Background and Purpose-Several studies have shown, in different populations, that modest elevation of plasma C-reactive protein (CRP) in the range seen in apparently healthy individuals is a strong predictor of future vascular events. Elevated plasma CRP concentrations are also associated with an increased risk of cerebrovascular events and an increased risk of fatal and nonfatal cardiovascular events in ischemic stroke patients. These epidemiological and clinical observations suggest that determination of plasma CRP concentrations could be used as an adjunct for risk assessment in primary and secondary prevention of cerebrovascular disease and be of prognostic value. The aim of this review is to summarize the evidence for CRP as an independent predictor of cerebrovascular events in at-risk individuals and ischemic stroke patients and to consider its usefulness in evaluating prognosis after stroke. Summary of Review-CRP fulfils most of the requirements of a new risk and prognostic predictor, but several issues await further confirmation and clarification before this marker can be included in the routine evaluation of stroke patients and subjects at risk for cerebrovascular disease. Potentially important associations have been established between elevated plasma CRP concentrations and increased efficacy of established therapies, particularly lipid-lowering therapy with statins. Conclusion-At present, there is not sufficient evidence to recommend measurement of CRP in the routine evaluation of cerebrovascular disease risk in primary prevention, because there is insufficient evidence as to whether early detection, or intervention based on detection, improves health outcomes, although shared risk of cardiovascular disease indicates this may be of value. In secondary prevention of stroke, elevated CRP adds to existing prognostic markers, but it remains to be established whether specific therapeutic options can be derived from this.

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Purpose This 7-year longitudinal study identifies factors influencing the growth of healthcare Virtual Communities of Practices (VCoPs) using metrics from social-network and semantic analysis. Studying online communication along the three dimensions of social interactions (connectivity, interactivity and language use) we aim to provide VCoPs managers with valuable insights to improve the success of their communities. Design/methodology/approach Communications over a period of 7 years (April 2008 to April 2015), and between 14,000 members of 16 different healthcare VCoPs coexisting on the same web-platform, were analyzed. Multilevel regression models were used to reveal the main determinants of community growth over time. Independent variables were derived from social network and semantic analysis measures. Findings Results show that structural and content-based variables predict the growth of the community. Progressively more people will join a community if: its structure is more centralized, leaders are more dynamic (they rotate more), and the language used in the posts is less complex. Research limitations/implications The available dataset included one web platform and a limited number of control variables. In order to consolidate the findings of the present study, the experiment should be replicated on other healthcare VCoPs. Originality/value The study provides useful recommendations for setting up and nurturing the growth of professional communities, considering at the same time the structure of the interaction patterns among community members, the dynamic evolution of these interactions and the use of language. New analytical tools are presented, together with the use of innovative interaction metrics which can significantly influence community growth, such as rotating leadership