Knowledge of heart attack and stroke symptomology: a cross-sectional comparison of rural and non-rural US adults

<p>Abstract</p> <p>Background</p> <p>Understanding the signs and symptoms of heart attacks and strokes are important not only in saving lives, but also in preserving quality of life. Findings from recent research have yielded that the prevalence of cardiovascular disease risk factors are higher in rural populations, suggesting that adults living in rural locales may be at higher risk for heart attack and/or stroke. Knowledge of heart attack and stroke symptomology as well as calling 911 for a suspected heart attack or stroke are essential first steps in seeking care. This study sought to examine the knowledge of heart attack and stroke symptoms among rural adults in comparison to non-rural adults living in the U.S.</p> <p>Methods</p> <p>Using multivariate techniques, a cross-sectional analysis of an amalgamated multi-year Behavioral Risk Factor Surveillance Survey (BRFSS) database was performed. The dependent variable for this analysis was low heart attack and stroke knowledge score. The covariates for the analysis were: age, sex, race/ethnicity, annual household income, attained education, health insurance status, having a health care provider (HCP), timing of last routine medical check-up, medical care deferment because of cost, self-defined health status and geographic locale.</p> <p>Results</p> <p>The weighted n for this study overall was 103,262,115 U.S. adults > =18 years of age. Approximately 22.0% of these respondents were U.S. adults living in rural locales. Logistic regression analysis revealed that those U.S. adults who had low composite heart attack and stroke knowledge scores were more likely to be rural (OR = 1.218 95%CI 1.216-1.219) rather than non-rural residents. Furthermore, those with low scores were more likely to be: male (OR = 1.353 95%CI 1.352-1.354), >65 years of age (OR = 1.369 95%CI 1.368-1.371), African American (OR = 1.892 95%CI 1.889-1.894), not educated beyond high school (OR = 1.400 955CI 1.399-1.402), uninsured (OR = 1.308 95%CI 1.3-6-1.310), without a HCP (OR = 1.216 95%CI 1.215-1.218), and living in a household with an annual income of < $50,000 (OR = 1.429 95%CI 1.428-1.431).</p> <p>Conclusions</p> <p>Analysis identified clear disparities between the knowledge levels U.S. adults have regarding heart attack and stroke symptoms. These disparities should guide educational endeavors focusing on improving knowledge of heart attack and stroke symptoms.</p

A population-based cross-sectional study of health service deficits among U.S. adults with depressive symptoms

BACKGROUND: Depression is a psychiatric condition that affects approximately one in five U.S. adults in their lifetime. No study that we know of has examined depressive symptoms and health service deficits in rural compared with non-rural populations. Four factors constitute the variable health service deficits: did not have health insurance, did not have a healthcare provider, deferred medical care because of cost and did not have a routine medical exam, all within the last 12 months. The aim of this study was to ascertain the prevalence of health service deficits in rural versus non-rural adults with depressive symptoms. Examining depressive symptoms by health service deficits is important because it allows us to approximate those with the condition who might not be receiving care for it. By analyzing national, population-based data, this study sought to fill in some important epidemiological gaps regarding depressive symptoms and health service deficits. METHODS: For this analysis the population of interest was U.S. adults identified as currently having depressive symptoms using the PHQ-8 criteria. Behavior Risk Factor Surveillance Survey 2006 data were used in this analysis. Health service deficits was the primary dependent variable. Multivariate logistic regression analysis was performed to examine health service deficits experienced by adults with depression controlling for socioeconomic status, race and ethnicity and geographic locale (rural or non-rural). RESULTS: Logistic regression analysis yielded that U.S. adults currently having depressive symptoms who were of low socioeconomic status, Hispanic ethnicity, or living in a rural locale were more likely to have at least one health service deficit. CONCLUSION: Analyzing data collected by a large surveillance system such as BRFSS, allows for an analysis incorporating an array of covariates not available from clinically-based data such as electronic health records. By identifying clinically depressed U.S. adults who also have at least one health service deficit, we were able to ascertain those most likely not receiving care for this debilitating condition. We believe community pharmacists are well suited to assist in connecting depressed, vulnerable populations with appropriate and needed care. This care would be best provided by an inter-professional team led by a primary care provider

Multi-trait analysis of post-harvest storage in rocket salad (Diplotaxis tenuifolia) links sensorial, volatile and nutritional data

AbstractRocket salad (Diplotaxis tenuifolia; wild rocket) is an important component of ready to eat salads providing a distinct peppery flavour and containing nutritionally relevant compounds. Quality deteriorates during post-harvest, in relation to time and storage temperature amongst other factors. Volatile organic compounds (VOCs) are easily measurable from rocket leaves and may provide useful quality indicators for e.g. changes in isothiocyanates derived from nutritionally important glucosinolates. VOC profiles discriminated storage temperatures (0, 5 and 10°C) and times (over 14days). More specifically, concentrations of aldehydes and isothiocyanates decreased with time paralleling a fall in vitamin C and a reduction in sensorial quality at the two higher temperatures. Sulphur containing compounds rise at later time-points and at higher temperatures coincident with an increase in microbial titre, mirroring a further drop in sensorial quality thus indicating their contribution to off-odours

Study Bioprospecting of Medicinal Plant Extracts of the Semiarid Northeast: Contribution to the Control of Oral Microorganisms

Dental pathologies can be caused by plaque-forming bacteria and yeast, which reside in the oral cavity. The bacteria growing in dental plaque, a naturally occurring biofilm, display increased resistance to antimicrobial agents. The objective was the evaluation of a preclinical assay of medicinal plants of the semiarid region from the northeast against oral pathogenic microorganism, aiming at bioprospecting a new product. The selection of plant material for this study was based on the ethnobotanical data on the traditional use of plants from the semiarid region. The thirty extracts were subjected to the determination of antibiofilm activity against gram-positive, gram-negative bacteria and yeast. The hydroalcoholic extract which showed positive antibiofilm activity against most of the microorganisms tested in agar diffusion assay was further tested for the determination of minimum inhibitory concentration (MIC) and Bioassay with Artemia salina. Plant samples tested in this study exhibited good antibiofilm activity for the treatment of oral problems. The Schinopsis brasiliensis showed greater activity for Pseudomonas aeruginosa and Staphylococcus aureus, but toxicity against Artemia salina

Evaluation of Glaucomatous Damage via Functional Magnetic Resonance Imaging, and Correlations Thereof with Anatomical and Psychophysical Ocular Findings

PurposeTo evaluate the functional magnetic resonance imaging (fMRI) response to binocular visual stimulation and the association thereof with structural ocular findings and psychophysical test results in patients with glaucoma, and controls.MethodsCross-sectional study. Participants underwent a complete ophthalmic examination, including Humphrey 24-2 visual field (VF) testing and optical coherence tomography. Binocular VF in each quadrant was determined using an integrated method. Patients with glaucoma were assigned to three subgroups: initial, asymmetrical and severe glaucoma. Regions of interest (ROIs) were determined anatomically. fMRI (3 T) was performed using a bilaterally presented polar angle stimulus, and the accompanying changes in blood oxygen level-dependent (BOLD) signals were obtained from the occipital poles and calcarine ROIs. We used generalized estimation equation models to compare anatomical and functional data between the groups.ResultsA total of 25 subjects were enrolled, of whom 17 had glaucoma and 8 were controls. Significant associations between quadrant binocular VF sensitivities and fMRI responses were found in the occipital pole ROIs (p = 0.033) and the calcarine ROIs (p = 0.045). in glaucoma severity subgroup analysis, retinal nerve fiber layer (RNFL) thickness was associated with the BOLD response of the calcarine and occipital pole ROIs (p = 0.002 and 0.026, respectively). the initial and asymmetrical glaucoma subgroups had similar binocular VF sensitivities and RNFL thicknesses, but distinct BOLD responses.ConclusionsThe response of the visual cortex to binocular stimulation was associated with binocular VF sensitivity. RNFL thickness was associated with the BOLD response of the calcarine and occipital pole ROIs.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Universidade Federal de São Paulo, Dept Ophthalmol, São Paulo, BrazilHosp Israelita Albert Einstein, São Paulo, BrazilUniv São Paulo, Inst Psychol, Dept Expt Psychol, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Ophthalmol, São Paulo, BrazilFAPESP: 2007/07339-2Web of Scienc

Acute paraquat poisoning - Report of a survival case following intake of a potential lethal dose

When properly used, paraquat (PQ) is a widely used bipyridil herbicide with a good safety record. Most cases of PQ poisoning result from intentional ingestion, with death resulting from hypoxemia secondary to lung fibrosis in moderate to severe poisonings. With high ingestion volumes (> 50 mL of a 20% wt/vol formulation), death results from multiple organ failure and cardiovascular collapse within 1 week after intoxication. The present report describes a successful clinical case regarding the intoxication of a 15-year-old girl by a presumed lethal dose of PQ. The adolescent ingested approximately 50 mL of a commercialized concentrate (20% wt/vol of dichloride salt) formulation of PQ. High serum and urinary levels of PQ confirmed the bad prognosis. However, the therapeutic protocol followed in the present clinical case led to a positive outcome. Besides the measures for decreasing PQ absorption and increasing its elimination, other protective procedures were applied in aiming to reduce the production of reactive oxygen species (ROS), to scavenge ROS, to repair ROS-induced lesions, and to reduce inflammation. The status-of-the-art concerning the biochemical and toxicological aspects of PQ poisoning and the pharmacologic basis of the respective treatment is also presented

Acute paraquat poisoning - Report of a survival case following intake of a potential lethal dose

When properly used, paraquat (PQ) is a widely used bipyridil herbicide with a good safety record. Most cases of PQ poisoning result from intentional ingestion, with death resulting from hypoxemia secondary to lung fibrosis in moderate to severe poisonings. With high ingestion volumes (> 50 mL of a 20% wt/vol formulation), death results from multiple organ failure and cardiovascular collapse within 1 week after intoxication. The present report describes a successful clinical case regarding the intoxication of a 15-year-old girl by a presumed lethal dose of PQ. The adolescent ingested approximately 50 mL of a commercialized concentrate (20% wt/vol of dichloride salt) formulation of PQ. High serum and urinary levels of PQ confirmed the bad prognosis. However, the therapeutic protocol followed in the present clinical case led to a positive outcome. Besides the measures for decreasing PQ absorption and increasing its elimination, other protective procedures were applied in aiming to reduce the production of reactive oxygen species (ROS), to scavenge ROS, to repair ROS-induced lesions, and to reduce inflammation. The status-of-the-art concerning the biochemical and toxicological aspects of PQ poisoning and the pharmacologic basis of the respective treatment is also presented