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

Hemorrhagic infarction of the basal ganglia was observed in 2 young adult patients with acute leukemia who presented with progressive hemiparesis combined with severe mental alterations. In case 1 (AML) lethal infarction due to thrombosis of both internal cerebral veins occurred during induction therapy for relapsed leukemia; in case 2 (cALL) a devastating stroke probably due to deep cerebral venous thrombosis happened during the third remission. Neither of them had hyperleukocytosis, signs of infection, disseminated intravascular coagulation or CNS leukemia. We discuss long-term glucocorticoid therapy (case 1) and combined prophylactic CNS treatment (case 2) as possible risk factors for cerebrovascular thrombosis in acute leukemia.
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PMID:Hemorrhagic infarction of the basal ganglia. An unusual complication of acute leukemia. 664 5

Physical electro- and echocardiographic methods were used to study myocardial function in 70 patients with acute leukemia (AL). 40% of them in the primary active phase had hypokinetic, while 60% hyperkinetic circulation. Leucocytosis and thrombocytopenia proved prognostically unfavorable for myocardium condition. Cardiotoxic rubomycin doses have been established. Pathogenic mechanisms underlying deterioration of myocardial contractility, reduction of stroke volume and rearrangement of central hemodynamics are considered. Administration of riboxin with finoptine promoted normalization of clinical and improvement of echo-CG sings of myocardiopathy in patients given total rubomycin doses 200-450 mg/m2.
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PMID:[Changes in myocardial function in patients with acute leukemias under the influence of rubomycin]. 790 29

We evaluated clinical effects and toxicities of a combination of fosfomycin (FOM) and clavulanic acid/ticarcillin (CVA/TIPC) for treatment of infections complicated with hematological disorders in 61 patients. Fifty-eight patients were evaluable, including 40 with acute leukemia, 13 with malignant lymphoma and 5 with other hematological disorders. Clinical efficacies were excellent in 21 cases, good in 13 cases, fair in 2 cases and poor in 22 cases. The efficacy rate was 58.6% (34 cases/58 cases). This treatment was also effective in 12 of 20 cases in which granulocyte counts were less than 500/microliters through the course of administration. No subjective side effects were observed. Abnormal values in laboratory tests were noted in 1 case. Mild elevations of GOT and GPT were observed. Thus, the combination of FOM and CVA/TIPC is an effective and safe regimen for the treatment of infections in patients complicated with hematological disorders.
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PMID:[Clinical effects of a combination treatment with fosfomycin and clavulanic acid/ticarcillin for infections in patients complicated with hematological disorders]. 805 94

Cunninghamella spp. are unusual opportunistic pathogens that have been identified with increased frequency in immunocompromised patients. Clinical infection by this fungus is almost always devastating and usually fatal. Infections with this group of organisms have been seen most frequently in patients with hematological malignancy. Here we report the case of a patient with acute leukemia who developed multiorganic failure as a consequence of hematological dissemination by Cunninghamella bertholletiae. The case highlights the mortality associated with this fungal infection in immunocompromised patients, confirms the risk factors associated with non-candida fungal infections and shows a clinical presentation mimicking myocardial infarct and cerebrovascular stroke.
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PMID:Cunninghamella bertholletiae infection (mucormycosis) in a patient with acute T-cell lymphoblastic leukemia. 1516 Sep 28

Although intracranial hemorrhage accounts for approximately 10 to 15% of all cases of stroke, it is associated with a high mortality rate. Bleeding disorders account for a small but significant risk factor associated with intracranial hemorrhage. In conditions such as hemophilia and acute leukemia associated with thrombocytopenia, massive intracranial hemorrhage is often the cause of death. The authors present a comprehensive review of both the physiology of hemostasis and the pathophysiology underlying spontaneous ICH due to coagulation disorders. These disorders are divided into acquired conditions, including iatrogenic and neoplastic coagulopathies, and congenital problems, including hemophilia and rarer diseases. The authors also discuss clinical features, diagnosis, and management of intracranial hemorrhage resulting from these bleeding disorders.
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PMID:Spontaneous intracerebral hemorrhage due to coagulation disorders. 1534 96

Strokes are rarely secondary to spontaneous carotid artery thrombosis. The objectives of this retrospective analysis were to define characteristic features and the clinical course. The study population included eight patients (6 females/2 males) seen at six university neurological centers. Age of onset was 46.5 years (range 38-52). Half of the patients had no vascular risk factor. Symptoms were TIA (n=1), strokes (n=7). Echotomography revealed intraluminal thrombus, with occlusion in 2 cases. Thrombi were found in common carotid artery (n=3), carotid bifurcation (n=2) and internal carotid artery (n=3). The thrombus was mobile in 4 cases. Seven patients were treated by anticoagulation therapy, one by surgery because of recurrent TIA. Further echotomographic exams revealed total resolution (3 cases) or decrease of the thrombus (3 cases). Occlusion was definitive in one patient. A cause was identified in six patients: acute leukemia (n=1), thrombocytopenic purpura (n=1), iron deficiency anemia (n=4).
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PMID:[Spontaneous thrombosis of lesion-free carotid arteries: a retrospective analysis of eight patients]. 1567 2

Acute leukemia is a rare malignancy of pregnancy. When it develops, there are many complications to consider and management becomes exceedingly difficult. We report a case of acute myelogenous leukemia presenting as preeclampsia and fetal demise at 36 weeks of gestation. A 30-year-old multigravida presented with intrauterine fetal demise at 36 weeks' gestation, hypertension, and thrombocytopenia. The patient received platelet and packed red blood cell transfusion, with concurrent prophylactic magnesium sulfate and dexamethasone treatment. Following labor induction, the patient delivered a nonviable female fetus and suffered a stroke postpartum. Peripheral smear and flow cytometry revealed the patient had acute myeloid leukemia with prominent monocytic differentiation. The patient expired on postpartum day six. Acute leukemia during the pregnancy is associated with an unfavorable outcome.
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PMID:Acute myelogenous leukemia mimicking a hemolysis, elevated liver enzymes, and low platelets syndrome during pregnancy: case report and review of the literature. 1709 46

The purpose of this study was to investigate the clinical value of plasma thrombomodulin (PTM) in different diseases or in different severity or complications of diseases, PTM in 979 patients and 60 healthy controls was determined by ELISA method. The results showed that the PTM level in the control group was 20.40 +/- 7.72 microg/L, there was no difference in sex and ages. In chronic primary glomerular disease, the PTM level in chronic renal failure (CRF) group was higher than that in non-CRF group (P < 0.01). PTM level > 70 microg/L was defined as its positive criterion. The sensitivity, specificity and positive predictive value in PTM were 85.7%, 82.4% and 77.8% respectively. The PTM level in septemia group was higher than that in non-septemia group (P < 0.01), the sensitivity, specificity and positive predictive value were 86.6%, 89.5% and 76.5% respectively (> 50 microg/L as its positive criterion). With respect of multiple trauma, the PTM level in multiple organ failare (MOF) group was higher than that in non-MOF group (P < 0.01), while the sensitivity, specificity and positive predictive value were 77.8%, 77.3% and 73.7% respectively (> 40 microg/L as its positive criterion). For systemic lupus erythematosus (SLE), the PTM level in the patients with albuminuria was higher than that in the patients without albuminuria (P < 0.01), and the sensitivity, specificity and positive predictive value were 77.8%, 92.3% and 93.3% respectively (> 35.54 microg/L as its positive criterion). For diabetes, the PTM level in complication group was higher than that in group without complications, the sensitivity, specificity and positive predictive value were 53.4%, 97.1% and 98.6% respectively (> 35.54 microg/L as its positive criterion). The PTM level in microangiopathy group was higher than that in macroangiopathy group (P < 0.01). The sensitivity, specificity and positive predictive value were 71.2%, 97.1% and 97.9% respectively. Acute leukemia (AL) and multiple myeloma (MM) had higher PTM level and PTM level was extremely high when renal failure developed (P < 0.01). As compared the acute stage with the restoration stage in stroke, pre-chemotherapeutics with post-chemotherapeutics in AL and MM, and pre-operation with post-operation in cancer, the PTM level was connected with clinical development. The PTM level in the patients with microangiopathy was higher than that in the patients with macroangiopathy (P < 0.01). The defined PTM level was higher than its normal upper limit as PTM positive criterion in microangiopathy diseases, the sensitivity, specificity and positive predictive value were 77.7%, 71.2% and 75.6% respectively. It is concluded that PTM level is a good criterion in evaluating the microangiopathy, and PTM is also a valuable indicator in prediction or assessment of the severity of diseases, or evaluation of therapeutic effectiveness.
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PMID:Clinical study of plasma thrombomodulin detection. 1749 May 34

Comorbidities are often present in adult patients treated for malignant hematological diseases. In older patients, these disabilities can have an influence on the natural course of the malignant disease, on the tolerance to treatment and clinical decision making. Moreover caring of patients with several illnesses may generate high costs. To evaluate their incidence and their influence on treatment decisions, we conducted a retrospective analysis of 330 charts of patients treated for malignant diseases in the Department of Hematology at Saint Antoine Hospital during 2003 and 2004. The median age was 61 years. Forty percent of the patients were treated for lymphomas, mainly non-Hodgkin lymphomas; 16% for myelomas, 16% for chronic lymphocytic leukemia, 16% for a myeloproliferative disorder and 8% for acute leukemia. Comorbidities were present in 84% of the patients: hypertension in 35%, coronary disease in 16%, diabetes and chronic obstructive pulmonary disease in 13%, renal failure, heart failure and arrhythmias in 10% respectively. Due to the presence of comorbidities, treatment was changed in 62/276 patients (22,46%). The diseases associated with a change were in a decreasing order: neurologic deficiency (out of stroke) (odds ratio [OR]: 4.86; 95% CI: [1.47-16.02]; P = 0.009), insulin-dependent diabetes (OR: 4.33; 95% CI: [1.40-13.31]; P = 0.01), chronic obstructive pulmonary disease (OR: 3.33; 95% CI: [1.37-8.08]; P = 0.007), renal failure (OR: 3.07; 95% CI: [1.27-7.43]; P = 0.01), coronary disease (OR: 2.89; 95% CI: [1.30-6.42]; P = 0.009) and hypertension (OR: 2.74; 95% CI: [1.39-5.38]; P = 0.003). Comorbidities are an important factor to define precisely patients with hematological malignant diseases and have to be integrated in any cost caring evaluation. Likewise, comorbidities have to be correctly assessed in oncological studies.
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PMID:[Influence of comorbidities on decision caring of malignant haematological diseases]. 1946 87

Stroke like symptoms in children such as hemiparesis are often associated with infection, cranial trauma, cardiac anomalies or sickle cell disease. In childhood leukemia, stroke like symptoms at presentation are rare and normally caused by cerebral bleedings. Here we report a patient who presented with classical stroke symptoms and hemiparesis prior to the diagnosis of acute lymphoblastic leukemia without proven CNS infiltration by leukemic cells. In general, acute leukemia or cerebral lymphoma do not lead to extensive defects of brain tissue. This unusual case suggests that acute lymphoblastic leukemia may present with stroke like CNS symptoms including hemiparesis.
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PMID:Coincidence of recurrent hemiparesis and detection of ALL in a 4-year-old girl: one or two diseases? 1989 Jul 94


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