Findings described in this report are for 6,763 white male Seventh-day Adventists who completed a dietary questionnaire in 1960. Between 1960 and 1980 mortality data were collected on cohort members. Overweight men had a significantly higher risk of fatal prostate cancer than men near their desirable weight. The predicted relative risk of fatal prostate cancer was 2.5 for overweight men. Suggestive positive associations were also seen between fatal prostate cancer and the consumption of milk, cheese, eggs, and meat. There was an orderly dose-response between each of the four animal products and risk. The predicted relative risk of fatal prostate cancer was 3.6 for those who heavily consumed all four animal products. The results of this study and others suggest that animal product consumption and obesity may be risk factors for fatal prostate cancer.
This report examines the association between mortality from all causes during a 21-year period and frequency of consumption of 28 specific foods among 27,530 adult California members of the Seventh-Day Adventist Church. Food consumption was measured at the beginning of the study (1960) by a self-administered questionnaire. Deaths were identified by computer-assisted matching of study subjects to the file of death certificates for all deaths that occurred in California during 1960-1980. All-cause mortality showed a significant negative association with green salad consumption and a significant positive association with consumption of eggs and meat. For green salad and eggs, the association was stronger for women; for meat, the association was stronger for men. All the observed associations were adjusted for age, sex, smoking history, history of major chronic disease, and age at initial exposure to the Adventist Church.
We present a case of severe systolic anterior motion developing intraoperatively after aortic valve replacement for aortic valve stenosis.KEYWORDS aortic valve replacement; cardiopulmonary bypass; mitral valve; systolic anterior motion; transthoracic echocardiogram S ystolic anterior motion (SAM) of the mitral valve is a paradoxical motion of the anterior, and occasionally posterior, mitral valve leaflet toward the ventricular septum during ventricular systole. Although SAM is well reported in cases of hypertrophic cardiomyopathy, there are relatively fewer cases that describe severe SAM in association with aortic valve replacement (AVR) for aortic valve stenosis.
We performed a retrospective chart review to investigate a potential relation between pulmonary artery (PA) diameter as measured by intraoperative transesophageal echocardiography and PA pressures measured by PA catheter with the aim of determining whether main PA diameter can aid clinicians in the diagnosis of PA hypertension. A total of 82 adult patients undergoing cardiac surgery were included in our study. Main PA diameter showed a moderate correlation with systolic and diastolic pressures, r ¼ 0.576 (95% confidence interval [CI], 0.407-0.703), P < 0.001, and r ¼ 0.504 (95% CI, 0.319-0.648), P < 0.001, respectively. The authors believe that although a moderate correlation exists between main PA diameter and PA pressure, confounding hemodynamic variables prevent main PA diameter from being an accurate and reliable means of diagnosing PA hypertension.
Introduction: Delirium occurs frequently after lung transplantation and is associated with poor clinical outcomes. Significantly prolonged jugular venous congestion (JVC) occurs during off-pump lung transplantation and is thought to impair cerebral perfusion. Our study aimed to test the hypothesis that increased intraoperative JVC is associated with an increased risk of postoperative delirium among lung transplantation recipients. Methods: This is a retrospective observational cohort study. Adult patients who received off-pump lung transplantation at the Vanderbilt University Medical Center between 2006 and 2016 are included. The magnitude of JVC was calculated by the area under the curve (AUC) of the central venous pressure (CVP) above the threshold of 12 mmHg. Postoperative delirium was assessed by Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) criteria during their ICU stay. Multivariate regression analysis was used to determine the association of intraoperative JVC with postoperative delirium, adjusting for baseline demographics, surgical, and intraoperative characteristics.Results: Thirty-two (23.5%) out of 136 patients developed delirium in the ICU. There was no statistical difference in terms of intraoperative JVC between patients with delirium and those without (4058 ± 6650 vs. 3495 ± 10 151 mmHg min; p = .772).Furthermore, during multivariate regression analysis, JVC was not associated with an increased risk of delirium (odds ratio: 1.03 per 100 mmHg min increase in venous congestion; 95% confidence interval: .31, 3.39; p = .96).Conclusions: Delirium occurred frequently after off-pump lung transplantation.Although physiologically plausible, the present study did not find an association between increased JVC during off-pump lung transplantation and an increased risk of postoperative delirium.
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