Stroke Research and Treatment最新文献

{"title":"Frequency of Aspirin Resistance in Ischemic Stroke Patients and Healthy Controls from Colombia.","authors":"Alejandro Roman-Gonzalez,&nbsp;Carlos Andrés Naranjo,&nbsp;Walter D Cardona-Maya,&nbsp;Dionis Vallejo,&nbsp;Francisco Garcia,&nbsp;Cesar Franco,&nbsp;Leonor Alvarez,&nbsp;Luis Ignacio Tobón,&nbsp;Marta Ibeth López,&nbsp;Carolina Rua,&nbsp;Gabriel Bedoya,&nbsp;Ángela Cadavid,&nbsp;José Domingo Torres","doi":"10.1155/2021/9924710","DOIUrl":"https://doi.org/10.1155/2021/9924710","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the aspirin resistance prevalence in patients with previous ischemic cerebrovascular disease undergoing aspirin therapy for secondary prevention.</p><p><strong>Materials and methods: </strong>Three hundred fifty patients presenting ischemic strokes and 100 healthy controls under aspirin treatment were evaluated using the optic platelet aggregation test.</p><p><strong>Results: </strong>Aspirin resistance was found in 7.4% of the patients with ischemic stroke and 4% of controls. Aspirin resistance was associated with stroke recurrence in univariate analysis (<i>p</i> = 0.004). Aspirin resistance was not associated with smoking, diabetes, or hypercholesterolemia.</p><p><strong>Conclusion: </strong>Aspirin resistance is present in Colombian patients with ischemic stroke as well as in healthy controls.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2021 ","pages":"9924710"},"PeriodicalIF":1.5,"publicationDate":"2021-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8164531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39066165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex, Knowledge, and Attitude of Stroke Survivors Attending Bebe Herbal Center on Risk Factors before and after Stroke.","authors":"Polycarp U Nwoha,&nbsp;Florence O Okoro,&nbsp;Emmanuel C Nwoha,&nbsp;Fidelia N Chukwu,&nbsp;Chidinma O Nwoha,&nbsp;Nkeiru C Ogoko,&nbsp;Peace N Nwoha,&nbsp;Chika A Idaguko,&nbsp;Augustine U Obi,&nbsp;Ezenna M Agwu,&nbsp;Iyanu O Ayoola,&nbsp;Sunday O Osonwa,&nbsp;Ifeoma H Okpara","doi":"10.1155/2021/6695522","DOIUrl":"https://doi.org/10.1155/2021/6695522","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to investigate the extent stroke survivors who attended an herbal center knew of stroke risk factors and whether significant sex differences existed. <i>Study Design</i>. This was a cross-sectional study conducted from January to June 2018 at Bebe Herbal Center, and it involved two well-trained assistants who interviewed 149 first-time stroke survivors after consent and ethical approval were obtained. The survivors self-reported their knowledge, attitude, and beliefs on risk factors before and after stroke. <i>Statistical Analyses</i>. Means of continuous variables were compared using Student's unpaired <i>t</i>-test, while categorical variables between males and the females were analyzed using Pearson's chi-square test. <i>P</i> < 0.05 was taken as significant.</p><p><strong>Results: </strong>Mean age of men (64.81 ± 1.24 yrs) was significantly higher than that of women (61.39 ± 1.42 yrs) (<i>F</i> = 0.096, <i>t</i> = 1.79, df = 147; <i>P</i> < 0.05). More men than women were 60 years and above while more women than men were below 60 years. Pearson's chi-square test showed significant association of sex with education (<i>χ</i> ² = 12.31; df = 3, <i>P</i> < 0.006), occupation (<i>χ</i> ² = 23.65; df = 4, <i>P</i> < 0.001), alcohol intake (<i>χ</i> ² = 24.23; df = 1; <i>P</i> < 0.001), and smoking (<i>χ</i> ² = 9.823; df = 1; <i>P</i> < 0.001). The commonest risk factor suffered was hypertension (73.1%), followed by alcohol intake (59.1%), smoking (31.5%), and diabetes mellitus (26.7%); these affected men more than women. Male survivors unaware of their hypertensive status were more likely to have stroke than females, and age had a significant effect on the likelihood of developing a stroke; the same was occupation.</p><p><strong>Conclusions: </strong>These survivors suffered mainly from hypertension, triggered by psychosocial problems and diabetes mellitus; their stroke seemed fueled by unrecognized hypertension, unrecognized diabetes mellitus, ignorance of hyperlipidemia, and wide-scale belief in witchcraft as risk factor. Awareness programs in the third world should take these observations into consideration.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2021 ","pages":"6695522"},"PeriodicalIF":1.5,"publicationDate":"2021-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8102117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38996448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of a Self-Managed, Video-Guided Exercise Program for Community-Dwelling People with Stroke.","authors":"Katharine Scrivener,&nbsp;Jessica Sewastenko,&nbsp;Alexandra Bouvier-Farrell,&nbsp;Katherine MacDonald,&nbsp;Tegan Van Rijn,&nbsp;Joshua Tezak,&nbsp;Nicholas Mandis,&nbsp;Sherrie Love","doi":"10.1155/2021/5598100","DOIUrl":"https://doi.org/10.1155/2021/5598100","url":null,"abstract":"<p><strong>Background: </strong>Ongoing rehabilitation after stroke is limited. Using video-guided exercises, which are implemented with a self-management approach, may be a way to facilitate ongoing exercise in the home environment.</p><p><strong>Objectives: </strong>To investigate the feasibility of a video-guided exercise program, implemented with a self-management approach for people with stroke.</p><p><strong>Methods: </strong>A phase I, single-group, clinical trial. The study comprised two phases: in phase one, four weeks of the program was supported by weekly supervised sessions and in phase two, four weeks of the program was completed without direct supervision. Demographic information was recorded at baseline. Adherence and adverse events were self-reported via a logbook. Acceptability was measured through a purpose-built scale. Physical performance, physical activity, and exercise self-efficacy were measured at baseline and 4 and 8 weeks.</p><p><strong>Results: </strong>Sixteen people with stroke were recruited; however, 14 commenced and completed the study. Adherence during the supervised phase was 3.3 hours per week and 2.3 hours per week during the self-directed phase. There were no adverse events. Most participants indicated that the program was easy to use (92%) and would recommend the program to others (86%). Walking speed improved over the duration of the program (mean difference -0.12 m/s, 95% CI -0.22 to -0.02, <i>p</i> = 0.02). Self-efficacy and physical activity did not change over the duration of the program.</p><p><strong>Conclusion: </strong>The findings support the feasibility of a video-guided exercise program for people with stroke. Further research to confirm the effectiveness of this intervention to improve physical function is warranted.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2021 ","pages":"5598100"},"PeriodicalIF":1.5,"publicationDate":"2021-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8116139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39018149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treadmill Exercise during Pregnancy Decreased Vulnerability to Neonatal Hypoxia-Ischemia through Reducing Inflammation and Increasing Antiapoptotic Gene Expressions and Antioxidant Capacity in Rats.","authors":"Elahe Gorgij,&nbsp;Hamed Fanaei,&nbsp;Parichehr Yaghmaei,&nbsp;Mohammad Reza Shahraki,&nbsp;Hadi Mirahmadi","doi":"10.1155/2021/5512745","DOIUrl":"https://doi.org/10.1155/2021/5512745","url":null,"abstract":"<p><strong>Background: </strong>The purpose of present study was to assess the impact of maternal treadmill exercise during pregnancy on inflammation, oxidative stress, expression of Bax and Bcl-2 genes, and brain-derived neurotrophic factor (BDNF) level in neonatal rat brain after the hypoxia-ischemia injury. <i>Material and Methods</i>. A total of 24 female Wistar rats were utilized in this research. Two groups are randomly considered for rats: (1) not exercised through pregnancy and (2) exercised during pregnancy. Offsprings were divided into four groups including after delivery: (1) sham, (2) sham/exercise (sham/EX), (3) HI, and (4) HI+exercise. HI was induced in pups at postnatal day 8. Neurobehavioral tests were done seven days after HI induction. Then, the brain tissue was taken from the skull to estimate Bcl-2 and Bax gene expressions, BDNF, cerebral edema, infarct volume, inflammatory factors, oxidative stress, and neurological function.</p><p><strong>Results: </strong>The BDNF level in the HI+exercise group was considerably higher than the HI, sham, and sham/EX groups. Tumor necrosis factor (TNF-<i>α</i>), C-reactive protein (CRP), and the whole oxidant capacity (TOC) levels in the HI group were significantly higher than the sham and sham/EX groups. TNF-<i>α</i>, CRP, and TOC levels in the HI+exercise group were significantly lower than the HI group. Total antioxidant capacity (TAC) level in the HI+exercise group was significantly higher than the HI group. Infarct volume and edema percent in the HI+exercise group were significantly lower than the HI group. Neurological function in the HI+exercise group was significantly better than the HI group. Bax expression in the HI+exercise group was significantly lower than the HI group. Bcl-2 expression in the HI+exercise group was significantly higher than the HI group. In the sham group, BDNF, TNF-<i>α</i>, CRP, TAC, TOC, edema levels, and neurological function had no significant difference with the sham/EX group.</p><p><strong>Conclusion: </strong>It appears that the maternal treadmill exercise during pregnancy exerts a supportive impact against neonatal HI brain injury through increasing antioxidant capacity, Bcl-2 expression, and BDNF levels and decreasing inflammation that is resulted in the lower infarct volume and sensorimotor dysfunction.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2021 ","pages":"5512745"},"PeriodicalIF":1.5,"publicationDate":"2021-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8060122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38950448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of DLBS1033 on Functional Outcomes for Patients with Acute Ischemic Stroke: A Randomized Controlled Trial.","authors":"Rizaldy Taslim Pinzon,&nbsp;Raymond R Tjandrawinata,&nbsp;Vincent Ongko Wijaya,&nbsp;Vanessa Veronica","doi":"10.1155/2021/5541616","DOIUrl":"https://doi.org/10.1155/2021/5541616","url":null,"abstract":"<p><strong>Background: </strong>There are still some unmet needs for stroke management and safety. DLBS1033 is a protein fraction extracted from the earthworm <i>Lumbricus rubellus</i> that has shown fibrinolytic and fibrinogenolytic activities, reduces blood viscosity, and inhibits platelet aggregation that it can be considered an add-on therapy and potential medical breakthrough in acute ischemic stroke management.</p><p><strong>Objective: </strong>This study is aimed at measuring the benefit of DLBS1033 in acute ischemic stroke management.</p><p><strong>Methods: </strong>This was a randomized, open-label trial at a referral stroke center from November 2019 to December 2020. Subjects who met the inclusion criteria were randomly divided into a control group and an experimental group. The control group received standard therapy consisting of aspirin 100 mg once daily, atorvastatin 20 mg once daily, and vitamin B₁₂ 100 mg three times daily. The experimental group received standard therapy and DLBS1033 three times daily. The functional outcomes were measured using the National Institutes of Health Stroke Scale (NIHSS), Barthel Index (BI), and modified Rankin Scale (mRS) at baseline, hospital discharge, and day 30.</p><p><strong>Results: </strong>Collected data from 180 subjects was analyzed. The NIHSS scores' improvements were significantly greater in the experimental group compared to the control group at both hospital discharge (-5.57 ± 2.16 vs. -3.64 ± 2.65; <i>p</i> < 0.001) and day 30 (-6.62 ± 2.64 vs. -5.14 ± 2.41; <i>p</i> = 0.001). Compared with the control group, the improvements in the BI scores were significantly better in the experimental group, at both hospital discharge (10.69 ± 5.36 vs. 6.64 ± 5.04; <i>p</i> < 0.001) and day 30 (10.9 ± 8.19 vs. 8.56 ± 7.45; <i>p</i> = 0.003). The distribution of mRS scores was improved in both groups during 30 days of follow-up and was more favorable in the experimental group. In both groups, a favorable outcome (mRS < 2) was achieved better at day 30 (86.7% vs. 80%; <i>p</i> = 0.302) than at baseline (0% vs. 6.7%; <i>p</i> = 0.028) and at hospital discharge (58.9% vs. 43.3%; <i>p</i> = 0.085). There was no clinically significant adverse event related to the study product.</p><p><strong>Conclusions: </strong>DLBS1033 in addition to the standard care was more effective in improving functional status compared to standard care alone in acute ischemic stroke patients with a similar safety profile.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2021 ","pages":"5541616"},"PeriodicalIF":1.5,"publicationDate":"2021-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8049819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38933557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ABCD3-I and ABCD2 Scores in a TIA Population with Low Stroke Risk.","authors":"Fredrik Ildstad,&nbsp;Hanne Ellekjær,&nbsp;Torgeir Wethal,&nbsp;Stian Lydersen,&nbsp;Hild Fjærtoft,&nbsp;Bent Indredavik","doi":"10.1155/2021/8845898","DOIUrl":"https://doi.org/10.1155/2021/8845898","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to evaluate the ABCD3-I score and compare it with the ABCD2 score in short- (1 week) and long-term (3 months; 1 year) stroke risk prediction in our post-TIA stroke risk study, MIDNOR TIA.</p><p><strong>Materials and methods: </strong>We performed a prospective, multicenter study in Central Norway from 2012 to 2015, enrolling 577 patients with TIA. In a subset of patients with complete data for both scores (<i>n</i> = 305), we calculated the AUC statistics of the ABCD3-I score and compared this with the ABCD2 score. A telephone follow-up and registry data were used for assessing stroke occurrence.</p><p><strong>Results: </strong>Within 1 week, 3 months, and 1 year, 1.0% (<i>n</i> = 3), 3.3% (<i>n</i> = 10), and 5.2% (<i>n</i> = 16) experienced a stroke, respectively. The AUCs for the ABCD3-I score were 0.72 (95% CI, 0.54 to 0.89) at 1 week, 0.66 (95% CI, 0.53 to 0.80) at 3 months, and 0.68 (0.95% CI, 0.56 to 0.79) at 1 year. The corresponding AUCs for the ABCD2 score were 0.55 (95% CI, 0.24 to 0.86), 0.55 (95% CI, 0.42 to 0.68), and 0.63 (95% CI, 0.50 to 0.76).</p><p><strong>Conclusions: </strong>The ABCD3-I score had limited value in a short-term prediction of subsequent stroke after TIA and did not reliably discriminate between low- and high-risk patients in a long-term follow-up. The ABCD2 score did not predict subsequent stroke accurately at any time point. Since there is a generally lower stroke risk after TIA during the last years, the benefit of these clinical risk scores and their role in TIA management seems limited. <i>Clinical Trial Registration</i>. This trial is registered with NCT02038725 (retrospectively registered, January 16, 2014).</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2021 ","pages":"8845898"},"PeriodicalIF":1.5,"publicationDate":"2021-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7932764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25467079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Modifiable Risk Factors of Uncontrolled Hypertension in Stroke: A Systematic Review and Meta-Analysis.","authors":"Arif Setyo Upoyo, Ismail Setyopranoto, Heny Suseani Pangastuti","doi":"10.1155/2021/6683256","DOIUrl":"10.1155/2021/6683256","url":null,"abstract":"<p><strong>Objective: </strong>This review aimed at figuring out the risk factors of uncontrolled hypertension in stroke.</p><p><strong>Method: </strong>This study systematically analyzed the hypertension risk factors available in the ProQuest, EBSCO, and PubMed databases published between 2010 and December 2019. The risk factors' pooled odds ratio (POR) included in this research was calculated using both fixed and random-effect models. The meta-data analysis was processed using the Review Manager 5.3 (Rev Man 5.3).</p><p><strong>Result: </strong>Of 1868 articles, seven studies were included in this review searched using specific keywords. Based on the analysis results, there were 7 risk factors of uncontrolled hypertension in stroke: medication nonadherence (POR = 2.23 [95% CI 1.71-2.89], <i>p</i> = 0.342; <i>I</i> ² = 6.7%), use of antihypertensive drugs (POR = 1.13 [95% CI 1.19-1.59, <i>p</i> = 0.001; <i>I</i> ² = 90.9%), stage of hypertension (POR = 1.14 [95% CI 1.02-1.27], <i>p</i> = <0.001; <i>I</i> ² = 97.1%), diabetes mellitus (POR = 0.71 [95% CI 0.52-0.99], <i>p</i> = <0.001; <i>I</i> ² = 96.5%), atrial fibrillation (POR = 1.74 [95% CI 1.48-2.04)], <i>p</i> = <0.001; <i>I</i> ² = 93.1%), triglycerides (POR = 1.47 [95% CI 1.23-1.75], <i>p</i> = 0.879; <i>I</i> ² = 0%), and age (POR = 1.03 [95% CI 0.89-1.18], <i>p</i> = <0.001; <i>I</i> ² = 97.5%]. There were no bias publications among studies. Medication nonadherence and triglycerides had homogeneous variations, while the others had heterogeneous variations.</p><p><strong>Conclusion: </strong>Medication nonadherence, triglycerides, stage of hypertension, atrial fibrillation, and use of antihypertensive drugs significantly affect the uncontrolled hypertension in stroke.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2021 ","pages":"6683256"},"PeriodicalIF":1.5,"publicationDate":"2021-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7929677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25446493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Value of the Alberta Stroke Program Early CT Score (ASPECTS) in the Outcome of the Acute Ischemic Stroke and Its Correlation with Stroke Subtypes, NIHSS, and Cognitive Impairment.","authors":"Ahmed Esmael, Mohammed Elsherief, Khaled Eltoukhy","doi":"10.1155/2021/5935170","DOIUrl":"10.1155/2021/5935170","url":null,"abstract":"<p><strong>Objectives: </strong>This study is aimed at correlating ASPECTS with mortality and morbidity in patients with acute middle cerebral artery territory infarction and at determining the cutoff value of ASPECTS that may predict the outcome.</p><p><strong>Methods: </strong>150 patients diagnosed with acute middle cerebral artery territory infarction were involved in this study. Risk factors, initial NIHSS, and GCS were determined. An initial or follow-up noncontrast CT brain was done and assessed by ASPECTS. Outcomes were determined by mRS during the follow-up of cases after 3 months. Correlations of ASPECTS and outcome variables were done by Spearman correlation. Logistic regression analysis and ROC curve were done to detect the cutoff value of ASPECTS that predicts unfavorable outcomes.</p><p><strong>Results: </strong>The most common subtypes of ischemic strokes were lacunar stroke in 66 patients (44%), cardioembolic stroke in 39 patients (26%), and LAA stroke in 30 cases (20%). The cardioembolic stroke had a statistically significant lower ASPECT score than other types of ischemic strokes (<i>P</i> < 0.05). Spearman correlation showed that lower ASPECTS values (worse outcome) were more in older patients and associated with lower initial GCS. ASPECTS values were inversely correlated with initial NIHSS, inpatient stay, inpatient complications, mortality, and mRS. The ASPECTS cutoff value determined for the prediction of unfavorable outcomes was equal to ≤7. The binary logistic regression analysis detected that patients with ASPECTS ≤ 7 were significantly associated with about fourfold increased risk of poor outcomes (OR 3.95, 95% CI 2.09-11.38, and <i>P</i> < 0.01).</p><p><strong>Conclusions: </strong>ASPECTS is a valuable and appropriate technique for the evaluation of the prognosis in acute ischemic stroke. Patients with high ASPECTS values are more likely to attain favorable outcomes, and the cutoff value of ASPECTS is a strong predictor for unfavorable outcomes. This trial is registered with ClinicalTrials.gov NCT04235920.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2021 ","pages":"5935170"},"PeriodicalIF":1.5,"publicationDate":"2021-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7864728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25360007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of COVID-19 Pandemic on the Incidence, Prehospital Evaluation, and Presentation of Ischemic Stroke at a Nonurban Comprehensive Stroke Center.","authors":"Cesar Velasco,&nbsp;Brandon Wattai,&nbsp;Scott Buchle,&nbsp;Alicia Richardson,&nbsp;Varun Padmanaban,&nbsp;Kathy J Morrison,&nbsp;Raymond Reichwein,&nbsp;Ephraim Church,&nbsp;Scott D Simon,&nbsp;Kevin M Cockroft","doi":"10.1155/2021/6624231","DOIUrl":"https://doi.org/10.1155/2021/6624231","url":null,"abstract":"<p><strong>Introduction: </strong>Many reports have described a decrease in the numbers of patients seeking medical attention for typical emergencies during the COVID-19 pandemic. These reports primarily relate to urban areas with widespread community transmission. The impact of COVID-19 on nonurban areas with minimal community transmission is less well understood.</p><p><strong>Methods: </strong>Using a prospectively maintained prehospital quality improvement database, we reviewed our hospital EMS transports with a diagnosis of stroke from January to April 2019 (baseline) and January to April 2020 (pandemic). We compared the volume of patients, transport/presentation times, severity of presenting symptoms, and final diagnosis.</p><p><strong>Results: </strong>In January, February, March, and April 2019, 10, 11, 17, and 19 patients, respectively, were transported in comparison to 19, 14, 10, and 8 during the same months in 2020. From January through April 2019, there was a 53% increase in transports, compared to a 42% decrease during the same months in 2020, constituting significantly different trend-line slopes (3.30; 95% CI 0.48-6.12 versus -3.70; 95% CI -5.76--1.64, <i>p</i> = 0.001). Patient demographics, comorbidities, and symptom severity were mostly similar over the two time periods, and the number of patients with a final diagnosis of stroke was also similar. However, the median interval from EMS dispatch to ED arrival for patients with a final diagnosis of stroke was significantly longer in January to April 2020 (50 ± 11.7 min) compared to the same time period in 2019 (42 ± 8.2 min, <i>p</i> = 0.01). <i>Discussion/Conclusion</i>. Our data indicate a decrease in patient transport volumes and longer intervals to EMS activation for suspected stroke care. These results suggest that even in a nonurban location without widespread community transmission, patients may be delaying or avoiding care for severe illnesses such as stroke. Clinicians and public health officials should not ignore the potential impact of pandemic-like illnesses even in areas of relatively low disease prevalence.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2021 ","pages":"6624231"},"PeriodicalIF":1.5,"publicationDate":"2021-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7814411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38874189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insight on the Genetics of Atrial Fibrillation in Puerto Rican Hispanics.","authors":"Ariel F Gonzalez-Cordero,&nbsp;Jorge Duconge-Soler,&nbsp;Hilton Franqui-Rivera,&nbsp;Roberto Feliu-Maldonado,&nbsp;Abiel Roche-Lima,&nbsp;Israel Almodovar-Rivera","doi":"10.1155/2021/8819896","DOIUrl":"https://doi.org/10.1155/2021/8819896","url":null,"abstract":"<p><p>Non-Hispanic whites present with higher atrial fibrillation (AF) prevalence than other racial minorities living in the mainland USA. In two hospital-based studies, Puerto Rican Hispanics had a lower prevalence of atrial fibrillation of 2.5% than non-Hispanic Whites with 5.7%. This data is particularly controversial because Hispanics possess a higher prevalence of traditional risk factors for developing AF yet have a lower AF prevalence. This phenomenon is known as the atrial fibrillation paradox. Despite recent advancements in understanding AF, its pathogenesis remains unclear. In this study, we compared a genetic dataset of Puerto Rican Hispanics to 111 SNP known to be associated with AF in a large European cohort and determine if they are associated with AF susceptibility in our cohort. To achieve this aim, we performed a secondary analysis of existing data using the following two studies: (1) <i>The Pharmacogenetics of Warfarin in Puerto Ricans study</i> and the (2) <i>A Genomic Approach for Clopidogrel in Caribbean Hispanics</i>, and assess for the presence of European SNPs associated with AF from the genome-wide association study of 1 million people identifies 111 loci for atrial fibrillation. We used data from 555 cardiovascular Puerto Rican Hispanic patients, consisting of 486 control and 69 cases. We found that the following SNPs showed significant association with AF in PHR: rs2834618, rs6462079, rs7508, rs2040862, and rs10458660. Some of these SNPs are proteins involved in lysosomal activities responsible for breaking ceramides to sphingosines and collagen deposition around atrial cardiomyocytes. Furthermore, we performed a machine learning analysis and determined that Native American admixture and heart failure were strongly predictive of AF in PHR. For the first time, this study provides some genetic insight into AF's mechanisms in a Puerto Rican Hispanic cohort.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2021 ","pages":"8819896"},"PeriodicalIF":1.5,"publicationDate":"2021-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7810540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38874190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}