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1. Understanding the Role of Metabolic Syndrome as a Risk Factor for Hepatocellular Carcinoma

Author

Chavez-Tapia NC, Murúa-Beltrán Gall S, Ordoñez-Vázquez AL, Nuño-Lambarri N, Vidal-Cevallos P, and Uribe M

Subjects
metabolic syndrome, hepatocellular carcinoma, excess body weight, diabetes mellitus, non-alcoholic fatty liver disease., Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Norberto C Chavez-Tapia,1,2 Sofía Murúa-Beltrán Gall,1 Ana Luisa Ordoñez-Vázquez,1 Natalia Nuño-Lambarri,2 Paulina Vidal-Cevallos,1 Misael Uribe1 1Gastroenterology Department, Medica Sur Clinic & Foundation, Mexico City, Mexico; 2Transational Research Department, Medica Sur Clinic & Foundation, Mexico City, MexicoCorrespondence: Norberto C Chavez-Tapia, Gastroenterology Department, Medica Sur Clinic & Foundation, Puente de Piedra 150. Col. Toriello Guerra, Tlalpan, Mexico City, CP 14050, Mexico, Email nchavezt@medicasur.org.mxAbstract: Hepatocellular carcinoma (HCC) and metabolic syndrome (MetS) have a rising prevalence worldwide. The relationship between these two entities has long been studied and understanding it has become a public health and clinical priority. This association follows, in most patients, the path through non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH), cirrhosis and finally HCC. Nonetheless, increasing evidence has been found, that shows MetS as an independent risk factor for the development of HCC. This review brings together the clinical evidence of the relationship between these highly prevalent diseases, with a particular interest in the impact of each component of MetS on HCC; It aims to summarize the complex physiopathological pathways that explain this relationship, and to shed light on the different clinical scenarios of this association, the impact of treating the different components of MetS on the risk of HCC and what is known about screening for HCC in patients with MetS. By doing so, it hopes to improve awareness on this topic.Keywords: metabolic syndrome, hepatocellular carcinoma, excess body weight, diabetes mellitus, non-alcoholic fatty liver disease

Published
2022

2. AB1486 BASELINE CHARACTERISTICS OF PATIENTS WITH INFLAMMATORY RHEUMATIC MUSCULOSKELETAL DISORDERS: DATA FROM A PROSPECTIVE OBSERVATIONAL COHORT FROM THE GERMAN REGISTRY LORE

Author

Kiltz, U., primary, Luedemann, I. A., additional, Redeker, I., additional, De Jong, K., additional, Tsiami, S., additional, Alshakaki, F., additional, Andreica, I., additional, Guminski, B., additional, Haeusler, U., additional, Karagkiozidou, D., additional, Kavruk, H., additional, Kiefer, D., additional, Lochowski, R., additional, Patru, A. M., additional, Sewerin, P., additional, Vossen, D., additional, Waldecker-Gall, S., additional, and Baraliakos, X., additional

Published
2024
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5. Age and sex disparities in cardiovascular risk factor management prior to stroke: Linked registry and general practice data.

Author

Bam, K, Kilkenny, MF, Kim, J, Cadilhac, DA, Pearce, C, Andrew, NE, Sanders, L, Thrift, AG, Nelson, MR, Gall, S, Daraganova, G, Olaiya, MT, Bam, K, Kilkenny, MF, Kim, J, Cadilhac, DA, Pearce, C, Andrew, NE, Sanders, L, Thrift, AG, Nelson, MR, Gall, S, Daraganova, G, and Olaiya, MT

Abstract

INTRODUCTION: There is limited evidence about the management of cardiovascular risk factors within 12 months before stroke/transient ischaemic attack (TIA) in Australian general practices. We evaluated whether age and sex disparities in cardiovascular risk factor management for primary prevention exist in general practice. METHODS: A retrospective cohort study using data from the Australian Stroke Clinical Registry (2014-2018) linked with general practice data from three primary health networks in Victoria, Australia. We included adults who had ≥2 encounters with a general practitioner within 12 months immediately before the first stroke/TIA. Cardiovascular risk factor management within 12 months before stroke/TIA was evaluated in terms of: assessment of risk factors (blood pressure [BP], serum lipids, blood glucose, body weight); prescription of prevention medications (BP, lipid-, glucose-lowering, antithrombotic agents); and attainment of risk factor targets. RESULTS: Of 2,880 patients included (median age 76.5 years, 48.4% women), 80.9% were assessed for BP, 49.9% serum lipids, 46.8% blood glucose, and 39.3% body weight. Compared to patients aged 65-84 years, those aged <65 or ≥85 years were less often assessed for risk factors, with women aged ≥85 years assessed for significantly fewer risk factors than their male counterparts. The most prescribed prevention medications were BP-lowering (64.9%) and lipid-lowering agents (42.0%). There were significant sex differences among those aged <65 years (34.7% women vs. 40.2% men) and ≥85 years (34.0% women vs. 44.3% men) for lipid-lowering agents. Risk factor target attainment was generally poorer in men than women, especially among those aged <65 years. CONCLUSION: Age-sex disparity exists in risk factor management for primary prevention in general practice, and this was more pronounced among younger patients and older women.

Published
2024

6. Pragmatic solutions to reduce the global burden of stroke: a World Stroke Organization–Lancet Neurology Commission

Author

Feigin, V, Owolabi, M, Abd-Allah, F, Akinyemi, R, Bhattacharjee, N, Brainin, M, Cao, J, Caso, V, Dalton, B, Davis, A, Dempsey, R, Duprey, J, Feng, W, Ford, G, Gall, S, Gandhi, D, Good, D, Hachinski, V, Hacke, W, Hankey, G, Ishida, M, Johnson, W, Kim, J, Lavados, P, Lindsay, P, Mahal, A, Martins, S, Murray, C, Nguyen, T, Norrving, B, Olaiya, M, Olalusi, O, Pandian, J, Phan, H, Platz, T, Ranta, A, Rehman, S, Roth, G, Sebastian, I, Smith, A, Suwanwela, N, Sylaja, P, Thapa, R, Thrift, A, Uvere, E, Vollset, S, Yavagal, D, Yaria, J, Abera, S, Ibrahim, N, Liu, L, Ovbiagele, B, Piradov, M, Abanto, C, Addissie, A, Adeleye, A, Adilbekov, Y, Adilbekova, B, Adoukonou, T, Aguiar de Sousa, D, Akhmetzhanova, Z, Akpalu, A, El Alaoui-Faris, M, Ameriso, S, Andonova, S, Arsovska, A, Awoniyi, F, Bakhiet, M, Barboza, M, Basri, H, Bath, P, Bereczki, D, Beretta, S, Berkowitz, A, Bernhardt, J, Berzina, G, Bhavsar, B, Bisharyan, M, Bohara, M, Bovet, P, Budincevic, H, Cadilhac, D, Cerimagic, D, Charway-Felli, A, Chen, C, Chin, J, Christensen, H, Chwojnicki, K, Conforto, A, Correia, M, Mora Cuervo, D, Czlonkowska, A, D'Amelio, M, Danielyan, K, Davis, S, Demarin, V, Demchuk, A, Dichgans, M, Dokova, K, Donnan, G, Duran, J, Ekeng, G, Elkind, M, Endres, M, Fischer, U, Flomin, Y, Gankpe, F, Gavidia, M, Gaye Saavedra, A, Gebreyohanns, M, George, M, Gierlotka, M, Giroud, M, Gnedovskaya, E, Goncalves, I, Gongora-Rivera, F, Gunaratne, P, Hamadeh, R, Hamzat, T, Heldner, M, Ibrahim, E, Ihle-Hansen, H, Jee, S, Jiann-Shing, J, Johnston, S, Jovanovic, D, Jurjans, K, Kalani, R, Kalkonde, Y, Kamenova, S, Karaszewski, B, Kelly, P, Kiechl, S, Kondybayeva, A, Korv, J, Kozera, G, Kravchenko, M, Krespi, Y, Krishnamurthi, R, Kruja, J, Kutluk, K, Langhorne, P, Law, Z, Lebedynets, D, Lee, T, Leung, T, Liebeskind, D, Lopez-Jaramillo, P, Lotufo, P, Machline-Carrion, M, Maia, L, Malojcic, B, Markus, H, Marquez-Romero, J, Medina, M, Medukhanova, S, Mehndiratta, M, Miglane, E, Mihejeva, I, Mikulik, R, Mirrakhimov, E, Mohl, S, Munakomi, S, Murphy, S, Musa, K, Nasreldein, A, Nogueira, R, Nolte, C, Noubiap, J, Novarro-Escudero, N, Ocampo, C, O'Donnell, M, Ogun, Y, Ogunniyi, A, Oraby, M, Orken, D, Ozdemir, A, Ozturk, S, Paccot, M, Pereira, T, Peeters, A, Potpara, T, Proios, H, Rathore, F, Sacco, R, Sahathevan, R, Sandset, E, Renato Santos, I, Saposnik, G, Sarfo, F, Sargento-Freitas, J, Sharma, M, Shaw, L, Sheth, K, Shin, Y, Shobhana, A, Silva, S, Tedim Cruz, V, Thakur, K, Thapa, L, Toni, D, Topcuoglu, M, Torales, J, Towfighi, A, Truelsen, T, Tsiskaridze, A, Tulloch-Reid, M, Useche, J, Vanacker, P, Vassilopoulou, S, Vukorepa, G, Vuletic, V, Wahab, K, Wang, W, Wijeratne, T, Wojtyniak, B, Wolfe, C, Yacouba, M, Yang, J, Yifru, Y, Yock-Corrales, A, Yonemoto, N, Yperzeele, L, Zagozdzon, P, Feigin V. L., Owolabi M. O., Abd-Allah F., Akinyemi R. O., Bhattacharjee N. V., Brainin M., Cao J., Caso V., Dalton B., Davis A., Dempsey R., Duprey J., Feng W., Ford G. A., Gall S., Gandhi D., Good D. C., Hachinski V., Hacke W., Hankey G. J., Ishida M., Johnson W., Kim J., Lavados P., Lindsay P., Mahal A., Martins S., Murray C., Nguyen T. P., Norrving B., Olaiya M. T., Olalusi O. V., Pandian J., Phan H., Platz T., Ranta A., Rehman S., Roth G., Sebastian I. A., Smith A. E., Suwanwela N. C., Sylaja P. N., Thapa R., Thrift A. G., Uvere E., Vollset S. E., Yavagal D., Yaria J., Abera S. F., Akinyemi R., Dempsey R. J., Ibrahim N. M., Liu L., Ovbiagele B., Piradov M., Suwanwela N., Abanto C., Addissie A., Adeleye A. O., Adilbekov Y., Adilbekova B., Adoukonou T. A., Aguiar de Sousa D., Akhmetzhanova Z., Akpalu A., El Alaoui-Faris M., Ameriso S. F., Andonova S., Arsovska A., Awoniyi F. E., Bakhiet M., Barboza M. A., Basri H., Bath P. M., Bereczki D., Beretta S., Berkowitz A. L., Bernhardt J., Berzina G., Bhavsar B., Bisharyan M. S., Bohara M., Bovet P., Budincevic H., Cadilhac D. A., Cerimagic D., Charway-Felli A., Chen C., Chin J. H., Christensen H., Chwojnicki K., Conforto A. B., Correia M., Mora Cuervo D. L., Czlonkowska A., D'Amelio M., Danielyan K. E., Davis S., Demarin V., Demchuk A. M., Dichgans M., Dokova K., Donnan G., Duran J. C., Ekeng G., Elkind M. S., Endres M., Fischer U., Flomin Y., Gankpe F., Gavidia M., Gaye Saavedra A., Gebreyohanns M., George M., Gierlotka M., Giroud M., Gnedovskaya E. V., Goncalves I. P., Gongora-Rivera F., Gunaratne P. S., Hamadeh R. R., Hamzat T. -H. K., Heldner M. R., Ibrahim E., Ihle-Hansen H., Jee S., Jiann-Shing J., Johnston S. C., Jovanovic D., Jurjans K., Kalani R., Kalkonde Y., Kamenova S., Karaszewski B., Kelly P., Kiechl S., Kondybayeva A., Korv J., Kozera G., Kravchenko M., Krespi Y., Krishnamurthi R., Kruja J., Kutluk K., Langhorne P., Law Z. K., Lebedynets D., Lee T. -H., Leung T. W., Liebeskind D. S., Lopez-Jaramillo P., Lotufo P. A., Machline-Carrion M. J., Maia L. F., Malojcic B., Markus H. S., Marquez-Romero J. M., Medina M. T., Medukhanova S., Mehndiratta M. M., Miglane E., Mihejeva I., Mikulik R., Mirrakhimov E., Mohl S., Munakomi S., Murphy S., Musa K. I., Nasreldein A., Nogueira R. G., Nolte C. H., Noubiap J. J., Novarro-Escudero N., Ocampo C., O'Donnell M., Ogun Y., Ogunniyi A., Oraby M. I., Orken D. N., Ozdemir A. O., Ozturk S., Paccot M., Pereira T., Peeters A., Potpara T., Proios H., Rathore F. A., Sacco R. L., Sahathevan R., Sandset E. S., Renato Santos I., Saposnik G., Sarfo F. S., Sargento-Freitas J., Sharma M., Shaw L., Sheth K. N., Shin Y. -I., Shobhana A., Silva S. N., Tedim Cruz V., Thakur K., Thapa L. J., Toni D., Topcuoglu M. A., Torales J., Towfighi A., Truelsen T., Tsiskaridze A., Tulloch-Reid M., Useche J. N., Vanacker P., Vassilopoulou S., Vukorepa G., Vuletic V., Wahab K. W., Wang W., Wijeratne T., Wojtyniak B., Wolfe C., Yacouba M. N., Yang J., Yifru Y. M., Yock-Corrales A., Yonemoto N., Yperzeele L., Zagozdzon P., Feigin, V, Owolabi, M, Abd-Allah, F, Akinyemi, R, Bhattacharjee, N, Brainin, M, Cao, J, Caso, V, Dalton, B, Davis, A, Dempsey, R, Duprey, J, Feng, W, Ford, G, Gall, S, Gandhi, D, Good, D, Hachinski, V, Hacke, W, Hankey, G, Ishida, M, Johnson, W, Kim, J, Lavados, P, Lindsay, P, Mahal, A, Martins, S, Murray, C, Nguyen, T, Norrving, B, Olaiya, M, Olalusi, O, Pandian, J, Phan, H, Platz, T, Ranta, A, Rehman, S, Roth, G, Sebastian, I, Smith, A, Suwanwela, N, Sylaja, P, Thapa, R, Thrift, A, Uvere, E, Vollset, S, Yavagal, D, Yaria, J, Abera, S, Ibrahim, N, Liu, L, Ovbiagele, B, Piradov, M, Abanto, C, Addissie, A, Adeleye, A, Adilbekov, Y, Adilbekova, B, Adoukonou, T, Aguiar de Sousa, D, Akhmetzhanova, Z, Akpalu, A, El Alaoui-Faris, M, Ameriso, S, Andonova, S, Arsovska, A, Awoniyi, F, Bakhiet, M, Barboza, M, Basri, H, Bath, P, Bereczki, D, Beretta, S, Berkowitz, A, Bernhardt, J, Berzina, G, Bhavsar, B, Bisharyan, M, Bohara, M, Bovet, P, Budincevic, H, Cadilhac, D, Cerimagic, D, Charway-Felli, A, Chen, C, Chin, J, Christensen, H, Chwojnicki, K, Conforto, A, Correia, M, Mora Cuervo, D, Czlonkowska, A, D'Amelio, M, Danielyan, K, Davis, S, Demarin, V, Demchuk, A, Dichgans, M, Dokova, K, Donnan, G, Duran, J, Ekeng, G, Elkind, M, Endres, M, Fischer, U, Flomin, Y, Gankpe, F, Gavidia, M, Gaye Saavedra, A, Gebreyohanns, M, George, M, Gierlotka, M, Giroud, M, Gnedovskaya, E, Goncalves, I, Gongora-Rivera, F, Gunaratne, P, Hamadeh, R, Hamzat, T, Heldner, M, Ibrahim, E, Ihle-Hansen, H, Jee, S, Jiann-Shing, J, Johnston, S, Jovanovic, D, Jurjans, K, Kalani, R, Kalkonde, Y, Kamenova, S, Karaszewski, B, Kelly, P, Kiechl, S, Kondybayeva, A, Korv, J, Kozera, G, Kravchenko, M, Krespi, Y, Krishnamurthi, R, Kruja, J, Kutluk, K, Langhorne, P, Law, Z, Lebedynets, D, Lee, T, Leung, T, Liebeskind, D, Lopez-Jaramillo, P, Lotufo, P, Machline-Carrion, M, Maia, L, Malojcic, B, Markus, H, Marquez-Romero, J, Medina, M, Medukhanova, S, Mehndiratta, M, Miglane, E, Mihejeva, I, Mikulik, R, Mirrakhimov, E, Mohl, S, Munakomi, S, Murphy, S, Musa, K, Nasreldein, A, Nogueira, R, Nolte, C, Noubiap, J, Novarro-Escudero, N, Ocampo, C, O'Donnell, M, Ogun, Y, Ogunniyi, A, Oraby, M, Orken, D, Ozdemir, A, Ozturk, S, Paccot, M, Pereira, T, Peeters, A, Potpara, T, Proios, H, Rathore, F, Sacco, R, Sahathevan, R, Sandset, E, Renato Santos, I, Saposnik, G, Sarfo, F, Sargento-Freitas, J, Sharma, M, Shaw, L, Sheth, K, Shin, Y, Shobhana, A, Silva, S, Tedim Cruz, V, Thakur, K, Thapa, L, Toni, D, Topcuoglu, M, Torales, J, Towfighi, A, Truelsen, T, Tsiskaridze, A, Tulloch-Reid, M, Useche, J, Vanacker, P, Vassilopoulou, S, Vukorepa, G, Vuletic, V, Wahab, K, Wang, W, Wijeratne, T, Wojtyniak, B, Wolfe, C, Yacouba, M, Yang, J, Yifru, Y, Yock-Corrales, A, Yonemoto, N, Yperzeele, L, Zagozdzon, P, Feigin V. L., Owolabi M. O., Abd-Allah F., Akinyemi R. O., Bhattacharjee N. V., Brainin M., Cao J., Caso V., Dalton B., Davis A., Dempsey R., Duprey J., Feng W., Ford G. A., Gall S., Gandhi D., Good D. C., Hachinski V., Hacke W., Hankey G. J., Ishida M., Johnson W., Kim J., Lavados P., Lindsay P., Mahal A., Martins S., Murray C., Nguyen T. P., Norrving B., Olaiya M. T., Olalusi O. V., Pandian J., Phan H., Platz T., Ranta A., Rehman S., Roth G., Sebastian I. A., Smith A. E., Suwanwela N. C., Sylaja P. N., Thapa R., Thrift A. G., Uvere E., Vollset S. E., Yavagal D., Yaria J., Abera S. F., Akinyemi R., Dempsey R. J., Ibrahim N. M., Liu L., Ovbiagele B., Piradov M., Suwanwela N., Abanto C., Addissie A., Adeleye A. O., Adilbekov Y., Adilbekova B., Adoukonou T. A., Aguiar de Sousa D., Akhmetzhanova Z., Akpalu A., El Alaoui-Faris M., Ameriso S. F., Andonova S., Arsovska A., Awoniyi F. E., Bakhiet M., Barboza M. A., Basri H., Bath P. M., Bereczki D., Beretta S., Berkowitz A. L., Bernhardt J., Berzina G., Bhavsar B., Bisharyan M. S., Bohara M., Bovet P., Budincevic H., Cadilhac D. A., Cerimagic D., Charway-Felli A., Chen C., Chin J. H., Christensen H., Chwojnicki K., Conforto A. B., Correia M., Mora Cuervo D. L., Czlonkowska A., D'Amelio M., Danielyan K. E., Davis S., Demarin V., Demchuk A. M., Dichgans M., Dokova K., Donnan G., Duran J. C., Ekeng G., Elkind M. S., Endres M., Fischer U., Flomin Y., Gankpe F., Gavidia M., Gaye Saavedra A., Gebreyohanns M., George M., Gierlotka M., Giroud M., Gnedovskaya E. V., Goncalves I. P., Gongora-Rivera F., Gunaratne P. S., Hamadeh R. R., Hamzat T. -H. K., Heldner M. R., Ibrahim E., Ihle-Hansen H., Jee S., Jiann-Shing J., Johnston S. C., Jovanovic D., Jurjans K., Kalani R., Kalkonde Y., Kamenova S., Karaszewski B., Kelly P., Kiechl S., Kondybayeva A., Korv J., Kozera G., Kravchenko M., Krespi Y., Krishnamurthi R., Kruja J., Kutluk K., Langhorne P., Law Z. K., Lebedynets D., Lee T. -H., Leung T. W., Liebeskind D. S., Lopez-Jaramillo P., Lotufo P. A., Machline-Carrion M. J., Maia L. F., Malojcic B., Markus H. S., Marquez-Romero J. M., Medina M. T., Medukhanova S., Mehndiratta M. M., Miglane E., Mihejeva I., Mikulik R., Mirrakhimov E., Mohl S., Munakomi S., Murphy S., Musa K. I., Nasreldein A., Nogueira R. G., Nolte C. H., Noubiap J. J., Novarro-Escudero N., Ocampo C., O'Donnell M., Ogun Y., Ogunniyi A., Oraby M. I., Orken D. N., Ozdemir A. O., Ozturk S., Paccot M., Pereira T., Peeters A., Potpara T., Proios H., Rathore F. A., Sacco R. L., Sahathevan R., Sandset E. S., Renato Santos I., Saposnik G., Sarfo F. S., Sargento-Freitas J., Sharma M., Shaw L., Sheth K. N., Shin Y. -I., Shobhana A., Silva S. N., Tedim Cruz V., Thakur K., Thapa L. J., Toni D., Topcuoglu M. A., Torales J., Towfighi A., Truelsen T., Tsiskaridze A., Tulloch-Reid M., Useche J. N., Vanacker P., Vassilopoulou S., Vukorepa G., Vuletic V., Wahab K. W., Wang W., Wijeratne T., Wojtyniak B., Wolfe C., Yacouba M. N., Yang J., Yifru Y. M., Yock-Corrales A., Yonemoto N., Yperzeele L., and Zagozdzon P.

Published
2023

9. Primary stroke prevention worldwide: translating evidence into action

Author

Owolabi, M, Thrift, A, Mahal, A, Ishida, M, Martins, S, Johnson, W, Pandian, J, Abd-Allah, F, Yaria, J, Phan, H, Roth, G, Gall, S, Beare, R, Phan, T, Mikulik, R, Akinyemi, R, Norrving, B, Brainin, M, Feigin, V, Abanto, C, Abera, S, Addissie, A, Adebayo, O, Adeleye, A, Adilbekov, Y, Adilbekova, B, Adoukonou, T, Aguiar de Sousa, D, Ajagbe, T, Akhmetzhanova, Z, Akpalu, A, Alvarez Ahlgren, J, Ameriso, S, Andonova, S, Awoniyi, F, Bakhiet, M, Barboza, M, Basri, H, Bath, P, Bello, O, Bereczki, D, Beretta, S, Berkowitz, A, Bernabe-Ortiz, A, Bernhardt, J, Berzina, G, Bisharyan, M, Bovet, P, Budincevic, H, Cadilhac, D, Caso, V, Chen, C, Chin, J, Chwojnicki, K, Conforto, A, Cruz, V, D'Amelio, M, Danielyan, K, Davis, S, Demarin, V, Dempsey, R, Dichgans, M, Dokova, K, Donnan, G, Elkind, M, Endres, M, Fischer, U, Gankpe, F, Gaye Saavedra, A, Gil, A, Giroud, M, Gnedovskaya, E, Hachinski, V, Hafdi, M, Hamadeh, R, Hamzat, T, Hankey, G, Heldner, M, Ibrahim, E, Ibrahim, N, Inoue, M, Jee, S, Jeng, J, Kalkonde, Y, Kamenova, S, Karaszewski, B, Kelly, P, Khan, T, Kiechl, S, Kondybayeva, A, Korv, J, Kravchenko, M, Krishnamurthi, R, Kruja, J, Lakkhanaloet, M, Langhorne, P, Lavados, P, Law, Z, Lawal, A, Lazo-Porras, M, Lebedynets, D, Lee, T, Leung, T, Liebeskind, D, Lindsay, P, Lopez-Jaramillo, P, Lotufo, P, Machline-Carrion, J, Makanjuola, A, Markus, H, Marquez-Romero, J, Medina, M, Medukhanova, S, Mehndiratta, M, Merkin, A, Mirrakhimov, E, Mohl, S, Moscoso-Porras, M, Muller-Stierlin, A, Murphy, S, Musa, K, Nasreldein, A, Nogueira, R, Nolte, C, Noubiap, J, Novarro-Escudero, N, Ogun, Y, Oguntoye, R, Oraby, M, Osundina, M, Ovbiagele, B, Orken, D, Ozdemir, A, Ozturk, S, Paccot, M, Phromjai, J, Piradov, P, Platz, T, Potpara, T, Ranta, A, Rathore, F, Richard, E, Sacco, R, Sahathevan, R, Santos Carquin, I, Saposnik, G, Sarfo, F, Sharma, M, Sheth, K, Shobhana, A, Suwanwela, N, Svyato, I, Sylaja, P, Tao, X, Thakur, K, Toni, D, Topcuoglu, M, Torales, J, Towfighi, A, Truelsen, T, Tsiskaridze, A, Tulloch-Reid, M, Useche, N, Vanacker, P, Vassilopoulou, S, Vukorepa, G, Vuletic, V, Wahab, K, Wang, W, Wijeratne, T, Wolfe, C, Yifru, Y, Yock-Corrales, A, Yonemoto, N, Yperzeele, L, Zhang, P, Owolabi M. O., Thrift A. G., Mahal A., Ishida M., Martins S., Johnson W. D., Pandian J., Abd-Allah F., Yaria J., Phan H. T., Roth G., Gall S. L., Beare R., Phan T. G., Mikulik R., Akinyemi R. O., Norrving B., Brainin M., Feigin V. L., Abanto C., Abera S. F., Addissie A., Adebayo O., Adeleye A. O., Adilbekov Y., Adilbekova B., Adoukonou T. A., Aguiar de Sousa D., Ajagbe T., Akhmetzhanova Z., Akpalu A., Alvarez Ahlgren J., Ameriso S., Andonova S., Awoniyi F. E., Bakhiet M., Barboza M., Basri H., Bath P., Bello O., Bereczki D., Beretta S., Berkowitz A., Bernabe-Ortiz A., Bernhardt J., Berzina G., Bisharyan M., Bovet P., Budincevic H., Cadilhac D., Caso V., Chen C., Chin J., Chwojnicki K., Conforto A., Cruz V. T., D'Amelio M., Danielyan K., Davis S., Demarin V., Dempsey R., Dichgans M., Dokova K., Donnan G., Elkind M. S., Endres M., Fischer U., Gankpe F., Gaye Saavedra A., Gil A., Giroud M., Gnedovskaya E., Hachinski V., Hafdi M., Hamadeh R., Hamzat T. K., Hankey G., Heldner M., Ibrahim E. A., Ibrahim N. M., Inoue M., Jee S., Jeng J. -S., Kalkonde Y., Kamenova S., Karaszewski B., Kelly P., Khan T., Kiechl S., Kondybayeva A., Korv J., Kravchenko M., Krishnamurthi R. V., Kruja J., Lakkhanaloet M., Langhorne P., Lavados P. M., Law Z. K., Lawal A., Lazo-Porras M., Lebedynets D., Lee T. -H., Leung T., Liebeskind D. S., Lindsay P., Lopez-Jaramillo P., Lotufo P. A., Machline-Carrion J., Makanjuola A., Markus H. S., Marquez-Romero J. M., Medina M., Medukhanova S., Mehndiratta M. M., Merkin A., Mirrakhimov E., Mohl S., Moscoso-Porras M., Muller-Stierlin A., Murphy S., Musa K. I., Nasreldein A., Nogueira R. G., Nolte C., Noubiap J. J., Novarro-Escudero N., Ogun Y., Oguntoye R. A., Oraby M. I., Osundina M., Ovbiagele B., Orken D. N., Ozdemir A. O., Ozturk S., Paccot M., Phromjai J., Piradov P., Platz T., Potpara T., Ranta A., Rathore F., Richard E., Sacco R. L., Sahathevan R., Santos Carquin I., Saposnik G., Sarfo F. S., Sharma M., Sheth K., Shobhana A., Suwanwela N., Svyato I., Sylaja P. N., Tao X., Thakur K. T., Toni D., Topcuoglu M. A., Torales J., Towfighi A., Truelsen T. C., Tsiskaridze A., Tulloch-Reid M., Useche N., Vanacker P., Vassilopoulou S., Vukorepa G., Vuletic V., Wahab K. W., Wang W., Wijeratne T., Wolfe C., Yifru Y. M., Yock-Corrales A., Yonemoto N., Yperzeele L., Zhang P., Owolabi, M, Thrift, A, Mahal, A, Ishida, M, Martins, S, Johnson, W, Pandian, J, Abd-Allah, F, Yaria, J, Phan, H, Roth, G, Gall, S, Beare, R, Phan, T, Mikulik, R, Akinyemi, R, Norrving, B, Brainin, M, Feigin, V, Abanto, C, Abera, S, Addissie, A, Adebayo, O, Adeleye, A, Adilbekov, Y, Adilbekova, B, Adoukonou, T, Aguiar de Sousa, D, Ajagbe, T, Akhmetzhanova, Z, Akpalu, A, Alvarez Ahlgren, J, Ameriso, S, Andonova, S, Awoniyi, F, Bakhiet, M, Barboza, M, Basri, H, Bath, P, Bello, O, Bereczki, D, Beretta, S, Berkowitz, A, Bernabe-Ortiz, A, Bernhardt, J, Berzina, G, Bisharyan, M, Bovet, P, Budincevic, H, Cadilhac, D, Caso, V, Chen, C, Chin, J, Chwojnicki, K, Conforto, A, Cruz, V, D'Amelio, M, Danielyan, K, Davis, S, Demarin, V, Dempsey, R, Dichgans, M, Dokova, K, Donnan, G, Elkind, M, Endres, M, Fischer, U, Gankpe, F, Gaye Saavedra, A, Gil, A, Giroud, M, Gnedovskaya, E, Hachinski, V, Hafdi, M, Hamadeh, R, Hamzat, T, Hankey, G, Heldner, M, Ibrahim, E, Ibrahim, N, Inoue, M, Jee, S, Jeng, J, Kalkonde, Y, Kamenova, S, Karaszewski, B, Kelly, P, Khan, T, Kiechl, S, Kondybayeva, A, Korv, J, Kravchenko, M, Krishnamurthi, R, Kruja, J, Lakkhanaloet, M, Langhorne, P, Lavados, P, Law, Z, Lawal, A, Lazo-Porras, M, Lebedynets, D, Lee, T, Leung, T, Liebeskind, D, Lindsay, P, Lopez-Jaramillo, P, Lotufo, P, Machline-Carrion, J, Makanjuola, A, Markus, H, Marquez-Romero, J, Medina, M, Medukhanova, S, Mehndiratta, M, Merkin, A, Mirrakhimov, E, Mohl, S, Moscoso-Porras, M, Muller-Stierlin, A, Murphy, S, Musa, K, Nasreldein, A, Nogueira, R, Nolte, C, Noubiap, J, Novarro-Escudero, N, Ogun, Y, Oguntoye, R, Oraby, M, Osundina, M, Ovbiagele, B, Orken, D, Ozdemir, A, Ozturk, S, Paccot, M, Phromjai, J, Piradov, P, Platz, T, Potpara, T, Ranta, A, Rathore, F, Richard, E, Sacco, R, Sahathevan, R, Santos Carquin, I, Saposnik, G, Sarfo, F, Sharma, M, Sheth, K, Shobhana, A, Suwanwela, N, Svyato, I, Sylaja, P, Tao, X, Thakur, K, Toni, D, Topcuoglu, M, Torales, J, Towfighi, A, Truelsen, T, Tsiskaridze, A, Tulloch-Reid, M, Useche, N, Vanacker, P, Vassilopoulou, S, Vukorepa, G, Vuletic, V, Wahab, K, Wang, W, Wijeratne, T, Wolfe, C, Yifru, Y, Yock-Corrales, A, Yonemoto, N, Yperzeele, L, Zhang, P, Owolabi M. O., Thrift A. G., Mahal A., Ishida M., Martins S., Johnson W. D., Pandian J., Abd-Allah F., Yaria J., Phan H. T., Roth G., Gall S. L., Beare R., Phan T. G., Mikulik R., Akinyemi R. O., Norrving B., Brainin M., Feigin V. L., Abanto C., Abera S. F., Addissie A., Adebayo O., Adeleye A. O., Adilbekov Y., Adilbekova B., Adoukonou T. A., Aguiar de Sousa D., Ajagbe T., Akhmetzhanova Z., Akpalu A., Alvarez Ahlgren J., Ameriso S., Andonova S., Awoniyi F. E., Bakhiet M., Barboza M., Basri H., Bath P., Bello O., Bereczki D., Beretta S., Berkowitz A., Bernabe-Ortiz A., Bernhardt J., Berzina G., Bisharyan M., Bovet P., Budincevic H., Cadilhac D., Caso V., Chen C., Chin J., Chwojnicki K., Conforto A., Cruz V. T., D'Amelio M., Danielyan K., Davis S., Demarin V., Dempsey R., Dichgans M., Dokova K., Donnan G., Elkind M. S., Endres M., Fischer U., Gankpe F., Gaye Saavedra A., Gil A., Giroud M., Gnedovskaya E., Hachinski V., Hafdi M., Hamadeh R., Hamzat T. K., Hankey G., Heldner M., Ibrahim E. A., Ibrahim N. M., Inoue M., Jee S., Jeng J. -S., Kalkonde Y., Kamenova S., Karaszewski B., Kelly P., Khan T., Kiechl S., Kondybayeva A., Korv J., Kravchenko M., Krishnamurthi R. V., Kruja J., Lakkhanaloet M., Langhorne P., Lavados P. M., Law Z. K., Lawal A., Lazo-Porras M., Lebedynets D., Lee T. -H., Leung T., Liebeskind D. S., Lindsay P., Lopez-Jaramillo P., Lotufo P. A., Machline-Carrion J., Makanjuola A., Markus H. S., Marquez-Romero J. M., Medina M., Medukhanova S., Mehndiratta M. M., Merkin A., Mirrakhimov E., Mohl S., Moscoso-Porras M., Muller-Stierlin A., Murphy S., Musa K. I., Nasreldein A., Nogueira R. G., Nolte C., Noubiap J. J., Novarro-Escudero N., Ogun Y., Oguntoye R. A., Oraby M. I., Osundina M., Ovbiagele B., Orken D. N., Ozdemir A. O., Ozturk S., Paccot M., Phromjai J., Piradov P., Platz T., Potpara T., Ranta A., Rathore F., Richard E., Sacco R. L., Sahathevan R., Santos Carquin I., Saposnik G., Sarfo F. S., Sharma M., Sheth K., Shobhana A., Suwanwela N., Svyato I., Sylaja P. N., Tao X., Thakur K. T., Toni D., Topcuoglu M. A., Torales J., Towfighi A., Truelsen T. C., Tsiskaridze A., Tulloch-Reid M., Useche N., Vanacker P., Vassilopoulou S., Vukorepa G., Vuletic V., Wahab K. W., Wang W., Wijeratne T., Wolfe C., Yifru Y. M., Yock-Corrales A., Yonemoto N., Yperzeele L., and Zhang P.

Abstract

Stroke is the second leading cause of death and the third leading cause of disability worldwide and its burden is increasing rapidly in low-income and middle-income countries, many of which are unable to face the challenges it imposes. In this Health Policy paper on primary stroke prevention, we provide an overview of the current situation regarding primary prevention services, estimate the cost of stroke and stroke prevention, and identify deficiencies in existing guidelines and gaps in primary prevention. We also offer a set of pragmatic solutions for implementation of primary stroke prevention, with an emphasis on the role of governments and population-wide strategies, including task-shifting and sharing and health system re-engineering. Implementation of primary stroke prevention involves patients, health professionals, funders, policy makers, implementation partners, and the entire population along the life course.

Published
2022

20. The state of stroke services across the globe: Report of World Stroke Organization–World Health Organization surveys

Author

Owolabi, M, Thrift, A, Martins, S, Johnson, W, Pandian, J, Abd-Allah, F, Varghese, C, Mahal, A, Yaria, J, Phan, H, Roth, G, Gall, S, Beare, R, Phan, T, Mikulik, R, Norrving, B, Feigin, V, on behalf of the Stroke Experts Collaboration, G, Abera, S, Addissie, A, Adeleye, A, Adilbekov, Y, Adilbekova, B, Adoukonou, T, Aguiar, D, Akhmetzhanova, Z, Akinyemi, R, Akpalu, A, Ameriso, S, Andonova, S, Abanto, C, Awoniyi, F, Bakhiet, M, Basri, H, Bath, P, Bereczki, D, Beretta, S, Berkowitz, A, Bernhardt, J, Berzina, G, Bhavsar, B, Bisharyan, M, Bovet, P, Brainin, M, Budincevic, H, Cabral, N, Cadilhac, D, Caso, V, Chen, C, Chin, J, Christensen, H, Chwojnicki, K, Conforto, A, Cruz, V, D'Amelio, M, Danielyan, K, Davis, S, Demarin, V, Dempsey, R, Dichgans, M, Dokova, Donnan, G, Duran, J, Elizondo, M, Elkind, M, Endres, M, Etedal, I, Faris, M, Fischer, U, Gankpe, F, Gavidia, M, Gaye-Saavedra, A, Giroud, M, Gongora-Rivera, F, Hachinski, V, Hacke, W, Hamadeh, R, Hamzat, T, Hankey, G, Heldner, M, Ibrahim, N, Inoue, M, Jee, S, Jiann-Shing, J, Johnston, S, Kalkonde, Y, Kamenova, S, Kelly, P, Khan, T, Kiechl, S, Kondybayeva, A, Korv, J, Kravchenko, M, Krishnamurthi, R, Langhorne, P, Kang, Z, Kruja, J, Lavados, P, Lebedynets, D, Leung, T, Liebeskind, D, Lindsay, P, Liu, L, Lopez-Jaramillo, P, Lotufo, P, Machline-Carrion, J, Markus, H, Marquez-Romero, J, Medina, M, Medukhanova, S, Mehndiratta, M, Mirrakhimov, E, Mohl, S, Murphy, S, Musa, K, Nasreldein, A, Nogueira, R, Nolte, C, Noubiap, J, Novarro-Escudero, N, O'Donnell, M, Ogun, V, Oraby, M, Ovbiagele, B, Orken, D, Ozdemir, A, Ozturk, S, Paccot, M, Peters, A, Piradov, M, Platz, T, Potpara, T, Ranta, A, Rathore, F, Sacco, R, Sahathevan, R, Santos, I, Saposnik, G, Sarfo, F, Sharma, M, Sheth, K, Shobhana, A, Silva, S, Suwanwela, N, Sylaja, P, Thakur, K, Toni, D, Topcuoglu, M, Torales, J, Towfighi, A, Truelsen, T, Tsiskaridze, A, Tsong-Hai, L, Tulloch-Reid, M, Useche, J, Vanacker, P, Vassilopoulou, S, Venketasubramanian, N, Vukorepa, G, Vuletic, V, Wahab, K, Wang, W, Wijeratne, T, Wolfe, C, Yifru, M, Yock-Corrales, A, Yonemoto, N, Yperzeele, L, Owolabi M. O., Thrift A. G., Martins S., Johnson W., Pandian J., Abd-Allah F., Varghese C., Mahal A., Yaria J., Phan H. T., Roth G., Gall S. L., Beare R., Phan T. G., Mikulik R., Norrving B., Feigin V. L., on behalf of the Stroke Experts Collaboration Group, Abera S. F., Addissie A., Adeleye A., Adilbekov Y., Adilbekova B., Adoukonou T. A., Aguiar D. S. D., Akhmetzhanova Z., Akinyemi R. O., Akpalu A., Ameriso S. F., Andonova S., Abanto C., Awoniyi F. E., Bakhiet M., Basri H., Bath P. M., Bereczki D., Beretta S., Berkowitz A. L., Bernhardt J., Berzina G., Bhavsar B., Bisharyan M. S., Bovet P., Brainin M., Budincevic H., Cabral N. L., Cadilhac D. A., Caso V., Chen C., Chin J. H., Christensen H., Chwojnicki K., Conforto A. B., Cruz V. T., D'Amelio M., Danielyan K. E., Davis S., Demarin V., Dempsey R. J., Dichgans M., Donnan G., Duran J., Elizondo M. A. B., Elkind M. S., Endres M., Etedal I., Faris M. E., Fischer U., Gankpe F., Gavidia M., Gaye-Saavedra A., Giroud M., Gongora-Rivera F., Hachinski V., Hacke W., Hamadeh R. R., Hamzat T. K., Hankey G. J., Heldner M. R., Ibrahim N. M., Inoue M., Jee S., Jiann-Shing J., Johnston S., Kalkonde Y., Kamenova S., Kelly P., Khan T., Kiechl S., Kondybayeva A., Korv J., Kravchenko M., Krishnamurthi R., Langhorne P., Kang Z. L., Kruja J., Lavados P. M., Lebedynets D., Leung T. W., Liebeskind D. S., Lindsay P., Liu L., Lopez-Jaramillo P., Lotufo P. A., Machline-Carrion J. M., Markus H. S., Marquez-Romero J. M., Medina M. T., Medukhanova S., Mehndiratta M. M., Mirrakhimov E., Mohl S., Murphy S., Musa K. I., Nasreldein A., Nogueira R., Nolte C. H., Noubiap J. J., Novarro-Escudero N., O'Donnell M., Ogun V., Oraby M. I., Ovbiagele B., Orken D. N., Ozdemir A. O., Ozturk S., Paccot M., Peters A., Piradov M., Platz T., Potpara T., Ranta A., Rathore F. A., Sacco R. L., Sahathevan R., Santos I. C., Saposnik G., Sarfo F. S., Sharma M., Sheth K. N., Shobhana A., Silva S. N., Suwanwela N., Sylaja P. N., Thakur K., Toni D., Topcuoglu M. A., Torales J., Towfighi A., Truelsen T., Tsiskaridze A., Tsong-Hai L., Tulloch-Reid M., Useche J. N., Vanacker P., Vassilopoulou S., Venketasubramanian N., Vukorepa G., Vuletic V., Wahab K. W., Wang W., Wijeratne T., Wolfe C., Yifru M. Y., Yock-Corrales A., Yonemoto N., Yperzeele L., Owolabi, M, Thrift, A, Martins, S, Johnson, W, Pandian, J, Abd-Allah, F, Varghese, C, Mahal, A, Yaria, J, Phan, H, Roth, G, Gall, S, Beare, R, Phan, T, Mikulik, R, Norrving, B, Feigin, V, on behalf of the Stroke Experts Collaboration, G, Abera, S, Addissie, A, Adeleye, A, Adilbekov, Y, Adilbekova, B, Adoukonou, T, Aguiar, D, Akhmetzhanova, Z, Akinyemi, R, Akpalu, A, Ameriso, S, Andonova, S, Abanto, C, Awoniyi, F, Bakhiet, M, Basri, H, Bath, P, Bereczki, D, Beretta, S, Berkowitz, A, Bernhardt, J, Berzina, G, Bhavsar, B, Bisharyan, M, Bovet, P, Brainin, M, Budincevic, H, Cabral, N, Cadilhac, D, Caso, V, Chen, C, Chin, J, Christensen, H, Chwojnicki, K, Conforto, A, Cruz, V, D'Amelio, M, Danielyan, K, Davis, S, Demarin, V, Dempsey, R, Dichgans, M, Dokova, Donnan, G, Duran, J, Elizondo, M, Elkind, M, Endres, M, Etedal, I, Faris, M, Fischer, U, Gankpe, F, Gavidia, M, Gaye-Saavedra, A, Giroud, M, Gongora-Rivera, F, Hachinski, V, Hacke, W, Hamadeh, R, Hamzat, T, Hankey, G, Heldner, M, Ibrahim, N, Inoue, M, Jee, S, Jiann-Shing, J, Johnston, S, Kalkonde, Y, Kamenova, S, Kelly, P, Khan, T, Kiechl, S, Kondybayeva, A, Korv, J, Kravchenko, M, Krishnamurthi, R, Langhorne, P, Kang, Z, Kruja, J, Lavados, P, Lebedynets, D, Leung, T, Liebeskind, D, Lindsay, P, Liu, L, Lopez-Jaramillo, P, Lotufo, P, Machline-Carrion, J, Markus, H, Marquez-Romero, J, Medina, M, Medukhanova, S, Mehndiratta, M, Mirrakhimov, E, Mohl, S, Murphy, S, Musa, K, Nasreldein, A, Nogueira, R, Nolte, C, Noubiap, J, Novarro-Escudero, N, O'Donnell, M, Ogun, V, Oraby, M, Ovbiagele, B, Orken, D, Ozdemir, A, Ozturk, S, Paccot, M, Peters, A, Piradov, M, Platz, T, Potpara, T, Ranta, A, Rathore, F, Sacco, R, Sahathevan, R, Santos, I, Saposnik, G, Sarfo, F, Sharma, M, Sheth, K, Shobhana, A, Silva, S, Suwanwela, N, Sylaja, P, Thakur, K, Toni, D, Topcuoglu, M, Torales, J, Towfighi, A, Truelsen, T, Tsiskaridze, A, Tsong-Hai, L, Tulloch-Reid, M, Useche, J, Vanacker, P, Vassilopoulou, S, Venketasubramanian, N, Vukorepa, G, Vuletic, V, Wahab, K, Wang, W, Wijeratne, T, Wolfe, C, Yifru, M, Yock-Corrales, A, Yonemoto, N, Yperzeele, L, Owolabi M. O., Thrift A. G., Martins S., Johnson W., Pandian J., Abd-Allah F., Varghese C., Mahal A., Yaria J., Phan H. T., Roth G., Gall S. L., Beare R., Phan T. G., Mikulik R., Norrving B., Feigin V. L., on behalf of the Stroke Experts Collaboration Group, Abera S. F., Addissie A., Adeleye A., Adilbekov Y., Adilbekova B., Adoukonou T. A., Aguiar D. S. D., Akhmetzhanova Z., Akinyemi R. O., Akpalu A., Ameriso S. F., Andonova S., Abanto C., Awoniyi F. E., Bakhiet M., Basri H., Bath P. M., Bereczki D., Beretta S., Berkowitz A. L., Bernhardt J., Berzina G., Bhavsar B., Bisharyan M. S., Bovet P., Brainin M., Budincevic H., Cabral N. L., Cadilhac D. A., Caso V., Chen C., Chin J. H., Christensen H., Chwojnicki K., Conforto A. B., Cruz V. T., D'Amelio M., Danielyan K. E., Davis S., Demarin V., Dempsey R. J., Dichgans M., Donnan G., Duran J., Elizondo M. A. B., Elkind M. S., Endres M., Etedal I., Faris M. E., Fischer U., Gankpe F., Gavidia M., Gaye-Saavedra A., Giroud M., Gongora-Rivera F., Hachinski V., Hacke W., Hamadeh R. R., Hamzat T. K., Hankey G. J., Heldner M. R., Ibrahim N. M., Inoue M., Jee S., Jiann-Shing J., Johnston S., Kalkonde Y., Kamenova S., Kelly P., Khan T., Kiechl S., Kondybayeva A., Korv J., Kravchenko M., Krishnamurthi R., Langhorne P., Kang Z. L., Kruja J., Lavados P. M., Lebedynets D., Leung T. W., Liebeskind D. S., Lindsay P., Liu L., Lopez-Jaramillo P., Lotufo P. A., Machline-Carrion J. M., Markus H. S., Marquez-Romero J. M., Medina M. T., Medukhanova S., Mehndiratta M. M., Mirrakhimov E., Mohl S., Murphy S., Musa K. I., Nasreldein A., Nogueira R., Nolte C. H., Noubiap J. J., Novarro-Escudero N., O'Donnell M., Ogun V., Oraby M. I., Ovbiagele B., Orken D. N., Ozdemir A. O., Ozturk S., Paccot M., Peters A., Piradov M., Platz T., Potpara T., Ranta A., Rathore F. A., Sacco R. L., Sahathevan R., Santos I. C., Saposnik G., Sarfo F. S., Sharma M., Sheth K. N., Shobhana A., Silva S. N., Suwanwela N., Sylaja P. N., Thakur K., Toni D., Topcuoglu M. A., Torales J., Towfighi A., Truelsen T., Tsiskaridze A., Tsong-Hai L., Tulloch-Reid M., Useche J. N., Vanacker P., Vassilopoulou S., Venketasubramanian N., Vukorepa G., Vuletic V., Wahab K. W., Wang W., Wijeratne T., Wolfe C., Yifru M. Y., Yock-Corrales A., Yonemoto N., and Yperzeele L.

Abstract

Background: Improving stroke services is critical for reducing the global stroke burden. The World Stroke Organization–World Health Organization–Lancet Neurology Commission on Stroke conducted a survey of the status of stroke services in low and middle-income countries (LMICs) compared to high-income countries. Methods: Using a validated World Stroke Organization comprehensive questionnaire, we collected and compared data on stroke services along four pillars of the stroke quadrangle (surveillance, prevention, acute stroke, and rehabilitation) in 84 countries across World Health Organization regions and economic strata. The World Health Organization also conducted a survey of non-communicable diseases in 194 countries in 2019. Results: Fewer surveillance activities (including presence of registries, presence of recent risk factors surveys, and participation in research) were reported in low-income countries than high-income countries. The overall global score for prevention was 40.2%. Stroke units were present in 91% of high-income countries in contrast to 18% of low-income countries (p < 0.001). Acute stroke treatments were offered in ∼ 60% of high-income countries compared to 26% of low-income countries (p = 0.009). Compared to high-income countries, LMICs provided less rehabilitation services including in-patient rehabilitation, home assessment, community rehabilitation, education, early hospital discharge program, and presence of rehabilitation protocol. Conclusions: There is an urgent need to improve access to stroke units and services globally especially in LMICs. Countries with less stroke services can adapt strategies from those with better services. This could include establishment of a framework for regular monitoring of stroke burden and services, implementation of integrated prevention activities and essential acute stroke care services, and provision of interdisciplinary care for stroke rehabilitation.

Published
2021

28. Direct-synthesis of AgxCu100-x bimetallic nanoparticles on p-Si supports for the photoelectrochemical reduction of CO2

Author

Chaliyawala, Harsh, Bastide, Stéphane, Muller-Bouvet, D., Bourouina, T., Marty, Frédéric, Rezgui, Abir, Le Gall, S., Torralba, E., Institut de Chimie et des Matériaux Paris-Est (ICMPE), Institut de Chimie du CNRS (INC)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Centre National de la Recherche Scientifique (CNRS), and Torralba, Encarnacion

Subjects
[CHIM.MATE] Chemical Sciences/Material chemistry, [CHIM] Chemical Sciences, [CHIM]Chemical Sciences, [CHIM.MATE]Chemical Sciences/Material chemistry
Abstract

International audience

Published
2022

34. The state of stroke services across the globe: Report of World Stroke Organization–World Health Organization surveys

Author

Thrift A. G., Martins S., Johnson W., Pandian J., Abd-Allah F., Varghese C., Mahal A., Yaria J., Phan H. T., Roth G., Gall S. L., Beare R., Phan T. G., Mikulik R., Norrving B., Feigin V. Abera S. F., Addissie A., Adeleye A., Adilbekov Y., Adilbekova B., Adoukonou T. A. Aguiar de Sousa D., Akhmetzhanova Z., Akinyemi R. O., Akpalu A. MB. ChB, Ameriso S. F., Andonova S., Abanto C., Awoniyi F. E., Bakhiet M., Basri H., Bath P. M., Bereczki D., Beretta S., Berkowitz A. L., Bernhardt J., Berzina G., Bhavsar B., Bisharyan M. S., Bovet P., Brainin M., Budincevic H., Cabral N. L., Cadilhac D A. , Caso V., Chen C., Chin J. H., Christensen H, Chwojnicki K., Conforto A. B., Cruz V. T., D'Amelio M., Danielyan K. E., Davis S., Demarin V, Dempsey R. J., Dichgans M., Dokova Donnan, G. Duran, Elizondo M. A. B., Elkind M. S., Endres M., Etedal I., Faris M. E., Fischer U., Gankpe F., Gavidia M., GayeSaavedra A., Giroud M., Gongora-Rivera F., Hachinski V., Hacke W., Hamadeh R. R., Hamzat T. K., Hankey G. J., Heldner M. R., Ibrahim N. M., Inoue M., Jee S., Jiann-Shing J., Johnston S. C., Kalkonde Y., Kamenova S., Kelly P., Khan T., Kiechl S., Kondybayeva A., Kõrv J., Kravchenko M., Krishnamurthi R., Langhorne P., Kang Z. L., Kruja J., Lavados P. M., Lebedynets D., Leung T. W., Liebeskind D. S., Lindsay P., Liu L., López-Jaramillo P., Lotufo P. A., Machline-Carrion J. M., Markus H. S., Marquez-Romero J. M., Medina M. T., Medukhanova S., Mehndiratta M. M., Mirrakhimov E., Mohl S., Murphy S., Musa K. I., Nasreldein A, Nogueira R., Nolte C. H., Noubiap J. J., Novarro-Escudero N., O'Donnell M., Ogun Y., Oraby M. I., Ovbiagele B., Ōrken D. N., Ōzdemir A. O., Ozturk S., Paccot M., Peters A., Piradov M., Platz T., Potpara T., Ranta A., Rathore F. A., Sacco R. L., Sahathevan R., Santos I. C., Saposnik G., Sarfo F. S., Sharma M., Sheth K. N., Shobhana A., Silva S. N., Suwanwela N. C., Sylaja P. N., Thakur K., Toni D., Topcuoglu M. A., Torales J., Towfighi A., Truelsen T., Tsiskaridze A., Tsong-Hai L., Tulloch-Reid M., Useche J. N., Vanacker P., Vassilopoulou S., Venketasubramanian N., Vukorepa G., Vuletic V., Wahab K. W., Wang W., Wijeratne T., Wolfe C, Yifru M. Y., YockCorrales A., Yonemoto N., Yperzeele L., Owolabi, MO, Thrift, AG, Martins, S, Johnson, W, Pandian, J, Abd-Allah, F, Varghese, C, Mahal, A, Yaria, J, Phan, HT, Roth, G, Gall, SL, Beare, R, Phan, TG, D'Amelio M, Mikulik, R, Norrving, B, Feigin, VL, and Thrift A. G., Martins S., Johnson W., Pandian J., Abd-Allah F., Varghese C., Mahal A., Yaria J., Phan H. T., Roth G., Gall S. L., Beare R., Phan T. G., Mikulik R., Norrving B., Feigin V. Abera S.F., Addissie A., Adeleye A., Adilbekov Y., Adilbekova B., Adoukonou T.A. Aguiar de Sousa D., Akhmetzhanova Z., Akinyemi R.O., Akpalu A. MB. ChB , Ameriso S.F. , Andonova S., Abanto C., Awoniyi F.E., Bakhiet M., Basri H., Bath, P.M., Bereczki D., Beretta S., Berkowitz A.L., Bernhardt J., Berzina G., Bhavsar B., Bisharyan M.S., Bovet P., Brainin, M., Budincevic H., Cabral N.L., , Cadilhac D A. , Caso V., , Chen C., Chin J.H. , Christensen H, , Di, Chwojnicki K., Conforto A.B., Cruz V.T., D'Amelio M., Danielyan K.E., Davis, S., Demarin V, Dempsey R.J., Dichgans M., Dokova, Donnan, G., Duran, J., Elizondo M.A.B., Elkind M.S., Endres M., Etedal I., Faris M.E., Fischer U., Gankpe F., Gavidia M., GayeSaavedra A., Giroud M., Gongora-Rivera F., Hachinski V. , Hacke, W., Hamadeh R.R., Hamzat T.K., Hankey G.J., Heldner M.R., Ibrahim, N.M., Inoue M., Jee S., Jiann-Shing J., Johnston S. C., Kalkonde Y., Kamenova S., Kelly P., Khan T., Kiechl S., Kondybayeva A., Kõrv J., Kravchenko M., Krishnamurthi R., Langhorne, P., Kang Z.L., Kruja, J., Lavados P.M., Lebedynets D., Leung T.W., Liebeskind D.S., Lindsay P., Liu, L., López-Jaramillo P., Lotufo P.A., Machline-Carrion J.M., Markus, H.S., Marquez-Romero J.M., Medina M.T., Medukhanova S., Mehndiratta M.M., Mirrakhimov E., Mohl S., Murphy S., Musa K.I., Nasreldein A, Nogueira R., Nolte C.H., Norrving B., Noubiap J.J., Novarro-Escudero N., O'Donnell M., Ogun Y., Oraby M.I., Ovbiagele B., Ōrken D.N., Ōzdemir A.O., Ozturk S., Paccot M., Peters A., Piradov, M., Platz T., Potpara T., Ranta A., Rathore F.A., Roth G., Sacco R.L., Sahathevan R., Santos I.C., Saposnik G., Sarfo F.S., Sharma M., Sheth K.N., Shobhana A., Silva, S.N., Suwanwela N. C., Sylaja P.N., Thakur K., Toni D., Topcuoglu M.A., Torales J., Towfighi A., Truelsen, T., Tsiskaridze A., Tsong-Hai L., Tulloch-Reid M., Useche J.N., Vanacker P., Vassilopoulou S., Venketasubramanian N., Vukorepa G., Vuletic V., Wahab K.W., Wang W., Wijeratne T., Wolfe C, Yifru M.Y., YockCorrales A., Yonemoto N., Yperzeele L.

Subjects
Gerontology, medicine.medical_specialty, medicine.medical_treatment, media_common.quotation_subject, Globe, Commission, stroke quadrangle, Global Health, World Health Organization, World health, Article, Stroke service, rehabilitation, low and middle-income countrie, 03 medical and health sciences, 0302 clinical medicine, State (polity), prevention, Acute care, Surveys and Questionnaires, medicine, Humans, 030212 general & internal medicine, high-income countrie, Stroke, Developing Countries, media_common, Stroke services, Rehabilitation, business.industry, Stroke Rehabilitation, medicine.disease, 3. Good health, medicine.anatomical_structure, Neurology, low- and middle-income countrie, Settore MED/26 - Neurologia, acute care, business, 030217 neurology & neurosurgery
Abstract

Background Improving stroke services is critical for reducing the global stroke burden. The World Stroke Organization–World Health Organization– Lancet Neurology Commission on Stroke conducted a survey of the status of stroke services in low and middle-income countries (LMICs) compared to high-income countries. Methods Using a validated World Stroke Organization comprehensive questionnaire, we collected and compared data on stroke services along four pillars of the stroke quadrangle (surveillance, prevention, acute stroke, and rehabilitation) in 84 countries across World Health Organization regions and economic strata. The World Health Organization also conducted a survey of non-communicable diseases in 194 countries in 2019. Results Fewer surveillance activities (including presence of registries, presence of recent risk factors surveys, and participation in research) were reported in low-income countries than high-income countries. The overall global score for prevention was 40.2%. Stroke units were present in 91% of high-income countries in contrast to 18% of low-income countries (p Conclusions There is an urgent need to improve access to stroke units and services globally especially in LMICs. Countries with less stroke services can adapt strategies from those with better services. This could include establishment of a framework for regular monitoring of stroke burden and services, implementation of integrated prevention activities and essential acute stroke care services, and provision of interdisciplinary care for stroke rehabilitation.

Published
2021

35. Facilitators to more timely treatment following aneurysmal subarachnoid hemorrhage in southeast australia: results from an embedded mixed-methods study.

Author

Nguyen T., Stirling C., Jose K., Nichols L., Chandra R., Rehman S., Buscot M.-J., Smith K., Blizzard L., Lai L., Asadi H., Dubey A., Froelich J., Thani N., Reeves M., Thrift A., Gall S., Nguyen T., Stirling C., Jose K., Nichols L., Chandra R., Rehman S., Buscot M.-J., Smith K., Blizzard L., Lai L., Asadi H., Dubey A., Froelich J., Thani N., Reeves M., Thrift A., and Gall S.

Abstract

Background: We explored facilitators of more timely treatment following aneurysmal subarachnoid haemorrhage (aSAH) to help inform interventions to reduce treatment delays. Method(s): Embedded mixed-methods design was used. Data of first-ever aSAH cases at two Australian tertiary hospitals during 2010-2016 were extracted from medical records, including time from onset to treatment, demographics, severity of aSAH (mFisher grade; WFNS), risk factors, pre-hospital care, and presenting symptoms. Facilitators identified using univariable linear regression analysis were entered into a multivariable model including purposefully selected confounders to determine factors independently associated with more timely treatment. Interviews and workshops with key informants were used to obtain clinical perspective on facilitators. Result(s): Among 482 patients (mean[SD] age 54.1[14.5] years; 69.9% female) with aSAH, median (IQR) time-to-treatment was 19.4 (10.6, 31.0) hours, with 30% treated <=12.5h, 32% treated 12.5-24h and 38% treated >24h from onset. There was agreement between facilitators identified via quantitative and qualitative analysis (Figure 1). Predictors of quicker treatment (top panel-Figure 1) from quantitative analysis included: younger age, female, closer to treating hospital, patients presenting with stroke-like symptoms compared to non-specific symptoms; arriving at the ED by ambulance compared to private car; triaged in category 2 compared to category 1, more severe aSAH (mFisher grade 2-3 and 4 compared to mFisher grade 0-1), and not having DSA. Facilitators to more timely treatment from qualitative analysis (9 interviews, 2 workshops [22 participants]) fell into five themes: demographics, symptoms, presentations, severity, and investigations (bottom panel-Figure 1), which covered all quantitative predictors. Conclusion(s): Demographic predictors and severity of aSAH are non-modifiable while other facilitators are potentially modifiable. Challenges remain for t

Published
2022

36. Predictors of optimal treatment time following aneurysmal subarachnoid hemorrhage across two tertiary referral centers in Australia.

Author

Nguyen T., Stirling C., Nichols L., Chandra R., Rehman S., Buscot M.-J., Smith K., Blizzard L., Lai L., Asadi H., Dubey A., Froelich J., Thani N., Reeves M., Thrift A., Gall S., Nguyen T., Stirling C., Nichols L., Chandra R., Rehman S., Buscot M.-J., Smith K., Blizzard L., Lai L., Asadi H., Dubey A., Froelich J., Thani N., Reeves M., Thrift A., and Gall S.

Abstract

Background and aims: We explored predictors of very early (<=12.5h) and early (12.5-24h) treatment compared to late (>24h) treatment following aneurysmal subarachnoid haemorrhage (aSAH) in order to inform interventions to reduce treatment delays. Method(s): Confirmed first-ever aSAH cases were identified from two Australian tertiary referral centers during 2010-2016. We used medical and ambulance records to extract details of participants, including time from onset to either endovascular coiling or neurosurgical clipping, demographics, severity of aSAH (mFisher grade; WFNS), risk factors, pre-hospital care, and presenting symptoms. Factors associated with treatment <=12.5h or 12.5-24h compared to >24h on univariable multinomial regression were entered into a multivariable model including purposefully selected confounders to identify factors independently associated with time to treatment. Result(s): Among 482 patients (mean [SD] age 54.1 [14.5] years; 69.9% female) with aSAH, median (IQR) time to treatment was 19.4 (10.6, 31.0) hours with 30% treated <=12.5h, 32% treated 12.5-24h and 38% treated >24h from onset. In multivariable analyses (Table 1), arriving by ambulance and presenting with stroke-like symptoms predicted treatment <=12.5h and 12.5-24h. More extensive aSAH on CT imaging (mFisher grade 2-3) predicted treatment <=12.5h. In contrast, people living further away from treating hospital and having diagnostic cerebral angiography more often had treatment >24h from onset. Conclusion(s): A substantial proportion of people after aSAH were not treated within timeframes associated with better outcomes. Presentation with stroke-like symptoms and ambulance arrival were associated with more timely treatment. Interventions to improve community awareness and recognition of aSAH may reduce delay to treatment. (Table Presented).

Published
2022

37. Association of Onset-to-Treatment Time with Discharge Destination, Mortality, and Complications among Patients with Aneurysmal Subarachnoid Hemorrhage

Author

Buscot, MJ, Chandra, RV, Mainguard, J, Nichols, L, Blizzard, L, Stirling, C, Smith, K, Lai, L, Asadi, Hamed, Froelich, J, Reeves, MJ, Thani, N, Thrift, A, Gall, S, Buscot, MJ, Chandra, RV, Mainguard, J, Nichols, L, Blizzard, L, Stirling, C, Smith, K, Lai, L, Asadi, Hamed, Froelich, J, Reeves, MJ, Thani, N, Thrift, A, and Gall, S

Abstract

Importance: Rapid access to specialized care is recommended to improve outcomes after aneurysmal subarachnoid hemorrhage (SAH), but understanding of the optimal onset-to-treatment time for aneurysmal SAH is limited. Objective: To assess the optimal onset-to-treatment time for aneurysmal SAH that maximized patient outcomes after surgery. Design, Setting, and Participants: This cohort study assessed 575 retrospectively identified cases of first-ever aneurysmal SAH occurring within the referral networks of 2 major tertiary Australian hospitals from January 1, 2010, to December 31, 2016. Individual factors, prehospital factors, and hospital factors were extracted from the digital medical records of eligible cases. Data analysis was performed from March 1, 2020, to August 31, 2021. Exposures: Main exposure was onset-to-treatment time (time between symptom onset and aneurysm surgical treatment in hours) derived from medical records. Main Outcomes and Measures: Clinical characteristics, complications, and discharge destination were extracted from medical records and 12-month survival obtained from data linkage. The associations of onset-to-treatment time (in hours) with (1) discharge destination of survivors (home vs rehabilitation), (2) 12-month survival, and (3) neurologic complications (rebleed, delayed cerebral ischemia, meningitis, seizure, hydrocephalus, and delayed cerebral injury) were investigated using natural cubic splines in multivariable Cox proportional hazards and logistic regression models. Results: Of the 575 patients with aneurysmal SAH, 482 patients (mean [SD] age, 55.0 [14.5] years; 337 [69.9%] female) who received endovascular coiling or neurosurgical clipping were studied. A nonlinear association of treatment delay was found with the odds of being discharged home vs rehabilitation (effective df = 3.83 in the generalized additive model, χ2test P =.002 for the 4-df cubic spline), with a similar nonlinear association remaining significant after adjus

Published
2022

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