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Query: UMLS:C0004153 (atherosclerosis)
77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Strokes in young adults are uncommon and often a diagnostic challenge. A retrospective study of strokes due to intracerebral hemorrhage, subarachnoid hemorrhage, or cerebral infarction was undertaken. We reviewed the medical records of 113 young patients aged 15-45 years who were admitted to the Medical Center Hospital of Vermont with a diagnosis of stroke between 1982 and 1987. This group comprised 8.5% of patients of all ages admitted for stroke, 2.3 times the proportion observed in the National Survey of Stroke. Nontraumatic intracerebral hemorrhage was diagnosed in 46 young patients (41%); the main causes included aneurysms, arteriovenous malformations, hypertension, and tumors. Subarachnoid hemorrhage was found in 19 young patients (17%); the majority were due to aneurysms. The remaining 48 young patients (42%) had cerebral infarction, the majority due to cardiogenic emboli and premature atherosclerosis. Mitral valve prolapse, the use of oral contraceptives, alcohol drinking, and migraine were infrequent sole causes of cerebral infarction in the absence of other risk factors. The case-fatality rate for this group of young patients with stroke was 20.4% compared with 23.9% for the National Survey of Stroke. Young adults with stroke deserve an extensive but tailored evaluation, which should include angiography and echocardiography.
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PMID:Stroke in young adults. 230 61

The "paradoxical" occurrence of high rates of stroke and low rates of coronary heart disease observed in Asian and other populations has been examined using accumulated clinical and autopsy data obtained during the long-term follow-up from 1965 to 1985 of cohorts of Japanese men living in Hawaii and Japan. The search for explanatory variables revealed three with the characteristics of having both opposing patterns of associations with clinical stroke compared with coronary heart disease and of being more prevalent in Japan than in Hawaii. These variables were low serum cholesterol levels, high intake of alcohol, and some aspect of an Oriental diet characterized by low intake of fat and protein from animal sources. Analysis of associations of these variables with measures of atherosclerosis in coronary and cerebral arteries revealed no paradoxical differences, with the possible exception of some dietary variables. Associations with autopsy-measured myocardial infarctions, cerebral infarction, and hemorrhage, however, showed opposing patterns similar to those found for clinical disease. The main inference from this work is that the paradoxically high risk of stroke observed in populations with low risk of coronary heart disease is not due to atherosclerosis in the major cerebral arteries. Rather, it is more likely due to lesions in the small intracerebral arteries and appears to be related to low levels of serum cholesterol, high alcohol intake, and some aspect of a traditional Oriental diet.
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PMID:The paradox of high risk of stroke in populations with low risk of coronary heart disease. 231 92

That non-rheumatic atrial fibrillation is an independent risk factor for cerebral infarction has not been established with certainty. The rationale underlying contemporary clinical trials of warfarin therapy for the prevention of stroke in patients who have non-rheumatic atrial fibrillation is that the majority of strokes in such patients are due to cardiogenic cerebral embolism. However, there is evidence to suggest that the increased probability of stroke attributed to this arrhythmia is due to its association with other risk factors such as hypertension, diabetes mellitus, and atherosclerosis. The question of who should be anticoagulated is a major public health issue since atrial fibrillation is present in approximately ten per cent of the general population aged 65 or more years.
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PMID:Is atrial fibrillation an independent risk factor for stroke? 235 52

Fifty six patients aged 17 to 45 years who had Ischemic Cerebral Infarction (I.C.I.) were studied. The following etiologies were established: 1. Juvenile atherosclerosis (21 patients); 2. Cerebral embolism either from cardiac (10 patients) and from unknown source (3 patients); 3. Secondary coagulopathies (4 patients); 4. Non atherosclerotic vasculopathies (6 patients); 5. Traumas of skull and neck (3 patients); 6. Migraine (2 patients); 7. Oral contraceptives use (1 patient). In 6 cases the etiology remained unknown. Young subjects with I.C.I. are a heterogeneous group: however in most of them a reasonable cause can be found. The occurrence of acute death (14%) was high, while recurrent stroke (5%) and non acute death (3%) were rare when compared to older patients. At the follow-up 80% had a very little residual motor deficit but only 43% were able to return to previous work.
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PMID:Ischaemic cerebral infarction in young adults. 236 Apr 74

It has been postulated that an accumulation of a sulfhydryl-containing amino acid, homocysteine in plasma may induce arteriosclerosis. In order to explore a possible contribution of homocysteine to the development of cerebral infarction in middle-aged and elderly patients, plasma sulfhydryl-containing amino acid profiles of 45 patients with cerebral infarction (CI) were compared with those of 45 normotensive and 45 hypertensive controls, and 20 patients with cerebral bleeding (CB), of similar ages and sex. The concentrations of both free and total homocysteine in plasma were highest in patients with CI among the 4 groups, while plasma free and total cysteinylglycine levels were similar. Although both free and total cysteine levels were also higher in patients with CI than in normotensive controls, the total homocysteine/total cysteine ratio was highest in patients with CI among the four groups. The hypertensive controls had higher plasma free and total concentrations than normotensive controls, but the levels did not differ between the 21 normotensive and 24 hypertensive CI patients. Our results suggest that high levels of plasma homocysteine in conjunction with hypertension could be one of the risk factors for arteriosclerotic CI.
Atherosclerosis 1989 Oct
PMID:Plasma sulfhydryl-containing amino acids in patients with cerebral infarction and in hypertensive subjects. 259 23

Platelet aggregation inhibitors have been more extensively and better studied than all other treatments used in the prevention of cerebral ischaemia. It has been demonstrated that both aspirin (300 mg/day) and ticlopidine (500 mg/day) are effective in the secondary prevention of cerebral ischaemic accidents associated with atherosclerosis, with a 20 and 30 p. 100 respectively reduction of risk. At the moment, there is no evidence that these compounds are effective in the primary prevention or treatment of cerebral infarction in the acute phase. The best way of preventing thromboembolic stroke of cardiac origin is to treat the responsible heart disease and prescribe anticoagulants. However, several studies are in progress to evaluate the effectiveness of aspirin in the primary and secondary prevention of cerebral thromboembolism due to non-valvular atrial fibrillation.
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PMID:[Platelet antiaggregants in cerebral ischemic pathology]. 268 44

Since hypertension is an important risk factor for atherosclerosis, it is logical to assume that treatment to lower blood pressure will prevent atherosclerosis. However, the relationship between hypertension and atherosclerosis is indirect and complex. Drugs that lower pressure will prevent heart failure and arteriolar complications such as renal failure or strokes caused by lacunar infarction or brain haemorrhage due to rupture of microaneurysms. However, there is little evidence that atherosclerotic complications can be reduced by lowering pressure. It is important to understand the pathogenesis of atherosclerosis and its complications, which are related to lipoproteins and arterial flow disturbances, in order to develop an approach to selecting those antihypertensive drugs which may prevent atherosclerotic complications related not only to initiation and progression of atherosclerotic plaques, but to the embolisation of platelet clumps or atherosclerotic debris, or events such as intraplaque haemorrhages, that lead to myocardial or cerebral infarction. Antihypertensive drugs have different effects on lipoproteins and on arterial flow disturbances that may have important implications for prevention. Alpha-blockers and drugs with beta 2 agonist activity have beneficial effects on lipoprotein profiles, ACE inhibitors and calcium channel antagonists have some anti-atherosclerotic effects in animal models, while beta-blockers have beneficial effects on flow disturbances and are anti-atherosclerotic in animal models and man. Future studies to determine how to prevent atherosclerotic complications in hypertensive patients will require methods for noninvasive measurement of atherosclerosis.
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PMID:Pathogenesis of atherosclerosis and its complications: effects of antihypertensive drugs. 269 95

Diffuse, alimentary tract ganglioneuromatosis-lipomatosis, bilateral adrenal myelolipomas, pancreatic telangiectasias, and a multinodular thyroid goiter were found at autopsy in a 56-year-old, white male with a history of insulin-dependent diabetes, hypertension, peptic ulcer, and remote cerebral infarction. The degree of atherosclerosis, arterionephrosclerosis, and cardiac disease found at autopsy did not correlate with the patient's history or his sudden death. The typical features of the multiple endocrine neoplasia syndrome, type II-B, were not identified. The findings in this patient may represent a variant of the multiple endocrine neoplasia complex, or a separate, previously unrecognized syndrome.
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PMID:Alimentary tract ganglioneuromatosis-lipomatosis, adrenal myelolipomas, pancreatic telangiectasias, and multinodular thyroid goiter. A possible neuroendocrine syndrome. 286 Aug 6

The correlation of serum levels of lipoprotein (a) [Lp(a)] with the progression of cervical atherosclerosis was investigated and compared with the common risk factors. The carotid arteries of 100 subjects were examined by direct bi-directional Doppler ultrasonic imaging. A highly significant elevation of the mean values of Lp(a) in group 1 (P1, with smooth surface plaques) and in group 2 (P2, with exulcerations) vs the control (P0, with no detectable plaques) was established. Low density lipoprotein cholesterol (LDL-C) was highly significantly elevated in P1, but only significantly higher in P2. Total cholesterol (TC) was significantly higher in P1 and highly significantly elevated in P2. Diabetes was also found to be significantly associated with atherosclerotic plaque formation, in contrast to triglycerides (TG), high density lipoprotein cholesterol (HDL-C) and its ratio to TC, hypertension and cigarette smoking. In a smaller collective of 30 patients--40-60 years old--being equally divided into 3 groups (p0, p1, p2), Lp(a) showed again to be the most significant parameter. LDL-C, TC and its ratio to HDL-C were highly significantly altered in subgroup p1 and significantly altered in subgroup p2. In this selection there were 12 patients with and 18 without cerebral infarction (CI). The difference of the medians of Lp(a) serum levels between these 2 groups was also found to be highly significant.
Atherosclerosis 1985 Dec
PMID:A dominant role of lipoprotein(a) in the investigation and evaluation of parameters indicating the development of cervical atherosclerosis. 293 55

Attempts were made to prepare antisera monospecific for Lp(a) lipoprotein and to investigate the distribution of subjects according to plasma levels of Lp(a) in Japanese controls and patients with coronary heart disease or cerebral infarction. Positive plasma reactions to the double diffusion test for Lp(a) (Ouchterlony) were observed in 32.3% of the healthy Japanese subjects, which is similar to results previously reported in western countries. The plasma threshold level of 17 mg/dl was considered an appropriate point for dividing subjects into positive and negative groups depending on reactions to the double diffusion test. When subjects were divided into two groups at 17 mg/dl, a significant association was found between a high plasma level of Lp(a) and either coronary heart disease or cerebral infarction in the distribution of the cortical artery. These results suggest that Lp(a) may play an important part as a risk factor for coronary heart disease and cerebral infarction.
Atherosclerosis 1986 Feb
PMID:Lp(a) lipoprotein as a risk factor for coronary heart disease and cerebral infarction. 293 94


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