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Mecha M, Sisay Y, Melaku T. Prevalence of diabetes mellitus among stroke patients in Ethiopia: Systematic review and meta-analysis. INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2024; 21:200288. [PMID: 38828465 PMCID: PMC11141455 DOI: 10.1016/j.ijcrp.2024.200288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 05/12/2024] [Accepted: 05/16/2024] [Indexed: 06/05/2024]
Abstract
Background Diabetes mellitus (DM) is a chronic metabolic condition that considerably increases the risk of stroke. According to studies, stroke patients with diabetes have a greater mortality rate and are more likely to have repeated strokes than those without diabetes. Therefore, this systematic review and meta-analysis determined the pooled prevalence of diabetes mellitus among stroke patients in Ethiopia. Methods The searches were conducted in electronic databases such as PubMed/MEDLINE, EMBASE, Science Direct, Web of Science, and Google Scholar. Observational study designs were selected, and studies published until November 30, 2023, addressing the prevalence of diabetes mellitus among stroke patients were identified. EndNote Citation Manager software version X9 for Windows was used to collect and organize the search outcomes and remove duplicate articles. Relevant data were extracted from the included studies using a format prepared in Microsoft Excel and exported to STATA 18.0 software for outcome measures analyses and subgrouping. Results Twenty-eight research articles were included in the final analysis. The studies included an evaluation of 6589 stroke patients, among whom 645 were diagnosed with DM. This resulted in a pooled prevalence estimate of 10 % (95 % CI: 8-13 %)] DM. The subgroup analysis by region revealed that the highest pooled prevalence of DM was 16 % [95 % CI: (9 %-24 %)], which was from the Oromia region, followed by Addis Ababa city 12 % [95 % CI: (10 %-14 %)]. The other three regions (Tigray, South Nations nationalities and people's region and Amhara) had similar pooled prevalence of DM 7 % [95 % CI: (3 %-10 %)], 7 % [95 % CI: (3 %-11 %)], 7 % [95 % CI: (4 %-9%)], respectively. Conclusion Overall, the prevalence of DM among stroke patients is high. Notably, the Oromia region exhibited the highest prevalence rate at 16 %, followed by Addis Ababa city at 12 %. Conversely, the other three regions displayed similar rates of 7 %. These findings underscore the critical importance of screening and managing DM in stroke patients.
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Affiliation(s)
- Mohammed Mecha
- Department of Internal Medicine, Institute of Health, Jimma University, Ethiopia
| | - Yordanos Sisay
- Department of Epidemiology, Wolaita Sodo University, Ethiopia
| | - Tsegaye Melaku
- School of Pharmacy, Institute of Health, Jimma University, Ethiopia
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Wang PY, Chen YW, Lin MH. Translation and validation of the Chinese version of the stroke knowledge test for the hypertension patient. Sci Rep 2023; 13:17446. [PMID: 37838764 PMCID: PMC10576787 DOI: 10.1038/s41598-023-44682-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 10/11/2023] [Indexed: 10/16/2023] Open
Abstract
The measurement of hypertensive patients' stroke knowledge is an important stroke prevention indicator of health care service quality. The aim of this study was to develop a Chinese version of the Stroke Knowledge Test and examine its psychometric properties, reliability, and validity for hypertensive patients. A sample of 200 hypertensive patients completed the Chinese version of the Stroke Knowledge Test, and 30 of the participants were retested after 2 weeks. The final Chinese version of the Stroke Knowledge Test included 20 items with acceptable content validity (I-CVI = 0.88 ~ 1.00, S-CVI/Ave = 0.97). These items showed satisfactory internal reliability consistency (Kuder Richardson-20 = 0.62) and test-retest reliability was 0.77. The 40% of the difficulty index was in the acceptable range, and 25% was in the difficult range, as well as the 90% items overall values for discrimination were ranged from 0.2 to > 0.4. Known-group validity testing was performed based on the education level, and the result exhibited significant difference (F = 21.21, p < 0.001). The Chinese version of the Stroke Knowledge Test demonstrated acceptable psychometric properties, thus providing a new tool for the future care of hypertensive patients in Taiwan. It also could be as a reference for healthcare providers to educate hypertensive patients on stroke prevention.
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Affiliation(s)
- Pao-Yu Wang
- Department of Nursing, MacKay Junior College of Medicine, Nursing and Management, New Taipei City, Taiwan, ROC
| | - Yu-Wei Chen
- Department of Neurology, Neuroscience Center, Landseed International Hospital, Taoyuan, Taiwan, ROC
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan, ROC
| | - Mei-Hsiang Lin
- School of Nursing, National Taipei University of Nursing and Health Sciences, No. 365, Mingde Rd. Beitou Dist, Taipei, Taiwan, ROC.
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Wang G, Zhou Y, Zhong T, Song A, Xue Q. Longitudinal variation of circulating Inc-ITSN1-2: A novel biomarker reflecting disease severity, inflammation, recurrence, and death risk in acute ischemic stroke patients. J Clin Lab Anal 2022; 36:e24468. [PMID: 35500161 PMCID: PMC9169226 DOI: 10.1002/jcla.24468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 11/08/2022] Open
Abstract
Background Long noncoding RNA intersectin 1–2 (lnc‐ITSN1‐2) regulates inflammation and neuronal apoptosis; meanwhile, the latter two factors participate in the pathogenesis of acute ischemic stroke (AIS). Therefore, this study detected lnc‐ITSN1‐2 at multiple time points, aiming to explore its longitudinal variation and clinical value in the management of AIS patients. Methods The current study enrolled 102 AIS patients, then detected their lnc‐ITSN1‐2 in peripheral blood mononuclear cell (PBMC) at baseline (D0), day (D)1, D3, D7, month (M)1, M3, M6, and year (Y)1 after admission using RT‐qPCR. Additionally, lnc‐ITSN1‐2 in PBMC of 50 controls was also detected. Results Lnc‐ITSN1‐2 was up‐regulated in AIS patients than that in controls (p < 0.001). Lnc‐ITSN1‐2 positively associated with NIHSS score, TNF‐α, and IL‐17A (all p < 0.050) but was not linked with IL‐6 (p = 0.093) in AIS patients. Notably, lnc‐ITSN1‐2 was gradually increased from D0 to D3; while it switched to decrease from D3 to Y1 in AIS patients. Lnc‐ITSN1‐2 disclosed similar longitudinal variation during 1 year in non‐recurrent (p < 0.001), recurrent (p = 0.001), and survived patients (p < 0.001), while the variation of lnc‐ITSN1‐2 in died patients was not obvious (p = 0.132). More importantly, lnc‐ITSN1‐2 at D0, D3, D7, M1, M3, M6, and Y1 was higher in recurrent AIS patients than that in non‐recurrent AIS patients (all p < 0.050); moreover, lnc‐ITSN1‐2 at D3, D7, M1, M3, and M6 was up‐regulated in died AIS patients than AIS survivors (all p < 0.050). Conclusion The dynamic variation of Inc‐ITSN1‐2 could serve as a biomarker reflecting disease severity, inflammatory cytokines, recurrence, and death risk in AIS patients.
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Affiliation(s)
- Gang Wang
- Department of Neurology, The First Affiliated Hospital of Hebei North University, Zhangjiakou, China
| | - Ying Zhou
- Department of ICU, The First Affiliated Hospital of Hebei North University, Zhangjiakou, China
| | - Tingting Zhong
- Department of Neurology, The First Affiliated Hospital of Hebei North University, Zhangjiakou, China
| | - Aixia Song
- Department of Neurology, The First Affiliated Hospital of Hebei North University, Zhangjiakou, China
| | - Qian Xue
- Department of Neurology, The First Affiliated Hospital of Hebei North University, Zhangjiakou, China
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Koton S, Schneider AL, Windham BG, Mosley TH, Gottesman RF, Coresh J. Microvascular Brain Disease Progression and Risk of Stroke: The ARIC Study. Stroke 2020; 51:3264-3270. [PMID: 32998653 PMCID: PMC7769118 DOI: 10.1161/strokeaha.120.030063] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 08/07/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND AND PURPOSE Data on the significance of combined white matter hyperintensities (WMH)/lacunar brain infarcts, and their progression over time for the prediction of stroke are scarce. We studied associations between the progression in combined measures of microvascular brain disease and risk of stroke in the ARIC study (Atherosclerosis Risk in Communities). METHODS Prospective analysis of 907 stroke-free ARIC participants who underwent a brain magnetic resonance imaging (MRI) in 1993 to 1995, a second brain MRI in 2004 to 2006, and were subsequently followed for stroke incidence through December 31, 2017 (median [25%-75%] follow-up 12.6 [8.9-13.4] years). A combined measure of microvascular brain disease was defined at each visit and categorized by progression from first to second brain MRI as no progression; mild progression (increase of ≥1 unit in WMH grade or new lacune), and moderate progression (increase of ≥1 unit in WMH grade and new lacune). All definite/probable ischemic or hemorrhagic incident strokes occurring after this second MRI, and through 2017, were included. Associations between microvascular brain disease, progression in the combined measures, and stroke incidence were studied with Cox proportional hazard models, adjusting for age, sex, race, education level, time from first to second MRI, body mass index, smoking, hypertension, diabetes mellitus, and coronary heart disease. RESULTS At the second brain MRI (mean age 72), the distribution of the combined measure was 37% WMH grade <2 and no lacune; 57% WMH grade ≥2 or lacune; and 6% WMH grade ≥2 and lacune. No progression in the combined measures was observed in 38% of participants, 57% showed mild progression and 5% showed moderate progression. Sixty-four incident strokes occurred during the follow-up period. Compared with no change in the combined measure, moderate progression of microvascular brain disease was significantly associated with higher risk of stroke (adjusted hazard ratio, 3.00 [95% CI, 1.30-6.94]). CONCLUSIONS Progression of microvascular brain disease, manifesting as both new lacunes and increase in WMHs grade, is related to substantial increase in long-term risk of stroke.
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Affiliation(s)
- Silvia Koton
- Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Epidemiology, Johns Hopkins University School of Public Health, Baltimore, Maryland, USA
| | - Andrea L.C. Schneider
- Department of Epidemiology, Johns Hopkins University School of Public Health, Baltimore, Maryland, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - B. Gwen Windham
- Department of Geriatric Medicine, University of Mississippi School of Medicine, Jackson, MI
| | - Thomas H. Mosley
- Memory Impairment and Neurodegenerative Dementia (MIND) Center, University of Mississippi Medical Center, Jackson, MS, USA
| | - Rebecca F. Gottesman
- Department of Epidemiology, Johns Hopkins University School of Public Health, Baltimore, Maryland, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Josef Coresh
- Department of Epidemiology, Johns Hopkins University School of Public Health, Baltimore, Maryland, USA
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Affiliation(s)
- Thomas Raphael Meinel
- Department of Neurology (T.R.M., U.F.), Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Johannes Kaesmacher
- Institute of Diagnostic and Interventional Neuroradiology, Institute of Diagnostic, Interventional and Pediatric Radiology and Department of Neurology (J.K.), Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Laurent Roten
- Department of Cardiology (L.R.), Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Urs Fischer
- Department of Neurology (T.R.M., U.F.), Inselspital, Bern University Hospital, University of Bern, Switzerland
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Verma A, Ha AC, Kirchhof P, Hindricks G, Healey JS, Hill MD, Sharma M, Wyse DG, Champagne J, Essebag V, Wells G, Gupta D, Heidbuchel H, Sanders P, Birnie DH. The Optimal Anti-Coagulation for Enhanced-Risk Patients Post-Catheter Ablation for Atrial Fibrillation (OCEAN) trial. Am Heart J 2018; 197:124-132. [PMID: 29447772 DOI: 10.1016/j.ahj.2017.12.007] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 12/05/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND The optimal long-term antithrombotic regimen for patients after successful catheter-based atrial fibrillation (AF) ablation is not well defined. Presently, practice variation exists, and the benefits of oral anticoagulation over antiplatelet therapy across the entire spectrum of stroke risk profile remain undefined in the postablation population. To date, there are no randomized trials to inform clinicians on this therapeutic question. OBJECTIVE The objective was to assess whether rivaroxaban is superior to acetylsalicylic acid (ASA) in reducing the risk of clinically overt stroke, systemic embolism, or covert stroke among patients without apparent recurrent atrial arrhythmias for at least 1 year after their most recent AF ablation procedure. METHODS/DESIGN A prospective, multicenter, open-label, randomized trial with blinded assessment of outcomes is under way (NCT02168829). Atrial fibrillation patients with at least 1 stroke risk factor (as defined by the CHA2DS2-VASc score) and without known atrial arrhythmia recurrences for at least 12 months after ablation are randomized to rivaroxaban 15 mg or ASA 75-160 mg daily. The primary outcome is a composite of clinically overt stroke, systemic embolism, and covert stroke based on brain magnetic resonance imaging. Key secondary outcomes include major bleeding outcomes, intracranial hemorrhage, transient ischemic attack, neuropsychological testing, quality of life, and an economic analysis. Subjects will be followed for 3 years. The estimated overall sample size is 1,572 subjects (786 per arm). DISCUSSION The OCEAN trial is a multicenter randomized controlled trial evaluating 2 antithrombotic treatment strategies for patients with risk factors for stroke after apparently successful AF ablation. We hypothesize that rivaroxaban will reduce the occurrence of clinically overt stroke, systemic embolism, and covert stroke when compared with ASA alone.
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Sex differences in ischaemic stroke: potential cellular mechanisms. Clin Sci (Lond) 2017; 131:533-552. [PMID: 28302915 DOI: 10.1042/cs20160841] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 12/16/2016] [Accepted: 01/09/2017] [Indexed: 12/12/2022]
Abstract
Stroke remains a leading cause of mortality and disability worldwide. More women than men have strokes each year, in part because women live longer. Women have poorer functional outcomes, are more likely to need nursing home care and have higher rates of recurrent stroke compared with men. Despite continued advancements in primary prevention, innovative acute therapies and ongoing developments in neurorehabilitation, stroke incidence and mortality continue to increase due to the aging of the U.S. POPULATION Sex chromosomes (XX compared with XY), sex hormones (oestrogen and androgen), epigenetic regulation and environmental factors all contribute to sex differences. Ischaemic sensitivity varies over the lifespan, with females having an "ischaemia resistant" phenotype that wanes after menopause, which has recently been modelled in the laboratory. Pharmacological therapies for acute ischaemic stroke are limited. The only pharmacological treatment for stroke approved by the Food and Drug Administration (FDA) is tissue plasminogen activator (tPA), which must be used within hours of stroke onset and has a number of contraindications. Pre-clinical studies have identified a number of potentially efficacious neuroprotective agents; however, nothing has been effectively translated into therapy in clinical practice. This may be due, in part, to the overwhelming use of young male rodents in pre-clinical research, as well as lack of sex-specific design and analysis in clinical trials. The review will summarize the current clinical evidence for sex differences in ischaemic stroke, and will discuss sex differences in the cellular mechanisms of acute ischaemic injury, highlighting cell death and immune/inflammatory pathways that may contribute to these clinical differences.
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Wong BW, Marsch E, Treps L, Baes M, Carmeliet P. Endothelial cell metabolism in health and disease: impact of hypoxia. EMBO J 2017. [PMID: 28637793 DOI: 10.15252/embj.201696150] [Citation(s) in RCA: 160] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
In contrast to the general belief, endothelial cell (EC) metabolism has recently been identified as a driver rather than a bystander effect of angiogenesis in health and disease. Indeed, different EC subtypes present with distinct metabolic properties, which determine their function in angiogenesis upon growth factor stimulation. One of the main stimulators of angiogenesis is hypoxia, frequently observed in disease settings such as cancer and atherosclerosis. It has long been established that hypoxic signalling and metabolism changes are highly interlinked. In this review, we will provide an overview of the literature and recent findings on hypoxia-driven EC function and metabolism in health and disease. We summarize evidence on metabolic crosstalk between different hypoxic cell types with ECs and suggest new metabolic targets.
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Affiliation(s)
- Brian W Wong
- Laboratory of Angiogenesis and Vascular Metabolism, Department of Oncology, Leuven Cancer Institute KU Leuven, Leuven, Belgium.,Laboratory of Angiogenesis and Vascular Metabolism, VIB Center for Cancer Biology, VIB, Leuven, Belgium
| | - Elke Marsch
- Laboratory of Angiogenesis and Vascular Metabolism, Department of Oncology, Leuven Cancer Institute KU Leuven, Leuven, Belgium.,Laboratory of Angiogenesis and Vascular Metabolism, VIB Center for Cancer Biology, VIB, Leuven, Belgium
| | - Lucas Treps
- Laboratory of Angiogenesis and Vascular Metabolism, Department of Oncology, Leuven Cancer Institute KU Leuven, Leuven, Belgium.,Laboratory of Angiogenesis and Vascular Metabolism, VIB Center for Cancer Biology, VIB, Leuven, Belgium
| | - Myriam Baes
- Laboratory for Cell Metabolism, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Peter Carmeliet
- Laboratory of Angiogenesis and Vascular Metabolism, Department of Oncology, Leuven Cancer Institute KU Leuven, Leuven, Belgium .,Laboratory of Angiogenesis and Vascular Metabolism, VIB Center for Cancer Biology, VIB, Leuven, Belgium
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Liu CT, Wu BY, Hu WL, Hung YC. Gender-based differences in mortality and complementary therapies for patients with stroke in Taiwan. Complement Ther Med 2016; 30:113-117. [PMID: 28137521 DOI: 10.1016/j.ctim.2016.12.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Revised: 07/10/2016] [Accepted: 12/18/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Stroke is a leading cause of death worldwide. In this retrospective study, we investigated the different effects of gender on medical behavior, medical service, medical cost, and death from stroke in Taiwan. METHODS We collected data on the stroke-associated mortality rate according to gender and age group for the period between 2009 and 2013 from the official registry of Ministry of Health and Welfare, Taiwan. We analyzed the data related to stroke-associated medical care and costs in 2013 from the National Health Insurance Research Database (NHIRD). RESULTS The mortality rate due to stroke was higher in men than in women, despite more inpatient or outpatient medical treatment and higher medical costs, especially in patients aged <50years. Married women showed a significantly lower stroke-associated mortality compared to married men. Women were significantly more likely to accept Western medicine combined with traditional Chinese medicine (TCM) treatment than men (81.51% of women and 74.27% of men). They had lower medical expenditure and lower mortality from stroke than men did. Combined use of integrative Chinese and Western medicine also was associated with lower mortality from stroke than use of conventional Western medicine alone. CONCLUSIONS In Taiwan, stroke-associated mortality is higher in men. Marriage or female sex hormone may have protective effect against stroke in women. Women also more tended to seek TCM complementary therapies combined with Western medicine. Integrated Chinese and Western medicine could thus be a potential treatment for stroke.
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Affiliation(s)
- Chun-Ting Liu
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Bei-Yu Wu
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wen-Long Hu
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Kaohsiung Medical University College of Medicine, Kaohsiung, Taiwan; Fooyin University College of Nursing, Kaohsiung, Taiwan
| | - Yu-Chiang Hung
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; School of Chinese Medicine for Post Baccalaureate, I-Shou University, Kaohsiung, Taiwan.
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Abstract
BACKGROUND Accurate assessment of stroke knowledge (SK) is fundamental to the successful understanding of, monitoring of, and intervening to improve the SK of patients and the public. PURPOSE The purpose of this study is to perform a systematic review of the existing SK tests and appraise their conceptual basis, feasibility, and psychometric properties. We conducted 2-step searching of MEDLINE, CINAHL, PsycINFO, and Scopus electronic databases from January 1, 2000, to December 31, 2014, to identify relevant SK tests for the appraisal. RESULTS Our study found 59 SK tests, out of a total of 93 articles, with full content available that had been referred to in the published literature. Ten of them had been used in more than 1 study, and 2 (the Stroke Knowledge Test and the Stroke Action Test) of them have had at least 1 of their psychometric properties validated. Only 1 test (the Stroke Knowledge Test) was developed using rigorous methodology, covers a wide range of concepts, and met all feasibility criteria; however, its limitations include no articulated conceptual basis, inadequate internal consistency reliability (α = .65), and lack of some validated psychometric properties. CONCLUSIONS Our study revealed that current available tools are not sufficiently able to accurately and reliably assess SK to promote stroke prevention and management. CLINICAL IMPLICATIONS This study highlights the attention of applying current SK tests and need for revising existing tests or developing a new test.
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Nunez S, Doroudchi MM, Gleichman AJ, Ng KL, Llorente IL, Sozmen EG, Carmichael ST, Hinman JD. A Versatile Murine Model of Subcortical White Matter Stroke for the Study of Axonal Degeneration and White Matter Neurobiology. J Vis Exp 2016. [PMID: 27023377 DOI: 10.3791/53404] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Stroke affecting white matter accounts for up to 25% of clinical stroke presentations, occurs silently at rates that may be 5-10 fold greater, and contributes significantly to the development of vascular dementia. Few models of focal white matter stroke exist and this lack of appropriate models has hampered understanding of the neurobiologic mechanisms involved in injury response and repair after this type of stroke. The main limitation of other subcortical stroke models is that they do not focally restrict the infarct to the white matter or have primarily been validated in non-murine species. This limits the ability to apply the wide variety of murine research tools to study the neurobiology of white matter stroke. Here we present a methodology for the reliable production of a focal stroke in murine white matter using a local injection of an irreversible eNOS inhibitor. We also present several variations on the general protocol including two unique stereotactic variations, retrograde neuronal tracing, as well as fresh tissue labeling and dissection that greatly expand the potential applications of this technique. These variations allow for multiple approaches to analyze the neurobiologic effects of this common and understudied form of stroke.
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Risk of Cerebrovascular Events in Patients With Patent Foramen Ovale and Intracardiac Devices. JACC Cardiovasc Interv 2014; 7:1221-6. [DOI: 10.1016/j.jcin.2014.04.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 03/31/2014] [Accepted: 04/25/2014] [Indexed: 11/19/2022]
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