Neurology
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Until 4 decades ago, the rates of stroke in low- and middle-income countries were considerably lower than those in more economically robust countries. In the intervening years, however, the rates of stroke in places such as southern India and rural South Africa have approximately doubled, whereas stroke rates in more economically developed nations have decreased. What is far more striking is that rates of disability and mortality arising from stroke are at least 10 times greater in medically underserved regions of the world compared with the most developed nations. ⋯ In addition, the lack of access to common drugs and basic medical equipment, as well as the lack of poststroke follow-up programs, rehabilitation, and secondary stroke prevention, means that individuals who would, in countries with better medical care, likely recover from stroke, instead have high rates of death and disability. Several global organizations, most notably the World Health Organization, have formulated and begun to implement public health programs to address these underserved regions. Their success depends on the support and expansion of these efforts so that short-term response to stroke, long-term stroke prevention and care, and screening and treatment of poststroke disabilities can be improved in underserved regions and the human and economic burden on these populations can be minimized.
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To quantitatively characterize domain-specific cognition in individuals with symptomatic lacunar stroke in a systematic review. ⋯ Results of this systematic review are consistent with previous characterizations of cognitive impairment associated with lacunar strokes. However, impaired cognition in this stroke subtype appears less selective than previously thought, involving all major cognitive domains.
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Review Meta Analysis
Inflammation in complex regional pain syndrome: a systematic review and meta-analysis.
We conducted a systematic review of the literature with meta-analysis to determine whether complex regional pain syndrome (CRPS) is associated with a specific inflammatory profile and whether this is dependent on the duration of the condition. ⋯ CRPS is associated with the presence of a proinflammatory state in the blood, blister fluid, and CSF. Different inflammatory profiles were found for acute and chronic cases.