Stroke is the third most common cause of death in industrialized countries. Stroke is the most important cause of morbidity and longterm disability in Europe as well as in other industrialized nations. Prevalence rate was higher among men compared with women 3.44 and 2.41 per 1000 respectively. Data from the Northern Manhattan study showed the age adjusted incidence of first ischemic stroke per 100,000 was 88 in Whites 191 in Blacks and 149 in Hispanics. Black has almost thrice the risk of first ever stroke compared with Whites. The age adjustment stroke incidence rates for first ever stroke are 167 for White males, 138 for White females, 323 for Black males and 260 for Black females. Among American-Indian age 65-74, the annual rates per 1,000 population of new and recurrent stoke are 6.1 for men and 6.6 for women. 22The prevalence of stroke in American Indian mean age 45-74 ranges from 0.2 to 1.4 percent and in women from 0.2 to 0.7 percent 5 . In a study in Bangladesh the prevalence rate of stroke were 2.0, 3.0, 2.0, 10.0 , and 10.0 per 1000 within age groups of 40 -49 years, 50-59 years, 60-69 years, 70-79 years and 80 years to above age group respectively 6 . Prevalence rate rose with age. People with age range 70-79 years compared to 40-49 years age range is 4.98 times and people with age range > 80 years compared to 40-49 years age range is 4.78 times more likely to have suffered from stroke. Prevalence rate was higher among men compared with women 3.44 and 2.41 per 1000 respectively 7 . On average every 45 seconds someone in the United States has a stroke. Each year about 700,000 people experience a new or current stroke 5 . About 500,000 of these are first attack and 200,000 are recurrent attacks 4 . Each year about 46,000 more men than women have a stroke 6 . Men's stroke incidence rate is 1.25 times greater than women's 6 .
Background Ileus is common after elective colorectal surgery, and is associated with increased adverse events and prolonged hospital stay. The aim was to assess the role of non‐steroidal anti‐inflammatory drugs (NSAIDs) for reducing ileus after surgery. Methods A prospective multicentre cohort study was delivered by an international, student‐ and trainee‐led collaborative group. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The primary outcome was time to gastrointestinal recovery, measured using a composite measure of bowel function and tolerance to oral intake. The impact of NSAIDs was explored using Cox regression analyses, including the results of a centre‐specific survey of compliance to enhanced recovery principles. Secondary safety outcomes included anastomotic leak rate and acute kidney injury. Results A total of 4164 patients were included, with a median age of 68 (i.q.r. 57–75) years (54·9 per cent men). Some 1153 (27·7 per cent) received NSAIDs on postoperative days 1–3, of whom 1061 (92·0 per cent) received non‐selective cyclo‐oxygenase inhibitors. After adjustment for baseline differences, the mean time to gastrointestinal recovery did not differ significantly between patients who received NSAIDs and those who did not (4·6 versus 4·8 days; hazard ratio 1·04, 95 per cent c.i. 0·96 to 1·12; P = 0·360). There were no significant differences in anastomotic leak rate (5·4 versus 4·6 per cent; P = 0·349) or acute kidney injury (14·3 versus 13·8 per cent; P = 0·666) between the groups. Significantly fewer patients receiving NSAIDs required strong opioid analgesia (35·3 versus 56·7 per cent; P < 0·001). Conclusion NSAIDs did not reduce the time for gastrointestinal recovery after colorectal surgery, but they were safe and associated with reduced postoperative opioid requirement.
Background: To investigate the relative contributions of cerebral cortex and basal ganglia to movement stopping, we tested the optimum combination Stop Signal Reaction Time (ocSSRT) and median visual reaction time (RT) in patients with Alzheimer’s disease (AD) and Parkinson’s disease (PD) and compared values with data from healthy controls. Methods: Thirty-five PD patients, 22 AD patients, and 29 healthy controls were recruited to this study. RT and ocSSRT were measured using a hand-held battery-operated electronic box through a stop signal paradigm. Result: The mean ocSSRT was found to be 309 ms, 368 ms, and 265 ms in AD, PD, and healthy controls, respectively, and significantly prolonged in PD compared to healthy controls (p = 0.001). The ocSSRT but not RT could separate AD from PD patients (p = 0.022). Conclusion: Our data suggest that subcortical networks encompassing dopaminergic pathways in the basal ganglia play a more important role than cortical networks in movement-stopping. Combining ocSSRT with other putative indices or biomarkers of AD (and other dementias) could increase the accuracy of early diagnosis.
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