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

Activation of group II metabotropic glutamate (mGlu2/3) receptors reduces excessive glutamate release that is often associated with neurodegenerative and psychiatric disorders. This finding encouraged the search for potent and selective agonists as potential therapeutic agents. The search led to the discovery of LY379268 {(-)-2-oxa-4-aminobicyclo[3.1.0]hexane-4,6-dicarboxylic acid}, which is a highly potent and systemically available mGlu2/3 receptor agonist. LY379268 was effective in several animal models of stroke, epilepsy, drug abuse, schizophrenia, and pain. Suppression of motor activity is the major side effect of LY379268. Upon repeated administration tolerance develops to this side effect, while the therapeutic effects of LY379268 remain. To date, no clinical data with LY379268 are available. This review article summarizes the preclinical pharmacology of LY379268.
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PMID:The preclinical properties of a novel group II metabotropic glutamate receptor agonist LY379268. 1807 28

Rhabdomyolysis is not an uncommon cause of acute renal failure (ARF). It is usually caused by severe traumatic crush injury, severe exercise, septicemia, drug abuse, alcoholic intoxication, heat stroke and myopathy. In this case, we present a patient who developed rhabdomyolysis after severe hypokalemia (serum potassium 1.9mmol/L). This is an unusual cause of rhabdomyolysis even though hypokalemia is a common medical problem. This patient developed acute oliguric renal failure that required daily hemodialysis for 12 days, before start of recovery. This case demonstrates that hypokalemia is a preventable cause of rhabdomyolysis and ARF.
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PMID:Acute Renal Failure due to Rhabdomyolysis Caused by Hypokalemia. 1820 73

This article provides an overview on the management of risk factors to prevent primary strokes, the gaps in successful management, and future directions for the research and management of stroke risk factors. The major focus is given to the management of modifiable risk factors for stroke, including hypertension, diabetes, dyslipidemia, atrial fibrillation and other cardiac conditions, carotid artery stenosis, smoking, poor diet, physical inactivity, and obesity. A brief discussion on the management of potentially modifiable risk factors, such as alcohol and drug abuse, sleep apnea, and hyperhomocysteinemia, is included, as is the use of antiplatelet therapy in primary stroke prevention. Finally, prognostic scores to assess an individual risk for a first stroke are reviewed.
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PMID:Risk factor management to prevent first stroke. 1902 1

Stroke, which is unusual in young adults, has been linked to recreational drug use and the antiphospholipid syndrome (aPS). Cocaine use has been related to stroke in this population, and aPS is a known cause of thrombotic neurologic events. We report a patient with positive lupus anticoagulant and anticardiolipin antibodies as well as a history of cocaine use immediately preceding the acute onset of multiple neurologic deficits. The findings in this case suggest a relationship between the use of cocaine, the aPS, and stroke in young adults.
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PMID:Antiphospholipid antibodies, cocaine use, and stroke in a young woman. 1907 91

In principle, only patients with an ASA (American Society of Anaesthesiologists)-score I or II qualify for an elective surgical procedure, such as an implantation treatment. Surgical risks are weighed against the potential benefits offered by oral implants. Counter-indications to implant rehabilitation include recent myocardial infarction and cerebrovascular accident, immunosuppression, active treatment of malignancy, drug abuse, as well as long-standing intravenous bisphosphonate use. In the case of patients with an endocarditis risk, and also in the case of patients with an orthopedic prosthesis, implants should be placed with some reluctance. If the decision is made for treatment, then consultation with the treating specialist is recommended. Beside absolute counter-indications, there are also conditions which compromise the success of an implant treatment, such as radiation of the jaw or long-term smoking. Concerning the effect which medical conditions have on the life-expectancy of the implant, little is known. There appear to be few existing factors which actually have a negative influence on the chance that an implant will survive.
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PMID:[Surgical dilemmas. Medical restrictions and risk factors]. 1914 31

Alcohol dependence and alcohol abuse or harmful use cause substantial morbidity and mortality. Alcohol-use disorders are associated with depressive episodes, severe anxiety, insomnia, suicide, and abuse of other drugs. Continued heavy alcohol use also shortens the onset of heart disease, stroke, cancers, and liver cirrhosis, by affecting the cardiovascular, gastrointestinal, and immune systems. Heavy drinking can also cause mild anterograde amnesias, temporary cognitive deficits, sleep problems, and peripheral neuropathy; cause gastrointestinal problems; decrease bone density and production of blood cells; and cause fetal alcohol syndrome. Alcohol-use disorders complicate assessment and treatment of other medical and psychiatric problems. Standard criteria for alcohol dependence-the more severe disorder-can be used to reliably identify people for whom drinking causes major physiological consequences and persistent impairment of quality of life and ability to function. Clinicians should routinely screen for alcohol disorders, using clinical interviews, questionnaires, blood tests, or a combination of these methods. Causes include environmental factors and specific genes that affect the risk of alcohol-use disorders, including genes for enzymes that metabolise alcohol, such as alcohol dehydrogenase and aldehyde dehydrogenase; those associated with disinhibition; and those that confer a low sensitivity to alcohol. Treatment can include motivational interviewing to help people to evaluate their situations, brief interventions to facilitate more healthy behaviours, detoxification to address withdrawal symptoms, cognitive-behavioural therapies to avoid relapses, and judicious use of drugs to diminish cravings or discourage relapses.
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PMID:Alcohol-use disorders. 1941 Jul 5

In the acute-care setting patients with altered mental status as a result of such diverse etiologies as stroke, traumatic brain injury, degenerative neurologic impairments, dementia, or alcohol/drug abuse are routinely referred for dysphagia testing. A protocol for dysphagia testing was developed that began with verbal stimuli to determine patient orientation status and ability to follow single-step verbal commands. Although unknown, it would be beneficial to ascertain if this information on mental status was predictive of aspiration risk. The purpose of this investigation was to determine if there was a difference in odds for aspiration based upon correctly answering specific orientation questions, i.e., 1. What is your name? 2. Where are you right now? and 3. What year is it?, and following specific single-step verbal commands, i.e., 1. Open your mouth. 2. Stick out your tongue. and 3. Smile. In a consecutive retrospective manner data from 4070 referred patients accrued between 1 December 1999 and 1 January 2007 were analyzed. The odds of liquid aspiration were 31% greater for patients not oriented to person, place, and time (odds ratio [OR] = 1.305, 95% CI = 1.134-1.501). The odds of liquid aspiration (OR = 1.566, 95% CI = 1.307-1.876), puree aspiration (OR = 1.484, 95% CI = 1.202-1.831), and being deemed unsafe for any oral intake (OR = 1.688, 95% CI = 1.387-2.054) were, respectively, 57, 48, and 69% greater for patients unable to follow single-step verbal commands. Being able to answer orientation questions and follow single-step verbal commands provides information on odds of aspiration for liquid and puree food consistencies as well as overall eating status prior to dysphagia testing. Knowledge of potential increased odds of aspiration allows for individualization of dysphagia testing thereby optimizing swallowing success.
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PMID:Answering orientation questions and following single-step verbal commands: effect on aspiration status. 1926 6

Stroke associated with drug abuse has been frequently reported, particularly in young patients. The most commonly implicated drugs include cocaine, heroine, and amphetamines. Despite its widespread abuse, cannabis associated stroke is only infrequently reported. The cause and effect association between cannabis use and stroke is not firmly established. Presuming that cannabis may cause stroke, potential pathophysiologic mechanisms are not known. In this paper, we shall review the literature linking cannabis use and stroke and possible mechanisms supporting this link.
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PMID:Cannabis and stroke: is there a link? 1932 2

The National Institute of Mental Health in cooperation with the National Institute on Drug Abuse and the National Institute of Neurological Disorders and Stroke organized a meeting on July 24-25, 2008 to develop novel research directions for neuroAIDS research. The deliberations of this meeting are outlined in this brief report. Several critical research areas in neuroAIDS were identified as areas of emphasis. Opportunities for collaborations between large NIH-funded projects were also discussed.
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PMID:Planning Future Strategies for Domestic and International NeuroAIDS Research, July 24-25, 2008. 1945 26

Previous reports of comorbid conditions in poliomyelitis survivors mainly focused on some disease categories, such as respiratory diseases, gastrointestinal diseases, psychiatric diseases, neurological diseases and cancer. Data regarding a wide spectrum of medical comorbidities in patients with poliomyelitis is still sparse. This study aimed to investigate and profile the wide range of comorbidities among the survivors of paralytic poliomyelitis in a Chinese population. In total, 2,032 paralytic poliomyelitis patients were selected as the study group and the comparison group consisted of 10,160 randomly selected enrollees. The comorbidities for analysis were based on a modified version of the Elixhauser Comorbidity Index. Conditional logistic regression analyses were computed to investigate the risk of comorbidities for these two groups. As compared to controls, patients with paralytic poliomyelitis had significantly higher prevalence of hypertension, ischemic heart disease, hyperlipidemia, congestive heart failure, cardiac arrhythmias, peripheral vascular disorder, stroke, paralysis, migraines, Parkinson's disease, rheumatoid arthritis, ankylosing spondylitis, pulmonary circulation disorders, chronic pulmonary disease, liver disease, peptic ulcers, hepatitis B or C, deficiency anemias, depression, and lymphoma. Most of the differences are of clinical interest, ORs often being between 2 and 3. No significant difference between poliomyelitis patients and controls was observed in the prevalence of SLE, tuberculosis, alcohol abuse and drug abuse. Our findings demonstrate that survivors of paralytic poliomyelitis in Taiwan are at higher risk of having multiple medical comorbidities although some potential confounding factors including educational level, marital status, obesity and physical activity are not available in our database. The pattern is generally consistent with previous observations from Western populations. Nevertheless, we found several novel associations which have rarely, if ever, been reported previously.
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PMID:Comorbidity profile of poliomyelitis survivors in a Chinese population: a population-based study. 2127 17


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