[Endothelial dysfunction in ischemic strokes in diabetes mellitus].

The progression of an ischemic stroke concerns the activation of endothelial cells especially in patients with diabetes mellitus type 2. The aim of our study was to evaluate the endothelial dysfunction in patients with acute ischemic stroke with diabetes mellitus type 2. We measured the plasma activities of von Willebrand factor (vWf) as endothelial markers. The plasma vWf activities were significantly elevated in the index group compared to patients with ischemic stroke and arterial hypertension and controls. The correlation of the neurologic deficit severity to day 21 with the activity of endothelial dysfunction was revealed as well.

Risk factors for Alzheimer's disease in Russia: a case-control study.

No reliable data on risk factors of Alzheimer's disease (AD) are available in Russia. We aimed to evaluate the relative importance of various putative environmental and medical risk factors of AD in a Russian population. We conducted a hospital-based case-control study. Two hundred and sixty consecutive AD patients and an equal number of cognitive impairment-free control subjects matched for sex, age, level of education and place of birth selected from nursing homes and other long-term healthcare facilities in the Novosibirsk region for the period from 1998 to 2002 were examined. A conditional logistic regression analysis was employed to calculate odds ratios (OR) and corresponding 95% confidence intervals (CI) for various putative risk factors. Of the 260 patients with AD, 187 (72%) were females. Patients' age varied from 40 to 89 years (mean +/- SD: 69.2 +/- 7.7 years). The majority of the patients (77%) had secondary education and 12% had university education. Risk factors independently associated with AD were family history of parkinsonism among first-degree relatives (OR = 4.2; 95% CI 1.2-15.1), hypothyroidism (OR = 2.7; 95% CI 1.1-6.7), and history of head trauma with loss of consciousness (OR = 1.7; 95% CI 1.0-2.8). The most important risk factors for AD in the Russian community are family history of parkinsonism, hypothyroidism and a history of head trauma with loss of consciousness. These findings have implications for developing preventive strategies of AD.

[A study of the risk factors of stroke development in the framework of WHO program "MONICA-psychosocial"].

The study was conducted in the framework of WHO program "MONICA--psychosocial" in 1994-2002 using a randomized representative sample of males aged 25-64 years recruited from one district of Novosibirsk city. Over 8 years all stroke cases in the cohort have been registered and relative risk (RR) of stroke development was determined by special statistical methods. RR proved to be higher as follows: in males with depression--5,9-fold; with life exhaustion--3-fold; with low index of close relation--3-fold; with low index of social relations--4-fold; with sleep disturbance--2,7-fold; with stressful events in the family--2-fold; with stressful events at the job--4-fold. High level of hostility did not exert any influence on stroke development. Most frequently stroke occurred in men with higher negative psychosocial factors, i.e. widowers, divorced, those with primary and not-completed secondary school education and those engaged in hard and moderate manual labor as well as pensioners and individuals with low social support.

[The WHO program "MONICA-psychosocial": risk of stroke and psychosocial factors (epidemiological study)]. / Programma VOZ "MONICA-psikhosotsial'naia": risk vozniknoveniia insul'ta i psikhosotsial'nye faktory (épidemiologicheskoe issledovanie).

An aim of the study was to investigate the influence of psychosocial factors on risk of stroke development during 16 years in men aged 25-64 years. Three scanning population surveys (1984, 1988, 1994) have been conducted in the frame of the WHO program "MONICA-psychosocial". Men at the age of 25-64 years, dwelling in a district of Novosibirsk city, were studied during a control period of 1984-2000. Statistical analysis was performed using SPPS-10 statistical package. Cox-proportional regression model was used for relative risk evaluation. The highest percentage of patients with stroke was found in the older group of 55-64 years. A distribution of personality anxiety level in men who survived stroke was as follows: 72.2% with high anxiety level and 27.8%-with a moderate one. The highest relative risk of stroke was observed in men with high anxiety, who related to the following groups: widowed and divorced; with primary and not-completed secondary school education; pensioners and those engaged in hard and moderate manual labor. The highest relative risk was during the first 5 years, being 6.8 times higher in subjects with higher anxiety level than in those with moderate level. For the following 10 years, relative risk was 5 times higher in men with high level of anxiety and after 16 years it was 3 times higher than in those with moderate anxiety level. The results obtained suggest that stroke most often develops at age of 55-64 years; its risk is associated with social gradient and is highest in the first 5 years. To prevent stroke, conditions reducing an impact of psychosocial factors on population are needed.