North Greenville University

The objective of this study is to determine risk factors that may contribute to exclusion decision from recombinant tissue plasminogen activator (rtPA) in patients with acute ischemic stroke (AIS) with a combined current or history of smoking and obesity. This study was conducted on data from 5469 patients with AIS collected from a regional stroke registry. Risk factors associated with inclusion or exclusion from rtPA were determined using multivariate logistic regression analysis. The adjusted odds ratios and 95% confidence interval for each risk factor were used to predict the increasing odds of an association of a specific risk factor with exclusion from rtPA. In the adjusted analysis, obese patients with AIS with a history of smoking (current and previous) excluded from rtPA were more likely to present with carotid artery stenosis (OR = 0.069, 95% CI 0.011-0.442), diabetes (OR = 0.604, 95% CI 0.366-0.997), higher total cholesterol (OR = 0.975, 95% CI 0.956-0.995), and history of alcohol use (OR = 0.438, 95% CI 0.232-0.828). Higher NIHSS score (OR = 1.051, 95% CI 1.017-1.086), higher triglycerides (OR = 1.004, 95% CI 1.001-1.006), and higher high-density lipoprotein (OR = 1.028, 95% CI 1.000-1.057) were associated with the inclusion for rtPA. Our findings reveal specific risk factors that contribute to the exclusion of patients with AIS with a combined effect of smoking and obesity from rtPA. These findings suggest the need to develop management strategies to improve the use of rtPA for obese patients with AIS with a history of smoking.

This study aims to determine sex differences in poststroke hypertriglyceridemia (serum triglyceride levels ⩾ 200 mg/dl) and high stroke severity in ischemic stroke patients. Our study analyzed data from 392 males and 373 females with hypertriglyceridemia. Stroke severity on admission was measured using the National Institute of Health Stroke Scale (NIHSS) with a value ⩽7 indicating a more favorable post-stroke prognosis while a score of >7 indicates poorer post-stroke outcomes. Logistic regression models adjusted for demographic and risk factors. The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for each clinical risk factor were used to predict the increasing odds of an association of a specific clinical baseline risk factor with the male or female AIS with hypertriglyceridemia. In the adjusted analysis, male patients with hypertriglyceridemia, diastolic blood pressure (OR = 1.100, 95% CI, 1.034-1.171, P = .002), and Ischemic stroke mortality (OR = 6.474, 95% CI, 3.262-12.847, P < .001) were significantly associated with increased stroke severity. In female patients with hypertriglyceridemia, age (OR = 0.920, 95% CI, 0.866-0.978, P = .008) was associated with reduced stroke severity, while ischemic stroke mortality score (OR = 37.477, 95% CI, 9.636-145.756, P < .001) was associated with increased stroke severity. Increased ischemic stroke mortality risk score was associated with increased severity in both male and female AIS patients with hypertriglyceridemia. Our findings provide information about sex differences in specific risk factors that can be managed to improve the care of male and female ischemic stroke patients with hypertriglyceridemia.

Introduction : The role that specific clinical factors play in contributing to gender differences in Alzheimer’s patients with mild cognitive impairment (MCI) is not yet fully understood. In this study, we tested the hypothesis that pharmacological, demographic, and risk factors may contribute to gender difference in Alzheimer’s patients with MCI. Methods : Methods Data collected for 5 years was analyzed using a retrospective data analytical approach on 33,064 Alzheimer patients, including 13,569 men and 19,495 women that presented with MCI. Receiver operating characteristic (ROC) curve analysis and multivariate regression models were used to identify specific factors that contribute to gender differences in MCI patients. Results : Results Our records indicate that women that presented with MCI were more likely to be taking Buspirone (OR = 0.767, 95% CI, 0.683‐0.861, P&lt;0.001) while men within this population were more likely to be taking Galantamine (OR = 0.559, 95% CI, 0.382‐0.818, P&lt;0.001). ETOH use was associated with MCI in both men (OR = 0.696, 95% CI, 0.638‐0.760, P&lt;0.001) and women with Alzheimer’s Dementia (OR = 0.484, 95% CI, 0.442‐0.529, P&lt;0.001). Conclusions : Conclusion Our findings reveal gender differences in men and women that presented with MCI. Management strategies should consider identified factors to provide better care for Alzheimer patients with MCI.

This meeting abstract was removed due to the OA licensing requirements of this journal. The full abstract is listed here : https://www.svin.org/files/SVIN_2021_Abstracts_for_Web.pdf

Introduction : Age is the single most important risk factor for stroke and an estimated 75% of all strokes occur in people &gt;65 years of age. In addition, adults &gt;75 years’ experience more hospitalization stays and higher mortality rates with an estimated 50% in the occurrence of all strokes. Several comorbidities have been linked to an increased risk and severity of acute ischemic stroke (AIS). How these factors differentially contribute to the severity of stroke in patients ages &gt;65 and &lt;75 as well as those ≥75 is not known. In this study, we aim to investigate how age, coupled with various clinical risk factors, affects AIS severity within these two age categories. Methods : This retrospective data analysis study was conducted using the data collected from the PRISMA Health Stroke Registry between 2010 and 2016. Baseline clinical and demographic data for patients ages &gt;65 and &lt;75 as well as those ≥75 was analyzed using univariate analysis. Receiver operating characteristic (ROC) curve analysis and multivariate regression models were used to examine the association of specific baseline risk factors or comorbidities associated with worsening or improving neurologic functions. The primary functions were risk factors associated with improving or worsening neurologic outcome in each age category. Results : Adjusted multivariate analysis showed that AIS population of patients &gt;65 and &lt;75 experiencing heart failure (OR = 4.398, 95% CI, 3.912 – 494.613, P = 0.002) and elevated HDL levels (OR = 1.066, 95% CI, 1.009 – 1.126, P = 0.024) trended towards worsening neurologic functions while patients experiencing obesity (OR = 0.177, 95% CI, 0.041 – 0.760, P = 0.020) exhibited improving neurologic functions. For the patients ≥75 years of age, direct admission (OR = 0.270, 95% CI, 0.085 – 0.856, P = 0.026) was associated with improvement of patients treated in the telestroke. Conclusions : Age is a strong risk factor for AIS, and aged stroke patients have higher morbidity and worsening functional recovery than younger patients. In this study, we observed differences in stroke risk factor profiles for &gt;65 and &lt;75 and ≥75 age categories. Heart failure and elevated HDL levels were significantly associated with worsening neurologic functions among AIS for patients aged &gt;65 and &lt;75. Obese patients and individuals ≥75 years who were directly admitted were most likely to exhibit improving neurologic functions. Most importantly, findings from this study reveal specific risk factors that can be managed to improve the care in older stroke patients treated in the telestroke network.

This study investigates dietary intake between urban and rural secondary school students in a low-income country to provide information on an important target group for dietary interventions. A cross-sectional survey was conducted in a representative sample of 180 senior secondary school classes 1-3(SSS1-SSS3) that comprise of 13–18 years students in the rural and urban areas of Ile-Ife, Nigeria.

This essay asserts that “temperance” for Spenser is not an imagined state of self-sameness that must be learned by Guyon at the end of Book II of the Faerie Queene. Rather, Spenser dubs Guyon the “Knight of Temperance” because he tempers the overmoist, luxuriant Bower through an action he accomplishes rather than a trait he embodies. The Bower of Bliss was designed to alter the knights’ humoral complexions through their exchange with this garden, a garden that has more influence on the knights than the temptress Acrasia. To break the Bower’s force, Guyon moderates the improperly-mixed Bower by destroying the Italianate garden features and burning the Bower, a common early modern remedy for land that was too moist. Through this allegory on temperance, Spenser warns the English against over-cultivating their gardens and lands, lest the English also become over-refined like the Italians and French.