Epstein and Eckoff in 1967 devised a scheme to summarize population differences in the rise of mean values of systolic blood pressure by age in accordance with their slopes and levels. For the first time, the validity of this scheme can be examined with data from a single study, INTERSALT. This study included 52 populations in 32 countries. On the basis of these data, collected in an exceptionally well-standardized mode under a common protocol, the diversity of populations in the slopes of age differences in median values of systolic blood pressure has been strongly reconfirmed. Populations with no increase in median systolic blood pressure were again observed and remained exceptional. The analyses of these data also indicate a positive relation between the slope of rising systolic blood pressure with age and urinary sodium, urinary sodiumpotassium ratio, and reported alcohol consumption as well as a negative association between urinary potassium excretion and M ean values of systolic blood pressure (SBP) increase with age among adults in most populations. Epstein and Eckoff 1 in 1967 demonstrated marked variation among populations with respect to the nature of this increase. They devised a scheme to summarize differences in SBP by age in accordance with the slopes (categories 0 through 4) and levels (categories a through c) that generally described the results of 34 cross-sectional surveys reported by 1965 (Fig 1).The average increments in blood pressure per year of age corresponding to these slopes can be estimated as follows from Fig 1: 0=0 mm Hg/y, 1=0.17 mmHg/y, 2=0.33 mm Hg/y, 3=0.50 mm Hg/y, and 4=0.67 mm Hg/ y. Populations with no increase were exceptional; among the remaining majority, the greatest incremental differences observed by year of age were four times as great as the least incremental differences. Nearly all potential combinations of slope and level in the scheme were observed within the set of surveys reviewed. This scheme thus demonstrated striking evidence of the diversity among populations in this aspect of the epidemiology of blood pressure. Recently, data published by the INTERSALT Cooperative Research Group 26 allow direct examination of these issues. INTERSALT is a landmark international collaborative study in which coordinated, highly standardized measurements of blood pressure and related factors were obtained in some 10 000 participants aged 20 to 59 years in 52 populations in 32 countries. Based on the resulting data, for the first time the scheme of Epstein and Eckoff can be tested with data from a single study, with greatly reduced chances of systematic errors of blood pressure measurement, in contrast to the previous surveys designed and conducted independently. We have therefore used the data reported by the INTERSALT group to reexamine the population diversity characterized by Epstein and Eckoff some 25 years ago. These data permit both replication of their classification of populations by slope and level and consideration of the relation between these parameters ...
HighlightsIntestinal angiosarcoma is a diagnostic challenge due to non-specific clinical presentation and rarity.The diagnosis of intestinal angiosarcoma must be considered in a patient with gastrointestinal bleeding and history of radiation therapy.The adjuvant therapy to intestinal angiosarcoma is not well established.
INTRODUCTIONHemophilic pseudotumor is a rare complication that occurs in patients with severe hemophilia. Results from multiple episodes of bleeding into the bones and soft tissues.PRESENTATION OF CASEA 31 years old male patient, with severe hemophilia A. Diagnosed with an abdominal tumor 10 years ago during routine screening, that progressively grew to encompass the entire abdominal area, with symptoms of intestinal obstruction.DISCUSSIONHemophilic pseudotumor appears as a painless tumor of slow growth that can compress vital organs producing bone destruction, muscle and skin necrosis. The tumor may have fistulas or break spontaneously.CONCLUSIONThe abdominal hemophilic pseudotumor is a rare pathological entity, with few reports worldwide, but must be considered in hemophilic patients with a well documented abdominal tumor.
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