Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The plasma vWF levels in patients with CVD were determined using ELISA technique with two monoclonal anti-human vWF antibodies. The results showed that the vWF values in the acute stage of CVD increased significantly. They gradually decreased third weeks after the onset of the CVD. The vWF in the chronic stage of CVD remained higher than normal, but lower than that in the acute stage. The plasma vWF values showed practically no difference in either cerebral infarction or hemorrhage. The average plasma vWF level in the patients with TIA was higher than that in the controls but lower than that in the patients with complete stroke. It was found that the plasma vWF correlated with platelet aggregation induced by ADP constantly, but not with other risk factors. It was considered that elevated vWF would rather be regarded in CVD as a relatively independent risk factor.
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PMID:[A study of plasma von Willebrand factor concentration in patients with cerebrovascular disease]. 149 7

The present study was undertaken in patients subjected to endarterectomy for extracranial carotid stenosis in order to verify the efficacy and the safety of medical treatment with indobufen (2-[4-(1-oxo-2-isoindolinyl)-phenyl] butyric acid), a drug which has been successfully used in the long-term treatment of cardiovascular ischemic diseases, and which showed a significant antiplatelet effect. One hundred thirty-eight patients entered into the study with previous diagnosis of cerebrovascular ischemic event within 3 months before surgery. Patients were treated after surgery with indobufen 400 mg/die/orally in the first 2 months after discharge and than 200 mg/die/orally. The planned duration of medical treatment was 24 months. Any patient interrupting the medical treatment for a cumulative period greater than 30 days/year was excluded from the analysis; the end points of the study were considered death and the occurrence of disabling stroke. Eleven patients were considered as dropped out because of treatment interruption. The operative (at 1 month after surgery) mortality rate was 0.79%. The cumulative operative mortality and morbidity rate was estimated in 2.37%. The mean follow-up period was 6 months and the cumulative mortality rate at 36 months was estimated in 7.14%. The cumulative risk/year of TIA or ischemic stroke is higher than the risk for myocardial infarction, but the long-term mortality rate mainly depends on the latter complication which occurred later. Treatment with indobufen after carotid surgery seems to be effective as far it was restricted to an homogeneous group of patients presenting symptomatic extracranial carotid disease.
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PMID:Antiplatelet treatment after carotid endarterectomy: a pilot study. 150 Sep 57

In 163 patients with focal cerebral lesions, 43 of them with completed stroke, 43 patients with TIA, 33 patients with ICH and 29 patients with malignant and 15 patients with benign tumors EEG mapping and CT was performed. The results of EEG mapping obtained using automated artifact detection were compared to those achieved by means of visual control of raw EEG. Furthermore the impact of long (850 +/- 250s) or short (32s) analysis time was studied. Eliminating artifacts by means of visual control of raw EEG significantly more positive results were obtained than using automated artifact detection. That was found in patients with as well as in patients without lesions in CT. In relation to etiology a significant difference was found only in cerebrovascular diseases but not in the other patients-groups. Corresponding results were found in 75% of the patients. The visual control provided additional lateralization especially in patients with CS (37%) and TIA (26%). A longer duration of analysed EEG epochs did not increase the number of focal changes in EEG mapping.
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PMID:[A comparison of EEG mapping with and without visual artefact control in focal cerebral lesions]. 150 34

In a prospective study of 3,017 patients with transient ischemic attack or minor ischemic stroke from the Dutch Transient Ischemic Attack Trial, the presence or absence of diffuse hypodensity of the white matter on a baseline computed tomography (CT) scan of the brain was related to the occurrence of subsequent stroke. On entry, 337 patients were judged to have diffuse hypodensity of the white matter on CT; they were older (71.4 +/- 7.4 years versus 64.4 +/- 9.9 years), more often had hypertension (50% versus 41%), and more often had lacunar infarcts on CT scan (40% versus 26%) than did patients with normal white matter. Strokes, fatal or nonfatal, occurred in 51 (15%) of the patients with diffuse hypodensity of the cerebral white matter, compared to 217 (8%) in the group with normal white matter (crude hazard ratio, 2.0; 95% confidence interval, 1.4-2.7). After adjustment for age and other relevant entry variables, the hazard ratio was 1.6 (95% confidence interval, 1.2-2.2). In patients younger than 70 years the crude hazard ratio was 2.7 (95% confidence interval, 1.7-4.2). The distribution between the main subtypes of stroke was similar for patients with and those without diffuse hypodensity of the cerebral white matter: Intracerebral hemorrhage occurred in 6 and 9%, cortical infarction in 47 and 45%, and lacunar infarction in 34 and 29%, respectively. We conclude that hypodensity of the cerebral white matter in patients with transient ischemic attack or minor stroke is associated with an extra risk of future stroke, from large as well as from small vessels, and particularly in patients under 70 years old; this increase of risk is independent of other risk factors for stroke.
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PMID:Hypodensity of the cerebral white matter in patients with transient ischemic attack or minor stroke: influence on the rate of subsequent stroke. Dutch TIA Trial Study Group. 151 Mar 58

We retrospectively reviewed our last 100 consecutive patients who had an intraaortic balloon pump (IABP) placed through the ascending aorta for postoperative cardiogenic shock. Eighty-one patients survived to have their IABP removed and were evaluated for complications. Complications that may have been related to the transthoracic route of IABP introduction included balloon rupture in 6.2% (5/81), cerebral vascular accident in 2.5% (2/81), transient ischemic attack in 1.2% (1/81), bleeding at the IABP arteriotomy site in 3.7% (3/81), and mediastinitis in 3.7% (3/81). Compared with expected rates of development of complications in this high-risk group of patients, it appeared that balloon rupture and mediastinal bleeding were increased because of the transthoracic placement of the IABP. The rates of neurologic events and mediastinal infection do not appear to be increased. Transthoracic IABP placement avoids ischemic problems in the lower extremities and has proved a useful route for IABP introduction.
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PMID:Experience in 100 transthoracic balloon pumps. 843 Oct 90

The purpose of this study was to review data from published cerebrovascular studies to determine if it is possible to predict, based on clinical manifestations (eg, cervical bruit, transient ischemic attack, or stroke) of cerebrovascular atherosclerosis, the annual probability of having a stroke, as well as to determine and discuss the methods used in calculating and reporting vascular event rates. This overview analysis reveals that the annual stroke rates are as follows: for asymptomatic carotid stenosis, 1.3% (95% confidence interval [CI], 1.0 to 1.6); for transient monocular blindness, 2.2% (95% CI, 1.3 to 3.0); for transient ischemic attack, 3.7% (95% CI, 3.1 to 4.3); for minor stroke, 6.1% (95% CI, 5.7 to 6.6); and for major stroke, 9.0% (95% CI, 8.0 to 9.9). The data analyzed here suggest that a hierarchical profile of worsening clinical characteristics mirrors a hierarchical progression of increasing risk of stroke. These data support the idea that there is a clinical risk profile, in addition to the conventional atherosclerosis risk factor profile, for predicting subsequent stroke.
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PMID:Vascular event rates in patients with atherosclerotic cerebrovascular disease. 152 19

Patients presenting with symptoms suggestive of amaurosis fugax, or with findings of Hollenhorst plaques on fundoscopy are frequently referred for duplex evaluation to detect possible carotid artery disease. To better determine the reliability of monocular visual loss and the presence of Hollenhorst plaques for predicting the presence or significance of carotid artery stenosis, we prospectively studied 66 patients with these ocular signs and symptoms. After evaluation, the patients were categorized as follows: 34 of 66 (52%) patients had amaurosis fugax, 23 (35%) had asymptomatic Hollenhorst plaques, 7 (11%) had retinal artery occlusion, and 2 (3%) had venous stasis retinopathy. All patients were evaluated ophthalmologically, with carotid duplex scanning and spectral analysis. A stenosis of greater than 60% was regarded as significant. The presence of risk factors including hypertension, diabetes, a history of CVA or TIA's, tobacco use and hyperlipidemia was recorded. There were no statistically significant differences (p greater than 0.05) in the incidence of atherosclerotic risk factors between the four groups. Patients with amaurosis fugax were more likely to have a significant carotid artery stenosis than those with asymptomatic Hollenhorst plaques or retinal artery occlusion (53% vs 9% vs 0% respectively) (p less than 0.006). We conclude that routine carotid duplex scanning is indicated in all patients with amaurosis fugax in view of the frequent association with significant carotid stenosis (53%). However, the presence of Hollenhorst plaques in the absence of visual symptoms appears not to have a significant association with carotid disease and may not necessarily require routine screening unless other risk factors for carotid stenosis are present.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Correlation of ophthalmic findings with carotid artery stenosis. 152 43

The results of CT were studied prospectively in 606 patients with a transient ischaemic attack (TIA), 422 patients with a reversible ischaemic neurological deficit (RIND), and 1054 patients with a minor stroke, were all entered into a multi-centre clinical trial. CT scanning showed a relevant ischaemic lesion in 13% (95% confidence interval 10-16%) of TIAs, 35% (95% confidence interval 30-40%) of RINDs, and 49% (95% confidence interval 46-52%) of minor strokes (p less than 0.000001). Even within the 24 hour margin, relevant infarcts occurred more often with longer attacks, but were still found in some patients with attacks lasting less than a minute. The type and location of the infarcts were similar in the three groups. These findings suggest that the differences between TIAs, RINDs, and minor strokes are quantitative rather than qualitative.
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PMID:TIA, RIND, minor stroke: a continuum, or different subgroups? Dutch TIA Study Group. 153 34

We retrospectively reviewed the records of 88 patients who underwent a total of 95 in-situ bypass operations. Seventy-eight percent were diabetics, 56% hypertensives, 23% had a history of a myocardial infarction, 18% a previous stroke or transient ischemic attack, and 19% a renal transplant. Eighty-eight percent had general anesthesia. Eighty-four percent of the operations extended distal to the popliteal trifurcation, with an average operating time of 5.12 +/- 1.25 hours and blood loss of 354 +/- 239 ml. The overall mortality was 4.2%, with two deaths due to wound sepsis and two deaths due to congestive heart failure. The perioperative myocardial infarction rate was 6.3%. The average age of the patients who died was significantly greater than the age of those who survived (78.2 +/- 17.7 years vs. 59.9 +/- 14.8 years, p less than 0.05). The Goldman risk index was not helpful in predicting cardiac complications. The results show that patients undergoing in-situ bypass operations are at high risk for cardiovascular complications. Aggressive perioperative evaluation and management similar to that shown to reduce such complications in abdominal aortic aneurysm surgery should be helpful.
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PMID:Complications and mortality of the in-situ saphenous vein bypass for lower extremity ischemia. 153 65

Several models of total artificial hearts have been used for transient or permanent circulatory support in patients with decompensation. The most successful and widely used device, however, has been the Symbion total artificial heart. From Dec. 12, 1982, to Jan. 1, 1991, 180 Symbion total artificial hearts were implanted in 176 patients in 28 centers. Five patients received a Symbion total artificial heart as a permanent circulatory support device, whereas 171 patients received the device as a bridge to heart transplantation. Of the 175 bridge devices (171 patients) 141 were Symbion J7-70 hearts and 34 were Symbion J7-100 hearts. Four patients received two total artificial hearts, the second one after the failure of a transplanted heart because of either rejection (two patients) or donor heart failure (2 patients). Most of the recipients were males (152). The age was 42 +/- 12 years (mean +/- SD) with a weight of 74 +/- 14 kg. The most common indications for implantation included deterioration while awaiting heart transplant (36%) and acute cardiogenic shock (32%). The cause of heart disease was primarily ischemic (52%) and idiopathic (35%) cardiomyopathy. Duration of implantation ranged from 0 to 603 days (mean 25 +/- 64 days). One hundred three (60%) patients had the device less than 2 weeks, 37 (22%) between 2 to 4 weeks and 31 (18%) more than 4 weeks. Complications during implantation included infection (37%), thromboembolic events (stroke 7%, transient ischemic attack 4%), kidney failure requiring dialysis (20%), bleeding requiring intervention (26%), and device malfunction (4%). Of the 171 patients, 118 (69%) underwent orthotopic heart transplantation. Actuarial survival for all patients with implants was 62% for 30 days and 42% for 1 year, and for patients with transplants was 72% for 30 days and 57% for 1 year. The main causes of death were sepsis (33%), multiorgan failure (21%), and posttransplant rejection (10%). The results indicate a relative success of this treatment for patients with an otherwise fatal prognosis. Moreover, as the demand for donor organs far exceeds availability, continued investigation of total artificial hearts is justified.
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PMID:Summary of the clinical use of the Symbion total artificial heart: a registry report. 154 May 98


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