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

Oxygen uptake, cardiac output, stroke volume and arterial and central blood pressures were measured before and after induction of neuroleptanaesthesia in 27 subjects. Nine were elderly patients operated on for obliterative arteriosclerotic disease, and the other 18--nine elderly and nine younger patients--underwent operation for varicose veins. Cardiac output, stroke volume and systolic arterial blood pressure decreased significantly with a corresponding decrease in oxygen uptake. The changes were most pronounced in the patients with arteriosclerotic disease. The arterio-venous oxygen difference was unchanged in the arteriosclerotics and decreased in the other two groups. The central pressures remained unchanged in all groups. It is concluded that the cardiovascular changes induced by neuroleptanaesthesia are due to a decrease in oxygen uptake and not to myocardial depression.
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PMID:The cardiovascular effects of neuroleptanaesthesia. 84 53

Discharge survival following variceal bleeding was similar in 27 elderly subjects, aged 65-93 years, and 125 younger subjects, aged under 65 (63% versus 70%, p greater than 0.05). Of 39 elderly subjects with varices which were not bleeding on admission, 82% were discharged alive but subsequent mortality was higher and long-term survival was similar (median 1 year) on life-table analysis. The overall long-term survival in the 66 elderly subjects was far worse than in the comparable group of 269 subjects under 65 (p less than 0.001). However, the excess deaths were from causes unrelated to hepatic failure or bleeding (e.g. stroke). Considering only deaths from hepatic failure or bleeding, long-term survival in the elderly and young was similar (p greater than 0.5). We conclude that elderly subjects with varices should be managed as actively as younger subjects since the majority are discharged alive and prolonged survival is common (25% at 3 years).
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PMID:The prognosis of elderly subjects with oesophageal varices. 278 31

Stellate ganglia from patients who had succumbed to various diseases were examined by a fluorescent histochemical technique using 2% glyoxylic acid. Catecholamines were detectable in the major neurons, in small intensely fluorescent cells, and in adrenergic fibers with varicosities at levels that varied with the patient's age, cause of death, duration of the agonal period, the treatment administered, and the time when the material had been taken after death. All adrenergic structures of the ganglia were clearly demonstrable after early autopsies of those who had died suddenly from pulmonary artery thromboembolism in the absence of other abnormalities. The ganglia were found to be greatly depleted of catecholamines in cases of sudden cardiac death in the presence of ischemic heart disease before the development of myocardial infarction as well as in those of rapid death from stroke.
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PMID:[Changes in the adrenergic structures of the human stellate ganglia in pathological states]. 344 9

Modern contraceptive methods are discussed, with special emphasis on oral contraceptives, which are regarded as the most effective. They are also regarded as generally safe, although there are contraindications and the drugs should only be prescribed after careful examination. The need for selecting the drug most suitable for the individual patients, mainly on the basis of the characteristics of the menstrual cycle (suggesting a predominance of estrogen or progestin, within safety limits, such as 50 mcg of estrogen), is emphasized. The examinations required include a general clinical, gynecological, and breast examination, cytology tests, evaluation of the menstrual flow pattern, measurements of arterial pressure, weight, glucose, cholesterol and triglyceride levels, and urine tests. They should be repeated at 6-month intervals, or 3-month intervals in the case of high-risk patients (varicose veins, obesity, heavy smokers, high cholesterol and triglyceride levels, history of jaundice, slight heart condition, clinical or potential diabetes, porphyria or predisposition to uterine myoma). Oral contraceptives are contraindicated in cases presenting a history of thromboembolism, phlebitis, cerebral apoplexy; sickle cell anemia, which indicates a predisposition to thromboembolic accidents; serious liver disease or recent hepatitis; serious heart disease; hormone-dependent neoplasia (breast cancer); predisposition to uterine cancer; erythematous lupus; metorrhagia of unknown origin; psychic disorders, especially of a depressive type. They should also be avoided for 3-4 years after puberty, in order to avoid interfering with the development of the hypothalamus and with growth. A carcinogenic effect of the pill and an increase in the risk of giving birth to abnormal children can be ruled out, although the incidence of abortions due to chromosome anomalies after suspending treatment is rather high (due to the previous inhibition of ovulation, a situation similar to repeated pregnancies at short intervals, which involve the same risk).
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PMID:[Current clinical problems of contraception]. 502 53

The prevalence of obesity in the UK, defined as a Body Mass Index (BMI) exceeding 30, is increasing. Obese people with BMI greater than 30 have a much greater risk of dying earlier than people with desirable levels of fatness (as do extremely lean people with BMI less than 20). The relationship between obesity and the likelihood of suffering certain metabolic diseases such as coronary heart disease, stroke and diabetes is now thought to be associated as much with the distribution of the excess fat as with the amount of excess fat. Fat distribution is usually measured in the population by the waist to hip circumference ratio (WHR). A high WHR seems to be a proxy measurement for an excess of intra-abdominal fat. Subcutaneous fat mass can be estimated using skinfold measurements. Exact determinations can only be performed directly using expensive equipment, such as computed tomography (CT). People with high WHR measurements can be said to have a 'central' fat distribution: people with low WHR measurements can be said to have a 'peripheral' fat distribution. 'Central' fat distribution carries most metabolic risks and is associated with a predisposition towards coronary heart disease, stroke, diabetes, breast cancer and gallstones. In some cases, the distribution of fat is a stronger risk factor than total obesity. 'Peripheral' fat distribution carries least metabolic risk. However, risks related to the mechanical problems of carrying excess fat, such as varicose veins, are increased. The risks of obesity therefore depend on the distribution of fat as well as total fatness.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Obesity in men and women. 789 23

Selective degeneration of postsynaptic neuronal dendrites is a pathological hallmark of brain injury in stroke and other neurological disorders. We examined dendritic injury in primary cultures dissociated from mouse neocortex. Neuronal morphology was visualized using the fluorescent membrane tracer, Dil, or immunofluorescence with antibodies to the dendrite-specific microtubule-associated protein, MAP2. Deprivation of oxygen and glucose for 30-60 min resulted in segmental dendritic beading, or varicosities, and loss of dendritic spines. This pattern of dendritic injury was blocked by addition of selective NMDA antagonists, and was reproduced within 5 min of exposure to 10-100 microM NMDA. Widespread dendritic varicosity formation occurred even with exposures to oxygen-glucose deprivation or NMDA which resulted in little neuronal death by the following day. Despite marked structural changes affecting virtually all neurons, dendrite shape returned to normal within 2 h of terminating sublethal oxygen-glucose deprivation or NMDA application. Rapid, reversible changes in dendritic structure may contribute to alterations in neuronal function following glutamate receptor stimulation under physiological or pathological conditions.
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PMID:Rapid alterations in dendrite morphology during sublethal hypoxia or glutamate receptor activation. 898 22

Two cases of moyamoya disease observed in two children are reported. The two cases recall the frequency of ischemic strokes, transient ischemic attacks, and seizures revealing the disease. Diagnosis is made by cerebral arteriography showing carotid stenosis and the dense deep arterial collateral as seen in these two cases. Magnetic resonance imaging makes it possible to identify this vascular disease as it reveals vascular varicosities in the basal ganglia, as in case 1. Strokes can sometimes be prevented by constructing an anastomosis between the superficial temporal artery and the middle cerebral artery, as demonstrated in case 1. Thus, the diagnosis of moyamoya disease has been improved by magnetic resonance imaging and there is now a surgical treatment to prevent ischemic stroke.
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PMID:Moyamoya disease in children. A review of the clinical and radiological features and current treatment. 945 75

(1) The precise cardiovascular risk of oral contraceptives is poorly known because of a lack of reliable clinical studies and the numerous potential biases in epidemiological studies. (2) The absolute risk of coronary events is very low in women under 35 who are non smokers, have no history of coronary heart disease and have normal blood pressure. In women over 35, smoking over 10 cigarettes a day and arterial hypertension substantially increase the risk of coronary heart disease. (3) The absolute risk of stroke is low in young women who are not hypertensive and do not smoke. It is higher in the case of arterial hypertension. (4) The absolute risk of deep vein thrombosis is increased but remains moderate. Obesity, a family history of deep vein thrombosis, and hereditary clotting disorders are risk factors. (5) The cardiovascular risks linked to oral contraception seem to disappear after cessation. (6) The use of oral contraceptives with very low doses of oestrogen (less than 50 mug ethinylestradiol) reduces the associated risk of stroke. The risk of deep vein thrombosis is probably higher with combined contraceptives containing a third-generation progestagen (desogestrel or gestoden). (7) The coronary and cerebrovascular risks of progestagen-only contraceptives are poorly documented. Low-dose progestagen-only oral contraceptives have little effect on clotting factors or on carbohydrate and lipid metabolism. There may be a risk of deep vein thrombosis, however, with this type of contraceptive. (8) History, physical examination and simple laboratory tests before prescribing or renewing oral contraceptives are sufficient to detect the main contraindications, i.e. arterial hypertension, a history of coronary or cerebrovascular conditions, deep vein thrombosis, hypercholesterolaemia exceeding 3 g/l, hypertriglyceridaemia exceeding 3 g/l, unusually severe headache on a combined oral contraceptive and prolonged immobilisation. However, a combined oral contraceptive can be considered for some women with cardiovascular risk factors such as moderate hypercholesterolaemia or hypertriglyceridaemia, well-controlled insulin-dependent diabetes, uncomplicated cardiac valve disease, migraine not worsened by a combined oral contraceptive, varicose veins or a family history of deep vein thrombosis. (9) Pharmacists should be aware of these risk factors so that they can advise patients to see a doctor if new health problems arise between visits.
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PMID:Cardiovascular risk of oral contraceptives. Low, and mainly in women at risk. 1034 51

Cerebrovascular disorders in association with licit or illicit drugs have rarely been reported. We report a first case of stroke associated with the parenteral use of ephedrine. A 44-year-old woman underwent spinal anaesthesia for varicose vein surgery. She was usually treated with propranolol and occasionally with phenoxazoline. During anaesthesia, ephedrine was administered by the venous route because of arterial hypotension. She developed intracranial hypertension and focal cerebral deficits related to multiple haemorrhagic cerebral infarcts associated with a reversible beading appearance on angiography consistent with the diagnosis of acute cerebral arteritis. The role of ephedrine in this case is discussed beside other causes of acute cerebral arteritis.
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PMID:Acute reversible cerebral arteritis associated with parenteral ephedrine use. 1054 95

Acute venous thromboembolism (VTE) is a serious and potentially fatal disorder, which often complicates the course of hospitalized patients, but may also affect ambulatory and otherwise healthy people. While the introduction of thromboprophylactic measures is expected to have reduced the occurrence of postoperative VTE, there is an increasing awareness of the importance of medical conditions in determining thromboembolic events. Among the conditions that predispose patients to VTE are increasing age, cancer and its treatment, prolonged immobility, stroke or paralysis, previous VTE, congestive heart failure, acute infection, pregnancy or puerperium, dehydration, hormonal treatment, varicose veins, long air travel, acute inflammatory bowel disease, rheumatologic disease, and nephrotic syndrome. Other factors that have recently been associated with an increased risk of VTE disorders include persistent elevation of D-dimer and atherosclerotic disease. Recognition of the incidence and clinical importance of thrombosis will most likely encourage more widespread use of antithrombotic prophylaxis in medical patients.
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PMID:Acquired risk factors for venous thromboembolism in medical patients. 1630 20


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