Hydration Status, Kidney Function, and Kidney Injury in Florida Agricultural Workers.

OBJECTIVE: Recent findings suggest that laboring in hot occupational environments is related to kidney damage in agricultural workers. We examined hydration status and kidney function in 192 Florida agricultural workers. METHODS: Blood and urine samples were collected over 555 workdays during the summers of 2015 and 2016. Urine-specific gravity (USG), serum creatinine, and other kidney function markers were examined pre- and post-shift on each workday. Multivariable mixed modeling was used to examine the association of risk factors with hydration status and acute kidney injury (AKI). RESULTS: Approximately 53% of workers were dehydrated (USG ≥1.020) pre-shift and 81% post-shift; 33% of participants had AKI on at least one workday. The odds of AKI increased 47% for each 5-degree (°F) increase in heat index. CONCLUSION: A strikingly high prevalence of dehydration and AKI exists in Florida agricultural workers.

Family history associated with improved functional outcome following ischemic stroke.

BACKGROUND: Few studies to date have documented genetic influences on outcomes of hospitalization among patients with acute ischemic stroke. OBJECTIVE: To assess the influence of the family history of stroke on in-hospital mortality and hospitalization outcome among patients having acute ischemic stroke. METHODS: The medical records for 916 consecutive adult patients admitted for acute ischemic stroke during 12/1/2001-2/28/2002 at 34 randomly selected Georgia hospitals were centrally abstracted. The patients were classified as having a positive family history of stroke or not. The two groups were compared on risk factors, comorbidities, admission characteristics, hospital disposition status, and outcome measures. Multivariate logistic regression was used to assess the independent contributions of important variables identified by univariate screening. RESULTS: A positive family history of stroke was significantly associated with a decreased frequency of medical history of coronary artery disease, a decreased frequency of medical history of congestive heart failure, an increased frequency of medical history of hypertension, and younger age among patients with acute ischemic stroke who were 18 years or older. The family history was not associated with in-hospital mortality (odds ratio 1.49, 95% confidence interval 0.79-2.80 for incident cases). The interaction of family history and age was significantly associated with discharge destination and discharge functional status. CONCLUSIONS: Preliminary analyses found associations between family history and stroke outcome. The role of a family history of stroke in stroke outcome merits further study.