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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Prophylaxis of deep vein thrombosis with standard heparin and low molecular weight heparin has been studied in many clinical trials in surgical patients and in few and various medical conditions in hospitalized subjects. Clinical trials have been conducted in patients with recent myocardial infarction, heart failure, stroke, pulmonary sepsis, cancer, or any acute disease with a high risk factors for deep vein thrombosis (previous thromboembolism, thrombophilia, obesity, recent bedridden, dehydratation.). The combination of a high risk disease with a high risk factor related to the history of the patient might reasonably conduct to a prophylaxis with low molecular weight heparins. The duration of this treatment has to be short and limited to the period of the acute medical condition inducing a high risk for deep vein thrombosis. Prophylaxis has to be offered to patients with ischemic stroke, cardiac failure, recent myocardial infarction, active cancer or any other acute medical disease in patients with a previous thromboembolism or thrombophilia history. Bedridden status and age are not, by themselves, an indication for prophylaxis with heparins. A widespread diffusion of these recommendations is needed to reduce overprescriptions.
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PMID:[Prevention of deep venous thrombosis in medical patients]. 1089 73

Presented here is a clinical case of thalamic stroke which affected mainly non-specific thalamic regions. In acute disease stage, the patient exhibited a prominent psychopathological features, slight hemihypoaesthesia and sleep disturbances. Polysomnography confirmed the disturbances of sleep structure: the increase of sleep onset latency, number of awakenings, waking time and stage 1 duration, decrease of both deep sleep stages (3 and 4) and REM sleep. Visual analysis revealed EEG spindle asymmetry in stage 2 of the first sleep cycle, with sleep spindles predominating in the undamaged hemisphere. Spectral EEG analysis confirmed the presence of power asymmetry not only in the sigma-band but also in the other band ranges. This clinical case allows discussing the role of the thalamus in generation of quiet sleep EEG phenomena.
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PMID:[The case of prominent EEG sleeping activity in thalamic stroke patients]. 1283 May 17

Targeting apoptotic cell death pathways provides wide-ranging opportunities for the discovery and development of novel drugs. Some targeted therapies that selectively induce apoptosis in cancer cells are already marketed, and numerous pro-apoptotic drugs for treating cancer are currently being developed. The anti-apoptotic drugs that are most advanced in development are targeting acute disease indications such as stroke, myocardial infarction and sepsis, in which the role of apoptosis has been best defined and inhibitors of the apoptotic pathway have shown activity in various animal models. In the future, novel drugs might also result from an understanding of apoptotic pathways in chronic disorders.
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PMID:Apoptosis: target for novel drugs. 1457 60

The central hemodynamic state in 111 patients has been studied, 78 (70.27%) of them underwent surgical operation. The depression of central homodynamic indices which correlated with the severity of patients' state, cardiovascular system reserves, was revealed by means of current diagnostic procedures. Among the main reliable characteristics of central hemodynamic by which we can forecast consequences of disease are an ejection fraction of the left ventricle, stroke volume, and minute volume. In the process of preoperative preparation it is necessary to consider common peripheral vascular resistance fluctuation. An increase in this peripheral vascular resistance can lead to myocardial infarction, acute disorder of coronal blood flow, hypertension stroke. The optimal tactics of treatment of such patients with heart insufficiency is the correction of coronal blood flow after an operation and assessment the risk of carrying out an surgical operation.
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PMID:[Changes of central hemodynamics during the progression of cholelithic and cardiovascular diseases]. 1560 17

Between January 1998 and December 2003 thirty-one patients with extracranial common and internal carotid artery aneurysms underwent surgical treatment at the Department of Vascular Surgery, Russian Scientific Center of Surgery. Of these patients, 29 subjects were provided reconstructions on these arteries and two patients underwent ligature operations. In the short-term postoperative period, one (3.2%) patient died. The lethal outcome was induced by acute disorder of cerebral circulation (ADCC). Disorders of cerebral circulation (DOC) occurred in 4 (12.8%) patients. Of 2 (3.2%) cases of stroke, one eventuated in lethal outcome and 2 (6.4%) patients developed transient ischemic attacks (TIA). The lethality in the long-term postoperative period (the follow up lasted as long as 5 years) accounted for 6 (19.3%) cases. In patients who had undergone reconstructions, the long-term postoperative lethality reached 13.8% (4 cases) whereas the lethality following ligature operations constituted 100% (2 cases). So, the reconstructive operation is a highly effective and safe enough approach to the treatment of patients with extracranial carotid artery aneurysms. The short- and long-term results were beneficial.
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PMID:Surgical treatment of patients with extracranial carotid artery aneurysms. 1603 31

Nanomedicine promises to enhance the ability of clinicians to address some of the serious challenges responsible for cardiovascular mortality, morbidity and numerous societal consequences. Targeted imaging and therapy applications with perfluorocarbon nanoparticles are relevant to a broad spectrum of cardiovascular diseases, ranging from asymptomatic atherosclerotic disease to acute myocardial infarction or stroke. As illustrated in this article, perfluorocarbon nanoparticles offer new tools to recognize and characterize pathology, to identify and segment high-risk patients and to treat chronic and acute disease.
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PMID:Nanomedicine opportunities for cardiovascular disease with perfluorocarbon nanoparticles. 1771 62

Niacin (vitamin B(3)) is required to form nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP), which are involved in scores of anabolic and catabolic redox reactions throughout metabolism. It is now understood that NAD(+) is also a substrate for several families of ADP-ribosylation reactions, which control processes like DNA repair, replication and transcription, the activity of G-proteins, chromatin structure and intracellular calcium signalling. Poly(ADP-ribose)polymerase-1 (PARP-1) is the most active of the PARP enzymes, and it has been implicated in both prevention and aggravation of disease processes. Inhibition of poly-ADP-ribose formation will tend to cause genomic instability and tumorigenesis in chronic models of DNA damage, but the same inhibition can prevent many acute disease processes, such as stroke, myocardial infarction and septic shock. In models of acute stress, PARP-1 inhibition may protect cellular NAD pools and prevent nuclear factor-kappaB-dependent inflammatory signalling, while long-term protective roles for PARP-1 include DNA repair and regulation of chromatin structure. Promising new PARP-1 inhibitors may display interactions with dietary niacin status and may have long-term deleterious effects on genomic stability, but may be extremely valuable for the treatment of acute inflammatory conditions.
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PMID:Poly ADP-ribose polymerase-1 and health. 2046 95

Human ischemic stroke is an acute disorder followed by a recovery period which may be of varying duration and mechanism. Imaging has created a means to explore the stroke process in vivo, particularly its underlying pathophysiology and recovery mechanisms. Evidence from multicenter studies has shown that, in the acute phase, arterial recanalization and reperfusion of ischemic brain tissue are the most important determinants of recovery. This is followed by functional and structural changes in the perilesional tissue and in large-scale bihemispheric networks that continue with different dynamics for weeks to months. Proof-of-principle studies have revealed that the behavioral gains induced by rehabilitation are paralleled by changes in functional representations. This is supported by data from neuroimaging and electrophysiological studies early after stroke which have shown that dedicated training can induce changes in cerebral functional representations. Accordingly, there is clear evidence that neuroimaging has a significant potential for monitoring the hemodynamic, functional, and structural factors determining recovery from stroke. New imaging methods may provide relevant biomarkers for treatment decisions and therapeutic monitoring. By combining neuroimaging with electrophysiological measures, opportunities exist to develop neuroscience-based strategies in rehabilitation.
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PMID:Role of neuroimaging in promoting long-term recovery from ischemic stroke. 2088 6

Although the huge economic and social impact and the predicted incidence increase, neuroprotection for ischemic stroke remains as a therapeutically empty niche. In the present study, we investigated the rationale of the C-Phycocyanin (C-PC) treatment on global cerebral ischemia/reperfusion (I/R) injury in gerbils. We demonstrated that C-PC given either prophylactically or therapeutically was able to significantly reduce the infarct volume as assessed by triphenyltetrazolium chloride (TTC) staining and the neurological deficit score 24h post-stroke. In addition, C-PC exhibited a protective effect against hippocampus neuronal cell death, and significantly improved the functional outcome (locomotor behavior) and gerbil survival after 7 days of reperfusion. Malondialdehyde (MDA), peroxidation potential (PP) and ferric reducing ability of plasma (FRAP) were assayed in serum and brain homogenates to evaluate the redox status 24h post-stroke. The treatment with C-PC prevented the lipid peroxidation and the increase of FRAP in both tissue compartments. These results suggest that the protective effects of C-PC are most likely due to its antioxidant activity, although its anti-inflammatory and immuno-modulatory properties reported elsewhere could also contribute to neuroprotection. To our knowledge, this is the first report of the neuroprotective effect of C-PC in an experimental model of global cerebral I/R damage, and strongly indicates that C-PC may represent a potential preventive and acute disease modifying pharmacological agent for stroke therapy.
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PMID:C-Phycocyanin is neuroprotective against global cerebral ischemia/reperfusion injury in gerbils. 2166 60

The process of atherosclerosis may begin in youth and continue for decades, leading to both nonfatal and fatal cardiovascular events, including myocardial infarction, stroke, and sudden death. With primordial and primary prevention, cardiovascular disease is largely preventable. Clinical trial evidence has shown convincingly that pharmacological treatment of risk factors can prevent events. The data are less definitive but also highly suggestive that appropriate public policy and lifestyle interventions aimed at eliminating tobacco use, limiting salt consumption, encouraging physical exercise, and improving diet can prevent events. There has been concern about whether efforts aimed at primordial and primary prevention provide value (ie, whether such interventions are worth what we pay for them). Although questions about the value of therapeutics for acute disease may be addressed by cost-effectiveness analysis, the long time frames involved in evaluating preventive interventions make cost-effectiveness analysis difficult and necessarily flawed. Nonetheless, cost-effectiveness analyses reviewed in this policy statement largely suggest that public policy, community efforts, and pharmacological intervention are all likely to be cost-effective and often cost saving compared with common benchmarks. The high direct medical care and indirect costs of cardiovascular disease-approaching $450 billion a year in 2010 and projected to rise to over $1 trillion a year by 2030-make this a critical medical and societal issue. Prevention of cardiovascular disease will also provide great value in developing a healthier, more productive society.
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PMID:Value of primordial and primary prevention for cardiovascular disease: a policy statement from the American Heart Association. 2178 92


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