BACKGROUND： Studies have demonstrated that the risk factors of vascular dementia following stroke are greatly different in region, race and other aspects. OBJECTIVE： To analyze the conditions and incidental risk fac...BACKGROUND： Studies have demonstrated that the risk factors of vascular dementia following stroke are greatly different in region, race and other aspects. OBJECTIVE： To analyze the conditions and incidental risk factors of vascular dementia in patients with acute cerebral infarction from Chongqing City. DESIGN： Case analysis. SETTING： Department of Neurology, Daping Hospital, Third Military Medical University of Chinese PLA. PARTICIPANTS： Altogether 546 inpatients with acute ischemic stroke admitted to Department of Neurology, Daping Hospital, Third Military Medical University of Chinese PLA between May 1999 and December 2002 were involved in this study. The involved patients, including 295 males and 251 females, aged 55 - 94 years, dwelled in Chongqing over 5 years. They were admitted to hospital within 48 hours of attack of acute ischemic stroke, and survived for over 3 months. Informed consents were obtained from all the involved subjects. METHODS： ① Following the same standard, cognitive and social function evaluations were conducted by one physician on admission and 3 months after admission, Unified questionnaire, consisting of general characteristics, vascular risk factors, stroke characteristics, neurological physical sign, and other 28 factors of involved subjects, was used in all the patients. According to the investigation results, the patients were assigned into 2 groups： dementia group and non-dementia group. ②Ischemic stroke was diagnosed according to acute ischemic brain disorder 〉 24 hours and CT or MRI imageology.③ Neurophysiological examination was conducted in all the patients at 7 to l0 days after stroke （score was two SD less than or equaled to normal level was considered as abnormal）. ④Diagnosis and statistics of dementia were carried out with Mini-Mental State Examination and The Diagnostic and Statistical Manual of Mental Disorders-Ⅳ （published by American Psychiatric Association） on admission and 3 months after admission. Neurologic deficit scoring was carried out with the National Institutes of Health Stroke Scale. ⑤ Chi-square test was used for categorical variable, and t test for quantitative variable between dementia group and non-dementia group. Dementia-related factors were performed multiple-factor Logistic regression model analysis. MAIN OUTCOME MEASURES： Incidence of dementia and dementia-related risk factors of patients. RESULTS： Altogether 546 patients with stroke were involved in this study, 403 of them participated in the final analysis, and 143 dropped out. A total of 342 were followed-up in the hospital and 61 at home. At 3 months after cerebral infarction, vascular dementia occurred in 87 （21.6%） of 403 patients. The main risk factors were age （OR 1.179; 95%CI 1.130 - 1.230）, low education level （OR 1.806; 95%CI 1.024 - 3.186）, daily alcohol drinking （OR 3.447; 95%（1/ 1.591 - 7.468）, stroke history （OR 2.531; 95%CI 1.419 - 4.512）, atrial fibrilation（OR 3.475; 95%CI 1.712 - 7.057）, dysphonia （OR 5.873; 95%6/2.620 - 13.163） and left carotid artery infarction （OR 1.975; 95%（1/1.152 - 3.388）. CONCLUSION： The incidence of vascular dementia is determined by synthetic action of multiple risk factors. Dysphonia is the most important influencing factor.展开更多
<strong>Objectives:</strong> To identify the main risk factors of vascular cognitive impairment in patients with acute cerebral infarction by Meta-analysis, and provide references for the effective prevent...<strong>Objectives:</strong> To identify the main risk factors of vascular cognitive impairment in patients with acute cerebral infarction by Meta-analysis, and provide references for the effective prevention of the cognitive impairment in stroke patients. <strong>Methods:</strong> To retrieve the observational research literatures that refer to the risk factors of vascular cognitive impairment in patients with ischemic stroke, which are published on China National Knowledge Infrastructure (CNKI), Wanfang and Weipu Chinese databases. The screening and data extraction of these literatures are independently completed by two researchers, who also give the quality evaluation of the literatures according to the evaluation criterion of the Australian JBI Evidence-Based Health Care Center. Then, Meta-analysis is conducted by using Revman5.3 software. <strong>Results:</strong> There are twenty-eight articles selected from 1507 literatures, with a total of 10,711 cases and 50 risk factors included. Among them, there are combined effects of ten factors which have statistical significance, such as infarction area, alcohol consumption, smoking, hyper homocysteinemia, hypertension, diabetes mellitus, age, history of cerebral infarction, hyperlipoidemia and education level. The relational merging OR value and 95% CI between the type-variable factors and cognitive impairment are 3.25 (1.84, 5.76);2.98 (2.58, 3.45);2.79 (1.69, 4.59);2.35 (1.93, 2.85);2.25 (1.86, 2.71);2.14 (2.10, 2.18);1.82 (1.62, 2.03);1.54 (1.24, 1.92);1.45 (1.34, 1.56);0.83 (0.78, 0.89). <strong>Conclusion: </strong>Infarction area, alcohol consumption, smoking, hyper homocysteinemia, hypertension, diabetesmellitus, age, history of cerebral infarction, hyperlipoidemia and low education level are the main risk factors for vascular cognitive impairment in patients with acute cerebral infarction. Clinical nursing staff should include it into the routine assessment of patients with acute cerebral infarction and actively prevent and intervene.展开更多
AIM: To explore the way in which Latin American psychiatrists approach the screening of vascular risk factors in patients receiving antipsychotic medication.METHODS: This was a descriptive, cross sectional study that ...AIM: To explore the way in which Latin American psychiatrists approach the screening of vascular risk factors in patients receiving antipsychotic medication.METHODS: This was a descriptive, cross sectional study that surveyed Latin-American physicians to evaluate differences between groups divided in three main sections. The first section included demographic and professional data. The second section asked about the available medical resources: weighing scales, sphygmomanometer and measuring tape. Finally, the third section aimed at looking into the attitudes towards car-diovascular prevention. The latter was also divided into two subsections. In the first one, the questions were about weight, blood pressure and waist perimeter. In the second subsection the questions asked about the proportion of patients:(1) that suffered from overweight and/or obesity;(2) whose lipids and glycemia were controlled by the physician;(3) that were questioned by, and received information from the physician about smoking; and(4) that received recommendations from the physician to engage in regular physical activity. The participants were physicians, users of the medical website Intramed. The visitors were recruited by a banner that invited them to voluntarily access an online self-reported structured questionnaire with multiple options. RESULTS: We surveyed 1185 general physicians and 792 psychiatrists. Regarding basic medical resources, a significantly higher proportion of general physicians claimed to have weighing scales(χ2 = 404.9; P < 0.001), sphygmomanometers(χ2 = 419.3; P < 0.001), and measuring tapes(χ2 = 336.5; P < 0.001). While general physicians measured overweight and metabolic indexes in the general population in a higher proportion than in patients treated with antipsychotics(Z =-11.91; P < 0.001), psychiatrists claimed to measure them in patients medicated with antipsychotics in a higher proportion than in the general population(Z =-3.26; P < 0.001). Also general physicians tended to evaluate smoking habits in the general population more than psychiatrists(Z =-7.02; P < 0.001), but psychiatrists evaluated smoking habits in patients medicated with antipsychotics more than general physicians did(Z =-2.25; P = 0.024). General physicians showed a significantly higher tendency to control blood pressure(χ2 = 334.987; P < 0.001), weight(χ2 = 435.636; P < 0.001) and waist perimeter(χ2 = 96.52; P < 0.001) themselves and they did so in all patients. General physicians suggested physical activity to all patients morefrequently(Z =-2.23; P = 0.026), but psychiatrists recommended physical activity to patients medicated with antipsychotics more frequently(Z =-7.53; P < 0.001). CONCLUSION: Psychiatrists usually check vascular risk factors in their patients, especially in those taking antipsychotics. General practitioners check them routinely without paying special attention to this population.展开更多
AIM: To measure the retinal vessels of primary open angle glaucoma(POAG) patients on spectral domain optical coherence tomography(SD-OCT) with a full-width at half-maximum(FWHM) algorithm to better explore their struc...AIM: To measure the retinal vessels of primary open angle glaucoma(POAG) patients on spectral domain optical coherence tomography(SD-OCT) with a full-width at half-maximum(FWHM) algorithm to better explore their structural changes in the pathogenesis of POAG.METHODS: In this retrospective case-control study, the right eyes of 32 patients with POAG and 30 healthy individuals were routinely selected.Images of the supratemporal and infratemporal retinal vessels in the B zones were obtained by SD-OCT, and the edges of the vessels were identified by the FWHM method.The internal and external diameters, wall thickness(WT), wall cross-sectional area(WCSA) and wall-to-lumen ratio(WLR) of the blood vessels were studied.RESULTS: Compared with the healthy control group, the POAG group showed a significantly reduced retinal arteriolar outer diameter(RAOD), retinal arteriolar lumen diameter(RALD) and WSCA in the supratemporal(124.22±12.42 vs 138.32±10.73 μm, 96.09±11.09 vs 108.53±9.89 μm,and 4762.02 ± 913.51 vs 5785.75 ± 114 8.28 μm^(2), respectively, all P<0.05) and infratemporal regions(125.01±15.55 vs 141.57±10.77 μm, 96.27±13.29 vs 110.83 ± 10.99 μm, and 4925.56 ± 1302.88 vs 6087.78±1061.55 μm^(2), all P<0.05).The arteriolar WT and WLR were not significantly different between the POAG and control groups, nor were the retinal venular outer diameter(RVOD), retinal venular lumen diameter(RVLD) or venular WT in the supratemporal or infratemporal region.There was a positive correlation between the arteriolar parameters and visual function.CONCLUSION: In POAG, narrowing of the supratemporal and infratemporal arterioles and a significant reduction in the WSCA is observed, while the arteriolar WT and WLR do not change.Among the venular parameters, the external diameter, internal diameter, WT, WLR, and WSCA of the venules are not affected.展开更多
Context: Diabetic patients are at high risk for microvascular complications of disease such as diabetic retinopathy (DR) and diabetic neuropathy. Imaging the retinal micro-vasculature offers a chance to measure quanti...Context: Diabetic patients are at high risk for microvascular complications of disease such as diabetic retinopathy (DR) and diabetic neuropathy. Imaging the retinal micro-vasculature offers a chance to measure quantitatively the microvascular changes in diabetic patients’ onset and progression. However, the relation between retinal biomarkers and diabetic risk factors is unclear in Chinese hospitalized type 2 diabetic patients. Aims: To examine the associations of retinal vascular tortuosity with risk factors of type 2 diabetes and diabetic retinopathy in Chinese hospitalized patients. Patients and Methods: Our cross-sectional study includes 504 participants with type 2 diabetes hospitalized in the department of endocrinology in Shengjing hospital, Shenyang, China. Patients’ socio-demographic, clinical and biological information was retrieved from their ID card, the interview, and the local hospital information system. Retinal photographs were taken by laser-scanning ophthalmoscopy of both eyes and checked if gradable for analysis. The weighted mean and standard deviation of tortuosity were calculated from the retinal photographs using a novel robust and fully automatic quantitative method. DR was assessed from the retinal photographs by the ophthalmologist according to the modified Airlie House classification into No DR and Any DR in our current study. Data were analyzed by SPSS Version 22 with Student’s t test, Mann-Whitney U test, Chi-square test, and linear regression. Results: For the total participants (504) in this study, the weighted mean and standard deviation (SD) of tortuosity was 12.05 × 10?3 (SD: 1.66 × 10?3) and 24.31 × 10?3 (SD: 3.69 × 10?3), respectively. 386 (76.6%) patients were diagnosed with DR who had older age, long duration of diabetes, higher brachial ankle pulse wave velocity (baPWV), higher systolic blood pressure (SBP), higher diastolic blood pressure (DBP), and higher retinal vascular tortuosity values. In univariable linear regression analyses, older age, longer duration, higher baPWV, higher urine microalbuminuria, higher urine albumin/creatinine ratio, diagnosed with high blood pressure, thrombosis or Any DR, were significantly associated with both higher tortuosity measures (all P values展开更多
文摘BACKGROUND： Studies have demonstrated that the risk factors of vascular dementia following stroke are greatly different in region, race and other aspects. OBJECTIVE： To analyze the conditions and incidental risk factors of vascular dementia in patients with acute cerebral infarction from Chongqing City. DESIGN： Case analysis. SETTING： Department of Neurology, Daping Hospital, Third Military Medical University of Chinese PLA. PARTICIPANTS： Altogether 546 inpatients with acute ischemic stroke admitted to Department of Neurology, Daping Hospital, Third Military Medical University of Chinese PLA between May 1999 and December 2002 were involved in this study. The involved patients, including 295 males and 251 females, aged 55 - 94 years, dwelled in Chongqing over 5 years. They were admitted to hospital within 48 hours of attack of acute ischemic stroke, and survived for over 3 months. Informed consents were obtained from all the involved subjects. METHODS： ① Following the same standard, cognitive and social function evaluations were conducted by one physician on admission and 3 months after admission, Unified questionnaire, consisting of general characteristics, vascular risk factors, stroke characteristics, neurological physical sign, and other 28 factors of involved subjects, was used in all the patients. According to the investigation results, the patients were assigned into 2 groups： dementia group and non-dementia group. ②Ischemic stroke was diagnosed according to acute ischemic brain disorder 〉 24 hours and CT or MRI imageology.③ Neurophysiological examination was conducted in all the patients at 7 to l0 days after stroke （score was two SD less than or equaled to normal level was considered as abnormal）. ④Diagnosis and statistics of dementia were carried out with Mini-Mental State Examination and The Diagnostic and Statistical Manual of Mental Disorders-Ⅳ （published by American Psychiatric Association） on admission and 3 months after admission. Neurologic deficit scoring was carried out with the National Institutes of Health Stroke Scale. ⑤ Chi-square test was used for categorical variable, and t test for quantitative variable between dementia group and non-dementia group. Dementia-related factors were performed multiple-factor Logistic regression model analysis. MAIN OUTCOME MEASURES： Incidence of dementia and dementia-related risk factors of patients. RESULTS： Altogether 546 patients with stroke were involved in this study, 403 of them participated in the final analysis, and 143 dropped out. A total of 342 were followed-up in the hospital and 61 at home. At 3 months after cerebral infarction, vascular dementia occurred in 87 （21.6%） of 403 patients. The main risk factors were age （OR 1.179; 95%CI 1.130 - 1.230）, low education level （OR 1.806; 95%CI 1.024 - 3.186）, daily alcohol drinking （OR 3.447; 95%（1/ 1.591 - 7.468）, stroke history （OR 2.531; 95%CI 1.419 - 4.512）, atrial fibrilation（OR 3.475; 95%CI 1.712 - 7.057）, dysphonia （OR 5.873; 95%6/2.620 - 13.163） and left carotid artery infarction （OR 1.975; 95%（1/1.152 - 3.388）. CONCLUSION： The incidence of vascular dementia is determined by synthetic action of multiple risk factors. Dysphonia is the most important influencing factor.
文摘<strong>Objectives:</strong> To identify the main risk factors of vascular cognitive impairment in patients with acute cerebral infarction by Meta-analysis, and provide references for the effective prevention of the cognitive impairment in stroke patients. <strong>Methods:</strong> To retrieve the observational research literatures that refer to the risk factors of vascular cognitive impairment in patients with ischemic stroke, which are published on China National Knowledge Infrastructure (CNKI), Wanfang and Weipu Chinese databases. The screening and data extraction of these literatures are independently completed by two researchers, who also give the quality evaluation of the literatures according to the evaluation criterion of the Australian JBI Evidence-Based Health Care Center. Then, Meta-analysis is conducted by using Revman5.3 software. <strong>Results:</strong> There are twenty-eight articles selected from 1507 literatures, with a total of 10,711 cases and 50 risk factors included. Among them, there are combined effects of ten factors which have statistical significance, such as infarction area, alcohol consumption, smoking, hyper homocysteinemia, hypertension, diabetes mellitus, age, history of cerebral infarction, hyperlipoidemia and education level. The relational merging OR value and 95% CI between the type-variable factors and cognitive impairment are 3.25 (1.84, 5.76);2.98 (2.58, 3.45);2.79 (1.69, 4.59);2.35 (1.93, 2.85);2.25 (1.86, 2.71);2.14 (2.10, 2.18);1.82 (1.62, 2.03);1.54 (1.24, 1.92);1.45 (1.34, 1.56);0.83 (0.78, 0.89). <strong>Conclusion: </strong>Infarction area, alcohol consumption, smoking, hyper homocysteinemia, hypertension, diabetesmellitus, age, history of cerebral infarction, hyperlipoidemia and low education level are the main risk factors for vascular cognitive impairment in patients with acute cerebral infarction. Clinical nursing staff should include it into the routine assessment of patients with acute cerebral infarction and actively prevent and intervene.
文摘AIM: To explore the way in which Latin American psychiatrists approach the screening of vascular risk factors in patients receiving antipsychotic medication.METHODS: This was a descriptive, cross sectional study that surveyed Latin-American physicians to evaluate differences between groups divided in three main sections. The first section included demographic and professional data. The second section asked about the available medical resources: weighing scales, sphygmomanometer and measuring tape. Finally, the third section aimed at looking into the attitudes towards car-diovascular prevention. The latter was also divided into two subsections. In the first one, the questions were about weight, blood pressure and waist perimeter. In the second subsection the questions asked about the proportion of patients:(1) that suffered from overweight and/or obesity;(2) whose lipids and glycemia were controlled by the physician;(3) that were questioned by, and received information from the physician about smoking; and(4) that received recommendations from the physician to engage in regular physical activity. The participants were physicians, users of the medical website Intramed. The visitors were recruited by a banner that invited them to voluntarily access an online self-reported structured questionnaire with multiple options. RESULTS: We surveyed 1185 general physicians and 792 psychiatrists. Regarding basic medical resources, a significantly higher proportion of general physicians claimed to have weighing scales(χ2 = 404.9; P < 0.001), sphygmomanometers(χ2 = 419.3; P < 0.001), and measuring tapes(χ2 = 336.5; P < 0.001). While general physicians measured overweight and metabolic indexes in the general population in a higher proportion than in patients treated with antipsychotics(Z =-11.91; P < 0.001), psychiatrists claimed to measure them in patients medicated with antipsychotics in a higher proportion than in the general population(Z =-3.26; P < 0.001). Also general physicians tended to evaluate smoking habits in the general population more than psychiatrists(Z =-7.02; P < 0.001), but psychiatrists evaluated smoking habits in patients medicated with antipsychotics more than general physicians did(Z =-2.25; P = 0.024). General physicians showed a significantly higher tendency to control blood pressure(χ2 = 334.987; P < 0.001), weight(χ2 = 435.636; P < 0.001) and waist perimeter(χ2 = 96.52; P < 0.001) themselves and they did so in all patients. General physicians suggested physical activity to all patients morefrequently(Z =-2.23; P = 0.026), but psychiatrists recommended physical activity to patients medicated with antipsychotics more frequently(Z =-7.53; P < 0.001). CONCLUSION: Psychiatrists usually check vascular risk factors in their patients, especially in those taking antipsychotics. General practitioners check them routinely without paying special attention to this population.
基金Supported by Zhejiang Province Public Welfare Technology Application Research Project (No.LGF22H120017)Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialists (No.SZGSP014)+1 种基金Sanming Project of Medicine in Shenzhen (No.SZSM202011015)Shenzhen Fundamental Research Program (No.JCYJ20220818103207015)。
文摘AIM: To measure the retinal vessels of primary open angle glaucoma(POAG) patients on spectral domain optical coherence tomography(SD-OCT) with a full-width at half-maximum(FWHM) algorithm to better explore their structural changes in the pathogenesis of POAG.METHODS: In this retrospective case-control study, the right eyes of 32 patients with POAG and 30 healthy individuals were routinely selected.Images of the supratemporal and infratemporal retinal vessels in the B zones were obtained by SD-OCT, and the edges of the vessels were identified by the FWHM method.The internal and external diameters, wall thickness(WT), wall cross-sectional area(WCSA) and wall-to-lumen ratio(WLR) of the blood vessels were studied.RESULTS: Compared with the healthy control group, the POAG group showed a significantly reduced retinal arteriolar outer diameter(RAOD), retinal arteriolar lumen diameter(RALD) and WSCA in the supratemporal(124.22±12.42 vs 138.32±10.73 μm, 96.09±11.09 vs 108.53±9.89 μm,and 4762.02 ± 913.51 vs 5785.75 ± 114 8.28 μm^(2), respectively, all P<0.05) and infratemporal regions(125.01±15.55 vs 141.57±10.77 μm, 96.27±13.29 vs 110.83 ± 10.99 μm, and 4925.56 ± 1302.88 vs 6087.78±1061.55 μm^(2), all P<0.05).The arteriolar WT and WLR were not significantly different between the POAG and control groups, nor were the retinal venular outer diameter(RVOD), retinal venular lumen diameter(RVLD) or venular WT in the supratemporal or infratemporal region.There was a positive correlation between the arteriolar parameters and visual function.CONCLUSION: In POAG, narrowing of the supratemporal and infratemporal arterioles and a significant reduction in the WSCA is observed, while the arteriolar WT and WLR do not change.Among the venular parameters, the external diameter, internal diameter, WT, WLR, and WSCA of the venules are not affected.
文摘Context: Diabetic patients are at high risk for microvascular complications of disease such as diabetic retinopathy (DR) and diabetic neuropathy. Imaging the retinal micro-vasculature offers a chance to measure quantitatively the microvascular changes in diabetic patients’ onset and progression. However, the relation between retinal biomarkers and diabetic risk factors is unclear in Chinese hospitalized type 2 diabetic patients. Aims: To examine the associations of retinal vascular tortuosity with risk factors of type 2 diabetes and diabetic retinopathy in Chinese hospitalized patients. Patients and Methods: Our cross-sectional study includes 504 participants with type 2 diabetes hospitalized in the department of endocrinology in Shengjing hospital, Shenyang, China. Patients’ socio-demographic, clinical and biological information was retrieved from their ID card, the interview, and the local hospital information system. Retinal photographs were taken by laser-scanning ophthalmoscopy of both eyes and checked if gradable for analysis. The weighted mean and standard deviation of tortuosity were calculated from the retinal photographs using a novel robust and fully automatic quantitative method. DR was assessed from the retinal photographs by the ophthalmologist according to the modified Airlie House classification into No DR and Any DR in our current study. Data were analyzed by SPSS Version 22 with Student’s t test, Mann-Whitney U test, Chi-square test, and linear regression. Results: For the total participants (504) in this study, the weighted mean and standard deviation (SD) of tortuosity was 12.05 × 10?3 (SD: 1.66 × 10?3) and 24.31 × 10?3 (SD: 3.69 × 10?3), respectively. 386 (76.6%) patients were diagnosed with DR who had older age, long duration of diabetes, higher brachial ankle pulse wave velocity (baPWV), higher systolic blood pressure (SBP), higher diastolic blood pressure (DBP), and higher retinal vascular tortuosity values. In univariable linear regression analyses, older age, longer duration, higher baPWV, higher urine microalbuminuria, higher urine albumin/creatinine ratio, diagnosed with high blood pressure, thrombosis or Any DR, were significantly associated with both higher tortuosity measures (all P values
