Breast cancer therapy and age difference in cardiovascular disease risks: A population-based cohort study in Taiwan.

OBJECTIVE: Cardiovascular events induced in breast cancer patients receiving radiotherapy (RT), chemotherapy (CT), or a combination of both (CRT) can increase the risk of death. This nationwide population-based study aims to estimate the risk of cardiovascular complications with a follow-up period of 5 years. MATERIALS AND METHODS: The study cohorts consisted of all patients hospitalized with a principal diagnosis of breast cancer who underwent treatment in 2002. The Cox proportional hazard model and Kaplan-Meier plot were analyzed to compare the cardiovascular event-free survival rate among breast cancer patients treated with different modalities. RESULTS: Of the 5514 breast cancer patients identified, 289 patients had cardiovascular disease (CVD): 110 (5.7%) from the surgery-alone group, 24 (4.1%) from the RT group, 79 (4.6) from the CT group, and 76 (5.8%) from the CRT group. Breast cancer patients who undergo CT and CRT at an age less than 55 years had a higher risk of CVD when compared with the surgery-alone group (for both groups, p < 0.001). By contrast, breast cancer patients aged over 55 years had no increased risk of CVD among the different treatment modalities. CONCLUSION: Breast cancer patients receiving CT and/or CRT have a higher risk of CVD, especially younger patients (aged < 55 years). Therefore, regular examinations of cardiac functions and electrocardiogram should be considered in cases of young breast cancer patients who are receiving CT and/or CRT.

Hyperthyroidism and thrombophilia in cerebral arterial and venous thrombosis: a case report and critical review.

INTRODUCTION: People with hyperthyroidism, thrombophilia, or oral contraceptive (OC) use are reported to have a risk in developing arterial or venous thrombosis. There has been a rare case reporting concurrent arterial and venous thrombosis in such patients. CASE REPORT: We presented a 44-year-old woman with Grave disease and metabolic syndrome developing cerebral venous and arterial thrombosis and later deep vein thrombosis after OC use. At the acute stage, hyperthyroidism was associated with an increase in factor VIII and antithrombin III deficiency. At follow-up, antithrombin III level remained decreased. Her daughter with Hashimoto thyroiditis in a euthyroid state presenting with headache and OC use was also found to have antithrombin III deficiency. CONCLUSIONS: Elevated factor VIII and antithrombin III deficiency were associated with a series of arterial and venous thrombotic events in this patient. Thyroid disease and OC use may have an impact on these coagulation parameters. We suggested that the exclusion of thrombophilia and of alterations of coagulative parameters should precede any decision of OC prescription in thyroid disease patient with a family history of venous thromboembolism.

Chinese medicine patterns in patients with post-stroke dementia.

UNLABELLED: A stroke often results in post-stroke dementia, a rapid decline in memory and intelligence causing dysfunctions in daily life. The Chinese medicine doctor uses 4 examinations of inspection, listening, smelling, and feeling to determine the Chinese medicine pattern (CMP). Therefore, the purpose of the present study was to investigate the CMP in patients with post-stroke dementia. A total of 101 stroke patients were examined, consistent with the DSM IV diagnostic criteria of the American Psychiatric Association, as well as the National Institute of Neurological Disorders and Stroke-Association International pour Ia Recherche et I'Enseignement en Neurosciences vascular dementia diagnostic criteria of post-stroke dementia. RESULTS: 100 patients (99.0%) were KEDP (kidney essence deficiency pattern, shèn jing kui xu zhèng, ), 83 patients were AHLYP (ascendant hyperactivity of liver yang pattern, gan yáng shàng kàng zhèng, ), 83 patients were QBDP (qi-blood deficiency pattern, qì xuè kui xu zhèng, ), 81 patients were SBOCP (static blood obstructing the collaterals pattern, yu xuè zǔ luò zhèng, ), 72 patients were BSTRP (bowels stagnation turbidity retention pattern, fǔ zhì zhuó liú zhèng, ), 50 patients were FHIEP (fire heat interior excess pattern, huǒ rè nèi sheng zhèng, ), and 39 participants (38.6%) were PTOOP (phlegm turbidity obstructing the orifices pattern, tán zhuó zǔ qiào zhèng, ); one to 31 patients have at least 2 CMPs simultaneously. In conclusion, the most CMP is KEDP CMP in the post-stroke dementia patients, and one patient may have one or at least 2 CMPs simultaneously.