Risk factors for ischemic stroke in a Russian community: a population-based case-control study.

BACKGROUND AND PURPOSE: This study was conducted to determine the risk factors for ischemic stroke in a defined Russian population. METHODS: Our data are based on a population-based case-control study of 237 patients with first-ever ischemic stroke and 237 age- and sex-matched controls. Logistic regression methods for matched pairs were used to estimate the relative risk for the variables studied. RESULTS: In a multivariate analysis, hypertension, left ventricular hypertrophy on electrocardiography, ischemic heart disease, mitral valve disease, current cigarette smoking, and high body mass index were significant and independent risk factors for ischemic stroke in this Russian community. CONCLUSIONS: The significant risk factors for ischemic stroke in Novosibirsk are similar to those from other populations and cohorts. This study, the first of stroke risk factors in Russia, has implications for clinical practice and the planning of stroke prevention in the population.

Helicobacter pylori in a Chukotka Native male population.

Helicobacter pylori (HP) is a widespread human pathogen closely associated with gastroduodenal diseases. Thirty-four males from one of the settlements of coastal Chukotka (72% of total adult male population, mean age 31.6 years) underwent upper endoscopy, and HP was examined histologically in antral biopsies (Giemsa stain). Histology revealed normal mucosa in 16%, antral superficial gastritis in 29%, and atrophic gastritis in 55%. HP was found in 40% of histological specimens of normal mucosa, in 100% of superficial gastritis, and in 77% of atrophic gastritis. Correlation was found between the degree of bacterial contamination and both the activity of gastritis and grade of mononuclear infiltration. Data indicate a high prevalence of HP among Chukotka Natives (77%) which may partly explain the significant frequency of antral gastritis in this population.

Dietary fat and disease patterns in Chukotka Native adults.

It is well documented that dietary patterns have been changing for northern indigenous peoples as they adapt to a contemporary lifestyle. Recent dietary research among Chukotka Native adults showed a higher intake of saturated fatty acids (15% of energy) and sugar, and lower content of polyunsaturated fatty acids (5%) compared with our previous studies. We showed a higher percentage of dietary fat from animal fats (31%) and meat products (28%) than from seafoods and fish, which provide only 11% of daily fat intake. Increasing use of marketed foods and decreasing consumption of traditional foods among Chukotka Native adults contribute to more frequent cases of overweight, diabetes mellitus, and cancer. Dietary recommendations with an emphasis on traditional eating patterns should be considered for promotion of a healthy diet in Chukotka inhabitants. Promoting local foods of high biological value and establishing educational nutrition programs are of great importance.

Cancer in Russian Inuit.

Using the framework of the Native Cancer Registry, cancer morbidity among Russian Inuit can be obtained from 1960 onwards. Earlier data are available, but have not been verified. Unfortunately, the absence of accurate demographic data for the Native population of about 16 000 people, including the increase from 1 149 to 1 452 Inuit between 1970 and 1989 prevents comparison and analysis of morbidity and mortality data with the non-Inuit population. Nevertheless, the number of cancers has risen in the Native population of Chukotka during the last decade (1979-1988), with a predominance of oesophagus, lung and stomach cancer among the Inuit. In contrast, no cases were observed of the salivary gland, nasopharyngeal and cervical cancers common in other Inuit populations.

Stroke epidemiology in Novosibirsk, Russia: a population-based study.

OBJECTIVE: To determine first-ever stroke incidence, 30-day case-fatality rates, and frequency of various risk factors among patients with stroke in Novosibirsk, Russia, during 1992. DESIGN: A population-based study of an administratively defined district of Novosibirsk was conducted to identify residents with a first-ever stroke that occurred between Jan. 1, 1992, and Dec. 31, 1992. MATERIAL AND METHODS: For case ascertainment, mortality statistics, death certificates, hospital registrations, outpatient clinical data, and all ambulance calls for the study area were reviewed. Patients with stroke or suspected stroke were examined and interviewed by a cerebrovascular neurologist, and the type of stroke was determined. RESULTS: During the 12-month study period, 366 patients with first-ever stroke were registered. A diagnosis of cerebral infarction or intracerebral hemorrhage was confirmed by computed tomography or autopsy in 42% of cases. The diagnosis of subarachnoid hemorrhage was established by cerebrospinal fluid examination in all 14 cases. The age- and sex-adjusted annual incidence rate for stroke was 232 per 100,000. The distribution of incidence cases by diagnostic category was as follows: cerebral infarction, 87.7%; intracerebral hemorrhage, 8.5%; and subarachnoid hemorrhage, 3.8%. The overall 30-day case-fatality rate for stroke was 22.4%. Hypertension, angina pectoris, and cigarette smoking were the most frequent risk factors in patients with stroke in Novosibirsk. CONCLUSION: The incidence rate of first-ever stroke in Novosibirsk, Russia, is one of the highest in the world, but the 30-day case-fatality rates are similar to those in other populations.

Prevalence and risk factors of iron-deficiency in women of Chukotka.

A study of iron deficiency states (IDS) in Chukotkan native women aged 20-59 years revealed a relatively high prevalence of 36.4%. The prevalence of anemia was 5.6%. Some risk factors of IDS have been defined including frequent deliveries, prolonged lactation and also some peculiarities in the nutrition of these women.

Prevalence of diagnosed diabetes in circumpolar indigenous populations.

The prevalence of diagnosed diabetes in several genetically closely related indigenous populations in the circumpolar arctic and subarctic regions of Russia, Alaska and Canada is compared. The age-standardized (to the IARC's hypothetical world population) prevalence ranged from 1.8/1000 among the Chukchi and Eskimo of Chukotka, 3.6 and 7.9/1000 among the Eskimos/Inuit of the Canadian Northwest Territories (NWT) and Alaska respectively, 7.1, 9.3 and 18.6/1000 among Athapaskan Indians in the NWT, Yukon and Alaska respectively, to a high of 22.7/1000 among the Aleuts in Alaska. All are below the US all-race prevalence of 23.5/1000 and far below the extreme high prevalence reported from many North American Indian tribes. As a group, such arctic and subarctic peoples have a much shorter and less intense history of European contact and acculturation. Environmental factors are also likely to be responsible for the current differences between these indigenous populations in the circumpolar region, assuming that they share susceptibility genes for diabetes inferred from their close genetic relationships based on markers in other loci. Formal surveys of glucose tolerance and potential risk factors such as diet, physical activity, obesity, insulin resistance and genetic admixture in the circumpolar region would improve knowledge of the aetiology of diabetes in genetically and culturally diverse human populations.

The validation of serum thiocyanate smoking data in a population survey.

The estimation of smoking using blood serum thiocyanate concentration definition was performed in a representative sample of the population of the city of Novosibirsk. 1741 men and 1665 women aged 25-64 were surveyed. The concentration of blood serum thiocyanate increases with the number of cigarettes smoked, and depends on the time interval from the last smoking to the moment of taking the blood sample. It was shown that, as far as men are concerned, there is general agreement between the data obtained from the questionnaire on smoking and the data obtained through the biochemical estimation of inhaled tobacco smoke. In women, a discrepancy was noted between the data obtained using these two different methods.

Arterial-wall tissue factors influencing haemocoagulation, and their release into circulation in endarterectomy.

The wall of lover-limb arteries affected with severe atherosclerosis contains a Complex of substances with pro- and anticoagulative activities. The arterial wall, traumatized in endarterectomy by separation of the individual coats, releases procoagulative substances into blood circulation. The most conspicuous local manifestations of hypercoagulation and hypofibrinolysis appear on the day of surgery. The artery operated upon releases the thromboplastic factor for nine days; substances shortening the thrombin time (antiheparin substance, thrombin accelerator), for five days; and inhibitors of fibrinolysis, for four days after operation. A correlation was found between the regenerative process in the endarterectomized artery and the dynamics of the release of tissue factors influencing the haemocoagulation.