An epidemiological study was conducted to determine the geographical variations in stroke mortality among three U.S. areas. They were Savannah, Georgia (high stroke rates), Hagerstown, Maryland (intermediate stroke rates) and Pueblo, Colorado (low stroke rates). In each area samples were drawn of the population in the 35--54 age group. The subjects were interviewed and examined to obtain the information required on medical conditions and/or living habits which would characterize each area. A brief medical and family history, as well as demographic and personal data, were obtained by interview. The medical examination included blood pressure, ECG, blood and urine chemistry, height and weight. In all three cities the response rate in the final sample selected was 90% (2,375 individuals) interviewed and 74% (1.939 individuals) examined.

An epidemiological study was conducted of geographic differences in stroke mortality between the following areas within the United States; Savannah, Georgia (high stroke rates), Hagerstown, Maryland (intermediate stroke rates) and Pueblo, Colorado (low stroke rates). Population samples 35--54 years of age of the three cities were drawn for interview and examination to determine medical conditions and living habits of these populations. The population samples were compared with emphasis on possible risk factors for stroke: serum cholesterol and glucose tolerance test determinations, weight and height measurements, blood pressure and cigarette smoking. The gradient of increasing prevalence of stroke-related risk factors from low to intermediate to high for the three cities was present for blood pressure in black females and white males and for glucose tolerance tests in whites and nonwhites. No other consistent pattern of increasing prevalence of risk factors for stroke was evident.

This is the second of a series of reports comparing 604 deaths from stroke among U.S. veterans over 12 months in 1967–1968 in Georgia with 560 stroke deaths in the states of Colorado, Idaho, Montana, Utah and Wyoming; 1210 and 1644 deaths randomly selected from all other deaths in 2 areas, respectively, in the same year are used as controls.

Background/aims To determine whether the development of non-arteritic anterior ischaemic optic neuropathy (NAION) is increased among patients newly diagnosed with obstructive sleep apnoea (OSA) in a large general population. Methods A 12-year nationwide, population-based, retrospective cohort study including 1 025 340 beneficiaries in the 2002–2013 Korean National Health Insurance Service database was performed. We identified 919 patients newly diagnosed with OSA aged ≥40 years and matched 9190 non-OSA controls using estimated propensity scores in reference to age, sex, demographics, comorbidities and co-medications. We applied Kaplan-Meier curves and Cox proportional hazard models to determine the risk of developing NAION in the OSA group compared with the non-OSA group. Results The 10-year incidence probability of NAION was higher in the OSA group (0.92%; 95% CI 0.88 to 0.97) than the non-OSA group (0.42%; 95% CI 0.41 to 0.44, p=0.002, log-rank test). The OSA group was at increased risk of developing NAION compared with the non-OSA group (HR 3.80; 95% CI 1.46 to 9.90) after adjusting for demographics, comorbidities and co-medications. Conclusions Our results suggest that patients with newly diagnosed OSA have an increased risk of NAION, although the absolute risk of NAION is low.

This is the third of a series of reports which compare 604 deaths from stroke in U.S. veterans between 1 July 1967 and 30 June 1968 in Georgia with 560 stroke deaths over the same period in the states of Colorado, Idaho, Montana, Utah and Wyoming; 1210 and 1644 deaths selected from among all other causes are used for controls.

The "Stroke Belt" describes a region of the southeastern United States with a high incidence of stroke and mortality due to stroke. In an effort to address the problem of stroke in this region, we have formed the Stroke Belt Consortium (SBC). This report describes the formation and functions of the SBC. The SBC is a unique organization with representatives from many areas, including health care, government, nonprofit organizations, the pharmaceutical industry, minority groups, educational groups, and managed care. The goals of the consortium are to advance public and professional education about stroke in the Stroke Belt, with a special emphasis on the populations in that region. The first meeting of the consortium was held in November 1994. Many helpful and innovative ideas and initiatives were generated at the first SBC meeting. These included improved techniques for professional education, the development of a mass media campaign for public education, screening of college students for stroke risk factors, and using fast-food restaurants and sporting events as venues to promote stroke education. This type of organized effort may produce cost-effective programs and initiatives, particularly for largescale educational efforts, that will enhance the prevention and treatment of stroke patients. If successful in the Stroke Belt, similar organizations can be formed in other regions of the nation to address specific issues related to stroke prevention, education, and treatment.

Clinical records relating to the last year of life of 2072 U.S. Veterans, who died in Georgia or in five western states during 1 yr, were reviewed to determine the occurrence of cerebrovascular disease as a cause of death.

We have conducted a study to examine some possible explanations for the apparent differences among various sections of the United States in mortality from cerebrovascular disease. Copies of death certificates were obtained for all male veterans who died during the 12 months from July 1967 to June 1968 in 5 western states, Colorado, Idaho, Montana, Utah and Wyoming, or in the state of Georgia. All death certificates showing an entry of nontraumatic cerebrovascular disease were included for study, and a sample of other deaths was selected for comparison.

We have compared the survival to 17 years after simple orchiectomy or after orchiectomy with retroperitoneal lymph node resection for germ cell tumors of the testis. The latter, more radical procedure may have had short-term value in men with embryonal carcinoma. Short-term value in other tumor groups, and long-term value in all tumor groups are questionable. In men who initially had clinical evidence of metastasis, radical surgery appears to have substantially improved survival. Only limited data on therapeutic irradiation were available, but survival was best in men whose multiportal skin exposures to radiation were between 5,000 R and 9,000 R. Deaths in the 3rd through the 17th year after surgery were grouped as due to metastases (37 cases), new primary malignancies (15 cases), irradiation effects (24 cases), or all other causes (30 cases). Deaths from metastasis tended to occur early, and accounted for over half of the mortality in years 3 to 7. Deaths from new primary malignancies are three times more common than expected. Radiation appears to diminish in importance as a cause of death while new primary malignancies become more important.

We have extended the follow-up for mortality to 17 years for 834 Army men treated surgically in the years 1940 to 1947 for germ cell tumors of the testis, the group first reported by Friedman and Moore and Dixon and Moore. Mortality was ascertained through the Veterans Administration by procedures known to be at least 98% complete. All other data used in this report were taken from punchcards prepared for the earlier work. Seventeen years after surgery, 53% of the 834 men were still alive, and 81% of 547 men who lived 2 years lived another 15 years. The prospect for survival to the 17th year after surgery for testis tumor never does quite achieve expectation as derived from the 1959–1961 life table for men. Men with embryonal carcinoma with or without seminoma, group II tumors as classified by Dixon and Moore, had the poorest survival at 2 years and also after 2 years, but survival after 2 years did not show the striking differences among tumor groups that were present in the first 2 years.

A study was made of the level of serum cholesterol in 783 men (approximately 13 per cent Negro) in 34 Veterans Administration Hospitals who had recent episodes of myocardial or cerebral infarction due to atherosclerosis. Myocardial infarction was present in 369 patients and cerebral infarction in 414 others. The diagnosis of either cerebral or myocardial infarction was based on well-defined clinical and laboratory criteria, the patients comprising part of the samples of two nationwide Veterans Administration studies of therapy in atherosclerosis. Blood samples for cholesterol determinations were taken approximately 4 weeks after discharge from the hospital at which time trial therapies were initiated. All determinations of serum cholesterol were made in a central research laboratory under carefully maintained standards.

For many years hypercholesterolemia has been associated with the development of atherosclerosis in experimental animals and with an increased incidence of coronary thrombosis in man. The correlation between elevated serum cholesterol and atherosclerotic heart disease has led to the therapeutic use of cholesterol-reducing diets and medications in patients with this disorder. On the other hand, the correlation between cerebral thrombosis and hypercholesterolemia has been less well studied, and efforts to reduce serum cholesterol in this form of atherosclerosis have not been widely recommended. Patients with cerebral atherosclerosis might be expected to have an elevation of serum cholesterol comparable to that found in coronary vascular disease; however, differences in age, sex, and racial incidence of the 2 diseases could possibly produce differences in the level of this serum lipid. Coronary thrombosis, for example, occurs much more frequently in males,1appears in lower age groups,2and has a lower incidence