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21 young female and 15 young male patients with cerebrovascular insults were examined for risk factors. 14 of the 15 male patients showed clear cut risk factors: obesity, diabetes, hyperlipidemia, arterial hypertension, smoking, thromboses, vitium cordis. 20 of the 21 female patients took oral contraceptives. 60% of the female patients with angiographically confirmed stenoses and occlusion did not show any other risk factor. These results support the hypothesis that oral contraceptives are in themselves a risk factor.
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PMID:[The importance of risk factors in cerebrovascular processes while taking oral contraceptives (author's transl)]. 41 98

1477 employees of a large industrial firm in Munich (868 males and 609 females, aged 40-59) were examined for coronary heart diseases risk factors. Among males, hypercholesterolemia predominates with a distribution of over 40%. Every fifth male has high blood pressure or is a heavy cigarette smoker. The females under 50 years of age clearly show fewer risk factors, but toward 60 years they exceed the males in frequency of some factors. Among women, too, the top risk factor is cholesterol, followed by overweight and high blood pressure. On the average, about 8% of the men and women have a preclinical or manifest diabetes. About every fifth male examined and every seventh female can be considered as especially endangered by the presence of 3 or more risk factors.
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PMID:[Coronary heart disease risk factors in white-collar and manual workers at a large Munich industrial firm (author's transl)]. 41 13

Stroke is increasingly becoming a major cause of death and morbidity in African population among most of which the frequencies of hypertension are considerable, although hard data based on community surveys are lacking and most of the information available is from hospital data. The epidemiology of stroke in the Africans is reviewed. The frequencies in hospital populations varied from 0.9% to 4.0% and stroke accounted for 0.5% to 45% of neurological admissions. There is male predominance in published series. The main risk factors are hypertension, diabetes mellitus and homozygous sickle cell disease (in children only). Ischaemic stroke is by far the commonest clinical type encountered. These conclusions are further supported by experience at Ibadan, of over 1100 Africans seen over 18 years reported briefly in this communication. The results of the first community study over a 2-year period on the incidence of stroke in an African Urban (Ibadan) Community are presented. The study was carried out as part of a multinational multicentric study initiated and sponsored by the World Health Organization. The male to female ratio was five to two. Incidence rates reached peaks in the eighth decade in males and in seventh decade in females and were higher in males in all age groups, and the rates are comparable with those recorded in European populations, except in those under the age of 40 in Ibadan, in which age-specific incidence rates are considerably lower than in European and Japanese populations. Hypertension, diabetes mellitus constituted the main risk factors. Mortality and recurrence rates are described and are similar to experience in the Caucasians. Hypertension in the Nigerians predispose to a high frequency of cerebrovascular disease other than through mainly cerebral atherosclerosis. With increasing longevity of Nigerians and other Africans, the mortality and morbidity caused by cerebrovascular disease would probably become of enormous dimensions and adequate control of high blood pressure on a community basis may be the only way of preventing this: this would be desirable as myocardial infarction in contradistinction to hypertensive heart disease is an uncommon complication of high blood pressure in the Africans and prevention of hypertensive heart disease as shown by experience elsewhere can be achieved by control of high blood pressure, which does not seem to prevent ischaemic myocardial disease.
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PMID:Stroke in the Africans. 41 66

Proximal gastric vagotomy without drainage is the operation of choice for uncomplicated duodenal ulcer. There are few contraindications for PGV as uremia, diabetes, hypertension, age over 65 years and a history of splenectomy. Only in cases of severe pyloric stenosis or bleeding ulcer or perforation in the pyloric area, a pyloroplasty should be added. The Wangensteen pyloroplasty is a safe drainage procedure and especially recommended in case of extensive scarring of the pylorus.
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PMID:[Proximal selective vagotomy with or without pyloroplasty?]. 42 62

We examined 38 patients with disturbed blood supply to the optic nerve. The observations suggest: 1. men are more frequently affected than women. 2. the first attack of apoplexia nervi optici occurs most often in the left eye. 3. diabetes mellitus and most probably arterial hypertension are risk factors.
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PMID:[The circulatory disturbance of the optic nerve with special reference to the side distribution and other dispositional factors (author's transl)]. 43 Oct 10

A study about gout associated with hypertension, diabetes, ischemic cardiopathy and different alterations in the sanguineous levels of lipids was conducted on 80 patients of the Rheumatology Service at the National Institute of Cardiology in Mexico City. We found abnormal levels of tryglicerids in the blood of 55% of the patients and a high level of cholesterol in only 5%. In 27% of the patients, some alteration showed in the carbo-hydrates methabolism, and in 22,5% of them we found systemic arterial hipertension. Slight ischemic cardiopathy was showing in a 37% of the patients, but uric acid level in blood seemed to be of little importance for the frequency, type or severity of the coronary heart disease. We made a comparison between the results we obtained through these studies and those found among the Mexican population and with information found in international medical publications.
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PMID:[Incidence of coronary disease and other metabolic diseases in 80 gout patients]. 43 57

For the last 10 years 500 iridencleisis and 250 trepanotrabeculectomies were performed. For this study are subjected only 205 cases of basal and total iridencleisis and 100 cases of trepanotrabeculectomy, performed in chronic open and chronic closed angle glaucoma. The authors point out that some common factors play the role on the final results, independently of the type of the operation. It was observed that the results were worse in patients having the diabetes and/or arterial hypertension, when the operation is performed in the advanced age or in the late stage of glaucoma, and also if the eye was already operated. To evaluate the result of the operations (basal and total iridencleisis, trepanotrabeculectomy) the authors estimate that is not enough to take the intraocular tension as the unic parameter, one should take in consideration also the visual field, visual acuity and also the state of the optic disc in the follow-up period (see Tbl. 4). This period should not be shorter than one year. With the trepanotrabeculectomy (85%) and with total iridencleisis (86,5%) the intraocular tensions could be normalised in the higher percentage than with the basal iridencleisis (75,5%). On the other hand, if one take also the other parameters for the evaluation (visual field, visual acuity, status of the optic disc) one could conclude that the best result was achieved with trepanotrabeculectomy (80% the complete consolidation), and than with total iridencleisis (69,4%) or basal iridencleisis (67%). In trepanotrabeculectomy the peroperative and postoperative complications are rare.
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PMID:[Comparative results of trepanotrabeculectomy and iridencleisis in primary glaucoma]. 44 10

An optimal diet cannot yet be defined. If we knew what an optimal diet was, additional research in nutrition would not be necessary. There is abundant evidence, however, that the usual American diet is not optimal and adequate reason to recommend modification. Current dietary recommendations were developed to prevent the occurrence of nutritional deficiency disease in the 1930's and 1940's. They have been largely successful. They were made, however, before any knowledge was available about the effects of diet upon chronic disease which now represent the primary health problems of the United States. Large amounts of data are available indicating the kids of recommendations which should be made to control hypercholesterolemia--a primary risk factor of coronary artery disease. These kinds of data together with less information upon diet and cancer, hypertension, obesity, diabetes, etc. lead to sensible and consistent dietary recommendations to moderate the dietary practices of most Americans.
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PMID:Optimal nutrition. 44 85

Regional cerebral blood flow (rCBF) was measured by 133Xe inhalation in 46 normal volunteers, aged 21 to 63 years, and 14 neurologically asymptomatic subjects above age 40 with risk factors for atherothrombotic stroke, including hypertension, diabetes mellitus, and hyperlipidemia. In normal volunteers, there was diffuse and progresive reduction of gray matter flow and weight as well as increases of cerebrovascular resistance (CVR) with advancing age. Reduction of gray matter flow with advancing age appears to be attributed in part to neuronal atrophy and in part to cerebral arteriosclerosis. Regional increases of CVR and reduction of gray matter flow with advancing age were most evident in the middle cerebral arterial (MCA) distribution and were enhanced by the association of risk factors. Development of cerebral arteriosclerosis with age and/or risk factors appears to be most evident in MCA distribution.
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PMID:Effects of advancing age on regional cerebral blood flow. Studies in normal subjects and subjects with risk factors for atherothrombotic stroke. 45 46

The most important advancement in perinatology during the past few years has been the possibility to selectively establish a criterion to judge high risk pregnancies, which still represent the great majority of cases of materno-infant morbimortality. Social, economic, and cultural factors, age, biological antecedents of the mother, previous pregnancies, and medical history, have all a great influence in the evaluation of gestation. Through the years several models have been constructed to evaluate high perinatal risks; excluding complications due to danger of congenital abnormalities only 19% of women are exposed to high risk pregnancy. Among prenatal risk factors the most common are toxemia, chronic hypertension, severe cardiopathy, and diabetes; risk factors that may become more evident during delivery or shortly before it are toxemia again, premature rupture of membranes, meconial amniotic fluid, and abnormal presentation.
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PMID:[Perinatal medicine. Medico-social implications. I. Technics used in the identification of high risk pregnancy]. 45 11


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