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PubMed1999

Possible protective effect of milk, meat and fish for cerebrovascular disease mortality in Japan.

Cerebrovascular disease was a leading cause of death from 1955 to 1980 in Japan. The mortality rate from this disease has decreased sharply in recent decades. This downward trend seems to correspond to the dietary habits of Japanese. Data from a large prospective cohort study were analyzed to examine the association between dietary habits and cerebrovascular disease mortality in Japan. The subjects for this analysis were 223,170 men and women aged 40 to 69 at baseline in December 1965. There were 6,168 deaths in men and 4,862 deaths in women due to cerebrovascular disease (ICD7: 330-334) during the follow-up period from January 1966 to December 1981. Rate ratio (RR) and 95% confidence interval (95% CI) adjusted for sex, attained age, follow-up period, prefecture, cigarette smoking, alcohol drinking and occupation was used for comparison. In this study, the risk of mortality from cerebrovascular disease was inversely associated with dairy milk, meat and fish consumption. Therefore the joint effect of dairy milk, meat and fish (DMF) as animal fat and protein was of interest. In the binary analysis, DMF (D, M, F) means the combination of dairy milk (1-3 times/week or more), meat (1-3 times/week or more) and fish (4 times/week or more). Thus DMF (d, m, f) was the reference group having dairy milk (less than 1 time/week), meat (less than 1 time/week) and fish (less than 4 times/week). For the disease, the RR of DMF (D, M, F) was 0.68 with 95% CI of 0.63 to 0.74, relative to the reference group. Furthermore the joint effect of DMF was more strongly associated with cerebral haemorrhage (ICD7: 331, DMF (D, M, F); RR: 0.63, 95% CI: 0.55-0.70) than with cerebral embolism and thrombosis (ICD7: 332, DMF (D, M, F); RR: 0.79, 95% CI: 0.70-0.89). These findings suggest that the increasing intake of animal fat and/or protein may have played a key role in reducing cerebrovascular disease in Japan.

Adult↗
PubMedDate not supplied

[FAT EMBOLISM].

Explore the source record for details and available documents.

Contusions↗
PubMed2005

[Strategy for treatment of peritrochanteric fractures in senile patients].

OBJECTIVE: To analyze the clinical manifestations, operative applications, complications and outcomes of peritrochanteric fracture of femur in patients 75-years old and over. METHODS: The clinical data of 261 patients, aged 79.5 (75-96), of peritrochanteric fracture (265 hips) were analyzed. RESULTS: The incidence of different accompanied medical diseases was 2.6/person on average. The internal fixation methods included DHS, DHS plus trochanteric steady plate or intramedullary interlocking nails, such as Gamma nail, PFN and reconstructive nails. The mean operation time was 73 minutes. 224 cases were followed-up over 6 months after operation 81% of which got excellent or good results. The complications included acute heart failure, brain infarction, cerebral thrombosis, pulmonary embolism, deep venous thrombosis of lower extremities, lung infection, and stress ulceration, bed sore, and acute respiratory failure. Thirteen cases died of cardiopulmonary insufficiency, cardiac infarction, brain thrombosis, or pulmonary embolism. CONCLUSION: Complications are frequent in aged patients. Appropriate operative methods help reduce complications and mortality rates.

Aged↗
PubMed2006

[Analysis of complications and prognosis for different types of stroke patients registered between 1993 and 2000 in Aichi Prefecture].

PURPOSE: This study was designed to analyze complications and prognosis for different types of stroke patients registered in Aichi Prefecture between 1993 and 2000. METHODS: A total of 23,979 out of 27,304 registered patients in the Aichi stroke patient registration program with 4 type of strokes (cerebral thrombosis (CRT), cerebral embolism (CRE), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH)) were analyzed for complications and prognosis (survival, disability, dementia), with reference to gender, age-groups, and types of stroke. RESULTS: A total of 13,365 (55.7%) male (65.5 +/- 12.2 yr: Mean +/- SD) and 10,614 (44.3%) female (69.7 +/- 13.3 yr) patients were registered. As the type of stroke, CRT comprised the highest percentage, both in males (49.5%) and females (41.1%), followed by ICH (males: 30.4%, females: 29.8%). The percentage of SAH in females (17.3%) was found to be about twice as high as that in males (8.3%). Analyses of complications revealed hypertension to be the greatest risk factor in both sexes (about 50%), followed by history of stroke (males: 20.1%, females: 16.2%). Male patients had a significantly higher overall survival rate (84.7%) than females (81.0%) (P <0.001). SAH was associated with the lowest survival rate in both sexes (about 60%), with statistical significance (P<0.001). Development of disability or/and dementia as sequela of stroke was higher in females (disability: 54.5%, dementia: 21.1%) than in males (44.2%, 15.1%, respectively) (P< 0.001). Logistic regression analyses revealed that the factors most contributing to death were advanced age, a history of stroke, heart disease, and renal insufficiency. For the development of disability and dementia, being femal, of advanced age, with a history of stroke, heart disease, and renal insufficiency were important. Abnormal lipid metabolism appeared to be a protection factor regarding prognosis (survival, disability, dementia). CONCLUSIONS: This study demonstrated that hypertension is the most frequently reported complication for all types of stroke except CRE, and logistic regression analyses revealed that the factor contributing most to prognosis (survival, disability, dementia) was a history of stroke. The results suggested the importance of: i) removing hypertansion as the most significant risk factor, as well as diabetes and heart disease in order to prevent strokes; and ii) preventing re-attack(s) of stroke in order to improve the prognosis.

Aged↗
PubMedDate not supplied

[Percutaneous transluminal angioplasty in aortic coarctation. The short- and median-term results].

Percutaneous transluminal angioplasty (PTA) was performed in 34 patients with aortic coarctation (Ao Co). One of them with coarctation after surgical correction, the rest were native Ao Co. We used one balloon in 28 patients and two balloons simultaneously in 6. They were separated in three groups according to the degree of aortic arc hypoplasia. Group I (mild to moderate hypoplasia N = 9) the gradient dropped 39% with angiographic improvement of 48% during the follow-up (m = 13.1 months). Three cases with restenosis, 2 were satisfactory dilated and one was sent to surgery. In Group II (severe hypoplasia N = 4) the gradient dropped 31% with angiographic improvement of 30% (follow-up 16.3 months). Two cases with recoarctation were sent to surgery. In Group III (without hypoplasia N = 21) we obtained dropped of gradient of 71% with angiographic improvement of 60% (follow-up 18.5 months). Two cases were redilated successfully. The complications were: cerebral hemorrhage with death due to hypertensive crisis, (1) cerebral embolism, (1) thrombosis in the puncture site 1 and small aneurysm in dilated zone. (1) We think PTA is a good choice to conventional surgery with low rate of morbidity-mortality. The results depend basically on the anatomic type of coarctation and degree of aortic arch hypoplasia.

Adolescent↗
PubMed1989

Comparative value of glutamic oxaloacetic transaminase and lactic dehydrogenase enzyme pattern in serum and cerebrospinal fluid in acute cerebrovascular accidents.

A study of glutamic oxaloacetic transaminase (GOT) and lactic dehydrogenase (LDH) enzymes in serum and cerebrospinal fluid (CSF) was carried out on 30 cases of acute cerebrovascular accident (CVA) to determine their role in precise diagnosis and prognosis of the cases. The CSF GOT and LDH activities were well correlated with the severity, mortality and peak and proper timing in relation to infarct, same is about serum GOT. A characteristic rise of GOT and LDH was observed in cerebral haemorrhage especially in fatal cases. However, in cerebral thrombosis and embolism specially in non-fatal cases, the enzyme change was not so marked. GOT and LDH enzyme pattern in CSF and serum may, therefore, serve as an early, relatively easy and widely available tool for differential diagnosis and prognosis of cases of acute CVA.

Aspartate Aminotransferases↗
PubMed1983

[Intracranial hypertension].

Intracranial hypertension is caused by various pathologic processes. From oncologic point of view, they are 1) intracranial space-occupying lesions, especially malignant tumors, 2) leptomeningeal tumors, 3) hemorrhage in the brain tumors, 4) intracranial hemorrhage due to hemorrhagic diathesis related to the malignant tumors, and 5) cerebral thrombosis or embolism due to increased blood coagulability secondary to malignancy. In the increase of intracranial pressure, brain edema or disturbance of cerebrospinal fluid (CSF) circulation due to the presence of brain tumors play more important role than the tumor bulk itself. CT scan is useful for demonstrating the process causing the intracranial hypertension. Therapeutic measures in all patients with increased intracranial pressure are initiated promptly to restore the cardiopulmonary dysfunction if any. Hyperventilation and intravenous infusion of hyperosmolar agents such as mannitol and glycerol have an immediate effect in reducing intracranial pressure when brain edema plays role in increasing it. Steroids are also very effective in reducing brain edema; the effect is less immediate but long lasting. CSF drainage or shunt operation is necessary when dilated ventricular system plays role in the intracranial hypertension. The radical treatment of the intracranial hypertension is a removal of the tumor causing it; however, if not indicated, the second choice is the internal or external decompressions. Postoperative radiotherapy and chemotherapy are also indicated for the malignant brain tumors.

Brain Neoplasms↗
PubMed1996

[Late supraventricular arrhythmia complicating Fontan or cavopulmonary type procedures. Apropos of 7 cases].

The authors report 7 cases of late arrhythmias after atriopulmonary (5 cases) or total cavopulmonary (2 cases) bypass procedures. There were 6 cases of atrial flutter and one case of atrial tachycardia. The condition presented with cardiac failure in 5 cases. In 2 patients, atrial flutter caused syncope or dizziness. The arrhythmia was reduced by atrial stimulation (3 cases) or by cardioversion (1 case). Prevention of recurrence with oral amiodarone was effective in all cases but was responsible for secondary effects in 4 cases. In one patient, recurrence of atrial flutter was complicated by right atrial thrombosis with cerebral embolism. Five patients were reoperated after cardiac catheterisation and angiography. Surgery consisted of resection of a stenosis of the anastomosis in one case, and the transformation of atriopulmonary anastomosis into a total cavopulmonary bypass because of a very dilated right atrium without stenosis in 4 patients. The immediate postoperative period was complicated by a recurrence of the arrhythmia in 3 children not treated by antiarrhythmic therapy. At long-term, one patient died 6 months after withdrawal of amiodarone therapy of recurrence of atrial flutter. Five of the 6 survivors are treated with amiodarone or a betablocker; 3 have had pacemaker implantation for severe bradycardia. Late atrial arrhythmias complicating atrio- and cavopulmonary bypass procedures carry a risk of cardiac failure and sudden death. When diagnosed, the patient should be investigated for stenosis of the anastomosis but severe dilatation of the right atrium is often the only finding. After restoration of sinus rhythm, maintenance antiarrhythmic therapy should be continued indefinitely.

Amiodarone↗