CDC Grand Rounds: Public Health Strategies to Prevent and Treat Strokes

George, Mary G.; Fischer, Leah S.; Koroshetz, Walter J.; Bushnell, Cheryl; Frankel, Michael; Foltz, Jennifer L.; Thorpe, Phoebe

doi:10.15585/mmwr.mm6618a5

Cited by 34 publications

(34 citation statements)

References 22 publications

(21 reference statements)

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“…Women in 1996 had a rate of 84.4, which dropped to 42.3 in 2011. And, like the other studies 7,8,13,14,21 ,mainly according to George et al, 2017 23 , hypertension and diabetes are the most important risk factors and the great control of this two diseases culminates in reduction of stroke incidence rates, prevalence and mortality.…”

Section: Global Burden Stroke (Gbs)mentioning

confidence: 84%

“…The patient who arrives at an emergency care unit has as priority his hemodynamic stabilization, to be performed by the immediate assistance team. The fact of been recurrent or primary, the NIH Stroke Scale Grade (NIHSS), the time to achieve clinical stability and stroke associated complications predict the functional prognosis of each patient 1,4,13,[23][24][25][26][27] .…”

Section: Discussionmentioning

confidence: 99%

“…Many health services do not practice the best recommendation for stroke assessment and management [22][23][24][25][26][27][28][29][30] . The reasons may be related to access to expert human resources, diagnostic equipment and certain interventions 51 .…”

Section: Discussionmentioning

confidence: 99%

“…Tins et al (2013) reported the Brazilian challenges and experiences in the implementation of the National Stroke Project 7 . Cooperation between states and municipalities leads to development of local acute stroke prevention plans, by promoting public health and social inclusion actions, consistent with the principles af the Brazilian Unified Health System 4,5,19,21,23,36 .…”

Section: Discussionmentioning

confidence: 99%

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Stroke management and quality of care in low and middle-income countries: an integrative literature review

Godoi

Vianna

Santos

2020

BJD

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Section: Global Burden Stroke (Gbs)mentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Stroke management and quality of care in low and middle-income countries: an integrative literature review

Godoi

Vianna

Santos

2020

BJD

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“…Stroke is the primary cause of serious long-term disability in the United States (1). Ischemic stroke is the most common form, accounting for approximately 80% of all cases, and results in focal cerebral ischemia secondary to thromboembolic arterial occlusion.…”

Section: Introductionmentioning

confidence: 99%

Targeted disruption of Kv2.1-VAPA association provides neuroprotection against ischemic stroke in mice by declustering Kv2.1 channels

et al. 2020

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Kv2.1 channels mediate cell death–enabling loss of cytosolic potassium in neurons following plasma membrane insertion at somatodendritic clusters. Overexpression of the carboxyl terminus (CT) of the cognate channel Kv2.2 is neuroprotective by disrupting Kv2.1 surface clusters. Here, we define a seven–amino acid declustering domain within Kv2.2 CT (DP-2) and demonstrate its neuroprotective efficacy in a murine ischemia-reperfusion model. TAT-DP-2, a membrane-permeable derivative, induces Kv2.1 surface cluster dispersal, prevents post-injurious pro-apoptotic potassium current enhancement, and is neuroprotective in vitro by disrupting the association of Kv2.1 with VAPA. TAT-DP-2 also induces Kv2.1 cluster dispersal in vivo in mice, reducing infarct size and improving long-term neurological function following stroke. We suggest that TAT-DP-2 induces Kv2.1 declustering by disrupting Kv2.1-VAPA association and scaffolding sites required for the membrane insertion of Kv2.1 channels following injury. We present the first evidence of targeted disruption of Kv2.1-VAPA association as a neuroprotective strategy following brain ischemia.

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Black/Hispanic Disparities in a Vulnerable Post-Stroke Home Care Population

Feldman

McDonald

Eimicke

et al. 2018

J. Racial and Ethnic Health Disparities

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Significant racial and ethnic disparities in stroke risk factors, occurrence and outcomes persist in the United States. This article examines socio-economic and health disparities in a diverse, hypertensive sample of 495 post-stroke Black, non-Hispanic and Hispanic home health patients at risk of a recurrent stroke due to elevated systolic blood pressure (SBP), defined as SBP ≥ 140 mmHg. The article, which analyzes cross-sectional data, focuses on correlates of patients' SBPthe leading modifiable cause of stroke -and physical function -a key stroke sequela and indicator of post-stroke quality of life. Of the 495 participants, 69.7% were Black, non-Hispanic, and 30.3% Hispanic. Black participants had significantly higher mean SBP than Hispanics. After controlling for multiple potential confounders/predictors, being Black was associated with a 3.55 mmHg elevation in SBP relative to being Hispanic. There were no significant Black/Hispanic differences in physical function measures. Seven independent variables significantly predicted better physical function: being male, younger, having fewer comorbidities, lower BMI, fewer depressive symptoms, higher health literacy and current alcohol drinking (vs abstinence). Our data provide a unique comparison of homebound Black and Hispanic stroke survivors at heightened risk of recurrent stroke absent targeted intervention. The finding of a significant Black/Hispanic disparity in SBP is striking in this narrowly defined home health care population all of whom are at risk for recurrent stroke. Priority should be given to culturally tailored interventions designed to link vulnerable home care patients to continuous, responsive hypertension care.

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CDC Grand Rounds: Public Health Strategies to Prevent and Treat Strokes

Cited by 34 publications

References 22 publications

Stroke management and quality of care in low and middle-income countries: an integrative literature review

Stroke management and quality of care in low and middle-income countries: an integrative literature review

Targeted disruption of Kv2.1-VAPA association provides neuroprotection against ischemic stroke in mice by declustering Kv2.1 channels

Black/Hispanic Disparities in a Vulnerable Post-Stroke Home Care Population

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