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Acute-Phase Fatigue Predicts Limitations with Activities of Daily Living 18 Months after First-Ever Stroke.

https://arctichealth.org/en/permalink/ahliterature283199
Source
J Stroke Cerebrovasc Dis. 2017 Mar;26(3):523-531
Publication Type
Article
Date
Mar-2017
Author
Anners Lerdal
Caryl L Gay
Source
J Stroke Cerebrovasc Dis. 2017 Mar;26(3):523-531
Date
Mar-2017
Language
English
Publication Type
Article
Keywords
Activities of Daily Living - psychology
Acute Disease
Adult
Aged
Aged, 80 and over
Fatigue - epidemiology - etiology
Female
Humans
Male
Middle Aged
Norway - epidemiology
Predictive value of tests
Retrospective Studies
Severity of Illness Index
Statistics as Topic
Stroke - complications - epidemiology - psychology
Stroke rehabilitation
Abstract
Fatigue during the acute phase following stroke has been shown to predict long-term physical health, specifically increased bodily pain and poorer self-rated general health. The aim of this analysis was to determine whether acute-phase fatigue also predicts patients' limitations in activities of daily living (ADL) 18 months after the first stroke.
Patients with first-ever stroke (N?=?88) were recruited upon admission at 2 hospitals in Norway. Patients were assessed within 2 weeks following admission and at 18 months using the Barthel Index of Activities of Daily Living (BI), Fatigue Severity Scale, and Beck Depression Inventory II. The relationship between acute-phase fatigue and later activity limitations (BI?
PubMed ID
28040378 View in PubMed
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Assessment of periodontal conditions and systemic disease in older subjects. II. Focus on cardiovascular diseases.

https://arctichealth.org/en/permalink/ahliterature187843
Source
J Clin Periodontol. 2002 Sep;29(9):803-10
Publication Type
Article
Date
Sep-2002
Author
R E Persson
L G Hollender
V L Powell
M. MacEntee
C C L Wyatt
H A Kiyak
G R Persson
Author Affiliation
Department of Oral Medicine, University of Washington, Seattle, WA, USA. rper@u.washington.edu
Source
J Clin Periodontol. 2002 Sep;29(9):803-10
Date
Sep-2002
Language
English
Publication Type
Article
Keywords
Aged
Alveolar Bone Loss - complications - epidemiology - radiography
British Columbia - epidemiology
Calcinosis - radiography
Carotid Artery Diseases - complications - epidemiology - radiography
Carotid Artery, Internal - radiography
Chi-Square Distribution
Ethnic Groups
Female
Geriatric Assessment
Humans
Linear Models
Male
Medical History Taking
Middle Aged
Myocardial Infarction - complications - epidemiology
Odds Ratio
Periodontitis - complications - epidemiology - radiography
Prevalence
Radiography, Panoramic
Statistics, nonparametric
Stroke - complications - epidemiology
Washington - epidemiology
Abstract
Panoramic radiographs (PMX)s may provide information about systemic health conditions.
i). To study clinical periodontal conditions and collect self-reported health status in a cohort of 1084 older subjects; ii). to study signs of alveolar bone loss and carotid calcification from panoramic radiographs obtained from these subjects; and iii). to study associations between study parameters.
PMXs from 1064 adults aged 60-75 (mean age 67.6, SD +/- 4.7) were studied. Signs of alveolar bone loss, vertical defects, and molar furcation radiolucencies defined periodontal status. Medical health histories were obtained via self-reports. Signs of carotid calcification were identified from panoramic radiographs.
The PMX allowed assessment of 53% of the films (Seattle 64.5% and Vancouver 48.4%). A self-reported history of a stroke was reported by 8.1% of men in Seattle and 2.9% of men in Vancouver (P
PubMed ID
12423292 View in PubMed
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Atrial fibrillation, stroke risk, and warfarin therapy revisited: a population-based study.

https://arctichealth.org/en/permalink/ahliterature107741
Source
Stroke. 2013 Nov;44(11):3103-8
Publication Type
Article
Date
Nov-2013
Author
Staffan Björck
Bo Palaszewski
Leif Friberg
Lennart Bergfeldt
Author Affiliation
From the Department of Health Care Evaluation, Regionens Hus, Gothenburg, Sweden (S.B., B.P.); Department of Cardiology, Danderyd Hospital, Karolinska Institute, Stockholm, Sweden (L.F.); and Department of Molecular and Clinical Medicine/Cardiology, Sahlgrenska Academy, University of Gothenburg, Sweden (L.B.).
Source
Stroke. 2013 Nov;44(11):3103-8
Date
Nov-2013
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Anticoagulants - adverse effects - therapeutic use
Atrial Fibrillation - complications - epidemiology
Cohort Studies
Female
Humans
Hypertension - complications - epidemiology
Male
Middle Aged
Odds Ratio
Prevalence
Registries
Regression Analysis
Risk factors
Stroke - complications - epidemiology
Sweden - epidemiology
Warfarin - adverse effects - therapeutic use
Abstract
Atrial fibrillation (AF) is a major risk factor for ischemic stroke. This study aims to update the knowledge about AF and associated stroke risk and benefits of anticoagulation.
We extracted data from the hospital, specialized outpatient, and primary healthcare and drug registries in a Swedish region with 1.56 million residents. We identified all individuals who had received an AF diagnosis during the previous 5 years; all stroke events during 2010; and patients with AF aged =50 years who had received warfarin during 2009.
AF had been diagnosed in 38 446 subjects who were alive at the beginning of 2010 (prevalence of 3.2% in the adult [=20 years] population); ˜46% received warfarin therapy. In 2010, there were 4565 ischemic stroke events and 861 intracranial hemorrhages. AF had been diagnosed in 38% of ischemic events (=50% among those aged =80 years) and in 23% of intracranial hemorrhages. An AF diagnosis was often lacking in hospital discharge records after stroke events. Warfarin therapy was associated with an odds ratio of 0.50 (confidence interval, 0.43-0.57) for ischemic stroke and, despite an increased risk of intracranial hemorrhage, an odds ratio of 0.57 (confidence interval, 0.50-0.64) for the overall risk for stroke.
AF is more common than present guidelines suggest. The attributable risk of AF for ischemic stroke increases with age and is close to that of hypertension in individuals aged =80 years. Because a majority of patients with AF with increased risk for stroke had not received anticoagulation therapy, there is a large potential for improvement.
PubMed ID
23982711 View in PubMed
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Cancer, other comorbidity, and risk of venous thromboembolism after stroke: a population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature281880
Source
Thromb Res. 2016 Nov;147:88-93
Publication Type
Article
Date
Nov-2016
Author
Priscila Corraini
Anne Gulbech Ording
Victor W Henderson
Szimonetta Szépligeti
Erzsébet Horváth-Puhó
Henrik Toft Sørensen
Source
Thromb Res. 2016 Nov;147:88-93
Date
Nov-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Cohort Studies
Comorbidity
Denmark - epidemiology
Female
Humans
Male
Middle Aged
Neoplasms - complications - epidemiology
Risk factors
Stroke - complications - epidemiology
Venous Thromboembolism - epidemiology
Young Adult
Abstract
The impact of cancer and other comorbidity on the risk of venous thromboembolism (VTE) after stroke is poorly understood.
We used Danish population-based national databases to conduct a cohort study encompassing 201,025 patients diagnosed with a first-time ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage or unspecified stroke between 1995 and 2012. As a comparison cohort, 983,222 members of the general population were matched to the stroke patients by date of diagnosis, year of birth, sex, and specific comorbidities, using conditions in the Charlson Comorbidity Index and other VTE risk factors. We computed VTE cumulative risks, rates, and rate ratios. We examined the interaction with comorbidity, defined as the excess VTE rates not explained by stroke and comorbidity alone, for up to five years following stroke.
Five-year VTE risks were 2.1% and 1.9% in the stroke and comparison cohorts, respectively. Three-month VTE rates peaked at a 5-fold increase (95% confidence interval [CI]: 4.4; 5.2) in stroke patients and remained 13% to 43% increased relative to the general population during subsequent follow-up. During the first three months after stroke, 15% to 33% of the VTE rates were attributable to the interaction between stroke and moderate (2-3) to high (=4) comorbidity based on Charlson Comorbidity Index scores. Non-metastatic solid tumors and metastatic disease accounted for most observed interaction with stroke, representing 41% and 56% of attributable three-month VTE rates, respectively. No such interaction between comorbidity and stroke was observed during subsequent follow-up.
Comorbidity, particularly cancer, increased the risk of VTE within three months following stroke.
PubMed ID
27710857 View in PubMed
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Cardiovascular events after ischemic stroke in young adults: A prospective follow-up study.

https://arctichealth.org/en/permalink/ahliterature282329
Source
Neurology. 2016 May 17;86(20):1872-9
Publication Type
Article
Date
May-17-2016
Author
Karoliina Aarnio
Bob Siegerink
Jani Pirinen
Juha Sinisalo
Mika Lehto
Elena Haapaniemi
Alexander-Heinrich Nave
Markku Kaste
Turgut Tatlisumak
Jukka Putaala
Source
Neurology. 2016 May 17;86(20):1872-9
Date
May-17-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Brain Ischemia - complications - epidemiology
Cardiovascular Diseases - epidemiology - etiology
Female
Finland - epidemiology
Follow-Up Studies
Humans
Incidence
Kaplan-Meier Estimate
Male
Middle Aged
Proportional Hazards Models
Prospective Studies
Recurrence
Registries
Risk
Stroke - complications - epidemiology
Young Adult
Abstract
To study the long-term risk of recurrent cardiac, arterial, and venous events in young stroke patients, and whether these risks differed between etiologic subgroups.
The study population comprised 970 patients aged 15-49 years from the Helsinki Young Stroke Registry (HYSR) who had an ischemic stroke in 1994-2007. We obtained follow-up data until 2012 from the Finnish Care Register and Statistics Finland. Cumulative 15-year risks were analyzed with life tables, whereas relative risks and corresponding confidence intervals (CI) were based on hazard ratios (HR) from Cox regression analyses.
There were 283 (29.2%) patients with a cardiovascular event during the median follow-up of 10.1 years (range 0.1-18.0). Cumulative 15-year risk for venous events was 3.9%. Cumulative 15-year incidence rate for composite vascular events was 34.0 (95% CI 30.1-38.2) per 1,000 person-years. When adjusted for age and sex, patients with an index stroke caused by high-risk sources of cardioembolism had the highest HR for any subsequent cardiovascular events (3.7; 95% CI 2.6-5.4), whereas the large-artery atherosclerosis group had the highest HR (2.7; 95% CI 1.6-4.6) for recurrent stroke compared with patients with stroke of undetermined etiology.
The risk for future cardiovascular events after ischemic stroke in young adults remains high for years after the index stroke, in particular when the index stroke is caused by high-risk sources of cardioembolism or large-artery atherosclerosis.
PubMed ID
27164672 View in PubMed
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Cardiovascular risk in patients with sleep apnoea with or without continuous positive airway pressure therapy: follow-up of 4.5 million Danish adults.

https://arctichealth.org/en/permalink/ahliterature259837
Source
J Intern Med. 2014 Dec;276(6):659-66
Publication Type
Article
Date
Dec-2014
Author
M. Lamberts
O W Nielsen
G Y H Lip
M H Ruwald
C B Christiansen
S L Kristensen
C. Torp-Pedersen
M L Hansen
G H Gislason
Source
J Intern Med. 2014 Dec;276(6):659-66
Date
Dec-2014
Language
English
Publication Type
Article
Keywords
Age Factors
Brain Ischemia - complications - epidemiology
Comorbidity
Continuous Positive Airway Pressure
Denmark - epidemiology
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Myocardial Infarction - complications - epidemiology
Poisson Distribution
Risk factors
Sleep Apnea Syndromes - complications - epidemiology - therapy
Stroke - complications - epidemiology
Abstract
The prognostic significance of age and continuous positive airway pressure (CPAP) therapy on cardiovascular disease in patients with sleep apnoea has not been assessed previously.
Using nationwide databases, the entire Danish population was followed from 2000 until 2011. First-time sleep apnoea diagnoses and use of CPAP therapy were determined. Incidence rate ratios (IRRs) of ischaemic stroke and myocardial infarction (MI) were analysed using Poisson regression models.
Amongst 4.5 million individuals included in the study, 33 274 developed sleep apnoea (mean age 53, 79% men) of whom 44% received persistent CPAP therapy. Median time to initiation of CPAP therapy was 88 days (interquartile range 34-346). Patients with sleep apnoea had more comorbidities compared to the general population. Crude rates of MI and ischaemic stroke were increased for sleep apnoea patients (5.4 and 3.6 events per 1000 person-years compared to 4.0 and 3.0 in the general population, respectively). Relative to the general population, risk of MI [IRR 1.71, 95% confidence interval (CI) 1.57-1.86] and ischaemic stroke (IRR 1.50, 95% CI 1.35-1.66) was significantly increased in patients with sleep apnoea, in particular in patients younger than 50 years (IRR 2.12, 95% CI 1.64-2.74 and IRR 2.34, 95% CI 1.77-3.10, respectively). Subsequent CPAP therapy was not associated with altered prognosis.
Sleep apnoea is associated with increased risk of ischaemic stroke and MI, particularly in patients younger than 50 years of age. CPAP therapy was not associated with a reduced rate of stroke or MI.
Notes
Comment In: J Intern Med. 2014 Dec;276(6):648-5025169029
PubMed ID
25169419 View in PubMed
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Clinical depression, antidepressant use and risk of future cardiovascular disease.

https://arctichealth.org/en/permalink/ahliterature112411
Source
Eur J Epidemiol. 2013 Jul;28(7):589-95
Publication Type
Article
Date
Jul-2013
Author
Iffat Rahman
Keith Humphreys
Anna Michaela Bennet
Erik Ingelsson
Nancy Lee Pedersen
Patrik Karl Erik Magnusson
Author Affiliation
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, 17177, Stockholm, Sweden. Iffat.Rahman@ki.se
Source
Eur J Epidemiol. 2013 Jul;28(7):589-95
Date
Jul-2013
Language
English
Publication Type
Article
Keywords
Aged
Antidepressive Agents - adverse effects - therapeutic use
Cardiovascular Diseases - epidemiology - etiology
Coronary Disease - epidemiology - etiology
Depression - diagnosis - drug therapy - epidemiology
Female
Humans
Interviews as Topic
Male
Middle Aged
Morbidity - trends
Mortality - trends
Prospective Studies
Questionnaires
Registries
Risk factors
Socioeconomic Factors
Stroke - complications - epidemiology - etiology
Sweden - epidemiology
Abstract
Many studies have shown that depression contributes to a higher risk of developing cardiovascular disease (CVD). Use of antidepressants and its association with CVD development has also been investigated previously but the results have been conflicting. Further, depression and use of antidepressants have been more widely studied in relation to coronary heart disease rather than stroke. A population-based cohort study consisting of 36,654 Swedish elderly twins was conducted with a follow-up of maximum 4 years. Information on exposures, outcomes and covariates were collected from the Swedish national patient registers, the Swedish prescribed drug registry and the Swedish twin registry. Depression and antidepressant use were both associated with CVD development. The risk was most pronounced among depressed patients who did not use antidepressants (HR 1. 48, CI 1.10-2.00). When assessing the two main CVD outcomes coronary heart disease and ischemic stroke separately, the predominant association was found for ischemic stroke while it was absent for coronary heart disease. The association between depression and stroke also remained significant when restricting to depression diagnoses occurring at least 10 years before baseline. The study supports that depression is a possible risk factor for development of CVD. Moreover, the hazard rate for CVD outcomes was highest among depressed patients who had not used antidepressants. The association with clinical depression is more marked in relation to stroke and disappears in relation to development of coronary heart disease.
PubMed ID
23836399 View in PubMed
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Combined effects of socioeconomic position, smoking, and hypertension on risk of ischemic and hemorrhagic stroke.

https://arctichealth.org/en/permalink/ahliterature258771
Source
Stroke. 2014 Sep;45(9):2582-7
Publication Type
Article
Date
Sep-2014
Author
Helene Nordahl
Merete Osler
Birgitte Lidegaard Frederiksen
Ingelise Andersen
Eva Prescott
Kim Overvad
Finn Diderichsen
Naja Hulvej Rod
Source
Stroke. 2014 Sep;45(9):2582-7
Date
Sep-2014
Language
English
Publication Type
Article
Keywords
Adult
Aged
Blood pressure
Brain Ischemia - complications - epidemiology
Cohort Studies
Denmark
Female
Humans
Hypertension - complications - epidemiology - physiopathology
Incidence
Intracranial Hemorrhages - complications - epidemiology
Male
Middle Aged
Proportional Hazards Models
Risk factors
Smoking - adverse effects - epidemiology
Social Class
Stroke - complications - epidemiology
Abstract
Combined effects of socioeconomic position and well-established risk factors on stroke incidence have not been formally investigated.
In a pooled cohort study of 68 643 men and women aged 30 to 70 years in Denmark, we examined the combined effect and interaction between socioeconomic position (ie, education), smoking, and hypertension on ischemic and hemorrhagic stroke incidence by the use of the additive hazards model.
During 14 years of follow-up, 3613 ischemic strokes and 776 hemorrhagic strokes were observed. Current smoking and hypertension were more prevalent among those with low education. Low versus high education was associated with greater ischemic, but not hemorrhagic, stroke incidence. The combined effect of low education and current smoking was more than expected by the sum of their separate effects on ischemic stroke incidence, particularly among men: 134 (95% confidence interval, 49-219) extra cases per 100 000 person-years because of interaction, adjusted for age, cohort study, and birth cohort. There was no clear evidence of interaction between low education and hypertension. The combined effect of current smoking and hypertension was more than expected by the sum of their separate effects on ischemic and hemorrhagic stroke incidence. This effect was most pronounced for ischemic stroke among women: 178 (95% confidence interval, 103-253) extra cases per 100 000 person-years because of interaction, adjusted for age, cohort study, and birth cohort.
Reducing smoking in those with low socioeconomic position and in those with hypertension could potentially reduce social inequality stroke incidence.
PubMed ID
25123220 View in PubMed
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Comparing consequences of right and left unilateral neglect in a stroke rehabilitation population.

https://arctichealth.org/en/permalink/ahliterature154635
Source
Am J Phys Med Rehabil. 2008 Nov;87(11):910-20
Publication Type
Article
Date
Nov-2008
Author
Joy Y M Wee
Wilma M Hopman
Author Affiliation
Department of Physical Medicine and Rehabilitation, Queen's University, Kingston, Ontario, Canada.
Source
Am J Phys Med Rehabil. 2008 Nov;87(11):910-20
Date
Nov-2008
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aphasia, Wernicke - epidemiology - etiology
Cohort Studies
Female
Hemianopsia - epidemiology - etiology
Humans
Length of Stay
Male
Ontario - epidemiology
Perceptual Disorders - epidemiology - etiology - rehabilitation
Prevalence
Prospective Studies
Recovery of Function
Stroke - complications - epidemiology - rehabilitation
Abstract
This article details right and left unilateral neglect (UN) in a stroke rehabilitation population.
This prospective observational cohort study documented hemipersonal neglect and hemispatial neglect in 309 of 325 stroke rehabilitation patients consecutively admitted over a 28-month period. Shoulder-hand complications, safety concerns, length of stay, discharge function, and discharge destination were documented.
Of the 85 with right UN and 113 with left UN, 17.7% had expressive aphasia, and 17.7% had mixed or receptive aphasia. Hemispatial neglect was associated with hemianopsia (29.2% and 31.8% for right and left, respectively). Having both hemipersonal neglect and hemispatial neglect was related to greater safety risk (46.9% vs. 24.3%), greater incidence of shoulder-hand complications (28.3% vs. 9.9%), lower FIM scores (>10 points lower), longer length of stay (8 days), and less likelihood of discharge to home (67.3% vs. 87.4%) than subjects without UN. Results were similar for those with right and left UN.
Right and left UN occur after stroke, can be detected even in the presence of aphasia, and are associated with shoulder-hand problems, lower discharge function, and lower likelihood of discharge home. Having both hemispatial neglect and hemipersonal neglect impacts people more than having either type of UN alone.
PubMed ID
18936556 View in PubMed
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Complaints of poststroke insomnia and its treatment with mianserin.

https://arctichealth.org/en/permalink/ahliterature187264
Source
Cerebrovasc Dis. 2003;15(1-2):56-62
Publication Type
Article
Date
2003
Author
Heikki Palomäki
Anu Berg
Esa Meririnne
Markku Kaste
Riitta Lönnqvist
Matti Lehtihalmes
Jouko Lönnqvist
Author Affiliation
Department of Neurology, University of Helsinki, Helsinki, Finland. heikki.palomaki@hus.fi
Source
Cerebrovasc Dis. 2003;15(1-2):56-62
Date
2003
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Antidepressive Agents, Second-Generation - therapeutic use
Depression - epidemiology - etiology - therapy
Dose-Response Relationship, Drug
Double-Blind Method
Female
Finland - epidemiology
Follow-Up Studies
Humans
Male
Mianserin - therapeutic use
Middle Aged
Patient satisfaction
Predictive value of tests
Prevalence
Quality of Life
Risk factors
Severity of Illness Index
Sex Factors
Sleep Initiation and Maintenance Disorders - epidemiology - etiology - therapy
Statistics as Topic
Stroke - complications - epidemiology - therapy
Time Factors
Treatment Outcome
Abstract
We assessed the prevalence and associations of symptoms of insomnia in patients with acute ischemic stroke, and evaluated whether mianserin as a sedative antidepressant is beneficial in the treatment of poststroke insomnia. One hundred consecutively hospitalized patients were randomized to receive 60 mg/day of mianserin (n = 51) or placebo for 1 year in a double-blind trial with a 6-month follow-up after the therapy. Symptoms of insomnia were assessed with the three insomnia-related items of the Hamilton Depression Scale; patients were defined as insomniacs if any of these items was positive. Complaints of insomnia occurred in 68% of patients on admission, and in 49% at 18 months, and they were as frequent in all subgroups of patients. From 2 months, symptoms of insomnia were associated independently with depression. Living alone before stroke (at 0 and 2 months) and age (at 12 months) were other independent predictors of insomnia. The rate of recovery as evaluated by the insomnia score was more rapid in patients on mianserin than in those on placebo. At 2 months, the scores were significantly different favoring mianserin treatment (1.3 vs. 0.8, p = 0.02). We conclude that insomnia is a common complaint after ischemic stroke. Mianserin had a beneficial influence on the recovery from symptoms of insomnia, even though the intensity of poststroke depression was low.
PubMed ID
12499712 View in PubMed
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46 records – page 1 of 5.