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

In ten hypertensive late pregnant women with passing crises of hypertension cardiovascular analysis with the method of quantitative sphygmometry, the unbloody recording of the blood pressure and the direct electronic measuring of the pulse wave velocity were made before and after the intravenous injection of 300 mg Diazoxid (Hypertonalum). This drug is recommended to the treatment of severe preeclampsia and eclampsia because of lessening the arterial blood pressure and the total peripheral resistance, increasing the heart rate, stroke volume and cardiac output.
 ...
PMID:[The haemodynamic principle of action of diazoxide (hypertonalum) in the treatment of acute hypertensive crises in late pregnant women (author's transl)]. 46 55

Epidemiologists compared data on 434 cases of fatal stroke which occurred between 1986-88 in England and Wales with data on 1268 living matched controls to determine the association between use of the newer, low dose oral contraceptives (OCs) and the risk of stroke. History of hypertension was significantly associated with a 9-fold rise in the risk of subarachnoid hemorrhage (p.001) and an 8-fold rise in the risk of any hemorrhagic stroke. History of preeclampsia was also significantly associated with subarachnoid hemorrhage (p.01) and any hemorrhagic stroke. Cigarette smoking had a 2.6-fold increased risk of subarachnoid hemorrhage (p.001). The epidemiologists found an estimated relative risk of subarachnoid hemorrhage related to current OC use to be only 1.1 and when they controlled for confounding factors it was still small and insignificant (1.3). The power of the study showed the lowest significant increased relative risk of subarachnoid hemorrhage related to OC use that epidemiologists could have detected with 90% certainty to be 1.6. When the epidemiologists controlled for confounding factors, the insignificant relative risk of occlusive stroke associated with OC use was 4.4 while the power of the study indicated it to be 28.4. This was consistent with other studies, but other studies found the association to be significant. These findings revealed a possible small increase in the risk of subarachnoid hemorrhage associated with OC use.
 ...
PMID:Fatal stroke and use of oral contraceptives: findings from a case-control study. 141 30

The decreasing incidence of direct causes of maternal death over the past half century has led to a heightened awareness of nonobstetric factors responsible for maternal mortality. For example, cerebrovascular accidents are an important nonobstetric cause of maternal morbidity and mortality. During the 6.5-year period from 1984 to mid-1990, we encountered 15 women in whom pregnancy or the puerperium was complicated by an acute cerebrovascular accident. Six of these women had hemorrhagic strokes and nine had ischemic strokes. During this same time, approximately 90,000 women were delivered at Parkland Memorial Hospital, and thus the incidence of stroke was about one in 6000 pregnancies. Chronic hypertension or preeclampsia was causative in three cases of hemorrhagic stroke. It is important that 20% of the women died as a result of stroke, and of the 12 survivors, 40% have residual neurologic deficits. An aggressive work-up to define the etiology of stroke is necessary in order to implement cause-specific management, with subsequent reduction in morbidity and mortality.
 ...
PMID:Cerebrovascular accidents complicating pregnancy and the puerperium. 204 65

Antiphospholipid antibodies are associated with a spectrum of serious medical conditions. Several of these are of special concern to the obstetrician because they have a tendency to occur during pregnancy. Untreated pregnant women with aPLA appear to be especially prone to thrombotic events, including stroke. Atypically early-onset preeclampsia occurs in a large proportion of women with aPLA and a history of pregnancy loss. Conversely, a modest proportion of women with early-onset preeclampsia have aPLA. Although rare, a syndrome of postpartum pleuropulmonary disease and thrombosis is associated with aPLA. Finally, certain neurologic conditions, such as TIAs and chorea gravidarum, appear to be related to aPLA. It is important to recognize pregnant women with aPLA so they can be appropriately managed in an effort to avoid fetal loss and thromboembolic events.
 ...
PMID:Antiphospholipid antibodies and pregnancy: maternal implications. 218 47

Arachidonic acid is metabolized in endothelial cells to antiaggregatory, vasodilatory prostacyclin (PGI2), and in platelets to aggregatory, vasoconstrictory thromboxane A2 (TxA2). The balance of these two prostanoids is supposed to be involved with thrombogenesis and atherogenesis. Acetylsalicylic acid (ASA) inhibits irreversibly the key enzyme of the synthesis of these prostanoids, i.e. cyclo-oxygenase. Platelets do not synthetize new protein, but endothelial cells do. Because of this, and certain pharmacokinetic characteristics of ASA, it should be possible to shift the balance between PGI2 and TxA2 to the dominance of the former with the proper dose of this drug. Altogether more than 50,000 subjects have volunteered for studies on the effect of ASA in the primary or secondary prevention of myocardial infarction or ischemic stroke. The results show that it is possible to reduce vascular attacks by ASA. Furthermore, ASA has also found to prevent pre-eclampsia. Conclusions on the effect of ASA on the PGI2/TxA2-balance are hampered by uncertainties concerning the measurement PGI2 and TxA2 productions in vivo. It is, however, evident that the doses of ASA used in most trials have been high enough to inhibit partly also the production of PGI2. Whether smaller doses or less frequent administration would be more efficient, remains to be studied.
 ...
PMID:Acetylsalicylic acid and the balance between prostacyclin and thromboxane A2. 224 78

Thromboxane (Tx) A2 is a biologically potent and chemically unstable metabolite of prostaglandin endoperoxides. Recent developments in measurement techniques and the availability of both selective inhibitors of Tx synthetase and TxA2 receptor antagonists have facilitated the implication of TxA2 as a physiological modulator and as a mediator in thrombotic, vasospastic, and bronchospastic conditions. TxA2 is synthesized by platelets and contributes to platelet activation and irreversible platelet aggregation in physiological hemostasis and in thrombosis (e.g., unstable angina, stroke). TxA2 is also synthesized in intestinal, pulmonary, and renal tissues by cells other than platelets. Particularly in these tissues, TxA2 appears to act as a physiological modulator of changes in blood flow distribution and airway caliber. Strong stimuli for TxA2 release from these tissues may initiate ulcer, pulmonary hypertension, bronchoconstriction, and renal vasoconstriction. Evidence supports participation of TxA2 and/or TxA2 receptors in modulation of natural cytotoxic cell cytotoxicity, in tumor growth and metastasis, in complications of pregnancy (e.g., preeclampsia), and in the progression of ischemic injury after coronary artery occlusion. This evidence supports pivotal involvement of TxA2 in pathophysiology and provides a strong rationale for pursuing TxA2-blocking strategies in drug development.
 ...
PMID:Overview of physiological and pathophysiological effects of thromboxane A2. 294 37

There were 37 maternal deaths among the 109,221 livebirths registered during the period 1977-86 in Bahrain, Arabian Gulf. The maternal mortality rate was 33.9/100,000 for the 10-year study period; however, disaggregation reveals a decline in this rate from 42.3/100,000 in 1977-81 to 26.9/100,000 in 1982-86. This decline presumably reflects streamlining of the Ministry of Health's maternity services, including a central maternity hospital with all modern facilities that serves as a referral center for all of Bahrain, 2 peripheral hospitals with provision for blood transfusion and surgical deliveries, and 3 maternity units managed by fully qualified midwives. About 80% of deliveries are covered by these maternity services; only 2.5% of deliveries occur in the home. Despite this highly developed maternity care system, 18 of the maternal deaths were due to direct obstetric cause: hemorrhage, 7; pre-eclampsia and eclampsia, 5; abortion septicemia, 2; bowel perforation during cesarean section, 1; thromboembolism, 2; and amniotic fluid embolism, 1. The causes of the 19 indirect maternal deaths were: pulmonary embolism, 5; infection, 7; cardiac failure, 2; cerebrovascular accident, 2; pulmonary hypertension, 1; and uncertain, 2. Of interest is the finding that sickle cell disease was the underlying cause of maternal death in 12 of the 37 deaths in this series. Sickle cell disease was implicated in 3 of the deaths from hemorrhage, all 5 deaths from pulmonary embolism, 2 deaths from septicemia, and the 2 cases of cardiac failure. In this series, 50% of the patients with sickle cell disease had thromboembolic crises following treatment of anemia with packed cell transfusion. Blood transfusion, especially of packed cells, should be given with caution to these patients since it may precipitate vaso-occlusive crisis by increasing blood viscosity. Since sickle cell disease represents a high risk during pregnancy in this Arab population, such patients should have frequent prenatal check-ups and deliver in a well-equipped hospital.
 ...
PMID:Maternal mortality in Bahrain with special reference to sickle cell disease. 321 81

Nutritional antioxidants support prostacyclin synthesis by preventing lipid hydroperoxide-mediated inhibition of prostacyclin synthetase. Recent preliminary clinical studies indicate that supplementary antioxidants exert antithrombotic effects in vivo that are most likely attributable to enhanced prostacyclin production. Optimal antioxidant nutrition may thus have preventive and therapeutic value for disorders in which inappropriate platelet aggregation plays an etiologic role, including MI, stroke, atherogenesis, pre-eclampsia, and the vascular complications of diabetes. In light of evidence that platelet aggregation encourages the implantation of hematogenous tumor metastases, supplemental antioxidants should also impede tumor dissemination--an effect which will be complemented by the immunostimulant actions of these nutrients. By exerting anticarcinogenic, immunostimulant and anti-metastatic effects, nutritional antioxidants should act to inhibit neoplasia at each stage of its development.
 ...
PMID:An antithrombotic role for nutritional antioxidants: implications for tumor metastasis and other pathologies. 352 Feb 53

The hemodynamic effects of lumbar epidural anesthesia (LEA) were evaluated in 11 patients with severe preeclampsia. All patients were receiving magnesium sulfate upon entry into the study. Hemodynamic measurements were obtained before and after LEA, at delivery, and 2 hr postpartum. Lumbar epidural anesthesia significantly reduced mean arterial pressure from 121.4 mm Hg to 97.7 mm Hg, without altering cardiac index, pulmonary vascular resistance, central venous pressure (CVP), or pulmonary capillary wedge pressure (PCWP). There was a slight but statistically insignificant decrease in systemic vascular resistance from 1078 to 900.7 dynes X sec X cm-5. Cardiac index and left ventricular stroke work index were elevated in these patients, suggesting hyperdynamic left ventricular function. There was poor correlation between PCWP and CVP in several patients. We conclude that LEA may be used safely in severe preeclamptic patients and that pulmonary arterial catheters may help guide appropriate therapy in preeclamptic patients with cardiac failure or oliguria refractory to modest fluid challenges.
 ...
PMID:Severe preeclampsia: hemodynamic effects of lumbar epidural anesthesia. 394 Apr 67

Three patients with eclampsia and four with severe preeclampsia underwent pulmonary artery catheterization before either labor or significant volume infusion. There was no difference in systemic or pulmonary vascular resistance, cardiac index, left ventricular stroke work index, or any other hemodynamic parameters between the eclamptic and severely preeclamptic patients. Despite the small numbers, plasma colloid osmotic pressures were significantly lower in the eclamptic patients. Factors other than the intensity of peripheral vasospasm may primarily affect the occurrence of grand mal seizures in patients with preeclampsia.
 ...
PMID:Preeclampsia/eclampsia: hemodynamic and neurologic correlations. 402 95


1 2 3 4 5 6 7 8 9 10 Next >>