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Trends in the PAF of stroke DALYs due to risk factors, for both sexes, 1990-2021 Data in parentheses are 95% uncertainty intervals. DALYs=disability-adjusted life-years. PAF=population attributable fraction.
Source publication
Background: Up-to-date estimates of stroke burden and attributable risks and their trends at global, regional, and national levels are essential for evidence-based health care, prevention, and resource allocation planning. We aimed to provide such estimates for the period 1990–2021.
Methods: We estimated incidence, prevalence, death, and disabilit...
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Background
Stroke remains a significant global health challenge, with persistent disparities in burden across different countries and regions. This study aimed to assess the temporal trends in cross-country inequalities of stroke and its subtypes burden from 1990 to 2021.
Methods
We conducted a secondary analysis of the Global Burden of Diseases,...
Citations
... In this large population-based, retrospective cohort study, we found that 13,780 individuals aged 18-60 suffered an ischemic stroke from 2016 to 2021 in Catalonia, representing a global raw incidence of 30.3 cases per 100,000 persons-year. Our incidence is similar to other countries, such as Switzerland and Ireland, but comparing our results to other European countries, the rates vary significantly [20]. But it is well known, that the incidence of ischemic stroke among younger individuals shows significant variation across different regions globally, explained by various factors, including ethnicity, sex, prevalence of risk factors, lifestyle, socioeconomic status, and healthcare quality [5]. ...
Background
Revised European Stroke Organization guidelines in 2018 recommend early patent foramen ovale (PFO) detection and closure in patients aged 60 or younger who suffered an ischemic stroke. Our primary aim was to analyze the impact of these guidelines on the detection of PFO. Our secondary endpoints were to investigate the differences in the risk of recurrence and mortality among PFO status.
Methods
We conducted a population-based, retrospective cohort study in Catalonia using linked health administration databases. We included all ischemic stroke patients aged 18–60 from 2016 to 2021, collecting PFO diagnosis, demographics, comorbidities, stroke recurrence, and mortality.
Results
A total of 13,780 individuals suffered an ischemic stroke, representing a raw annual incidence rate of 30.3 cases-per-100,000 inhabitants/year. PFO was detected in 749(5.4%), and these were younger, and had a lower prevalence of risk factors than patients without PFO (all p value < 0.05). After adjusting for age and sex, PFO diagnoses increased by 59% following the guidelines update. Five-year recurrence was 12.1% [95%CI 11.3–12.9] with no differences by age and PFO. Socioeconomical status and diabetes emerged as predictors of recurrence. Stroke patients with PFO showed a lower mortality rate (p value = 0.016). However, when stratified by age, PFO was linked to lower 4-year mortality only in patients ≤ 50 years.
Conclusions
We confirm a greater detection of PFO in real-world practice following the update of guidelines. Regarding the risk of recurrence, socioeconomic status and diabetes were the only independent predictors of new stroke events. Additionally, we found a lower all-cause mortality in younger patients with PFO.
... It ranks as the third most prevalent cause of disability and the second leading cause of mortality worldwide, according to the latest Global Burden of Disease (GBD) figures. These conditions significantly contribute to increased global healthcare expenditures [1]. In the chronic phase of stroke, stroke survivors, often facing the cognitive and physical challenges of stroke, rely on their caregivers for daily activities [2,3]. ...
Objective
The dependence of stroke survivors on family caregivers negatively affects the quality of life, resilience, and adaptation of these caregivers. This study was conducted to identify the effect of education on the quality of life, resilience, and adaptation of family caregivers of stroke survivors based on Roy’s adaptation model (RAM).
Study design and methodology
This randomized clinical trial, conducted in 2023, enrolled 104 family caregivers of stroke survivors. Participants were chosen using the available method and then assigned to either the intervention or control groups through the random block method. In the intervention group, participants received four education sessions and telephone follow-ups. Tools, including a demographic information form, the Roy’s Adaptation Model Assessment Form (RAM-AF), the Adult Carers Quality of Life Questionnaire (AC-QOL), and the Connor and Davidson Resilience Questionnaire (CD-RISC), were used. The final evaluation was performed two months after the intervention.
Findings
Most participants in both groups were female (56.1%), married (59.2%), and had a son or daughter relationship with the patient (73.5%). The average age of the participants was 40.61 ± 10.77 years. The scores for quality of life, resilience, and adaptation did not exhibit significant differences between the intervention and control groups before the intervention (P > 0.05). However, a significant difference emerged after the intervention (P < 0.001).
Conclusion
The results indicate that education based on RAM can enhance the adaptive response of family caregivers of stroke survivors and improve their physical, mental, and social health. (IRCT20230208057360N2 and date: 2023-06-21).
... Gout is one of the top chronic diseases in society that needs primary concern [1]. It regarding to highly incidence per year [2], multiple complications, decreasing quality of life, as well as its potential impact on economic status [3]. The prevalence of gout has increased globally as well as nationally. ...
... The prevalence of gout globally in 2020 reached 55.8 million people worldwide [1,2]. This data shows an increase of 22.5% compared to 1990 [3,4]. The prevalence was predicted to increase up to 95.8 million people in 2050 [3,4]. ...
... This data shows an increase of 22.5% compared to 1990 [3,4]. The prevalence was predicted to increase up to 95.8 million people in 2050 [3,4]. Meanwhile, the prevalence of gout in Indonesia from 2022 to 2023 reached 3.21% [5]. ...
Gout was still one of the chronic disease trends suffered by the community which was characterised by elevated uric acid levels. This condition is closely related to lifestyle, namely the consumption of purine-rich foods. However, there were not studies that discovered the relationship between purine-rich food intake with elevated uric acid levels. This study aims to analyse the relationship between purine-rich food intake with elevated uric acid levels. This study used a correlational design with a cross-sectional approach. The population was the community in village "x" who suffered from gout with a total of 70 people. From them, 66 people were selected as participants who met the inclusion criteria through a purposive sampling method. The instrument used was a questionnaire for the variable of purine-rich food intake and uric acid test with a GCU meter. The results showed that there was a strong positive correlation between purine-rich food intake with elevated uric acid levels (p = 0,000; r = 0,567), this is evidenced by the fact that the majority of participants with high uric acid levels had a history of consuming purine-rich foods exceeding the daily tolerance limit, whereas low or normal uric acid levels were found in participants with a history of consuming high purine foods below the threshold or even not consuming purine-rich foods. These results indicated that consuming purine-rich foods could have a significant impact on elevated uric acid levels, so it was necessary to reduce or limit daily purine food intake.
... Stroke is a leading cause of death and disability worldwide, with ischemic stroke being responsible for almost 70% of all cases. Each year, more than 7 million individuals experience ischemic stroke, resulting in more than 3 million deaths [1]. Furthermore, this incidence is projected to increase to 9.6 million cases in 2030 [2]. ...
... A study was eligible for inclusion if: (1) it was a controlled experimental research study that produced original results; (2) it investigated microglia from rodents, non-human primates or other non-human mammals; (3) the study conducted at least one of the following experimental models of ischemic stroke: (a) middle cerebral artery occlusion (MCAO), common carotid artery occlusion (CCAO), umbilical cord occlusion (UCO), hypoxic ischemic encephalopathy (HIE), or mechanical/thermal injury of brain blood vessels in animals; or (b) oxygen-glucose deprivation (OGD) in microglial cell cultures; (4) the study administered MSC-EVs as the therapeutic intervention for the experimental model, without restrictions on the source of stem cells, administration route, or dose; (5) the control group received placebo (e.g., saline, vehicle, or only brain ischemia/OGD); (6) the study reported at least one of the following pre-specified outcomes in microglia, without restrictions to the method of detection: (a) gene or protein expression of TNF-α, IL-1β, IL-1α, IL-2, lipocalin, CD16, CD86, iNOS, MHC II, MMPs, IL-6, IL-4, IL-10, IL-17, TGF-β, CD68, Arginase-1, CD206, C3, C1q, CXCL12, CX3CR1, CXCL1, TREM2, Tmem119, EMR1/F4, MerTK, Iba1, P2RY12, NF-kB, MAPK, PPARy, IRF3, or other markers related to microglial reactivity, as long as they were colocalized or co-expressed with the microglial markers Iba1 or CD11b high /CD45 low ; (b) measures of microglial morphology (e.g., number of ramifications, nodes, or cells with ramified or ameboid morphology); (c) phagocytosis/endocytosis of MSC-EVs by microglia; (d) microglial phagocytic activity (e.g., colocalization of microglia with cellular debris, gene or protein expression of the phagosome markers Lamp1 or Rab5); (e) microglial cellular viability; or (f) expression of genes or proteins related to autophagy in microglia (e.g., NLRP3, LC31/2, or ASC). ...
The modulation of microglial reactivity has emerged as a potential target for developing ischemic stroke therapies. Mesenchymal stem cell-derived extracellular vesicles (MSC-EVs) possess immunomodulatory properties that may influence microglial responses following ischemia. However, individual studies assessing this influence have provided limited results. Therefore, we conducted a systematic review and meta-analysis to investigate whether MSC-EVs treatment alters microglial responses in animal and cellular models of ischemic stroke. In accordance with the PRISMA 2020 statement, we searched PubMed, Web of Science, and EMBASE until October 2023 for studies assessing cellular and molecular parameters of microglial reactivity following MSC-EVs treatment in models of ischemic stroke. We estimated treatment effects using a random-effects meta-analysis of standardized mean differences and estimated heterogeneity via the I² statistic. The risk of bias was assessed using the SYRCLE questionnaire. The search identified 297 studies, 27 of which met the inclusion criteria. In animal models, MSC-EVs reduced the number, surface area, and fluorescence intensity of Iba1⁺ cells, as well as the number of Iba1⁺ cells co-expressing the pro-inflammatory markers CD16, CD32, CD85, and iNOS. Conversely, MSC-EVs increased the number of Iba1⁺ cells co-expressing the anti-inflammatory markers Arg-1 and CD206. In cellular models, we observed decreased concentrations of TNF-α, IL-1β, and IL-6 in the culture medium. Our meta-analysis consolidates the immunomodulatory effects of MSC-EVs on microglial responses to ischemia, underscoring the potential of microglia-specific therapeutics in the development of MSC-EVs-based and regenerative treatments for ischemic stroke.
... Stroke, the third leading cause of combined mortality and disability-adjusted life years lost worldwide, 1,2 results in upper limb impairments in approximately 77% of survivors. 3 Arm paresis in particular has a significant impact on daily life activities. ...
... Therefore, this randomized crossover study aimed to investigate the acute effects of a 1.0 kilohertz frequency versus a low-frequency electrical stimulation of the wrist extensors on (1) stimulation efficiency (force/ stimulation intensity), (2) force production, (3) perceived discomfort, and (4) muscle fatigue in individuals with stroke and arm paresis at submaximal stimulation intensity. We hypothesized that a 1.0 kilohertz frequency stimulation results in comparable stimulation efficiency, force production, and muscle fatigue, as well as less discomfort, compared to low-frequency stimulation. ...
Background
Electrical stimulation is an effective treatment method for improving motor function after stroke, but the optimal current type for patients with stroke and arm paresis remains unclear.
Objective
To compare the effects of kilohertz frequency with low‐frequency current on stimulation efficiency, electrically induced force, discomfort, and muscle fatigue in patients with stroke.
Design
A randomized crossover study.
Setting
Neurological inpatient rehabilitation clinic in Germany.
Participants
A total of 23 patients with arm paresis after stroke within the last 6 months were recruited, 21 were enrolled, and 20 completed the study (7 females; mean ± SD: 66 ± 12 years; 176 ± 11 cm; 90 ± 19 kg; 57 ± 34 days since stroke).
Intervention
All patients underwent both kilohertz and low‐frequency stimulation in a randomized order on 2 days (48‐hour washout). Each day included a step protocol with a gradual increase in stimulation intensity, starting at the first measurable force (up to 12 steps, 1 mA increments, 8 seconds stimulation, 60 second rest) and a fatigue protocol (30 repetitions, 8 second stimulation, 3 second rest).
Main Outcome Measure
Primary outcome was stimulation efficiency (electrically induced force/stimulation intensity) [N/mA], measured during each step of the stepwise increase in current intensity protocol.
Results
Linear‐mixed‐effects models showed significantly higher stimulation efficiency for low‐frequency stimulation (mean difference 0.14 [95% confidence interval, 0.01–0.27 N/mA], p = .031). However, current type did not significantly affect electrically induced force, level of discomfort, or muscle fatigue ( p > .05).
Conclusion
The findings suggest that low‐frequency stimulation is more efficient than kilohertz‐frequency stimulation. However, both current types yield similar effects on force, discomfort, and fatigue, making them both viable options for wrist extensor stimulation in patients after stroke. Considering the variability among individuals, customizing the current type based on electrically induced force and perceived discomfort may enhance therapeutic outcomes. Further research on the long‐term treatment effects of both current types is warranted.
... Stroke is the second leading cause of death globally, responsible for 7.3 million deaths in 2021, and ranks as the third leading cause of disability, with 160.5 million disabilityadjusted life years (DALYs) lost during the same year. 1 The burden of stroke is rising due to population aging and lifestyle changes, 1 with stroke-related deaths expected to rise from 6.6 million to 9.7 million by 2050, and DALYs from 144.8 million to 189.3 million. 2 However, there is currently no effective method to eradicate this disease. ...
The dietary index for gut microbiota was associated with a reduced risk of stroke, with inflammation partially mediating this association.
... The grid search method (GSM) calculates all potential join points, selecting the one with the smallest mean squared error (MSE) as the optimal inflection point. The number of optimal joinpoints was determined using Monte Carlo permutation tests (18). The final model calculated the annual percentage change (APC) and average annual percentage change (AAPC). ...
Objective
To investigate the trends in cataract-related blindness and vision impairment burden among cataract patients in China, the largest developing country, from 1990 to 2021, providing evidence to inform future cataract prevention and control strategies in developing countries.
Patients and methods
This study utilized data from the Global Burden of Disease (GBD) 2021 database to assess the prevalence, age-standardized prevalence rates (ASPR), and years lived with disability (YLDs) associated with cataract-related blindness and visual impairment in China and other regions from 1990 to 2021. Joinpoint regression, decomposition analysis, and ARIMA modeling were employed to analyze trends and predict future disease burden.
Results
From 1990 to 2021, the number and crude rate for cataract related blindness and visual impairment increasing significantly in China. The age-standardizes rate increased from 878.30 to 989.58 per 100,000 population for cataract prevalence, and from 73.40 to 61.39 per 100,000 population for cataract YLDs. The majority of number of prevalence and YLDs are concentrated in the 65–89 age range. Women had higher cataract prevalence and YLDs than men. Population aging is the primary driver of the growing burden of cataract, contributing 73.12% and 98.3% to the increases in prevalence and YLDs, respectively. By 2035, the crude prevalence rate and crude YLDs rate of cataracts are projected to increase by 26.06% and 23.03%, respectively, compared to 2021. The age-standardized prevalence and YLDs rate attribute to cataract in China were lower than global averages and ranked third among neighboring countries.
Conclusion
Despite advancements in cataract treatment that have alleviated some of the disease burden, population growth and aging continue to drive the increasing prevalence of cataract-related vision impairment in China. Addressing gender disparities and improving access to cataract surgery and preventive care are crucial for reducing this growing burden.
... According to data released by the World Health Organization, stroke is the second leading cause of death and the third leading cause of disability globally [1]. The global burden of stroke is substantial, with significant socioeconomic implications [2]. Cerebral small vessel disease (CSVD) is a common cause of small vessel stroke, affecting 25% of individuals with stroke [3]. ...
Cerebrovascular diseases have caused substantial social and economic burdens, and new treatment methods are urgently needed. Evaluating the feasibility of the use of antidiabetic drugs for treating cerebrovascular diseases is meaningful in this field. We designed a comprehensive study process that includes two-sample Mendelian randomization (MR), which uses genetic proxies for antidiabetic drug targets, summary-based MR (SMR) for mRNAs, and colocalization for drug target genes to assess their causal relationships with 10 cerebrovascular disease phenotypes. Seven of the eight main types of clinical antidiabetic drugs were identified, yielding eleven potential drug targets. Our study observed that sulfonylureas (KCNJ11) and metformin (GPD1) reduce the risk of stroke and that TZDs (PPARG) reduce the risk of hippocampal perivascular spaces. In addition, sulfonylureas can reduce the risk of certain cerebral small vessel disease. These results show that antidiabetic drugs have hypoglycemic properties and affect cerebrovascular health. Our study supports repurposing antidiabetic drugs as disease-modifying therapies to improve cerebrovascular health. Future research should focus on studying the role of drugs in different phenotypes of cerebrovascular diseases and explore the potential molecular mechanisms to analyze further the potential effects of antidiabetic drugs on cerebrovascular diseases.
... Stroke is a worldwide disease caused by blood flowing into brain tissue. In 2021, Stroke was the third common cause of death and fourth cause of disability-adjusted life-years, and there was research indicated that there were about 93.8 million prevalent, 11.9 million incident strokes, and 160.5 million DALYs from stroke [1]. Some sequels of stroke will greatly affect patients' quality of life; therefore, interventions are needed to improve recovery. ...
Objective
This systematic review and meta-analysis aim to summarize and analyze the available evidence of non-invasive transcranial ultrasound stimulation on stroke recovery in stroke patients and stroke animal models.
Data Sources
PubMed, Scopus, Web of Science and Cochrane Library databases were searched for relevant articles from database inception to October 31, 2024.
Study Selection
The inclusion criteria were randomized controlled human trials and controlled animal studies, which included trials exploring the transcranial ultrasound stimulation effects toward clinical and pre-clinical, neuroimaging, neurophysiological, and biochemical outcomes. The research identified 463 potential articles with 5 human studies and 13 animal studies included.
Result
The data indicates that transcranial ultrasound stimulation is effective in supporting stroke recovery, especially the motor functions. However, the results are inhomogeneous across studies: (1) transcranial ultrasound stimulation induce greater effects if applied together with other therapies, and (2) apply transcranial ultrasound stimulation at different time delay or different therapy time induce different effects on functional motor ability.
Conclusion
Evidence suggests that transcranial ultrasound stimulation is a promising intervention in improving daily lives of stroke patients or animals. While further research is encouraged to prove the effect sizes in stroke patients.
... The growth and aging of our population contribute to the increasing cases of stroke, and of the 15 million annual cases of stroke, 5 million are faced with permanent disability (World Health Organization, n.d.). Stroke risk is associated with various preventable behavioral and environmental factors (Feigin et al., 2024). For instance, high BMI, diets with high-sugar beverages and red meat, and low physical activity were factors associated with a global increase in the rate of life-year loss due to stroke-related disability from 1990 to 2021 (Feigin et al., 2024). ...
... Stroke risk is associated with various preventable behavioral and environmental factors (Feigin et al., 2024). For instance, high BMI, diets with high-sugar beverages and red meat, and low physical activity were factors associated with a global increase in the rate of life-year loss due to stroke-related disability from 1990 to 2021 (Feigin et al., 2024). ...
