Biomedical subjects

A Menotti

Publications and source records attributed to A Menotti.

At least 73 records · Page 4Linked to original sources

PubMed1997

Factors associated with gallstone disease in the MICOL experience. Multicenter Italian Study on Epidemiology of Cholelithiasis.

The epidemiological associations of gallstone disease were evaluated in a general population sample of 29,584 individuals (15,910 men and 13,674 women; age range, 30-39 years) belonging to 14 cohorts examined between December 1984 and April 1987. Subjects were screened for the presence of gallstones by gallbladder ultrasonography, completed a questionnaire, and underwent a physical examination and blood chemistry tests. Participants were considered to have gallstone disease if they had already had cholecystectomy or gallstones. Statistical associations were established by univariate analysis of the age-standardized data and by stepwise multiple logistic regression. Increasing age and body mass index and a maternal family history of gallstone disease were the most consistent associations (both at univariate and multivariate analysis and in both sexes) found in this study. Personal history of dieting was associated with gallstone disease in men, and at univariate analysis, in women. Decreasing serum total cholesterol levels and increasing serum triglycerides were associated with gallstone disease in both sexes in the multivariate analysis. In women, associations were also found with a number of pregnancies and paternal family history of gallstone disease. A slight but negative association with contraceptive pill use was identified only at multivariate analysis. Associations (investigated at univariate analysis) were also found with diabetes, cirrhosis, angina or myocardial infarction, and peptic ulcer. There was no association with smoking habits and use of aspirin or antirheumatic drugs.

Adult↗

PubMed1997

The inverse relation of average population blood pressure and stroke mortality rates in the seven countries study: a paradox.

This study attempts to explain the unexpected finding of an inverse population (ecological) relationship between mean systolic blood pressure levels and stroke death rates in 25 years follow-up of the Seven Countries Study, a cross-cultural study of cardiovascular disease. Sixteen cohorts of all men aged 40-59 in seven countries (one cohort in the USA, two in Finland, one in the Netherlands, three in Italy, two in Croatia (former Yugoslavia), three in Serbia (former Yugoslavia), two in Greece, two in Japan) were surveyed from 1958 to 1964. Risk factors and personal characteristics were measured and follow-up for vital status and cause of death was then carried out over 25 years. Analyses were based on comparisons of mean levels of risk factors and death rates within and among the 16 cohorts. Mean entry population levels of systolic blood pressure among the cohorts were strongly and inversely related with their 25-year stroke death rates (R -0.55; CI -0.81 and -0.06; p = 0.0276). Within cohorts in contrast, the individual relation of blood pressure and stroke was strongly positive and significant in 14 of the 16 cohorts. Mean population levels of serum cholesterol were inversely and strongly related to stroke death rates (R -0.79; CI -0.92 and -0.46; p = 0.0003), while the partial correlation coefficient of systolic blood pressure, computed in models including serum cholesterol, became small and not significant (-0.05; CI -0.55 and +0.48; p = 0.8537). Age at death for stroke (average 68.9 +/- 7.1 years) was significantly higher than age at dath from myocardial infarction and sudden death (average 65.8 +/- 7.8 years) suggesting a competition effect between the conditions. Multivariate models including population average systolic blood pressure and serum cholesterol provided no added explanation for the lack of direct and significant relationship of population blood pressure with stroke death rates. They were based on these variables: age at stroke death, age at myocardial infarction death or and sudden death, death rates from myocardial infarction and sudden death, the interaction term of systolic blood pressure with serum cholesterol and the multivariate coefficients for systolic blood pressure from Cox models run in individuals. Similar findings were obtained using diastolic instead of systolic blood pressure and excluding the Japanese cohorts. The paradox of the inverse ecologic relation of population blood pressure and stroke mortality and a direct relation for individual is only partly explained by the cofounding effect of population mean serum cholesterol levels. An effect of low cholesterol levels on excess stroke mortality cannot be excluded. A major limitation of the study was our inability to segregate thrombotic from heamorrhagic strokes.

Adult↗

PubMed1997

Changes in population cholesterol levels and coronary heart disease deaths in seven countries.

BACKGROUND: Are trends in coronary heart disease deaths based on risk factor changes? OBJECTIVE: To study the relationship between trends in coronary deaths and changes in blood cholesterol in the Seven Countries Study. MATERIAL AND METHODS: Sixteen cohorts of men aged 40-59 years from seven countries (U.S.A., Finland, the Netherlands, Italy, Croatia (former Yugoslavia), Serbia (former Yugoslavia), Greece, Japan) were units for the analyses of serum cholesterol measured at entry and after 5 and 10 years, and for mortality over 25 years. RESULTS: In the populations, the ecological relationship of mean serum cholesterol at entry to late coronary heart disease death rates during the 10- to 25-year follow-up was weak, with an R-square of 0.31. Cholesterol measurements made at year 10, and an indicator of cholesterol change during the first 10 years, increased the association (R-square, 0.49). A negative and significant interaction was shown between baseline population cholesterol levels and their 10-year change. As an indicator of acceleration in mortality, cholesterol change over 10 years was also positively correlated (partial R-square 0.44) with the ratio of 25-year to 5-year deaths. CONCLUSIONS: In the Seven Countries Study, late coronary heart disease death rates are largely "explained' by changes in blood cholesterol levels during the early phases of the study, mainly due to increases in lower cholesterol levels among some cohorts.

Adult↗

PubMed1997

The relation of chronic diseases to all-cause mortality risk--the Seven Countries Study.

The relation of chronic conditions on all-cause mortality in population samples was studied based on observations from the Seven Countries Study. The objective of this work was to study the risk of death during a 15-year follow-up of middle-aged men in relation to six chronic diseases. Fifteen cohorts of men aged 50-69, totalling 8122 subjects, were examined around 1970 in seven countries: Finland, The Netherlands, Italy, Croatia (former Yugoslavia), Serbia (former Yugoslavia), Greece and Japan. Clinical diagnoses findings were made for coronary heart disease (CHD), 'other heart diseases' (OTH), peripheral arterial disease (PAD), stroke (STR), chronic obstructive pulmonary disease (COPD), and diabetes mellitus (DIAB). All-cause mortality was assessed in the subsequent 15 years. Death rates and relative risks were estimated from crude data, and in proportional hazards models after adjustment for age, systolic blood pressure and serum cholesterol level, cigarette smoking and body mass index. Large regional differences were found in the prevalence of the six conditions. Weak relations were found between population prevalence of each disease and population death rates for that disease. Among cohorts the relative risk of death in 15 years from any cause, adjusted for other risk factors, showed little variation among countries. Pooled relative risks, adjusted by the inverse of variance (with 95% CI) were: for CHD, 1.81 (1.60-2.06); for OTH, 1.47 (1.28-1.69); for PAD, 1.64 (1.39-1.93); for STR, 1.56 (1.23-1.98); for COPD, 1.67 (1.48-1.88); and for DIAB, 1.75 (1.43-2.15). The smallest variability of prognosis among countries was found for CHD, OTH and DIAB; the largest for PAD, STR and COPD. Despite simple clinical diagnostic procedures and large differences in prevalence, the relation of established prevalent conditions to subsequent all-cause mortality is relatively uniform among countries and across these conditions, with a relative risk of dying in 15 years usually ranging between 1.5 and 2.0.

Aged↗

PubMed1997

Determinants of physical performance at cycloergometer in healthy middle aged men in Italy. The ECCIS project. Epidemiology and Clinics of Silent Ischemic Heart Disease.

OBJECTIVE: The purpose of this analysis is to relate the performance at cycloergometer of healthy middle aged men, identified in a population, with a number of personal characteristics to explain part of their physical fitness indicators. SETTING AND PARTICIPANTS: A sample of 5,163 men aged 40-59, belonging to sedentary occupational groups in Florence and Rome, were screened by a complex diagnostic procedure (participation rate = 66.3%). 3,893 were judged "healthy" from the cardiovascular point of view. MEASURES: A cycloergometric test and the measurement of some individual characteristics allowed to correlate indicators of performance at exercise (work load, test duration, work load/heart rate, PWC150 and PWC150/kg) with body mass index, resting pulse rate, systolic, diastolic and mean blood pressure. HDL and non-HDL cholesterol, a score of physical exercise and cigarette consumption. RESULTS: Univariate and multivariate analysis showed significant relationship of exercise performance indicators with age, resting pulse rate, blood pressure, cigarette consumption (inverse) and with physical exercise score (direct). These individual characteristics could explain 14-15% of the variance of exercise performance indicators. CONCLUSIONS: The analysis could not establish how much the individual characteristics were causes or effects of individual physical fitness. A reasonable cause effect relationship can be argued for physical exercise score and likely for cigarette smoking. Relatively large differences in performance indicators can be expected for people with largely different individual characteristics.

Adult↗

PubMed1997

Electrocardiographic Minnesota code findings predicting short-term mortality in asymptomatic subjects. The Italian RIFLE Pooling Project (Risk Factors and Life Expectancy).

Aim of the study was to analyze the predictive power on short term mortality of electrocardiographic findings in asymptomatic subjects belonging to samples of the general population. In the Italian RIFLE Pooling Project (Risk Factors and Life Expectancy) 12 180 men and 10 373 women aged 30 to 69 years had a resting electrocardiogram (ECG) recorded at baseline examination. All of them were free from clinically symptomatic heart disease and represented 23 cohorts spread all over Italy. ECGs were read by the Minnesota Code using 5 large categories of abnormalities, i.e. Q-QS abnormalities, ST-T abnormalities, high R. waves, major arrhythmias, and blocks. Some clinically relevant ECG combination of abnormalities were also analyzed. Six-year mortality from coronary heart disease (CHD), cardiovascular diseases (CVD) and all-cause mortality (ALL) were the end-point. Those ECG findings were relatively common and covered the majority (80 to 90%) of all abnormalities found in the general population before excluding subjects with symptomatic heart disease. Most ECG findings on most occasions were associated with an excess mortality from the three end-points in both men and women and among relatively young (age 30-49) and mature (age 50-69) adults. The strongest predictor of fatal events were Q-QS items and blocks. The most consistent predictors were ST-T findings, although this was true for men and not for women. Relative risk against the absence of abnormalities (one by one and all together) were adjusted by multivariate analysis feeding in the models some possible confounders, i.e. age, systolic blood pressure, serum cholesterol, cigarette consumption and body mass index. Relative risks in cells with more than 20 events (cells being separately made by men, women, the 5 ECG findings categories and the 3 end-points) were ranging 1.00 to 9.88 for Q-QS abnormalities, 1.03 to 3.76 for ST-T abnormalities, 1.28 to 5.14 for high R waves, 0.81 to 2.28 for arrhythmias and 0.79 to 3.59 for blocks. Most of these relative risks were statistically significant. Combinations of clinically relevant ECG findings in the same individual (LVH, possible and definite myocardial infarction) were rare but carried a severe prognosis with high and statistically significant relative risks among men (ranging between 3.19 and 7.24) while they could not be properly tested in most cells for women due to the small numbers involved. It is concluded that in the general population high rates of prevalent ignored ECG abnormalities in asymptomatic subjects are associated with significant excess mortality from CHD, CVD and all-cause mortality, suggesting a high prevalence of silent heart disease.

Adult↗

PubMed1997

Prevalence and correlates of echocardiographic determined left ventricular hypertrophy in 2318 asymptomatic middle-aged men: the ECCIS project. Epidemiolgia e Clinica della Cardiopatia Ischemica Silente.

It is well established that left ventricular hypertrophy is a strong and independent risk factor for cardiovascular morbidity and mortality. This study was designed to determine the prevalence and correlates of left ventricular hypertrophy (LVH) among a sample population of 2318 totally asymptomatic men aged 40-59. This sample is a subset of the participants in the ECCIS Project. Left ventricular mass was estimated by echocardiography. The following individual variables were employed in the multiple linear regression analyses: age, diastolic and systolic blood pressure at rest and at peak exercise, body mass index, body surface area, conditioning physical activity. Three indexes of left ventricular mass were used: left ventricular mass/height, left ventricular mass/body surface area and "adjusted left ventricular mass" derived from adjustment, using a regression model, of left ventricular mass by age, body mass index and body surface area. The sample was subdivided in 3 blood pressure classes; normotensive (n = 1605), borderline (n = 390) and hypertensive (n = 323). All the variables considered with the exception of diastolic blood pressure both at rest and peak exercise were significantly correlated with left ventricular mass. Upper normal limits for left ventricular mass indexed to height and body surface area and of adjusted left ventricular mass were 143 g/m, 129 g/m2, and 245 g respectively. The prevalences of left ventricular hypertrophy, as determined by the reference standard of left ventricular mass/height, left.ventricular mass/body surface area and adjusted left ventricular mass, ranged 2.7-3.2% in the normotensive group, 4.2-5.4% in the borderline group and 11.8-14.5% in the hypertensive group, and were lower using adjusted left ventricular mass index. The results of this study show that the prevalence of left ventricular hypertrophy using adjustment by age, body surface area and body mass index reduces variability of left ventricular mass associated with age and body size and may be useful for the correct identification of left ventricular hypertrophy and hypertensive heart disease.

Adult↗

PubMed1997

Incidence of major coronary heart disease events: the experience of the Project "Community Control of Chronic Diseases".

Data on incidence of first major coronary heart disease (CHD) event have been collected in a population sample studied in the control area, the municipality of Priverno in Central Italy, 100 km South-East of Rome as part of a Community Control Project of Chronic Diseases run in nearby communities. Men and women aged 40-69 years, examined in population screenings, were followed-up for variable periods of time ranging from 1 month to 11 years, after exclusion of those already carrier of a previous major CHD event. A total of 1427 men and 1675 women corresponding to a maximum of 9590 and 11499 person/years respectively were followed-up. Diagnostic criteria were based on a number of different items including history and ECG data, from screening examinations; discharge records from local hospitals; causes of death from death certificates; and information from mail questionnaires. Four hundred and forty-six men and 501 women were considered partially non respondent since they were examined only once, they did not answer the postal questionnaire, although they were surely alive at the end of the observation period. Incidence estimates were based on different denominators, including or excluding these non respondents. The age adjusted lower incidence estimate was of 40.7 per 10000 person/years among men and 19.7 among women; the higher estimate was of 51.3 and 24.4 per 10000 person/years respectively. Rates were higher among men than among women and were increasing with aging. These incidence rates were slightly lower than those reported from other population studies conducted in Italy in the 1970's and the 1980's, but were in line with the hypothesis of a declining incidence paralleling the decline in CHD mortality. These data, including also estimates in women, represent a reference point for the early 1990's of the frequency and distribution of major CHD events.

Adult↗

PubMed1997

[Univariate analysis of potential risk factors for early mortality (within 28 days) after aortocoronary bypass in Italy. OP-RISK Study Group].

The multicenter OP-RISK study, developed during 1994-96, was aimed at: 1) investigating early (28 days) death rates following aortocoronary bypass surgery among patients recruited from four Centers representing geographical distribution in Italy; 2) defining possible risk factors for early mortality, also comparing these factors with those reported in previous studies. Average values are reported and compared of 65 variables (36 preoperative, 10 operative and 19 postoperative) out of 984 patients subdivided into alive (n = 940) or dead (n = 44, 4.47%) at 28 days (155 +/- 174 hours, interval between 12 and 576 hours) postoperatively. Causes of death were cardiac in 37 (77%), pulmonary in 3 (0.7%), vascular in 2 (0.5%) and infective in 2(0.5%) patients, respectively. During the study a total of 1126 patients were operated upon in the collaborative Centers with the diagnosis of coronary artery disease and 51 deaths were reported officially in-hospital (4.53%). Therefore, OP-RISK data represent 87% of overall patients and a superposable death rate. The potential role as risk factors of early mortality was assessed univariately for 17 preoperative, 5 operative (in 3 cases for the first time) and 5 postoperative factors. In general, it was confirmed that factors defining left ventricular function are sensitive predictors of mortality. In OP-RISK we were able to show, in addition, that tachycardia (> 130 b/min) at induction of anesthesia, and total time of anesthesia, cardiopulmonary bypass and aortic cross clamping may be significant factors among operative variables as might be among postoperative ones several arrhythmia types or a lower rate in antithrombotic therapy with aspirin at 6-12 hours postoperatively. The protective role of bypass surgery performed with at least 1 arterial segment was also ascertained. Most of these potential factors were significantly related to outcome (either directly or inversely) as were among them, as seen in a subsample (65%) of 639 patients in whom a correlation matrix was performed among 16 factors selected on the basis of the common denominator principle. Our results suggest that it is possible to collect in a multicenter experience univariate predictors of early mortality following aortocoronary bypass surgery in Italy, which are not different from those reported from previous studies performed abroad. Operative indicators may also have predictive capabilities. The effort may be worthwhile and demands further cooperative studies to be undertaken, aimed at obtaining nationwide coefficients of risk along with representative average values of factors that soon might emerge once multivariate statistics will be performed on this material.

Analysis of Variance↗

PubMed1997

Change in cardiovascular risk factors during a 10-year community intervention program.

The study describes changes in cardiovascular risk factors during 10 years of a community intervention program conducted in a rural area in Central Italy. Two areas were involved, one for treatment and one for reference. In 1983-84, 739 men and 859 women in the treatment area and 942 men and 1045 women in the control area, aged 20-69 years, were screened; total and HDL cholesterol, systolic and diastolic blood pressure, fasting blood glucose, smoking habit, weight and height were measured. Between 1983 and 1993 several intervention activities based on community medicine were carried out in the treatment area. They were based on interaction with the local socio-sanitary institutions and school system in order to influence individual persons, small groups and entire community. Major effort was addressed to mass health education, nutrition education, antismoking-propaganda and detection and treatment of hypertension, diabetes and hyperlipidemia.

Adult↗

PubMed1997

[Knowledge, attitude and practice regarding coronary cardiopathy. The Italian section of the HELP (Heart European Leaders Panel) study].

A population sample telephone survey was conducted in Italy among 1000 adults from the general public defined as non-high-risk subjects, 500 adults defined as high-risk subjects (based on the presence of too many unhealthy habits), 250 post-infarction patients and 250 relatives of patients. Questionnaires were aimed towards identifying knowledge, attitude and practice with regard to primary and secondary prevention of heart disease. In general, greater knowledge, attitude and practice were found among post-infarction patients and their families, followed by the general public and, lastly, by high-risk subjects. However, all groups believe that stress is the major cause of heart disease and that cancer is a major health problem and the primary cause of death in the country. No more than 25% of the general public and less than 10% of high-risk subjects have modified their habits over the past 2 years by taking care of diet and exercise and limiting smoking habits. All groups rely on and have confidence in the medical profession and medical organizations, including private foundations and associations dedicated to heart problems. The major source of information about heart disease is represented by the mass media, especially television, although post-infarction patients and their families receive most information from general practitioners and cardiologists. Overall, concepts on the existence of educational campaigns are limited and their fall-out is thought to have a minor impact. High-risk subjects are sufficiently informed but refuse to take any action to protect their health. The overall picture suggests that there is a need to continue with more penetrating information campaigns, mainly through television, and to look for new tools aimed towards identifying and treating high-risk individuals.

Adult↗

PubMed1997

[Dynamics of post-infarction blood lipids].

During 1993-1994, 3590 patients who recovered from acute myocardial (undergone 1 to 6 years earlier) were examined by 139 ambulatory cardiologists. Aim of the study was to investigate blood lipid changes in 2435 (67.82%) patients in whom total-HDL-and LDL-cholesterol and triglycerides were obtained. These lipids were not abnormally elevated and actually very similar to (or slightly lower than) those of the general population examined in Italy in the context of the RIsk Factors and Life Expectancy Pooling Project (including 70,000 individuals). However, blood lipids were, in general, higher in women than in men and declined as age increased (unless HDL-cholesterol which tended to increase). Among postinfarction patients lipid-lowering drugs were taken by 19% of men and 14% of women, which contrasts with proportions observed in the general population (5 and 4%, respectively). Mean blood lipid values were higher among those who were treated with lipid-lowering drugs, either from the postinfarction series or the general population (unless HDL-cholesterol which had an opposite trend). These data may indicate why treatment was undertaken, although no conclusion may be drawn about drug-efficacy. Postinfarction patients examined after 1-2 years from illness showed lower values of mean blood lipids than those examined 3-6 years after the acute episode (however, the opposite was true for HDL-cholesterol). There are several possible explanations for these observations: high lethality in infarction-patients with high blood lipids, efficacy of lipid-lowering drugs, diet or metabolic changes following acute myocardial infarction. Nevertheless, the proportion of postinfarction patients treated with lipid-lowering drugs was lower than anticipated from (and/or recommended based on) results of recent secondary preventive trials. It seems necessary to repeat (possibly periodically) this investigation in large samples of postinfarction patients to assess whether and how, in clinical practice, indications are applied from recent large trials on secondary prevention of ischemic heart disease.

Adult↗

PubMed1996

Physical activity and cardiovascular risk factors among elderly men in Finland, Italy, and the Netherlands.

Physical activity pattern and its relation with cardiovascular risk factors was investigated in 1,402 men aged 69-90 years who participated in the 30-year follow-up survey of the Finnish (Eastern and Western Finland), Italian (Montegiorgio and Crevalcore), and Dutch (Zutphen) cohorts of the Seven Countries Study. Physical activity was assessed with a validated self-administered questionnaire designed for retired men. Total physical activity varied largely within cohorts. Median total reported physical activity ranged from 50 minutes/day in Montegiorgio to 89 minutes/day in Crevalcore. Walking, gardening, and bicycling together contributed more than 70% of total physical activity in all cohorts. Depending on the definition of physical inactivity, the estimated prevalence of inactivity varied between 5% and 33% in Zutphen and between 18% and 68% in Montegiorgio. Total physical activity was inversely associated with resting heart rate (r= -0.11, p < 0.001) and was positively associated with high density lipoprotein (HDL) cholesterol (r = 0.08, p < 0.01) in pooled data. These associations remained statistically significant after adjustment for age, cohort, smoking, body mass index, and alcohol intake. Total activity was not associated with total cholesterol, non-HDL cholesterol, blood pressure, or body mass index. The authors conclude that physical activity may have a beneficial effect on HDL cholesterol levels in elderly men. Walking, gardening, and bicycling contribute substantially to their physical activity pattern.

Aged↗

PubMed1996

Spirometric prediction equations for male Italians 7-18 years of age.

The purpose of this study was to develop spirometric predictive equations (SPE) for forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and maximum midexpiratory flow (MMF25-75) derived from a large sample of healthy italian boys and male adolescents. We used the univariate and multiple linear regression models and considered as independent variables age and the following anthropometric measurements: height, weight, chest circumference. The predictive power of multivariate models was slightly higher than that of the univariate model using height as independent variable for FVC, FEV1 and MMF25-75.

Adolescent↗

PubMed1996

Alcohol, fish, fibre and antioxidant vitamins intake do not explain population differences in coronary heart disease mortality.

BACKGROUND: Within the Seven Countries Study data we investigated whether population differences in 25-year mortality rates from coronary heart disease could be explained by population differences in alcohol, fish, fibre and antioxidant intake. METHODS: Baseline surveys were carried out between 1958 and 1964, on 12 763 middle-aged men constituting 16 cohorts in seven countries. In 1987 and 1988 equivalent food composites representing the average food intake of each cohort at baseline were collected locally and analysed for their fibre and antioxidant content in one central laboratory. The vital status of all participants was verified at regular intervals over 25 years. RESULTS: Alcohol and fish intake were inversely related to 25-year mortality from coronary heart disease in univariate analyses. These associations became non-significant when the confounding effects of saturated fatty acids, flavonoids and smoking were taken into account. Fibre and antioxidant vitamins intake were not related to coronary heart disease mortality in either uni- or multivariate analysis. CONCLUSION: These cross-cultural analyses show that alcohol, fish, fibre and antioxidant vitamins do not explain population differences in coronary heart disease mortality, independently of saturated fatty acids and flavonoids intake and cigarette smoking.

Adult↗

PubMed1996

Incidence and prediction of stone recurrence after lithotripsy in idiopathic calcium stone patients: a multivariate approach.

In order to evaluate the recurrence of calcium kidney stones, 520 patients (275 males and 245 females), aged 14-79 years, previously treated with lithotripsy were followed up for 23 months on average (median = 24 months; range = 12-48 months), and 101 relapses (10%/year) were recorded. Among the possible predictors of recurrence, measured at the beginning of the follow-up and analyzed in univariate and multivariate statistical ways, age was inversely related with occurrence of event (multivariate t value = -2.12) whereas urinary calcium (UC; t = 2.78), alkaline phosphatase (AP; t = 3.55) and history of previous relapses (t = 2.07) were directly related to the recurrence. The levels of UC were not correlated to those of AP (linear correlation coefficient r = 0.0032), but the combination of their high levels increased the risk of recurrences. The contribution of the other considered factors to stone formation were not significant (sex, family history of stone disease, gallstone, renal failure, serum calcium, phosphate, uric acid, sodium and proteins, urinary phosphate, sodium, magnesium and uric acid.

Adolescent↗

PubMed1996

Twenty-five-year prediction of stroke deaths in the seven countries study: the role of blood pressure and its changes.

BACKGROUND AND PURPOSE: This report explores the prediction of long-term stroke mortality in cohorts of the Seven Countries Study. METHODS: Sixteen cohorts of men aged 40 to 59 years at entry were examined at years 0, 5, and 10, with mortality follow-up through 25 years. RESULTS: Stroke death rates in 25 years were high in rural Serbia, Croatia, and Japan; intermediate in Italy, Greece, and urban Serbia; and low in Finland, the Netherlands, and the United States. Age and blood pressure were powerful predictors of 25-year stroke mortality in almost all cohorts and countries. Proportional hazards regression coefficients were .0232 increase in stroke death hazard per millimeter of mercury (t=14.60) for systolic blood pressure and .0409 (t=13.41) for diastolic blood pressure. Moderate blood pressure increases from low usual levels were associated with lower stroke mortality rates in years 10 to 25. Increases of blood pressure starting from high usual levels were associated with increased rates of stroke mortality. Systolic blood pressure was associated with stroke mortality at given levels of diastolic pressure, but diastolic blood pressure was not predictive of stroke mortality at given levels of systolic blood pressure. CONCLUSIONS: Associations of systolic and diastolic blood pressure with stroke mortality were similar in cultures with different stroke mortality rates. Increases in blood pressure were associated with subsequent excess stroke mortality only in those who started from high usual levels; this study finds lower stroke risk in those men whose blood pressure increased moderately from low usual levels. Diastolic blood pressure is not independently associated with stroke risk in these populations.

Adult↗

PubMed1996

[Heart rupture at the right atrial level as the first manifestation of malignant lymphoma].

Primary heart lymphoma is an extremely rare condition and metastatic lymphomas constitute 9% of the total heart metastases. In most cases the lymphomatous involvement of the heart and/or pericardium is seen only at autopsy. It is unlikely that cardiac manifestations are the initial presentation of malignant lymphoma. We report a case of malignant lymphoma presenting with cardiac tamponade secondary to right atrial rupture.

Aged↗