急性脑卒中并发下肢静脉血栓临床因素分析

目的急性脑卒中患者可发生肢体功能障碍,是下肢静脉血栓(deep vein thrombosis,DVT)形成的高危人群,本研究对急性脑卒中后下肢静脉血栓形成临床特征进行调查分析,为临床预防性治疗及护理措施的制订提供借鉴。方法对2016-01-30-2018-01-30南阳市中心医院收治的798例急性脑卒中患者中发生下肢静脉血栓的83例患者临床资料进行收集整理,并对其脑卒中后发生下肢静脉血栓的相关因素进行单因素和Logistic多因素回归分析,总结脑卒中后发生下肢静脉血栓的相关因素及临床特征。结果脑卒中患者下肢静脉血栓形成总发生率为10.40%。脑卒中后患侧下肢静脉血栓发生率明显高于健侧和双侧,差异有统计学意义,χ~2=11.642,P=0.013。单因素分析显示,脑卒中类型(χ~2=4.935,P=0.037)、年龄(χ~2=4.755,P=0.039)、卧床时间(χ~2=5.172,P=0.025)、体质量指数(χ~2=5.315,P=0.023)、下肢NIHSS评分(χ~2=5.953,P=0.019)、Wells评分(χ~2=5.183,P=0.024)、抗凝药物(χ~2=8.037,P=0.015)、下肢气压治疗(χ~2=11.761,P=0.005)各组内下肢静脉血栓形成比例差异均具有统计学意义。Logistic多因素回归分析结果显示,出血性脑卒中(OR=2.677,95%CI为1.360～5.227,P=0.006)、年龄≥65岁(OR=3.228,95%CI为1.650～6.318,P=0.003)、卧床时间≥2周(OR=2.814,95%CI为1.567～5.053,P=0.002)、BMI≥25(OR=3.962,95%CI为1.612～9.740,P=0.008)、下肢NIHSS评分≥3分(OR=5.496,95%CI为2.096～14.216,P=0.001)和Wells评分≥2分(OR=4.655,95%CI为1.732～12.508,P=0.007)是脑卒中后发生下肢静脉血栓形成的高危因素,应用抗凝药物(OR=0.280,95%CI为0.157～0.498,P0.001)、下肢气压治疗(OR=0.240,95%CI为0.128～0.449,P0.001)是保护性因素。结论年龄大、卧床时间长、BMI高、下肢NIHSS评分高、Wells评分高是下肢静脉血栓形成的危险因素;应用抗凝药物、下肢气压治疗是下肢静脉血栓形成的保护性因素。     

老年脑卒中患者并发下肢深静脉血栓影响因素

目的老年脑卒中发病率逐年上升,本研究对老年脑卒中患者并发下肢深静脉血栓(deep venous thrombosis,DVT)相关影响因素进行分析,以期为降低脑卒中患者下肢DVT发生率提供理论依据。方法回顾性分析巩义市人民医院2015-10-05-2017-11-05接诊的老年脑卒中患者临床资料,根据是否出现DVT共选取80例患者作为研究对象,分为DVT组29例和非DVT组51例,对影响DVT的相关因素进行分析。结果 DVT组与非DVT组比较,性别(χ~2=4.381,P=0.036)、卧床时间(χ~2=24.390,P<0.001)、是否患有高血压(χ~2=27.990,P<0.001)、是否进行股静脉穿刺(χ~2=9.851,P=0.002)所占比例差异有统计学意义。Logistic回归分析发现,卧床时间长短(OR=0.029,95%CI为0.004～0.211,P<0.001)、高血压(OR=0.035,95%CI为0.005～0.236,P=0.001)、股静脉穿刺(OR=0.180,95%CI为0.032～0.996,P=0.049)是影响患者发生深静脉血栓的因素。结论老年脑卒中患者并发下肢深静脉血栓的主要因素为长期卧床、高血压和股静脉穿刺,应该给予正确预防,避免相关危险因素的发生,减少老年脑卒中患者DVT的形成。     

辽宁省城市地区≥40岁居民脑卒中患病现状及其相关危险因素分析

目的分析城市≥40岁居民脑卒中患病特征及其相关危险因素,为制定综合有效的脑卒中防控策略提供参考依据。方法于2018年3月—2019年2月对辽宁省辽阳市弓长岭区和刘二堡以及丹东市振安区5 424例≥40岁的常驻居民进行问卷调查、体格检查和实验室检查,采集脑卒中患病特征及其相关危险因素资料。结果辽宁省城市≥40岁居民脑卒中患病人数为292例,脑卒中患病粗率为5.4%,男性高于女性(7.2%vs 4.4%,P 0.001)。脑卒中标化患病率为3.8%,男性和女性分别为4.8%和3.4%。多因素logistic回归分析结果显示,男性(OR=2.25,95%CI=1.75～2.97)、超重或肥胖(OR=1.35,95%CI=1.03～1.77)、缺乏锻炼(OR=1.86,95%CI=1.31～12.65)、高血压(OR=2.84,95%CI=2.08～3.89)、糖尿病(OR=1.93,95%CI=1.49～2.50)、脑卒中家族史(OR=2.13,95%CI=1.64～2.78)等是脑卒中患病的主要危险因素。结论辽宁省城市地区≥40岁居民脑卒中患病率较高,疾病负担较重,亟待开展积极有效的脑卒中相关危险因素综合干预。     

老年脑卒中患者发生下肢深静脉血栓危险因素的meta分析

目的 系统评估老年脑卒中患者下肢深静脉血栓(DVT)形成的危险因素。方法 全面检索从建库至2021年3月关于老年脑卒中患者下肢深静脉血栓形成危险因素的病例对照研究。采用Stata 12.0进行meta分析。结果 共纳入23篇文献,病例组1 965例,对照组8 985例。Meta分析结果显示,卧床（OR = 4.65,95%CI:2.97～7.26）、合并高血压（OR = 3.94,95%CI:2.97～5.23）、股静脉穿刺（OR = 27.55,95%CI:16.14～47.03）、肺部感染（OR = 2.34,95%CI:1.70～3.23）、高龄（OR = 2.08,95%CI:1.46～2.96）、D - 2聚体升高（OR = 2.17,95%CI:1.77～2.67）、C-反应蛋白升高（OR = 4.18,95%CI:2.98～5.86）、血浆纤维蛋白原升高（OR = 1.12,95%CI:1.03～1.22）、同型半胱氨酸升高（OR = 1.47,95%CI:1.16～1.85）、BI评分低（OR = 2.71,95%CI:1.59～4.6）、GCS评分低（OR = 2.32,95%CI:1.41～3.81）、Wells评分高（OR = 4.62,95%CI(2.77～7.71）、无康复治疗（OR = 1.90,95%CI:1.39～2.61）、无抗凝治疗（OR = 1.77,95%CI:1.28～2.45）、吸烟史（OR = 1.41,95%CI:1.11～1.80）、心力衰竭（OR = 1.43,95%CI:1.10～1.87）、糖尿病（OR = 1.36,95%CI:1.06～1.74）是老年脑卒中患者下肢DVT发病的危险因素。结论 老年脑卒中患者下肢深静脉血栓的预防应从保持良好的饮食和生活习惯、血清生化指标的持续监控、早期康复和抗凝治疗、其他合并疾病的及时治疗等方面提供及时有效的措施。     

急性肺栓塞患者深静脉血栓形成的 危险因素分析

目的 分析急性肺血栓栓塞(PTE)患者深静脉血栓形成(DVT)的临床危险因素.方法 资料来源于2002年6月至2004年12月入选肺栓塞溶栓与抗凝治疗多中心随机对照研究的454例患者.全部患者均经CT肺动脉造影和/或核素肺通气灌注扫描或磁共振肺动脉造影或直接肺动脉造影明确诊断为急性PTE.比较PTE有DVT与PTE无DVT的两组患者,筛选出PTE中DVT的危险因素.结果 对有DVT和无DVT患者,进行性别、年龄、BMI及基础疾病包括高血压、冠心病、慢性阻塞性肺疾病、糖尿病、脑卒中和肿瘤等比较,除糖尿病外(χ2=4.481,P=0.034),其余各指标在两组间的差异均无统计学意义.DVT的体征包括下肢水肿、静脉炎和双下肢周径差≥1 cm在两组间的差异均具有统计学意义(P＜0.01).通过logistic回归确定下肢水肿(OR=2.255;95%CI:1.493～3.408)、静脉炎(OR=2.380;95%CI:1.426～3.973)和双下肢周径差≥1 cm(OR=3.834;95%CI:2.561～5.738)是DVT的独立判断因素.结论 下肢水肿、静脉炎和双下肢周径差≥1 cm是DVT的危险因素.在临床工作中应注意检查DVT的体征,尤其应注意测量双下肢周径.     

脑卒中合并医院获得性肺炎危险因素Meta分析

目的评价脑卒中并发医院获得性肺炎危险因素。方法利用Meta分析对1997—2006年我国符合条件的8篇有关脑卒中合并医院获得性肺炎危险因素的文献进行定量分析,计算每个危险因素的综合OR值。结果共有7个因素有统计学意义,分别为:年龄(OR=2.77,95%CI:2.32～3.30)、吸烟史(OR=1.87,95%CI:1.48～2.37)、糖尿病(OR=2.70,95%CI:1.71～4.26)、心力衰竭(OR=2.46,95%CI:1.68～3.60)、意识障碍(OR=4.97,95%CI:3.28～7.52)、卧床时间(OR=2.93,95%CI:1.78～4.82)、吞咽困难(OR=3.07,95%CI:2.20～4.27)。结论年龄、吸烟史、糖尿病、心力衰竭、意识障碍、卧床时间、吞咽困难是脑卒中并发医院获得性肺炎的危险因素,而性别、脑卒中类型和肺部疾病史尚不能确定。     

精神分裂症住院患者危险行为发生情况及相关因素分析

目的 探讨精神分裂症住院患者危险行为的发生现状及相关危险因素。方法 选取2020年1月—2022年6月江西省康宁医院收治的126例精神分裂症住院患者,根据危险行为发生情况将患者分为危险组(n=35)和非危险组(n=91)。采用多因素Logistic回归分析精神分裂症住院患者发生危险行为的危险因素。结果 多因素分析结果显示,发病前受刺激(OR=4.159,95%CI:1.348～12.832)、SSRS评分<20分(OR=2.990,95%CI:1.142～7.830)、PSS-Fa评分<6分(OR=4.984,95%CI:1.892～13.131)、MMAS-8评分<6分(OR=3.242,95%CI:1.064～9.875)和SDS评分≥53分(OR=3.147,95%CI:1.031～9.599)是精神分裂症住院患者发生危险行为的独立危险因素。结论 精神分裂症住院患者发生危险行为的风险较高。发病前受刺激、SSRS评分<20分、PSS-Fa评分<6分、MMAS-8评分<6分和SDS评分≥53分会增加精神分裂症住院患者发生危险行为的风险。     

鲍曼不动杆菌院内获得性肺炎发生和死亡的危险因素分析

目的 探讨鲍曼不动杆菌(鲍氏不动杆菌)院内获得性肺炎(Ab-HAP)的易感因素和死亡的危险因素.方法 收集2012-2015年北京积水潭医院明确诊断的Ab-HAP患者65例,并随机收集同期非Ab-HAP患者80例作为对照组,分析人口学、基础疾病、治疗情况及转归等信息.采用Logistic回归法分析发生Ab-HAP的独立危险因素以及Ab-HAP患者30 d死亡的独立危险因素.结果 Ab-HAP组和对照组在合并基础病、意识障碍、APACHⅡ评分≥16、机械通气≥5 d、碳青霉烯抗生素暴露史方面差异有统计学意义(x2=36.327、31.208、72.616、22.029和64.476,P均＜0.01).多因素分析显示,APACHⅡ评分≥16(OR=1.140,95％CI:1.058～1.229)、碳青霉烯抗生素暴露史(OR=7.118,95％CI:1.965～25.787)是发生Ab-HAP的独立危险因素.Logistic回归分析证实,降钙素原≥2 ng/mL(OR=6.020,95％CI:7.428～2 819.026)、肺炎严重性评分(PSI)≥Ⅲ级(OR=4.260,95％CI:3.185～1 573.536)和脓毒性休克(OR=4.186,95％CI:2.056～2 104.507)是Ab-HAP患者30 d死亡的独立危险因素.结论 APACHⅡ评分≥16、碳青霉烯抗生素暴露史能增加Ab-HAP发生率;PSI≥Ⅲ级、降钙素原≥2 ng/mL和脓毒休克是Ab-HAP患者30 d死亡的独立危险因素.     

重症脑卒中患者并发失禁相关性皮炎的影响因素研究

目的分析重症脑卒中患者并发失禁相关性皮炎(IAD)的影响因素,为IAD防治提供依据。方法收集125例重症脑卒中患者临床资料,根据住院期间患者有无IAD,分为IAD组和非IAD组,分析患者的性别、年龄、昏迷、体温、BMI、合并慢性病、神经功能(NIHSS)评分、卒中类型、营养和免疫等因素与并发IAD的关联性。结果 125例重症脑卒中患者中,30例并发IAD,占24.00%。其中轻度20例,中度7例,重度3例。多因素Logistic回归分析显示,年龄≥60岁(OR=7.515,95%CI:2.369~21.454)、体温≥38℃(OR=5.225,95%CI:2.612~10.774)、NIHSS评分≥12分(OR=3.467,95%CI:1.455~7.767)、出血性脑卒中(OR=0.596,95%CI:0.387~0.895)、低蛋白血症(OR=8.120,95%CI:3.574~27.644)是IAD发生的影响因素。结论高龄、发热≥38℃、NIHSS评分≥12分、缺血性脑卒中、低蛋白血症可能是重症脑卒中患者并发IAD的危险因素,应采取针对性的干预措施预防IAD发生。     

河南省新乡县农村居民脑卒中流行现况及影响因素分析

目的 了解河南省新乡县农村地区成年常住居民脑卒中流行现况及其影响因素。方法 于2017年4月—2017年6月采用整群抽样方法,随机抽取河南省新乡县朗公庙、七里营2个乡镇17个农村村落的成年常住居民(≥18岁)10 691人进行脑卒中及相关因素的问卷调查、体格检查与实验室检测。结果 本次调查共纳入资料完整对象10 455人进行分析,河南省新乡县农村地区脑卒中粗患病率为6.60%,年龄标准化患病率为5.05%;其中40岁以上人群脑卒中粗患病率为6.58%,标准化患病率为2.89%;男性、女性的性别粗患病率分别为8.39%和5.35%,标准化患病率分别为3.63%和2.39%。在脑卒中常见慢性共患病中,高血压共病率最高,为55.94%,糖尿病共病率最低,为14.64%。多因素logistic回归分析显示,年龄≥50岁(50～59岁:OR = 3.968, 95%CI: 2.654～5.933; 60～69岁:OR = 8.694, 95%CI: 5.906～12.798; ≥70岁:OR = 8.854, 95%CI: 5.855～13.390)、职业为农民(OR = 1.821, 95%CI:1.174～2.824)、高血压(OR = 2.151, 95%CI: 1.816～2.547)、血脂异常(OR = 2.434, 95%CI: 1.950～3.038)、糖尿病(OR = 1.393, 95%CI: 1.091～1.778)、冠心病(OR = 1.385, 95%CI: 1.117～1.718)可能是脑卒中患病的危险因素(P＜0.05);女性(OR = 0.542, 95%CI: 0.455～0.646)、有适度(OR = 0.668, 95%CI: 0.544～0.819)/剧烈运动(OR = 0.696, 95%CI: 0.571～0.849)可能是脑卒中患病的保护因素(P＜0.05)。结论 河南省新乡县农村地区成年常住居民脑卒中患病率较高,男性、≥50岁、农民、无适度/剧烈运动者、合并高血压、血脂异常、冠心病和糖尿病者仍是脑卒中防治的重点人群。     

北京某大型综合医院术后静脉血栓栓塞症发生的危险因素分析

目的 探索北京某大型综合医院术后静脉血栓栓塞症(VTE)发生的危险因素,为临床预防和管理术后VTE提供参考依据。方法 检索病案首页数据,查询2012 - 2017年在北京某三甲医院进行外科手术治疗的患者,以出院诊断包含深静脉血栓形成(DVT)或肺血栓栓塞症(PE)的患者作为病例组,对照组采用1∶2匹配方法选择出院诊断无DVT或PE的患者,应用条件logistic回归分析术后VTE发生的危险因素。结果 （1）纳入试验组患者373例,对照组患者710例。高龄、麻醉时间长、术后卧床时间长是术后VTE的独立危险因素（P＜0.05）。（2）术前住院日长、术前采用血栓风险评估、术后采用物理抗凝措施是降低术后VTE风险的因素（P＜0.05）。（3）术后卧床时间对不同性别患者的术后VTE的发生风险影响不同;体腔开放性手术的术后卧床时间对术后VTE发生的OR值为1.24（95%CI:1.12～1.38）,高于腔镜手术（1.14,95%CI:1.09～1.19）。结论 高龄、麻醉时间长、术后卧床时间长的患者发生术后VTE的风险较高,而术前进行血栓风险评估、术后采取物理抗凝措施可以降低术后VTE的发生风险。     

先天性泌尿生殖系统结构畸形危险因素的研究

目的：探讨有关因素在先天性泌尿生系统结构畸形发病中的作用。方法：采用成组匹配的病列对照研究方法。对95例患先天性泌尿生殖系统 的围产儿和160例对照围产儿及其父母的情况进行调查。采用非条件logistic回归模型进行多因素分析,计算OR值及OR的95％可信限。结果：先天性泌尿生殖系统结构畸形多发生于男性围产儿（性别成比为74．7％,X^2＝74．863,P＝0．001）,多元逐步回归分析表明：母亲孕早、中期感冒（OR＝7．034,95％CI＝3．488－14．187）、低出生体重（OR＝4．075,95％CI＝1．774－9．362）、孕次≥2（OR＝3．133,95％CI＝1．514－6．483）及母亲孕前职业性接触有害化学物质（OR＝10．496,95％CI＝1．053－104．651）为先天性泌尿生殖系统结构畸形的危险因素,结论：胎儿男性别,母亲孕早、中期感冒、低出生体重,母亲孕次≥2及孕前职业性接触有害化学物质与胎儿发生先天性泌尿生系统畸形有关联。     

Selective screening for cervical neoplasia: an approach for resource-poor settings

BACKGROUND: Cervical malignancies are the leading cause of cancer-related morbidity and mortality among women in developing countries. Although early detection programmes using cytological methods, followed by aggressive treatment of precursor lesions are accepted as the main disease control strategy, fiscal limitations make this strategy unfeasible in many countries. METHODS: To screen selectively, we developed two risk scores using data from a population-based case-control study in Jamaica with 202 cases and 363 controls. Independent risk factors for cervical neoplasia were determined using logistic regression. An unweighted risk score for each subject was developed by a simple count of risk factors present and a weighted risk score was calculated by summing regression coefficients for each risk factor. RESULTS: Four patient characteristics were independently predictive of cervical neoplasia, older age (OR = 3.4, 95% CI : 1.8-6.7), > or = 4 pregnancies (OR = 5.6, 95% CI : 1.2-18.7), poverty (OR = 2.1, 95% CI : 1.3-3.3) and cigarette smoking (OR = 1.9, 95% CI : 1.2-3.2). Using cut-off points of > or = 20 for the weighted scores and > 3 for unweighted scores, the sensitivity and specificity were 65% and 69% for the unweighted score and 75% and 61%, respectively, for the weighted score. Areas under the receiver operating characteristic (ROC) curves for the weighted versus the unweighted scores were similar, suggesting similar overall accuracy. CONCLUSION: Selective screening using risk assessment strategies is potentially useful, particularly in resource-poor settings. However, whether weighting factors is essential is dependent on prevalence of factors in a given setting. Although this approach needs validation in other populations, women at highest risk for cervical neoplasia can be identified using demographic factors available during a regular clinic visit.     

Chin-Shan Community Cardiovascular Cohort in Taiwan-baseline data and five-year follow-up morbidity and mortality

A cohort consisting of 3602 residents (82.8% of the target population) aged 35 years and older was established in 1990 in the Chin-Shan Community, a suburb 20 miles outside of metropolitan Taipei, Taiwan. The long-term objective was to investigate the prospective impact on cardiovascular health in a society undergoing transition from a developing to a developed nation. This article presents the study design, selected baseline risk factors of cardiovascular diseases (CVD), and CVD events at the 5-year follow-up evaluation with an emphasis on sociodemographic differences. The multivariate logistic regression analyses revealed that white-collar individuals were more likely than blue-collar workers to have dyslipidemia including high-density lipoprotein cholesterol (HDL-C) levels <35 mg/dl [odds ratio (OR) = 1.7, 95% confidence interval (CI) = 1.2-2.4] and low-density lipoprotein cholesterol (LDL-C) levels >/=160 mg/dl (OR = 1.3, 95% CI = 1.0-1.7). However, they were at slightly lower risk for stroke and CVD/sudden death, and at moderately higher risk for coronary artery disease and diabetes, although both these trends were not significant. Men were more likely than women to have HDL-C levels <35 mg/dl (OR = 1.8, 95% CI = 1.4-2.2), but they were less likely to have LDL-C levels >/=160 mg/dl (OR = 0.7, 95% CI = 0.6-0.8). The risk of CVD/sudden death was higher for men than for women during the follow-up period (OR = 1.9, 95% CI = 1.3-2.9). This could be due to risk factors such as a much higher prevalence of tobacco (61.9% vs. 4.5%) and alcohol (43.7% vs. 6.4%) use in men. In conclusion, individuals of higher socioeconomic status have a higher prevalence of dyslipidemia but slightly lower 5-year incidence of CVD events.     

Spontaneous superficial venous thrombophlebitis: does it increase risk for thromboembolism? A historic follow-up study in primary care

OBJECTIVE: To determine the risk of arterial and venous complications after a spontaneous superficial venous thrombophlebitis (SVTP) in the leg in a general practice population. STUDY DESIGN: Retrospective cohort study (LOE: 2b [CEBM]). Exposure consisted of the diagnosis of SVTP of the lower limbs on an index date. The exposed cohort was compared with an (unexposed) cohort of practice-, age-, and sex-matched controls without SVTP. POPULATION: Patients with spontaneous SVTP in the leg were identified through diagnostic coding in the medical registers of 40,013 patients, enlisted with 5 health centers in Amsterdam, The Netherlands. OUTCOMES: Primary outcomes were deep venous thrombosis (DVT), pulmonary embolism (PE), acute coronary events, or ischemic stroke over a 6-month follow-up period. Odds ratios (OR) were used to quantify the associations between SVTP and outcome events. RESULTS: No statistically significant odds ratios were found for PE, coronary events or stroke. DVT was the only primary outcome to show a significant relationship. DVT occurred in 2.7% of all SVTP patients as compared with 0.2% in the controls (OR=10.2; 95% confidence interval [CI], 2.0-51.6). When controlling for prior history of DVT, the OR decreased to 7.1 and the confidence interval crossed 1.0 (95% CI, 0.9-65.6). DISCUSSION: Spontaneous SVTP in the leg is a risk factor for DVT, but is less predictive in patients with prior DVT. Although effective treatments for the prevention of DVT are available, the absolute risk is too low to advocate prophylaxis in a general practice population. More research on prophylaxis is needed to stratify these patients at risk.     

脑卒中后癫痫发作的相关危险因素分析

目的 分析脑卒中后癫痫发作的临床特点,并对其相关因素进行分析。方法 对1 008例脑卒中患者进行回顾性研究,并分析可能影响卒中后继发癫痫发作的相关危险因素。结果 脑卒中后癫痫发作的发生率约为5.36%,其中早发型癫痫占63.11%,发作类型以单纯部分发作为主,迟发型癫痫占38.89%,发作类型以全身强直-阵挛发作为主,单因素分析结果显示:性别（χ2=4.12,P=0.042）、糖尿病（χ2=4.89,P=0.027）、肺部感染（χ2=8.95,P=0.003）、病灶部位（χ2=45.14,P<0.001）和病灶范围（χ2=23.32,P<0.001）与卒中后癫痫发作有关;多元Logistic分析结果显示:性别（OR=1.946,95%CI:1.039~3.644）、肺部感染（OR=3.618,95%CI:1.536~8.520）、病灶部位（OR=6.435,95%CI:3.353~12.349）和病灶范围（OR=2.513,95%CI:1.374~4.599）等因素可能与卒中后癫痫发作有关（均有P<0.05）。结论 男性,肺部有感染,病灶部位在皮质和病灶范围大可能是卒中后癫痫发作的危险因素。     

Risk factors for haemorrhagic stroke: a case-control study

A hospital based pair-matched case-control study was undertaken to identify risk factors for haemorrhagic stroke. The study took place in the Government Medical College Hospital, Nagpur, India, a tertiary care hospital. The study consisted of 166 hospitalised computerised tomography scan proved cases of haemorrhagic stroke (International Classification Diseases 9, 431-432), and an age and sex matched control per case. The controls were selected from patients who attended the study hospital for conditions other than stroke. The study included hypertension, serum total cholesterol, alcohol intake, smoking, diabetes mellitus, obesity, physical inactivity, type A personality, use of anticoagulants/antiplatelets, family history of stroke, history of cardiac diseases, past history of transient ischaemic attack, history of claudication and oral contraceptive use in women, as risk factors for haemorrhagic stroke. Bivariate analysis included odds ratio (OR), 95% confidence intervals (CI) for OR and McNemar's chi2 test. Multivariate analysis was carried out by conditional multiple logistic regression analysis. Attributable Risk Percent (ARP), Population Attributable Risk Percent (PARP) and their 95% CI were estimated for significant factors. On conditional multiple logistic regression five risk factors-hypertension (OR=1.9, 95% CI 1.5-2.5), serum total cholesterol (OR=2.3, 95% CI 1.4-4.9), use of anticoagulants and antiplatelet agents (OR=3.4, 95% CI 1.1-10.4), past history of transient ischaemic attack (OR=8.4, 95% CI 2.1-33.6) and alcohol intake (OR=2.1, 95% CI 1.3-3.6) were significant. Estimates of ARP and PARP for these factors confirmed their etiological and preventable role respectively. The current study recognised the significance of five risk factors, which are preventable. These risk factors may be considered for devising effective risk factor intervention strategy for haemorrhagic stroke.     

Overall adherence to the dietary guidelines for americans is associated with reduced prevalence of early age-related nuclear lens opacities in women

Few studies have examined the efficacy of the Dietary Guidelines for Americans in the prevention of age-related chronic disease, such as age-related cataract. We examined whether adherence to the Guidelines was associated with a lower prevalence of age-related nuclear lens opacities in women. Eye exams were conducted in 479 Nurses' Health Study participants aged 52 to 73 y without previously diagnosed cataract or diabetes living in the Boston, MA area. Four FFQs, collected during a 9- to 11-y period before evaluation of lens status, were used to define diet quality according to the following: 1) daily number of servings of fruits, vegetables, and whole grains; 2) Recommended Foods Score (RFS); and 3) Healthy Eating Index (HEI). Nuclear opacities were defined as scores >/= 2.5 using the Lens Opacification Classification System III. After adjusting for age, smoking, and other risk factors, women in the highest quartile category of HEI scores were significantly less likely to have nuclear opacities than those in the lowest category [odds ratio (OR) = 0.47; 95% CI: 0.26-0.84]. This association appeared to be stronger among nonusers of supplemental vitamin C (OR = 0.23; 95% CI: 0.10-0.52). Decreased prevalence odds of nuclear opacities were also observed with high intake of fruit (OR = 0.58; 95% CI: 0.32-1.05) and whole grains (OR = 0.64; 95% CI: 0.36-1.15). These results suggest that overall compliance with the Dietary Guidelines, as measured by the HEI, protects against nuclear opacities.     

A controlled study of ischemic stroke risk in migraine patients

To help resolve the uncertain relationship between migraine headache and ischemic stoke, we performed a hospital-based, case-control study. Eighty-nine cases ages 15-65 with a head computed tomography (CT) scan supported diagnosis of ischemic stroke were matched to 178 control subjects. Using information obtained by telephone interview, the patients were placed into three categories according to explicit criteria: classic migraine; common migraine; and no migraine headache. Overall, the association between migraine and ischemic stroke is significantly increased only in patients with classic migraine [odds ratio (OR) = 2.6, 95% confidence interval (CI) 1.1-6.6]. In addition, classic migraine does not appear to increase ischemic stroke when hypertension, diabetes or smoking are present; however, when these other risk factors are absent, classic migraine is strongly and significantly associated with the risk of ischemic stroke [no hypertension, OR = 5.7 (95% CI 1.6-20.2); no diabetes, OR = 3.4 (95% CI 1.2-9.3); non-smoker OR = 4.3 (95% CI 1.2-15.0)]. Since none of the migraine patients in our study had a migrainous stroke, an underlying disorder other than prolonged vasospasm may be responsible for the observed increased risk. Our data suggest that classic migraine may be a marker for patients at increased risk for ischemic stroke unrelated to a migraine attack.     

Factors of non-compliance with the therapeutic regimen among hypertensive men and women: A case-control study to investigate risk factors of stroke

To identify potential risk factors among the therapeutic regimen and life style which may increase the risk for stroke, a pair matched case-control study was conducted in Gaza Strip among 112 patients, who had been hospitalized for acute stroke and history of hypertension, and 224 controls with history of hypertension. Conditional logistic regression models show significant associations between stroke and medication not taking as prescribed (OR = 6.07; 95% CI: 1.53, 24.07), using excessive salt at meals (OR = 4.51; 95% CI: 2.05, 9.90), eating diet high in fat (OR = 4.67; 95% CI: 2.09, 10.40), and high level of stress (OR = 2.77; 95% CI: 1.43, 5.38). No significant association between smoking and the development of stroke (OR = 2.12; 95% CI: 0.82, 5.51) was found. Regular physical exercise was a protective factor (OR = 0.26; 95% CI: 0.12, 0.57). Using excessive salt at meals was a significant risk factor (OR = 16.61; 95% CI: 4.40, 62.80) in people having low level of stress, whereas it was not significant in people having high level of stress. (OR = 1.76; 95% CI: 0.58, 5.33). Smoking in combination with low level of stress was a significant risk factor for stroke (OR = 9.88; 95% CI: 2.52, 38.78), but a non-significant protective factor in combination with high level of stress (OR = 0.52; 95% CI: 0.14, 1.99). An increase in compliance with the pharmacological and non-pharmacological therapeutic regimen might be a key to a reduction of stroke incidence and prevalence among hypertensive patients.