scholarly journals Cerebral hemodynamic abnormalities of patients with ischemic stroke who are opium addicted: A study by transcranial doppler ultrasonography

Author(s):  
Yaser Moadabi ◽  
Alia Saberi ◽  
Sajjad Hoseini ◽  
Ashkan Karimi ◽  
Shahrokh Yousefzadeh-Chabok

Background: Ischemic stroke as the major cause of mortality and morbidity worldwide has different risk factors. One of its modifiable risk factors is opium addiction whose role is not clear yet. This study aimed at assessing the hemodynamic parameters in ischemic stroke patients addicted to opium using transcranial Doppler (TCD) ultrasonography and comparing them with non-addicted patients. Methods: This comparative cross-sectional study was conducted in an academic hospital in the north of Iran in 2016. All the patients diagnosed as ischemic stroke underwent cerebrovascular ultrasound in the first 4 days of symptoms onset. Frequency of hemodynamic abnormalities confirmed by pulsatility index (PI) and mean flow velocity (MFV) were determined and compared between the two groups. The data were analyzed by chi-square test, t-test, and multiple logistic regression models using SPSS software. Results: A total of 353 patients with ischemic stroke (92 addicted and 261 non-addicted patients) were enrolled in the study. Univariate analysis indicated that the PI and MFV differences were statistically significant between two groups of addicted and nonaddicted patients (P = 0.0001). By multivariate logistic regression model, the age [odds ratio (OR) = 1.143], diabetes mellitus (DM) (OR = 3.875), hypertension (HTN) (OR = 2.557), and opium usage (OR = 9.615) had influence on PI and only opium usage (OR = 3.246) had influence on MFV. Conclusion: Opium usage affects the cerebral hemodynamic parameters and increases the chance of having abnormal PI as ten-fold and abnormal MFV as three-fold.  

2022 ◽  
Author(s):  
Xueqian Wang ◽  
Xuejiao Ma ◽  
Mo Yang ◽  
Yan Wang ◽  
Yi Xie ◽  
...  

Abstract Background Lung cancer was often accompanied by depression and anxiety. Nowadays, most investigations for depression and anxiety were concentrated in western medical hospitals, while few related studies have been carried out in the tradition Chinese medicine (TCM) ward. It was necessary to understand the prevalence and risk factors of depression and anxiety in the inpatients with lung cancer in TCM hospital. Methods This study adopted cross-sectional research method, which enrolled a total of 222 inpatients with lung cancer in TCM hospital. PHQ-9 and GAD-7 scales were used to assess depression and anxiety for the inpatients, respectively. Demographic and clinical data were also collected. Statistical methods of the univariate analysis and the multivariate logistic regression model were used. Results The prevalence of depression and anxiety in the inpatients with lung cancer were 58.1% and 34.2%, respectively. Multivariate logistic regression analysis prompted that the common risk factor of depression and anxiety was the symptom of insomnia. Constipation and gender were the two anther risk factors of depression. Conclusion Depression and anxiety were common for the inpatients with lung cancer in TCM hospital. Gender, insomnia and constipation were risk factors for depression, and insomnia was risk factor for anxiety. Therefore, medical workers should pay close attention to the emotional changes of these high-risk patients and intervene the symptoms as early as possible.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yisen Zhang ◽  
Chao Wang ◽  
Zhongbin Tian ◽  
Wei Zhu ◽  
Wenqiang Li ◽  
...  

Abstract Background The aim of this study was to comprehensively evaluate the risk factors of periprocedural ischemic stroke associated with endovascular treatment of intracranial aneurysms using a real-world database. Methods From August 2016 to March 2017, 167 patients were enrolled. Univariate analysis and multivariate logistic regression analysis were used to examine the risk factors for periprocedural ischemic stroke. Results Among the 167 cases, periprocedural ischemic stroke occurred in 20 cases (11.98%). After univariate analysis, the ischemic group had a higher proportion of large (≥ 10 mm) aneurysms than the control group (45.0% vs. 23.1%, p = 0.036). The incidence of periprocedural ischemic stroke was higher in cases treated by flow diverter (21.6%) or stent-assisted coiling (11.8%) than in cases treated by coiling only (2.7%), and the differences were statistically significant (p = 0.043). After multivariate logistic regression analysis, treatment modality was the independent risk factor for periprocedural ischemic stroke. Compared with the coiling-only procedure, flow diverter therapy was associated with a significantly higher rate of periprocedural ischemic stroke (OR 9.931; 95% CI 1.174–84.038; p = 0.035). Conclusions Aneurysm size and treatment modality were associated with periprocedural ischemic stroke. Larger aneurysms were associated with increased risk of periprocedural ischemic stroke. Flow diverter therapy was associated with significantly more periprocedural ischemic stroke than the coiling procedure alone.


2020 ◽  
Author(s):  
Xiaohua Yang ◽  
Huijuan Chen ◽  
Wanling Yang ◽  
Bin Deng ◽  
Jialing Zheng ◽  
...  

Abstract Background: Stroke-associated pneumonia (SAP) is a major complication after stroke, oral microorganisms are important contributors to SAP. Here, we aimed to investigate whether the oral hygiene was associated with SAP and related risk factors of them in patients with acute ischemic stroke. Methods: We performed a cross-sectional study that recruited 331 patients with acute ischemic stroke from two medical centers. A series of assessments were performed to evaluate the neurological status and habits of oral hygiene. According to whether the oral hygiene was abnormal and SAP occurred, univariate analyses were performed in cohort 1 (normal / abnormal oral hygiene groups) and cohort 2 (SAP / non-SAP groups). Multiple logistic regression analyses were conducted to confirm risk factors of oral cleanliness and SAP in stroke patients. Results: A total of 12 and 8 independent variables were included in the model 1 and 2 analysis. After adjusting for confounders, multivariable logistic regression analysis showed that oral cleanliness was not only closely related to SAP (OR=2.219, P=0.026), dental caries (OR=1.292, P=0.005) and age (OR=1.030, P=0.006) in model 1, but also an independent risk factor for predicting SAP (OR=1.678, P=0.001) in model 2. Barthel index was a protective factor for oral cleanliness (OR=0.986, P=0.019) and SAP (OR=0.977, P=0.002) in ischemic stroke patients. Conclusions: Mutually primary risk roles of abnormal oral cleanliness and SAP exist in patients with acute ischemic stroke. Dental caries and aging are important risk factors for oral health disorders. Improving the activities of daily living would have protective effects on both oral hygiene and SAP prevention in stroke patients.


2020 ◽  
Author(s):  
Wei Chen ◽  
Ya Cao ◽  
Quan Yong Chen ◽  
Yan Lu ◽  
Bing Wang ◽  
...  

Abstract Background:This study examined the risk factors for hypotension after caesarean spinal anesthesia with low dose of bupivacaine and sulfentanyl in parturients with scarred uterus. Methods:A total of 322 singleton-pregnancy parturients with scarred uterus who had been scheduled for caesarean spinal anesthesia were randomly sampled. The data on the basic information of the parturients, the gestation, the fetus and the anesthesia were recorded and filed according to the clinical questionnaires on hypotension in caesarean section. The parturients whose systolic blood pressure dropped below 90 mmHg or decreased by 20% during the time from the completion of anesthesia until the delivery of infant were classified as Group hypotension (Group H) and the rest were in Group non-hypotension (Group N). This study analyzed the correlation of 39 factors to the occurrence of hypotension, and further analyzed the statistically significant factors through binary classification logistic regression.Results:Of the 322 sampled parturients, 148 parturients suffered hypotension. The incidence of hypotension in this study was 45.96%. The result of univariate analysis showed statistically significant differences in the factors including height (p=0.005), post-pregnancy Body Mass Index (BMI) (p=0.00), fasting time (p=0.031),weight gain in gestation (p=0.000), fundal height (p=0.047), exercise history in gestation (p=0.006) and dermatomal level of analgesia (p=0.000) between the two groups. The variables with statistical significance were analyzed by multivariate logistic regression model. The result showed that BMI in gestation (OR=1.146, 95% CI 1.041-1.262, p <0.05), weight gain in gestation (OR = 1.126, 95% CI 1.060-1.198, p <0.001), exercise history in gestation (OR = 0.399, 95% CI 0.205-0.778, p = 0.007), and dermatomal level of analgesia (OR = 2.248, 95% CI 1.645-3.074, p <0.001) were risk factors for hypotension after caesarean spinal anesthesia in parturients with scarred uterus. Conclusion:The incidence of hypotension after caesarean spinal anesthesia in parturients with scarred uterus was relatively high. The post-pregnancy BMI, weight gain in gestation, exercise history in gestation and dermatomal level of analgesia after anesthesia were risk factors for hypotension after caesarean spinal anesthesia in parturients with scarred uterus. These findings play an important role in predicting the occurrence of hypotension after caesarean spinal anesthesia in parturients with scarred uterus. Trial registration:Chinese Clinical Trial Registry (chiCTR-ROC-17011251)


2020 ◽  
Author(s):  
Wei Chen ◽  
Ya Cao ◽  
quan yong chen ◽  
Yan Lu ◽  
Bing Wang ◽  
...  

Abstract Backgroud:This study aims to discuss the risk factors to hypotension for caesarean parturients with scarred uterus when low dose of bupivacaine and sulfentanyl are used in spinal anesthesia. Methods:A total of 322 singleton-pregnancy parturients with scarred uterus who had been scheduled for caesarean spinal anesthesia were randomly sampled. The data about the basic information of the parturients, the gestation, the fetus and the anesthesia has been recorded and filed according to the clinical questionnaires about hypotension in caesarean section. The parturients whose systolic pressure drops below 90mmHG or decreases by 20% during the time from the completion of anesthesia until the delivery of infant were classified to be Group Hypotension (Group H) and the rest are in Group non-hypotension (Group N). This study analyzes the correlation of 39 factors to the occurrence of hypotension and then further analyzes the statistically significant factors through binary classification logistic regression.Results:Of the 322 sampled parturients, 148 parturients suffered hypotension. The incidence of hypotension in this study is 45.96%. The result of univariate analysis shows that the differences in the factors including height (p=0.005), post-pregnancy Body Mass Index (BMI) (p=0.00), weight gain in gestation (p=0.000), fundal height(p=0.047), fasting time (p=0.031), exercise history in gestation (p=0.006) and dermatomal level of analgesia (p=0.000) between two groups are statistically significant. The variables with statistical significance are analyzed by multivariate logistic regression model. The result shows that BMI in gestation (OR=1.146 95%, CI 1.041-1.262, p <0.05), weight gain in gestation (OR = 1.126 95%, CI 1.060-1.198, p <0.001), exercise history in gestation (OR = 0.399, 95% CI 0.205-0.778, p = 0.007), dermatomal level of analgesia (OR = 2.248, 95% CI 1.645-3.074, p <0.001) are risk factors to hypotension occurrence after caesarean spinal anesthesia for parturients with scarred uterus. Conclusion:The incidence of hypotension occurring after caesarean spinal anesthesia for parturients with scarred uterus is relatively high. Factors including post-pregnancy BMI, weight gain in gestation, exercise history in gestation and dermatomal level of analgesia after anesthesia are risk factors to hypotension occurring after caesarean spinal anesthesia for parturients with scarred uterus. The result plays an important role in predicting the occurrence of hypotension after spinal anesthesia by parturients with scarred uterus in clinic. Trial registration:Chinese Clinical Trial Registry(chiCTR-ROC-17011251)


2021 ◽  
Vol 8 (4) ◽  
pp. 636
Author(s):  
N. Rajeshwari ◽  
A. Savitha ◽  
J. Prahada

Background: “Signs of inflammation that can kill” (SICK) score is one of the severities scoring systems used for predicting outcome of children at admission. The aim of the present study was to study the clinical and demographic profile of children admitted to Paediatric ward, to assess the usefulness of SICK score in predicting the mortality and evaluate the risk factors in predicting mortality.  Methods: SICK scoring was done for 369 children on admission. The outcome was recorded as death or discharge. The associated factors were analysed using SPSS software package analysis. Receiver operating curve was used to arrive at the cut-off point of SICK score for predicting mortality. Quantitative data differences between children who died and children who were discharged from the hospital were analysed using student independent t test. Need for assisted ventilation, presence of shock, age less than 3 years, and SICK score>2 were studied to find their association with mortality. Statistical analysis was done using univariate analysis and those factors that were significantly associated with mortality were subjected multivariate logistic regression analysis.Results: The performance of SICK score was “excellent” in discriminating between death and survival with area under the receiver operating characteristics curve 0.94. Age<3-year presence of shock, need for mechanical ventilation and SICK score>2 showed statistically significant association with mortality as evidenced by multivariate logistic regression model.  Conclusions: SICK score performed extremely well in predicting mortality on admission. Age<3 years, SICK score>2, Presence of Shock and need for assisted ventilation showed statistically significant association with mortality.


2019 ◽  
Vol 27 (5) ◽  
pp. 678-687
Author(s):  
Guohua Zheng ◽  
Xin Zheng ◽  
Junzhe Li ◽  
Tingjin Duan ◽  
Kun Ling ◽  
...  

This study investigated the effects of Tai Chi compared with no exercise control on the cerebral hemodynamic parameters and other health-related factors in community older adults at risk of ischemic stroke. A total of 170 eligible participants were randomly allocated to Tai Chi or control group. The cerebral hemodynamic parameters and physical fitness risk factors of cardiovascular disease were measured at baseline, 12 weeks, and 24 weeks. After the 12-week intervention, Tai Chi significantly improved the minimum of blood flow velocity (BFVmin); BFVmean; pulsatility index and resistance index of the right anterior cerebral artery; and BFVmax, BFVmin, and BFVmeanparameters of the right middle cerebral artery. Tai Chi training also decreased triglyceride, fasting blood glucose, and homocysteine levels, and improved balance ability. Therefore, the supervised 12-week Tai Chi exercise had potential beneficial effects on cerebral hemodynamics, plasma risk factors, and balance ability in older community adults at risk of ischemic stroke.


2021 ◽  
Author(s):  
Yisen Zhang ◽  
Chao Wang ◽  
Zhongbin Tian ◽  
Wei Zhu ◽  
Wenqiang Li ◽  
...  

Abstract BackgroundThe aim of this study was to comprehensively evaluate the risk factors of periprocedural ischemic stroke associated with endovascular treatment of intracranial aneurysms using a real-world prospective database.MethodsFrom August 2016 to March 2017, 200 patients with 217 aneurysms who underwent 206 endovascular procedures were enrolled. Univariate analysis and multivariate logistic regression analysis were used to examine the risk factors for periprocedural ischemic stroke.ResultsAmong the 206 endovascular procedures, periprocedural ischemic stroke occurred in 23 procedures (11.17%). After univariate analysis, the ischemic group had a higher proportion of large (≥ 10 mm) aneurysms than the control group (39.1% vs. 20.2%, p = 0.040). The incidence of periprocedural ischemic stroke was higher in cases treated by flow diverter (18.60%) or stent-assisted coiling (12.28%) than in cases treated by coiling only (2.04%), and the differences were statistically significant (p = 0.036). After multivariate logistic regression analysis, treatment modality was the independent risk factor for periprocedural ischemic stroke. Compared with the coiling-only procedure, flow diverter therapy was associated with a significantly higher rate of periprocedural ischemic stroke (OR 13.839; 95% CI 1.617–118.416; p = 0.016). Stent-assisted coiling also tended to present more often with periprocedural ischemic stroke than coiling alone (OR 7.559; 95% CI 0.958–59.618; p = 0.055).ConclusionsAneurysm size and treatment modality were associated with periprocedural ischemic stroke. Larger aneurysms were associated with increased risk of periprocedural ischemic stroke. Flow diverter therapy was associated with significantly more periprocedural ischemic stroke than the coiling procedure alone.


2004 ◽  
Vol 25 (6) ◽  
pp. 485-491 ◽  
Author(s):  
Werner E. Bischoff ◽  
Michelle L. Wallis ◽  
Keith B. Tucker ◽  
Beth A. Reboussin ◽  
Robert J. Sherertz

AbstractObjective:To evaluate the prevalence and risk factors of nasalStaphylococcus aureus(SA) in the community.Design:Cross-sectional study.Setting:Wake Forest University, Winston-Salem, North Carolina.Participants:Four hundred fifty students were screened for nasal SA carriage during the fall of 2000, 2001, and 2002.Methods:Students were screened by nose swabs. A self-administered questionnaire collected information on demographics and medical history. Antibiotic testing and PFGE were performed on isolates. Risk factors were determined by logistic regression analysis.Results:Of 450 volunteers, 131 (29%) were SA carriers. Antibiotic resistance was high for azithromycin (26%) and low for ciprofloxacin (1%), tetracycline (5%), mupirocin (1%), and methicillin (2%). PFGE patterns were not associated with carriage. Age, male gender, white race, medical student, allergen injection therapy, chronic sinusitis, rheumatoid arthritis, hospitalization for 6 months or less, and use of antibiotics were associated with carrier status by univariate analysis. Stepwise multivariate logistic regression led to a best fitting model with older age (OR, 1.04; CI95, 1.005-1.079), male gender (OR, 1.50; CI95, 0.982-2.296), and chronic sinusitis (OR, 2.71; CI95, 0.897-8.195) as risk factors. Antibiotic use (< 4 weeks) (OR, 0.41; CI95, 0.152-1.095) and allergen injection therapy (OR 0.41; CI95, 0.133-1.238) were protective. Analyses of carriers revealed candidate factors for persistent carriage to be nasal SA colonization rate and male gender. Factors for azithromycin resistance were non-medical students and antibiotic use in the past 6 months.Conclusion:Older male volunteers suffering from chronic sinusitis and not taking antibiotics were at higher risk for carrying SA.


2020 ◽  
Author(s):  
Wei Chen ◽  
Ya Cao ◽  
Quan Yong Chen ◽  
Yan Lu ◽  
Bing Wang ◽  
...  

Abstract Background:This study examined the risk factors for hypotension after caesarean spinal anesthesia with low dose of bupivacaine and sulfentanyl in parturients with scarred uterus. Methods:A total of 322 singleton-pregnancy parturients with scarred uterus who had been scheduled for caesarean spinal anesthesia were randomly sampled. The data on the basic information of the parturients, the gestation, the fetus and the anesthesia were recorded and filed according to the clinical questionnaires on hypotension in caesarean section. The parturients whose systolic blood pressure dropped below 90 mmHg or decreased by 20% during the time from the completion of anesthesia until the delivery of infant were classified as Group hypotension (Group H) and the rest were in Group non-hypotension (Group N). This study analyzed the correlation of 39 factors to the occurrence of hypotension, and further analyzed the statistically significant factors through binary classification logistic regression.Results:Of the 322 sampled parturients, 148 parturients suffered hypotension. The incidence of hypotension in this study was 45.96%. The result of univariate analysis showed statistically significant differences in the factors including height (p=0.005), post-pregnancy Body Mass Index (BMI) (p=0.00), fasting time (p=0.031),weight gain in gestation (p=0.000), fundal height (p=0.047), exercise history in gestation (p=0.006) and dermatomal level of analgesia (p=0.000) between the two groups. The variables with statistical significance were analyzed by multivariate logistic regression model. The result showed that BMI in gestation (OR=1.146, 95% CI 1.041-1.262, p <0.05), weight gain in gestation (OR = 1.126, 95% CI 1.060-1.198, p <0.001), exercise history in gestation (OR = 0.399, 95% CI 0.205-0.778, p = 0.007), and dermatomal level of analgesia (OR = 2.248, 95% CI 1.645-3.074, p <0.001) were risk factors for hypotension after caesarean spinal anesthesia in parturients with scarred uterus. Conclusion:The incidence of hypotension after caesarean spinal anesthesia in parturients with scarred uterus was relatively high. The post-pregnancy BMI, weight gain in gestation, exercise history in gestation and dermatomal level of analgesia after anesthesia were risk factors for hypotension after caesarean spinal anesthesia in parturients with scarred uterus. These findings play an important role in predicting the occurrence of hypotension after caesarean spinal anesthesia in parturients with scarred uterus. Trial registration:Chinese Clinical Trial Registry (chiCTR-ROC-17011251)


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