietal cortex, frontal gyrus, supplementary motor area (SMA), and contralesional angular and decreased between the ipsilesional M1 and bilateral M1. After the treatment, the FC between the ipsilesional M1 and contralesional M1 increased while the FC between the ipsilesional M1 and ipsilesional SMA and paracentral lobule decreased. A statistically significant correlation was found between the FC change in the bilateral M1 and the Fugl-Meyer assessment (FMA) score change. Our results revealed an abnormal motor network after stroke and suggested that the FC could serve as a biomarker of motor function recovery in stroke patients with hemiplegia. (orig.)

  20. Social Information Transmission in Animals: Lessons from Studies of Diffusion

    Science.gov (United States)

    Duboscq, Julie; Romano, Valéria; MacIntosh, Andrew; Sueur, Cédric

    2016-01-01

    The capacity to use information provided by others to guide behavior is a widespread phenomenon in animal societies. A standard paradigm to test if and/or how animals use and transfer social information is through social diffusion experiments, by which researchers observe how information spreads within a group, sometimes by seeding new behavior in the population. In this article, we review the context, methodology and products of such social diffusion experiments. Our major focus is the transmission of information from an individual (or group thereof) to another, and the factors that can enhance or, more interestingly, inhibit it. We therefore also discuss reasons why social transmission sometimes does not occur despite being expected to. We span a full range of mechanisms and processes, from the nature of social information itself and the cognitive abilities of various species, to the idea of social competency and the constraints imposed by the social networks in which animals are embedded. We ultimately aim at a broad reflection on practical and theoretical issues arising when studying how social information spreads within animal groups. PMID:27540368

  1. Social Information Transmission in Animals: Lessons from Studies of Diffusion.

    Science.gov (United States)

    Duboscq, Julie; Romano, Valéria; MacIntosh, Andrew; Sueur, Cédric

    2016-01-01

    The capacity to use information provided by others to guide behavior is a widespread phenomenon in animal societies. A standard paradigm to test if and/or how animals use and transfer social information is through social diffusion experiments, by which researchers observe how information spreads within a group, sometimes by seeding new behavior in the population. In this article, we review the context, methodology and products of such social diffusion experiments. Our major focus is the transmission of information from an individual (or group thereof) to another, and the factors that can enhance or, more interestingly, inhibit it. We therefore also discuss reasons why social transmission sometimes does not occur despite being expected to. We span a full range of mechanisms and processes, from the nature of social information itself and the cognitive abilities of various species, to the idea of social competency and the constraints imposed by the social networks in which animals are embedded. We ultimately aim at a broad reflection on practical and theoretical issues arising when studying how social information spreads within animal groups. PMID:27540368

  2. Microwave hemorrhagic stroke detector

    Energy Technology Data Exchange (ETDEWEB)

    Haddad, Waleed S. (Dublin, CA); Trebes, James E. (Livermore, CA)

    2002-01-01

    The microwave hemorrhagic stroke detector includes a low power pulsed microwave transmitter with a broad-band antenna for producing a directional beam of microwaves, an index of refraction matching cap placed over the patients head, and an array of broad-band microwave receivers with collection antennae. The system of microwave transmitter and receivers are scanned around, and can also be positioned up and down the axis of the patients head. The microwave hemorrhagic stroke detector is a completely non-invasive device designed to detect and localize blood pooling and clots or to measure blood flow within the head or body. The device is based on low power pulsed microwave technology combined with specialized antennas and tomographic methods. The system can be used for rapid, non-invasive detection of blood pooling such as occurs with hemorrhagic stroke in human or animal patients as well as for the detection of hemorrhage within a patient's body.

  3. Physical activity, sedentary behaviour and metabolic control following stroke: a cross-sectional and longitudinal study.

    Directory of Open Access Journals (Sweden)

    Sarah A Moore

    Full Text Available BACKGROUND: Physical activity and sedentary behaviour are key moderators of cardiovascular disease risk and metabolic control. Despite the importance of a physically active lifestyle, little is known about the effects of stroke on physical activity. We assessed physical activity and sedentary behaviour at three time points following stroke compared to a healthy control group. METHODS: Physical activity and sedentary behaviour were objectively measured using a portable multi-sensor array in 31 stroke participants (73±9 years, National Institute of Health Stroke Scale 2±2, mobile 10 metres with/without aid within seven days and at three and six months. Stroke data were compared with an age, sex and body mass index matched healthy control group (n = 31. RESULTS: Within seven days of stroke, total energy expenditure and physical activity were significantly lower and sedentary time higher in the stroke group compared to controls (total energy expenditure 1840±354 vs. 2220±489 kcal, physical activity 28±32 vs. 79±46 min/day, steps 3111±2290 vs. 7996±2649, sedentary time 1383±42 vs. 1339±44 min/day, p<0.01. At three months physical activity levels had increased (64±58 min/day but plateaued by six months (66±68 min/day. CONCLUSIONS: Physical activity levels are reduced immediately post-stroke and remain below recommended levels for health and wellbeing at the three and six month time points. Clinicians should explore methods to increase physical activity and reduce sedentary behaviour in both the acute and later stages following stroke.

  4. Cause-specific mortality after stroke

    DEFF Research Database (Denmark)

    Mogensen, Ulla Brasch; Olsen, Tom Skyhøj; Andersen, Klaus Kaae;

    2013-01-01

    We investigated cause-specific mortality in relation to age, sex, stroke severity, and cardiovascular risk factor profile in the Copenhagen Stroke Study cohort with 10 years of follow-up. In a Copenhagen community, all patients admitted to the hospital with stroke during 1992-1993 (n = 988) were.......2% for nonvascular disease. Death after stroke was associated with older age, male sex, greater stroke severity, and diabetes regardless of the cause of death. Previous stroke and hemorrhagic stroke were associated with death by stroke, ischemic heart disease was associated with death by heart/arterial disease...... registered on admission. Evaluation included stroke severity, computed tomography scan, and a cardiovascular risk profile. Cause of death within 10 years according to death certificate information was classified as stroke, heart/arterial disease, or nonvascular disease. Competing-risks analyses were...

  5. Optical bedside monitoring of cerebral perfusion: technological and methodological advances applied in a study on acute ischemic stroke

    Science.gov (United States)

    Steinkellner, Oliver; Gruber, Clemens; Wabnitz, Heidrun; Jelzow, Alexander; Steinbrink, Jens; Fiebach, Jochen B.; MacDonald, Rainer; Obrig, Hellmuth

    2010-11-01

    We present results of a clinical study on bedside perfusion monitoring of the human brain by optical bolus tracking. We measure the kinetics of the contrast agent indocyanine green using time-domain near-IR spectroscopy (tdNIRS) in 10 patients suffering from acute unilateral ischemic stroke. In all patients, a delay of the bolus over the affected when compared to the unaffected hemisphere is found (mean: 1.5 s, range: 0.2 s to 5.2 s). A portable time-domain near-IR reflectometer is optimized and approved for clinical studies. Data analysis based on statistical moments of time-of-flight distributions of diffusely reflected photons enables high sensitivity to intracerebral changes in bolus kinetics. Since the second centralized moment, variance, is preferentially sensitive to deep absorption changes, it provides a suitable representation of the cerebral signals relevant for perfusion monitoring in stroke. We show that variance-based bolus tracking is also less susceptible to motion artifacts, which often occur in severely affected patients. We present data that clearly manifest the applicability of the tdNIRS approach to assess cerebral perfusion in acute stroke patients at the bedside. This may be of high relevance to its introduction as a monitoring tool on stroke units.

  6. The Course of Fatigue during the First 18 Months after First-Ever Stroke: A Longitudinal Study

    Directory of Open Access Journals (Sweden)

    Anners Lerdal

    2012-01-01

    Full Text Available Background. Little is known about the course of poststroke fatigue. Objectives. To describe the course of poststroke fatigue in relation to the patient's level of physical functioning, depressive symptoms, and self-reported history of prestroke fatigue. Methods. A longitudinal study using structured face-to-face interviews, questionnaires, and patients' medical records. Data were collected from 95 patients in Norway with first-ever stroke. Fatigue was measured with the Fatigue Severity Scale 7 item version and assessed for change between the acute phase, six, 12, and 18 months after stroke using 2-way ANOVA repeated-measures analyses. Results. The patients' level of fatigue did not change over time. However, those who reported prestroke fatigue showed a relatively high level of fatigue over time in the poststroke period, while patients with no history of pre-stroke fatigue showed a stable course of relatively low fatigue over time. Conclusion. Studies on poststroke fatigue should control for the patient's pre-stroke fatigue level.

  7. Contralesional cortical structural reorganization contributes to motor recovery after sub-cortical stroke: A longitudinal voxel-based morphometry study

    Directory of Open Access Journals (Sweden)

    Jianxin Cai

    2016-08-01

    Full Text Available Although changes in brain gray matter after stroke have been identified in some neuroimaging studies, lesion heterogeneity and individual variability make the detection of potential neuronal reorganization difficult. This study attempted to investigate the potential structural cortical reorganization after sub-cortical stroke using a longitudinal voxel-based gray matter volume (GMV analysis. Eleven right-handed patients with first -onset, subcortical, ischemic infarctions involving the basal ganglia regions underwent structural magnetic resonance imaging in addition to National Institutes of Health Stroke Scale and Motricity Index assessments in the acute (< 5 days and chronic stages (1 year later. The GMVs were calculated and compared between the two stages using nonparametric permutation paired t tests. Moreover, the Spearman correlations between the GMV changes and clinical recoveries were analyzed. Compared with the acute stage, significant decreases in GMV were observed in the ipsilesional precentral gyrus (PreCG, paracentral gyrus, and contralesional cerebellar lobule VII in the chronic stage. Additionally, significant increases in GMV were found in the contralesional orbitofrontal cortex (OFC and middle (MFG and inferior (IFG frontal gyri. Furthermore, severe GMV atrophy in the ipsilesional PreCG predicted poorer clinical recovery, and greater GMV increases in the contralesional OFG and MFG predicted better clinical recovery. Our findings suggest that structural reorganization of the contralesional ‘cognitive’ cortices might contribute to motor recovery after sub-cortical stroke.

  8. Recovery in stroke rehabilitation through the rotation of preferred directions induced by bimanual movements: a computational study.

    Directory of Open Access Journals (Sweden)

    Ken Takiyama

    Full Text Available Stroke patients recover more effectively when they are rehabilitated with bimanual movement rather than with unimanual movement; however, it remains unclear why bimanual movement is more effective for stroke recovery. Using a computational model of stroke recovery, this study suggests that bimanual movement facilitates the reorganization of a damaged motor cortex because this movement induces rotations in the preferred directions (PDs of motor cortex neurons. Although the tuning curves of these neurons differ during unimanual and bimanual movement, changes in PD, but not changes in modulation depth, facilitate such reorganization. In addition, this reorganization was facilitated only when encoding PDs are rotated, but decoding PDs are not rotated. Bimanual movement facilitates reorganization because this movement changes neural activities through inter-hemispheric inhibition without changing cortical-spinal-muscle connections. Furthermore, stronger inter-hemispheric inhibition between motor cortices results in more effective reorganization. Thus, this study suggests that bimanual movement is effective for stroke rehabilitation because this movement rotates the encoding PDs of motor cortex neurons.

  9. Continuous theta-burst stimulation combined with occupational therapy for upper limb hemiparesis after stroke: a preliminary study.

    Science.gov (United States)

    Yamada, Naoki; Kakuda, Wataru; Kondo, Takahiro; Shimizu, Masato; Sageshima, Masashi; Mitani, Sugao; Abo, Masahiro

    2014-12-01

    The purpose of this study was to assess the safety, feasibility and efficacy of continuous theta-burst stimulation (cTBS) combined with intensive occupational therapy (OT) for upper limb hemiparesis after stroke. Ten patients with history of stroke and upper limb hemiparesis (age 62.0 ± 11.1 years, time since stroke 95.7 ± 70.2 months, mean ± SD) were studied. Each patient received 13 sessions, each comprising 160 s of cTBS applied to the skull on the area of the non-lesional hemisphere (using a 70-mm figure-8 coil, three pulse bursts at 50 Hz, repeated every 200 ms, i.e., 5 Hz, with total stimulation of 2,400 pulses), followed by intensive OT (comprising 120-min one-to-one training and 120-min self-training) during 15-day hospitalization. The motor function of the affected upper limb was evaluated by Fugl-Meyer Assessment (FMA) and Wolf Motor Function Test (WMFT) on the days of admission and discharge. All patients completed the 15-day protocol without any adverse effects. Treatment significantly increased the FMA score (from 46.6 ± 8.7 to 51.6 ± 8.2 points, p stroke.

  10. The effect of involuntary motor activity on myoelectric pattern recognition: a case study with chronic stroke patients

    Science.gov (United States)

    Zhang, Xu; Li, Yun; Chen, Xiang; Li, Guanglin; Zev Rymer, William; Zhou, Ping

    2013-08-01

    Objective. This study investigates the effect of the involuntary motor activity of paretic-spastic muscles on the classification of surface electromyography (EMG) signals. Approach. Two data collection sessions were designed for 8 stroke subjects to voluntarily perform 11 functional movements using their affected forearm and hand at relatively slow and fast speeds. For each stroke subject, the degree of involuntary motor activity present in the voluntary surface EMG recordings was qualitatively described from such slow and fast experimental protocols. Myoelectric pattern recognition analysis was performed using different combinations of voluntary surface EMG data recorded from the slow and fast sessions. Main results. Across all tested stroke subjects, our results revealed that when involuntary surface EMG is absent or present in both the training and testing datasets, high accuracies (>96%, >98%, respectively, averaged over all the subjects) can be achieved in the classification of different movements using surface EMG signals from paretic muscles. When involuntary surface EMG was solely involved in either the training or testing datasets, the classification accuracies were dramatically reduced (97%). Significance. The findings of this study can be used to guide the appropriate design and implementation of myoelectric pattern recognition based systems or devices toward promoting robot-aided therapy for stroke rehabilitation.

  11. Mechanisms for the recovery of aphasia following stroke. A positron emission tomography study

    International Nuclear Information System (INIS)

    Language disorders following stroke are common and are a major source of distress and disability. Most patients show some recovery with time implying the potential for neuronal plasticity within the brain for recovery of language. The mechanisms underlying recovery are poorly understood, making strategies for speech therapy and further investigation of potential therapeutic agents difficult. These studies were designed to explore the cortical re-organisation which underlies at least some language recovery using positron emission tomography (PET). With the rapid developments in PET technology and advances in image data processing it is now well established that language tasks can be studied in terms of responses within brain regions, and interactions between regions. The results can be interpreted with reference to neuropsychological theory and models. Many language activation studies have been performed in the normal brain. The studies reported here concentrated on one behavioural task - the verbal fluency task - the strategy being to compare patterns of activation in normal subjects with those in recovered aphasic patients performing the same fluency task. In the first part of this thesis, a detailed PET study of a verb retrieval task was made using different control tasks in normal volunteers. The results show that this task engages a widespread network of regions, predominantly in the left hemisphere i.e. the dorsolateral temporal cortex, the inferolateral temporal cortex and inferior parietal cortex, an extensive area of the dorsolateral prefrontal cortex (LDLPFC), the anterior cingulate and the supplementary motor area (SMA). The experiments using different control tasks suggest that the dorsolateral temporal cortex is involved with auditory and lexical processing of the stimulus nouns and it is demonstrated that observation of an activation in this region is dependent on the particular control task used with the retrieval task. This explains discrepancies

  12. Ischemic Stroke.

    Science.gov (United States)

    Capriotti, Teri; Murphy, Teresa

    2016-05-01

    Each year, more than 795,000 people in the United States suffer a stroke and by 2030, it is estimated that 4% of the U.S. population will have had a stroke. Home healthcare clinicians will be increasingly called upon to assist stroke survivors and their caregivers adjust to disability and assist the survivor during their reintegration into the community. Therapeutic modalities are changing with advanced technology. Great strides are being made in the treatment of acute stroke; particularly endovascular interventions. More patients are surviving the acute stroke event and therefore will need to learn how to live with various degrees of disability. It is important for home healthcare clinicians to understand the process from acute event to medical stabilization, and from rehabilitation to long-term adaptation. PMID:27145407

  13. Mechanisms for the recovery of aphasia following stroke. A positron emission tomography study

    Energy Technology Data Exchange (ETDEWEB)

    Warburton, E

    1998-07-01

    Language disorders following stroke are common and are a major source of distress and disability. Most patients show some recovery with time implying the potential for neuronal plasticity within the brain for recovery of language. The mechanisms underlying recovery are poorly understood, making strategies for speech therapy and further investigation of potential therapeutic agents difficult. These studies were designed to explore the cortical re-organisation which underlies at least some language recovery using positron emission tomography (PET). With the rapid developments in PET technology and advances in image data processing it is now well established that language tasks can be studied in terms of responses within brain regions, and interactions between regions. The results can be interpreted with reference to neuropsychological theory and models. Many language activation studies have been performed in the normal brain. Thestudies reported here concentrated on one behavioural task - the verbal fluency task - the strategy being to compare patterns of activation in normal subjects with those in recovered aphasic patients performing the same fluency task. In the first part of this thesis, a detailed PET study of a verb retrieval task was made using different control tasks in normal volunteers. The results show that this task engages a widespread network of regions, predominantly in the left hemisphere i.e. the dorsolateral temporal cortex, the inferolateral temporal cortex and inferior parietal cortex, an extensive area of the dorsolateral prefrontal cortex (LDLPFC), the anterior cingulate and the supplementary motor area (SMA). The experiments using different control tasks suggest that the dorsolateral temporal cortex is involved with auditory and lexical processing of the stimulus nouns and it is demonstrated that observation of an activation in this region is dependent on the particular control task used with the retrieval task. This explains discrepancies

  14. Cerebrorenal interaction and stroke.

    Science.gov (United States)

    Toyoda, Kazunori

    2013-01-01

    Beyond the original meaning of chronic kidney disease (CKD) as high-risk state for future dialysis, CKD is now known as an established risk factor for cardiovascular diseases. Stroke is a major player of cardiovascular disease and has deep two-way relationships with CKD. CKD is an evident risk factor for stroke. Meta-analyses of cohort studies and trials indicate that proteinuria/albuminuria increases the risk of stroke by 71-92%, and reduced glomerular filtration rate increases the risk by 43%. In addition, CKD has a strong relationship with subclinical brain damage including white matter changes, microbleeds, cognitive impairment, and carotid atherosclerosis. CKD is prevalent in acute stroke patients; patients with estimated glomerular filtration rate management of stroke are influenced by CKD. Therapeutic effects of several antithrombotic and thrombolytic agents, including recently-developed novel oral anticoagulants, are affected by renal function. Moreover, reduced glomerular filtration rate is independently associated with increased 1- and 10-year mortalities in the end. Stroke also has deep relationships with end-stage kidney disease. Stroke occurs much more commonly in dialysis patients than general population or CKD patients without need for dialysis. The triggers of ischemic and hemorrhagic stroke in patients with end-stage kidney disease include special characteristics unique to dialysis, such as drastic hemodynamic change, dialysate and anticoagulants, and vascular calcification. As cohorts of dialysis patients become older, more hypertensive, and more diabetic than before, stroke become more prevalent and more serious events in dialysis clinics. Now, clinicians should have much interest in the association between CKD and cerebrovascular diseases, so-called the cerebro-renal interaction.

  15. The caregiving relationship and quality of life among partners of stroke survivors: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Wilson Keith G

    2011-05-01

    Full Text Available Abstract Background Since the majority of stroke survivors return home following their stroke, families play a pivotal role in their care. Few studies have addressed both positive and negative aspects of this role or the broader construct of health-related quality of life (HRQL. Furthermore, little consideration has been given to the context of care in terms of relationship quality, and reciprocity. The present study examined the relationships between caregiver quality of life (HRQL, caregiver role, relationship satisfaction, balance and reciprocity in caregivers of partners who had experienced a stroke. Specific hypotheses were made based on equity theory in social relations. Methods Fifty-six partner caregivers completed a postal survey that included measures of HRQL (SF-36, caregiver role (negative and positive aspects, relationship satisfaction, reciprocity and balance. Data were also collected on the care recipients' quality of life (Stroke Specific Quality of Life scale. Results Compared to a normative sample, caregivers' HRQL was lower for all SF-36 domains. Care recipient and caregiver age, care recipient quality of life and caregiver role (negative significantly predicted physical component summary scores on the SF-36, while care recipient quality of life and caregiver role (negative significantly correlated with mental component summary scores. Relationship satisfaction and intrinsic rewards of caregiving were found to be important predictors of positive aspects of the caregiver role. Caregivers who viewed their relationship as less balanced in terms of give and take had significantly greater caregiver burden than those who viewed their relationship as more equitable. Conclusions The study highlights the importance of taking a broader approach to examining partner caregiving in the context of stroke, in terms of the caregiving relationship and their influence on the health and well-being of caregivers.

  16. Animal study for airway inflammation triggered by gastroesophageal reflux

    Institute of Scientific and Technical Information of China (English)

    LAI Yun-gang; WANG Zhong-gao; JI Feng; WU Ji-min; CHEN Xiu; LI Zhen; DONG Shu-kui

    2009-01-01

    Background Gastroesophageal reflux disease with extra-esophageal symptoms, especially those with respiratory istress was attracting more and more attention. The related mechanisms were still in controversy. The purpose of the work was to explore airway inflammation triggered by gastroesophageal reflux.Methods Sixteen Sprague-Dawley rats were used as study group and 9 as control. In the study group, a plastic extender with a trumpet-shaped distal end was inserted into the lower esophagus to dilate the cardia, the pylorus was ligated. One ml of 0.1 mol/L hydrochloric acid was injected into the stomach, While a simple laparotomy was performed for control animals. All animals from two groups were sacrificed 24 hours after operation. Then tracheotomy was carried and the bronchoalveolar lavage fluid was collected in all animals. Cells in the fluid were counted and levels of intedeukin (IL)-5, -6, -8 in it were measured.Results Compared with control group, the study group presented a neutrophil pattem of airway inflammation and an elevated concentration of IL-5, -6, -8 with no significant difference regarding eosinophil count.Conclusion The gastroesophageal reflux-triggered airway inflammation is characterized by a neutrophilic airway inflammation which differed from that caused by asthma, and enhanced levels of IL-5, -6 and -8, which are similar to that caused by asthma.

  17. Stroke: current concepts.

    Science.gov (United States)

    Albertson, Megan; Sharma, Jitendra

    2014-11-01

    Cerebrovascular accidents (CVAs) are the leading cause of disability and the fourth leading cause of death in the U.S. The WHO defines stroke as "rapidly developing clinical signs of focal disturbance of cerebral function lasting more than 24 hours with no apparent cause other than of vascular origin." Strokes are subdivided into two major classifications: ischemic (80-87 percent) andhemorrhagic (13-20 percent). Ischemic strokes occur from thrombi, emboli, or global hypoperfusion. Hemorrhagic strokes are either parenchymal (10 percent of all strokes) or subarachnoid (3 percent of all strokes). There are a variety of recognized risk factors for stroke which include: age, race, family history, hypertension, diabetes mellitus, atherosclerosis, cardiac arrhythmias, prosthetic valves, hyperlipidemia, cigarette smoking, and others (drugs or hormones). The initial assessment of a patient suspected of stroke should be done quickly enough to ensure maximal reperfusion of brain tissue. The steps to achieve this goal are: 1) exclude an intracranial hemorrhage, 2) assess for contraindications to thrombolytics, 3) characterize the infarct. The workup for a patient should first include a history (especially the time when neurologic symptoms began), a physical exam (including the NIHSS), and imaging studies (to rule out hemorrhagic components). In addition, several lab studies can also be obtained including: PT/INR, glucose, complete blood count, metabolic panel, creatine kinase, ECG, echocardiogram, lipid panel, carotid Doppler, MRA or CTA. Acute management of a stroke is primarily focused on stabilizing the patient and allowing as much reperfusion as possible for at-risk brain tissue. Stroke management in the acute setting includes: use of thrombolytics if indicated, and re-assessment to monitor progression. Several trials have been completed in pursuit of safety and effectiveness of intra-arterial stroke therapy for patients outside the recommended thrombolytic time window

  18. Successfully Climbing the “STAIRs”: Surmounting Failed Translation of Experimental Ischemic Stroke Treatments

    Directory of Open Access Journals (Sweden)

    Michael P. Kahle

    2012-01-01

    Full Text Available The Stroke Therapy Academic Industry Roundtable (STAIR provided initial (in 1999 and updated (in 2009 recommendations with the goal of improving preclinical stroke therapy assessment and to increase the translational potential of experimental stroke treatments. It is important for preclinical stroke researchers to frequently consider and revisit these concepts, especially since promising experimental stroke treatments continue to fail in human clinical trials. Therefore, this paper will focus on considerations for several key aspects of preclinical stroke studies including the selection and execution of the animal stroke model, drug/experimental treatment administration, and outcome measures to improve experimental validity and translation potential. Specific points of interest discussed include the incorporation of human comorbid conditions and drugs, the benefits of defining a proposed mechanism of action, replication of results using multiple methods, using clinically relevant routes of administration and treatment time windows, and performing and reporting good experimental methods to reduce bias such as, as suggested by the updated STAIR recommendations, sample size calculations, randomization, allocation concealment, blinding, and appropriate inclusion/exclusion criteria. It is our hope that reviewing and revisiting these considerations will benefit researchers in their investigations of stroke therapies and increase the likelihood of translational success in the battle against stroke.

  19. Plasticity in the sensorimotor cortex induced by Music-supported therapy in stroke patients: A TMS study

    Directory of Open Access Journals (Sweden)

    Jennifer eGrau-Sánchez

    2013-09-01

    Full Text Available Playing a musical instrument demands the engagement of different neural systems. Recent studies about the musician’s brain and musical training highlight that this activity requires the close interaction between motor and somatosensory systems. Moreover, neuroplastic changes have been reported in motor-related areas after short and long-term musical training. Because of its capacity to promote neuroplastic changes, music has been used in the context of stroke neurorehabilitation. The majority of patients suffering from a stroke have motor impairments, preventing them to live independently. Thus, there is an increasing demand for effective restorative interventions for neurological deficits. Music-supported Therapy (MST has been recently developed to restore motor deficits. We report data of a selected sample of stroke patients who have been enrolled in a MST program (1 month intense music learning. Prior to and after the therapy, patients were evaluated with different behavioral motor tests. Transcranial Magnetic Stimulation (TMS was applied to evaluate changes in the sensorimotor representations underlying the motor gains observed. Several parameters of excitability of the motor cortex were assessed as well as the cortical somatotopic representation of a muscle in the affected hand. Our results revealed that participants obtained significant motor improvements in the paretic hand and those changes were accompanied by changes in the excitability of the motor cortex. Thus, MST leads to neuroplastic changes in the motor cortex of stroke patients which may explain its efficacy.

  20. Plasticity in the sensorimotor cortex induced by Music-supported therapy in stroke patients: a TMS study.

    Science.gov (United States)

    Grau-Sánchez, Jennifer; Amengual, Julià L; Rojo, Nuria; Veciana de Las Heras, Misericordia; Montero, Jordi; Rubio, Francisco; Altenmüller, Eckart; Münte, Thomas F; Rodríguez-Fornells, Antoni

    2013-01-01

    Playing a musical instrument demands the engagement of different neural systems. Recent studies about the musician's brain and musical training highlight that this activity requires the close interaction between motor and somatosensory systems. Moreover, neuroplastic changes have been reported in motor-related areas after short and long-term musical training. Because of its capacity to promote neuroplastic changes, music has been used in the context of stroke neurorehabilitation. The majority of patients suffering from a stroke have motor impairments, preventing them to live independently. Thus, there is an increasing demand for effective restorative interventions for neurological deficits. Music-supported Therapy (MST) has been recently developed to restore motor deficits. We report data of a selected sample of stroke patients who have been enrolled in a MST program (1 month intense music learning). Prior to and after the therapy, patients were evaluated with different behavioral motor tests. Transcranial Magnetic Stimulation (TMS) was applied to evaluate changes in the sensorimotor representations underlying the motor gains observed. Several parameters of excitability of the motor cortex were assessed as well as the cortical somatotopic representation of a muscle in the affected hand. Our results revealed that participants obtained significant motor improvements in the paretic hand and those changes were accompanied by changes in the excitability of the motor cortex. Thus, MST leads to neuroplastic changes in the motor cortex of stroke patients which may explain its efficacy. PMID:24027507

  1. A numerical study on bow shocks around the lightning return stroke channel

    International Nuclear Information System (INIS)

    Bow shock structures are important to various hydrodynamics and magnetohydrodynamics (MHD) phenomena in geophysics and astrophysics. The formation and propagation of bow shocks around the lightning return stroke channel are investigated based on the self-similar motion theory and simulated with a two-dimensional Eulerian finite volume resistive radiation MHD code. In this framework, as verification of theoretical models, the evolving structures of many quantities, such as the plasma density, temperature, pressure, shock velocity, and magnetic field, can be obtained, which present all the characteristics of bow shocks in the lightning return stroke processes. The evolution characteristics and the configuration of the curved return stroke channels, e.g., the non-ideal effects and the scaling laws, are discussed in detail. The results may have applications for some observed features of the return stroke channels and other phenomena in the lightning discharge plasmas

  2. A numerical study on bow shocks around the lightning return stroke channel

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Qiang, E-mail: cq0405@126.com; Chen, Bin, E-mail: emcchen@163.com; Yi, Yun [National Key Laboratory of Electromagnetic Environment and Electro-Optical Engineering, PLA University of Science and Technology, Nanjing 210007 (China); Chen, P. F., E-mail: chenpf@nju.edu.cn [School of Astronomy and Space Science, Nanjing University, Nanjing 210023 (China); Mao, Yunfei [The China Satellite Maritime Tracking and Control Department, Yuan Wang III, Jiangyin 214400 (China); Xiong, Run [Engineer Academy of PLA, Xuzhou 221004 (China)

    2015-03-15

    Bow shock structures are important to various hydrodynamics and magnetohydrodynamics (MHD) phenomena in geophysics and astrophysics. The formation and propagation of bow shocks around the lightning return stroke channel are investigated based on the self-similar motion theory and simulated with a two-dimensional Eulerian finite volume resistive radiation MHD code. In this framework, as verification of theoretical models, the evolving structures of many quantities, such as the plasma density, temperature, pressure, shock velocity, and magnetic field, can be obtained, which present all the characteristics of bow shocks in the lightning return stroke processes. The evolution characteristics and the configuration of the curved return stroke channels, e.g., the non-ideal effects and the scaling laws, are discussed in detail. The results may have applications for some observed features of the return stroke channels and other phenomena in the lightning discharge plasmas.

  3. Arterial ischemic stroke in HIV: Defining and classifying etiology for research studies.

    Science.gov (United States)

    Benjamin, Laura A; Bryer, Alan; Lucas, Sebastian; Stanley, Alan; Allain, Theresa J; Joekes, Elizabeth; Emsley, Hedley; Turnbull, Ian; Downey, Colin; Toh, Cheng-Hock; Brown, Kevin; Brown, David; Ison, Catherine; Smith, Colin; Corbett, Elizabeth L; Nath, Avindra; Heyderman, Robert S; Connor, Myles D; Solomon, Tom

    2016-08-01

    HIV infection, and potentially its treatment, increases the risk of an arterial ischemic stroke. Multiple etiologies and lack of clear case definitions inhibit progress in this field. Several etiologies, many treatable, are relevant to HIV-related stroke. To fully understand the mechanisms and the terminology used, a robust classification algorithm to help ascribe the various etiologies is needed. This consensus paper considers the strengths and limitations of current case definitions in the context of HIV infection. The case definitions for the major etiologies in HIV-related strokes were refined (e.g., varicella zoster vasculopathy and antiphospholipid syndrome) and in some instances new case definitions were described (e.g., HIV-associated vasculopathy). These case definitions provided a framework for an algorithm to help assign a final diagnosis, and help classify the subtypes of HIV etiology in ischemic stroke.

  4. STUDY ON MULTIMEDIA ANIMATION SYSTEM OF ACUPOINT ANATOMY WITH FLASH

    Institute of Scientific and Technical Information of China (English)

    WANG Bin; LUO Zhi-yong; PU Yu-feng; HONG Hong; ZUO Zhi-xiong

    2006-01-01

    Mastering anatomic structures of acupoints is of active significance for avoiding blindly needling and preventing accidents of acupuncture and moxibustion. This multimedia animation system of acupoint anatomy adopts Flash software as developing tool and can dynamically display anatomic layers of needle insertion, with objectivity, convenient operation and English-Chinese control, higher reliability, easy to study and master anatomic knowledge of acupoint anatomy, increase teaching efficiency, and richen teaching ways. This system can be used as a teaching tool of acupuncture and moxibustion, a software of studying anatomy of acupoints and an adjuvant tool of medical workers in studying anatomy.

  5. Robot-assisted reaching exercise promotes arm movement recovery in chronic hemiparetic stroke: a randomized controlled pilot study

    Directory of Open Access Journals (Sweden)

    Rymer W Zev

    2006-06-01

    Full Text Available Abstract Background and purpose Providing active assistance to complete desired arm movements is a common technique in upper extremity rehabilitation after stroke. Such active assistance may improve recovery by affecting somatosensory input, motor planning, spasticity or soft tissue properties, but it is labor intensive and has not been validated in controlled trials. The purpose of this study was to investigate the effects of robotically administered active-assistive exercise and compare those with free reaching voluntary exercise in improving arm movement ability after chronic stroke. Methods Nineteen individuals at least one year post-stroke were randomized into one of two groups. One group performed 24 sessions of active-assistive reaching exercise with a simple robotic device, while a second group performed a task-matched amount of unassisted reaching. The main outcome measures were range and speed of supported arm movement, range, straightness and smoothness of unsupported reaching, and the Rancho Los Amigos Functional Test of Upper Extremity Function. Results and discussion There were significant improvements with training for range of motion and velocity of supported reaching, straightness of unsupported reaching, and functional movement ability. These improvements were not significantly different between the two training groups. The group that performed unassisted reaching exercise improved the smoothness of their reaching movements more than the robot-assisted group. Conclusion Improvements with both forms of exercise confirmed that repeated, task-related voluntary activation of the damaged motor system is a key stimulus to motor recovery following chronic stroke. Robotically assisting in reaching successfully improved arm movement ability, although it did not provide any detectable, additional value beyond the movement practice that occurred concurrently with it. The inability to detect any additional value of robot-assisted reaching

  6. Studying The Effects Of Transcranial Direct Current Stimulation In Stroke Recovery Using Magnetic Resonance Imaging

    Directory of Open Access Journals (Sweden)

    Charlotte J Stagg

    2013-12-01

    Full Text Available Transcranial direct current stimulation (tDCS is showing increasing promise as an adjunct therapy in stroke rehabilitation. However questions still remain concerning its mechanisms of action, which currently limit its potential. Magnetic Resonance (MR techniques are increasingly being applied to understand the neural effects of tDCS. Here, we review the MR evidence supporting the use of tDCS to aid recovery after stroke and discuss the important open questions that remain.

  7. Study on Romanian Consumers’ Opinion Regarding the Animal Welfare Labelling of Animal Products

    Directory of Open Access Journals (Sweden)

    Ludovic Toma Cziszter

    2010-10-01

    Full Text Available The aim of the paper was to investigate the influence some factors on the consumers’ opinion regarding the animal welfare labelling of animal products. The analysed question was: “When purchasing eggs, meat or milk can you easily identify from the label those products sourced from animal welfare friendly production systems?” Respondents chosen only one answer out of the five offered: yes, most of the time; yes, some of the time; no, very rarely; no, never; and don’t know. Thirty three percent of females considered they could find sometime information regarding the animal welfare on the labels, while males considered that this information could be found very rarely. Up to 55 years of age, 50% of the consumers consider that the labels do not contain the information about animal welfare, while after this age most of consumers consider they found this information on the labels. Over 50% of Orthodox and Roman Catholic responders considered that the information on animal welfare on the labels was found some of the time or very rarely. Respondents, irrespective of their living area or monthly income, considered that there is scarce information regarding animal welfare on the labels. Internet access significantly influenced the consumers regarding the availability of the information on the labels.

  8. Aspirin After Mini-Stroke May Help Prevent Full-Blown Stroke

    Science.gov (United States)

    ... gov/news/fullstory_158939.html Aspirin After Mini-Stroke May Help Prevent Full-Blown Stroke Study finds risk is reduced by as much ... HealthDay News) -- Taking aspirin immediately after a mini-stroke significantly reduces the risk of a major stroke, ...

  9. CHA2DS2-VASc score, left atrial size and atrial fibrillation as stroke risk factors in the Tromsø Study

    Science.gov (United States)

    Tiwari, Sweta; Løchen, Maja-Lisa; Jacobsen, Bjarne K; Hopstock, Laila A; Nyrnes, Audhild; Njølstad, Inger; Mathiesen, Ellisiv B; Schirmer, Henrik

    2016-01-01

    Objective CHA2DS2-VASc score, left atrial (LA) size and atrial fibrillation (AF) have individually been associated with stroke risk. Our aim was to investigate the predictive ability of combinations of these factors for the odds of incident stroke in a population-based cohort study. Methods We followed 2844 participants from the Tromsø Study from 1994 to 2012. Information on LA size and CHA2DS2-VASc score (age, sex, congestive heart failure, hypertension, vascular disease, stroke and diabetes) were obtained at baseline. AF status was recorded from medical records. The outcome measure was all strokes. The association between covariates and stroke was investigated by means of multivariate logistic regression analysis. Results A total of 325 participants (45% women, mean age at baseline 59.3 years) had a stroke. Incidence rates for stroke were 6.4 in women and 8.4 in men per 1000 person-years. Participants with CHA2DS2-VASc ≥1 and LA size <2.8 had ∼4 times (95% CI 2.6 to 5.3) increased odds of stroke, whereas participants with CHA2DS2-VASc ≥1 and LA size ≥2.8 had ∼9 times (95% CI 5.3 to 16.4) increased odds of stroke, compared with participants with CHA2DS2-VASc score 0, irrespective of AF status. Adjustment for significant covariates had minimal impact on the OR estimates. Conclusions Combining CHA2DS2-VASc score ≥1 and enlarged LA size identified participants with high odds of stroke regardless of AF status.

  10. Markedly impaired bilateral coordination of gait in post-stroke patients: Is this deficit distinct from asymmetry? A cohort study

    Directory of Open Access Journals (Sweden)

    van Lummel Rob C

    2011-05-01

    Full Text Available Abstract Background Multiple aspects of gait are typically impaired post-stroke. Asymmetric gait is common as a consequence of unilateral brain lesions. The relationship between the resulting asymmetric gait and impairments in the ability to properly coordinate the reciprocal stepping activation of the legs is not clear. The objective of this exploratory study is to quantify the effects of hemiparesis on two putatively independent aspects of the bilateral coordination of gait to gain insight into mechanisms and their relationship and to assess their potential as clinical markers. Methods Twelve ambulatory stroke patients and age-matched healthy adults wore a tri-axial piezo-resistive accelerometer and walked back and forth along a straight path in a hall at a comfortable walking speed during 2 minutes. Gait speed, gait asymmetry (GA, and aspects of the bilateral coordination of gait (BCG were determined. Bilateral coordination measures included the left-right stepping phase for each stride φi, consistency in the phase generation φ_CV, accuracy in the phase generation φ_ABS, and Phase Coordination Index (PCI, a combination of accuracy and consistency of the phase generation. Results Group differences (p Conclusions In ambulatory post-stroke patients, two gait coordination properties, GA and PCI, are markedly impaired. Although these features are not related to each other in healthy controls, they are strongly related in stroke patients, which is a novel finding. A measurement approach based on body-fixed sensors apparently may provide sensitive markers that can be used for clinical assessment and for enhancing rehabilitation targeting in post-stroke patients.

  11. Validation of the RRE-90 Scale to Predict Stroke Risk after Transient Symptoms with Infarction: A Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Bo Song

    Full Text Available The risk of stroke after a transient ischemic attack (TIA for patients with a positive diffusion-weighted image (DWI, i.e., transient symptoms with infarction (TSI, is much higher than for those with a negative DWI. The aim of this study was to validate the predictive value of a web-based recurrence risk estimator (RRE; http://www.nmr.mgh.harvard.edu/RRE/ of TSI.Data from the prospective hospital-based TIA database of the First Affiliated Hospital of Zhengzhou University were analyzed. The RRE and ABCD2 scores were calculated within 7 days of symptom onset. The predictive outcome was ischemic stroke occurrence at 90 days. The receiver-operating characteristics curves were plotted, and the predictive value of the two models was assessed by computing the C statistics.A total of 221 eligible patients were prospectively enrolled, of whom 46 (20.81% experienced a stroke within 90 days. The 90-day stroke risk in high-risk TSI patients (RRE ≥4 was 3.406-fold greater than in those at low risk (P <0.001. The C statistic of RRE (0.681; 95% confidence interval [CI], 0.592-0.771 was statistically higher than that of ABCD2 score (0.546; 95% CI, 0.454-0.638; Z = 2.115; P = 0.0344 at 90 days.The RRE score had a higher predictive value than the ABCD2 score for assessing the 90-day risk of stroke after TSI.

  12. [Neuroprotector effect of human recombinant erythropoietin sorbed on polymer nanoparticles studied on model of intracerebral post-traumatic hematoma (hemorrhagic stroke)].

    Science.gov (United States)

    Balaban'ian, V Iu; Solev, I N; Elizarova, O S; Garibova, T L; Litvinova, S A; Voronina, T A

    2011-01-01

    The neuroprotective activity of recombinant human erythropoietin (r-HuEpo) sorbed on poly(butyl)cyanoacrilate nanoparticles (EPO-PBCA) and on polylactic-co-glycolic acid nanoparticles (EPO-PLGA) has been studied on Wistar rats with intracerebral post-traumatic hematoma (model of hemorrhagic stroke) (IPH-HS) in comparison to native r-HuEpo. It is established that EPO-PBCA produced a protective effect in rats after IPH-HS that was manifested by a decrease in the number of animals with neurological disorders such as circus movement, paresis, and paralysis of hind limbs; the drug also improved coordination (rotating rod test), reduced the number of lost animals, and decreased the loss weight among survived rats. In addition, EPO-PBCA optimized the research behavior of rats with IPH-HS in the open field test and prevented amnesia of passive avoidance reflex (PAR), which was caused by the IPH-HS. These effects were manifested during a two-week observation period. EPO-PLGA has a similar but much less pronounced effect on the major disorders caused by IPH-HS. The efficiency of native r-HuEpo as a neuropotective agent was insignificant and only manifested by decrease in the number of lost animals with IPH-HS.

  13. Effects of epilepsy and selected antiepileptic drugs on risk of myocardial infarction, stroke, and death in patients with or without previous stroke: a nationwide cohort study

    DEFF Research Database (Denmark)

    Olesen, Jonas Bjerring; Abildstrøm, Steen Zabell; Erdal, Jesper;

    2011-01-01

    Patients with epilepsy have increased morbidity and mortality. We evaluated the risk of myocardial infarction (MI), stroke, and death associated with epilepsy and examined if this risk was modified by treatment with antiepileptic drugs (AEDs).......Patients with epilepsy have increased morbidity and mortality. We evaluated the risk of myocardial infarction (MI), stroke, and death associated with epilepsy and examined if this risk was modified by treatment with antiepileptic drugs (AEDs)....

  14. Muscle pain: animal and human experimental and clinical studies.

    Science.gov (United States)

    Marchettini, P

    1993-10-01

    The search for the identification of the sensory apparatus encoding muscle pain sensation in humans is recounted. Basic neurophysiologic animal studies, leading to a description of slowly conducting afferent from muscle and definition of high threshold polymodal muscle nociceptors, and pioneer psychophysic human studies together with recent microneurographic experiments in humans are described. The phenomena of muscle pain broad localization and distant referral are discussed, and clinical implications are extrapolated to interpret muscle pain as a localizing sign of mononeuropathy or radiculopathy. The identification of human muscle nociceptors has defined the scientific standard to test emerging clinical descriptions having muscle pain as a symptom.

  15. How a Stroke Is Diagnosed

    Science.gov (United States)

    ... News About Neurology Image Library Search The Internet Stroke Center Patients & Families About Stroke Stroke Diagnosis Stroke ... Diagnosis » How a Stroke is Diagnosed How a Stroke is Diagnosed How a Stroke is Diagnosed Lab ...

  16. How to study sex differences in addiction using animal models.

    Science.gov (United States)

    Carroll, Marilyn E; Lynch, Wendy J

    2016-09-01

    The importance of studying sex as a biological variable in biomedical research is becoming increasingly apparent. There is a particular need in preclinical studies of addiction to include both sexes, as female animals are often excluded from studies, leaving large gaps in our knowledge of not only sex differences and potential prevention and treatment strategies but also with regard to the basic neurobiology of addiction. This review focuses on methodology that has been developed in preclinical studies to examine sex differences in the behavioral aspects and neurobiological mechanisms related to addiction across the full range of the addiction process, including initiation (acquisition), maintenance, escalation, withdrawal, relapse to drug seeking and treatment. This review also discusses strategic and technical issues that need to be considered when comparing females and males, including the role of ovarian hormones and how sex differences interact with other major vulnerability factors in addiction, such as impulsivity, compulsivity and age (adolescent versus adult). Novel treatments for addiction are also discussed, such as competing non-drug rewards, repurposed medications such as progesterone and treatment combinations. Practical aspects of conducting research comparing female and male animals are also considered. Making sex differences a point of examination requires additional effort and consideration; however, such studies are necessary given mounting evidence demonstrating that the addiction process occurs differently in males and females. These studies should lead to a better understanding of individual differences in the development of addiction and effective treatments for males and females. PMID:27345022

  17. Long-term Outcomes after Stroke in Elderly Patients with Atrial Fibrillation: A Hospital-based Follow-up Study in China

    Directory of Open Access Journals (Sweden)

    Yuguang eZhao

    2016-03-01

    Full Text Available Background: Atrial fibrillation (AF significantly increases the risk of stroke and disease burden; it is an established predictor of poor outcomes after stroke. However, reported differences in outcomes after stroke among elderly patients between AF and non-AF group are conflicting. We aimed to compare differences in outcomes at 1 year and 3 years after stroke among elderly patients (aged≥75 years old between AF group and non-AF group. Methods: We recruited 1070 consecutive elderly patients who experienced acute ischemic stroke between January 2008 and December 2013 in Jiamusi University First Hospital, China in this study. Information regarding stroke subtype, severity, risk factors, and outcome (mortality, dependency, and recurrence at 3 and 12 months after stroke were recorded and assessed between AF group and non-AF group.Results: The prevalence of AF was 16.1% overall, with a similar trend in the prevalence of AF between men and women. The AF group were more likely to experience severe stroke compared to the non-AF group (32.0% vs. 11.9%, respectively; P<0.001. There were no obvious differences between groups regarding the prevalence of hypertension, dyslipidemia, obesity, current smoking, and alcohol drinking but there was a higher prevalence of diabetes in the non-AF group (20.3% vs 30.1%, P=0.010. Mortality and dependency rates were significantly higher in the AF group than in the non-AF group at 1 year after stroke (29.6% vs 17.8%, P=0.001 for mortality; and 59.5% vs 36.1%, P=0.010 for dependency and 3 years after stroke (46.1% vs 33.2%, P=0.032 for mortality; and 70.7% vs 49.2%, P=0.010 for dependency; however, there was no significant between-groups differences in rates of recurrence across the follow-up periods. The results for dependency remained stable after adjustment for sex, stroke severity, and stroke risk factors at 3 years after stroke (OR, 2.26; 95% CI, 1.06–4.81; P = 0.034; however, the relationship between AF and

  18. A 12-year prospective study of stroke risk in older Medicare beneficiaries

    Directory of Open Access Journals (Sweden)

    Pavlik Claire E

    2009-05-01

    Full Text Available Abstract Background 5.8 M living Americans have experienced a stroke at some time in their lives, 780K had either their first or a recurrent stroke this year, and 150K died from strokes this year. Stroke costs about $66B annually in the US, and also results in serious, long-term disability. Therefore, it is prudent to identify all possible risk factors and their effects so that appropriate intervention points may be targeted. Methods Baseline (1993–1994 interview data from the nationally representative Survey on Assets and Health Dynamics among the Oldest Old (AHEAD were linked to 1993–2005 Medicare claims. Participants were 5,511 self-respondents ≥ 70 years old. Two ICD9-CM case-identification approaches were used. Two approaches to stroke case-identification based on ICD9-CM codes were used, one emphasized sensitivity and the other emphasized specificity. Participants were censored at death or enrollment into managed Medicare. Baseline risk factors included sociodemographic, socioeconomic, place of residence, health behavior, disease history, and functional and cognitive status measures. A time-dependent marker reflecting post-baseline non-stroke hospitalizations was included to reflect health shocks, and sensitivity analyses were conducted to identify its peak effect. Competing risk, proportional hazards regression was used. Results Post-baseline strokes occurred for 545 (9.9%; high sensitivity approach and 374 (6.8%; high specificity approach participants. The greatest static risks involved increased age, being widowed or never married, living in multi-story buildings, reporting a baseline history of diabetes, hypertension, or stroke, and reporting difficulty picking up a dime, refusing to answer the delayed word recall test, or having poor cognition. Risks were similar for both case-identification approaches and for recurrent and first-ever vs. only first-ever strokes. The time-dependent health shock (recent hospitalization marker did

  19. 30-Year Trends in Stroke Rates and Outcome in Auckland, New Zealand (1981-2012: A Multi-Ethnic Population-Based Series of Studies.

    Directory of Open Access Journals (Sweden)

    Valery L Feigin

    Full Text Available Insufficient data exist on population-based trends in morbidity and mortality to determine the success of prevention strategies and improvements in health care delivery in stroke. The aim of this study was to determine trends in incidence and outcome (1-year mortality, 28-day case-fatality in relation to management and risk factors for stroke in the multi-ethnic population of Auckland, New Zealand (NZ over 30-years.Four stroke incidence population-based register studies were undertaken in adult residents (aged ≥15 years of Auckland NZ in 1981-1982, 1991-1992, 2002-2003 and 2011-2012. All used standard World Health Organization (WHO diagnostic criteria and multiple overlapping sources of case-ascertainment for hospitalised and non-hospitalised, fatal and non-fatal, new stroke events. Ethnicity was consistently self-identified into four major groups. Crude and age-adjusted (WHO world population standard annual incidence and mortality with corresponding 95% confidence intervals (CI were calculated per 100,000 people, assuming a Poisson distribution.5400 new stroke patients were registered in four 12 month recruitment phases over the 30-year study period; 79% were NZ/European, 6% Māori, 8% Pacific people, and 7% were of Asian or other origin. Overall stroke incidence and 1-year mortality decreased by 23% (95% CI 5%-31% and 62% (95% CI 36%-86%, respectively, from 1981 to 2012. Whilst stroke incidence and mortality declined across all groups in NZ from 1991, Māori and Pacific groups had the slowest rate of decline and continue to experience stroke at a significantly younger age (mean ages 60 and 62 years, respectively compared with NZ/Europeans (mean age 75 years. There was also a decline in 28-day stroke case fatality (overall by 14%, 95% CI 11%-17% across all ethnic groups from 1981 to 2012. However, there were significant increases in the frequencies of pre-morbid hypertension, myocardial infarction, and diabetes mellitus, but a reduction in

  20. Medication Persistence Rates and Factors Associated with Persistence in Patients Following Stroke: A Cohort Study

    Directory of Open Access Journals (Sweden)

    Joffres Michel R

    2008-07-01

    Full Text Available Abstract Background Medication nonadherence can be as high as 50% and results in suboptimal patient outcomes. Stroke patients in particular can benefit from pharmacotherapy for thrombosis, hypertension, and dyslipidemia but are at high risk for medication nonpersistence. Methods Patients who were admitted to the Queen Elizabeth II Health Sciences Centre in Halifax, Nova Scotia, with stroke between January 1, 2001 and December 31, 2002 were analyzed. Data collected were pre-stroke function, stroke subtype, stroke severity, patient outcomes, and medication use at discharge, and six and 12 months post discharge. Medication persistence at six and 12 months and the factors associated with nonpersistence at six months were examined using multivariable stepwise logistic regression. Results At discharge, 420 patients (mean age 68.2 years, 55.7% male were prescribed an average of 6.4 medications and mean prescription drug cost was $167 monthly. Antihypertensive (91% and antithrombotic (96% drug use at discharge were frequent, antilipidemic (73% and antihyperglycemic (25% drug use were less common. Self-reported persistence at six and 12 months after stroke was high (> 90% for all categories. In the multivariable model of medication nonpersistence at six months, people aged 65 to 79 years were less likely to be nonpersistent with antihypertensive medications than people aged 80 years or more (Odds ratio (OR 0.11, 95% Confidence Interval (CI 0.03–0.39. Monthly drug costs of Conclusion Patients reported high medication persistence rates six and 12 months after stroke. Identification of factors associated with nonpersistence (such as older age and prior disability will help predict which patients are at higher risk for discontinuing their medications.