scholarly journals Stroke Outcome and Determinants among Patients with and without Diabetes in a Tertiary Hospital in Ghana

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Josephine Akpalu ◽  
Alfred E. Yawson ◽  
Foster Osei-Poku ◽  
Yacoba Atiase ◽  
Ernest Yorke ◽  
...  
Keyword(s):  
Elevated Temperature ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Odds Ratio ◽  
Female Gender ◽  
Tertiary Hospital ◽  
Older Age ◽  
Stroke Outcome ◽  
Stroke Patients ◽  
Patients With Diabetes

Background. Diabetes mellitus, a well-established independent risk factor for stroke, has varied association with stroke outcome from previous studies. This study investigated stroke outcome and determinants among patients with and without diabetes in a tertiary hospital in Ghana. Methods. A prospective study conducted among stroke patients with and without diabetes admitted in a Ghanaian tertiary hospital. Baseline clinical and biochemical data were documented. Functional stroke outcome was evaluated at 1, 3, and 6 months after stroke using the modified Rankin Scale. Results. Number of participants enrolled were 326 and 105 (32.20%) had diabetes. Higher proportions of diabetes patients had poor functional stroke outcome at 1, 3, and 6 months (79%, 75.23%, 73.33%) compared with those without diabetes (70.13%, 65.16, 61.99) (p>0.05). Stroke patients with diabetes had lower survival compared with those without diabetes (p=0.0745). Mortality at 6 months was more likely among ischaemic stroke patients with diabetes compared with those without diabetes (Odds Ratio 2.037; CI: 1.058-3.923). Determinants of poor functional stroke outcome for diabetes patients were older age (Adjusted Odds Ratio (AOR)-1.07; CI-1.03-1.12), female gender (AOR-3.74; CI-1.26-12.65), and pneumonia (AOR-11.32; CI-1.93-220.05) whereas the determinants for those without diabetes were unemployment (AOR-4.19; CI-1.24-19.50), speech abnormalities (AOR-1.99; CI1.08-3.73), and pneumonia (AOR-4.05; CI-1.83-9.77). High fasting plasma glucose (HR-1.15; CI-1.07-1.23), elevated temperature (HR-1.41; CI-1.11-1.79), and pneumonia (HR-2.25; CI-1.44-3.50) were determinants of low survival among all stroke patients. Conclusion. Trends towards poorer functional outcome and reduced survival were found among Ghanaian stroke patients with diabetes compared with those without diabetes. Older age, female gender, pneumonia, elevated temperature, and fasting plasma glucose were determinants of adverse outcome in stroke patients with diabetes.

scholarly journals Frequency and Risk Factors of Pneumonia and Urinary Tract Infection during Hospitalization in Acute Stroke Patients.

2016 ◽  
Vol 32 (2) ◽  
pp. 74-84
Author(s):  
Shahed Ahmad ◽  
Matiur Rahman ◽  
Mostafa Hosen ◽  
Abul Kalam ◽  
Mohammed Shoab ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Acute Stroke ◽  
Female Gender ◽  
Older Age ◽  
Stroke Patients ◽  
Severe Stroke ◽  
Wide Range

Background: Acute stroke Patients are at risk of developing a wide range of complications. Among these medical complications the most common are infections, including pneumonia and urinary tract infection (UTI). This study was designed to see the frequency and risk factors of pneumonia and UTI after acute stroke in hospitalized patients. Methods : This prospective observational study was done in the Department of Neurology and Department of Medicine, Sylhet M.A.G Osmani Medical College Hospital, from May 2014 to November 2014. After hospitalization, a total number of 80 acute stroke patients were enrolled in this study. All patients of both sexes, presented with acute stroke, were confirmed by CT scan of head; vascular risk factors were recorded and relevant investigations were done. Results: Among the study subjects Urinary tract infection was found in 23 (28.8%) patients. Statistically significant risk factors for UTI were : > 65 years age (OR=2.926; 95% of CI=1.044-8.202; p=0.037). Female gender (OR=0.327; 95% of CI=0.120-0.889; p=0.026), diabetes (OR=2.015; 95% of CI=1.019-7.780; p=0.042), Severe stroke (OR=3.331; 95% of CI=1.217-9.116; p=0.017), Foley tube catheterization (OR=4.229; 95% of CI=1.492-11.982; p=0.005). Pneumonia developed in 17 (21.2%) patients and no pneumonia in 63 (78.8%) patients. Conclusion : UTI and pneumonia are common occurrence after acute stroke during stroke hospitalization. Older age, female gender, diabetes mellitus, severe stroke at presentation and urinary catheterization were found the risk factors of UTI; whereas older age, severe stroke at presentation, nasogastric tube feeding, oropharyngeal suction and difficulty in swallowing were found the risk factors of pneumonia in acute stroke. Bangladesh Journal of Neuroscience 2016; Vol. 32 (2): 74-84

Chemotherapy Near the End of Life in Onco–Hematological Adult Patients

2020 ◽  
Vol 37 (8) ◽  
pp. 641-647
Author(s):  
Marina Sánchez-Cuervo ◽  
Lorena García-Basas ◽  
Esther Gómez de Salazar-López de Silanes ◽  
Cristina Pueyo-López ◽  
Teresa Bermejo-Vicedo
Keyword(s):  
Observational Study ◽  
End Of Life ◽  
End Of Life Care ◽  
Odds Ratio ◽  
Chemotherapy Regimen ◽  
Female Gender ◽  
Tertiary Hospital ◽  
Life Care ◽  
Oncological Patients ◽  
Scarce Data

Objective: The use of chemotherapy near the end of life is not advisable. There are scarce data in Europe but shows signs of aggressiveness. We designed this study to analyze the proportion of onco–hematological patients receiving chemotherapy within their last 2 weeks of life as well as starting a new chemotherapy regimen in the 30 days prior to death. Methods: A retrospective observational study was conducted in a tertiary hospital. Adults who died of an onco-hematological neoplasia while hospitalized between April 2017 and March 2018 were included. We assessed the use of chemotherapy over the course of the last 14 days of life, defined as the administration of at least one dose of chemotherapy. We also examined the proportion of patients starting a new chemotherapy regimen in the last 30 days of life. Results: A total of 298 inpatients died in the Hematology and Oncology units. During the last 14 days, 28.2% (n = 11) of hematological and 26.3% (n = 68) of oncological patients received chemotherapy; the overall rate was 26.5% (n = 79). Furthermore, the proportion of patients starting a new chemotherapy regimen in the last 30 days of life was high (20.5% and 20.8%, respectively). Female gender (odds ratio [OR] = 1.99, 95% confidence interval [CI] = 1.18-3.35) and age <45 (OR = 2.68, 95% CI = 1.05-6.88) were associated with higher rates of chemotherapy. Conclusion: The proportion of patients receiving chemotherapy in the last 14 days of life was high, as well as the proportion of patients starting a new regimen in their last 30 days. This was indicative of excessive aggressiveness at the end-of-life care.

scholarly journals Fasting Plasma Glucose and Coronary Heart Disease in a Rural Population of North Henan, China

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Quan Guo ◽  
Fei Lin ◽  
Yi Liu ◽  
Yang Li ◽  
Xue-Hui Wang ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Rural Areas ◽  
Odds Ratio ◽  
Coronary Artery Lesions ◽  
Fasting Plasma ◽  
The Relationship ◽  
Different Levels

Even in individuals without diabetes, the incidence of coronary heart disease (CHD) increases with the rise in fasting plasma glucose (FPG); however, the threshold of FPG for CHD in rural areas of China is unclear. We retrospectively examined 2,987 people. Coronary angiography records were used to determine the presence of CHD as well as its severity. Risk factors for CHD and the relationship between different levels of FPG and CHD were analyzed. After adjusting for age, hypertension, dyslipidemia, smoking, drinking, chronic kidney disease, and previous ischemic stroke, the incidence of CHD in nondiabetic women began to increase when FPG exceeded 5.2 mmol/L (odds ratio (OR) = 1.438, 95% confidence interval (CI) = 1.099–1.880, p=0.008), and the degree of coronary artery lesions also became more severe (OR = 1.406, 95% CI = 1.107–1.788, p=0.005). However, no such correlations were found in nondiabetic men. In conclusion, among the nondiabetic women in rural areas of northern Henan, both the incidence of CHD and the severity of lesions increased when FPG levels were greater than 5.2 mmol/L, while no significant correlation between FPG and CHD was observed in diabetes-free men.

scholarly journals Pneumonia risk factors in stroke patients

Revista CEFAC ◽  
2020 ◽  
Vol 22 (6) ◽  
Author(s):  
Paulo Mateus Madureira Soares Mariano ◽  
Mateus de Sousa Rodrigues ◽  
Leonardo Fernandes e Santana ◽  
Manoel Pereira Guimarães ◽  
Paulo Adriano Schwingel ◽  
...  
Keyword(s):  
Univariate Analysis ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Older Age ◽  
Stroke Patients ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
Stroke Registry ◽  
Post Stroke

ABSTRACT Purpose: to assess the demographic and clinical characteristics associated with the development of pneumonia in post-stroke patients hospitalized in a tertiary hospital, located in the Vale do São Francisco, that covers the states of Pernambuco and Bahia, Brazil. Methods: a unicentric, observational, analytical, cross-sectional study, based on the medical records of patients diagnosed with stroke and included in the Stroke Registry (RAVESS study). The statistical analysis was made with the chi-square test, Fisher’s exact test, and the analysis of variance, with the Bonferroni’s post-test, and P≤0.05. Results: data from 69 patients presented with acute stroke were collected, aged 63.2±16.8 years; 37 (53.6%) were females; the prevalence of pneumonia during hospital stay was estimated at 31.9% (95% confidence interval: 21.2-44.2%). In the univariate analysis of predictors for post-stroke pneumonia, the following were identified: older age (72.6±17.9 vs. 58.8±14.5; P = 0.001), lower response signal to the Glasgow Coma Scale at admission (11.3±1.8 vs. 13.3±2.1; P = 0.001), and higher frequency of dysarthria at admission (61.9% vs. 27.9%; P = 0.009). Conclusion: pneumonia was a prevalent complication in post-stroke patients at a Brazilian tertiary hospital. It was related to the patient’s older age and the severity of the cerebral event.

Criteria for Screening Diabetes Mellitus Using Serum Fructosamine Level and Fasting Plasma Glucose Level

1993 ◽  
Vol 32 (03) ◽  
pp. 237-240 ◽  
Author(s):  
H. Kiyose ◽  
K. Ito ◽  
T. Iwatsuka ◽  
H. Kawai ◽  
Y. Goto ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Glucose Level ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Plasma Glucose Level ◽  
Fasting Plasma Glucose Level ◽  
Oral Glucose ◽  
Fasting Plasma ◽  
Serum Fructosamine ◽  
Patients With Diabetes

Abstract:A screening method using serum fructosamine level and the fasting plasma glucose level was used for screening patients with diabetes mellitus. The criteria for positive tests recommended by the Japanese Society of Multiphasic Health Testing and Services were evaluated. It was found that levels for the serum fructosamine of 290 µmol/l or higher (or, for the fasting plasma glucose of 110 mg/dl or higher) agreed with the standard oral glucose tolerance test in identifying patients with diabetes mellitus in 96.7% of cases, and the serum fructosamine test was simpler and less expensive.

scholarly journals The Ratio of Estimated Average Glucose to Fasting Plasma Glucose Level Is Superior to Glycated Albumin, Hemoglobin A1c, Fructosamine, and GA/A1c Ratio for Assessingβ-Cell Function in Childhood Diabetes

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Ji Eun Lee ◽  
Ji Woo Lee ◽  
Tatsuyoshi Fujii ◽  
Noriyoshi Fujii ◽  
Jong Weon Choi
Keyword(s):  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Cell Function ◽  
Glycated Albumin ◽  
Model Assessment ◽  
C Peptide ◽  
Fasting Plasma ◽  
Glucose Ratio ◽  
Patients With Diabetes ◽  
Average Glucose

Objective. This study investigated the use of the estimated average glucose to fasting plasma glucose ratio (eAG/fPG ratio) to screen forβ-cell function in pediatric diabetes.Methods. Glycated hemoglobin (HbA1c), glycated albumin (GA), fructosamine, insulin, and C-peptide levels were measured. The ratio of GA to HbA1c (GA/A1c ratio) was calculated, and the homeostasis model assessment ofβ-cell function (HOMA-β) was determined.Results. Median values of C-peptide, insulin, and HOMA-βlevels were significantly higher in patients with an increased eAG/fPG ratio than in those with a decreased eAG/fPG ratio. C-peptide and HOMA-βlevels were more closely correlated with the eAG/fPG ratio than with GA, HbA1c, the GA/A1c ratio, and fructosamine. In contrast, body mass index was significantly associated with GA, GA/A1c ratio, and fructosamine, but not with the eAG/fPG ratio and HbA1c levels. To test the diagnostic accuracies of the eAG/fPG ratio for identifying HOMA-β> 30.0% in patients with type 2 diabetes, the area under the ROC curve of the eAG/fPG ratio was significantly larger than that of the GA/A1c ratio [0.877 (95% CI, 0.780–0.942) versus 0.775 (95% CI, 0.664–0.865),P=0.039].Conclusions. A measurement of the eAG/fPG ratio may provide helpful information for assessingβ-cell function in pediatric patients with diabetes.

Control of hypertension and diabetes among adults aged over 40 years with or without physical disabilities

2015 ◽  
Vol 14 (2) ◽  
Author(s):  
Jung-A Lee ◽  
Jong Heon Park
Keyword(s):  
Plasma Glucose ◽  
Screening Program ◽  
Physical Disabilities ◽  
Female Gender ◽  
Healthcare Services ◽  
Tertiary Hospital ◽  
Health Screening ◽  
Effective Control ◽  
Screening Programs ◽  
Glucose Levels

AbstractDisabled individuals have poorer health compared to non-disabled individuals and they exhibit a higher prevalence of chronic diseases, such as hypertension (HTN) and diabetes mellitus (DM). We explored how effectively blood pressure (BP) and fasting plasma glucose (FPG) level, factors influencing development of HTN and DM, were controlled in disabled and non-disabled individuals over the age of 40 years. We hypothesized that control of BP and FPG levels in disabled individuals would be lower than that in non-disabled participants.Records of the National Health Insurance Scheme (NHIS) were analyzed and the health screening program database was examined between the years 2007 and 2009. We identified patients who had used healthcare services to treat HTN or DM. Health-related information that might influence effective control of both BP and FPG levels in those with or without physical disabilities were examined.The extent of effective BP and DM control did not differ between people with and without disabilities, but plasma glucose levels were slightly better controlled in individuals with disabilities than those without disabilities. HTN and DM control was more closely associated with female gender, age, grade of disability, non-smoking and non-drinker status, engagement in physical activity, presentation for health examinations, and frequent tertiary hospital visits for HTN management.Our paper is significant because of our focus on differences between disabled and non-disabled individuals. Our results and future data from NHIS health screening programs can be used to regularly monitor population health status and to evaluate information relevant to the management of HTN and DM control.

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