The Fundamental Role of Dissolved Oxygen Levels in Drinking Water, in the Etiopathogenesis, Prevention, Treatment and Recovery of Cerebral Vascular Events (Stroke)
Main Article Content
Abstract
Stroke is a clinically defined syndrome of acute focal neurological deficit attributed to vascular injury (infarction, hemorrhage) of the central nervous system. Stroke is the second leading cause of death and disability worldwide. Stroke is not a single disease but can be caused by a wide range of risk factors, disease processes and mechanisms. Approximately 15% of strokes worldwide are the result of intracerebral hemorrhage, which can be deep (basal ganglia, brainstem), cerebellar or lobar. A minority (about 20%) of intracerebral hemorrhages are caused by macrovascular lesions (vascular malformations, aneurysms, cavernomas), venous sinus thrombosis or rarer causes.
The prevalence of stroke is highest in developing countries, with ischemic stroke being the most common type. Stroke therapy primarily focuses on restoring blood flow to the brain and treating stroke-induced neurological damage. Lack of success in recent clinical trials has led to significant refinement of animal models, focus-driven study design and use of new technologies in stroke research.
Article Details
Copyright (c) 2025 Herrera AS, et al.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Kuriakose D, Xiao Z. Pathophysiology and Treatment of Stroke: Present Status and Future Perspectives. Int J Mol Sci. 2020 Oct 15;21(20):7609. Available from: https://doi.org/10.3390/ijms21207609
Kelly-Hayes M. Influence of age and health behaviors on stroke risk: Lessons from longitudinal studies. J Am Geriatr Soc. 2010;58:S325–S328. Available from: https://doi.org/10.1111/j.1532-5415.2010.02915.x
Collaborators G.S. Global, regional, and national burden of stroke, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019;18:439–458. Available from: https://doi.org/10.1016/s1474-4422(19)30034-1
Appelros P, Stegmayr B, Terént A. Sex differences in stroke epidemiology: A systematic review. Stroke. 2009;40:1082–1090. Available from: https://doi.org/10.1161/strokeaha.108.540781
Chen JC. Geographic determinants of stroke mortality: Role of ambient air pollution. Stroke. 2010;41:839–841. Available from: https://doi.org/10.1161/strokeaha.110.578476
GBD 2019 Stroke Collaborators. Global, regional, and national burden of stroke and its risk factors, 1990-2019: A systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol. 2021 Oct;20(10):795-820. Available from: https://doi.org/10.1016/s1474-4422(21)00252-0
Lloyd-Jones D, Adams RJ, Brown TM, Carnethon M, Dai S, De Simone G, et al. Heart disease and stroke statistics—2010 update. A report from the American Heart Association. Circulation. 2009 Feb 23;121(7):948-54. Available from: https://doi.org/10.1161/circulationaha.109.192666
Lanska DJ. Geographic distribution of stroke mortality in the United States: 1939–1941 to 1979–1981. Neurology. 1993;43:1839–1851. Available from: https://doi.org/10.1212/wnl.43.9.1839
Lanska DJ, Kuller LH. The geography of stroke mortality in the United States and the concept of a stroke belt. Stroke. 1995;26:1145–1149. Available from: https://doi.org/10.1161/01.str.26.7.1145
Lanska DJ, Kryscio R. The geographic distribution of hospital admissions, case fatality, and mortality from stroke among Medicare enrollees. Neurology. 1994;44:1541-1550. Available from: https://doi.org/10.1212/wnl.44.8.1541
Nefzger MD, Kuller LH, Lilienfeld AM, Diamond EL, Miller GD, Stolley PD, et al. Three-area epidemiologic study of geographic differences in stroke mortality, I: Background and methods. Stroke. 1977;8:546-550. Available from: https://doi.org/10.1161/01.str.8.5.546
Kovar MG, Pokras R, Collins JG. Trends in medical care and survival from stroke. Ann Epidemiol. 1993;3:466-470. Available from: https://doi.org/10.1016/1047-2797(93)90097-n
Dyken ML, Wolf PA, Barnett HJ, Bergen JJ. Risk factors in stroke: A statement for physicians by the Subcommittee on Risk Factors and Stroke of the Stroke Council. Stroke. 1984;15:1105-1111.
Lyon JL, Bishop CT, Nielsen NS. Cerebrovascular disease in Utah, 1968-1971. Stroke. 1981;12:564-566. Available from: https://doi.org/10.1161/01.str.12.5.564
Takahashi E. On the geographic distribution of death rates from vascular lesions affecting the central nervous system in the United States: An epidemiological hypothesis. Tohoku J Exp Med. 1962;76:224-232. Available from: https://www.jstage.jst.go.jp/article/tjem1920/76/3/76_3_224/_pdf
Gover M. Statistical studies of heart disease, IV: Mortality from heart disease (all forms) related to geographic section and size of city. Public Health Rep. 1949;64:439-456. Available from: https://pubmed.ncbi.nlm.nih.gov/18114617/
Howard G, Evans GW, Pearce K, Howard VJ, Bell RA, Mayer EJ, et al. Is the stroke belt disappearing? An analysis of racial, temporal and age effects. Stroke. 1995;26:1153-1158. Available from: https://doi.org/10.1161/01.str.26.7.1153
Wing S, Casper M, Davis WB, Pellom A, Riggan W, Tyroler HA. Stroke mortality maps: United States whites aged 35-74 years, 1962-1982. Stroke. 1988;19:1507-1513. Available from: https://doi.org/10.1161/01.str.19.12.1507
Solís Herrera A, Arias Esparza MC. Oxygen from the atmosphere cannot pass through the lung tissues and reach the bloodstream. The unexpected capacity of the human body to dissociate the water molecule. J Pulmonol Res Rep. 2022;SRC/JPRR-133. Available from: https://doi.org/10.47363/JPRR/2022(4)124
Herrera AS. The disdain importance of dissolved oxygen levels in drinking water in pandemic control. Adv Ecol Environ Res. 2020;5(11):296-299. Available from: https://www.ss-pub.org/wp-content/uploads/2020/11/AEER2020102201.pdf
Blaszczak JR, Koenig LE, Mejia FH, Gómez-Gener L, Dutton CL, Carter AM, et al. Extent, patterns, and drivers of hypoxia in the world's streams and rivers. Limnol Oceanogr Lett. 2023;8:453-463. Available from: https://doi.org/10.1002/lol2.10297
Total Maximum Daily Load (TMDL) For Dissolved Oxygen in Savannah Harbor Savannah River Basin Chatham and Effingham Counties, Georgia, Jasper County, South Carolina. Available from: https://epd.georgia.gov/sites/epd.georgia.gov/files/related_files/site_page/EPA_SavannahHarbor_DO_TMDL_2006.pdf
Ji X, Shang X, Dahlgren RA, Zhang M. Prediction of dissolved oxygen concentration in hypoxic river systems using support vector machine: A case study of Wen-Rui Tang River, China. Environ Sci Pollut Res. 2017;24:16062–16076. Available from: https://pubmed.ncbi.nlm.nih.gov/28537025/
Ni X, Zhou F, Zeng D, Li D, Zhang T, Wang K, et al. Long-term observations of hypoxia off the Yangtze River Estuary: Toward prediction and operational application. In: Frontiers in Ocean Observing: Emerging Technologies for Understanding and Managing a Changing Ocean. E.S. Kappel, V. Cullen, M.J. Costello, L. Galgani, C. Gordó-Vilaseca, A. Govindarajan, S. Kouhi, C. Lavin, L. McCartin, J.D. Müller, B. Pirenne, T. Tanhua, Q. Zhao, S. Zhao, eds. Oceanography. 2023;36(Supplement 1):40–41. Available from: https://doi.org/10.5670/oceanog.2023.s1.13
Blaszczak JR. Distribution, frequency, and global extent of hypoxia in rivers. U.S. Geological Survey. 2021.
Pu L, Wang L, Zhang R, Zhao T, Jiang Y, Han L. Projected global trends in ischemic stroke incidence, deaths and disability-adjusted life years from 2020 to 2030. Stroke. 2023;54(5):1330-1339. Available from: https://doi.org/10.1161/STROKEAHA.122.040073
Pope CA, Dockery DW. Health effects of fine particulate air pollution: Lines that connect. J Air Waste Manag Assoc. 2006;56:709–742. Available from: https://doi.org/10.1080/10473289.2006.10464485
Bell ML, McDermott A, Zeger SL, Samet JM, Dominici F. Ozone and short-term mortality in 95 US urban communities, 1987–2000. JAMA. 2004;292:2372–2378. Available from: https://doi.org/10.1001/jama.292.19.2372
Hong YC, Lee JT, Kim H, Kwon HJ. Air pollution: A new risk factor in ischemic stroke mortality. Stroke. 2002;33:2165–2169. Available from: https://doi.org/10.1161/01.str.0000026865.52610.5b
Wellenius GA, Schwartz J, Mittleman MA. Air pollution and hospital admissions for ischemic and hemorrhagic stroke among Medicare beneficiaries. Stroke. 2005;36:2549–2553. Available from: https://doi.org/10.1161/01.str.0000189687.78760.47
Dockery DW, Pope CA 3rd, Xu X, Spengler JD, Ware JH, Fay ME, et al. An association between air pollution and mortality in six U.S. cities. N Engl J Med. 1993;329:1753–1759. Available from: https://doi.org/10.1056/nejm199312093292401
Simkhovich BZ, Kleinman MT, Kloner RA. Air pollution and cardiovascular injury: Epidemiology, toxicology, and mechanisms. J Am Coll Cardiol. 2008;52:719–726. Available from: https://doi.org/10.1016/j.jacc.2008.05.029
Hutchins MG, Qu Y, Charlton MB. Successful modelling of river dissolved oxygen dynamics requires knowledge of stream channel environments. J Hydrol. 2021;603(B):126991. Available from: http://dx.doi.org/10.1016/j.jhydrol.2021.126991