Risk factors and features of stroke among young persons in urban and rural areas of the Tambov Region

Author(s):  
Ekaterina B. Zvonareva ◽  
Lubov I. Grigorova

Since 2011 according to the national project “Health” the Regional Vascular Center has been operating on the basis of the Tambov Regional Clinical Hospital. This is a ward for patients with acute cerebral circulation disorder. Since 2017 there has been an increase in patients due to an increase in the number of attached population to Tambov Regional Clinical Hospital and, accordingly, unfortunately, the mortality rate from acute cerebral circulation disorder has been increasing. Between 2016 and 2020, a study was conducted based on the follow-up of young patients with hemorrhagic and ischemic stroke. In the study we emphasized the research of regional features of the structure, causes, and risk factors of stroke in persons in the city of Tambov and the districts of the Tambov Region. We verified pathogenetic subtypes of stroke among young patients. We identified and considered main and concomitant factors determining stroke outcome, degree of neurological deficiency, and disabled patients. We identified the leading causes of stroke in persons, the main of which were: arterial hypertension, cardiac pathology, atherosclerosis.

2018 ◽  
Vol 27 (6) ◽  
pp. 508-514 ◽  
Author(s):  
Iqbal M. Fahs ◽  
Souheil Hallit ◽  
Mohamad K. Rahal ◽  
Diana N. Malaeb

Objective: To assess the role of the pharmacist in modifying risk factors for cardiovascular disease (CVD) among Lebanese adults in urban and rural areas. Methods: In a prospective survey, 865 out of 1,000 participants aged ≥45 years, previously interviewed, agreed to be followed at 1 and 2 years time points. Parameters including blood pressure, lipid profile, blood glucose, average number of risk factors, and atherosclerotic CVD (ASCVD) risk were assessed and evaluated at the beginning of the study, then after 1 and 2 years. Results: During both follow-ups, the mean average body mass index and systolic blood pressure decreased significantly and the lipid profile improved significantly. Further significant improvements in ASCVD risk occurred during the second follow-up. Monitoring parameters revealed significant improvements as well. Conclusion: This study showed that a plan that includes pharmacists, who regularly monitor and follow-up patients, could improve CVD prevention through the reduction of risk factors.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ingmar Schäfer ◽  
Heike Hansen ◽  
Agata Menzel ◽  
Marion Eisele ◽  
Daniel Tajdar ◽  
...  

Abstract Objectives The aims of our study were to describe the effect of the COVID-19 pandemic and lockdown on primary care in Germany regarding the number of consultations, the prevalence of specific reasons for consultation presented by the patients, and the frequency of specific services performed by the GP. Methods We conducted a longitudinal observational study based on standardised GP interviews in a quota sampling design comparing the time before the COVID-19 pandemic (12 June 2015 to 27 April 2017) with the time during lockdown (21 April to 14 July 2020). The sample included GPs in urban and rural areas 120 km around Hamburg, Germany, and was stratified by region type and administrative districts. Differences in the consultation numbers were analysed by multivariate linear regressions in mixed models adjusted for random effects on the levels of the administrative districts and GP practices. Results One hundred ten GPs participated in the follow-up, corresponding to 52.1% of the baseline. Primary care practices in 32 of the 37 selected administrative districts (86.5%) could be represented in both assessments. At baseline, GPs reported 199.6 ± 96.9 consultations per week, which was significantly reduced during COVID-19 lockdown by 49.0% to 101.8 ± 67.6 consultations per week (p < 0.001). During lockdown, the frequency of five reasons for consultation (-43.0% to -31.5%) and eleven services (-56.6% to -33.5%) had significantly decreased. The multilevel, multivariable analyses showed an average reduction of 94.6 consultations per week (p < 0.001). Conclusions We observed a dramatic reduction of the number of consultations in primary care. This effect was independent of age, sex and specialty of the GP and independent of the practice location in urban or rural areas. Consultations for complaints like low back pain, gastrointestinal complaints, vertigo or fatigue and services like house calls/calls at nursing homes, wound treatments, pain therapy or screening examinations for the early detection of chronic diseases were particularly affected.


2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Iqbal Fahs ◽  
Zainab Khalife ◽  
Diana Malaeb ◽  
Mohammad Iskandarani ◽  
Pascale Salameh

Introduction. CVDs are largely driven by modifiable risk factors. This study sought to determine the awareness and prevalence of the modifiable CVDs risk factors among the Lebanese population.Methods. In a cross-sectional survey, 1000 participants aged ≥ 45 years were randomly selected from pharmacies and interviewed. The data was analyzed with SPSS version 21.0 software.Results. Differences between urban and rural areas include alcohol consumption (2.8% versus 1.7%;p=0.0001), cardioprotective vegetable servings (6.1% versus 2.3%;p=0.016), sedentary hours per day (18.6% versus 15.1%;p=0.002), and hypertension (38.5% versus 25.4%;p=0.001). The prevalence of overweight and obesity (77.3% versus 75.2%;p=0.468), smoking (39.3% versus 43.3%;p=0.232), diabetes (25.4% versus 21.4%;p=0.173), and dyslipidemia (25 versus 21.2%) was reported. Measurements revealed 19.3% of undiagnosed hypertension (12.4% versus 22.4%,p=0.001), 61.7% of hypertension (59.8% versus 62.6%;p=0.203), and 7.9% of undiagnosed diabetes (6.6% versus 8.6%;p=0.323). The declared awareness of CVDs risk factors was highest for smoking (91.5% versus 89.7%;p=0.339) and lowest for diabetes (54.4 versus 55.7%;p=0.692).Conclusion. This study has shown a high prevalence of modifiable CVDs risk factors in the Lebanese population ≥ 45 years, among which hypertension is the most prominent.


2020 ◽  
Author(s):  
Xiaodong Chen ◽  
Zeting Lin ◽  
Ran Gao ◽  
Yijian Yang ◽  
Liping Li

Abstract Background: To investigate the prevalence of falls and risk factors among older adults in urban and rural areas and to facilitate the design of fall prevention interventions.Methods: We used cluster random sampling to investigate the sociodemographic information, living habits, medical history, and falls among 649 older adult participants. Univariable and multivariable logistic regression was used to examine fall risk factors in urban and rural areas.Results: The fall rate and rate of injury from falls among older adults in urban areas were 27.3% and 18.6%, respectively, which were higher than those in rural areas (17.0% and 12.2%; P<0.05). Multivariable analysis showed that the risk factors for falls among urban older adults included a high school or below education level (OR=3.737, 95% CI: 1.503~9.291); diabetes medicine use (OR=4.518, 95% CI: 1.228~16.626); incontinence (OR=8.792, 95% CI: 1.894~40.824); lack of fall prevention education (OR = 11.907, 95% CI: 1.321~107.354); and reduced balance function (OR = 3.901, 95% CI: 1.894~7.815). The risk factors among rural older adults included a previous nonfarming occupation (OR=2.496, 95% CI: 1.416~4.398); incontinence (OR =11.396, 95% CI: 1.901~68.327); poor living environment (OR=3.457, 95% CI: 1.488~8.033); and reduced balance function (OR =4.260, 95% CI: 2.361~7.688).Discussion: The rate of falls among older adults in urban areas is higher than that in rural areas of Shantou City. Fall prevention in urban areas should target older adults with low education and modify the diabetes medication use. Interventions should focus on improving the home environment of older adults in rural areas.


2012 ◽  
Vol 24 (8) ◽  
pp. 1235-1241 ◽  
Author(s):  
Y. Abe ◽  
N. Fujise ◽  
R. Fukunaga ◽  
Y. Nakagawa ◽  
M. Ikeda

ABSTRACTBackground: The aim of the present study was to investigate the differences in the prevalence of and risk factors for elderly depression between urban and rural areas in Japan and to further understanding of the features of elderly depression.Methods: A multistage, random sampling procedure and mailing method were used in urban and rural areas in Kumamoto Prefecture. A total of 2,152 participants aged 65 years and older were evaluated for depression using the Geriatric Depression Scale (GDS). Factors associated with depression were also examined. In order to assess the relationship between risk factors and subjective happiness, the Philadelphia Geriatric Center Morale Scale (PGC-MS) was used.Results: Depressive symptoms were associated with living alone, being unemployed, chronic illness, sleep disturbance, suicidal ideation, financial strain, and poor social support; the risk factors for elderly depression were almost the same in the two areas. Although three factors (financial strain, work status, and PGC-MS) were significantly associated with depression in both areas on logistic regression analysis, sleep disturbance was significant only for the urban area, and poor social support was significant only for the rural area.Conclusions: Although factors related to depression did not differ markedly between urban and rural elderly people, some risk factors differed between the two areas. Effective intervention programs for elderly depression should pay more attention to regional differences.


2020 ◽  
Author(s):  
Xintong Zhao ◽  
Jiaqiang Liu ◽  
Huifang Wang ◽  
Zihuan Zhang ◽  
Zhenbao Li

Abstract Purpose Single coiling may be the optimal strategy for ruptured aneurysms. But assisted techniques may be needed in some aneurysms. The authors report their experience of double microcatheter technique in the treatment of ruptured aneurysms in anterior cerebral circulation. Methods Between 2012 and 2018, 82 patients with ruptured aneurysms in anterior cerebral circulation were treated with double microcatheter technique. The clinical records, angiographic results, procedure-related complications were reviewed. Clinical and angiographic follow-up was performed. Results Completely occlusion, neck remnant and partial occlusion were achieved in 56.6%, 36.1% and 7.2% in the whole procedures, respectively. The overall rate of morbidity was 8.5% (7/82). The rate of permanent morbidity was 3.7% (3/82). Three patients (3.7%) died before discharge. There was no procedure-related mortality. The favorable outcomes were obtained in 75.6% (62/82) of the whole patients at discharge. High Hunt-Hess grade and suffering from craniotomy or EVD were risk factors for clinical outcomes at discharge. Sixty-eight patients received clinical follow-up at a mean interval of 15.75±12.71 months. Favorable outcomes were obtained in 61 (89.7%) patients. Angiographic follow-up was performed in 44 patients at an average of 13.16±13.12 months. The recurrence rate is 34.1%. Seven of them (15.9%) received retreatment. Conclusion Double microcatheter technique is a safe and effective method for treatment of ruptured aneurysms in anterior cerebral aneurysms with low morbidity. Recurrence remains a problem. Patients should be followed up regularly.


BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e039004
Author(s):  
Tessa Roberts ◽  
Oye Gureje ◽  
Rangaswamy Thara ◽  
Gerard Hutchinson ◽  
Alex Cohen ◽  
...  

IntroductionThere are few robust and directly comparable studies of the epidemiology of psychotic disorders in the Global South. INTREPID II is designed to investigate variations in untreated psychotic disorders in the Global South in (1) incidence and presentation (2) 2-year course and outcome, (3) help-seeking and impact, and (4) physical health.MethodsINTREPID II is a programme of research incorporating incidence, case–control and cohort studies of psychoses in contiguous urban and rural areas in India, Nigeria and Trinidad. In each country, the target samples are 240 untreated cases with a psychotic disorder, 240 age-matched, sex-matched and neighbourhood-matched controls, and 240 relatives or caregivers. Participants will be followed, in the first instance, for 2 years. In each setting, we have developed and are employing comprehensive case-finding methods to ensure cohorts are representative of the target populations. Using methods developed during pilot work, extensive data are being collected at baseline and 2-year follow-up across several domains: clinical, social, help-seeking and impact, and biological.Ethics and disseminationInformed consent is sought, and participants are free to withdraw from the study at any time. Participants are referred to mental health services if not already in contact with these and emergency treatment arranged where necessary. All data collected are confidential, except when a participant presents a serious risk to either themselves or others. This programme has been approved by ethical review boards at all participating centres. Findings will be disseminated through international conferences, publications in international journals, and through local events for key stakeholders.


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