BackgroundLifetime stroke risk has been calculated in a limited number of selected populations. We determined lifetime risk of stroke globally and at the regional and country level.MethodsUsing Global Burden of Disease Study estimates of stroke incidence and the competing risks of non-stroke mortality, we estimated the cumulative lifetime risk of ischemic stroke, hemorrhagic stroke, and total stroke (with 95% uncertainty intervals [UI]) for 195 countries among adults over 25 years) for the years 1990 and 2016 and according to the GBD Study Socio-Demographic Index (SDI).ResultsThe global estimated lifetime risk of stroke from age 25 onward was 24.9% (95% UI: 23.5–26.2): 24.7% (23.3–26.0) in men and 25.1% (23.7–26.5) in women. The lifetime risk of ischemic stroke was 18.3% and of hemorrhagic stroke was 8.2%. The risk of stroke was 23.5% in high SDI countries, 31.1% in high-middle SDI countries, and 13.2% in low SDI countries with UIs not overlapping for these categories. The greatest estimated risk of stroke was in East Asia (38.8%) and Central and Eastern Europe (31.7 and 31.6 %%), and lowest in Eastern Sub-Saharan Africa (11.8%). From 1990 to 2016, there was a relative increase of 8.9% in global lifetime risk.ConclusionsThe global lifetime risk of stroke is approximately 25% starting at age 25 in both men and women. There is geographical variation in the lifetime risk of stroke, with particularly high risk in East Asia, Central and Eastern Europe.

A prospective randomized controlled trial was conducted to examine the relative effects of the provision of information and of cognitive-behavioural counselling on the psychological adjustment of women who had previously been informed of an abnormal cervical smear result and subsequently required a further diagnostic procedure (colposcopy examination) and treatment. Altogether, 219 women were randomized to one of two groups: (a) counselling plus the provision of an information leaflet, and (b) information leaflet only. Patients in both groups received an information leaflet with their first colposcopy appointment. Patients in the counselling group also attended a counselling interview prior to their colposcopy examination. The Abnormal Smears Questionnaire (a measure of specific concerns relating to the smear result and subsequent diagnostic and treatment procedures), together with the Spielberger State Anxiety Inventory (STAI-Yl), the General Health Questionnaire (GHQ-30), and the Profile of Mood States (POMS-36) were administered pre-colposcopy, post-colposcopy, pre-treatment, post-treatment and at three-and six-month follow-ups. Additionally a counselling evaluation questionnaire was completed by women in the counselling group after their colposcopy examination.High levels of distress were reported by both groups of patients on all measures prior to the colposcopy examination, with a subsequent highly significant postcolposcopy reduction, again in both groups. There were no significant differences in psychological functioning between the two groups at post-colposcopy assessment. Some minor differences emerged between the two groups at treatment and

Background Stroke Unit care is now accepted as an effective service model for hospital care, but the effectiveness of outpatient care is less certain. This review focuses on therapy-based rehabilitation services targeted at stroke patients living at home. Objectives To assess the effects of therapy-based rehabilitation services targeted towards stroke patients resident in the community within one year of stroke onset/discharge from hospital following stroke.

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1. Endogenous digoxin-like immunoreactivity (EDLI) was measured in the serum of 85 normotensive pregnant (NTP) women and 77 women with pregnancy-induced hypertension (PIH) by a radioimmunoassay (New England Nuclear). All women were in the third trimester. 2. EDLI, which was undetectable in serum from non-pregnant women, was present in NTP and PIH and was significantly higher in PIH. EDLI correlated with gestational age in NTP, but not in PIH. 3. Ouabain-sensitive Na+ transport was estimated in normal peripheral blood leucocytes after incubation with sera from 50 NTP and 42 PIH women. Significant inhibition of active Na+ transport occurred only with the serum of hypertensive patients without proteinuria. 4. EDLI did not correlate with the effect of the sera on active Na+ transport. The radioimmunoassay therefore provides a poor index of Na+ transport inhibitory activity in PIH.