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

A case of a 38 year-old female patient admitted to the hospital with stroke is reported. Transesophageal echodoppler cardiogram showed mitral valve prolapse associated with a vegetation on its anterior leaflet, and this vegetation was a possible embolic source. The follow-up without signs of infectious disease, the good clinical outcome and the regression of the valvar vegetation without use of antibiotics consolidated the diagnosis of nonbacterial thrombotic endocarditis. As far as it is known, this is the first reported case with antemortem diagnosis and good outcome with treatment with aspirin and ticlopidine.
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PMID:[Nonbacterial thrombotic endocarditis]. 949 28

During 1996, 585 patients, aged 55 to 96, were admitted into hospital at the Geriatric Department of Ospedale Maggiore (Turin). Acute confusion was seen in 22.2% of these patients who tended to have more serious clinical condition, were more likely to have chronic cognitive impairment, were treated with a greater number of drugs and suffered more from immobility with pressure ulcer. The confusional state, manifested at admission to Geriatric department, was mostly related with the patient's clinical severity, while the one which developed during hospital stay was linked to situations of physical frailty, as pressure ulcer and low albumin values. The most frequent causes of acute confusional state were acute infectious diseases, heart failure, gastro-intestinal bleeding with secondary anaemia, stroke and dehydration. In many cases the very cause of the acute confusional state could not be identified. Falls, more than 31 days length of stay in hospital and death were more frequent in patients suffering from confusional state. Chronic cognitive impairment, functional dependence, clinical severity and treatment involving a great number of drugs, are the main contributing factors in this syndrome. Thus, a multi-dimensional evaluation which takes into account both clinical-functional and socio-economical aspects, is useful for a correct preventive and diagnostic approach of acute confusional state.
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PMID:[Acute confusion in the geriatric patient]. 967 28

Peripheral arterial disease of the lower limbs is a manifestation of atherosclerosis, and may also affect other vascular territories such as the coronary and cerebral arteries. Progressive narrowing of the vessels up to total occlusion can present as intermittent claudication or pain at rest, with or without cutaneous lesions. Patients with intermittent claudication are at a low risk of amputation, and the symptom has to be regarded as a warning signal for myocardial infarction and stroke. Nevertheless, if the patient's walking distance is too limited to allow a near-normal life, symptomatic treatment to improve quality of life should be considered. Treatment may consist of walking exercise, surgical or interventional radiological revascularisation, or, in some cases, administration of vasoactive drugs. Antiplatelet agents should be administered in an attempt to limit disease progression and prevent cardiac and cerebrovascular complications, together with active measures to reduce established risk factors such as smoking, diabetes, hyperlipidaemia, and arterial hypertension. The presence of pain at rest indicates that a lower limb is jeopardised, especially when the criteria for critical ischaemia have also been met. These criteria include the presence of chronic (lasting for more than 2 weeks) symptoms of ischaemia at rest and a systolic blood pressure less than 50 mm Hg or 30 mm Hg at the ankle or big toe, respectively. In such a situation, revascularisation should be attempted whenever possible. If this is not possible or if the procedure has failed, prostacyclin administered intravenously for days or weeks is an alternative. After revascularisation, early reocclusion may be prevented by administering anticoagulants and late reocclusion by antiplatelet agents, in conjunction with eradication of risk factors. In all situations, therapeutic decision-making should be undertaken in a multidisciplinary setting and should include the following: specialists in angiology (an internist) and interventional radiology; a vascular surgeon; an orthopaedic surgeon, if necessary; and diabetes and infectious disease specialists.
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PMID:[Drug treatment strategies for peripheral obliterative arteriopathy]. 984 99

The Philippines is an archipelago of about 7000 islands, with an area about the size of England, situated just above the equator in Southeast Asia. It has a population of 70 million. The Philippines has had extensive commercial and social contact with Asian neighbors, specifically the Chinese, even before the 377 years of Spanish colonization from 1521 to 1898 and the 48 years of American rule from 1898 to 1946. More than 80% of Filipinos are Catholics; the rest are Muslims and Protestants of various denominations, including those who belong to Filipino church groups. Infectious diseases such as tuberculosis, amoebiasis, typhoid fever, and malaria are still prevalent, and arteriosclerosis, cancer, and stroke are common and on the rise.
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PMID:Surgery in the Philippines. 1008 78

Migrant farmworkers lead a hard life filled with strenuous work, stress, and anxiety about employment; live under substandard conditions; and rarely get the health care they require. Preventive care is a luxury they cannot afford. Year-round nutritious meals are rarely possible, due to long working hours, traveling, and living in housing without adequate cooking and refrigeration facilities. Children may attend up to six or more schools during the course of a school year. Crowded housing conditions support the invasion of parasites, infectious diseases, and viral infections. Dermatological conditions from working around a wide variety of plants, dirt, and in the sun are frequent. Exposure to pesticides, herbicides, and other chemical additives creates the likelihood of acute reactions, such as headaches and rashes, and also puts workers at risk of developing chronic diseases as the level of exposure rises because of accumulation and mix of various chemicals. Yet, we know little about the health status of this population. We are unable to estimate crude death rates, age-specific death rates, or prevalence rates of most common causes of death, such as heart disease,cancer and stroke. There is no information about occupational accident rates, infectious disease rates, or even postneonatal mortality. We do know that when migrants go to a clinic, they are often likely to have the chronic conditions of hypertension or diabetes. They present symptoms of acute conditions such as dental problems, dermatitis, otitis media among children, and acute upper respiratory infections. Women frequently need obstetrical care, reflected (ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Health status and needs of migrant farm workers in the United States: a literature review. 1012 52

The mortality and complication rates have been studied in a series of 92 patients with stroke, who have been treated in a general medicine ward in central Italy. The data have been compared and discussed in relationship with analogous parameters reported about some series from north-European stroke units (SU) and general medicine wards (RMG). The mortality rates have been 11% over the first 7 days and 18% over the first 30 days. In a series of patients from northern Europe these parameters have been 12 and 19%. In severe prognosis patients the complication rate has been 83%, whereas in the series from northern Europe it has been estimated 97%. The infectious diseases have been complicating stroke in 21% of the patients. This rate is as high as in SU's, but lower than in RMG (49%). In the over 65 patients the mean hospital stay has been 19 days versus 24 in the SU. The percentage of the patients dismissed home has been higher than in the SU and in the RMG. Taking into consideration only the above-mentioned short term parameters and the acute phase management, the SU do not apparently have any advantage in comparison to the general medicine ward in central Italy which has been considered for this study.
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PMID:[The treatment of stroke in internal medicine wards or in an intensive care unit?]. 1022 53

From 1991 to 1997 at the I Clinic of Infectious Diseases of Silesian Medical Academy in Bytom 123 patients with purulent, bacterial meningoencephalitis were treated. Mortality in the analysed group was 28.5% (35 cases). In the course of disease various complications were observed: seizures (43.1% cases), ischaemic stroke (2.4% cases), brain abscess (4.1%). Permanent consequences subsequent to the disease were found in 16.3% cases: deafness and partial deafness, psychic disorders, paresis and paralysis, epilepsy and cranial nerves paralysis. Bacterial infections of the central nervous system are still danger diseases producing high lethality, complications and subsequent neurological sequelae.
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PMID:[Complications and sequelae of the purulent, bacterial meningoencephalitis in the material from the 1st Clinic of Infectious Diseases of Silesian Medical Academy in Bytom in the years 1991-1997]. 1032 Oct 93

Geriatric patients with known dementia and suffering from an acute somatic disease are highly vulnerable to develop delirium. It is therefore essential to suspect and recognize delirium in these patients, especially in emergency wards. In the present study we evaluated activities on a dedicated delirium ward at a Swedish University Hospital. Over one and a half years 637 patients were treated for suspected delirium, the majority of patients being referred from the emergency ward at the same hospital. Infectious diseases were the main cause of delirium in 67% of cases. Other common causes were heart disease and stroke. Drug use as the only cause of delirium was found in less than 1% of cases. Approximately 70% of patients had cognitive disturbances, either dementia or mild cognitive impairment. The existence of multiple diseases as causative factors was frequent. Knowledge about delirium and how it is both diagnosed and treated is of great importance in all kinds of settings where acute somatic treatments are common.
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PMID:Delirium in clinical practice: experiences from a specialized delirium ward. 1047 45

A growing amount of epidemiologic, experimental, and clinical evidence has linked infection as a risk factor to variousatherosclerotic diseases including acute myocardial infarction and cerebral infarction. Bacteremic infections with and without endocarditis carry a high risk for both stroke and acute myocardial infarction. During the last decade, chronic bacterial infections such as Chlamydia pneumoniae and dental infections have been associated as risk factors for various atherosclerotic diseases. These chronic bacterial infections are risk factors for acute cardiovascular events, but they may also have some role in the etiopathogenesis of atherosclerotic process itself. There are many known mechanisms that might explain the observed association of infection and atherosclerotic diseases, but it is probable that these mechanisms are complex and multifactorial and probably differ from infection to infection and from patient to patient. Infection theory is by no means against classic risk factor theory in the etiopathogenesis of atherosclerosis. Infection may also act as a synergistic risk factor together with classic risk factors in the development of various atherosclerotic diseases.
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PMID:Role of infections in atherosclerosis. 1053 42

The established risk factors for ischemic stroke do not sufficiently explain all clinical and epidemiological features of the disease, such as the winter peak of stroke incidence, the decline of stroke during this century and the time point of cerebral ischemia. A role of infectious disease as stroke risk factor may partly explain above features. Several case-control studies with both hospital and population control groups showed that acute infection within the preceding week and mainly respiratory infection of both viral and bacterial origin increase the risk of cerebral ischemia independent from other risk factors (odds ratio 2.9-14.5). Infection as a risk factor appears to be most important in young age groups. Infection may cause a procoagulant state and thus, trigger thrombosis and cerebral ischemia. There is increasing evidence for chronic infection as stroke risk factor. A case-control study indicated chronic and recurrent bronchitis to increase stroke risk. Two case-control and one cohort study showed that chronic dental infection, mainly parodontitis, is a risk factor for stroke. There are conflicting results on chronic infection with cytomegalovirus and insufficient evidence for a role of Helicobacter pylorii infection in pathogenesis of stroke. Seroepidemiological studies and analyses of carotid plaques indicate a role of Chlamydia pneumoniae in ischemic stroke. However, causality can not yet be inferred from present results. Acute and chronic infectious diseases are treatable and partly preventable conditions. Their recognition as stroke risk factors could therefore be important for stroke prevention.
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PMID:[Infection, atherosclerosis and acute ischemic cerebrovascular disease]. 1069 60


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