scholarly journals Traditional Chinese Medicine Reduces the Incidence of Chemotherapy-Induced Stroke: A Five-Year Nationwide Population-Based Cohort Study From Taiwan

2021 ◽  
Vol 12 ◽  
Author(s):  
Chien-Chen Huang ◽  
Yu-Cih Yang ◽  
Iona MacDonald ◽  
Ching-Yuan Lai ◽  
Cheng-Hao Tu ◽  
...  
Keyword(s):  
Risk Factor ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Large Scale ◽  
Population Based ◽  
Incidence Rates ◽  
First Year ◽  
Subdistribution Hazard ◽  
Stroke Incidence ◽  
Kaplan Meier

Background: Chemotherapy is suspected to be a risk factor for stroke in patients with cancer, athough the results from large-scale studies are controversial. Few strategies are available for reducing the stroke-related risks.Methods: We analyzed stroke incidence rates in Taiwan’s Longitudinal Health Insurance database 2000 (LHID2000) for patients aged ≥20 years with newly-diagnosed cancer between Jan 1, 2000 and Dec 31, 2006, who did or did not receive chemotherapy. Moreover, we compared stroke incidence rates among chemotherapy users who did or did not use traditional Chinese medicine. All study participants were followed-up for 5 years or until they had a stroke.Results: In adjusted Kaplan-Meier analysis, the incidence of stroke was higher within the first year of cancer diagnosis among chemotherapy recipients compared with those who did not receive chemotherapy (31.1 vs. 9.75; adjusted subdistribution hazard ratio [sHR] 2.21; 95% confidence interval [CI], 1.52–3.20; p < 0.001). This between-group difference persisted at 4 years of follow-up (13.6 vs. 5.42; adjusted sHR 1.94; 95% CI, 1.53–2.46; p < 0.001). Similarly, the 5-year incidence rate of stroke was significantly lower among chemotherapy recipients using TCM vs. non-TCM users (0.19 vs. 0.46; adjusted sHR 0.45; 95% CI, 0.26–0.79; p < 0.001), as was the mortality rate (adjusted sHR 0.55; 95% CI, 0.44–0.68; p < 0.001).Conclusion: These Taiwanese data suggest that chemotherapy is a risk factor for stroke and that the use of TCM can significantly mitigate this risk. TCM also appears to reduce the mortality risk associated with chemotherapy.

scholarly journals Seasonal Variation in Incidence of Stroke in a General Population of 1.4 Million Japanese: The Shiga Stroke Registry

2021 ◽  
pp. 1-7
Author(s):  
Takako Fujii ◽  
Hisatomi Arima ◽  
Naoyuki Takashima ◽  
Yoshikuni Kita ◽  
Naomi Miyamatsu ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Seasonal Variation ◽  
General Population ◽  
Intracerebral Hemorrhage ◽  
Large Scale ◽  
Population Based ◽  
Incidence Rates ◽  
Stroke Incidence ◽  
Stroke Registry ◽  
Age And Sex

<b><i>Introduction:</i></b> The purpose of this study was to investigate seasonal variation in stroke incidence using data from a large-scale stroke registry of general population in current Japan. <b><i>Methods:</i></b> Shiga Stroke Registry (SSR) is an ongoing population-based registry of stroke that occurred in the Shiga Prefecture in central Honshu, Japan. A total 6,688 cases of first-ever stroke, with onset dates ranging from 1 January 2011 to 31 December in 2013 were included in this study. Incidence rates of first-ever stroke in each season were estimated using the person-year approach and adjusted for age and sex using the Poisson regression models. <b><i>Results:</i></b> From 2011 to 2013, we identified a total of 6,688 stroke cases (3,570 men, 3,118 women), of which 4,480 cases had ischemic stroke (2,518 men, 1,962 women), 1,588 had intracerebral hemorrhage (857 men, 731 women) and 563 had subarachnoid hemorrhage (166 men, 397 women). Age- and sex-adjusted incidence rates of total stroke were 151 (95% confidence interval [CI] 144–160, <i>p</i> = &#x3c;0.001 vs. summer) in spring, 130 (95% CI 122–137) in summer, 141 (95% CI 133–149, <i>p</i> = 0.020 vs. summer) in autumn and 170 (95% CI 161–179, <i>p</i> = &#x3c;0.001 vs. summer) in winter. Seasonal variation was more pronounced in intracerebral hemorrhage than in ischemic stroke. <b><i>Conclusion:</i></b> In the present large-scale stroke registry of general population, incidence rates of stroke were highest in winter and lowest in summer in current Japan.

Use of traditional Chinese medicine in patients with hyperlipidemia: A population-based study in Taiwan

2015 ◽  
Vol 168 ◽  
pp. 129-135 ◽  
Author(s):  
Shih-Meng Chu ◽  
Wei-Tai Shih ◽  
Yao-Hsu Yang ◽  
Pau-Chung Chen ◽  
Yen-Hua Chu
Keyword(s):  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Population Based ◽  
Population Based Study

scholarly journals Stroke in systemic lupus erythematosus: a Swedish population-based cohort study

2017 ◽  
Vol 76 (9) ◽  
pp. 1544-1549 ◽  
Author(s):  
Elizabeth V Arkema ◽  
Elisabet Svenungsson ◽  
Mia Von Euler ◽  
Christopher Sjöwall ◽  
Julia F Simard
Keyword(s):  
Systemic Lupus Erythematosus ◽  
General Population ◽  
Ischaemic Stroke ◽  
Lupus Erythematosus ◽  
Haemorrhagic Stroke ◽  
Population Based ◽  
Incidence Rates ◽  
First Year ◽  
Systemic Lupus ◽  
Swedish Population

ObjectiveTo study the occurrence of ischaemic and haemorrhagic stroke in systemic lupus erythematosus (SLE) compared with the general population by age, sex and time since SLE diagnosisMethodsAdults with incident SLE were identified from the Swedish National Patient Register (NPR, n=3390) and general population comparators from the Total Population Register were matched on age, sex and county (n=16730). Individuals were followed prospectively until first of death, December 2013, emigration or incident stroke (identified from the NPR, Cause of Death Register and the Stroke Register). Incidence rates, rate differences and HR were estimated comparing SLE with non-SLE. Estimates were stratified by sex, age and time since diagnosis.ResultsWe observed 126 strokes in SLE and 304 in the general population. Individuals with SLE had a twofold increased rate of ischaemic stroke compared with the general population (HR 2.2; 95% CI 1.7 to 2.8). The HR for intracerebral haemorrhage was 1.4 (95% CI 0.7 to 2.8). There was effect modification by sex and age, with the highest HRs for females and individuals <50 years old. The HR for ischaemic stroke was highest in the first year of follow-up (3.7; 95% CI 2.1 to 6.5).ConclusionsThe relative risk of ischaemic stroke in SLE was more than doubled compared with the general population, and importantly, the highest relative risks were observed within the first year after SLE diagnosis. Thus, the first encounter with patients presents an opportunity for rheumatologists to screen for risk factors and intervene.

Abstract T MP66: Injury to the Head or Neck Increases Risk of Ischemic Stroke Three-fold After Trauma.

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Christine K Fox ◽  
Adam L Numis ◽  
Steve Sidney ◽  
Heather J Fullerton
Keyword(s):  
Ischemic Stroke ◽  
Traumatic Injury ◽  
Young Patients ◽  
Risk Groups ◽  
Population Based ◽  
Incidence Rates ◽  
Neck Injury ◽  
Diagnostic Code ◽  
Stroke Incidence ◽  
Diagnostic Codes

Background: Over 2 million people under age 50 are seen in a U.S. emergency room monthly for non-fatal injuries. Our objective was to measure ischemic stroke incidence after traumatic injury in young patients and identify stroke risk factors. Methods: We performed a population-based study of ischemic stroke after trauma among people <50 years old in a Northern Californian integrated health care system. We electronically identified a cohort of patients with diagnostic codes for trauma (ICD-9 800-959.9) in emergency and inpatient encounters from 1997-2011, then identified ischemic stroke outcomes within 4 weeks. To determine stroke, we required an ICD-9 stroke code (433-438) plus a radiology report of brain imaging containing a keyword: stroke, infarct#, thromb#, ischemi#, lacun#, or dissect#. A neurologist reviewed the reports to exclude those inconsistent with ischemic stroke. We obtained clinical data such as injury type from electronic databases to calculate stratified incidence rates and risk ratios. Results: From 1.5 million trauma encounters, we identified 197 ischemic strokes. The 4-week stroke incidence after any traumatic injury was 0.013% (95% CI 0.011, 0.015). Patients with stroke had a mean age of 37.7 years (SD 12.2) versus 24.0 years (SD 13.8) in those without stroke (P<0.0001). Patients with injury to the head or neck were more likely to have a stroke compared to those with other types of injuries (Table). The 4-week stroke incidence after head or neck injury was 0.07% (95% CI 0.05, 0.09) among adults and 0.005% (95% CI 0.001, 0.01) among children (P<0.0001). Of the 197 stroke cases, 16% (95% CI 11, 22) had a diagnostic code for cranio-cervical dissection. Conclusions: A 4-week stroke incidence of 0.013% suggests that 260 young people have an ischemic stroke after a traumatic injury every month in the U.S. Further research is needed to identify the highest risk groups, such as those with head or neck injury, and opportunities for stroke prevention.

Abstract P287: Sex Differences in Stroke Incidence: The REGARDS Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Virginia J Howard ◽  
Suzanne E Judd ◽  
Abraham J Letter ◽  
Dawn O Kleindorfer ◽  
Leslie A McClure ◽  
...  
Keyword(s):  
Sex Differences ◽  
Stroke Risk ◽  
Proportional Hazards ◽  
Population Based ◽  
Incidence Rates ◽  
National Data ◽  
Stroke Incidence ◽  
The Difference ◽  
Regards Study

Background: There are strikingly few national data available to describe sex differences in age-specific stroke incidence. Methods: REGARDS is a national, population-based, longitudinal study of black and white participants aged > 45 years old, with oversampling of blacks and residents of the stroke belt. Between 2003 and 2007, 30,239 participants were enrolled and examined; follow-up is every 6 months by telephone for self- or proxy-reported stroke, with retrieval and adjudication of medical records by physicians. This analysis included 27,756 participants with follow up data who had no physician-diagnosed stroke at baseline. Stroke incidence rates were calculated as the number of stroke events divided by the person-years at risk with 95% confidence limits. Proportional hazards models were used to assess the race-specific association of sex with stroke risk by age strata (<65, 65–74, and 75+) after adjustment for socioeconomic factors, and Framingham stroke risk factors. Results: There were 613 incident strokes events over 135,551 person-years of follow-up. Stroke incidence rates increased with age (from 237/100,000 to 1003/100,000), and were higher in men than women in both blacks and whites (left panel of figure). After multivariable adjustment, men had higher risk than women at younger ages (<75) but for the 65–75 age group, the difference is larger for blacks than whites (right panel of figure). Discussion: These national data confirm the patterns in male/female stroke risk observed in the Greater Cincinnati/Northern Kentucky Stroke Study, with smaller sex differences at older ages, and for men, larger excess risk in whites than blacks.

Health Impacts of Large-Scale Floods: Governmental Decision-Making and Resilience of the Citizens

2008 ◽  
Vol 23 (S2) ◽  
pp. s70-s73 ◽  
Author(s):  
Dick Q.P. Fundter ◽  
Bas Jonkman ◽  
Steve Beerman ◽  
Corsmas L.P.M. Goemans ◽  
Rosanna Briggs ◽  
...  
Keyword(s):  
Decision Making ◽  
Large Scale ◽  
Health Impact ◽  
Population Based ◽  
Chronic Illnesses ◽  
Decision Makers ◽  
Natural Resistance ◽  
First Year ◽  
The Public ◽  
Life Saving

AbstractDuring the 15th World Congress on Disaster and Emergency Medicine in Amsterdam, May 2007 (15WCDEM), a targeted agenda program (TAP) about the public health aspects of large-scale floods was organized. The main goal of the TAP was the establishment of an overview of issues that would help governmental decision-makers to develop policies to increase the resilience of the citizens during floods. During the meetings, it became clear that citizens have a natural resistance to evacuations. This results in death due to drowning and injuries. Recently, communication and education programs have been developed that may increase awareness that timely evacuation is important and can be life-saving. After a flood, health problems persist over prolonged periods, including increased death rates during the first year after a flood and a higher incidence of chronic illnesses that last for decades after the flood recedes. Population-based resilience (bottom-up) and governmental responsibility (top-down) must be combined to prepare regions for the health impact of evacuations and floods. More research data are needed to become better informed about the health impact and consequences of translocation of health infrastructures after evacuations. A better understanding of the consequences of floods will support governmental decision-making to mitigate the health impact. A top-10 priority action list was formulated.

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