Sex Differences in the Impact of Shift Work Schedules on Pathological Outcomes in an Animal Model of Ischemic Stroke

Background The association between systemic hypertension and cerebrovascular disease is well documented. However, the impact of pulmonary hypertension (PH) on acute ischemic stroke outcomes is unknown despite PH being recognized as a risk factor for acute ischemic stroke. We aimed to determine the association between PH and adverse in‐hospital outcomes after acute ischemic stroke, as well as whether there are sex differences in this association. Methods and Results Acute ischemic stroke admissions from the US National Inpatient Sample between October 2015 and December 2017 were included. The relationship between PH and outcomes (mortality, prolonged hospitalization >4 days, and routine home discharge) was analyzed using logistic regressions adjusting for demographics, comorbidities, and revascularization therapies. Interaction terms between PH and sex and age groups were also included. A total of 221 249 records representative of 1 106 045 admissions were included; 2.9% of patients had co‐morbid PH, and 35.34% of those were male. PH was not associated with in‐hospital mortality (odds ratio [OR], 0.96; 95% CI, 0.86–1.09) but was associated with increased odds of prolonged hospitalization (OR, 1.15; 95% CI, 1.09–1.22) and decreased odds of routine discharge (OR, 0.87; 95% CI, 0.81–0.94) for both sexes. Older patients with PH were significantly less likely to be discharged routinely ( P =0.028) than their younger counterparts. Compared with female patients with PH, men were 31% more likely to die in hospital ( P =0.024). Conclusions PH was not significantly associated with in‐hospital mortality but was associated with prolonged hospitalization and adverse discharge status. Male patients with PH were more likely to die in hospital than female patients.

Download Full-text

Glycemic variability: prognostic impact on acute ischemic stroke and the impact of corrective treatment for hyperglycemia. The GLIAS-III translational study

Journal of Translational Medicine ◽

10.1186/s12967-020-02586-4 ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Blanca Fuentes ◽

Silvia Pastor-Yborra ◽

Raquel Gutiérrez-Zúñiga ◽

Noemí González-Pérez de Villar ◽

Elena de Celis ◽

...

Keyword(s):

Animal Model ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Glycemic Variability ◽

Prospective Clinical Study ◽

Prognostic Impact ◽

Translational Study ◽

Administration Routes ◽

Glucose Levels ◽

The Impact

Abstract Introduction Glycemic variability (GV) represents the amplitude of oscillations in glucose levels over time and is associated with higher mortality in critically ill patients. Our aim is to evaluate the impact of GV on acute ischemic stroke (IS) outcomes in humans and explore the impact of two different insulin administration routes on GV in an animal model. Methods This translational study consists of two studies conducted in parallel: The first study is an observational, multicenter, prospective clinical study in which 340 patients with acute IS will be subcutaneously implanted a sensor to continuously monitor blood glucose levels for 96 h. The second study is a basic experimental study using an animal model (rats) with permanent occlusion of the middle cerebral artery and induced hyperglycemia (through an intraperitoneal injection of nicotinamide and streptozotocin). The animal study will include the following 6 groups (10 animals per group): sham; hyperglycemia without IS; IS without hyperglycemia; IS and hyperglycemia without treatment; IS and hyperglycemia and intravenous insulin; and IS and hyperglycemia and subcutaneous insulin. The endpoint for the first study is mortality at 3 months, while the endpoints for the animal model study are GV, functional recovery and biomarkers. Discussion The GLIAS-III study will be the first translational approach analyzing the prognostic influence of GV, evaluated by the use of subcutaneous glucose monitors, in acute stroke. Trial registrationhttps://www.clinicaltrials.gov (NCT04001049)

Download Full-text

Prognostic Significance of Prolonged Corrected QT Interval in Acute Ischemic Stroke

Frontiers in Neurology ◽

10.3389/fneur.2021.759822 ◽

2021 ◽

Vol 12 ◽

Author(s):

Sung-Ho Ahn ◽

Ji-Sung Lee ◽

Young-Hak Kim ◽

Mi-Sook Yun ◽

Jung-Hee Han ◽

...

Keyword(s):

Heart Rate ◽

Sex Differences ◽

Ischemic Stroke ◽

Cardiovascular Risk ◽

Acute Ischemic Stroke ◽

Stroke Severity ◽

Qtc Interval ◽

The Impact ◽

Long Term Mortality

Background and Purpose: The aim of this study was to determine the relationship between the heart rate-corrected QT (QTc) interval and the risk of incident long-term mortality in patients with acute ischemic stroke (AIS), considering the impact of sex differences on clinical characteristics, outcomes, and QTc intervals.Methods: We analyzed prospectively registered data included patients with AIS who visited the emergency room within 24 h of stroke onset and underwent routine cardiac testing, such as measurements of cardiac enzymes and 12-lead ECG. QTc interval was corrected for heart rate using Fridericia's formula and was stratified by sex-specific quartiles. Cox proportional hazards models were used to examine the association between baseline QTc interval and incident all-cause death.Results: A total of 1,668 patients with 1,018 (61.0%) men and mean age 66.0 ± 12.4 years were deemed eligible. Based on the categorized quartiles of the QTc interval, cardiovascular risk profile, and stroke severity increased with prolonged QTc interval, and the risk of long-term mortality increased over a median follow-up of 33 months. Cox proportional hazard model analysis showed that the highest quartile of QTc interval (≥479 msec in men and ≥498 msec in women; hazard ratio [HR]: 1.49, 95% confidence interval [CI]: 1.07–2.08) was associated with all-cause death. Furthermore, dichotomized QTc interval prolongation, defined by the highest septile of the QTc interval (≥501 ms in men and ≥517 m in women: HR: 1.33, 95% CI: 1.00–1.80) was significantly associated with all-cause mortality after adjusting for all clinically relevant variables, such as stroke severity.Conclusions: Prolonged QTc interval was associated with increased risk of long-term mortality, in parallel with the increasing trend of prevalence of cardiovascular risk profiles and stroke severity, across sex differences in AIS patients.

Download Full-text

The impact of different shift work schedules on the levels of anxiety and stress in workers in a petrochemicals company

Estudos de Psicologia (Campinas) ◽

10.1590/s0103-166x2009000100002 ◽

2009 ◽

Vol 26 (1) ◽

pp. 15-23 ◽

Cited By ~ 6

Author(s):

Katie Moraes de Almondes ◽

John Fontenele Araújo

Keyword(s):

Shift Work ◽

Trait Anxiety ◽

Work Conditions ◽

Work Schedules ◽

Test Results ◽

State Trait Anxiety Inventory ◽

Shift Workers ◽

Stress Symptom ◽

Informed Consent Form ◽

The Impact

This study evaluated anxiety and stress in workers under different shift work conditions. The sample comprised 239 workers, with an average age of 42.6, standard deviation = 5.7 years, divided into fixed daytime working (n=52) and different working shifts (n=187). Documentation: Free and informed consent form; ID's; State-Trait Anxiety Inventory; Lipp's Stress Symptom Inventory for Adults. We used the t-test for independent samples, ANOVA, Pearson's correlation and the two-sample Comparison of proportions Test. Results showed that shift workers had higher State-Trait Anxiety scores than fixed daytime workers (t=-4.994; p=0.0001; t=-2.816; p=0.005, respectively). Both samples exhibited stress, but there were no statistically significant differences between the groups (t=-1.052; p=0.294). Shift work schedules caused more situational and dispositional anxiety, but did not significantly increase stress levels when compared to fixed daytime working.

Download Full-text

The impact of commutes, work schedules, and sleep on near-crashes during nurses’ post shift-work commutes: A naturalistic driving study

IISE Transactions on Occupational Ergonomics and Human Factors ◽

10.1080/24725838.2021.1945708 ◽

2021 ◽

pp. 1-12

Author(s):

Alec Smith ◽

Anthony D. McDonald ◽

Farzan Sasangohar

Keyword(s):

Shift Work ◽

Work Schedules ◽

Naturalistic Driving Study ◽

Naturalistic Driving ◽

The Impact ◽

Post Shift

Download Full-text

Sex Differences in Cerebral Aneurysms and Subarachnoid Hemorrhage

Stroke ◽

10.1161/strokeaha.121.037147 ◽

2022 ◽

Author(s):

Angelica M. Fuentes ◽

Laura Stone McGuire ◽

Sepideh Amin-Hanjani

Keyword(s):

Sex Differences ◽

Ischemic Stroke ◽

Subarachnoid Hemorrhage ◽

Cerebral Aneurysm ◽

Hemorrhagic Stroke ◽

Cerebral Aneurysms ◽

Future Research ◽

Current State ◽

Aneurysm Treatment ◽

The Impact

Sex differences in cerebral aneurysm occurrence and characteristics have been well described. Although sex differences in outcomes following ischemic stroke have been identified, the effect of sex on outcomes following hemorrhagic stroke, and in particular, aneurysm treatment has been less studied. We describe the current state of knowledge regarding the impact of sex on treatment and outcomes of cerebral aneurysms. Although prior studies suggest that aneurysm prevalence and progression may be related to sex, we did not find clear evidence that outcomes following subarachnoid hemorrhage vary based on sex. Last, we identify areas for future research that could enhance understanding of the role sex plays in this context.

Download Full-text