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4 results

  • Dietary fried fish intake increases risk of CVD: the REasons for Geographic And Racial Differences in Stroke (REGARDS) study

  • Fadi Nahab, Keith Pearson, Michael R Frankel, Jamy Ard, Monika M Safford, Dawn Kleindorfer, Virginia J Howard, Suzanne Judd
  • Journal:
    Public Health Nutrition / Volume 19 / Issue 18 / December 2016
    Published online by Cambridge University Press:
    24 June 2016, pp. 3327-3336
    • Article
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  • Objective

    The objective of the present study was to examine the relationship of dietary fried fish consumption and risk of cardiovascular events and all-cause mortality.

    Design

    Prospective cohort study among participants of the REasons for Geographic And Racial Differences in Stroke (REGARDS) study who resided in the USA.

    Setting

    The primary outcome measures included the hazard ratios (HR) of incident CVD including first incident fatal or non-fatal ischaemic stroke or myocardial infarction and all-cause mortality, based on cumulative average fish consumption ascertained at baseline.

    Subjects

    Participants (n 16 479) were enrolled between 2003 and 2007, completed the self-administered Block98 FFQ and were free of CVD at baseline.

    Results

    There were 700 cardiovascular events over a mean follow-up of 5·1 years. After adjustment for sociodemographic variables, health behaviours and other CVD risk factors, participants eating ≥2 servings fried fish/week (v. <1 serving/month) were at a significantly increased risk of cardiovascular events (HR=1·63; 95 % CI 1·11, 2·40). Intake of non-fried fish was not associated with risk of incident CVD. There was no association found with dietary fried or non-fried fish intake and cardiovascular or all-cause mortality.

    Conclusions

    Fried fish intake of two or more servings per week is associated with an increased risk of cardiovascular events. Given the increased intake of fried fish in the stroke belt and among African Americans, these data suggest that dietary fried fish intake may contribute to geographic and racial disparities in CVD.

  • 32 - Cerebrovascular disease

  • Edited by Michael F. Lubin, Emory University, Atlanta, Robert B. Smith, Emory University, Atlanta, Thomas F. Dodson, Emory University, Atlanta, Nathan O. Spell, Emory University, Atlanta, H. Kenneth Walker, Emory University, Atlanta
  • Book:
    Medical Management of the Surgical Patient
    Published online:
    12 January 2010
    Print publication:
    10 August 2006, pp 399-410

  • Summary

    Stroke affects about 750 000 people each year in the USA and is a leading cause of long-term adult disability. Over the past decade there have been considerable advances in treatment and prevention. This chapter will review many of these advances with emphasis on issues relevant to surgical patients.

    There are two types of stroke: ischemic and hemorrhagic. Ischemic events account for about 80% of all strokes. Most of these are related to atherothromboembolic events.

    Atherosclerosis is a systemic disease that most prominently affects the aorta, the coronary arteries, the extracranial carotid and vertebral arteries, and the arteries to the extremities. Atherosclerosis causes stroke by producing progressive stenosis, local thrombosis with occlusion, or distal embolization. Any one of these mechanisms can be the primary cause. For example, progressive atherosclerotic occlusion can cause distal hypoperfusion severe enough to result in tissue ischemia and infarction. Mild or moderate atherosclerotic stenosis that does not cause distal hypoperfusion can be the site of thrombosis and cause intra-arterial embolization leading to occlusion of an intracerebral artery downstream.

    The relative significance of local thrombosis versus intra-arterial embolization varies according to the site of atherosclerosis. Most strokes resulting from stenosis of the proximal internal carotid artery are caused by distal embolic occlusion of the middle cerebral artery or its branches. Cerebral infarction in the basilar artery territory usually results from occlusion of the small perforating vessels by local thrombosis.

    Ischemic strokes are divided into several categories including cardioembolic, lacunar, and atherosclerotic etiologies.

  • 12 - Cerebrovascular Disease

  • from SECTION III - SPECIFIC NEUROLOGICAL CONDITIONS
    • By Michael R. Frankel, Department of Neurology Grady Memorial Hospital Atlanta, Georgia, Marc Chimowitz, Department of Neurology Grady Memorial Hospital Atlanta, Georgia, Sam Josvai, Kalamazoo Center for Medical Studies/MSU Emergency Medicine Residency Program Kalamazoo, Michigan, Rashmi U. Kothari, Kalamazoo Center for Medical Studies/MSU Emergency Medicine Residency Program Kalamazoo, Michigan, Sid M. Shah, M.D. Ingham Regional Medical Center Sparrow Hospital/MSU, Emergency Medicine Residency Program Lansing, Michigan
  • Edited by Sid M. Shah, Michigan State University, Kevin M. Kelly, Drexel University, Philadelphia
  • Book:
    Principles and Practice of Emergency Neurology
    Published online:
    06 August 2009
    Print publication:
    18 February 2003, pp 131-145

  • Summary

    Cerebrovascular disease encountered in the emergency department (ED) includes transient ischemic attacks (TIAs) and infarcts (strokes). The purpose of the initial evaluation is to determine whether there is evidence of a stroke, what part of the brain is affected, and whether the patient is a candidate for urgent intervention such as thrombolytic therapy. A chemistry profile, complete blood count (CBC) with platelets, and coagulation profile are essential after completion of brief examination. Attention to adequate airway protection, oxygenation, and circulatory function is essential for management of patients with acute stroke. The use of anticoagulants (heparin or low molecular heparins) remains the most controversial subject in the management of acute stroke. Patients with acute or hemorrhagic strokes need to be admitted to the hospital for further evaluation and management. A neurosurgeon should participate in the care of most patients with intracerebral hemorrhages (ICH) and all patients with subarachnoid hemorrhages (SAH).