Gender differences in presenting signs and symptoms of acute ischemic stroke: a population-based study.

BACKGROUND: There are few population-based data regarding gender differences in signs and symptoms of acute ischemic stroke, and previously reported data have been inconsistent and conflicting. OBJECTIVE: The goal of this study was to address the gender differences of the presenting signs and symptoms of acute ischemic stroke in a population-based study. METHODS: All patients with first ischemic stroke occurring between 1985 and 1989 were identified; subjects were residents of Rochester, Minnesota. Signs and symptoms were collected via review of comprehensive medical records. Differences were identified using the Pearson χ(2) test. RESULTS: A total of 449 cases of first ischemic stroke were identified; 268 (60%) were women. Symptoms at ischemic stroke presentation differed between men and women. Women more commonly presented with generalized weakness (P = 0.005) and mental status change (P = 0.0001). Men more commonly presented with paresthesia (P = 0.003), ataxia (P = 0.006), and double vision (P = 0.005). Signs at ischemic stroke presentation differed between men and women. Men more commonly presented with nystagmus (P = 0.002) on examination. Significant trends were that women more commonly presented with fatigue (P = 0.02), disorientation (P = 0.04), and fever (P = 0.02), whereas men more commonly presented with sensory abnormalities (P = 0.02). CONCLUSIONS: There were gender differences in signs and symptoms at presentation of ischemic stroke in these study patients. In addition to selected focal symptoms, women more commonly presented with diffuse symptoms of generalized weakness, fatigue, disorientation, and mental status change.

Intestinal parasitic infection among new refugees to Minnesota, 1996-2001.

OBJECTIVES: The primary objective of this study was to evaluate the prevalence of pathogenic intestinal parasitic infection in primary refugees to Minnesota (MN). Secondary objectives were to determine the association of intestinal parasitic infection with gender, age and continent of origin. METHODS: A retrospective study was conducted on the first refugee screening visits done between January 1, 1996 and December 31, 2001 on data from the Minnesota Department of Health. RESULTS: Of the 10,358 refugees with screening results, 1969 (19%) had pathogenic intestinal parasites. Parasites were more common in men (OR=1.3; p<0.0001) and were less prevalent with increasing 10 year age intervals (OR=0.79; p<0.001). Asians had the highest proportion of refugees with intestinal parasitic infection (33.6%; p<0.0001). The most common pathogenic intestinal parasites were Trichuris trichiura (7.1%), Giardia lamblia (5.7%), Ascaris lumbricoides (2.1%), and hookworm (2.0%). CONCLUSION: In this study almost 20% of newly arrived refugees to the state of MN had evidence of intestinal parasitic infection. With very little organized access to health care following arrival of refugees to a new country, risk of transmission of infection, and persistence of infection, the first health visit should be used as a critical opportunity for the screening and treatment of high-risk patients. Future public health work should focus on enhanced screening and surveillance strategies, follow-up for ensuring adequate treatment completion and eradication of parasitosis, as well as research on cost effectiveness of screening versus predeparture anti-helminthic treatment.

The epidemiology of tuberculosis among primary refugee arrivals in Minnesota between 1997 and 2001.

BACKGROUND: Minnesota (MN) is home to one of the highest number of refugees in the United States. The primary objective of this study was to evaluate the prevalence of latent and active tuberculosis (TB) infection in primary refugee arrivals to MN. Secondary objectives were to determine the association of TB infection with gender, age, and ethnicity of the refugees. METHODS: A retrospective study of primary refugee arrivals to MN between January 1, 1997, and December 31, 2001, was conducted. Chi-square tests and logistic regression analyses were used to assess the association of TB infection with gender, age, and ethnicity. RESULTS: Of the 9,842 refugees who had Mantoux test results, 4,990 (50.7%) had a positive test. A positive test was more common in men [odds ratio (OR) = 1.6; p < 0.0001], in Africans (OR = 1.6, p = <0.0001), and increased with 10-year age intervals (OR = 1.4; p < 0.0001). A total of 116 (0.8%) refugees received treatment for active TB. Active TB was more common in men (OR = 1.7; p = 0.006), African ethnicity (OR = 4.3; p < 0.0001), and increased with 10-year age intervals (OR = 1.1; p = 0.05). CONCLUSIONS: Screening and treatment for latent and active TB should be actively managed among refugees resettling in the United States, as this is common and can have significant public health implications.