Evaluation of hypertensive retinopathy in patients of essential hypertension with high serum lipids

Purpose: To evaluate the role of hyperlipidemia on fundus changes in hypertensive patients and to correlate the above findings with components of lipid profile. Materials and Methods: A cross-sectional study was carried out in 100 patients who were diagnosed to have systemic hypertension. Patients suffering from diabetes, high myopia, patients with hazy ocular media, and other retinal vascular disorders were excluded from the study. A detailed evaluation of patients′ hypertensive status was carried out by a physician after ruling out secondary causes of hypertension. Their detailed ophthalmological examination was carried out. All the patients were investigated for fasting serum lipid profile. Results: Out of the 100 patients with essential hypertension, 69 (69%) had retinopathy and the remaining 31 (31%) subjects having retinopathy were mainly concentrated in the 6 th decade (69.70%), increasing thereafter up to 83.78% who were over 60 years of age. This shows the increasing prevalence of hypertensive retinopathy with increasing age. No sex preponderance toward developing retinopathy was found in this study (o < 0.29). A positive correlation of hypertensive retinopathy was found with total cholesterol (P < 0.002), low-density lipoprotein (LDL)-cholesterol (P < 0.0001), Serum triglycerides (P < 0.01), and an low-density lipoprotein: high-density lipoprotein (LDL:HDL) ratio (P < 0.002). Conclusion: This study proved a definite association between serum lipid parameters and the prevalence of hypertensive retinopathy

Is age a barrier to pancreaticoduodenectomy? An Italian dual-institution study

The aim of this study is to evaluate the role of age after pancreaticoduodenectomy. This is a retrospective study of 223 patients who underwent pancreaticoduodenectomy for periampullary diseases. Three age groups of patients were compared: ≤70 years of age (group A); between 71 and 79 years of age (group B) and 80 years of age or older (group C). The primary endpoint was the postoperative mortality rate. Secondary endpoints were the overall postoperative morbidity, postoperative pancreatic fistula, postoperative pancreatic haemorrhage, bile leakage, delayed gastric emptying rates, the length of hospital stay, intensive care unit stay, the type of discharge from hospital, reoperation rate and overall survival. Uni-multivariate analyses and Kaplan-Meier curve were carried out. At univariate analysis, only the type of discharge from hospital showed that group B and C patients required a period of rehabilitation more frequently than group A (P = 0.047 and P < 0.001, respectively). Multivariate analysis confirmed that age was not related to postoperative mortality (P = 0.258), morbidity (P = 0.912) and overall survival (P = 0.658), but it was related to type of discharge (P < 0.001). The present study seems to suggest that a pancreaticoduodenectomy is a feasible and safe procedure, even in elderly and very elderly patients even if the latter require a longer period of rehabilitation