Date of birth and the incidence of acute ischemic stroke in Hungary. / Fecha de nacimiento e incidencia del ictus isquémico agudo en Hungría.

INTRODUCTION: The effect of the date of birth on the incidence of cardiovascular disease was confirmed in earlier studies. We aimed to determine whether the season of birth may be associated with a higher incidence of stroke in later life by analyzing thrombolysis numbers according over a ten-year period in Hungary. PATIENTS AND METHODS: We analyzed daily thrombolysis numbers between 2007 and 2016 according to the patients' date of birth based on seasons. The correlation between cumulative thrombolysis numbers between 2007 and 2016 per month and birth numbers per month based on data of the 1949 census were also examined. RESULTS: Our results indicate that being born in the spring and summer in the northern hemisphere may be associated with a higher frequency of ischemic stroke necessitating thrombolytic treatment. This equates to a higher risk when conception and early pregnancy occur in the summer and autumn months. CONCLUSIONS: This, however, cannot be defined as a causal relationship if we consider the number of live births in 1949, as both measures change similarly during the year, as indicated by the strong positive correlation between thrombolysis frequency according to date of birth between 2007 and 2016 and the number of births in the 1949 census by month.

TITLE: Fecha de nacimiento e incidencia del ictus isquémico agudo en Hungría.Introducción. El efecto de la fecha de nacimiento sobre la incidencia de enfermedad cardiovascular se ha confirmado en estudios anteriores. Nuestro objetivo fue determinar si la temporada de nacimiento puede estar asociada con una mayor incidencia de accidente cerebrovascular en etapas posteriores de la vida mediante el análisis de las cifras de trombólisis durante un período de 10 años en Hungría. Pacientes y métodos. Analizamos las cifras diarias de trombólisis entre 2007 y 2016 según la fecha de nacimiento de los pacientes según las estaciones. También se examinó la correlación entre las cifras de trombólisis acumuladas entre 2007 y 2016 por mes, y las cifras de nacimientos por mes según los datos del censo de 1949. Resultados. Nuestros resultados indican que nacer en primavera y verano en el hemisferio norte puede estar asociado con una mayor frecuencia de accidentes cerebrovasculares isquémicos que requieren tratamiento trombolítico. Esto equivale a un mayor riesgo cuando la concepción y el embarazo temprano ocurren en los meses de verano y otoño. Conclusión. Esto, sin embargo, no puede definirse como una relación causal si consideramos el número de nacidos vivos en 1949, ya que ambas medidas cambian de manera similar durante el año, como lo indica la fuerte correlación positiva entre la frecuencia de trombólisis según la fecha de nacimiento entre 2007 y 2016, y el número de nacimientos en el censo de 1949 por mes.

Fecha de nacimiento e incidencia del ictus isquémico agudo en Hungría / Date of birth and the incidence of acute ischemic stroke in Hungary

Introducción: El efecto de la fecha de nacimiento sobre la incidencia de enfermedad cardiovascular se ha confirmado en estudios anteriores. Nuestro objetivo fue determinar si la temporada de nacimiento puede estar asociada con una mayor incidencia de accidente cerebrovascular en etapas posteriores de la vida mediante el análisis de las cifras de trombólisis durante un período de 10 años en Hungría. Pacientes y métodos: Analizamos las cifras diarias de trombólisis entre 2007 y 2016 según la fecha de nacimiento de los pacientes según las estaciones. También se examinó la correlación entre las cifras de trombólisis acumuladas entre 2007 y 2016 por mes, y las cifras de nacimientos por mes según los datos del censo de 1949. Resultados: Nuestros resultados indican que nacer en primavera y verano en el hemisferio norte puede estar asociado con una mayor frecuencia de accidentes cerebrovasculares isquémicos que requieren tratamiento trombolítico. Esto equivale a un mayor riesgo cuando la concepción y el embarazo temprano ocurren en los meses de verano y otoño. Conclusión: Esto, sin embargo, no puede definirse como una relación causal si consideramos el número de nacidos vivos en 1949, ya que ambas medidas cambian de manera similar durante el año, como lo indica la fuerte correlación positiva entre la frecuencia de trombólisis según la fecha de nacimiento entre 2007 y 2016, y el número de nacimientos en el censo de 1949 por mes.(AU)

INTRODUCTION: The effect of the date of birth on the incidence of cardiovascular disease was confirmed in earlier studies. We aimed to determine whether the season of birth may be associated with a higher incidence of stroke in later life by analyzing thrombolysis numbers according over a ten-year period in Hungary. PATIENTS AND METHODS: We analyzed daily thrombolysis numbers between 2007 and 2016 according to the patients’ date of birth based on seasons. The correlation between cumulative thrombolysis numbers between 2007 and 2016 per month and birth numbers per month based on data of the 1949 census were also examined. RESULTS: Our results indicate that being born in the spring and summer in the northern hemisphere may be associated with a higher frequency of ischemic stroke necessitating thrombolytic treatment. This equates to a higher risk when conception and early pregnancy occur in the summer and autumn months. CONCLUSIONS: This, however, cannot be defined as a causal relationship if we consider the number of live births in 1949, as both measures change similarly during the year, as indicated by the strong positive correlation between thrombolysis frequency according to date of birth between 2007 and 2016 and the number of births in the 1949 census by month.(AU)

Daylight saving time and the incidence of thrombolysis to treat acute ischemic stroke.

BACKGROUND: Twenty-five percent of the global population lives in one of the more than 70 countries that observe daylight saving time (DST). These people are exposed to 1hour of time transition twice a year, influencing the circulatory system. We aimed to analyze the incidence of thrombolysis to treat acute ischemic stroke in relation to clock changes in Hungary over a 10-year period. METHODS: The number of thrombolytic treatments performed within the period between 2006 and 2015 was analyzed. Anonymized nationwide data on the dates and exact daily numbers of thrombolysis interventions were provided by the National Health Insurance Fund. We compared the mean number of thrombolytic treatments on the day before with that on the day after each transition, and also between the preceding and following one week and month. RESULTS: Our data including the last days of each month suggested a significant increase in thrombolysis numbers both in spring and in autumn on the day and the week after the clock change. However, when the last days of each month were excluded from analysis (as this in itself was associated with a 7-fold increase in stroke incidence in our earlier study), no significant difference in the number of thrombolysis treatments between the days and weeks before and after the clock change was detectable. The long-term, monthly analysis also did not reveal a significant difference. CONCLUSIONS: Our findings reflect that psychosocial factors, such as the approach of the last day of the month override the intrinsic effect of disturbances of the circadian rhythm on stroke incidence.

Preserved structural and functional characteristics of common carotid artery in properly treated normoglycemic women with gestational diabetes mellitus.

Women with gestational diabetes mellitus (GDM) are at high risk of subsequently developing type 2 diabetes mellitus which is an important cardiovascular risk factor. We have evaluated whether preclinical morphological and functional arterial changes are present in GDM. Diameter, intima-media thickness (IMT), intima-media cross-section area (IMCSA) and elasticity features (compliance, distensibility coefficient, circumferential strain, stiffness index (SI) α and ß, incremental elastic modulus) of the common carotid arteries (CCA) were studied in the 3rd trimester in 25 women with GDM, and 17 normal pregnant women matched for age and body mass index using an ultrasonographic vessel wall-movement tracking system and applanation tonometry. Mean IMT, IMCSA and SI α tended to be larger, whereas compliance was smaller in women with GDM but none of these differences were significant. Serum glucose (4.99 ± 0.51 vs. 4.79 ± 0.61 mmol/L, p=0.37) and HbA1c (5.33 ± 0.27 vs. 5.36 ± 0.47 mmol/L, p=0.85) proved normoglycemia in both groups. In conclusion, by the combination of methods we applied in this case control study, neither morphological nor functional characteristics of large elastic arteries differ significantly between well-treated normoglycemic women with GDM and non-diabetic pregnant women in the 3rd trimester.

Influence of neonatal vitamin A or vitamin D treatment on the concentration of biogenic amines and their metabolites in the adult rat brain.

Newborn male rats were treated with a single dose of 3 mg vitamin A (retinol) or 0.05 mg vita-min D (cholecalciferol), and three months later five brain regions (frontopolar cortex, hypothalamus, hippocampus, striatum, and brainstem) were studied for tissue levels of dopamine (DA), serotonin (5HT), and metabolites such as homovanillic acid (HVA), as well as 5-hydroxyindole-3-acetic acid (5HIAA). Vitamin A treatment as hormonal imprinting significantly decreased 5HIAA levels in each brain region. Vitamin D imprinting significantly elevated DA only in the brainstem and HVA levels in striatum and hypothalamus. Present and earlier brain-imprinting results (with brain-produced substances), show that the profound and life-long effect of neonatal hormonal imprinting on neurotransmitter production of the adult brain seems to be well established. As prophylactic treatment with these vitamins is frequent in the perinatal period, the imprinting effect of vitamin A and vitamin D must be taken into consideration.

[Headache in ischemic cerebrovascular diseases]. / Fejfájás ischaemiás cerebrovasculáris megbetegedésekben.

Most of the previous publications investigating the clinical features of ischemic cerebrovascular diseases stated headache as a main symptom. According to our experiences however headache seemed to be a rare symptom accompanying ischemic attacks. The clinical history of 204 cerebrovascular patients treated at the Department of Neurology of Semmelweis Medical University was analysed prospectively and retrospectively with special regard to the frequency of headache appearing as a clinical symptom. Our investigations did not prove causal relationship between ischemic disease and headache.