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

A study is made of the effects of associated causes of death, and of dependency among causes of death, by observing the relative importance of one cause of death when another is eliminated under various competing risk models. Two disease pairs, cancer and infectious disease and stroke and ischemic heart disease, are selected for analysis because they represent different types of disease dependence. Crude probabilities of death for each disease are calculated for the U.S. white male population in 1969. Next, the effects of the complementary disease in a pair are hypothetically eliminated in one of three ways: (a) a standard competing risk adjustment for cause elimination when deaths are singly caused (Chiang, 1968), (b) lethal defect-pattern of failure computations for multiply caused death when no causal order is inferred (Manton et al., 1976), and (c) relative susceptibility, computations for multiply caused deaths when causes are ordered (Wong, 1977). The paper closes with a discussion of the relative merits of the three types of adjustments.
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PMID:Effects of dependency among causes of death for cause elimination life table strategies. 45 7

An analysis was carried out of the mortality rate on the medical wards of the University College Hospital, Ibadan, over a 14-year period (1960-73). A total of 4,568 cases were reviewed with an annual death rate of between 300 and 400. Most of the deaths resulted from cardiovascular diseases, especially hypertension, the mortality rate from which has shown no appreciable decline over the years. Death from cerebrovascular accident is steadily increasing. Infections contribute considerably to mortality from chest and alimentary tract disease, although there has been a progressive decline in mortality rates from infectious diseases such as tetanus and typhoid fever. The standard of death certification needs to be improved upon, especially with respect to the clarification of the primary and the contributory causes of death and whether post-mortem examination was carrie dout or not. It is suggested that more effort should be made to ensure that post-mortem examination is carried out in cases where there is doubt about the ante-mortem diagnosis unless such a request is specifically refused by the relatives of the deceased after explaining to them the value of such an examination to medical knowledge.
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PMID:Analysis of the causes of death on the medical wards of the University College Hospital, Ibadan over a 14-year period (1960-1973). 84 50

Various disadvantages may be encountered with mechanical valve prostheses in the surgical management of mitral insufficiency; namely: 1) Early and secondary disinsertion; this is nearly always partial and is usually accompanied by haemolytic anaemial. 2) Infection with nil response to antibiotics. Death from septicaemia may be rapid. Replacement of the prosthesis is otherwise mandatory. 3) Thrombosis, usually partial, accompanied by one or more embolisms. Thrombo-embolism is more frequently noted in the first 6 months after implantation and becomes less common as time passes. 4) Deterioration of the movable part (ball variance) consisting of changes in colour and shape, with swelling and unevenness of the surface, breakage, pitting and loss of elasticity. 5) Low stroke volume syndrome. 6) Erosion of the septum and serious rhythm disturbances. 7) Proliferation of endothelial tissue leading to narrowing of the orifice. 8) Disturbed movement of the movable part, leading to intermittent or permanent blockage and loss of opening or closing play due to the interposition of fibrin and blood clots.
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PMID:[Disadvantages of mechanical valve prostheses in the surgical treatment of mitral insufficiency]. 119 37

Mortality due to chronic diseases has been increasing in all regions of Brazil with corresponding decreases in mortality from infectious diseases. The geographical variation in proportionate mortality for chronic diseases for 17 Brazilian state capitals for the year 1985 and their association with socio-economic variables and infectious disease was studied. Calculations were made of correlation coefficients of proportionate mortality for adults of 30 years or above due to ischaemic heart disease, stroke and cancer of the lung, the breast and stomach with 3 socio-economic variables, race, and mortality due to infectious disease. Linear regression analysis included as independent variables the % of illiteracy, % of whites, % of houses with piped water, mean income, age group, sex, and % of deaths caused by infectious disease. The dependent variables were the % of deaths due to each one of the chronic diseases studied by age-sex group. Chronic diseases were an important cause of death in all regions of Brazil. Ischaemic heart diseases, stroke and malignant neoplasms accounted for more than 34% of the mortality in each of the 17 capitals studied. Proportionate cause-specific mortality varied markedly among state capitals. Ranges were 6.3-19.5% for ischaemic heart diseases, 8.3-25.4% for stroke, 2.3-10.4% for infections and 12.2-21.5% for malignant neoplasm. Infectious disease mortality had the highest (p < 0.001) correlation with all the four socio-economic variables studied and ischaemic heart disease showed the second highest correlation (p < 0.05). Higher socio-economic level was related to a lower % of infectious diseases and a higher % of ischaemic heart diseases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Geographical patterns of proportionate mortality for the most common causes of death in Brazil. 134 34

The mortality rate and causes of death after a hip fracture were studied in 493 consecutive patients with a hip fracture. All patients were treated in three hospitals in Utrecht, The Netherlands. The mortality rate following hip fractures is high and age dependent. Forty-five patients, 38 women and 7 men, died during the period of hospitalization (9.1%). One year after the date of hip fracture 23.6% of the women had died and 33.0% of the men. Four years after the date of hip fracture the mortality rates in women and men were 44.4% and 55.3%, respectively. Male sex, concomitant illnesses and in-hospital complications are negative determinants of survival. The in-hospital mortality was due to: cerebrovascular accident (n = 7), cardiac decompensation (n = 12), myocardial infarction (n = 4), pulmonary infection (n = 6), intestinal bleeding (n = 1) and sepsis (n = 5). From the registration of death causes we learned that 54 deaths were directly due to the hip fracture, 4 due to bed sores, 34 due to infectious diseases, 62 due to cardiovascular disease, 22 due to cerebrovascular accidents, 14 due to diabetes mellitus, and 33 due to neoplasm. The high mortality rate within the first 8 weeks after the date of hip fracture was mainly attributed to the hip fracture.
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PMID:Mortality and causes of death after hip fractures in The Netherlands. 140 39

The aetiopathogenesis of haemorrhagic shock encephalopathy syndrome (HSES) remains unclear and after concern that a novel environmental agent was the cause, the British Paediatric Association and the Public Health Laboratory Service Communicable Disease Surveillance Centre in 1983 initiated surveillance of this condition in the British Isles. After 1986 cases were ascertained via the British Paediatric Surveillance Unit 'active' reporting scheme; this report presents the findings for 1985-8. Sixty five patients were reported, of whom 52 satisfied the criteria for inclusion. Of those whose outcome was known, 24 (46%) died, 18 had severe neurological damage, and six survived apparently intact. Epidemiological features of note were: the median age of 15 weeks (range 3-140); statistically significant clustering of admission times suggesting a peak onset period at night; lack of geographic clusters, of secular trends and, except for a slight excess in winter months, of seasonality. Clinical and pathological features followed a highly consistent pattern, suggesting that HSES is an individual clinical entity distinguishable from conditions with similar presentations, such as septicaemia and Reye's syndrome. There was no microbiological or epidemiological evidence to support the emergence of a novel environmental agent. Many of the features of HSES were, however, the same as those described in heat stroke and we suggest that the two conditions are the same even though there is usually no history of overt overheating.
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PMID:Haemorrhagic shock encephalopathy syndrome in the British Isles. 850 85

The objective of this study was to determine the probabilities of specific morbid events or death among patients with end-stage renal disease (ESRD) treated by hemodialysis. A prospective cohort study was performed between March 1988 and September 1989 in 18 hemodialysis centers in 13 Canadian cities, representing about one third of the hemodialysis population in Canada. The inception cohort consisted of 496 patients entering hemodialysis who had survived 1 month. The few new hemodialysis patients who received erythropoietin (EPO) in the last 3 months of the study were excluded. Survival curves were compared using the Cox proportional hazards regression model. Older age and history of cardiovascular disease were independently associated with a greater probability of death. Age and history of cardiovascular disease were also associated with a greater probability of nonfatal circulatory events (myocardial infarction, angina requiring hospitalization, or stroke), while a serum albumin level less than or equal to 30 g/L (3.0 g dL) was associated with an increased probability of pulmonary edema. The probability of surviving 12 months without receiving a blood transfusion was 47.2% for males and 27.5% for females. The incidence of non-A, non-B hepatitis, as estimated by unexplained elevations in serum aspartate aminotransferase (AST) values, was not different between patients receiving and not receiving blood transfusions. The probability of hospitalization for any cause was greater for patients with grafts for vascular access than for those with fistulae, for those with a history of cardiovascular disease, for those with a serum albumin level less than or equal to 30 g/L, and for those with renal disease due to diabetes or vascular disease. Hospitalization due to circulatory disease was more likely among those with a history of cardiovascular disease and among those with a lower serum albumin level. Hospitalization for infectious disease was more likely among those with a lower serum albumin level and less likely among those with a fistula for vascular access. Among all patients receiving hemodialysis treatment for more than 6 months, there were 14.8 hospital days per year.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Canadian Hemodialysis Morbidity Study. 155 66

A clinical case that occurred in a 42 years old female and which fulfils the diagnostic criteria for the entity described as Heat Stroke is presented. In this case, besides the usual manifestations of hyperpyrexia without sweating along with consciousness disorders, features of consumptive coagulopathy, rhabdomyolysis and well marked laboratory liver dysfunction have also been found. The severity of this situation and its less common occurrence in temperate climates, together with the uncertainty in establishing the diagnosis, namely when infection is suspected--in the present case the initial diagnosis was Sepsis, which led to patient's admission in an infectious diseases intensive care unit--motivate the authors to make this report. Furthermore, they consider this case to be a good example of the varied clinical and laboratory manifestations and possible severe complications that Heat Stroke may display.
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PMID:[Febrile coma and disseminated intravascular coagulation following heat stroke]. 160 73

A growing amount of clinical and experimental evidence suggests a link between infection and atherosclerotic diseases including both myocardial and cerebral infarction. A prime example is a greatly increased risk of stroke in septicaemic patients with and without endocarditis. Controlled clinical studies have recently shown, however, that certain other milder bacterial infections are also a risk factor for infarction. A preceding febrile respiratory infection was a major risk factor for stroke in young and middle aged patients. In patients with acute myocardial infarction Chlamydia pneumoniae and dental infections seem to be risk factors according to one controlled clinical study. Several possible mechanisms could explain the observed association of infection and infarction. For instance, infection causes a hypercoagulable state which increases the risk of thrombosis. In addition, infection has profound and harmful effects on prostaglandin and lipid metabolism. Infection may also have some role in the atherosclerotic process itself by inducing damage and inflammation in vascular endothelium in the presence of hypercholesterolemia. So far, however, little clinical evidence is available to suggest that by controlling infection the risk of infarction or development of atherosclerotic lesions might be reduced except in patients with endocarditis, where the risk of thromboembolic complications rapidly diminished when the infection is controlled with antimicrobial therapy.
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PMID:Infection as a risk factor for infarction and atherosclerosis. 175 23

Between March 1982 and March 1991, 225 heart transplantations (HTx) have been performed in 220 patients suffering end stage cardiac disease. Thirteen percent were females and 87% were males. Age range was from 5 to 68 years. The underlying cardiac disease was ischemic cardiopathy in 51.5%, congestive dilated cardiomyopathy in 42%, valvular cardiomyopathy in 3.5%, toxic myocarditis (post-adriamycin) in 1.5% and chronic rejection in 2.5% (retransplantation). Selection of the recipients was done following the currently well established criteria also taking into account the absolute major contraindications for HTx. Due to the still increasing demand of donor organs, currently donor age has been extended up to 50 years for male and 55 years for female donors. One quarter of the grafts were harvested on site in our institution, two other quarters were harvested somewhere else in Belgium and the last quarter provided by other countries cooperating with Eurotransplant. All patients have undergone orthotopic cardiac transplantation using the standard Lower and Shumway technique. Immunosuppression protocols have changed four times throughout the years. Nevertheless all were based on the use of Ciclosporine variously combined with other current immunosuppressive drugs. Rejection monitoring relied on routine endocardiac biopsy and was diagnosed according to the Billingham criteria. The in-hospital mortality is currently 11%. Infection, early right heart graft failure and acute rejection were the leading causes of death. The major causes of early morbidity were several curable infections, reversible rejection episodes, transient acute renal failure and controllable arterial hypertension. Among the survivors followed for at least one month up to nine years, half of late mortality was caused by chronic rejection followed by infection, sudden death, metabolic disorders, stroke and malignancy. Late morbidity involves cases of mild coronary graft diseases, biological renal insufficiency, some degree of arterial hypertension, dislipidemia. Current actuarial survival rate is 87% at one year, 76% at 5 years up to 9 years. Our experience confirms that HTx represents today and effective therapy for selected patients suffering end stage cardiac disease.
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PMID:A survey of nine years heart transplantation at Erasme Hospital, University of Brussels. 178 50


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