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Eshak E.S.,Osaka University | Eshak E.S.,Menoufia University | Iso H.,Osaka University | Mizoue T.,International Clinical Research Center | And 3 more authors.
Clinical Nutrition | Year: 2013

Background & aims: Japan has experienced a jump in the diabetes prevalence rates. We want to examine whether increased intake of soft drink and juices have contributed to this jump. Methods: Participants were 27,585 Japanese men and women aged 40-59 years who had no prior history of diabetes. Intakes of soft drink, 100% fruit juice and vegetable juice were measured by a validated food frequency questionnaire. Odds ratios of type 2 diabetes over 5 and 10 years were estimated by using logistic regression. Results: A total of 484 men and 340 women reported newly diagnosed diabetes during10 years. High soft drink intake was associated with increased risk of type 2 diabetes in women but not men; odds ratio (95% CI) for women with almost daily consumption versus non-consumers was 2.10 (1.23-3.59; P-trend = 0.004) and 1.79 (1.11-2.89; P-trend = 0.01) at 5 and 10 years, respectively. The association was evident in overweight, highly educated and premenopausal women, and women with blue collar job. Intakes of 100% fruit juice and vegetable juice were not associated with risk of type 2 diabetes for either gender (P-trend >0.05). Conclusions: Soft drink but not pure juices consumption was associated with increased risk of type 2 diabetes in Japanese women. © 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism.

Konecny T.,Mayo Medical School | Konecny T.,International Clinical Research Center | Somers V.K.,Mayo Medical School
Chest | Year: 2014

Sleep-disordered breathing (SDB) may be a treatable risk factor in patients with hypertrophic cardiomyopathy (HCM), the most common inherited cardiomyopathy. Evidence suggests a high prevalence of SDB in HCM. We summarize the pathophysiology of SDB as it relates to hypertension, coronary artery disease, atrial fi brillation, and sudden cardiac death in patients with HCM. The implications regarding the care of patients with HCM and SDB are discussed as well as the knowledge defi cits needing further exploration. © 2014 AMERICAN COLLEGE OF CHEST PHYSICIANS.

Mazya M.V.,Karolinska University Hospital | Mazya M.V.,Karolinska Institutet | Ahmed N.,Karolinska University Hospital | Ahmed N.,Karolinska Institutet | And 6 more authors.
Stroke | Year: 2014

Background and Purpose: Intracerebral hemorrhage after treatment with intravenous recombinant tissue-type plasminogen activator for ischemic stroke can occur in local relation to the infarct, as well as in brain areas remote from infarcted tissue. We aimed to describe risk factors, 3-month mortality, and functional outcome in patients with the poorly understood complication of remote intracerebral hemorrhage, as well as local intracerebral hemorrhage. METHODS-: In this study, 43 494 patients treated with intravenous recombinant tissue-type plasminogen activator, with complete imaging data, were enrolled in the Safe Implementation of Treatments in Stroke-International Stroke Thrombolysis Register (SITS-ISTR) during 2002 to 2011. Baseline data were compared among 970 patients (2.2%) with remote parenchymal hemorrhage (PHr), 2325 (5.3%) with PH, 438 (1.0%) with both PH and PHr, and 39 761 (91.4%) without PH or PHr. Independent risk factors for all hemorrhage types were obtained by multivariate logistic regression. RESULTS-: Previous stroke (P=0.023) and higher age (P<0.001) were independently associated with PHr, but not with PH. Atrial fibrillation, computed tomographic hyperdense cerebral artery sign, and elevated blood glucose were associated with PH, but not with PHr. Female sex had a stronger association with PHr than with PH. Functional independence at 3 months was more common in PHr than in PH (34% versus 24%; P<0.001), whereas 3-month mortality was lower (34% versus 39%; P<0.001). CONCLUSIONS-: Differences between risk factor profiles indicate an influence of previous vascular pathology in PHr and acute large-vessel occlusion in PH. Additional research is needed on the effect of pre-existing cerebrovascular disease on complications of recanalization therapy in acute ischemic stroke. © 2014 American Heart Association, Inc.

Calvin A.D.,Rochester College | Carter R.E.,Mayo Medical School | Adachi T.,Showa University | MacEdo P.G.,University Brazilia | And 8 more authors.
Chest | Year: 2013

Background: Epidemiologic studies link short sleep duration to obesity and weight gain. Insuffi- cient sleep appears to alter circulating levels of the hormones leptin and ghrelin, which may promote appetite, although the effects of sleep restriction on caloric intake and energy expenditure are unclear. We sought to determine the effect of 8 days/8 nights of sleep restriction on caloric intake, activity energy expenditure, and circulating levels of leptin and ghrelin. Methods: We conducted a randomized study of usual sleep vs a sleep restriction of two-thirds of normal sleep time for 8 days/8 nights in a hospital-based clinical research unit. The main outcomes were caloric intake, activity energy expenditure, and circulating levels of leptin and ghrelin. Results: Caloric intake in the sleep-restricted group increased by + 559 kcal/d (SD, 706 kcal/d, P = .006) and decreased in the control group by - 118 kcal/d (SD, 386 kcal/d, P = .51) for a net change of + 677 kcal/d (95% CI, 148-1,206 kcal/d; P = .014). Sleep restriction was not associated with changes in activity energy expenditure (P = .62). No change was seen in levels of leptin (P = .27) or ghrelin (P = .21). Conclusions: Sleep restriction was associated with an increase in caloric consumption with no change in activity energy expenditure or leptin and ghrelin concentrations. Increased caloric intake without any accompanying increase in energy expenditure may contribute to obesity in people who are exposed to long-term sleep restriction. © 2013 American College of Chest Physicians.

Mazya M.,Karolinska University Hospital | Mazya M.,Karolinska Institutet | Egido J.A.,Complutense University of Madrid | Ford G.A.,Newcastle University | And 7 more authors.
Stroke | Year: 2012

Background and Purpose-: Symptomatic intracerebral hemorrhage (SICH) is a serious complication in patients with acute ischemic stroke treated with intravenous thrombolysis. We aimed to develop a clinical score that can easily be applied to predict the risk of SICH. Methods-: We analyzed data from 31 627 patients treated with intravenous alteplase enrolled in the Safe Implementation of Treatments in Stroke (SITS) International Stroke Thrombolysis Register. The outcome measure was SICH per the Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST) definition: a Type 2 parenchymal hemorrhage with deterioration in National Institutes of Health Stroke Scale score of ≥4 points or death. Univariate risk factors associated with the outcome were entered into a logistic regression model after stratification of continuous variables. Adjusted ORs for the independent risk factors were converted into points, which were summated to produce a risk score. Results-: We identified 9 independent risk factors for SICH: baseline National Institutes of Health Stroke Scale, serum glucose, systolic blood pressure, age, body weight, stroke onset to treatment time, aspirin or combined aspirin and clopidogrel, and history of hypertension. The overall rate of SICH was 1.8%. The risk score ranged from 0 to 12 points and showed a >70-fold graded increase in the rate of SICH for patients with a score ≥10 points (14.3%) compared with a score of 0 point (0.2%). The prognostic discriminating capability by C statistic was 0.70. Conclusions-: The SITS SICH risk score predicts large cerebral parenchymal hemorrhages associated with severe clinical deterioration. The score could aid clinicians to identify patients at high as well as low risk of SICH after intravenous alteplase. © 2012 American Heart Association, Inc.

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