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

The frequency of cerebrovascular accidents and of risk factors including hypertension and diabetes was examined retrospectively in parents and siblings of 328 patients suffering from transient ischaemic attacks or non-embolic cerebral infarction and in a control group. The frequency of cerebrovascular accidents was significantly higher in the family of the patient compared to the family of the control. The relatives of the patient and the control had essentially the same frequency of diabetes, whereas hypertension was significantly more common in the family of the patient. When the relatives with one or both the risk factors were excluded and those with cerebrovascular accidents alone were compared, a greater frequency, though insignificant, was noted in the family of the patient. Hypertension and diabetes were more common in the relatives of the patient than in the control but this difference was not statistically significant. The significant excess of cerebrovascular accidents in the family of the patients suffering from transient ischaemic attacks and non embolic cerebral infarction cannot exclusively be attributed to the greater frequency of diabetes and hypertension.
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PMID:[Familial nature of acute cerebral vasculopathies of the ischemic type]. 666 82

In recent years, both a numerical and relative increase in the morbidity of cardiovascular and cerebral vascular diseases has been noted in Japanese diabetics. The trend of macroangiopathy in the period between 1953 and 1980 was studied in 210 autopsy cases (Group A: 1953-62, 27 cases, Group B: 1963-72, 43 cases and Group C: 1973-80, 140 cases). The incidence of myocardial infarction and cerebral infarction as a primary cause of death was 25. 9% in Group A, 23.3% in Group B and 37.9% in Group C. From the autopsy findings, the morbidity of cardiovascular disease was 14.8%, 30.2% and 34.3% respectively. In order to elucidate the clinical risk factors, the age at death, duration of diabetes at the time of death, and incidence of hypertension and serum cholesterol in the past history were studied. The percentages of those aged over 70 at death was 18.5%, 23.3% and 42.8% respectively, and those of the cases with durations of more than 10 years was 25.9%, 40.5% and 51.8% respectively. The prevalence of hypertension and hypercholesterolemia was almost identical in each group. From the above, the previous increase in the death-rate due to coronary heart disease and cerebrovascular disease in Japanese diabetics is thought to be attributable to the increasing number of elderly diabetics of long duration.
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PMID:Trend of macroangiopathy in diabetics studied by postmortem examination. 668 May 28

The incidence and mortality from stroke in Espoo-Kauniainen, Finland, in 1972-73 were compared to the incidence and mortality from stroke in the same area 1978-80. The factors at the acute stage influencing case fatality were also analyzed. A declining trend in age-adjusted incidence of stroke was observed, though failing to reach statistical significance. The greatest decline was seen in the incidence of cerebral hemorrhage in men, with a statistically significant difference. The incidence of subarachnoid hemorrhage also decreased, and in women the decline was significant. There was no decrease at all of the incidence of cerebral infarction. The total mortality displayed no clear declining trend. However, the mortality from cerebral hemorrhage after three months from stroke had gone down from 72% to 59%. The most important factors responsible for increased case fatality were: lowered level of consciousness, cerebral hemorrhage and old age. The case fatality was also higher for women than for men. Previous heart diseases increased the mortality, but hypertension, diabetes, pure myocardial infarction and previous transient ischaemic attacks had no influence on mortality. The cause of decline in the incidence of cerebral hemorrhage might be improved care of hypertension: the decline in the incidence of subarachnoid hemorrhage however remains unclear.
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PMID:Declining incidence and mortality of stroke? 670 33

The relationship of serum cholesterol and other risk factors to cardiovascular disease was investigated in a 16-year cohort of 16,711 residents of Hiroshima and Nagasaki. Examined in detail were the relationship of serum cholesterol, and the joint relationships of serum cholesterol, systolic blood pressure, diastolic blood pressure, and other risk factors to coronary heart disease (CHD), cerebral infarction (CI), and cerebral hemorrhage (CH). Baseline and biennially collected risk factor data were analyzed. The latter type of measurement permitted separate investigation of both the short-term and long-term effects of cholesterol measurements. In both types of analyses, both serum cholesterol and blood pressure showed strong associations with CHD incidence. In particular, there were strong associations with short-term and delayed CHD incidence. Furthermore, the association of cholesterol with short-term CHD incidence could not be explained by its association with delayed CHD incidence, or vice versa. Multivariate analyses that also included several other risk factors (smoking habits, clinical diagnosis of diabetes mellitus, left ventricular hypertrophy or strain on electrocardiogram, relative body weight, hematocrit, and proteinuria) for which data were available showed such risk factors to be of lesser, but generally non-negligible, importance in this population. In the case of CH and CI, serum cholesterol was found to be weakly or not at all related to incidence of either disease while blood pressure remained a strong correlate. For CI some suggestion of a statistical interaction between blood pressure and serum cholesterol was found. Discussed are implications for theories of disease pathogenesis for CHD, CI and CH.
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PMID:Serum cholesterol, other risk factors, and cardiovascular disease in a Japanese cohort. 674 46

All contributory factors to the unusual occurrence of stroke in young people were evaluated in patients under age 40 admitted to the Stroke Unit of the Austin Hospital in Melbourne, Australia. Over the August 1977 to December 1980 period there were 700 admissions. Of these 14 patients were under the age of 40. There were 7 males and 7 females whose ages ranged from 17-38 years. Each patient was screened for factors which might contribute to premature vascular disease including hypertension, diabetes, smoking, obesity, and hyperlipidemia. In addition, the following tests were performed to exclude an arteritic process: full blood examination; ESR; protein electrophoresis; syphilis serology; and the presence of antinuclear factor. Each of the 14 patients suffered cerebral infarction. A summary of each case is presented in a table. In 9 patients, infarction occurred in the carotid territory of supply. Large cortical infarcts with or without subcortical involvement occurred in cases 1-8, of whom 5 had major vessel occlusion demonstrated angiographically and another had stenosing and ulcerative atheromatous disease at the extracranial carotid bifurcation. In a further 4 patients, infarction occurred within the vertebrobasilar territory and was either confined to the brain stem, the occiptal cortex, or involved both. Angiograms were performed in 2 of these patients and showed irregular narrowing of the vertebral artery which was interpreted as spasm and segmentally narrowing of the basilar artery. The final patient had several ischemic events which included right sided amaurosis fugax, and left frontal, right parieto-occipital and left occipital infarctions. Angiography was normal. All patients survived the stroke and were able to go home. There may be an interrelationship between the pathological findings of Irey et al. (1978) and the effect oral contraceptives (OCs) has on migraine. This is relevant to Case 13. Sustained exposure to OCs may produce the pathological changes described (visible as segmental narrowing angiographically). In 2 patients cerebral infarction was caused by atheromatous or hypertensive occlusive vascular disease. In Case 3 an embolus occluded the middle cerebral artery. Infarction complicating migraine was diagnosed confidently in 4 patients on the basis of typical migrainous symptomatology in the past and accompanying the stroke. Of the 12 patients fully evaluated, there were no cases of polycythemia or thrombocytosis. There were no abnormalities of the clotting factors. Almost every patient had some form of emotional upset, and there were 7 who had significant psychiatric illness and emotional problems of extreme magnitide.
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PMID:Stroke syndromes in young people. 692 82

We followed 120 patients 4-14 yr after permanent pacemaker implantation for high-grade atrioventricular block to assess the effect of sex, age at implantation, date of implantation and various chronic co-existent illnesses on survival. The overall survival rates were 91% at 1 yr, 63% at 5 yr and 41% at 10 yr. Patients with congestive heart failure demonstrated the lowest survival rates of all cohorts studied. Survival rates of patients with congestive heart failure were significantly lower than survival rates of patients without congestive heart failure and were also significantly lower than those of patients with conduction system disease only. Similarly, patients with coronary heart disease demonstrated significantly lower survival rates than both patients without coronary heart disease and patients with conduction system disease only. The presence of hypertension, valvular heart disease, diabetes mellitus or cerebral infarction influenced survival less adversely than congestive heart failure or coronary heart disease. Survival decreased progressively with increasing age; however, the differences were not significant. Sex and date of implantation had no apparent effect on survival. Thus, coronary heart disease and the presence of congestive heart failure appear to be the major determinants of survival following permanent pacemaker implantation for high-grade atrioventricular block.
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PMID:Natural history of high-grade atrioventricular block following permanent pacemaker implantation. 706 9

The impact of blood pressure, serum cholesterol and triglycerides, and smoking on the risk of cerebral infarction and other stroke was studied by a longitudinal design. A random sample of the population aged 35-59 years in two counties of Eastern Finland was examined in 1972, with a participation rate of 92 per cent. In subjects (both sexes) standardized epidemiological measurements on blood pressure, height, weight, and serum lipids were made and questionnaire data were obtained on smoking. The cohort was followed for seven years by means of national hospital discharge and death certificate registers. During the follow-up 77 men and 65 women had a cerebral stroke. Based on multiple logistic risk function analysis, age, smoking, blood pressure, and history of previous stroke and diabetes turned out to be independent predictors of both cerebral infarction and other strokes in men. Diastolic blood pressure of 100 mm Hg or more was associated with a 1.9-fold (90% CI = 1.1-3.6) risk of cerebral infarction in men and 2.5-fold (90% CI = 1.1-5.6) risk in women with no previous stroke. In men 37% (90% CI = 21-53%) of all cerebral strokes were attributable to systolic blood pressure of 150 mm Hg or more and 27% (90% CI = 11-42%) to diastolic blood pressure of 95 mm Hg or more.
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PMID:Relation of blood pressure, serum lipids, and smoking to the risk of cerebral stroke. A longitudinal study in Eastern Finland. 708 Jan 26

The case of a 26 year old woman who had been taking tranexamic acid to prevent uterine bleeding due to an IUD and who died from thrombosis of the left internal carotid artery is reported. The patient's father had died at age 54 of myocardial infarction. Otherwise the family history was entirely negative for thromboembolic disease. The patient was a mild smoker. She had been previously healthy and in particular, she was not affected with hypertension, diabetes, or dyslipidemia. She had carried to term 2 uncomplicated pregnancies. 40 days prior to hospital admission her gynecologist had inserted an IUD. The insertion of the IUD was followed by persistent uterine bleeding, and for this reason she began treatment with tranexamic acid (1.5 g/daily). Uterine bleeding persisted despite this treatment, and the IUD was removed. Because of persistence of a mild uterine bleeding, tranexamic acid was continued. 2 hours before admission the patient suddenly presented a left sided hemiparesis with disarthria and vomiting. On admission she was stuporous. The left side of her face drooped and the strength of the left arm and leg was markedly decreased. Both arm and leg reflexes were symmetrical. Her blood pressure was 110/70. An electroencephalogram on arrival confirmed a right sided cerebral lesion. Subsequently the patient's condition deteriorated rapidly. She developed a full left hemiplegia and became deeply comatose. A CAT scan performed 4 hours after admission showed no abnormalities. A CAT scan performed 3 days after admission showed a large cerebral infarction involving nearly the whole right cerebral hemisphere. The patient's condition remained essentially unchanged until she died 6 days after admission. Permission for autopsy was refused. Antifibrinolytic drugs competitively inhibit plasminogen activators and noncompetitively plasmin. Thromboembolic complications after the administration of antifibrinolytic drugs have long been recognized. The use of IUDs is often associated with troublesome uterine bleeding and particularly excessive menstrual bleeding. To avoid these complaints, antifibrinolytic drugs are increasingly used.
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PMID:Tranexamic acid, intrauterine contraceptive devices and fatal cerebral arterial thrombosis. Case report. 710 62

Carotid bruit was routinely sought in the Framingham cohort and during eight years appeared in 66 men and 105 women, all of whom were asymptomatic. The incidence increased with age equally in the two sexes from 3.5% at 44 to 54 years, to 7.0% at 65 to 79 years. The eight-year incidence was greater in diabetes and hypertensive subjects. Transient ischemic attacks appeared in eight (two alone) and stroke in 21 of the 171, a stroke rate more than twice expected for age and sex. More often than not, cerebral infarction occurred in a vascular territory different from that of the carotid bruit, often in the posterior circulation, and ruptured aneurysm, embolism from the heart, and lacunar infarction was the mechanism of stroke in nearly half the cases. Incidence of myocardial infarction was also increased twofold in those with asymptomatic carotid bruit. General mortality were also increased; 1.7-fold with men, and 1.9-fold in women, with 79% of the deaths owing to cardiovascular disease, including stroke. Carotid bruit is clearly an indicator of increased stroke risk but chiefly as a general and nonfocal sign of advanced atherosclerotic disease and not necessarily as an indicator of local arterial stenosis preceding cerebral infarction.
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PMID:Asymptomatic carotid bruit and risk of stroke. The Framingham study. 720 46

HDL-cholesterol levels were determined by a heparin-Ca precipitation method in 89 survivors of cerebral infarction (CI) (75 males, 14 females) and 14 patients with transient ischemic attacks (TIA) (8 males, 6 females). The mean values of HDL-cholesterol concentration and HDL:LDL-cholesterol ratio for both sexes of CI patients were significantly lower than those of the healthy controls (37 males, 14 females). These values for CI patients were significantly lower than in patients with various diseases excluding cardiovascular disease, hepatic disease, hyperlipidemia, diabetes mellitus and degenerative disorders of the nervous system (46 males, 43 females). In patients with TIA, these differences were statistically significant only for men. Based on the patient's history, clinical signs and symptoms and the findings of computerized tomography and 4-vessel angiography, male CI patients were divided into 2 sub-groups, CI believed to be in the distribution of a perforating artery and CI in the distribution of a cortical artery; it was found that the HDL-cholesterol level and HDL:LDL-cholesterol ratio were significantly lower in the cortical artery group than in the perforating artery group, suggesting that these lipoprotein abnormalities may play a part in the pathogenesis of CI, particularly of the cortical artery area infarction.
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PMID:Lipoprotein abnormalities in the pathogenesis of cerebral infarction and transient ischemic attack. 723 60


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