ABSTRACT
OBJECTIVES: To assess the relationship between hematocrit and risk of fatal and non-fatal stroke in conjunction with meteorological variations. DESIGN: Prospective study of a series of Africans living in Kinshasa, Congo, followed up for 5 years. SUBJECTS: A total of 1,032 unselected patients consecutively admitted to hospitals for acute stroke. Main outcome measures. Fatal and non-fatal ischemic or hemorrhagic strokes. The association of hematocrit with stroke morbidity and mortality and meteorological variables were evaluated by simple or multiple linear regression and logistic regression. RESULTS: Patients were aged 53.7 +/- 12.1 years. Hematocrit was mostly correlated with mean ambient air temperature (r = 0.124; p < 0.001) and atmospheric pressure at 6 a.m GMT (r = 0.157; p < 0.001). Patients with hematocrit > 40% presented the highest levels of systolic blood pressure, fibrinogen, body temperature, resting heart rate, duration of coma and incidence of all stroke types and ischemic stroke (p < 0.001). Hematocrit > 40% was associated with stroke mortality (Odds ratio, 6.2, 4.5-8.6; p < 0.001). The risk of stroke mortality was multiplied by 21, 18.3 and 4.2 in conditions of a mean ambient air temperature > 28 degrees C, atmospheric pressure 975-977 mm Hg and body temperature > 37 degrees C respectively. CONCLUSIONS: Our study suggests that higher hematocrit is associated with an increased risk of stroke morbidity and mortality, particularly ischemic stroke at noon. This risk is probably mediated by increased susceptibility of African older hypertensive subjects to meteorological variations.
Subject(s)
Black People , Cerebrovascular Disorders/etiology , Hematocrit , Meteorological Concepts , Tropical Climate , Adolescent , Adult , Aged , Aged, 80 and over , Atmospheric Pressure , Body Temperature/physiology , Brain Ischemia/etiology , Cerebral Hemorrhage/etiology , Democratic Republic of the Congo , Female , Fibrinogen/analysis , Follow-Up Studies , Heart Rate/physiology , Humans , Hypertension/complications , Linear Models , Logistic Models , Male , Middle Aged , Prospective Studies , Risk Factors , Survival Rate , TemperatureABSTRACT
STUDY OBJECTIVE: To determine the prevalence of rheumatic heart disease and study the association of this disease to factor such as personal host and environment. DESIGN: A cross sectional survey was carried out by a specially trained medical team. SETTING: The study involved high risk school children aged 5-16 years from Binza-Kinshasa urban area and adjoining slums in semi-urban area of Kinshasa town. METHODS: A total of 4848 children randomly selected on the list of semi-urban and urban schools and representing 10% of the schools population were included in the survey with clinical echocardiographic examinations. RESULTS: Of the 4848 children screened, prevalence of rheumatic heart disease was 14.03/1000. The prevalence was significantly greater in slums schools (22.2/1000) than in urban school (4/1000). In slums area, the mitral valve was the valve most commonly affected by rheumatic heart disease. Risk factors such as birth in rainy season (RR=2.2), low birth weight (RR=1.81), low socioeconomic status (RR=2.68), malnutrition
Subject(s)
Rheumatic Heart Disease/epidemiology , Adolescent , Child , Child, Preschool , Cross-Sectional Studies , Democratic Republic of the Congo/epidemiology , Female , Humans , Male , Poverty Areas , Prevalence , Risk Factors , Urban PopulationABSTRACT
Les auteurs rapportent 1 cas de transplantation cardiaque. Apres une anamnese et un traitement clinique complet; une mise au point a ete realisee. Celle-ci comprend un catheterisme cardiaque complet avec mesure des resistances pulmonaires; une fraction d'ejection isotopique; un groupe sanguin et la clearance de la creatine de 24 heures. L'evolution du patient est assombrie par la persistance des affections avec une survie de 1 an
