THE PRESENCE OF MULTIPLE MICROBLEEDS AS A PREDICTOR OF SUBSEQUENT CEREBRAL HEMORRHAGE IN PATIENTS WITH MOYAMOYA DISEASE

Neurosurgery ◽  
2008 ◽  
Vol 62 (1) ◽  
pp. 104-112 ◽  
Author(s):  
Ken-ichiro Kikuta ◽  
Yasushi Takagi ◽  
Kazuhiko Nozaki ◽  
Nobukatsu Sawamoto ◽  
Hidenao Fukuyama ◽  
...  

Abstract OBJECTIVE To examine the relationship between asymptomatic microbleeds (MBs) and the occurrence of subsequent stroke in patients with moyamoya disease. METHODS Beginning in October 2003, 50 consecutive patients with moyamoya disease were enrolled in a prospective study using 3-T magnetic resonance imaging. These patients were followed from the date of the initial magnetic resonance study until the date of the first subsequent stroke or final magnetic resonance study. The median follow-up period was 15 months. The patients were comprised of 13 men and 37 women ranging in age from 9 to 68 years (mean age, 40.5 ± 16.2 yr). RESULTS Although no MBs were found in 27 patients in the initial magnetic resonance study, a total of 66 MBs were found in the remaining 23 patients. Eleven patients had a single MB and 12 had multiple MBs. The patients were divided into three groups according to the number of MBs: a non-MB group, a single-MB group, and a multi-MB group. Kaplan-Meier curves of the three groups showed a significantly higher likelihood of subsequent hemorrhage in the multi-MB group than in either the non-MB or single-MB groups (P = 0.0380). No significant differences among the three groups were seen in terms of their subsequent infarction-free ratios. Age-adjusted analysis performed with the Cox proportional hazard model also showed the presence of multiple MBs as an independent risk factor (hazard ratio, 2.89; 95% confidence interval, 1.001–13.24). CONCLUSION The presence of multiple MBs might be a predictor of subsequent hemorrhage in patients with moyamoya disease. Confirmation of these results will require a study with a larger number of patients and a longer follow-up period.

2018 ◽  
Vol 26 (4) ◽  
pp. 583-588
Author(s):  
Casey Mace Firebaugh ◽  
Simon Moyes ◽  
Santosh Jatrana ◽  
Anna Rolleston ◽  
Ngaire Kerse

The relationship between physical activity, function, and mortality is not established in advanced age. Physical activity, function, and mortality were followed in a cohort of Māori and non-Māori adults living in advanced age for a period of 6 years. Generalized linear regression models were used to analyze the association between physical activity and Nottingham Extended Activities of Daily Living scale, whereas Kaplan–Meier survival analysis and Cox proportional hazard models were used to assess the association between the physical activity and mortality. The hazard ratio for mortality for those in the least active physical activity quartile was 4.1 for Māori and 1.8 for non-Māori compared with the most active physical activity quartile. There was an inverse relationship between physical activity and mortality, with lower hazard ratios for mortality at all levels of physical activity. Higher levels of physical activity were associated with lower mortality and higher functional status in advanced-aged adults.


2020 ◽  
pp. 101053952097992
Author(s):  
Soojung Kim ◽  
Youn Jung

This study aimed to examine the association between working hours and onset of cardiovascular diseases (CVDs) using a prospective study design. We used the Korean Longitudinal Study of Aging (KLoSA) data from 2006 to 2016. A total of 2405 workers who were working 35 hours or more per week and who did not have CVD at baseline were analyzed. Cox proportional hazard model was used for the analysis to determine the association between working hours per week at baseline and the new onset of CVD. In addition, multivariable logistic regression analysis was used to test the relationship between average working hours throughout the entire follow-up period and the risk of CVD (N = 1134). Working above 52 hours per week at baseline was related to higher risk of CVD than working between 35 and 40 hours a week (hazard ratio [HR] = 2.08, 95% confidence interval [CI] = 1.60-2.70 for 52-60 hours; HR = 1.38, 95% CI = 1.05-1.81 for >60 hours). A worker’s average working hours throughout the following period were also significantly associated with elevated risks of CVD (odds ratio = 4.40, 95% CI = 1.58-12.22 for >60 hours). The findings underline the need for more proactive interventions to protect the health of workers exposed to long working hours.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Keita Tanaka ◽  
Yoichiro Yoshida ◽  
Teppei Yamada ◽  
Takaomi Hayashi ◽  
Hideki Shimaoka ◽  
...  

AbstractThe detection of circulating cell-free DNA (cfDNA) by liquid biopsy is reported to provide prognostic information in colorectal cancer (CRC). Although the frequency of BRAF V600E mutation in CRC is less than 10%, it is associated with poor responses to conventional chemotherapy. We conducted a prospective study to investigate the relationship between the perioperative mutant allele frequency (MAF) of BRAF V600E and tumor recurrence, and to evaluate the possibility of early detection of recurrence. Among 362 patients who underwent radical resection, cfDNA was extracted from the perioperative blood of 11 CRC patients with BRAF V600E mutation and analyzed using the digital polymerase chain reaction (dPCR) system. The median follow-up time was 22 months, and there were four cases of recurrence. Although there was no correlation between recurrence and the perioperative MAF of BRAF V600E, tumor diameter was correlated with the MAF (p = 0.024), and the MAF increased with time in two patients from whom additional samples were obtained prior to recurrence. In this study, we identified a correlation between the pathological tumor diameter and the MAF, but it was difficult to predict recurrence by measuring cfDNA with BRAF V600E mutation in the perioperative period of radical resection of CRC.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Norie Saito ◽  
Masato Furuhashi ◽  
Masayuki Koyama ◽  
Yukimura Higashiura ◽  
Hiroshi Akasaka ◽  
...  

AbstractFatty acid-binding protein 4 (FABP4) is secreted from adipose tissue and acts as an adipokine, and an elevated circulating FABP4 level is associated with metabolic disorders and atherosclerosis. However, little is known about the causal link between circulating FABP4 level and mortality in a general population. We investigated the relationship between FABP4 concentration and mortality including cardiovascular death during a 12-year period in subjects of the Tanno-Sobetsu Study, a population-based cohort (n = 721, male/female: 302/419). FABP4 concentration at baseline was significantly higher in female subjects than in male subjects. All-cause death occurred in 123 (male/female: 74/49) subjects, and 34 (male/female: 20/14) and 42 (male/female: 26/16) subjects died of cardiovascular events and cancer, respectively. When divided into 3 groups according to tertiles of FABP4 level at baseline by sex (T1–T3), Kaplan–Meier survival curves showed that there were significant differences in rates of all-cause death and cardiovascular death, but not cancer death, among the groups. Multivariable Cox proportional hazard model analysis with a restricted cubic spline showed that hazard ratio (HR) for cardiovascular death, but not that for all-cause death, significantly increased with a higher FABP4 level at baseline after adjustment of age and sex. The risk of cardiovascular death after adjustment of age, sex, body mass index and levels of brain natriuretic peptide and high-sensitivity C-reactive protein in the 3rd tertile (T3) group (HR: 4.96, 95% confidence interval: 1.20–22.3) was significantly higher than that in the 1st tertile (T1) group as the reference. In conclusion, elevated circulating FABP4 concentration predicts cardiovascular death in a general population.


Agriculture ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 334
Author(s):  
Ramūnas Antanaitis ◽  
Vida Juozaitienė ◽  
Dovilė Malašauskienė ◽  
Mindaugas Televičius ◽  
Mingaudas Urbutis ◽  
...  

The aim of the current study was to evaluate the relationship of different parameters from an automatic milking system (AMS) with the pregnancy status of multiparous cows at first service and to assess the accuracy of such a follow-up with regard to blood parameters. Before the insemination of cows, blood samples for measuring biochemical indices were taken from the coccygeal vessels and the concentrations of blood serum albumin (ALB), cortisol, non-esterified fatty acids (NEFA) and the activities of aspartate aminotransferase (AST) and gamma glutamyltransferase (GGT) were determined. From oestrus day to seven days after oestrus, the following parameters were registered: milk yield (MY), electric milk conductivity, lactate dehydrogenase (LDH) and β-hydroxybutyric acid (BHB). The pregnancy status was evaluated using ultrasound “Easy scan” 30–35 days after insemination. Cows were grouped by reproductive status: PG− (non-pregnant; n = 48) and PG+ (pregnant; n = 44). The BHB level in PG− cows was 1.2 times higher (p < 0.005). The electrical conductivity of milk was statistically significantly higher in all quarters of PG− cows (1.07 times) than of PG+ cows (p < 0.05). The arithmetic mean of blood GGT was 1.61 times higher in PG− cows and the NEFA value 1.23 times higher (p < 0.05) compared with the PG+ group. The liver function was affected, the average ALB of PG− cows was 1.19 times lower (p < 0.05) and the AST activity was 1.16 times lower (p < 0.05) compared with PG+ cows. The non-pregnant group had a negative energy balance demonstrated by high in-line milk BHB and high blood NEFA concentrations. We found a greater number of cows with cortisol >0.0.75 mg/dL in the non-pregnant group. A higher milk electrical conductivity in the non-pregnant cows pointed towards a greater risk of mastitis while higher GGT activities together with lower albumin concentrations indicated that the cows were more affected by oxidative stress.


Author(s):  
Parminderpal Singh ◽  
Kiranjit Kiranjit

Objective: The present study was aimed to analyze the side effects of olmesartan medoxomil and enalapril in hypertensive subjects.Methods: The study consisted of newly diagnosed hypertension categorized according to 7th report of Joint National Commission on prevention, detection, evaluation, and treatment of high blood pressure. The subjects were divided into two groups. The Group A subjects received olmesartan, and Group B subjects received enalapril. Pressure was recorded both in supine and sitting positions. The appearance of side effects was observed in the follow-up, i.e., dry cough, headache, postural hypotension, angioedema, dizziness, skin rashes, taste alterations, and urticaria. A statistical data were prepared on the basis of information obtained and analyzed thoroughly for antihypertensive effects and side effects of olmesartan and enalapril. SPSS software was used for analysis.Results: There was observed an increase in the incidence of taste alteration with drug therapy in Group B (Enalapril). There was observed an increase in the incidence of postural hypotension with drug therapy in both groups. In Group A (Olmesartan), the incidence of postural hypotension at the beginning of trial, 4 weeks, and 8 weeks was 0%, 2%, and 2%, respectively. In Group A (Olmesartan), there was no incidence of a headache at the beginning of trial, at 4 weeks and 8 weeks.Conclusion: From the study, it can be concluded that both olmesartan and enalapril are effective in Stage I and Stage II hypertension, but olmesartan is tolerated well with lesser side effects.


Rheumatology ◽  
2018 ◽  
Vol 58 (4) ◽  
pp. 650-655 ◽  
Author(s):  
Alexander Oldroyd ◽  
Jamie C Sergeant ◽  
Paul New ◽  
Neil J McHugh ◽  
Zoe Betteridge ◽  
...  

Abstract Objectives To characterize the 10 year relationship between anti-transcriptional intermediary factor 1 antibody (anti-TIF1-Ab) positivity and cancer onset in a large UK-based adult DM cohort. Methods Data from anti-TIF1-Ab-positive/-negative adults with verified diagnoses of DM from the UK Myositis Network register were analysed. Each patient was followed up until they developed cancer. Kaplan–Meier methods and Cox proportional hazard modelling were employed to estimate the cumulative cancer incidence. Results Data from 263 DM cases were analysed, with a total of 3252 person-years and a median 11 years of follow-up; 55 (21%) DM cases were anti-TIF1-Ab positive. After 10 years of follow-up, a higher proportion of anti-TIF1-Ab-positive cases developed cancer compared with anti-TIF1-Ab-negative cases: 38% vs 15% [hazard ratio 3.4 (95% CI 2.2, 5.4)]. All the detected malignancy cases in the anti-TIF1-Ab-positive cohort occurred between 3 years prior to and 2.5 years after DM onset. No cancer cases were detected within the following 7.5 years in this group, whereas cancers were detected during this period in the anti-TIF1-Ab-negative cases. Ovarian cancer was more common in the anti-TIF1-Ab-positive vs -negative cohort: 19% vs 2%, respectively (P < 0.05). No anti-TIF1-Ab-positive case <39 years of age developed cancer, compared with 21 (53%) of those ≥39 years of age. Conclusion Anti-TIF1-Ab-positive-associated malignancy occurs exclusively within the 3 year period on either side of DM onset, the risk being highest in those ≥39 years of age. Cancer types differ according to anti-TIF1-Ab status, and this may warrant specific cancer screening approaches.


2021 ◽  
Vol 8 ◽  
Author(s):  
Dana Bielopolski ◽  
Ruth Rahamimov ◽  
Boris Zingerman ◽  
Avry Chagnac ◽  
Limor Azulay-Gitter ◽  
...  

Background: Microalbuminuria is a well-characterized marker of kidney malfunction, both in diabetic and non-diabetic populations, and is used as a prognostic marker for cardiovascular morbidity and mortality. A few studies implied that it has the same value in kidney transplanted patients, but the information relies on spot or dipstick urine protein evaluations, rather than the gold standard of timed urine collection.Methods: We revisited a cohort of 286 kidney transplanted patients, several years after completing a meticulously timed urine collection and assessed the prevalence of major cardiovascular adverse events (MACE) in relation to albuminuria.Results: During a median follow up of 8.3 years (IQR 6.4–9.1) 144 outcome events occurred in 101 patients. By Kaplan-Meier analysis microalbuminuria was associated with increased rate of CV outcome or death (p = 0.03), and this was still significant after stratification according to propensity score quartiles (p = 0.048). Time dependent Cox proportional hazard analysis showed independent association between microalbuminuria and CV outcomes 2 years following microalbuminuria detection (HR 1.83, 95% CI 1.07–2.96).Conclusions: Two years after documenting microalbuminuria in kidney transplanted patients, their CVD risk was increased. There is need for primary prevention strategies in this population and future studies should address the topic.


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