气象因素与脑血管病关系的研究

目的 探讨脑血管病发病与气象因素间的关系。方法 收集青岛市1998～2002年6186例脑血管病患者[脑出血（CH）1179例、脑梗死（C1）4821例、蛛网膜下腔出血（SAH）186例]的发病时间及同期的月平均气温、气压、相对湿度、风速等气象资料。圆分布分析脑血管病发病的季节规律；直线相关、多元逐步回归分析气象因素与脑血管病发病之间的关系。结果 CH冬季高发，平均角在1月份（P〈0．05）；CI及SAH均于秋季高发，平均角在10门份（均P〈0．05）。CH多发于低气温、高气压的气象条件（r=-0．370、0．349，均P〈0．05），CI多发于高温、高气压、低湿度的气象条件（r=0．308、0．264、-0．370，均P〈0．05）。影响月发病人数的气象因素，CH是月平均气压、相对湿度和风速，CI是月平均气压和气温。结论 气象因素是脑血管病发病的影响因素，在脑血管病的预防工作中应充分考虑其发病的季节特点。气象因素为自变量的多元逐步回归方程不宜用来进行预测发病人数。     

脑梗死发病与气象因素的关系及其预测研究

目的分析青岛市脑梗死(CI)发病的时间变化规律,探讨青岛市气象因素对脑梗死CI发病的影响及其预测.方法收集青岛市1998年～2002年5年间4821例CI患者的发病时间及同期的气温、气压、相对湿度、风速等气象资料;圆分布分析探讨CI发病的时间规律,直线相关、多元逐步回归研究CI发病与气象因素之间的关系.结果(1)4821例CI患者中男性比例(55%)高于女性(45%)(x2=52.06,P＜0.01),男性发病年龄低于女性(男性67.7(10.8)岁,女性69.1(9.3岁),u=4.97,P＜0.01);(2)男、女性CI都在秋季高发,平均角所对应日期在10月(P＜0.05);(3)CI发病多见于高温、高气压、低湿度的气象条件(r=0.308,0.264,-0.370,P＜0.05),多元逐步回归筛选出来影响CI月发病人数的气象因素依次是月平均气压和月平均气温.结论气象因素是CI发病的影响因素,但由于较低的校正R2,故以气象因素为自变量的多元逐步回归方程不宜用来预测CI发病人数.     

气象因素与急性脑梗死发病相关性的研究

目的探讨天津市急性脑梗死发病与气象因素的相关性。方法回顾性分析我院2009年²013年急性脑梗死患者1198例及同期的气温、气压、相对湿度等气象资料;采用圆分布分析急性脑梗死发病的季节规律、直线相关分析及多元逐步回归分析气象因素与急性脑梗死发病之间的关系。结果 (1)急性脑梗死冬季高发,平均角在1月份(P<0.05);(2)急性脑梗死月发病例数与月平均气温、月平均最高气温、月平均最低气温呈负相关(P<0.05),与月平均气压正相关(P<0.05);(3)多元逐步回归筛选出来影响急性脑梗死月发病例数的气象因素是月平均最低气温,其次为月平均日较差。结论气象因素是脑梗死发病的影响因素,在冬季、低气温、高气压气象条件下脑梗死发病率高,这为制定脑血管病相应防治措施提供了依据。     

复发性抑郁障碍发病与季节气象要素变化的关联分析

目的了解抑郁障碍的复发与季节气象要素变化的相关性,为复发性抑郁障碍的防治提供参考。方法收集2013年-2017年深圳市某精神病专科医院复发性抑郁障碍住院患者病历资料和同期气象资料,对复发性抑郁障碍月入院量与同期各气象要素进行相关分析,采用多元线性回归模型进一步分析季节气象因素对抑郁障碍复发的影响。结果复发性抑郁障碍月入院量最多的三个月份分别为5月[85例(10. 39%)]、7月[78例(9. 54%)]和8月[77例(9. 41%)];入院量最多的季节为秋季[226例(27. 6%)],其次为夏季[212例(25. 9%)]。不同性别的复发性抑郁障碍月入院量差异无统计学意义(χ~2=9. 947,P0. 05)。复发性抑郁障碍患者月入院量与月平均降水量、月平均相对湿度呈正相关(r=0. 292、0. 370,P0. 05),与月平均风速呈负相关(r=-0. 475,P0. 05)。多元线性回归分析表明,月均风速越慢、月均湿度越高,复发性抑郁障碍入院量越高(P0. 05)。结论复发性抑郁障碍发病具有季节性,气象要素变化与复发性抑郁障碍发病存在关联,尤其是湿度与风速变化。     

情感性精神障碍与气象要素

目的探讨情感性精神障碍与气象要素的关系。方法对天津市安定医院1997-1999年情感性精神障碍月入院量和同期气象资料的相关性进行回顾性分析。结果情感性精神障碍月入院量与同期气压、日照有显著意义的相关。结论日照、气压和风速可能是情感性精神障碍发病的主要气象影响因素。     

C反应蛋白在缺血性卒中病情以及预后评估中的价值

目的探讨C反应蛋白水平(CRP)与初次缺血性卒中的病情的严重程度以及预后的相关性。方法连续性纳入2013年10月-2014年6月在郑州大学附属洛阳中心医院神经内科住院的发病时间≤72 h的首发缺血性卒中患者(CT或核磁共振证实),进行回顾性分析,按发病至入院时间在24 h、48 h、72 h之内将患者分组,进行CRP测定,同时在入院时及住院第10天分别进行NIHSS评分,分析两者的相关性。结果共纳入103例符合标准的缺血性卒中患者。发病24 h、48 h和72 h内入院患者,C反应蛋白水平比较无统计学差异。72 h内所有入院患者,CRP水平与入院时NIHSS评分严重程度正相关(r=0.683,P0.001);其中CRP≥6 mg/L患者的CRP值与NIHSS评分正相关(r=0.661,P0.001),而CRP6 mg/L患者的CRP值与NIHSS评分无相关性(r=-0.117,P=0.322)。72 h内入院患者的CRP值与住院10 d的NIHSS评分相对恢复率呈负相关(r=-0.252,P=0.010);其中经调整的CRP≥6 mg/L患者的CRP值与住院10 d时NIHSS评分相对恢复率呈负相关(r=-0.449,P=0.019)。结论 C反应蛋白可作为缺血性脑卒中发病严重程度以及预后判断的监控指标,是缺血性脑卒中发生、发展以及预后评价的敏感指标。     

动态气象变化对脑血管病发病的影响

目的：探讨气象因素尤其是动态气象变化对脑血管病发病的影响。方法：本研究收集了三年４３４例急性脑血管病病人发病时、病前６小时、２４小时详尽的气象资料，包括温度、气压、水汽、相对湿度及各种气象条件的极值和平均值，并对脑出血和脑梗塞发病的气象差异进行了分析。结果：各种气象条件对脑血管病发病均有影响，尤以动态气象变化的影响更明显，脑出血多见于高压、低温、低湿天气，脑梗塞的发病条件则相反。多元回归分析发现，起主要作用的有４个气象因素，即发病时温度与当日极高温度的温差，病前２４小时的气压，发病时气压与极低气压的压差，病前６小时的相对湿度，以此建立方程，经判别分析，误判率大于３０％。同时对脑出血和脑梗塞的发病高峰时间进行了分析，发现脑出血有一个年发病高峰和一个日发病高峰，分别为每年１２月～１月和下午４～５时，脑梗塞有两个年发病高峰，即每年春夏之交和秋冬之交，有１个日发病高峰，即晨８时左右。结论：气象因素对脑血管病发病确有影响，是脑血管病的一个危险因素     

张家口市气象因素变化与急性脑卒中疾病的相关性研究

目的 探讨张家口市气象因素变化与急性脑卒中疾病的相关性。方法 收集2018年2月至2020年6月在该院神经内科住院的1 426例患者资料进行回顾性分析。收集患者人口学特征、生活方式、入院时季节及入院时气候信息。根据患者入住医院病因是否为脑卒中将其分为2组,已确诊患有脑卒中疾病者为脑卒中组,其他疾病患者为非脑卒中组。比较2组患者上述各因素,并采用多因素Logistic回归分析判断各因素对脑卒中发病的综合作用。结果 调查的1 426例患者中共有327例(22.92%)为脑卒中患者,多因素Logistic回归分析结果显示,患者年龄增长(OR=1.474,95%CI=1.073~2.025)、有吸烟史(OR=1.493,95%CI=1.033~2.159 )、有饮酒史(OR=1.530,95%CI=1.094~2.139)、秋季(OR=1.418,95%CI=1.006~1.998)、冬季(OR=1.464,95%CI=1.035~2.071)、月平均气温下降(OR=1.486,95%CI=1.016~2.173)、月平均气压升高(OR=1.442,95%CI=1.009~2.060)为脑卒中发病的危险因素(P<0.05)。结论 张家口市脑卒中患者在秋、冬季节高发,月平均气温下降及月平均气压升高为张家口市脑卒中患者发病的危险因素,另外年龄、吸烟史、饮酒史也与脑卒中的发生密切相关。     

急性缺血性卒中患者胆碱能通路损伤与血管性认知障碍的相关性研究

目的 探索急性缺血性卒中患者胆碱能通路损伤与血管性认知障碍(VCI)的相关性.方法 连续收集在天津医科大学总医院神经内科住院的急性缺血性卒中患者87例.采用简易智能精神状态检查量表(MMSE)及蒙特利尔认知评估量表(MoCA)进行认知评估,同时使用脑胆碱能通路白质量表(CHIPS)和Fazekas量表进行脑白质病变测评,评价其对VCI的应用价值,并分析影像学评分与认知评估间的相关性.结果 以MMSE、MoCA作为界定认知障碍的标准时,缺血性卒中患者急性期认知障碍发生率分别为26.4％、79.3％,差异有统计学意义(P=0.000).CHIPS与MMSE、MoCA量表评分总分均呈负相关(r=-0.378,P=0.043;r =-0.504,P=0.005);Fazekas与MMSE及MoCA量表评分总分均无明显相关性(r=-0.094,P =0.627;r=-0.410,P =0.056);CHIPS评分与MoCA分项中视空间与执行功能、注意与抽象能力下降呈负相关,其中与视空间与执行功能下降关系最为密切(r=-0.514,P=0.004),而Fazekas评分仅与注意能力下降存在相关性(r=-0.404,P=0.030).结论 急性缺血性卒中患者胆碱能通路损伤与白质病变所致VCI相关;MoCA与CHIPS评分联合应用可以作为简便、快速筛查和评定白质病变所致VCI的良好工具.     

脑胶质瘤病人的预后多因素生存分析与相关性研究

目的研究影响脑胶质瘤病人生存和预后的相关因素,以及相关因素之间的相关性。方法 2005年1月-2009年6月在河北医科大学第二医院神经外科住院及接受手术治疗的脑胶质瘤患者79例,对其年龄、性别、术前KPS评分、发病至就诊时间、术前抽搐、肿瘤直径、肿瘤术中切除范围、肿瘤病理分级、术后放疗、术后化疗、肿瘤分子标志物如多发性进展期癌突变基因(PTEN)、抑癌基因P53、增殖细胞核抗原(PCNA)、DNA修复蛋白O6-甲基鸟嘌呤DNA甲基转移酶(MGMT)、基质金属蛋白酶9(MMP-9)及多药耐药基因(P170)的表达情况共16项因素进行生存分析。对肿瘤级别、肿瘤分子标志物之间的相关性使用Spearman相关性检验进行分析。结果单因素分析结果示:术前KPS评分、发病至就诊时间、术前抽搐、肿瘤切除范围、肿瘤病理分级、术后放疗、术后化疗、MMP-9的表达情况具有统计学意义。多因素分析结果示:术前KPS评分≥70的患者生存时间较长(P=0.047),术前有抽搐症状的患者生存时间较长(P=0.025),术中全切的患者生存时间较长(P=0.037),术后结合化疗的患者生存时间较长(P=0.005)。相关性分析结果显示:肿瘤级别与PCNA的表达情况呈正相关(r=0.250,P=0.027),PTEN与P170在胶质瘤的表达情况中成负相关(r=-0.252,P=0.025),MMP-9与P170在胶质瘤的表达情况中成正相关(r=0.382,P=0.001)。结论胶质瘤患者术前KPS评分≥70、术前有抽搐症状、肿瘤术中全切、术后结合化疗的患者生存时间较长,是脑胶质瘤患者预后较好的有利因素。     

Meteorological Factors and Seasonal Stroke Rates: A Four-year Comprehensive Study

Introduction: There is a growing body of evidence suggesting that acute cardiovascular events including stroke are not distributed randomly over time but instead depend on months/season of the year. We report the impact of meteorological variables in extremely hot and arid climate on stroke. Methods: Acute stroke patients admitted from January 2014 to December 2017 were included. The data included demographics, clinical risk factors, temperature, solar radiation, relative humidity, dew point, wind speed, and atmospheric pressure. We calculated stroke rates/100,000/month. Results: There were 3654 cases of stroke (ischemic stroke [IS]: 2956 [80.9%]; and intracerebral hemorrhage [ICH]: 698 [19.1%]) with no difference in hematocrit, creatinine, and blood urea between hot and cold seasons (p > .05). We observed a positive significant correlation of IS with the mean temperature (AOR: 1.023; 95% CI: 1.009-1.036; P = .001) and mean solar radiation (AOR: 1.268; 95% CI: 1.021-1.575; P = .032) showing a 2.3% and 26.8% higher risk relative to ICH respectively, a negative correlation between IS with relative humidity (AOR: 0.99; 95% CI: 0.984-0.997; P = .002), and atmospheric pressure (AOR: 0.977; 95% CI: 0.966-0.989; P < .001) was observed, 1% increase in the relative humidity correlate with 2.4% and 1% lower risk of IS incidence relative to ICH respectively. Conclusion: We demonstrated a distinct seasonal pattern in the incidence of stroke with an increase in IS rates relative to ICH during the summer months with higher solar radiations that cannot be explained by physiological measures suggestive of dehydration or hem-concentration.     

Influence of climatic factors in the incidence of multiple sclerosis relapses in a Portuguese population

Background and purpose:  Environmental factors are thought to be important in multiple sclerosis (MS) pathophysiology. We aimed to evaluate if there was an association between MS relapses and some climatic factors in a Portuguese population.
Methods:  Four year retrospective study analyzing 414 MS relapses in 249 consecutive relapsing–remitting patients. Non-parametric statistics were used to compare the distribution of relapses across months and seasons. Spearman's coefficient was determined to evaluate the correlation between relapses frequency and maximum and minimum atmospheric temperatures, humidity and atmospheric pressure.
Results:  The mean number of relapses was not significantly different between months or seasons. No correlation was found between relapse frequency and any climatic factor.
Conclusion:  Our series is one of the largest addressing the influence of specific climatic factors on MS relapses. The number of clinical MS relapses seems to be unrelated to climatic factors.     

Association of environmental factors with the onset of status epilepticus

OBJECTIVE: The goal of the work described here was to investigate the influence of environmental factors on admissions of patients with status epilepticus (SE) to the intensive care unit (ICU). METHODS: This retrospective cohort study analyzed all admissions to a university hospital ICU because of SE. Poisson regression and likelihood ratio tests were employed to determine associations between environmental factors and the incidence of SE. RESULTS: Data on 184 patients (mean age: 57, range: 18-89) indicated a significant (P<0.0001) diurnal pattern, with admissions peaking between 4 and 5 PM and reaching a minimum in the early morning. No significant weekly, monthly, or seasonal pattern was observed. Admissions varied significantly across the lunar cycle (P=0.003), peaking at Day 3 after new moon and being minimal 3 days before new moon. The incidence of SE increased on bright days (P=0.04) and with the duration of daily sunshine (P=0.03). High relative humidity (P<0.01), high temperature (P<0.05), and dark days (P=0.02) were significantly protective factors. The incidence of SE on weekends was significantly lower in the subgroup of patients with known epilepsy (P=0.004), and the risk of nonconvulsive SE was significantly higher in summer (P=0.04). CONCLUSIONS: Admissions of patients with SE to the ICU are significantly associated with several environmental protective and precipitating factors, such as diurnal, weekly, and lunar cycles and weather variables.     

Synchronized annual rhythms in violent suicide rate,ambient temperature and the light-dark span

To investigate whether violent and nonviolent suicide and homicide are related to atmospheric or geomagnetic activity, we investigated the relationships between weekly number of suicides or homicides for all Belgium for the period 1979–1987, and ambient temperature, relative humidity, air pressure, hours of sunlight and precipitation per day, wind speed and geomagnetic index. The occurrence of violent suicide was significantly and positively related to ambient temperature, sunlight duration, an increase in temperature over the few past weeks, and negatively to relative humidity. Higher ambient temperature and an increase in air temperature over the few past weeks were the most significant climatic predictors of violent suicide rate. A highly significant common annual rhythm with a common acrophase of 190° was detected in violent suicide rate, ambient temperature and sunlight duration. No significant time-relationships between nonviolent suicide or homicide and any of the weather variables were found. It is concluded that i) violent suicide may be related to short-term fluctuations in the weather and in particular to temperature; and ii) the annual rhythm in violent suicide may be synchronized by the annual rhythms in ambient temperature and light-dark span.     

Does proximity to clinic affect immunization rates and blood pressure?

OBJECTIVE: Primary care clinics are frequently placed in neighborhoods to improve access. Little is known whether or not this improves outcomes. We sought to determine if childhood immunization rates and adult blood pressure (BP) levels are related to proximity of home to clinic. METHOD: We conducted a retrospective chart review in a community family medicine clinic in a neighborhood grocery store (CC) and a hospital-based family medicine residency clinic (HC) in Milwaukee, Wisconsin. Randomly selected subjects included children aged 2-5 years (n = 151 CC; 241 HC) and adult continuity patients (n = 197 CC; 242 HC). ARC-GIS was used to geocode patient home addresses, and distances were analyzed using Kruskal-Wallis, Spearman's rank correlation, or Mann-Whitney test. Proportion of primary immunization by age 2 and age at completion, numerical BP, and proportion abnormal BP were each correlated to distance and driving distance to clinic. RESULTS: Median driving distance of patient to clinic was significantly less for CC than HC (children = 1.47 versus 2.35 miles, p < 0.0001; adults = 1.53 versus 3.12, p < 0.001). For each clinic, and for all subjects combined, and for subsets by gender, ethnicity and insurance status, there was no significant correlation between proportion immunized by age 2 or age at completion and linear or categorical driving distance (or linear distance) to clinic (p = 0.12-0.99), or between BP values or proportion abnormal and distances to clinic (p = 0.44-0.97). CONCLUSIONS: In this urban area, proximity of home to clinic did not correlate with primary immunization completion or blood pressure in either a hospital-based or a community clinic.     

Seasonal variation of Bell's palsy in Athens, Greece - a hospital-based retrospective evaluation over fifteen years

Epidemiological data on the incidence of Bell's palsy (BP) are conflicting. The aim of this retrospective study was to evaluate the variation of cases of BP acutely presented in the emergency room of our department over a 15-year period (January 1990 to December 2004). We examined the monthly and seasonal distribution of BPs among 36,312 patients who came to our emergency services and compared it with the assumed equal distribution of cases over the year (null hypothesis) using chi(2) techniques. During the observation period 1,252 of all patients (3.45%) presented due to BP. A decline during the summer was observed, in contrast to a peak documented during the autumn and winter. January and July were the months with the highest and lowest frequency of BP, respectively. Statistical analysis revealed a significantly different seasonal (chi(2) = 10.569; d.f. = 3; p = 0.014) and monthly (chi(2) = 25.445; d.f. = 11; p = 0.008) pattern of BP cases. The distribution of cases of BP shows a significant variation with a decline during the summer and an increase during the colder period of the year. A similar pattern has been described for reactivated herpetic ocular infections. Since a similar pathogenetic mechanism is regarded as the main cause of BP, the chronobiological aspects and the influence of meteorological factors on the reactivation of latent infections deserves further prospective evaluation.     

The cholinergic deficit coincides with Abeta deposition at the earliest histopathologic stages of Alzheimer disease

Effective therapeutic intervention in Alzheimer disease (AD) will be most effective if it is directed at early events in the pathogenic sequence. The cholinergic deficit may be such an early event. In the present study, the brains of 26 subjects who had no history of cognitive loss and who were in early histopathologic stages of AD (average Braak stage less than II) were examined at autopsy to determine whether a cortical cholinergic decrement was associated with Abeta concentration or deposition. In the superior frontal and inferior temporal gyri, the choline acetyltransferase (ChAT) activity of plaque-containing cases was significantly decreased (p < 0.05, unpaired, two-tailed t-tests), measuring 70.9% and 79.5%, respectively, relative to plaque-free cases. In the inferior temporal gyrus, Spearman's rank correlation analysis showed that ChAT activity had a significant inverse correlation with Abeta concentration (p = 0.075; r = -0.3552). The results indicate that the cholinergic deficit is established at an early histopathologic stage of AD, before the onset of clinical symptoms.     

Reliability and validity of questionnaire for neurobehavioral disability following traumatic brain injury

The neurobehavioral disability recognized in traumatic brain injury (TBI) is a severe sequela, but there is no appropriate classification due to its various manifestations. In the present study a questionnaire for a simple investigation of this disability was prepared, and its reliability and validity verified. The survey was conducted on 72 patients with TBI by the caregiver of each patient. As a result, good reliability was indicated by the split-half method (coefficient of reliability: 0.95, obtained using Spearman-Brown correction formula). The total score of the questionnaire had a significant correlation with the total score of the simultaneously conducted Japanese version of Neuropsychiatry Inventory at the 0.01 level (Spearman's rank correlation, 0.47). It also had a significant correlation with the total score of the simultaneously conducted Japanese version of the Dysexecutive Questionnaire at the 0.05 level (Spearman's rank correlation, 0.36). Six factors constituting this neurobehavioral disability were extracted from a factor analysis of the questionnaire survey. These factors are angry outburst, avolition, deficits of sympathy, depressed mood, discourse deficits, and degradation of appearance. Each factor indicated good internal consistency (Cronbach alpha, 0.86-0.94). The present results indicate that this questionnaire has good reliability and validity, therefore it can be a significant indicator in TBI neurobehavioral disability study.