Ortíz, Juan Fernando

The journal retracts the article, “Effect Comparison of E-Cigarette and Traditional Smoking and Association with Stroke—A Cross-Sectional Study of NHANES” [...]

Introduction: Acute ischemic stroke (AIS) is thesecond leading cause of death globally, accounting for approximately 11% of alldeaths, long-term disability, and functional impairments in survivors. TheCOVID-19 pandemic has raised concerns about its impact on AIS patients. Aim: This study aimed to assess the outcomes,including mortality and severity of disability in AIS hospitalizations withCOVID-19. Methods: We performed a retrospective cross-sectionalanalysis of the Nationwide Inpatient Sample (NIS-2020) in adulthospitalizations for AIS to compare the outcomes [death & APRDRGseverity/disability] in COVID-19 patients using ICD-10 codes. We performedweighted analyses using chi-square, unpaired t-test, and multivariate logisticregression models to evaluate COVID-19-associated poor outcomes amongst AISpatients. Results: Out of 504,460 AIS patients, 7,590 had AIStriggered by COVID-19. Amongst AIS hospitalizations, COVID-19 was more frequentin age group >65 year old 63.2%, male 52.6%, White race (51.4%), patientwith Medicare (58.7%), median household income 0-25 percentile (33.6%), Southzone (43.4%), and hypertensives (83.7%). AIS patients with COVID-19 had ahigher mortality (10.93% vs 3.8%) and severe/extreme disability (93.21% vs37.43%) rates in comparison to patients without COVID-19. (p<0.0001) Inregression analysis COVID-19 was associated with 213% higher odds of mortality(aOR: 3.13, 95% CI: 2.90-3.38, p<0.0001, c:0.671) and higher odds of severe/extreme disability(26.85, 24.53-29.39, p<0.0001, c:0.686) compared to AIS patients withoutCOVID-19. Conclusion: These findings emphasize the substantialimpact of COVID-19 on AIS patients by elevating mortality and risk of severedisability compared to their counterparts. Efforts should be directed towards earlyidentification of stroke population that is at higher risk ofCOVID-19-associated poor outcome and prompt management tomitigate the burden of the both diseases.

Introduction: Tobacco use is a known risk factor for stroke and other cardiovascular diseases. However, the relationship between e-cigarette smoking and stroke is largely unknown. Hypothesis: This study aims to assess the effect of e-cigarettes among people who have had a history of stroke. Methods: A cross-sectional survey was performed using the NHANES database from 2015 to 2018 in the US population. We identified participants 18 or older with a history of stroke and their smoking habits (e-cigarette, traditional, and dual smoking). The chi-square test, unpaired t-test, and multivariable logistic regression models were used to examine the association of e-cigarette consumption among the stroke population. Results: Out of a total of 266,058 respondents, 79,825 were smokers [E-cigarette: 7,756 (9.72%); Traditional: 48,625(60.91%), Dual smokers: 23,444 (29.37%)] Overall prevalence of stroke was 5.41% (n=4194) amongst various types of smokers. Amongst females with stroke, the prevalence of e-cigarette use was higher compared to traditional smoking. (36.36% vs 33.91%; p<0.001) Mexican Americans (21.21% vs. 6.02%) and other Hispanics (24.24% vs. 7.70%) had a higher prevalence of e-cigarette use than traditional smoking. (p<0.001) E-cigarette smokers were having an early onset of stroke in comparison with dual and traditional smokers. (Median age in years: 48 vs. 50 vs. 59, respectively; p<0.001). Stroke was more prevalent amongst traditional smokers compared to e-cigarette and dual smokers (6.75% vs. 1.09% vs. 3.72% p<0.001). In multivariable logistic regression analysis, the odds of having a history of stroke were higher amongst e-cigarettes in comparison with traditional smokers. (aOR:1.15; 95%CI: 1.15-1.16; p<0.001). Conclusion: Although stroke was more prevalent in traditional smokers, e-cigarette smokers had early-onset and higher odds of stroke compared to traditional smokers. More prospective studies are needed to evaluate the long-term effects and safety of e-cigarettes to mitigate the risk of cardio and cerebrovascular disorders.

Ataxia is a constellation of symptoms that involves a lack of coordination, imbalance, and difficulty walking. Hereditary ataxia occurs when a person is born with defective genes, and this degenerative disorder may progress for several years. There is no effective cure for ataxia, so we need to search for new treatments. Recently, interest in riluzole in the treatment of ataxia has emerged. We conducted this systematic review to analyze the safety and efficacy of riluzole for treating hereditary ataxia in recent clinical trials. We conducted a systematic review using PubMed and Google Scholar as databases in search of this relationship. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analysis of Observational Studies in Epidemiology (MOOSE) protocols to conduct this study. For inclusion criteria, we included full-text clinical trials on humans written in English and found three clinical trials. We excluded case reports, literature reviews, systematic reviews, and meta-analyses for this analysis. We aimed to evaluate the Scale for the Assessment and Rating of Ataxia (SARA) score, the International Cooperative Ataxia Rating Scale (ICARS) score, and the safety of the medication. Two out of the three clinical trials showed statistically significant clinical improvement in the ICARS and SARA scores, while the other trial did not show improvement in the clinical or radiological outcomes. The drug was safe in all clinical trials. Overall, the results of this analysis of riluzole for the treatment of hereditary ataxia are encouraging. Further clinical trials are needed to investigate the efficacy of riluzole on hereditary ataxia.

Introduction: Tobacco use is one of the most significant risk factors for stroke. Besides traditional cigarettes and combustible products, the use of e-cigarettes and electronic nicotine delivery products has been widespread among young adults in the recent era. Furthermore, the trend of vaping has increased over the last decade. However, the relationship between e-cigarettes and stroke is largely unknown. The aim of this study was to evaluate the prevalence and identify the relationship between e-cigarette smoking and stroke. Methods: A cross-sectional study was performed using the NHANES database of the US population. Adults with a history of smoking were considered in our study and divided into three groups, e-cigarette users, traditional, and dual smokers. The Chi-squared test, Wilcoxon rank-sum test, and multivariable logistic regression analysis were used to identify the prevalence and association of e-cigarette consumption and stroke. Results: Out of a total of 266,058 respondents from 2015 to 2018, we found 79,825 respondents who smoked e-cigarettes (9.72%) or traditional (29.37%) or dual smoking (60.91%). Stroke prevalence among e-cigarette smokers was 1.57%. Stroke was more prevalent among traditional smokers than among e-cigarette smokers. (6.75% vs. 1.09%; p < 0.0001) E-cigarette smokers had early onset of stroke in comparison with traditional smokers. (median age: 48 vs. 59 years; p < 0.0001). Among females with stroke, the prevalence of e-cigarette use was higher in comparison with traditional smoking (36.36% vs. 33.91%; p < 0.0001). Among the stroke population, the prevalence of e-cigarette use was higher among Mexican-Americans (21.21% vs. 6.02%) and other Hispanics (24.24% vs. 7.70%) compared with traditional smoking (p < 0.0001). The regression analysis found higher odds of stroke history among e-cigarette users than traditional smokers [aOR: 1.15; 95% CI: 1.15–1.16)]. Conclusion: Though stroke was more prevalent in traditional smokers, the incidence of stroke was early-in-onset and was strongly associated with e-cigarette use compared to traditional smokers. We have also identified vascular effects of e-cigarettes components as possible triggers for the stroke.