Stroke Incidence, Case Fatality, and Mortality in the WHO MONICA Project

Thorvaldsen, Per; Asplund, Kjell; Kuulasmaa, Kari; Rajakangas, Anna-Maija; Schroll, Marianne

doi:10.1161/01.str.26.3.361

Cited by 435 publications

(193 citation statements)

References 26 publications

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“…Entretanto, em pacientes adolescentes e adultos jovens estes eventos não são raros. Estudos epidemiológicos demonstram a ocorrência de doença cerebrovascular em pacientes entre os 15 e 40 anos de idade numa incidência aproximada de 6 casos por 100000 brancos, sendo este número 2,5 vezes maior em negros [5][6][7]9 . São etiologicamente distintos em relação àqueles dos idosos, em que a ateromatose extra e intracraniana responde por grande parte das lesões 1 .…”

Section: Discussionunclassified

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Doenças cerebrovasculares em pacientes entre 15 e 40 anos: achados neuropatológicos em 47 casos

Maggio

Montemór-Netto

Gasparetto

et al. 2001

Arq. Neuro-Psiquiatr.

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RESUMO -As doenças cerebrovasculares em pacientes entre 15 e 40 anos são pouco estudadas na literatura latino americana, principalmente no que tange aos achados neuropatológicos. Analisamos 47 encéfalos provenientes de necrópsias completas realizadas no período de 1987 a 1997 selecionados com base na faixa etária e alteração neuropatológica básica envolvendo fenômenos vasculares. Destes 47 casos analisados, 26 eram (55,3%) do sexo feminino. Quanto à distribuição etária, 12,8% (n=06) acometeram pacientes entre 15 e 20 anos, 51,1% (n=24) entre 21 e 30 anos, 36,2% (n=17) entre 31 e 40 anos. As doenças básicas que culminaram no óbito foram agrupadas, sendo mais frequentes as doenças cardíacas e hematológicas (19,2%), alterações decorrentes de complicações de gestação (12,8%), doenças infecciosas, doenças dos vasos sanguíneos e doenças neurológicas (10,7%) entre outras. As alterações neuropatológicas incluíram hérnia cerebral e/ou cerebelar (16%), edema cerebral (13,8%), hemorragia subaracnóidea (10%), infarto cerebral recente (9%), hemorragia intraparequimatosa (8%), encefalopatia hipóxico-isquêmica (3%) e eventos menos comuns como a síndrome de Sneddon e vasculite lúpica. Tais achados expressam que os fenômenos cerebrovasculares têm, nesta faixa etária, perfil próprio com estreita relação com a doença de base. PALAVRAS-CHAVE: doenças cerebrovasculares, neuropatologia, jovens. Cerebrovascular diseases in patients aged 15 to 40 years: neuropathological findings in 47 casesABSTRACT -Cerebrovascular diseases in patients between 15 and 40 years old are not a frequent subject in Latin-American literature, especially when focusing on neuropathology. We analyzed 47 brains from necropsies performed from 1987 to 1997 and selected on a basis of age and the presence of vascular pathology. From the 47 analyzed brains, 26 belonged to females (55.3%). When distributed among age groups, 12.8% (n=6) affected patients from 15 to 20 yo, 51,1% (n=24) from 21 to 30 yo, 36,2% (n=17) from 31 to 40 yo. The underlying diseases were: cardiac and haemathologic (19.2%), pregnancy complications (12.76%), infections, diseases of blood vessels and neurological (10.1% each) amongst others. The neuropathological abnormalities included cerebral and/or cerebellar herniation (16%), cerebral edema (13.8%), subarachnoid hemorrhage (10%), recent cerebral infarction (9%), intraparenchymatous hemorrhage (8.14%), hypoxic-ischemic encephalopathy (3%) and other events such as Sneddon syndrome and Lupus vasculitis. These findings express that the cerebrovascular phenomena in this age group are unique and closely related with the underlying disease.KEY WORDS: cerebrovascular diseases, neuropathology, youth. Fenômenos cerebrovasculares em pacientes jovens vêm, gradativamente, recebendo atenção dos pesquisadores, em virtude de seus mecanismos etiopatogênicos serem distintos em relação à contraparte nos idosos [1][2][3][4] . Quando presentes, estes fenômenos mostram íntima correlação com a doença básica principal do paciente, a qual culminou no óbito 5-7 .Apresen...

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Section: Discussionunclassified

“…Quando presentes, estes fenômenos mostram íntima correlação com a doença básica principal do paciente, a qual culminou no óbito [5][6][7] .…”

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Doenças cerebrovasculares em pacientes entre 15 e 40 anos: achados neuropatológicos em 47 casos

Maggio

Montemór-Netto

Gasparetto

et al. 2001

Arq. Neuro-Psiquiatr.

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“…21 This definition excludes transient ischemic attacks, silent brain infarction, venous strokes, and events associated with trauma, blood disease, malignancy, and neonates. For this article, data on stroke admissions from January 1, 2006, to December 31, 2012, were analyzed.…”

Section: Selection Criteriamentioning

confidence: 99%

“…Similar to MONICA, subsequent strokes after 28 days of the preceding stroke were treated as separate stroke episodes. 21 The Singapore population denominators for incidence and population case-fatality rates were obtained from the Department of Statistics, using the resident population size at the midpoint of the year.…”

Section: Participant Characteristics and Outcomesmentioning

confidence: 99%

Trends in Stroke Incidence and 28-Day Case Fatality in a Nationwide Stroke Registry of a Multiethnic Asian Population

Tan

Müller‐Riemenschneider

et al. 2015

Stroke

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Background and Purpose-This study investigated trends in stroke incidence and case fatality overall and according to sex, age, ethnicity, and stroke subtype in a multiethnic Asian population. Methods-The Singapore Stroke Registry identifies all stroke cases in all public hospitals using medical claims, hospital discharge summaries, and death registry data. Age-standardized incidence rates and 28-day case-fatality rates were calculated for individuals aged ≥15 years between 2006 and 2012. To estimate the annual percentage change of the rates, a linear regression model was fitted to the log rates, and a Wald test was performed to test for trend. P values <0.05 were considered significant. Results-A total of 40 623 cases were recorded. The total stroke incidence fell by ≈12.0%, and case fatality fell by 17.2% in the study. Declining trends in stroke incidence were stronger in women . Subgroup-specific findings for case fatality were similar. Conclusion-This is the first countrywide hospital-based registry study in a multiethnic Asian population, and it revealed marked overall reductions in stroke incidence and case fatality. However, it also identified important population groups with less favorable trends, especially younger adults and those of Malay ethnicity.

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“…The World Health Organization defines stroke as rapidly developing clinical signs of focal (or global) disturbance of cerebral function, with symptoms lasting for more than 24 hours or leading to death with no apparent other cause than vascular origin (3) . Consequences depend on the location of the lesion, size, and the amount of collateral blood flow.…”

Section: Introductionmentioning

confidence: 99%

Respiratory Changes in Patients with Stroke

Ocko

Costa

2014

BBR

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141 Biomedical and Biopharmaceutical Research J o r n a l d e I n v e s t i g a ç ã o B i o m é d i c a e B i o f a r m a c ê u t i c a Respiratory Changes in Patients with Stroke Alterações Respiratórias nos Pacientes com Acidente Vascular AbstractThis study aimed to review published literature concerning the major changes that occur in the respiratory system after stroke, and also the impact of respiratory muscle training in these patients. The literature search was conducted through electronic databases (PubMed, SciELO and Pedro) in Portuguese and English languages on themes related to changes in the respiratory system and methods of assessment and rehabilitation of respiratory muscle strength in individuals affected by stroke. There is scientific evidence that individuals affected by stroke may show decreased inspiratory and expiratory muscle strength. Studies suggest that respiratory muscle training through threshold load can bring benefits by improving respiratory function and respiratory muscle strength. However, more studies should be conducted to deepen the knowledge about the benefits and long-term effects of pulmonary rehabilitation in patients with stroke. Keywords: Stroke, Respiratory Muscle Strength, Maximum Respiratory Pressure and Respiratory MuscleTraining. ResumoO objetivo deste estudo foi realizar uma revisão de literatura sobre as principais alterações que ocorrem no sistema respiratório após o Acidente Vascular Cerebral (AVC) e também sobre os efeitos de treino muscular respiratório nestes pacientes. A metodologia adotada foi a pesquisa de artigos através das bases de dados electrónicas (Pubmed, Scielo e Pedro) em língua portuguesa e inglesa relacionando os temas: alterações do sistema respiratório e métodos de avaliação e reabilitação da força muscular respiratória em indivíduos acometidos pelo AVC. Existe evidência científica de que indivíduos acometidos pelo AVC podem apresentar diminuição da força muscular inspiratória e expiratória. Estudos sugerem que o treino muscular respiratório, através de carga limiar, pode trazer benefícios quanto a melhora da função respiratória e da força dos músculos respiratórios. Porém, mais estudos devem ser realizados para o aprofundamento do conhecimento sobre os benefícios e efeitos a longo prazo da reabilitação respiratória em pacientes com AVC.

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Stroke Incidence, Case Fatality, and Mortality in the WHO MONICA Project

Cited by 435 publications

References 26 publications

Doenças cerebrovasculares em pacientes entre 15 e 40 anos: achados neuropatológicos em 47 casos

Doenças cerebrovasculares em pacientes entre 15 e 40 anos: achados neuropatológicos em 47 casos

Trends in Stroke Incidence and 28-Day Case Fatality in a Nationwide Stroke Registry of a Multiethnic Asian Population

Respiratory Changes in Patients with Stroke

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