Kindness is the language which the deaf can hear and the blind can see.

                                                                               Mark Twain

THURSDAY, Jan. 19 (HealthDay News) -- Up to 30 percent of stroke patients develop delirium shortly after hospitalization and these patients fare worse than those without delirium, a new study finds.

Canadian researchers reviewed 10 studies that included more than 2,000 patients who were hospitalized after suffering either an ischemic (caused by blood vessel blockage) or hemorrhagic (bleeding) stroke.

In most of the studies, 10 percent to 28 percent of the patients experienced delirium, an acute state of confusion that includes disorientation, attention deficit, altered and fluctuating mental status, and sometimes hallucinations. In one study, 48 percent of patients experienced delirium.

Compared to patients without delirium, those who experienced delirium were 4.7 times more likely to die in the hospital or within a year of hospitalization, three times more likely to be discharged to a long-term care facility, and they stayed in the hospital nine days longer.

In general, stroke patients who experience delirium are older, have more medical problems and suffer more severe strokes, which might explain why stroke patients with delirium do worse than others.

The study appears Jan. 19 in the journal Stroke.

Delirium in stroke patients can be caused by other problems such as medicines, infection, substance abuse, metabolic abnormalities, and renal or heart failure.

Recognizing the underlying problems that cause delirium in stroke patients might help improve their prognosis, study senior author Dr. Gustavo Saposnik, director of the Stroke Outcomes Research Center at St. Michael's Hospital in Toronto, said in a journal news release.

More information

The Royal Society of Psychiatrists in the U.K. has more about delirium  .

THURSDAY, Jan. 19 (HealthDay News) -- Millions of Americans have an undiagnosed artery disorder that can lead to high blood pressure, stroke and aneurysms, a new study reveals.

The disorder is fibromuscular dysplasia, an accumulation of fibrous tissues in the arteries that causes them to narrow. The condition can occur in any artery but occurs most often in kidney or neck arteries. It affects close to 4 percent of Americans.

If untreated, fibromuscular dysplasia can lead to a potentially fatal tear in the artery.

Most patients with the condition are women, and high blood pressure and headache are the most common symptoms, according to a presentation this week at the annual International Symposium on Endovascular Therapy in Miami Beach, Fla.

The data from 339 registry patients enrolled at seven U.S. centers showed that 91 percent of the patients were women and more than 95 had one or more symptoms. The most common symptoms were: high blood pressure (66 percent); headaches (53 percent); rhythmic ringing in the ears (30 percent); dizziness (28 percent); whooshing sound in the ear (24 percent); and neck pain (22 percent).

Nineteen percent of the patients had suffered a tear in an artery, most often in the carotid (neck) artery, and 17 percent had suffered an aneurysm (a bulge in an artery), most often in the renal (kidney) artery, the study authors reported in a symposium news release.

In a subgroup of 309 patients, fibromuscular dysplasia occurred in the kidney arteries of 69 percent of patients and in the neck arteries of 62 percent of patients. Many patients have fibromuscular dysplasia in both their kidney and neck arteries.

The disorder often goes undiagnosed because doctors rarely look for it. The condition is often found by accident when patients undergo medical imaging for other conditions. It can be diagnosed with ultrasound, angiography, CT angiography, and magnetic resonance angiography, the study authors pointed out.

"It's important to diagnose the disease because 20 percent of people who have fibromuscular dysplasia have an aneurysm somewhere in their body which could leak or burst, a life-threatening condition," Dr. Jeffrey Olin, director of vascular medicine at the Mount Sinai School of Medicine in New York City, said in the news release.

"Doctors need to look for fibromuscular dysplasia, particularly in patients younger than 35 who have high blood pressure or migraine-type headaches," he added.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about fibromuscular dysplasia.

WEDNESDAY, Jan. 11 (HealthDay News) -- If you're a healthy distance runner, your chances of dying from sudden cardiac arrest during a race are extremely slim, a new study indicates.

In the last decade, one of every 259,000 runners who competed in a U.S. marathon or half-marathon died, the researchers found. And most who collapsed had underlying heart disease.

The findings should reassure those who participate in the sport -- and many do, with more than 450,000 U.S. finishes a year, according to David Watt, executive director of the American Running Association.

The study began in 2000, led by Dr. Aaron Baggish, director of the Cardiovascular Performance Program at Massachusetts General Hospital in Boston. The researchers analyzed the cardiac arrests suffered among competitors in marathons (26.2 miles) or half marathons (13.1 miles) through 2010.

Of nearly 11 million U.S. distance runners, 59 had a cardiac arrest, meaning their heart suddenly stopped beating. Forty occurred in full marathons, and the average age of the stricken runners was 42. Men were at significantly higher risk than women.

Forty-two of the cardiac arrests (71 percent) were fatal, found the study, published in the Jan. 12 issue of the New England Journal of Medicine. The average age of those who died was 39, compared with 49 for arrest survivors.

For the study, yearly statistics on race participation, provided by the trade association Running USA, went into a database. Researchers identified cardiac arrest cases through a combination of methods, including public search engines and contact with race directors.

They interviewed racers who survived cardiac arrest, or next of kin, and looked at medical records and autopsy data. This information was available for 31 of the 59 affected runners.

A condition called hypertrophic cardiomyopathy was the definite or likely cause of death for 15 runners, they determined. The condition is the most common cause of sudden cardiac death in young athletes.

Hypertrophic cardiomyopathy is essentially an overgrown heart muscle, which usually comes from some genetic abnormality, explained Dr. Kirk Garratt, clinical director of interventional cardiology research at Lenox Hill Hospital in New York City.

Nine who died of hypertrophic cardiomyopathy had additional heart conditions, such as obstructive coronary artery disease, congenital disorders and myocarditis, an inflammation of the heart muscle.

"One interesting finding: prevalence of coronary artery disease was low," Garratt said.

One runner died of heat stroke and another of hyponatremia, which can occur when a person drinks too much fluid, without taking in enough sodium. Two were presumed to have died of arrhythmia, an abnormal heart rhythm.

A key factor in survival was receipt of cardiopulmonary resuscitation (CPR) from race bystanders, said Baggish, the cardiologist for the Boston Marathon.

"We're actually going to be for the first time offering CPR training to runners this year who come to Boston for our marathon," Baggish said.

Prompt defibrillation is also crucial, said study co-author Dr. William Roberts, a professor of family medicine at the University of Minnesota and medical director of the Twin Cities Marathon. At that race, "you're always within a mile of a defibrillator," he said.

Every year new races crop up, especially half-marathons, Watt said. And they attract a different breed of runner.

"Today's runner is older, slower, committed to going to more events, possibly not as athletic," he said. Some are "experiential" or social runners who come to bond, race for charities or lose weight.

In the study, men had a cardiac arrest rate of 0.16 arrests per 100,000 runners, nearly double that of women, but still extremely small.

Garratt had some reservations about the study methodology. "They went to a racing agency for the denominator. Then they went to a variety of sources, including Internet-based sources. To make it worse, for about half of the incidents, they were unable to get complete clinical information," he said.

Roberts acknowledged that their data didn't take marathon preparation into account. "How do we know how many people we lose with shorter [training] races?" he asked.

He said that with proper conditioning, distance running "is safe if you listen to your body, if you don't try to push through chest pain or shortness of breath, or if you don't ignore factors like very high cholesterol."

"All runners, whether they're young or old, should have a discussion with their doctors about their intent to run and in that discussion there should be a very clear assessment of risk factors," Baggish said.

More information

The Cleveland Clinic offers advice on marathon fitness preparation  .

WEDNESDAY, Jan. 11 (HealthDay News) -- People who own a car and a television tend to be at increased risk for heart attack, a new study finds.

On the other hand, people in developed and developing countries who are physically active during work and leisure time have a significantly lower risk of heart attack, the researchers found.

The findings come from an analysis of data from more than 29,000 people in 52 countries in Africa, Asia, Australia, North and South America, Europe and the Middle East. The study was published online Jan. 11 in the European Heart Journal.

"Until now, few studies have looked at the different aspects of physical activity both at work and during leisure time in relation to the risk of heart attacks," first author Dr. Claes Held, an associate professor at Uppsala Clinical Research Center and the cardiology department at Uppsala University Hospital in Sweden, said in a journal news release.

"Much is already known about the association between physical activity and cardiovascular risk, but what this study adds, among many other things, is a global perspective. The study shows that mild to moderate physical activity at work, and any level of physical activity during leisure time reduces the risk of heart attack, independent of other traditional risk factors in men and women of all ages, in most regions of the world and in countries with low, middle or high income levels. Interestingly, heavy physical labor at work did not protect against heart attacks," Held said.

The data analysis revealed that people who did light or moderate physical activity at work had a 22 percent and 11 percent lower risk of heart attack, respectively, than those who did little physical activity at work. However, heavy physical labor did not reduce heart attack risk.

Compared to those who did little physical activity during leisure time, the risk of heart attack was 13 percent lower for people who did mild physical activity and 24 percent lower for those who did moderate or strenuous activity during leisure time.

People who owned both a car and TV had a 27 percent higher risk of heart attack than those who owned neither a car nor TV.

A higher percentage of people in low-income nations had sedentary jobs and did less physical activity in their leisure time, compared to those in middle- and high-income countries, the researchers noted.

"These differences in PA [physical activity] were most pronounced regarding leisure-time activity," they wrote. "This may partly be explained by differences in education and other socio-economic factors. In addition, this may also reflect differences in culture and in climate." It's less likely that an individual will performing leisure-time physical activity in tropical or hot climate zones than in more temperate areas of the world, they added.

All people should be encouraged to get daily moderate exercise in order to prevent heart disease, the researchers concluded.

"The data have some real-life implications," Held said. One suggestion could be getting lower-income countries more involved in promoting physical activity as their societies start to use more labor-saving devices, he said.

More information

The U.S. National Heart, Lung, and Blood Institute offers a guide to physical activity.