How Many Patients Become Functionally Dependent after a Stroke? A 3-Year Population-Based Study in Joinville, Brazil

<div><p>The decrease in stroke mortality will increase the burden of survivors with functional dependence (FD). The aim of this study was to evaluate how many patients become functionally dependent over 3 years after an incident event in Joinville, Brazil. The proportion of FD (defined as a modified Rankin score 3 to 5) among stroke survivors from the Joinville Stroke Registry was assessed using a validated telephone interview. Incidence of FD after stroke in Joinville in one year was 23.24 per 100,000 population. The overall proportion of FD among stroke survivors at discharge was 32.7%. Of 303 patients with first-ever ischaemic stroke (IS), one-third were FD at discharge, and 12%, 9% and 8%, respectively at 1, 2 and 3 years. Among 37 patients with haemorrhagic stroke (HS), 38% were dependent at discharge, 16% after 1 and 2 years and 14% after 3. Among 27 patients with subarachnoid haemorrhage (SAH), 19% were dependent at discharge and 4% from 1 to 3 years. Among IS subtypes, cardioembolic ones had the worst risk of FD. (RR 19.8; 95% CI: 2.2 to 175.9). Our results showed that one-third of stroke survivors have FD during the first year after stroke in Brazil. Therefore, a city with half a million people might expect 120 new stroke patients with FD each year.</p></div

Modified Rankin Scale (mRS) scores of 27 first-ever sub-arachnoid haemorrages stroke patients.

<p>Proportions of patients after hospital admission, 30 days and 1 to 3 years in Joinville, 2008 to 2010; Rankin score 0 to 2: functional Independence, 3 to 5:functional dependence and 6:death.</p

Risk factors for functional dependence at 12, 24 and 36 months after first-ever IS stroke, adjusted relative risks, 95%confidence intervals and p-values (n = 303).

<p>Risk factors for functional dependence at 12, 24 and 36 months after first-ever IS stroke, adjusted relative risks, 95%confidence intervals and p-values (n = 303).</p

Modified Rankin Scale (mRS) scores of 37 first-ever haemorrhagic stroke patients.

<p>Proportions of patients after hospital admission, 30 days and 1 to 3 years in Joinville, 2008 to 2010; Rankin score 0 to 2: functional Independence, 3 to 5:functional dependence and 6:death.</p

Evolution of functional status of 407 patients with all stroke types measured by Rankin scale over 3-years.

<p>Evolution of functional status of 407 patients with all stroke types measured by Rankin scale over 3-years.</p

Functional status of 303 patients after incident stroke measured by Rankin scale at 30 days and 3 years.

<p>Functional status of 303 patients after incident stroke measured by Rankin scale at 30 days and 3 years.</p

Modified Rankin Scale (mRS) scores of 303 first-ever ischaemic stroke patients.

<p>Proportions of patients after hospital admission, 30 days and 1 to 3 years in Joinville, 2008 to 2010; Rankin score 0 to 2: functional Independence, 3 to 5:functional dependence and 6:death.</p

Baseline characteristics of patients, risk factors, clinical severity and diagnosis.

<p>Baseline characteristics of patients, risk factors, clinical severity and diagnosis.</p

Characteristics of women diagnosed with mpox infection compared to men: A case series from Brazil

Background: Cisgender men were mostly affected during the 2022 mpox multinational outbreak, with few cases reported in women. This study compares the characteristics of individuals diagnosed with mpox infection according to gender in Rio de Janeiro. Methods: We obtained surveillance data of mpox cases notified to Rio de Janeiro State Health Department (June 12 to December 15, 2022). We compared women (cisgender or transgender) to men (cisgender or transgender) using chi-squared, Fisher's exact, and Mood's median tests. Results: A total of 1306 mpox cases were reported; 1188 (91.0%) men (99.8% cisgender, 0.2% transgender), 108 (8.3%) women (87.0% cisgender, 13.0% transgender), and 10 (0.8%) non-binary persons. Compared to men, women were more frequently older (40+years: 34.3% vs. 25.1%; p < 0.001), reported more frequent non-sexual contact with a potential mpox case (21.4% vs. 9.8%; p = 0.004), fewer sexual partnerships (10.9 vs. 54.8%; p < 0.001), less sexual contact with a potential mpox case (18.5% vs. 43.0%; p < 0.001), fewer genital lesions (31.8% vs. 57.9%; p < 0.001), fewer systemic mpox signs/symptoms (38.0% vs. 50.1%; p = 0.015) and had a lower HIV prevalence (8.3% vs. 46.3%; p < 0.001), with all cases among transgender women. Eight women were hospitalized; no deaths occurred. The highest number of cases among women were notified in epidemiological week 34, when the number of cases among men started to decrease. Conclusions: Women diagnosed with mpox presented differences in epidemiological, behavioral, and clinical characteristics compared to men. Health services should provide a comprehensive assessment that accounts for gender diversity