Risk factors for the occurrence and development of Binswanger disease: A controlled observation

BACKGROUND： Some scholars think that hypertension is the major risk factor to cause Binswanger disease （BD）, however, BD is also found in some persons with normal blood pressure, so we presume that some other factors, such as diabetes mellitus, hyperlipemia, coronary heart disease and transient ischemic attacks and so on, might participant in the onset of BD. OBJECTIVE： To comparatively observe the difference in accompanying diseases, transcranial doppler （TCD） performance, blood glucose and blood lipid level between BD patients and healthy subjects who received health examination, and between BD patients with different disease condition. DESIGN ： Case-control analysis SETTING ： Department of Emergency, Qingdao Municipal Hospita PARTICIPANTS： Totally 126 patients with BD, 65 male and 61 female, aged from 67 to 85 years old, who hospitalized in the Medical School Hospital of Qingdao University and Qingdao Municipal People＇s Hospital, were chosen, serving as BD patients group. All the patients met the clinical diagnostic criteria of BD introduced by Bennett et al. Another 126 persons, 65 male and 61 female, aged ranging from 67 to 80 years, who received health examination in the same hospital, were homeochronously chosen, serving as control group. Informed consents were obtained from all the subjects. METHODS ： After being admitted, all the subjects including BD patients and persons who homeochrenously received health examination in the same hospital were given examinations of blood pressure, blood lipid, blood glucose, electrocardiogram （ECG） and TCD. Fifty-seven patients with BD were in the stable period and 69 in the progressive period （Stable period： no local or subcortical function disorder found, and no changes in the range of white matter lesion showed by CT and/or MRI in recent 3 months; Progressive period： with local or subcortical function disorder and increase in the range of white matter lesion showed by CT and/or MRI in recent 3 months）. According to intimal thickening of carotid artery and vertebral artery preformed by TCD, BD was graded as mild intimal thickening （〈 1.1 mm）, moderate intimal thickening （1.1 to 1.2 mm） and severe intimal thickening （〉 1.2 mm）. MAIN OUTCOME MEASURES ： Comparison of the ratio of BD patients with accompanied diabetes mellitus, hypedipemia, coronary heart disease and transient ischemic attacks, TCD performance, blood glucose and blood lipid level between BD patients group and control group, and among BD patients with vadous disease conditions. RESULTS： Totally 126 BD patients and 126 subjects who received health examination all participated in the result analysis. Intergroup comparison： ①The ratio of BD patients with accompanied hypertension, diabetes mellitus, hypedipemia, transient ischemic attacks and coronary heart disease was 91.3%, 46.8%, 42.9%, 81.7% and 46.0% respectively in the BD patients group, and that was 36.5%, 17.5%, 15.9%, 34.1% and 34.1%, respectively in the control group. Significant difference existed between two groups （x^2=86.201, 24.907,25.660,58.620,9.900, P 〈 0.01 ）.②Compared with control group, anterior, middle cerebral and vertebrobasilar arteriosclerosis and insufficient cerebral blood supply existed significantly in BD patients with different disease condition （x^2=40.34,7.585,15.429, P 〈 0.01 ）.③Compared with control group, the level of blood glucose, total cholesterol and triglyceride of BD patients increased significantly （t=6.939,3.891,3.711 ,P 〈 0.01 ）. Comparison among BD patients with different disease condition： ① Compared with stable period, transient ischemic attacks and coronary heart disease were found much in the BD patients at progressive period, with significant difference （x^2=7.196,13.517,P 〈 0.01 ）.② Mild arteriosclerosis at stable period was found in 17 cases, and significant difference existed compared with progressive period （x^2=6.523,P 〈 0.05）.③ There was no significant difference in the blood glucose and blood lipid level （t=-1.755 6,0.583 1,0.824 6, P 〉 0.05）. CONCLUSION： Hypertension, cerebral arteriosclerosis, diabetes mellitus, hypedipemia, coronary heart disease and transient ischemic attacks have important effects on the onset of BD; Transient ischemic attacks and coronary heart disease can worsen the symptoms of BD patients.

Assessment of the impact of climate change on the occurrences of malaria,pneumonia,meningitis,and cholera in Lokoja City,Nigeria

This study examined the impact of climate change on the occurrence of malaria,pneumonia,meningitis,and cholera in Lokoja City,Nigeria,with the aim of investigating the spatial distribution and prevalence of the four kinds of diseases as well as the coping strategies of people in the area.We collected the rainfall and temperature data of Lokoja City during 2000-2020 from the National Aeronautics and Space Administration(NASA),and the medical records data of the four kinds of diseases from the Kogi State Ministry of Health.We also conducted a semi-structured questionnaire of 250 residents,who have experienced one of these diseases,to investigate their coping strategies with these diseases.The Pearson correlation and multiple regression analysis were used to research the relationship between the climate parameters and cases of diseases.The result showed annual variations in climatic parameters with R^(2)values of 0.0557,0.0009,and 0.4915 for rainfall,maximum temperature,and minimum temperature,respectively.A positive and significant relationship were observed between maximum temperature and malaria(r=0.80),rainfall and malaria(r=0.54),minimum temperature and meningitis(r=0.64),as well as rainfall and cholera(r=0.66)at P<0.05 level.For the regression analysis R^(2)=0.71,0.50,and 0.52 for malaria,cholera,and meningitis,respectively at P<0.05 level.During 2000-2020,cases of malaria were highest in Ward A with 15,422,while 715 cases of pneumonia were highest in Kupa North Ward.In Ward A,3787 cases of cholera were recorded to be the highest,while cases of meningitis were highest in Kupa North Ward with 2383 cases.Investigation revealed that malaria is more common in the wet season,while cholera and meningitis cases were highest in the dry season.The study revealed that the most practiced coping strategy is the use of medications by about 90%of the respondents.More studies are recommended in the study area to establish a causal link between climate change and disease occurrence,and intervention from government in form of prevention and control programmes should be vigorously implemented.