Return to work after ischaemic stroke in young adults: a scoping review.

OBJECTIVES: The aim of the study was to synthesize the body of knowledge on the factors that are important to the process of returning to work after ischaemic stroke in young adults under 55 years of age. METHODS: Guidelines regarding the scoping review methodology developed by the Joanna Briggs Institute, and the PRISMA checklist for scoping reviews were used. A total of 2,249 studies were identified through a bibliographic search in six databases. RESULTS: A total of ten studies were finally selected to respond to the research questions. Eight studies were quantitative observational studies, and two studies had a case study design. The rate of returning to work varied between the studies. The frequency of returning to work in young stroke patients, independent of the time of assessment, ranged from 42.4% to 86%. Returning to work after ischaemic stroke in young adults is a complex process and multidimensional problem which is affected by clinical variables (level of neurological deficits, cognitive ability, independency in activities of daily living, fatigue and depression, cardiovascular factors), as well as the socioeconomic and occupational status. CONCLUSION: There is insufficient evidence concerning interventions promoting return to work. Future studies should focus on examining effective interventions to help young stroke survivors return to work.

Porotic hyperostosis and cribra orbitalia in samples from the Late Hillfort Period sites at Detkovice - Za zahradama (district Prostejov) and Vídenská street (district Brno), Czech Republic.

Porotic hyperostosis and cribra orbitalia are pathological changes occurring on the human skull. These changes were observed and evaluated on skeletal remains from Detkovice - Za zahradama and Vídenská Street in Brno; both sites are dated back to the 10th to 12th centuries AD. A total of 605 subjects were assessed for age, sex, and the above-stated pathologies using standard methods. The influence of age and sex on the occurrence of these pathologies was examined statistically. Results indicated that at the site of Detkovice - Za zahradama, porotic hyperostosis, and cribra orbitalia do not depend on sex or age. However, at Vídenská Street in Brno, these pathologies do not depend on sex, but they depend on age so a higher incidence of pathologies in juveniles is observed. Differences between both sites could be caused by different numbers of evaluated individuals or different state of preservation of skeletal remains. The aetiology of the origin of these pathologies could not be determined by the methodology used here, but with the prevailing lower age of pathological subjects, a lack of nutrition with consequent absence of iron and developing anaemia might be the cause. Based on our statistical data, we can observe that the pathologies we studied occur more frequently in children older than newborns and younger infants. This may indicate that these studied pathologies arise only during the lifetime of the individual and do not have a prenatal occurrence.

Polymorphisms rs562556 and rs2479409 of the PCSK9 gene associated with obesity and cardiovascular disease.

OBJECTIVE: The primary objective was to comprehensively assess the association between single nucleotide polymorphisms (rs562556 and rs2479409) in the PCSK9 gene with biochemical parameters - C-reactive protein (CRP), glucose (GLU), triglyceride (TAG), low-density lipoprotein cholesterol (LDL CHOL), non-high-density lipoprotein cholesterol (non HDL CHOL), high-density lipoprotein cholesterol (HDL CHOL), cholesterol (CHOL), and anthropometric parameters (visceral fat), overweight/obesity and cardiovascular risk. METHODS: A total of 71 women aged 23-64 years were divided into three groups based on body mass index (BMI). BMI ≥ 25/≥ 30 kg/m2 was the criterion for assessment of overweight/obesity. Anthropometric, biochemical and genetic examinations were performed on the probands. Changes in markers in each group and their association with cardiovascular risk were monitored. RESULTS: We can conclude that in our study population we observed differences between the BMI categories for biochemical markers (CRP, LDL CHOL, non HDL CHOL, HDL CHOL, LDL CHOL) and anthropometric marker (visceral fat). Atherogenic index of plasma (AIP), Castelli's Risk Index I (CRI-I) and atherogenic coefficient (AC) confirmed high cardiovascular risk for the obese women category (0.045); (< 0.013); (< 0.010). Genotype and allele frequencies for the PCSK9 gene in the overweight and obese groups showed higher allele frequencies of allele A for both polymorphisms of the gene. CONCLUSIONS: PCSK9 gene expression is associated with biological processes such as lipid metabolism and inflammation. Cholesterol-lowering therapies are the gold standard for reducing the risk of cardiovascular mortality and morbidity. Administration of monoclonal antibodies (mAbs) against PCSK9 is a novel lipid-lowering therapeutic approach in adults to reduce the risk of cardiovascular disease.