An Investigation of the Glucose Monitoring Practices of Nurses in Stroke Care: A Descriptive Cohort Study

Glucose derangement is commonly observed among adults admitted to hospital with acute stroke. This paper presents the findings from a descriptive cohort study that investigated the glucose monitoring practices of nurses caring for adults admitted to hospital with stroke or transient ischaemic attack. We found that a history of diabetes mellitus was strongly associated with initiation of glucose monitoring and higher frequency of that monitoring. Glucose monitoring was continued for a significantly longer duration of days for adults with a history of diabetes mellitus, when compared to the remainder of the cohort. As glucose monitoring was not routine practice for adults with no history of diabetes mellitus, the detection and treatment of hyperglycaemia and hypoglycaemia events could be delayed. There was a significant positive association between the admission hospital that is most likely to offer stroke unit care and the opportunity for glucose monitoring. We concluded that adults with acute stroke, irrespective of their diabetes mellitus status prior to admission to hospital, are vulnerable to both hyperglycaemic and hypoglycaemic events. This study suggests that the full potential of nurses in the monitoring of glucose among hospitalised adults with stroke has yet to be realised.

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Acute Stroke Care during the COVID-19 Pandemic: Reduction in the Number of Admissions of Elderly Patients and Increase in Prehospital Delays

Cerebrovascular Diseases ◽

10.1159/000514140 ◽

2021 ◽

pp. 1-7

Author(s):

Gabriel Velilla-Alonso ◽

Andrés García-Pastor ◽

Ángela Rodríguez-López ◽

Ana Gómez-Roldós ◽

Antonio Sánchez-Soblechero ◽

...

Keyword(s):

Elderly Patients ◽

Acute Stroke ◽

Time Course ◽

Intravenous Thrombolysis ◽

Stroke Care ◽

Acute Stroke Care ◽

Group Data ◽

Radiological Data ◽

History Of ◽

Prehospital Delays

Introduction: We analyzed whether the coronavirus disease 2019 (COVID-19) crisis affected acute stroke care in our center during the first 2 months of lockdown in Spain. Methods: This is a single-center, retrospective study. We collected demographic, clinical, and radiological data; time course; and treatment of patients meeting the stroke unit admission criteria from March 14 to May 14, 2020 (COVID-19 period group). Data were compared with the same period in 2019 (pre-COVID-19 period group). Results: 195 patients were analyzed; 83 in the COVID-19 period group, resulting in a 26% decline of acute strokes and transient ischemic attacks (TIAs) admitted to our center compared with the previous year (p = 0.038). Ten patients (12%) tested positive for PCR SARS-CoV-2. The proportion of patients aged 65 years and over was lower in the COVID-19 period group (53 vs. 68.8%, p = 0.025). During the pandemic period, analyzed patients were more frequently smokers (27.7 vs. 10.7%, p = 0.002) and had less frequently history of prior stroke (13.3 vs. 25%, p = 0.043) or atrial fibrillation (9.6 vs. 25%, p = 0.006). ASPECTS score was lower (9 [7–10] vs. 10 [8–10], p = 0.032), NIHSS score was slightly higher (5 [2–14] vs. 4 [2–8], p = 0.122), onset-to-door time was higher (304 [93–760] vs. 197 [91.25–645] min, p = 0.104), and a lower proportion arrived within 4.5 h from onset of symptoms (43.4 vs. 58%, p = 0.043) during the COVID-19 period. There were no differences between proportion of patients receiving recanalization treatment (intravenous thrombolysis and/or mechanical thrombectomy) and in-hospital delays. Conclusion: We observed a reduction in the number of acute strokes and TIAs admitted during the COVID-19 period. This drop affected especially elderly patients, and despite a delay in their arrival to the emergency department, the proportion of patients treated with recanalization therapies was preserved.

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Electrocardiographic Findings of COVID-19 Patients and Their Correlation with Outcome; a Prospective Cohort Study

Frontiers in Emergency Medicine ◽

10.18502/fem.v5i2.5608 ◽

2021 ◽

Author(s):

Mehdi Pishgahi ◽

Mahmoud Yousefifard ◽

Saeed Safari ◽

Fatemeh Ghorbanpouryami

Keyword(s):

Diabetes Mellitus ◽

Cohort Study ◽

Prognostic Factors ◽

Hospital Mortality ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

P Wave ◽

Axis Deviation ◽

T Wave ◽

History Of

Introduction: Being infected with COVID-19 is associated with direct and indirect effects on the cardiopulmonary system and electrocardiography can aid in management of patients through rapid and early identification of these adversities. Objective: The present study was designed aiming to evaluate electrocardiographic changes and their correlation with the outcome of COVID-19 patients. Methods: This Prospective cohort study was carried out on COVID-19 cases admitted to the emergency department of an educational hospital, during late February and March 2020. Electrocardiographic characteristics of patients and their association with in-hospital mortality were investigated. Results: One hundred and nineteen cases with the mean age of 60.52±13.45 (range: 29-89) years were studied (65.5% male). Dysrhythmia was detected in 22 (18.4%) cases. T-wave inversion (28.6%), pulmonale P-wave (19.3%), left axis deviation (19.3%), and ST-segment depression (16.8%) were among the most frequently detected electrocardiographic abnormalities, respectively. Twelve (10.1%) cases died. There was a significant correlation between in-hospital mortality and history of diabetes mellitus (p=0.007), quick SOFA score > 2 (p<0.0001), premature ventricular contraction (PVC) (p=0.003), left axis deviation (LAD) (p=0.039), pulmonale P-wave (p<0.001), biphasic P-wave (p<0.001), inverted T-wave (p=0.002), ST-depression (p=0.027), and atrioventricular (AV) node block (p=0.002). Multivariate cox regression showed that history of diabetes mellitus, and presence of PVC and pulmonale P-wave were independent prognostic factors of mortality. Conclusions: Based on the findings of the present study, 18.4% of COVID-19 patients had presented with some kind of dysrhythmia and in addition to history of diabetes, presence of PVC and pulmonale P-wave were among the independent prognostic factors of mortality in COVID-19 patients.

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Birth order is associated with caries development in young children: a register-based cohort study

BMC Public Health ◽

10.1186/s12889-020-8234-7 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 4

Author(s):

A. Julihn ◽

F. C. Soares ◽

U. Hammarfjord ◽

A. Hjern ◽

G. Dahllöf

Keyword(s):

Cohort Study ◽

Dental Caries ◽

Young Children ◽

Birth Order ◽

Positive Association ◽

Outcome Variable ◽

Study Cohort ◽

Significant Positive Association ◽

Born Child ◽

Caries Increment

Abstract Background Birth order has been shown to affect the health of the child; less is known, however, about how birth order affects caries development in children. Thus, the present study investigated the association between birth order and dental caries development in young children. Methods This retrospective registry-based cohort study included all children born in 2000–2003 who were residing in Stockholm County, Sweden, at age 3 years (n = 83,147). The study followed the cohort until subjects reached 7 years of age. Children with registry data on dental examinations and sociodemographic characteristics at ages 3- and 7 years constituted the final study cohort (n = 65,259). The outcome variable was “caries increment from age 3- to 7 years” (Δdeft > 0) and the key exposure, “birth order”, was divided into five groups. A forward stepwise logistic binary regression was done for the multivariate analysis with adjustments for sociodemographic factors. Results At age 3 years, 94% had no fillings or manifest caries lesions. During the study period, 22.5% (n = 14,711) developed dental caries. The final logistic regression analysis found a statistically significant positive association between birth order and caries increment. Further, excess risk increased with higher birth order; with the mother’s first-born child as reference, risk for the second-born child was OR 1.17, 95% CI = 1.12–1.23; for the third-born child, OR 1.47, 95% CI = 1.38–1.56; for the fourth-born child, OR 1.69, 95% CI = 1.52–1.88; and for the fifth-born or higher birth-order child, OR 1.84, 95% CI = 1.58–2.14. Conclusions These findings show that birth order influences caries development in siblings, suggesting that birth order can be regarded as a predictor for caries development in young children. This factor may be helpful in assessing caries risk in preschool children and should be considered in caries prevention work in young children with older siblings.

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Acute Stroke Care in Dementia: A Cohort Study from the Swedish Dementia and Stroke Registries

Journal of Alzheimer s Disease ◽

10.3233/jad-180653 ◽

2018 ◽

Vol 66 (1) ◽

pp. 185-194 ◽

Cited By ~ 4

Author(s):

Eva Zupanic ◽

Ingemar Kåreholt ◽

Bo Norrving ◽

Juraj Secnik ◽

Mia von Euler ◽

...

Keyword(s):

Cohort Study ◽

Acute Stroke ◽

Stroke Care ◽

Acute Stroke Care

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Characterizing The Biological Constituents Of Platelet-poor Plasma--do The Platelets Matter? A Prospective Cohort Study

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119s00286 ◽

2019 ◽

Vol 7 (7_suppl5) ◽

pp. 2325967119S0028 ◽

Cited By ~ 1

Author(s):

Sandeep Mannava ◽

Kaitlyn E. Whitney ◽

Jillian King ◽

Mitchell Kennedy ◽

Grant Dornan ◽

...

Keyword(s):

Cohort Study ◽

Peripheral Blood ◽

Prospective Cohort ◽

Muscle Injury ◽

Platelet Rich Plasma ◽

Positive Association ◽

Magnetic Bead ◽

Biologically Active ◽

Biological Factors ◽

Significant Positive Association

Objectives: Platelet-rich plasma (PRP) is comprised of several biologically active factors that can stimulate musculoskeletal healing processes. The supernatant of PRP, known as PPP, is biologically active and may also stimulate tissue regeneration. In some instances, such as muscle injury, PPP may be preferred to PRP in order to stimulate muscle regrowth in a basic science study that was previously performed. Platelet poor plasma (PPP) is has several biologically active molecular factors that may be utilized to stimulate tissue healing. While platelet rich plasma has been previously studied and characterized, few studies have sought to quantify the biological constituents of PPP. The purpose of this study was to quantitate and assess growth factors, other chemokines, and cytokines in PPP derived from human peripheral blood that has been centrifuged. Study Design: Non-randomized, prospective cohort study; Level of evidence: 2. Methods: Peripheral blood was drawn to create PPP at three time points from sixteen healthy volunteers. Hematology analysis was conducted on the PPP to quantify the platelet fold-difference from baseline measurements. The PPP samples were immediately assayed and analyzed on the MagPix® following processing completion. Specific immunoassay kits used were human cytokine/chemokine magnetic bead panel, TGF-β magnetic bead panel, MMP magnetic bead panel 1, and MMP magnetic bead panel 2. Results: Among the biological factors tested, there was a significant positive association, defined by two factors being associated in that when one factor increases the other also increases, between BMI and the biological composition of PPP with PDGF AA, PDGF AB, MMP-1, MMP-9, MMP-13, and MMP-12 (p<0.05). Similarly, there was a significant positive association (p<0.05), between age and biological composition of PPP for MMP-9 and MMP-7. Conclusion: PPP has several biological factors, both anabolic and catabolic, that can potentially be utilized in musculoskeletal medicine to treat various conditions, such as muscle injury. PPP is biologically active and this study characterizes its anabolic and catabolic profile. These factors are influenced by certain demographic factors such as age and body mass index (BMI). Higher BMI significantly correlated to higher levels of PDGF AA, PDGF AB, MMP-1, MMP-9, MMP-13, and MMP-12 in PPP. This supernatant of the better-studied PRP is biological active and warrants further investigation for its therapeutic potential. Platelets could change the biological composition of plasma utilized for regenerative medicine applications, but this study demonstrates that the plasma alone has biological properties that may provide benefit in treating certain musculoskeletal conditions. This study will help clinicians better understand the biological nature of PPP and may aide in the more targeted use of PPP therapeutically.

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Significant association between intracranial volume and verbal intellectual abilities in patients with schizophrenia and a history of birth asphyxia

Psychological Medicine ◽

10.1017/s0033291721000489 ◽

2021 ◽

pp. 1-10

Author(s):

Laura Anne Wortinger ◽

Kjetil Nordbø Jørgensen ◽

Claudia Barth ◽

Stener Nerland ◽

Runar Elle Smelror ◽

...

Keyword(s):

Birth Asphyxia ◽

Positive Association ◽

Outcome Variable ◽

Intracranial Volume ◽

Birth Registry ◽

Significant Positive Association ◽

Intellectual Abilities ◽

History Of ◽

Magnetic Resonance Imaging Mri ◽

Biological Environment

Abstract Background The etiology of schizophrenia (SZ) is proposed to include an interplay between a genetic risk for disease development and the biological environment of pregnancy and birth, where early adversities may contribute to the poorer developmental outcome. We investigated whether a history of birth asphyxia (ASP) moderates the relationship between intracranial volume (ICV) and intelligence in SZ, bipolar disorder (BD) and healthy controls (HC). Methods Two hundred seventy-nine adult patients (18–42 years) on the SZ and BD spectrums and 216 HC were evaluated for ASP based on information from the Medical Birth Registry of Norway. Participants underwent structural magnetic resonance imaging (MRI) to estimate ICV and intelligence quotient (IQ) assessment using the Wechsler Abbreviated Scale of Intelligence (WASI). Multiple linear regressions were used for analyses. Results We found a significant three-way interaction (ICV × ASP × diagnosis) on the outcome variable, IQ, indicating that the correlation between ICV and IQ was stronger in patients with SZ who experienced ASP compared to SZ patients without ASP. This moderation by ASP was not found in BD or HC groups. In patients with SZ, the interaction between ICV and a history of the ASP was specifically related to the verbal subcomponent of IQ as measured by WASI. Conclusions The significant positive association between ICV and IQ in patients with SZ who had experienced ASP might indicate abnormal neurodevelopment. Our findings give support for ICV together with verbal intellectual abilities as clinically relevant markers that can be added to prediction tools to enhance evaluations of SZ risk.

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Evaluation of urinary N-acetyl-beta-D-glucosaminidase as a marker of early renal damage in patients with type 2 diabetes mellitus

Arquivos Brasileiros de Endocrinologia & Metabologia ◽

10.1590/0004-2730000003010 ◽

2014 ◽

Vol 58 (8) ◽

pp. 798-801 ◽

Cited By ~ 15

Author(s):

Beatriz R. Bouvet ◽

Cecilia V. Paparella ◽

Sandra M. M. Arriaga ◽

Adriana L. Monje ◽

Ana M. Amarilla ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Serum Creatinine ◽

Positive Association ◽

Tubular Damage ◽

Tubular Dysfunction ◽

Significant Positive Association ◽

Estimated Glomerular Filtration Rates

Objective To evaluate the clinical usefulness of urinary N-acetyl-beta-D-glucosaminidase (NAG) excretion for the detection of early tubular damage in type 2 diabetes mellitus (T2DM). Subjects and methods Thirty six patients with T2DM were divided into two groups based on urinary albumin to creatinine ratio (ACR): normoalbuminuria (ACR <30 mg/g; n=19) and microalbuminuria (ACR =30‐300 mg/g; n=17). The following parameters were determined in both groups: urinary NAG and albumin, serum and urine creatinine, fasting plasma glucose and glycated hemoglobin (HbA1c). Results Urinary NAG levels [Units/g creatinine; median (range)] were significantly increased in microalbuminuria group [17.0 (5.9 - 23.3)] compared to normoalbuminuria group [4.4 (1.5 - 9.2)] (P<0.001). No differences between groups were observed in fasting glucose, HbA1c, serum creatinine levels and estimated glomerular filtration rates (eGFR). Urinary NAG positively correlated with ACR (r=0.628; p<0.0001), while no significant association was observed between NAG and glycemia, HbA1c, serum creatinine and eGFR. Conclusions The increase of urinary NAG at the microalbuminuria stage of diabetic nephropathy (DN) suggests that tubular dysfunction is already present in this period. The significant positive association between urinary NAG excretion and ACR indicates the possible clinical application of urinary NAG as a complementary marker for early detection of DN in T2DM.

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