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

Beriberi heart disease should be considered in all patients with cardiac failure and a history of alcohol abuse or dietary deficiency. We studied the haemodynamic changes which took place immediately after intravenous administration of thiamine to a patient with high-output beriberi. Cardiac output and stroke volume fell rapidly, but not below normal levels, and systemic vascular resistance rose.
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PMID:Beriberi heart disease. A case report describing the haemodynamic features. 403 86

In 1979-80, 82 cases of grand mal status epilepticus (71 patients, 39 male and 32 female) were admitted to the Casualty Department of Meilahti University Hospital in Helsinki, Finland. The cause of the underlying epilepsy was symptomatic in 43 cases (52.4%) and idiopathic in 19 cases (23.2%). In 6 cases (7.3%), there was a history of alcohol withdrawal seizures, and in 14 cases (17.1%) there was no earlier history of convulsions. Status epilepticus was associated with an acute or progressive cerebral disorder in 14 episodes. These comprised 6 bouts of status with brain tumour, 4 with acute stroke and 4 with brain injury. Alcohol abuse preceded the status in 29 episodes (35.4%), 23 of which occurred in men (53.5% of the male cases). Excessive use of alcohol was the only obvious precipitating factor for status in 16 cases, and in 6 cases the status presented as a prolonged alcohol withdrawal seizure. A change or irregularity of anticonvulsive drug therapy could be documented in 14 cases and an acute infection outside the central nervous system in 7 cases. Intravenous diazepam, used as the only therapy for status epilepticus, was effective in 58 of 78 episodes. In 7 cases of prolonged status, a thiopental sodium anaesthesia proved effective. The total mortality was 4.2%, including 2 deaths from concomitant extracerebral disorders and one late death from brain metastasis.
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PMID:Status epilepticus and alcohol abuse: an analysis of 82 status epilepticus admissions. 651 94

Alcohol abuse is a more frequent contributor to hypertension than is generally appreciated. Although hypertension is transitory in most alcoholics and may not be evident after a short period of abstinence, it is potentially dangerous. Paroxysms of hypertension might result in target-organ damage. Hypertension may be the causal link to the increased incidence of stroke and coronary heart disease observed in problem drinkers as well as a contributor to the pathogenesis of alcoholic cardiomyopathy. Because of its transitory nature, however, alcohol-associated hypertension may, regrettably , be dismissed as inconsequential. Thus, a major potential cause of cardiovascular morbidity may go untreated.
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PMID:Alcohol use and hypertension. Clinical considerations and implications. 672 42

A history of alcohol abuse associated with hypertension and chronic alcohol consumption is the leading cause of secondary cardiomyopathy. Both acute and chronic alcohol consumption precipitate arrhythmias. However moderate alcohol intake exerts a protective effect against coronary heart disease and stroke. Morbidity is lowest among light drinkers, slightly higher among lifelong abstainers and much higher among heavy drinkers. Magnesium deficiency is common among chronic alcoholics and frequent in Brazil. Magnesium therapy may have beneficial effects when there is excessive ethanol consumption.
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PMID:[Cardiovascular impact of alcoholism]. 748 61

Ageing is followed by an involution of neuroendocrine functions, resulting in a decreased secretion of sex steroids and growth hormone. In addition, cortisol secretion may be inadequately elevated upon stress challenges, due to deficient braking functions by central glucocorticoid receptors. In combination, these endocrine perturbations will probably result in changes in psychological factors such as energy and well-being, altered body composition, and insulin resistance, as well as other risk factors for diseases characteristic of the ageing human, such as cardiovascular disease, non-insulin-dependent diabetes mellitus and stroke. This cluster of phenomena is frequently seen before the period of normal ageing, indicating premature ageing processes. The background factors in these conditions probably include psychosocial stressors, which are perceived differently depending on individual coping abilities. Socio-economic and other environmental factors, such as smoking and alcohol abuse, may well be responsible for the expression of this syndrome of premature ageing. Preventive and therapeutic trials with hormonal substitution therapy to treat these aberrations have been promising, and encourage further studies aimed at elucidating potential risks in relation to potential improvement of quality of life and, perhaps, longevity.
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PMID:Neuroendocrine ageing. 759 79

Cigarette smoking, alcohol abuse and stroke--the material consisted of 272 patients (169 men and 103) women aged between 25-65 years. There were 221 patients with ischemic stroke and 51 patients with haemorrhagic stroke. The control group consisted of 400 healthy subject of the same age and sex. In the stroke group excessive consumption of alcohol was reported by 61 patients (5 women and 56 men). Excessive smoking was reported by 130 patients (41 women and 89 men). It was found in both types of stroke alcohol was not an independent risk factor. In addition, the study revealed that alcohol and cigarette smoking did not increase the risk of developing stroke in patients with diabetes and hypertension. Excessive cigarette smoking was found however, to be an independent risk factor in haemorrhagic stroke.
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PMID:[Cigarette smoking and alcohol abuse effects on stroke development]. 765 87

This study examined the distribution of alcohol-related and other dementias in a sample of 130 cognitively impaired residents of long-term care facilities in a Northern Ontario community. Study procedures entailed standardized psychiatric, neurological, and neuropsychological evaluations. Diagnoses of dementia of the Alzheimer type (DAT) and vascular dementia were based on criteria of the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association. The diagnosis of alcohol-related dementia (ARD) was based on extensive review of medical history to assess before alcohol abuse and stabilization or improvement in cognitive functioning following institutionalization in conjunction with no other identifiable cause of dementia. ARD comprised 24% of this population compared with DAT (35%), vascular dementia (19%), and other causes (22%). The ARD group was, on average, 10 years younger than the other groups. It had nearly twice the average length of institutionalization and had milder cognitive impairment on both clinical ratings and neuropsychological tests. A diagnosis of ARD was present in the medical records for only 25% of patients in this group. These findings suggest that ARD may be more common than previously suspected in the distribution of dementias in long-term care facilities.
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PMID:Alcohol-related dementia in the institutionalized elderly. 769 26

Among hospitalized patients, it is estimated that between 20% and 35% have significant alcohol problems that remain largely undetected. Alcohol abuse is a risk factor for a variety of disorders, including diabetes mellitus, gastrointestinal problems, hypertension, liver disease, and stroke. In an era of health care cost containment, early detection, intervention, and referral of alcohol-abusing or -dependent patients by the CNS may significantly impact the cost effectiveness of hospital care. In this article, a guideline is described that can be used by the CNS relative to the assessment, intervention, and referral of alcohol-abusing or -dependent patients in the general hospital setting.
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PMID:Early detection and intervention for the hidden alcoholic: assessment guideline for the clinical nurse specialist. 770 65

The purpose of this study was to evaluate adult first seizures in an emergency department by analyzing etiologic and epidemiological data and studying the usefulness of biological screening, electroencephalogram (EEG), and cerebral computed tomography (CT) scan. This was a retrospective study of a 3-year period during which 247 patients were admitted to an emergency department for a first generalized seizure. A CT scan had been performed in 247 patients and an EEG in 209. Etiologies were found to be (1) unknown, (2) alcohol abuse, (3) stroke, and (4) tumor. Early recurrence rate was 18.5%. EEG was of low interest in emergency. The rate of cerebral focal lesions on CT scan was significantly lower when both examination results and EEG were normal. The rate of metabolic abnormalities was 4.9%. It was concluded that (1) a short hospitalization is advisable because of recurrences, (2) recurrence rate does not increase significantly in patients with focal cerebral lesion, (3) metabolic screening is necessary, and (4) CT scan will be an outpatient procedure for most patients.
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PMID:Adult first generalized seizure: etiology, biological tests, EEG, CT scan, in an ED. 783 26

Stroke continues to have a great impact on public health in the United States. Stroke is frequent, recurring, and is more often disabling than fatal. The annual incidence of new strokes in the United States is nearly one half million, with over 3 million stroke survivors alive today. Identifying risk factors for initial ischemic stroke, as well as characterizing the determinants of outcome (stroke recurrence and mortality) after ischemic stroke, is the basis for stroke prevention strategies. Modifiable and nonmodifiable risk factors for ischemic stroke have been identified and include age; gender; race/ethnicity; heredity; hypertension; cardiac disease, particularly atrial fibrillation; diabetes mellitus; hypercholesterolemia; cigarette smoking; and alcohol abuse. New risk factors, such as hypercoagulable states and patient foramen ovale, are currently being investigated. Follow-up studies have quantified case-fatality rates, early recurrence risk, and long-term mortality and recurrence risks. Despite advances in stroke prevention strategies and treatments, stroke recurrence is still the major threat to any stroke survivor. A major goal set by the Public Health Service in its National Health Promotion and Disease Prevention Objectives for the year 2000 is "to reduce stroke deaths to no more than 20 per 100,000." Part of this can be achieved if the risk of stroke recurrence is reduced. However, the frequency and determinants of stroke recurrence are poorly understood. Data from epidemiologic studies can help identify risk factors and outcomes after ischemic stroke, as well as the selection of high-risk individuals for focused risk-factor modification. Current information on these topics is discussed.
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PMID:Risk factors and outcomes for ischemic stroke. 788 84


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