Cerebral Vascular Accidents (CVA) Victims Conception and Birth Time-Links to Longevity, Lithuania, 1989-2013

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=53559#.VMiOzyzQrzE

ABSTRACT

In year 2001 a paper in the ANAS considered links between month of birth and longevity. In the following years we published four papers related to “big killers” (cardiac and oncology) that showed some differences in birth months distribution of this group and studied by LA, NS Gavrilov’s centenarians. The aim of this study was to study conception and birth months of another modern “big killer”—cerebral stroke (CVA) that is taking a leading role among cardiovascular causes of death in the last decades. Methods: 130,120 deaths of both gender CVA victims in Lithuania at 1989-2013 were studied. In addition to birth month, the months of conception (9 months before birth) were studied. Our data were compared with results of centenarians (birth of LA, NS Gavrilov’s study and transformed by authors also their conception month). Results: The maximum of births were January, March and May for CVA victims, while the analogical conception maximum were in April, June, May and July. The similar data for centenarians were that maximal births were in November, September, October (LA, NS Gavrilov) and conception in December, January, February. These results are similar to data related to cardiac and oncology deaths published in our previous publications. Conclusion: The conception and birth month of victims of CVA is different of similar data obtained by centenarians study. Different environmental conditions at different parts of the year and solar cycle can play a role affecting the embryo at early stages of development, predisposing to some pathologies in coming years of life.

Cite this paper

Stoupel, E. , Petrauskiene, J. , Kalediene, R. , Sauliune, S. and Abramson, E. (2015) Cerebral Vascular Accidents (CVA) Victims Conception and Birth Time-Links to Longevity, Lithuania, 1989-2013. Health, 7, 161-166. doi: 10.4236/health.2015.71018.

References

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http://dx.doi.org/10.4236/health.2014.621346
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Stroke Care in an Australian Rural Private Health Care Setting

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=53188#.VLcfFMnQrzE

ABSTRACT

Stroke is a leading cause of disability and death in Australia. There is a clear benefit in caring for stroke patients in stroke care units. Access to these centres is limited particularly in the rural setting. Certified stroke care units in the private health care setting are also unheard of. The superiority of these units is thought to be due to better adherence to processes of care (early utility of CT scan, allied health input within 24 hours, neurological observations, DVT prophylaxis and appropriate use of antiplatelet and anticoagulant use). We audited care of 100 patients who presented to the St. John of God Hospital (rural private hospital) over a period of 3 years. This included baseline demographics, adherence of processes of care, utility of appropriate investigations, and outcome measures such as discharge destination, level of function at discharge and complication rates. These data were compared with the national stroke report (AuSCR) and adherence to processes of care was compared with the SCOPE study (the first study to establish the benefit of POC). When compared with data from the AuSCR national report 2012, we found a higher mortality rate, an increased rate of disability on discharge, and a mixed adherence to processes of care. We also found a significant proportion of patients (40%) who were eligible to receive thrombolysis but did not. Overall we found that there were significant strengths to be drawn upon in the rural private healthcare setting and a more organised approach could improve outcomes.

Cite this paper

Vijiaratnam, N. , Yan, B. , Anjara, P. , Kraemer, T. , Lau, M. and Knight, B. (2015) Stroke Care in an Australian Rural Private Health Care Setting. World Journal of Neuroscience, 5, 7-12. doi: 10.4236/wjns.2015.51002.

References

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[12] Zaidi, S., Jumma, M., Urra, X., et al. (2011) Telestroke-Guided Intravenous Tissue-Type Plasminogen Activator Treatment Achieves a Similar Clinical Outcome as Thrombolysis at a Comprehensive Stroke Center. Stroke, 42, 3291-3293. http://dx.doi.org/10.1161/STROKEAHA.111.625046                                       eww150115lx

Optimal Adiposity Measurement and Risk Stratification in Established Ischaemic Stroke

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=52767#.VKNXlcnQrzE

ABSTRACT

Background: Prevention strategies post-stroke should target risk factor reduction which includes consideration of weight, diet and lipoprotein profiles. Limited data informs the optimal adiposity measurement post-stroke to target those at highest recurrent risk. This study aims to identify adiposity measurement/s post-stroke that best predict cardiovascular and co-morbid risk. Subjects and Methods: 142 stroke patients (100 males, 42 females; mean age 63 years) participated. Adiposity and metabolic profiles included BMI, waist circumference, waist to height ratio (WHR), triglyceride levels and hypertriglyceridemic waist. The predictive ability of these measures with indices of cardiovascular risk (Cardiovascular Risk Score) and co-morbidity (Charlson’s co-morbidity index) were examined. Results: In hierarchical multiple regression models, age and gender controlled, waist (p = 0.002), triglyceride levels (p = 0.006), BMI and WHR (p = 0.014), uniquely and significantly contributed to the variance in cardiovascular risk, in their models. Only one combination of measures (waist and triglyceride levels) improved the predictive ability of waist in cardiovascular risk stratification (p = 0.001). In men, waist (p = 0.013) and in women triglyceride levels (p = 0.012) performed as the best predictors of cardiovascular risk respectively. No combination of measures was superior to triglyceride levels in women or waist circumference measures in men in predicting cardiovascular risk. With Charlson’s co-morbidity index as the dependent variable, triglyceride levels significantly contributed to variance of the model with age and gender influences controlled (p = 0.047). No combination of measures improved the predictive ability of triglyceride levels for co-morbidity. Conclusion: Waist circumference and triglyceride levels should form a minimum dataset for adiposity when considering cardiovascular and comorbid risk post-stroke.

Cite this paper

Lennon, O. and Blake, C. (2014) Optimal Adiposity Measurement and Risk Stratification in Established Ischaemic Stroke. World Journal of Cardiovascular Diseases, 4, 655-665. doi: 10.4236/wjcd.2014.413077.

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Surgical Coronary Revascularization Using an Off-Pump, No-Touch Technique: The Cyclone (Hexalon) Experience

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=52508#.VJoozcCAM4

ABSTRACT

The CycloneTM System (Castlewood Surgical, Inc., Concord, MA) is a novel device that facilitates the attachment of the saphenous vein onto the ascending aorta for the purpose of creating a bypass graft during a coronary artery bypass grafting (CABG) operation. It allows the surgeon to perform a hand-sewn anastomosis with no disruption of the intima of the aorta, and no need for partial clamping. During a 36-month period 109 CABG operations were performed, and the CycloneTM System (and its predecessor, the HexalonTM) was utilized to create 138 proximal anastomoses. This study demonstrates that this is a safe and effective method of creating a clampless, no-touch proximal anastomoses during off-pump CABG.

Cite this paper

Schussler, J. , Theologes, T. and Hamman, B. (2014) Surgical Coronary Revascularization Using an Off-Pump, No-Touch Technique: The Cyclone (Hexalon) Experience. Open Journal of Thoracic Surgery, 4, 94-99. doi: 10.4236/ojts.2014.44019.

References

[1] Ayad, R.F., Bhella, P.S., Dockery, W.D., et al. (2011) Patency of Vein Graft Anastomoses Facilitated with the Hexalon Device. The Annals of Thoracic Surgery, 91, 894-898.
http://dx.doi.org/10.1016/j.athoracsur.2010.11.029
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http://dx.doi.org/10.1056/NEJMoa0804626
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http://dx.doi.org/10.1016/S0003-4975(02)04370-9
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http://dx.doi.org/10.1055/s-0030-1249831                                                                                eww141224lx

Stroke Epidemiology in Douala: Three Years Prospective Study in a Teaching Hospital in Cameroon

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=51293#.VGK2z2fHRK0

ABSTRACT

Background and Objectives: Cerebro-vascular accident or stroke constitutes a major challenge in sub-Saharan Africa. In Cameroon, basic epidemiologic data are not routinely available. Aims: The aim of this study was to determine the type, the associated risk factors, time to admission, the clinical presentation and the case fatality of stroke at the Douala General Hospital (DGH) in Cameroon. Methods: A cross-sectional study was performed from January 1, 2010 to December 31, 2012 at the neurology and intensive care units of the DGH. All patients above 15 years of age with a diagnosis of established stroke were enrolled. For each patient, socio-demographic, clinical and paraclinical data were recorded as well as the duration of hospitalization and the case fatality. Results: In all, 325 patients were enrolled with males constituting 68.1% and general mean age of 58.66 ± 13.6 years. The mean initial consultation delay was 47.36 ± 18.48 hours. The majors cerebro-vascular risk factors were hypertension (81.15%), chronic alcohol consumption (28.3%), diabetes mellitus (20.61%), obesity (18.15%), cigarette smoking (16%), dyslipidemia (8.9%) and atrial fibrillation (3.07%). Ischemic stroke accounted for 52% of cases while 48% were hemorrhagic. The mean duration of hospitalization was 8.58 ± 6.35 days with a case fatality rate of 26.8%. Septic conditions appeared to be the leading cause of death accounting for 35.6% of cases. Conclusion: Stroke in the DGH is associated with a high case fatality rate and hypertension remains the number one risk factor. There is a clear and urgent need for public health authorities to reinforce measures for the control of modifiable stroke risk factors.

Cite this paper

Mapoure, Y. , Kuate, C. , Tchaleu, C. , Ngahane, H. , Mounjouopou, G. , Ba, H. , Mbahe, S. , Fonsah, J. , Beyiha, G. , Luma, H. , Mouelle, A. , Ndouongo, P. and Njamnshi, A. (2014) Stroke Epidemiology in Douala: Three Years Prospective Study in a Teaching Hospital in Cameroon. World Journal of Neuroscience, 4, 406-414. doi: 10.4236/wjns.2014.45044.

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Incidence of Stroke among Swedish-Born and Migrant Women —The Role of Socio-Economic Status, Smoking, and Physical Activity

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=50844#.VE2lp1fHRK0

ABSTRACT

Introduction: The incidence of stroke has decreased in Sweden as well as in most developed countries, but a high number of migrants have arrived in Sweden, during the last decades, which may have influenced the incidence. Aim: The aim of this study was to examine the incidence of stroke in women, born outside as well as in Sweden. Furthermore, the aim was to examine how socio-economic factors, smoking, and physical activity could modify the risk for stroke. Method: Data from the “Malmö Diet and Cancer Study” was used for the analysis. In total, 16,857 women were included (14,849 of them born in and 2,008 born outside Sweden), aged 45 – 73 years with a mean age of 57.4 years. Result. A significantly increased relative risk (RR) was found for the incidence of stroke for current smokers in both Swedish-born and migrant women. In Swedish-born women the RR was 1.98 (CI: 1.66 – 2.36) and for migrant women the RR was 1.83(CI: 1.13 – 2.96). The adjusted relative risk for the incidence of stroke in Swedish-born women performing moderate/high physical activity was RR 0.71 (CI: 0.61 – 0.84) and for migrant women it was RR 0.77 (CI: 0.49 – 1.20). The relative risk in relation to low socio-economic circumstances (SES) was significant only for Swedish-born women (RR 0.85 [CI: 0.73 – 0.99]). Among currently smoking Swedish-born women with a low SES the RR was 1.27 (CI: 1.03 – 1.57) in comparison with smoking migrant women, whose RR was 1.68 (CI: 0.92 – 3.09). Conclusion: No differences were found indicating that migrant women in this population had a higher risk as compared to Swedish-born women. However, migrant smoking women were more vulnerable to stroke compared to Swedish-born women. Physical activity was effective in reducing the risk of stroke among the total population and especially in the Swedish-born women. To increase physical activity in middle-aged women, in both migrant and Swedish-born women, is a highly recommended public health strategy.

Cite this paper

Nayak, R. , Kahn, M. and Janzon, E. (2014) Incidence of Stroke among Swedish-Born and Migrant Women
—The Role of Socio-Economic Status, Smoking, and Physical Activity. World Journal of Cardiovascular Diseases, 4, 556-566. doi: 10.4236/wjcd.2014.411067.

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http://dx.doi.org/10.1097/00005053-200006000-00006                                                       eww141027lx

Reducing Participation Bias in Case-Control Studies: Type 1 Diabetes in Children and Stroke in Adults

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=48508#.VD9_ZFfHRK0

ABSTRACT

Background: Case-control studies have been used extensively in determining the aetiology of rare diseases. However, case-control studies often suffer from participation bias in the control group, resulting in biased odds ratios that cause problems with interpretation. Participation bias can be hard to detect and is often ignored. Methods: Population data can be used in place of the possibly biased control group, to investigate whether participation bias may have affected the results in previous studies, or in place of controls in future studies. We demonstrate this approach by reanalysing and comparing the results of two case-control studies: Type 1 diabetes in Yorkshire children and stroke in Indian adults. Findings: Using population data to represent the control groups reduced the width of the confidence intervals given in the original studies and confirmed the findings for the two diabetes risk factors used; caesarean birth (odds ratio (OR) = 2.12 (1.53, 2.95) compared with 1.84 (1.09, 3.10)) and amniocentesis (OR = 3.38 (2.09, 5.47) compared with 3.85 (1.34, 11.04)). The three stroke risk factors investigated were found to have increased odds ratios when using population data; hypertension (OR = 5.645 (5.639, 5.650) compared with 3.807 (2.114, 6.856)), diabetes (OR = 12.212 (12.200, 12.224) compared with 3.473 (1.757, 6.866)) and smoking (OR = 5.701 (5.696, 5.707) compared with 2.242 (1.255, 4.005)). Interpretation: Participation bias can greatly affect the results of a study and cause some potential risk factors to be over-or underestimated. This approach allows previous studies to be investigated for participation bias and presents an alternative to a control group in future studies, while improving precision.

Cite this paper

Keeble, C. , Barber, S. , Baxter, P. , Parslow, R. and Law, G. (2014) Reducing Participation Bias in Case-Control Studies: Type 1 Diabetes in Children and Stroke in Adults. Open Journal of Epidemiology, 4, 129-134. doi: 10.4236/ojepi.2014.43018.

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[23] Berkson, J. (1946) Limitations of the Application of Fourfold Table Analysis to Hospital Data. Biometrics Bulletin, 2, 47-53. http://dx.doi.org/10.2307/3002000                                                                                           eww141016lx