Suchergebnisse

Background: Evidence of a decline in the incidence of stroke has emerged from population-based studies. These have included retrospective and prospective cohorts. However, in Australia and other countries, government bodies and stroke foundations predict a rise in the prevalence of stroke that is anticipated to increase the burden of stroke across the entire domain of care. This increase in prevalence must be viewed as different from the decline in incidence being observed,a measure of new stroke cases. In Victoria, all public emergency department visits and public and private hospital admissions are reported to the Department of Health and Human Services and include demographic, diagnostic, and procedural/treatment information. Methods: We obtained data from financial years 1997/1998 to 2007/2008 inclusive, for all cases with a primary stroke diagnosis (ICD-10-AM categories) with associated data fields. Incident cases were established by using a 5-year clearance period. Results: From 2003/2004 to 2007/2008 inclusive, there were 53,425 patients with a primary stroke or TIA diagnosis. The crude incident stroke rate for first ever stroke was 211 per 100,000 per year (95% CI 205-217) [females-205 per 100,000 per year (95% CI 196-214) and males-217 per 100,000 per year (95% CI 210-224)]. The overall stroke rates were seen to significantly decline over the period [males (per 100,000 per year) 227 in 2003/2004 to 202 in 2007/2008 (p = 0.0157) and females (per 100,000 per year) 214 in 2003/2004 to 188 in 2007/2008 (p = 0.0482)]. Ischemic stroke rates also appeared to decline; however, this change was not significant. Conclusion: These results demonstrate a significant decline in stroke incidence during the study period and may suggest evidence for effectiveness of primary and secondary prevention strategies in cerebrovascular risk factor management.

PURPOSE: To analyse structural and non-structural modifications of acute stroke care pathways undertaken at healthcare institutions across the regions of Italy due to the coronavirus disease 2019 (COVID-19) pandemic. METHODS: Research on National decrees specific for the pandemic was carried out. The stroke pathways of four Italian regions from North to South, such as Lombardy, Veneto, Lazio and Campania, were analysed before and after the pandemic outbreak. FINDINGS: On 29 February 2020, the Italian Minister of Health issued national guidelines on how to address the COVID-19 emergency. Stroke management was affected and required changes, basically resulting in the need to prioritise the ongoing COVID-19 emergency. In the most affected regions, the closure of departments and hospitals led to a complete reorganisation of previously functioning stroke networks. With the closure of several Stroke Units and Stroke Centres, the transportation time to hospital lengthened significantly, especially for the outlying populations. DISCUSSION: The COVID-19 pandemic outbreak has been spreading rapidly in Italy and placing an overwhelming burden on healthcare systems. In response to this, political and healthcare decision-makers worked together to develop and implement efforts to sustain the national healthcare system while fighting the pandemic. Stroke care pathways changed during the pandemic and different organisational models were applied in the most affected regions. CONCLUSIONS: Stroke treatment pathways will need to be redesigned so to guarantee that severe and acute disease patients do not lose their rights to the access and delivery of care during the COVID-19 pandemics.

BACKGROUND-: To improve the quality of care for children with sickle cell anemia (SCA) in Kano, Nigeria, we initiated a standard care protocol in 2014 to manage children with strokes at Aminu Kano Teaching Hospital. METHOD-: The standard care protocol requires that children presenting with acute strokes be treated with hydroxyurea at a fixed dose of 20 mg/kg/day within 2 months of the stroke. RESULTS-: We identified 29 children with SCA who had an initial stroke within the study period, followed for a mean of 1.25 years (to either end of follow up or a second stroke) and corresponding to an initial stroke incidence rate of 0.88 per 100 patient-years. Six children had stroke recurrence while on hydroxyurea, with a stroke recurrence rate of 17.4 events per 100 patient-years, and one child died. None of the children treated with hydroxyurea had therapy held because of myelosuppression; although, adherence was approximately 60%, in part because families had to pay for hydroxyurea. Most likely, we underestimated the incidence of strokes because despite formal training for stroke detection during the quality improvement period, no participant had formal assessment using the pediatric stroke scale. CONCLUSION-: Our results provide strong evidence for the high prevalence of initial strokes in children with SCA in a low-resource setting, requirement for ongoing training to detect strokes with an objective stroke assessment, and the need for government support free access to hydroxyurea.

An intimate and uplifting memoir chronicling May Sarton's efforts to regain her health, art, and sense of self after suffering from a stroke Feeling cut off and isolated-from herself most of all-after suffering a stroke at age 73, May Sarton began a journal that helped her along the road to recovery. She wrote every day without fail, even if illness sometimes prevented her from penning more than a few lines. From her sprawling house off the coast of Maine, Sarton shares the quotidian details of her life in the aftermath of what her doctors identified as a small brain hemorrhage. What they d

Objective: Meta-nalysis of review of the recent epidemiology of stroke in some Asian countries, including burden, registry, mortality, incidence, prevalence, stroke subtypes and risk factors. Materials and Methods: We analyzed all the publications in the PubMed, Medline, Scopus, ScienceDirect, Web of Science, EBSCO, Google Scholar databases, from the time of entry into the database until March 2018. Results: Based on data from the WHO, GBD study, recent publications from Asian countries and our own studies, we summarized and compared the main epidemiological data on stroke in Asia, including Uzbekistan. With the economic transition of these countries, towards achieving "developed country" status, risk factors such as hypertension, diabetes mellitus, hypercholesterolemia, obesity, and cigarette smoking will become more prevalent, raising the incidence of stroke. However, due to insufficient healthcare facilities in these developing countries, the mortality will be high, and the number of disabled survivors will also rise. Conclusion: The global burden of stroke has the largest contribution from Asia. As life expectancy increases, with the aging of Asian populations and reduction in mortality due to infectious diseases, and the rise in the prevalence of vascular risk factors among economies in transition, the stroke burden in Asia will surely rise. Governments and healthcare workers need to work together, with an informed public, to stem this growing epidemic.

Objective: Meta-nalysis of review of the recent epidemiology of stroke in some Asian countries, including burden, registry, mortality, incidence, prevalence, stroke subtypes and risk factors. Materials and Methods: We analyzed all the publications in the PubMed, Medline, Scopus, ScienceDirect, Web of Science, EBSCO, Google Scholar databases, from the time of entry into the database until March 2018. Results: Based on data from the WHO, GBD study, recent publications from Asian countries and our own studies, we summarized and compared the main epidemiological data on stroke in Asia, including Uzbekistan. With the economic transition of these countries, towards achieving "developed country" status, risk factors such as hypertension, diabetes mellitus, hypercholesterolemia, obesity, and cigarette smoking will become more prevalent, raising the incidence of stroke. However, due to insufficient healthcare facilities in these developing countries, the mortality will be high, and the number of disabled survivors will also rise. Conclusion: The global burden of stroke has the largest contribution from Asia. As life expectancy increases, with the aging of Asian populations and reduction in mortality due to infectious diseases, and the rise in the prevalence of vascular risk factors among economies in transition, the stroke burden in Asia will surely rise. Governments and healthcare workers need to work together, with an informed public, to stem this growing epidemic.