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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

13 patients under 40 years of age had cerebral infarction and angiographic evidence of arterial stenosis or occlusion. None of them had cardiac disorders prone to cerebral embolism. Five patients had occlusion at the origin of the internal carotid artery, one had occlusion of the common carotid artery and one each had stenosis at the origin of the internal carotid and common carotid arteries, respectively. Two patients had unilateral occlusion of the supraclinoid portion of the carotid artery with basal collaterals that had some resemblance to the Moyamoya disease. Three patients demonstrated stenosis or occlusion of the middle and/or anterior cerebral arteries. Three patients had hypercholesterolemia, one of whom was hypertensive. None had confirmed diabetes mellitus. One female, who died, had taken oral contraceptives for 3 years. A male, with internal carotid artery occlusion, had serological evidence for syphilis.
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PMID:Occlusive cerebrovascular disease in young adults. 61 2

A total of 969 (73%) of 1,328 patients with cases of suspected transient ischemic attacks (TIAs) who came to six institutions during a 21-month period were followed up. Factors were identified and prospectively analyzed for risk for further TIAs, stroke, and deatn. A history of multiple carotid artery TIAs was significantly related to further TIAs. A single TIA placed the patient at greater risk for early infarction. Older age, male sex, and unreliability to take dangerous medication were risk factors for cerebral infarction. Anticoagulant therapy, older age, male sex, diabetes mellitus, heart disease, abnormal ECG, and poor surgical risk were factors for death. The increased mortality associated with anticoagulants was confined to the older age group. While white patients treated with antiplatelet-aggregating agents had a lower mortality than those treated otherwise, this was not true amont black patients.
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PMID:Cooperative study of hospital frequency and character of transient ischemic attacks. VIII. Risk factors. 67 2

Initial and follow-up fasting serum glucose levels following acute stroke were evaluated retrospectively in 392 selected hospitalized patients. Transitory reactive hyperglycaemia was observed in a large number of patients (28% of the total series) without a history of diabetes prior to the acute cerebrovascular event. The data from this group suggest a possible relationship between the impairment of carbohydrate metabolism and the type and location of stroke since both the frequency and severity of the hyperglycaemic response were higher in patients with haemorrhagic stroke and brainstem infarction as compared with cerebral infarction. The incidence and degree of the reactive hyperglycaemia were also related to the severity of the acute stroke. There were more comatose patients in the group showing this phenomenon. Initial serum glucose levels in the latter group were higher in unconscious patients than in alert ones. In addition, hospital mortality was significantly higher in these patients. Transitory reactive increases of serum glucose levels were also observed in the majority of patients with a history of overt diabetes prior to the acute stroke. The hyperglycaemic reaction following acute stroke may be attributed to several underlying mechanisms. These include: a non-specific reaction to acute stress and tissue injury with the associated autonomic, hormonal and metabolic alterations; uncovering of underlying latent diabetes by the acute stroke; increased secretion of growth hormone due to stroke-induced hypothalamic dysfunction; and irritation of the glucose regulatory centres in the hypothalamus and brain stem by blood-laden cerebrospinal fluid or local ischaemia.
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PMID:Reactive hyperglycaemia in patients with acute stroke. 97 11

The relative extent of raised and calcified coronary aortic lesions, prevalence of coronary stenosis and of fresh and old myocardial infarction, and mean heart weight were expressed on a continuous scale for 4 disease groups (coronary heart disease, cerebral infarction/haemorrhage, hypertension/diabetes, cancer). Within these groups the relative position for each of the lesions was calculated by subgroups of disease in order to show the elevating or depressing effect of hypertension, diabetes, obesity, and combinations of disease. The strength of association between 33 factors (town 5, disease 24, obesity, heart weight, age, and sex) and the lesions was calculated. An analysis of variance was carried out and the proportion of the variance of the different lesions accounted for by town, disease, etc., is shown. The extent of raised aortic lesions is strongly associated with age and hypertension. It is positively associated with coronary heart disease and inversely associated with cancer. Town factors have a small positive association which is larger than that due to obesity. 33 factors taken together account for 50% of the variance. Age alone accounts for 37% and sex for only 0.3%. The extent of calcified aortic lesion is strongly associated with age, town, hypertension, coronary heart disease and diabetes mellitus. It is inversely associated with cancer, more strongly in cancer of the bronchus and the liver than in other cancers. It is inversely associated with obesity. 33 factors together account for 30% of the variance and age alone accounts for about 13%. The extent of raised coronary lesions is strongly associated with age, coronary heart disease, sex, diabetes mellitus, hypertension and obesity. It is inversely associated with cancer, more strongly in cancer of the prostate and the liver than in other cancers. Town factors have a small association. 33 factors taken together account for about 43% of the variance. Age alone accounts for 25%. The extent of calcified coronary lesions is associated with coronary heart disease and age. There is a low association with hypertension and diabetes, an inverse association with cancer, and a low inverse association with obesity. 33 factors together account for 20% of the variance. Coronary heart disease alone accounts for 12% and age alone accounts for 8%. The prevalence of coronary stenosis is strongly associated with coronary heart disease, age, and sex. There is a small association with town factors, obesity, and hypertension, and an inverse association with cancer. All the factors together account for about 30% of the variance. Coronary heart disease alone accounts for 23% and age 10%.
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PMID:Aortic, coronary, and myocardial lesions in relation to various factors. 108 2

Twenty-six patients under 20 years of age having cerebrovascular disease were studied from 1968 to 1972. Common risk factors such as hypertension, diabetes mellitus, hyperlipidemia and heart disease were not present. Angiographical study showed a variety of abnormalities. No consistent defect was present. There was a high incidence of pyrexia and convulsions in the early stages of stroke and it appears possible that some form of arteritis might have been important in the production of the cerebral infarction.
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PMID:Stoke in the young: a four-year study, 1968 to 1972. 115 68

1) In 113 patients with cerebral infarction, the cause of infarction was cardiac embolism in 35, atherosclerotic thromboembolism in 45. It was either cardiac embolism or atherosclerosis but undetermined in 30. 2) Seven risk factors have been analysed. Eight patients (7 p.cent) had none of these factors. In the 105 remaining patients risk factors were: a) atrial fibrillation in 36, diagnosed in 21. Efficient treatment was applied in 1 or perhaps in 2 patients; b) High blood pressure in 39, diagnosed in 32, efficiently treated in 5; c) dyslipidemia in 42, diagnosed in 9, efficiently treated in 3; d) obesity in 50, efficiently tackled in 2; e) diabetes in 24, diagnosed in 11, efficiently treated in 2; f) hyperuricemia in 28, diagnosed in 1 with no efficient treatment; g) smoking in 44, abandonned by 1 only. 3) The high frequency of cardiac embolism is briefly commented. 4) Non diagnosis or unefficient treatment was present in a high proportion of cases. Realizing this regrettable state of affairs should result in better preventive diagnosis and treatment which, is assumed, could significantly reduce cerebral infarction.
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PMID:[Cerebral infarctions. Study of their prevention]. 120 32

An investigation limited to patients under 70 years of age was undertaken to study the incidence of new cerebrovascular strokes (cerebral hemorrhage, cerebral infarction, and cerebral embolism) in all cases from Uppsala county between 1967-1971. The total incidence of stroke is 36/1000,000 in this age category; the mean age was 59.9 years for men and 60.8 years for women. Of the total number, 25% were recurrences. The occurrence of a moderate but significant decrease during the period of study has been attributed to an extended and improved treatment of hypertension. All of the 6 females who had suffered strokes below 40 years of age had been on oral contraceptives at the time. A high incidence of diabetes and symptoms of cardiovascula r impairment (hypertension, transient ischemic attack, cardiosclerotic disease) was found. A high incidence of myocardial infarction and of strokes was found among parents of those suffering cerebral hemorrhage and cerebral infarctions, respectively.
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PMID:Studies on cerebrovascular stroke. I. Epidemiology of first-time strokes in persons under 70 years of age. 120 87

37 patients below the age of 50 have been observed following acute 1st-time cerebrovascular lesion. Predisposing factors were found in nearly all cases. Hypertension was found to be present in about 1/2 of the patients suffering from cerebral hemorrhage and in 1/4 of those with cerebral infarction, 6 females were on oral contraceptives. Mortality within 1 month was 35% and was essentially caused by a very high mortality among patients with cerebral hemorrhage. A check after 30 months showed that 16 patients were still alive and 11 were able to perform some sort of work. A high incidence of diabetes and impaired glucose metabolism was exhibited among the survivors as seen from intravenous glucose tolerance tests. As compared with higher age groups, those younger stroke survivors have fairly good chances of going back to work. Health surveys, screening of the relatives of patients wi th hypertension or other vascular diseases, and rehabilitative resources are needed to trace possible stroke victims early and to rehabilitate those who have already been stricken.
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PMID:Stroke before fifty. Experiences from a five-year study. 120 88

Fifty-three patients with acute cerebral infarction were treated in a double-blind study with either dexamethasone or placebo within 24 hours of the onset of stroke. Forty-one of these survived for longer than 28 days, and the patients treated with the steroid fared slightly worse than those treated with placebo at the end of this time. Two of the five patients who died in the placebo group died of cerebral edema, compared with three out of seven patients who died in the steroid group. Infectious complications, gastrointestinal hemorrhage, and occasional serious exacerbations of diabetes occurred more commonly in the steroid group.
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PMID:Steroid therapy in acute cerebral infarction. 124 99

We accessed the potential impact of diabetes mellitus and hyperglycemia on early prognosis in a study of 109 cases of CT proved brain infarction. Main end-points of this study were 30-days case-fatality rates and the probability of early discharge or prolonged hospitalization. Proportions of patients exhibiting diverse evolutions were compared by Fisher's test and, when the number of observations permitted, by chi-square test. Diabetes mellitus was diagnosed by history in 15.6% (17 patients). In 86 cases analysed within 72 hours of admission, hyperglycemia (glucose level higher than 110 mg/dL) was detected in 67.4% (including all 14 diabetic patients (35.3% vs 21.7%; p = 0.18), but these patients probably were discharged early less frequently (23.5% vs 51.1%; p = 0.06). Compared to the normoglycemic patients, hyperglycemic patients also fared worse, when considering altogether the early discharge and case fatality rates and the need for prolonged hospitalization (p = 0.06). They also exhibited a nonsignificant increase in early case fatality rate (31% vs 15.4%; p = 0.21) and a markedly reduced chance of obtaining early hospital discharge (37.9% vs 65.4%; p = 0.03). Case fatality rates were maximal in diabetic hyperglycemic patients (42.9%) and seemed intermediate in non-diabetic hyperglycemic patients (27.3%). Considering the three end-points evaluated, the apparent differences between non-diabetic hyper and normoglycemic patients did not reach statistical significance (p = 0.19). These results suggest that both diabetes mellitus and hyperglycemia "per se" have deleterious effects on the clinical evolution of patients with cerebral infarction.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Adverse prognostic influence of diabetes mellitus and hyperglycemia on the clinical course of cerebral infarction]. 130 81


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