To assess the role of acute alcohol ingestion as a risk factor for cerebral infarction, we administered a pretested questionnaire to 205 middle-aged and elderly acute ischemic stroke patients and 410 outpatient controls matched by age, sex, race, and method of hospital payment. Paired Mantel-Haenszel analysis revealed that alcohol ingestion within 24 (p = 0.07) and 72 (p = 0.001) hours of stroke onset and medical histories of smoking (p <0.0001), hypertension (p <0.001), and transient ischemic attacks (p = 0.051) were more common among stroke index cases than controls. Matched multiple logistic analysis revealed that both hypertension (p < 0.05) and smoking (p < 0.05) were independently associated with stroke, while alcohol consumption was not. In analyses to assess the possibility of mutual confounding effects of independent variables, the effect of alcohol ingestion was lost when adjusting for smoking. We conclude that acute alcohol ingestion is not an independent risk factor for cerebral infarction in middle-aged and elderly patients. The apparent association between alcohol ingestion and ischemic stroke may be the result of the confounding effects of smoking. suggest an association between alcohol intake and cerebral infarction or risk of death from stroke. Cerebral infarction has been reported following occasional ethanol intoxication or regular heavy drinking. "4 Younger individuals appear to be at particularly high risk; however, a paucity of controlled data is available to assess the relation in older populations. 14 The present study is a case-control study exploring the association between acute alcohol ingestion and ischemic stroke in predominantly black, middle-aged and elderly patients at 3 urban medical centers in Chicago, 111. Subjects and Methods Study PopulationTwo hundred and five consecutive acute ischemic stroke patients (index cases) hospitalized at the Michael Reese Hospital and Medical Center, the Univer- Supported in part by a Student Scholarship in Stroke, American Heart Association to J.C.; National Institutes of Health Contract #N01-NS-2-2399; and a grant from the AMOCO Foundation.Address for reprints: Philip B. Gorelick, MD, Department of Neurology, Michael Reese Hospital, 31st at Lake Shore Drive, Chicago, IL 60616.Received July 30, 1986; accepted December 10, 1986. sity of Illinois Hospital, and the Westside Veterans Administration Hospital between January 1,1984, and January 1, 1985, were included in the study. Index cases were selected if they were 44 years of age or older, had experienced their first carotid or vertebrobasilar ischemic stroke, and had cranial computed tomography (CCT) consistent with acute cerebral infarction." CCT studies were reviewed by one of the principal investigators and a neuroradiologist before patient entry into the study. Patients were excluded if there was transient cerebral ischemia only, subarachnoid hemorrhage, intraparenchymal hemorrhage, nonatherosclerotic stroke, 16 moderate or severe aphasia, or a moribund state. The diagnosis of cerebral in...

There are several controversies about the key factors for achieving a successful nutritional follow‐up aimed to weight loss. Patients' enthusiasm is considered as an important issue. Therefore the objective of the present study was to evaluate patients' perception about their own effort to accomplish nutritional recommendations, (highly attached, mildly attached or poorly attached) from the 1st to the 4th visit for the treatment. Percentages of patients who lost weight or body fat between visits were calculated. Results: 214 patients, both genders were considered in the analysis. Patients were certain of their achievements; as expected, in each visit, the patients who lost more weight and body fat, were those who considered themselves highly attached to their nutritional treatment. 62% with high attachment lost body fat while 84% lost weight between second and first visit. In comparison with those who showed poor attachment (57% lost body fat and 64% lost weight). There were no statistical differences between visits, the same behavior was seen between third and second visit and between third and fourth visit.. These findings show that self‐awareness is an important behavioral factor that improve adherence.