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Selected AbstractsThe MTHFR C677T polymorphism confers a high risk for stroke in both homozygous and heterozygous T allele carriers with Type 2 diabetesDIABETIC MEDICINE, Issue 5 2006M. P. Hermans Abstract Objective Individuals with Type 2 diabetes are at increased risk of stroke. Plasma homocysteine (tHcy) is an independent risk factor for cardiovascular (CV) disease. The methylene,tetrahydrofolate reductase (MTHFR) gene polymorphism (thermolabile variant C677T) is associated with CV risk, partly as a result of increased Hcy, especially in homozygous subjects. Aim To relate the occurrence of the MTHFR polymorphism with stroke prevalence by examining allelic frequency and genotype distribution in 165 subjects with Type 2 diabetes studied for the presence of thermolabile C677T MTHFR mutation. Results Mean age was 67.7 years, and tHcy 18.2 µmol/l. T allele frequency was 38.5%. MTHFR genotypes were: normal (CC) 40%; heterozygous (CT) 43%; homozygous (TT) 17%. Serum levels of folic acid and B12 vitamin were within normal limits. Stroke prevalence was 14%. Sixty-four per cent of stroke-free subjects had the normal C allele vs. 46% in stroke subjects. The frequencies of genotypes (CC-CT-TT) were (%): 44-41-15 in stroke-free vs. 17-57-26 in stroke patients. Coronary (CAD) and peripheral artery disease (PAD) were common in all groups, with no differences according to genotypes. Stroke prevalence was markedly higher in genotypes CT and TT (18 and 21%) compared with CC (6%). Mean tHcy levels were higher in TT subjects. Conclusion The allelic frequency of C677T MTHFR mutation in Type 2 diabetes subjects with stroke is markedly different from that of subjects without stroke. Genotypic characteristics suggest that C677T MTHFR mutation confers a higher risk for stroke to both homozygous and heterozygous T allele carriers that cannot be ascribed solely to raised tHcy and/or lower folate status in CT subjects, nor to phenotypic expression of conventional risk factors for stroke. The impact of the MTHFR polymorphism on stroke may result from T allele-linked deleterious effects, or C allele-linked protection. Confirmatory studies are warranted, as this cohort was not randomly selected, and a type 1 error cannot be ruled out. [source] The Debrecen Stroke Database: demographic characteristics, risk factors, stroke severity and outcome in 8088 consecutive hospitalised patients with acute cerebrovascular diseaseINTERNATIONAL JOURNAL OF STROKE, Issue 5 2009D. Bereczki Background High stroke mortality in central,eastern European countries might be due to higher stroke incidence, more severe strokes or less effective acute care than in countries with lower mortality rate. Hospital databases usually yield more detailed information on risk factors, stroke severity and short-term outcome than population-based registries. Patients and methods The Debrecen Stroke Database, data of 8088 consecutively hospitalised patients with acute cerebrovascular disease in a single stroke centre in East Hungary between October 1994 and December 2006, is analysed. Risk factors were recorded and stroke severity on admission was scored by the Mathew stroke scale. The modified Glasgow outcome scale was used to describe patient condition at discharge. Results Mean age was 68±13 years, 11·4% had haemorrhagic stroke. The rate of hypertension on admission was 79% in men, and 84% in women, 40·3% of men and 19·8% of women were smokers, and 34% of all patients had a previous cerebrovascular disease in their history. Case fatality was 14·9%, and 43% had some disability at discharge. Outcome at discharge was worse with higher age, higher glucose, higher blood pressure, higher white cell count and erythrocyte sedimentation rate and more severe clinical signs on admission. In multivariate analysis admission blood pressure lost its significance in predicting outcome. Conclusions In this large Hungarian stroke unit database hypertension on admission, smoking and previous cerebrovascular disease were more frequent than in most western databases. These findings indicate major opportunities for more efficient stroke prevention in this and probably other eastern European countries. [source] Retrospective study of 108 foals with septic osteomyelitisAUSTRALIAN VETERINARY JOURNAL, Issue 1-2 2010KM Neil Objective To determine the clinical characteristics, short-term outcome and future athletic performance of foals with septic osteomyelitis. Design Retrospective clinical study of 108 Thoroughbred foals with radiographic evidence of bone infection that were presented at the Scone Veterinary Hospital between August 1995 and December 2001. Medical records were reviewed and information concerning signalment, the clinical, laboratory and radiographic findings, treatment and outcome was obtained. Racing records were obtained and evaluated for surviving foals that had reached racing age. Results Mean age of foals at initial evaluation was 39 days (range 1,180 days); 21 foals had multiple radiographic bone lesions (19.4%), and 76 had concurrent septic arthritis (70.4%). The most frequently affected bones were the femur, tibia and distal phalanx. In total, 87 foals were discharged from the hospital (80.6%), 79 survived long-term to reach racing age and 52 raced (65.8%). Overall, 48% (52/108) of the foals treated for osteomyelitis raced. Foals less than 30 days of age at the time of diagnosis, critically ill foals and those with multiple bones or joints affected were significantly less likely to be discharged from hospital. Multiple septic joints, but not multiple bone involvement, had an unfavourable prognosis for racing. Conclusions The prognosis for survival of foals with septic osteomyelitis or osteitis is favourable. Multiple bone or joint involvement is an important short-term prognostic indicator; however, the involvement of multiple joints, but not multiple infected bones, is associated with an unfavourable prognosis for racing. [source] 4354: Relationship between flicker FDF perimetry and standard automated perimetryACTA OPHTHALMOLOGICA, Issue 2010P CALVO PEREZ Purpose To compare the main indices of flicker FDF perimetry (FDF, Heidelberg Engineering, Germany) with standard automated perimetry (SAP). Methods Twenty healthy subjects and twenty-three glaucoma patients were prospectively and consecutively selected. Glaucomatous patients had an intraocular pressure higher than 21 mmHg and glaucomatous optic disc appearance. All of them underwent at least one reliable perimetry with each device. SAPs were performed with a FDF perimeter (24-2 ASTA-Standard test) and Humphrey perimeter (Carl Zeiss (24-2 SITA standard algorithm). The Kolmogorov Smirnov test was applied to check that the data were normally distributed. Only one eye per subject was included in the study. Pearson correlations were calculated between both devices : mean deviation (MD), pattern standard deviation (PSD), and visual field index (VFI). Results Mean age was 58.41±12,4 years. MD of SAP was -2.82 ± 4.8 dB, and MD of FDF was -4.47 ± 4.8 dB (p=0.123); PSD of SAP was 3.11 ± 3.1, and PSD of FDF was 3.14 ± 1.4 (p = 0.953). The correlations between MDs were 0.521 (p<0.001) and between PSDs were 0.350 (p<0.001) Conclusion Moderate correlations were found between main visual field indices both devices. Altough no differences were found, FDF tends to present MD values lower than Humphrey. [source] Major eye diseases and risk factors associated with systemic hypertension in an adult chinese population: the Beijing Eye StudyACTA OPHTHALMOLOGICA, Issue 2009T LIBONDI Purpose To assess the relationship of hypertension with major eye diseases and other ocular parameters. Methods The Beijing Eye Study is a population-based study. Examination at baseline in 2001; follow-up examination in 2006; 3222 subjects had blood pressure measurements. All participants underwent a thourough ophthalmic examination and blood pressure measurement. Hypertension was defined as a systolic blood pressure ,140 mm Hg and/or a diastolic blood pressure ,90 mm Hg, and/or self-reported current treatment for hypertension with antihypertensive medication. Results Mean age of participants in the present study was 60.4±10.0 years. Hypertension was present in 1500 (46.6%) of the 3222 subjects who had their blood pressure measured. In multiple regression analysis, hypertension was associated with higher intraocular pressure (P = 0.005), arterio-venous nicking (P = 0.009),retinal vein occlusions (P = 0.02), and diabetic retinopathy (P = 0.02). Hypertension was not significantly associated with the prevalence of open-angle glaucoma (P = 0.19) or angle-closure glaucoma (P = 0.15), age-related macular degeneration (P = 0.73), nuclear cataract (P = 0.88), posterior subcapsular cataract (P = 0.30), cortical cataract (P = 0.10), or area of alpha zone (P=0.05) or beta zone of parapapillary atrophy (P = 0.95). Conclusion In Chinese persons, while controlling for other systemic parameters, hypertension was associated with increased intraocular pressure, retinal microvascular abnormalities, and prevalence of retinal vein occlusion and diabetic retinopathy. Hypertension was not associated significantly with age-related macular degeneration, age-related cataract, or glaucoma [source] | ||||||||||