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Query: UMLS:C0038454 (
stroke
)
147,016
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
A prospective prognostic study of all admissions to a geriatric assessment and rehabilitation unit was carried out which analysed the medical profiles of 205 patients admitted for the first time during a four month period. All patients were followed up for at least six months after discharge. Particularly poor prognosis was noted among patients with renal failure, ischaemic heart disease, depression,
pneumonia
, congestive cardiac failure, trauma, mental disorder and dementia. Good prognosis was reported in patients with Parkinson's disease, faecal impaction,
stroke
and adverse drug reactions. Multiple diagnoses were common, and only nine patients had no active medical problems during their admission. The implications for adequate training of geriatricians in medicine are discussed.
...
PMID:Medical profiles of patients admitted to a geriatric assessment and rehabilitation unit. 345 Nov 40
We performed a prospective, controlled study of kinetic therapy in acute, severe
stroke
. This therapy involved continuous mobilization of a bedridden patient by means of a specially designed rotating bed. All patients with acute
stroke
presenting to the Neurology Service over an 18-month period were screened, and those that qualified were assigned to confinement in either a routine hospital bed or a rotating bed. We found that the most common complication of
stroke
with bed confinement of 4 days or longer was bacterial infection consisting of either
pneumonia
, sepsis, or urinary tract infection. The two variables found to be of greatest significance in affecting the rate of infection were length of bed confinement, especially for greater than 13 days (2.3-fold increased risk, p less than 0.04), and placement in a routine hospital bed (2.9-fold increased risk, p = 0.023).
Stroke
PMID:Evaluation of kinetic therapy in the prevention of complications of prolonged bed rest secondary to stroke. 359 Feb 57
From among the pregnant women in the Collaborative Perinatal Project of the National Institute of Neurological and Communicative Disorders and
Stroke
, we identified 508 who had migraine, and 3192 who had no history of migraine, of taking headache medication during the previous 12 months, and of headaches during the pregnancy. Migraineurs smoked more heavily and had a longer smoking history than their headache-free peers. Among migraineurs, smokers were not more likely to consume analgesics than nonsmokers. Regardless of smoking classification, more migraineurs consumed tranquilizers, amphetamines, and sleeping pills than headache-free women. Among smokers only, migraine was associated with heart disease, thrombosis/phlebitis, asthma, peptic ulcer, and
pneumonia
. In nonsmokers, migraine was associated with drug sensitivity and other allergies.
...
PMID:Migraine and other diseases in women of reproductive age. The influence of smoking on observed associations. 363 73
A clinical and pathomorphological examination has covered 206 subjects who died due to various urgent somatic abnormalities (myocardial infarction, pulmonary thromboembolism,
pneumonia
, etc.) whose clinical picture was largely characterized by general cerebral and focal neurological symptoms. To denote the aforementioned conditions, the term "pseudo-stroke" has been utilized. Pathomorphological examination of the brain has revealed multiple cysts in the hemispheres and brain stem in 40.8%, single cysts in 17.0% and no focal damage to the cerebral matter in 42.2% of cases. On the basis of a retrospective analysis of neurological manifestations of the pseudo-
stroke
syndrome in urgent somatic abnormalities, the authors have identified the regularities of its course, criteria of differential diagnosis, and possible pathogenetic mechanisms of the development of the above conditions.
...
PMID:[Clinical picture and differential diagnosis of the pseudo-stroke syndrome in urgent somatic pathology]. 367 8
Various potential measures of quality of care are being used to differentiate hospitals. Last year, on the basis of diagnostic and demographic data, the Health Care Financing Administration identified hospitals in which the actual death rate differed from the predicted rate. We have developed a similar model. To understand why there are high-outlier hospitals (in which the actual death rate is above the predicted one) and low-outlier hospitals (in which the actual death rate is below the predicted one), we reviewed 378 medical records from 12 outlier hospitals treating patients with one of three conditions:
cerebrovascular accident
, myocardial infarction, and
pneumonia
. After adjustment for the severity of illness, the death rate in the high outliers exceeded that predicted from the severity of illness alone by 3 to 10 percent, and in the low outliers, the actual death rate fell short of the severity-adjusted predictions by 10 to 15 percent (P less than 0.01). Reviews of the process of care using 125 criteria revealed no differences between the high and low outliers. However, detailed reviews by physicians of the records of patients who died during hospitalization revealed a higher rate of preventable deaths in the high outliers than in the low outliers. For the three conditions studied, we project that 5.7 percent of a standard cohort of patients admitted to the high-outlier hospitals would have preventable deaths, as compared with 3.2 percent of patients admitted to the low-outlier hospitals (P less than 0.05). A meaningful comparison of hospital death rates requires adjustment for severity of illness. Our findings indicate that high-outlier hospitals care for sicker patients. However, these same hospitals or their medical staffs may also provide poorer care. Our results need confirmation before death-rate models can be used to screen hospitals.
...
PMID:Hospital inpatient mortality. Is it a predictor of quality? 368 9
Synchronously administered cis-platinum (cis-DDP) and radiation therapy have been used to treat unresectable squamous cell carcinomas of the head and neck. The purpose of this study was to evaluate the efficacy and tolerance of preoperative adjuvant cis-DDP plus radiation therapy in operable stage III and IV head and neck cancers. Radiation therapy (4,500 rad) was delivered in 180-rad daily fractions. Cis-DDP (20 mg/M2) was given before radiotherapy on days 1-4 and 21-24. Eighteen patients began therapy; 16 completed the combined regimen. Toxicity included stomatitis and WBC below 2,500/mm3. One patient died from therapy of a
cerebrovascular accident
. Sixteen patients (89%) achieved a complete or partial response to therapy. Complete responses were observed in 13 of 18 primary tumors (72%), and in all three patients with cervical lymphadenopathy. Complete responses were noted for lesions of the nasopharynx, oral cavity, pharynx, hypopharynx, and larynx, for all histologic grades of squamous cell carcinoma. Twelve patients underwent curative surgery. Site-related morbidity occurred in two patients (15%) and a third patient developed postoperative
pneumonia
. Five of 10 resected primary tumors with preoperative complete responses were pathologically negative for tumor. Concurrent bolus cis-DDP and radiation therapy are well-tolerated and result in impressive tumor reduction. Morbidity after subsequent curative surgery is low, and histologic complete responses are frequent.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:Preoperative simultaneously administered cis-platinum plus radiation therapy for advanced squamous cell carcinoma of the head and neck. 374 47
MICs of BRL 25000, a combination of a newly developed beta-lactamase inhibitor
CVA
and AMPC in the ratio of 1 to 2, were determined against a number of bacterial strains and compared with those of AMPC,
CVA
, CEX and CCL. The 98 bacterial strains tested included 2-S. aureus, 23-H. influenzae, 25-E. coli, 22-K. pneumoniae and 26-P. mirabilis. In pharmacokinetic studies, BRL 25000 medium granules were administered to groups of 3 male subjects, aged between 7 years 8 months and 9 years 5 months, at doses of 10, 15 and 20 mg/kg, 2 hours after a meal. The resultant serum and urine concentrations and drug recoveries were measured. Furthermore, BRL 25000 was administered to a total 43 patients (2-pharyngitis, 8-tonsillitis, 3-bronchitis, 2-
pneumonia
and 28-urinary tract infection) whom clinically evaluable. An average daily dosage of 45.3 mg/kg was given, in 3 or 4 divided doses, for a period of 8 days on average. Clinical and bacteriological effects as well as side effects were studied. In the microbiological studies on 98 clinical strains, including beta-lactamase negative bacteria, BRL 25000 showed MICs against the Gram-positive cocci (2-S. aureus) superior to the other 4 drugs at inoculum sizes of 10(8) and 10(6) cells/ml. For the Gram-negative bacilli, against H. influenzae at inoculum sizes of 10(8) and 10(6) cells/ml, BRL 25000 was inferior in the small MIC range but superior in the large MIC range to AMPC, and was superior to the other 3 drugs. Against E. coli at an inoculum of 10(8) cells/ml, BRL 25000 showed antibacterial activity next to AMPC and CCL whilst at an inoculum of 10(6) cells/ml, it was inferior in the small MIC range but superior in the large MIC range to AMPC and CEX and was inferior to CCL but superior to
CVA
. Against K. pneumoniae at an inoculum of 10(8) cells/ml, BRL 25000 was equal to AMPC,
CVA
and CEX but inferior to CCL, whilst at an inoculum of 10(6) cells/ml, it was inferior to CCL but superior to the other 3 drugs. Against P. mirabilis at inoculum sizes of 10(8) and 10(6) cells/ml, BRL 25000 was inferior in the small MIC range but equal or superior in the large MIC range to AMPC, and was superior to
CVA
and CEX.(ABSTRACT TRUNCATED AT 400 WORDS)
...
PMID:[Experimental and clinical trials of BRL 25000 (clavulanic acid-amoxicillin) granules in the field of pediatrics]. 389 76
Trends in sex specific mortality from six conditions (hip fracture, septicemia,
pneumonia
, cancer, heart disease, and
stroke
) were examined for the period 1968 to 1980 to determine if recent increases in life expectancy at advanced ages were associated with significant shifts in the pattern of cause specific mortality at those ages. Changes in life table parameters were assessed both at birth and age 85 to determine if the relative significance of certain conditions had increased or decreased at advanced ages. In particular, I examined whether three conditions (hip fracture, septicemia,
pneumonia
), often viewed as being associated with mortality among debilitated persons, had increased in the proportion of deaths they affected at advanced ages and if there had been changes in the mean age at death for persons with these conditions. I also examined trends in the mortality rates of three conditions (heart disease,
stroke
, cancer) that often are viewed as primary disease processes with high mortality risks. Overall there seemed to be little evidence that mortality for conditions associated with a debilitation had increased markedly at later ages.
...
PMID:Cause specific mortality patterns among the oldest old: multiple cause of death trends 1968 to 1980. 395 Mar 56
We performed a prospective study of the frequency and cause of fever, defined as a rectal temperature of greater than or equal to 101 degrees F detected within the first 5 days, in 104 consecutive adults admitted to a community/teaching hospital because of a nontraumatic
stroke
. Fever was documented in 23 patients. A source for the fever was identified in 19 patients and was attributed to a pulmonary insult, either aspiration chemical
pneumonitis
or an infectious
pneumonia
, in 13 of these patients. Patients who experienced lacunar infarcts did not develop fever. Fever occurring in the wake of a
stroke
should not be attributed to the vascular process, but should direct attention to inflammatory disorders of the lungs.
...
PMID:Fever in the wake of a stroke. 395 16
Twenty-six patients with refractory ventricular arrhythmias received the automatic implantable cardioverter-defibrillator. A patch lead only was placed during arrhythmia surgery in 7 other patients. During 13 +/- 6 (SD) months, the device discharged in 10 patients because of a sustained ventricular arrhythmia. No sudden deaths occurred. There were 31 complications in 17 patients, including postoperative refractory heart failure, coronary artery erosion, subclavian vein thrombosis, postoperative
stroke
after conversion of atrial fibrillation, atelectasis with
pneumonia
, symptomatic pleural effusions, and infection at the generator site. The cardioverter-defibrillator discharged in 9 asymptomatic patients, failed to terminate ventricular fibrillation during postoperative testing in 3 patients, and had premature battery failure in 4 patients. Tachycardia slowing during chronic amiodarone therapy and unipolar ventricular pacing during ventricular fibrillation precluded or delayed arrhythmia sensing. Thus, the cardioverter-defibrillator can be life saving, but its potential complications and interactions with antiarrhythmic drugs and pacemakers must be considered at patient selection.
...
PMID:The automatic implantable cardioverter-defibrillator: efficacy, complications, and device failures. 395 76
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