Abstract WP220: The Effect of Self-Reported Optimism on the Incidence of Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Ahmed Malik ◽  
Haseeb Rahman ◽  
Adnan Qureshi ◽  
Martha A Wojtowycz

Purpose: The purpose of this study is to determine whether having an optimistic outlook on life decreases the risk of developing incident stroke. Methods: Participants who developed incident stroke in Americans’ Changing Lives study, and participants who did not develop incident stroke (dependent variable) in were compared for demographics, baseline characteristics, comorbidities, and optimistic outlook on life. Numbers and proportions of respondents in both groups were reported for all categorical variables, while mean and standard deviation were reported for age. All statistically significant variables from the above analyses were entered into a logistic regression analysis to ascertain the association between optimistic outlook on life and stroke. Results: Of the 98,577,928 participants, 73,040,055 did not have stroke at baseline. There were 599,190 who developed incident stroke and 1,104,751 who did not develop incident stroke. The mean age (standard deviation) was lower in those who developed incident stroke compared to those who did not [45.9 (13.8) vs. 46.4 (9.9) p<.0001], and participants with an optimistic outlook on life, were 0.20 times less likely to develop stroke as those who did not have an optimistic outlook on life [OR (Odds ratio) 0.20 95% CI (95% confidence interval) 0.20,0.21], after adjusting for confounders. Conclusions: People who have an optimistic outlook on life are less likely to develop incident stroke. The protective value of optimism lends credence to the value of targeting unconventional risk factors in stroke prevention.

2019 ◽  
Vol 67 (1) ◽  
pp. 51-59 ◽  
Author(s):  
Jesús Manuel Romo-Gallegos ◽  
Carlos Cruz-Vázquez ◽  
Leticia Medina-Esparza ◽  
Miguel Ramos-Parra ◽  
Dora Romero-Salas

This study, carried out in 13 sheep flocks of central-western Mexico, aimed to identify the prevalence of anti-N. caninum antibodies, to develop a risk analysis of the infection and to estimate the prevalence of parasite DNA in blood. A total of 368 serum and blood samples were subjected to ELISA and PCR tests, respectively, and the association between the prevalence of antibodies and some management factors was estimated. The overall prevalence of anti-N. caninum antibodies was 13.5% [50/368; 95% confidence interval (CI) 10–17], ranging from 2.7 to 90% per flock, and 92% of the farms had seropositive animals. In ewes the prevalence was 14% (48/348, 95% CI 10–17) and in rams 10% (2/20; 95% CI 1– 33). The mean prevalence of Neospora DNA in blood was 27% (99/368, 95% CI 22–31), implying a range between 16 and 82%. In rams, the prevalence was 5% (1/20 95% CI 2–26), while in ewes it was 28% (98/348, 95% CI 23–33). The agreement between the tests was k = 0.19. The presence of other domestic animal species in the farms [odds ratio (OR) 4.4] and the consumption of placental debris, fetuses and stillborn lambs by dogs living in the farms (OR 5.8) were demonstrated to be risk factors.


Animals ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 2431
Author(s):  
Nicole Romness ◽  
Kate Fenner ◽  
Jessica McKenzie ◽  
Ashley Anzulewicz ◽  
Bibiana Burattini ◽  
...  

An evidence-based understanding of dangerous or unwelcome behaviour in horses would greatly benefit both horses and humans who interact with them. Using owner-reported data from the Equine Behaviour Assessment and Research Questionnaire (E-BARQ), the current study investigated in-hand behaviours associated with dangerous or unwelcome ridden behaviours, notably bolting, rearing and bucking. Respondents (n = 1584) to the ridden horse section of the E-BARQ answered 42 demographic questions, followed by 268 behavioural items. Parallel analysis was conducted to group individual behaviours into rotated components to create independent and dependent indices. Multivariable general linear modelling and ordinal logistic regression were used to identify behaviours associated with bolting, rearing and bucking. Results revealed that safety-from-bolt increased as social confidence with horses (Odds ratio (OR) = 1.06; 95% confidence interval (cf = 1.02–1.09) and other animals (OR = 1.08; cf = 1.03–1.12), compliance in-hand (OR = 1.10; cf = 1.06–1.16) and tolerance of restraint (OR = 1.05; cf = 1.0–1.11) increased; and decreased as loading problems (OR = 0.95; cf = 0.92–0.99) increased. Safety-from-rear increased as tolerance of restraint (OR = 1.07; cf = 1.02–1.12) and social confidence with other animals (OR = 1.05; cf = 1.01–1.09) increased; and decreased as loading problems (OR = 0.94; cf = 0.91–0.98) increased. Safety-from-buck increased as social confidence with horses (b-value = 0.011, p < 0.001) and other animals (b-value = 0.010, p = 0.002), compliance in-hand (b-value = 0.015, p < 0.001), tolerance of restraint (b-value = 0.009, p = 0.027) and tolerance of haltering/bridling (b-value = 0.016, p = 0.010) increased, and it decreased as loading problems increased (b-value = −0.011, p < 0.001). By revealing, for the first time, that specific behaviours on the ground are associated with particular responses in the same horses when ridden, this study advances equitation science considerably. Identification of risk factors for dangerous behaviour while under saddle can improve safety for horses and riders and highlights the importance of effective and humane in-hand training.


2017 ◽  
Vol 34 (1) ◽  
pp. 9-16 ◽  
Author(s):  
Henock Woldu ◽  
B. Joseph Guglielmo

Background: Particularly with the current increased vancomycin dosing trends, the true risk of the agent’s nephrotoxicity is not well characterized and remains of concern. Objective: To determine the incidence of vancomycin nephrotoxicity in acutely ill hospitalized children and to secondarily characterize the risk factors for this complication. Methods: A single-center retrospective cohort study conducted at UCSF Benioff Children’s Hospital from June 2012 to June 2015. Inpatients 3 months to <19 years who received intravenous vancomycin for ≥48 hours were included. The primary outcome was incidence of nephrotoxicity, defined as an increase in serum creatinine by ≥50% from baseline. Univariate and multivariate analyses were conducted to identify risk factors for vancomycin nephrotoxicity. Results: A total of 291 patients (272 nonnephrotoxic and 19 nephrotoxic) were included in the analysis. Of the 19 patients, 12 (4.1%) were found to have moderate to severe toxicity. The median duration of therapy was 3 (3-5) and 4 (3-6) days for the group with “no nephrotoxicity” and “nephrotoxicity,” respectively. The mean time for the serum creatinine to return to normal in patients with nephrotoxicity was 5.1 days. In the multivariate analysis, only final trough concentration ≥15mg/dL (odds ratio = 3.49, 95% confidence interval = 1.2-10.1; P = .021) and receipt of piperacillin/tazobactam (odds ratio = 3.14, 95% confidence interval = 1.02-9.6; P = .046) were significantly associated with nephrotoxicity. Conclusion: The rate of moderate to severe vancomycin-associated nephrotoxicity in acutely ill children is relatively uncommon and reversible. Kidney injury is associated with increased vancomycin trough concentrations and concomitant receipt of nephrotoxins, particularly piperacillin/tazobactam.


2020 ◽  
Author(s):  
Chang-yong Fu ◽  
Zhen-zhong Zhang ◽  
Jin Chen ◽  
Sandip Kumar Jaiswal ◽  
Fu-ling Yan

Abstract Background: Benign paroxysmal positional vertigo (BPPV) is self-limiting and recurrent but the cost is considerable. The recurrence of BPPV increased significantly under the quarantine policy in Hangzhou. The unhealthy lifestyle risk factors of the recurrence of BPPV have not yet been investigated. So, the objective is to analyze the unhealthy lifestyle risk factors of recurrent BPPV.Methods: A retrospective observational study was conducted in the Department of Neurology in Tongde Hospital of Zhejiang Province from December 2018 to March 2020. The study included 186 patients aged 23–86 years. All patients received the definitive diagnosis and canalith repositioning maneuvers (CRM) treatment and finally accomplished follow-up for one year. Demographic variables, potential recurrence risk factors, neurological examination, cranial computed tomography and lifestyle were assessed.Data Analyses: The t-test or chi-squared test was first performed for group comparison, then logistic regression analysis was performed to investigate the recurrence risk factors in all of the patients.Results: The 1-year recurrence rates of BPPV patients after reposition maneuvers were 36.02%, is significantly higher than other study especially in the first quarter of 2020 (38.8% of patients with BPPV recurrence). Logistic regression analysis shows that BPPV patients who was poor physical activities and prolonged recumbent position time have more recurrence risks. Poor physical activities (odds ratio =5.690, 95% confidence interval: 1.650-19.618, p <0.006), prolonged recumbent position time (odds ratio = 1.651, 95% confidence interval: 1.370-2.003, p = 0.000), were risk factors for the recurrence of BPPV in patients.Conclusion: We conclude that poor physical activities and prolonged recumbent position time may be independent risk factors for the recurrence of BPPV patients, but aging, Ménière’s disease, sudden deafness migraine, hypertension, hyperlipemia, diabetes, CHD, POCI, mental factors, and mental labor do not increase the recurrence risk.


2019 ◽  
Author(s):  
Shanshan Shen ◽  
Xingkun Zeng ◽  
Liyu Xu ◽  
Lingyan Chen ◽  
Zixia Liu ◽  
...  

Abstract Background: Motoric cognitive risk syndrome (MCR) is a newly proposed pre-dementia syndrome incorporating subjective cognitive complaints and slow gait. Previous studies have shown that subjective cognitive complaints and slow gait are reported to be associated with frailty in cognitively unimpaired older adults, but little is known giving attention to the link between MCR and frailty in older adults. Therefore, the aim of the study was to explore the associations of MCR and its components and frailty in Chinese older adults. Methods: In an observation cross-sectional study, a total of 429 older adults aged 60 years and older were admitted to the geriatric department. According to MCR criteria, all participants were classified to 4 groups: 1) MCR group; 2) subjective cognitive complaints group; 3) slow gait group; 4) healthy control group. Physical frailty was assessed by Clinical Frailty Scale (CFS). The multivariate logistic regression analysis was used to examine the association between MCR and frailty in older adults. Results: The prevalence of subjective cognitive complaints, slow gait and MCR was 15.9%, 10.0% and 4.0%, respectively. After adjusting for confounding variables, the logistic regression analysis showed that slow gait (odds ratio [OR] 3.40, 95% confidence interval [CI] 1.40-8.23, P=0.007) and MCR (odds ratio [OR] 5.53, 95% confidence interval [CI] 1.46-20.89, P=0.012) were independently associated with frailty, but not subjective cognitive complaints. Conclusions: MCR and slow gait were significantly associated with frailty in Chinese older adults. Further study should prospectively determine the causal relationship between MCR and frailty.


2019 ◽  
Author(s):  
Kwabena Acheampong ◽  
Xiongfeng Pan ◽  
Aizhong Liu

Abstract Background: Data examining whether anemia during different trimesters of pregnancy affects maternal and birth outcomes is lacking. Studies typically look at associations between risk factors and anemia or anemia and birth outcomes but have limited information as to whether birth outcomes differ with different trimesters of anemia. The main objective of this study is to determine whether anemia during different trimesters of pregnancy and hypertension disorders is associated with adverse maternal and perinatal outcomes in Ghana.Methods: This will be a primary analysis of data from a hospital-based prospective cohort study in four selected hospitals in the Bekwai Municipality, Ghana from February 2020 to August 2020. All singleton pregnancy at less than 20 weeks to women with at least one hemoglobin measure during pregnancy will be included. The risk of maternal and perinatal outcomes will be measured. Descriptive statistics will be used to describe the baseline characteristics of our cohort. Baseline characteristics of the two groups will be compared using Pearson Chi-square (χ2) test for categorical variables; the independent t-test and Mann–Whitney U test for parametric and nonparametric continuous variables, respectively. The risk associated with anemia and maternal and perinatal outcomes, using the history of anemia (Hb<11g/dL) in different trimesters will be calculated by logistic regression analysis, conditional on the baseline covariates. Possible confounding variables will be identified from background data, obstetric risk factors, and health behaviors. Multivariate analysis of significant effects (p<0.05) will be based on multiple logistic regression analysis. Confidence intervals will be evaluated at 95%. Data will be coded and examined using the SPSS program IBM version 20.Discussion: The better understanding of whether anemia during different trimesters of pregnancy and hypertension disorders is associated with adverse maternal and perinatal outcomes in Bekwai Municipality of Ghana. This study will establish targets for early intervention and identify risk factors to save and improve the lives of pregnant women and inborn by developing solutions that promote the quality and accountability of health services for the most vulnerable. These findings will be served as a policy document to governments in designing effective programs to curb the increasing prevalence of anemia and its associated health consequences.


2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Hiroaki Nakashima ◽  
Kei Ando ◽  
Kazuyoshi Kobayashi ◽  
Taisuke Seki ◽  
Shinya Ishizuka ◽  
...  

Osteoporosis is a disease characterized by deterioration of bone tissue and mass, with an increasing global prevalence. Therefore, the discovery of biomarkers for osteoporosis would help to guide appropriate treatment. Circulating microRNAs (miRNAs) have become increasingly recognized as biomarkers for detecting diseases. However, few studies have investigated the association of circulating miRNA with osteoporosis in the general population. The aim of this study was to identify miRNA associated with osteoporosis in a general resident health check-up for potential use as an osteoporosis biomarker. We conducted a cross-sectional study as part of a health check-up program and recruited 352 volunteers (139 men, 213 women, mean age 64.1±9.6 years). Osteoporosis was diagnosed according to the WHO classification. Twenty-two candidate microRNAs were screened through real-time quantitative PCR, and miRNAs associated with osteoporosis were analyzed using logistic regression analysis including other risk factors. In total, 95 females and 30 males were diagnosed with osteoporosis with bone mineral density tests (BMD: T‐score<−2.5). We found that miR195 was significantly lower in females, while miR150 and miR222 were significantly higher in males. The results of the logistic regression analysis indicated that in females, higher age and lower miR195 (odds ratio: 0.45, 95% confidential interval: 0.03–0.98) were significant risk factors for lower BMD, while the presence of a smoking habit and lower miR150 (odds ratio: 1.35, 95% confidential interval: 1.02–1.79) were significant risk factors for osteoporosis. Serum levels of miR195 and miR150 are independently associated with low bone mineral density in females and males, respectively.


2020 ◽  
Vol 33 (6) ◽  
pp. 534-542
Author(s):  
Chami Im ◽  
Tak Kyu Oh ◽  
In-Ae Song

Abstract Background This study aimed to determine whether use of preoperative antihypertensive medication is associated with postoperative 90-day mortality in the hypertensive adult population that underwent elective noncardiac surgery. Methods In this retrospective cohort study, medical records of preoperative hypertensive patients who underwent noncardiac surgery at a single tertiary academic hospital from 2012 to 2018 were reviewed. Among the hypertensive patients, those prescribed to take antihypertensive medication continuously for more than 1 month before admission were defined as the HTN MED group; others were defined as the non-HTN MED group. Multiple imputation, propensity score (PS) matching, and logistic regression analysis were used for statistical analysis. Results Overall, 35,589 preoperative hypertensive adult patients (HTN MED group: 26,154 patients, non-HTN MED group: 9,435 patients) were included in the analysis. After PS matching, each group comprised 6,205 patients; thus, 12,410 patients were included in the final analysis. The odds for 90-day mortality of the HTN MED group in the PS-matched cohort were 41% lower (odds ratio: 0.59, 95% confidence interval: 0.41–0.85; P = 0.005) than those of the non-HTN MED group. Comparable results were obtained in the multivariable logistic regression analysis of the entire cohort (odds ratio: 0.54, 95% confidence interval: 0.41–0.72; P &lt; 0.001). Conclusions This study showed that the use of preoperative antihypertensive medication was associated with lower 90-day mortality among hypertensive patients who underwent noncardiac surgery. Therefore, preoperative screening and treatment with appropriate antihypertensive medication are important for hypertensive patients.


Stroke ◽  
2013 ◽  
Vol 44 (10) ◽  
pp. 2898-2900 ◽  
Author(s):  
Dulka Manawadu ◽  
Shankaranand Bodla ◽  
Jeff Keep ◽  
Lalit Kalra

Background and Purpose— Thrombolysis in patients >80 years remains controversial; we hypothesized that >80-year-old patients with wake-up ischemic stroke (WUIS) will benefit from thrombolysis despite risks because of poor outcomes with no treatment. Methods— The study included 68 thrombolysed patients with WUIS (33 [48%] >80 years), 54 nonthrombolysed patients with WUIS (21 [39%] >80 years), and 117 patients (>80 years old) thrombolysed within 4.5 hours of symptom onset (reference group). Mortality and modified Rankin Scale (mRS) were assessed at 90 days. Results— Baseline characteristics of thrombolysed and nonthrombolysed >80 and ≤80-year-old patients with WUIS were comparable. Thrombolysis outcomes in >80-year-old patients with WUIS were better than in nonthrombolysed >80-year-old patients with WUIS (90-day mortality: 24% versus 47%, P =0.034; mRS 0–2: 30% versus 5%, P =0.023; mRS 0–1: 15% versus 5%, P =0.24) and comparable with thrombolysed ≤80-year-old patients with WUIS. Thrombolysis was associated with odds ratio 0.27 (95% confidence interval, 0.05–0.97) for mortality and odds ratio 28.6 (95% confidence interval, 1.8–448) for mRS 0 to 2 at 90 days in >80-year-old patients with WUIS after adjusting for stroke severity and risk factors. Conclusions— Thrombolysis may be associated with greater benefit in >80-year-old patients with WUIS but a selection bias favoring thrombolysis in those most likely to benefit may significantly reduce interpretability of these findings.


2019 ◽  
Vol 05 (01) ◽  
pp. e1-e4 ◽  
Author(s):  
Ganesan Ganesan ◽  
Phagal Vijayaraghavan

Context Osteoporosis is a silent disease until it is complicated by trivial fall fractures. There is an increasing interest within the orthopaedic community in the noninvasive cost-effective measurement of the bone mineral density. Aims The aim of the study is to assess whether urinary N-telopeptide level can be a new diagnostic tool in diagnosing osteoporosis. Methods and Material This prospective study was done at Sri Ramachandra Medical Centre (SRMC) hospital from October 2015 to October 2017. The study was conducted among patients who comes to SRMC as inpatient or outpatient with suspected osteoporosis and underwent dual-energy X-ray absorptiometry (DXA) scan and urinary N-telopeptide. The inclusion criteria were women aged 65 or older, women aged less than 65 with risk factors, younger postmenopausal women with one or more risk factors, men aged 70 or older, men less than 70 with risk factors, and any above group patients who comes within 24 hours following trivial fall fractures. The exclusion criteria were pathological fracture, history of any illness affecting bone metabolism. The results from DXA scan were taken as gold standard against urinary N-telopeptide. Then the patients were divided into two groups control and study. The control group contains patients who had normal DXA, while study group contains patients having either osteopenia or osteoporosis. Based on our inclusion and exclusion criteria, 110 persons were included in the study. We had 60 study and 50 controls patients. We had 88 females and 22 males. The results obtained were statistically analyzed. Statistical Analysis Used The collected data were analyzed with IBM SPSS statistics software 23.0 version. To describe about the data descriptive statistics frequency analysis, percentage analysis was used for categorical variables and the mean and standard deviation were used for continuous variables. To find the significant difference between the bivariate samples in independent groups, the unpaired sample t-test was used. To find the significance in categorical data, chi-square test was used. In both the earlier statistical tools, the probability value of 0.05 is considered as significant level. Results In our study, we had 18.2% osteopenic and 36.4% osteoporotic patients. The mean value of urinary N-telopeptide in control was 49.8 and in case was 182.5. The standard deviation of urinary N-telopeptide value in case was 159.9. Conclusion Urinary N-telopeptide can give reproducible results and be able to assist in the evaluation of the quantity as well as the quality and be a good judge of someone's risk of fracture. Hence, urinary N-telopeptide can be used as a diagnostic tool for diagnosing osteoporosis.


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