Standard method for developing stroke registers in low-income and middle-income countries: experiences from a feasibility study of a stepwise approach to stroke surveillance (STEPS Stroke)

Truelsen, Thomas; Heuschmann, PU; Bonita, Ruth; Arjundas, G; Dalal, P. M.; Damasceno, Albertino; Nagaraja, D; Ogunniyi, Adesola; Oveisgharan, Shahram; Radhakrishnan, Kurupath; Skvortsoya, VI; Stakhovskaya, V

doi:10.1016/s1474-4422(06)70686-x

Cited by 142 publications

(132 citation statements)

References 10 publications

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“…Staff in all the cities were trained to follow the "ideal" population-based study according to the World Health Organization steps criteria 7 . These methods have been extensively published elsewhere 8 .…”

Section: Period Of Data Collection and Ascertainment Strategymentioning

confidence: 99%

Prevalence of obesity among stroke patients in five Brazilian cities: a cross-sectional study

Vicente

Cabral

Nagel³

et al. 2018

Arq. Neuro-Psiquiatr.

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Objective: There is gap in knowledge about obesity prevalence in stroke patients from low-and middle-income countries. Therefore, we aimed to measure the prevalence of overweight and obesity status among patients with incident stroke in Brazil. Methods: In a crosssectional study, we measured the body mass index (BMI) of ischemic and hemorrhagic stroke patients. The sample was extracted in 2016, from the cities of Sobral (CE), Sertãozinho (SP), Campo Grande (MS), Joinville (SC) and Canoas (RS). Results: In 1,255 patients with first-ever strokes, 64% (95% CI, 62-67) were overweight and 26% (95%CI, 24-29) were obese. The obesity prevalence ranged from 15% (95%CI, 9-23) in Sobral to 31% (95%CI, 18-45) in Sertãozinho. Physical inactivity ranged from 53% (95%CI, 43-63) in Sobral to 80% (95%CI, 73-85) in Canoas. Conclusions: The number of overweight patients with incident stroke is higher than the number of patients with stroke and normal BMI. Although similar to other findings in high-income countries, we urgently need better policies for obesity prevention.Keywords: obesity; prevalence; stroke, epidemiology; cross-sectional studies RESUMO Objetivo: Há uma lacuna de conhecimento sobre a prevalência de obesidade em pacientes com AVC (acidente vascular cerebral) de países de baixa e média renda. Portanto, objetivamos medir a prevalência de sobrepeso e obesidade entre pacientes com AVC no Brasil. Métodos: Em um estudo transversal, medimos o índice de massa corporal (IMC) em pacientes com AVC isquêmico e hemorrágico. A amostra foi extraída em 2016, nas cidades de Sobral (CE), Sertãozinho (SP), Campo Grande (MS), Joinville (SC) e Canoas (RS). Resultados: Entre 1255 casos de AVC, 64% (95%CI, 62-67) apresentavam sobrepeso e 26% (95%CI, 24-29) obesidade. A prevalência de obesidade variou de 15% (95%CI, 9-23) em Sobral a 31% (95%CI, 18-45) em Sertãozinho. Conclusões: A quantidade de pacientes com AVC e IMC anormal é maior do que a de pacientes com AVC e IMC normal. Embora esta prevalência seja similar às de países de alta renda, precisamos urgentemente de melhores políticas de prevenção da obesidade. Atividade física deveria ser parte da prescrição médica.Palavras-chave: obesidade; prevalência; acidente vascular cerebral, epidemiologia; estudos transversais Obesity has reached epidemic proportions globally, with at least 2.8 million people dying each year as a result of being overweight or obese 1 . Once associated with high-income countries, obesity is now also prevalent in low-and middle-income countries 1 . In Brazil, a study by the Ministry of Health in 2011, showed that 48% of the population was either overweight (33%) or obese (15%) 2 . In 2006, these figures were 22.7% and 11.4% 2,3 . Because obesity is believed to cause a number of established risk factors for cardiovascular diseases such as hypertension, dyslipidemia and diabetes, the growing prevalence of obesity is assumed to increase the global cardiovascular disease burden 4 . For instance, in adults, the risk for ischemic stroke increases almost linear...

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Section: Period Of Data Collection and Ascertainment Strategymentioning

confidence: 99%

Prevalence of obesity among stroke patients in five Brazilian cities: a cross-sectional study

Vicente

Cabral

Nagel³

et al. 2018

Arq. Neuro-Psiquiatr.

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“…The methods for stroke ascertainment in our registry have previously been published 12 . In brief, we used multiple overlapping sources of ascertainment according to the World Health Organization STEPS criteria 13 .…”

Section: The Joinville Population Registrymentioning

confidence: 99%

Incidence and functional outcome of atrial fibrillation and non-atrial fibrillation- related cardioembolic stroke in Joinville, Brazil: a population-based study

Amaral

Nagel³

et al. 2017

Arq. Neuro-Psiquiatr.

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Among ischemic strokes, cardioembolic (CE) stroke has the worst outcome. We measured the incidence of atrial fibrillation (AF) and non-AF related CE strokes, previous anticoagulant use, and the 90-day functional outcome. Using multiple overlapping sources, we included all CE strokes that occurred in 2015 in Joinville, Brazil. Of the 374 ischemic strokes, 23% (84) were CE. The CE age-adjusted incidence, per 1,000 person-years, was 0.14 (0.11-0.17). Of the 26 patients with known prior AF, 73% (19) were not anticoagulated, 77% (20) had a CHA 2 DS 2 VASc score ≥ 3 and 81% (21) had a HAS-BLED score < 3. After three months, approximately one third of those 26 patients died or became disabled. The incidence of CE stroke in our sample was lower than in other population-based studies. The opportunity for anticoagulation was missed in one third of cases.Keywords: stroke; incidence; prognosis; population studies in public health. RESUMOEntre todos os subtipos de AVC isquêmico, os eventos cardioembólicos (CE) apresentam os piores prognósticos. Determinamos a incidência de AVC isquêmico CE, associada ou não à fibrilação atrial (FA), o uso prévio de anticoagulantes e os desfechos funcionais em Joinville, Brasil. Utilizando múltiplas e sobrepostas fontes de informação, registramos todos os primeiros eventos CE ocorridos em 2015. Entre 374 eventos isquêmicos, 23% (84) foram CE. A incidência ajustada, para qualquer fonte cardioembólica, foi 0.14 (0.11-0.17) por 1000 pessoas-ano. Entre 26 pacientes com FA previamente conhecida, 73% (19) não estavam anticoagulados, 77% (20) tinham ≥ 3 pontos na escala CHA 2 DS 2 VASc e 81 % (21) < 3 pontos na escala HAS-BLED. Após 3 meses, um terço destes 26 pacientes morreram ou ficaram dependentes. A incidência de AVC I CE em Joinville é menor do que em outros estudos de base populacional. Um terço dos casos de AVC I CE com FA previamente conhecida perderam a oportunidade de anticoagulação.Palavras-chave: acidente cerebral vascular; incidência; prognóstico; estudos populacionais em saúde pública.Worldwide, ischemic stroke is the most common major pathological type of stroke 1 . Among all ischemic stroke subtypes, cardioembolic (CE) stroke is particularly worrisome for two main reasons. The first one is demographic: as age is a risk factor for both atrial fibrillation (AF) and stroke, the aging of the population will progressively increase the burden of CE stroke in many countries.1,2 The second reason involves outcomes: in a population-based study in Oxfordshire, UK, 2,555 ischemic stroke subtypes were followed up from 2002 to 2014. After six months, two thirds were dependent. After one year, 42% had died. These outcomes are significantly higher than those reported for other ischemic stroke subtypes 2 . Therefore, knowing the incidence of CE stroke is crucial for primary and secondary prevention policies 1,2,3 .

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“…Stroke is the most important cause of adult disability in developed and developing countries [22,23]. With the increase in the elderly population, the incidence and prevalence is increasing with each passing day [24].…”

Section: Strokementioning

confidence: 99%

Stem Cell Therapy in the Treatment of Neurological Diseases

Kocaoğlu¹,

Korucu²,

Civlan³

et al. 2014

rain Disord Ther

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Before a half century, regeneration of neurons has been admitted as an impossible event. Thus, neurodegenerative disorders (e.g. Parkinson's disease, Alzheimer's disease, multiple sclerosis), vascular events (e.g. stroke) and traumatic diseases (e.g. spinal cord injury) have been admitted as incurable diseases. Afterward, tissue reparative and regenerative potential of stem cell researches for these disorders drew attention of the scientist to replacement therapy. Now, there are hundreds of current experimental and clinical regenerative treatment studies. One of the most popular treatment methods is cell transplantation. For this purpose many types of stem cells such as mononuclear stem cells, mesenchymal stem cells, and olfactory ensheathing cells can be used. As a result, cell transplantation has become a promising therapeutic option for these neurologic disorders. In this article, we reviewed stem cell treatment modalities for neurological disorders in the light of current literature.

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Standard method for developing stroke registers in low-income and middle-income countries: experiences from a feasibility study of a stepwise approach to stroke surveillance (STEPS Stroke)

Cited by 142 publications

References 10 publications

Prevalence of obesity among stroke patients in five Brazilian cities: a cross-sectional study

Prevalence of obesity among stroke patients in five Brazilian cities: a cross-sectional study

Incidence and functional outcome of atrial fibrillation and non-atrial fibrillation- related cardioembolic stroke in Joinville, Brazil: a population-based study

Stem Cell Therapy in the Treatment of Neurological Diseases

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