Background and Purpose-The association between elevated blood pressure (BP) and hematoma enlargement in acute intracerebral hemorrhage (ICH) has not been clarified. We investigated the association between maximum systolic BP (SBP) and hematoma enlargement, measuring SBP between a baseline and a second CT scan in patients with hypertensive ICH. Methods-We assessed 76 consecutive patients with hypertensive ICH retrospectively. We usually attempted to lower SBP below targets of 140, 150, or 160 mm Hg. Recordings of serial BP from admission until the second CT scan were assessed. A neuroradiologist, who was not informed of the aim of this study, reviewed CT films. Hematoma enlargement was defined as an increase in volume of Ն140% or 12.5 cm 3 . Results-Hematoma enlargement occurred in 16 patients. Maximum SBP was significantly associated with hematoma enlargement (Pϭ0.0074). A logistic regression model for predicting hematoma enlargement was constructed with the use of maximum SBP, hematoma volume, and Glasgow Coma Scale score at admission. After adjustment for these factors, maximum SBP was independently associated with hematoma enlargement (odds ratio per mm Hg, 1.04; 95% CI, 1.01 to 1.07). Target SBPs of Ն160 mm Hg were significantly associated with hematoma enlargement compared with those of Յ150 mm Hg (Pϭ0.025). Conclusions-Our findings suggest that elevated BP increases the risk of hematoma enlargement. Efforts to lower SBP below 150 mm Hg may prevent this risk.

Prostate cancer can be diagnosed as an incidental finding during the pathological examination of benign prostatic hyperplasia (BPH) specimens by Holmium laser enucleation of the prostate (HoLEP). BPH and comorbidities such as hypertension, diabetes, and dyslipidemia often coexist in elderly people. We identified which comorbidities can be used to predict the presence of incidental prostate cancer, particularly high-risk cancer, in men who had undergone HoLEP. On the basis of pathological findings of HoLEP specimens, patients with incidental cancer were categorized as low-risk (Gleason ≤6 and T1a) or high-risk (all others). Of the 654 patients who underwent HoLEP, 41 patients (6.3%) were identified as having incidental cancer (25 low-risk and 16 high-risk). There were no significant factors for overall prostate cancers. However, a significantly higher frequency of diabetes was observed in patients with high-risk cancer compared to those with BPH (31% vs. 13%; p = .033). Logistic regression analysis using prostate-specific antigen (PSA) and prostate volume (PV), and smoking showed that diabetes was an independent predictor of high-risk cancer (odds ratio, 3.15; 95% confidence interval, 1.06-9.43). Diabetes may be an important predictor of the presence of high-risk prostate cancer in men with BPH who have undergone HoLEP.

Complicating infection was an independent predictor of a prolonged ICU stay in patients with ICH.

There have been numerous studies of the relationship between intracerebral hemorrhage (ICH) and meteorological conditions, but their conclusions have been inconsistent. Poor discrimination of ICH subtypes (primary or secondary) may have obscured the conclusions. Although most studies have analyzed seasonal or monthly variation, daily meteorological data are more appropriate for determining whether weather conditions play a role in triggering the onset of ICH. No studies have examined the activity and location of patients at the time of onset. The aim of this study was to evaluate the relationship between the occurrence of hypertensive ICH and daily meteorological parameters, in addition to examining the effect of the location and activity of the patient at the time of onset. We analyzed 138 patients with severe hypertensive ICH in a hospital-based population. We assessed whether daily meteorological parameters for the days on which ICH occurred differed from the days without ICH onset. Days on which hypertensive ICH occurred had a significantly lower minimum temperature and a decreased minimum temperature from that of the previous day ( P=0.042 [corrected] and 0.012 [corrected] respectively). There were no significant differences among subgroups of patients categorized according to their location and activity at the time of onset for any of the meteorological parameters.

Alleviation of caregiver' burden was essential for continuous stay at home of elderly people regardless of care-needs levels. Also, the HN service was founded as the relevant LTCI service factor for staying at home continuously. The HN service use might affect the outcome when we consider the causal relationship. Therefore, the policy for the promotion of HN service use will be important to achieve the ultimate goal of LTCI, which is to allow elderly people to live in their communities for as long as possible.