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

Lysosomes are involved in atherogenesis. Therefore we have studied the level of serum beta-hexosaminidase isoenzymes (Hex A and Hex B) in relation to risk factors for atherosclerosis in a homogeneous population of 886 post-menopausal women. We found a relation with several risk factors such as serum triglycerides, diastolic and systolic blood pressure, blood glucose, waist/hip ratio and body mass index but not with serum cholesterol. Also, the mean values for Hex A and Hex B were higher in smokers than in non-smokers but only the mean value for Hex A differed significantly. The relation of serum beta-hexosaminidase isoenzymes to risk factors might be due to lysosomal over-loading, which gives rise to increased enzyme synthesis and enhanced secretion of lysosomal enzymes to circulation. The subjects in the 95-100 percentile of Hex A showed significantly increased frequency of myocardial infarction of their fathers and of stroke in their mothers and the subjects in the 95-100 percentile of Hex B showed increased frequency of stroke in their mothers. Thus the findings of a relation between Hex isoenzymes and heredity for vascular disease further stress the significant relation between Hex isoenzymes and risk factors. Since Hex B is a sensitive marker for alcohol abuse, we also investigated its serum level in subjects that could be suspected of alcohol abuse. However, we did not find any differences in these subjects compared with the others, possibly due to the relatively short half-life of Hex B after alcohol withdrawal.
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PMID:Serum beta-hexosaminidase isoenzymes are related to risk factors for atherosclerosis in a large population of postmenopausal women. 795 22

Cerebrovascular accidents are responsible for killing or disabling half a million Americans every year and are the third leading cause of death in this country. Finding cost-effective means of decreasing stroke mortality and morbidity is of great humanitarian and economic importance. Panoramic dental radiography was done on 19 white men who had a recent cerebrovascular accident and who were hospitalized at a Department of Veteran Affairs medical center. Inclusion criteria included clinical suspicion or imaging study evidence that the stroke arose from atheroembolic disease of the carotid artery bifurcation. Women were omitted from the study because of their paucity in the patient pool, and African-Americans and Asian-Americans were omitted because strokes in those groups usually develop as a result of disease of intracranial vessels. Carotid arterial calcifications appearing as a radiopaque nodular mass adjacent to the cervical vertebrae at or below intervertebral space C3-4 were noted in seven persons (37%). These patients had an average age of 65 years and demonstrated multiple risk factors (prior transient ischemic attacks, prior stroke, hypertension, obesity, tobacco and alcohol abuse, hyperlipidemia) associated with occurrence of a stroke. We concluded that some white men at risk for a cerebrovascular accident may be identified in the dentist's office by appropriate review of the panoramic dental radiograph and medical history. The presence of carotid artery calcifications demands an expeditious referral to an appropriate practitioner who can assist in the control of risk factors and arrange prophylactic surgical removal of the carotid arterial plaque, which are both safe and reliable methods of reducing the incidence of stroke.
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PMID:Prevalence of detectable carotid artery calcifications on panoramic radiographs of recent stroke victims. 806 36

Cerebrovascular accidents (CVAs) are the third commonest cause of death in France. Approximately 15% of them are due to stenosis of the extracranial internal carotid. The fact that a third of CVAs are followed by death and another third by major handicaps leads to the need for careful prevention. This has three aspects: 1) Correction of risk factors: hypertension, smoking, hyperglycemia, hyperlipidemia, obesity, alcohol abuse, hematological abnormalities and oral contraception; 2) the prescription of one of two platelet anti-aggregants, the efficacy of which has been proved: acetylsalicylic acid or ticlopidine; 3) surgical elimination of tight carotid stenoses. The following require surgery: 1) more than 70% stenosis following cerebral or ocular TIA or minor CVA; 2) more than 75% stenosis in asymptomatic patients or with episodes of VBI as well as 70% in case of thrombosis of the contralateral internal carotid; 3) following a CVA leaving serious sequelae: tight stenosis when it is reasonable to assume that a further CVA could lead to clinical worsening or to a loss of independence; 4) symptomatic and/or more than 80% restenosis. The decision should be made only after confirmation of the diagnosis and of the degree of stenosis and verification of the absence of any local or systemic contra-indication. The surgical team must have a low cumulative mortality and perioperative CVA rate. These patients require ongoing medical monitoring, particularly from a cardiological standpoint.
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PMID:[Treatment of patients with atherosclerotic carotid stenosis in 1993. Indications and long-term results of surgery]. 807 24

Patients with mild to moderate hypertension require only a simple schedule of investigations, especially if there is a history of stroke or hypertension in first degree relatives. Tests are necessary to profile other cardiovascular risk factors and to detect target organ damage with only limited screening for secondary hypertension. Careful history, physical examination, repeated blood pressure measurements over months and measurements of body mass index, random cholesterol, routine blood chemistry and urinalysis using impregnated paper strips are all that are required. More detailed investigations can be reserved for special groups such as those with peripheral vascular disease or abnormal renal function before or after treatment with angiotensin converting enzyme inhibitors or significant proteinuria or hypokalaemia. Patients with essential hypertension who are smokers with lipid abnormalities may go on to develop superimposed renovascular disease. Severe hypertension at any age and especially if there is a reliable negative family history also merits special consideration. Resistance to antihypertensive treatment is more often due to non-compliance or non-steroidal anti-inflammatory drug use or alcohol abuse than to underlying secondary causes.
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PMID:Hypertension: investigation, assessment and diagnosis. 820 68

Smoking tobacco contributes to and exacerbates many chronic diseases of aging, including hypertension, stroke, COPD, heart disease, and atherosclerosis. It is also associated with an increased risk of peptic ulcers and of cancers of the lungs and oral cavity. Older patients generally continue to smoke because of physiologic and psychological addiction to nicotine. Nicotine administration through gum or patch eases the symptoms of nicotine withdrawal for highly-tolerant patients. Detecting and treating alcohol abuse, depression, or life stress may then make it easier to motivate the patient to quit smoking. Physician advice combined with follow-up visits and phone calls has been shown to be one of most effective methods of getting patients to stop smoking.
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PMID:Smoking cessation: clinical steps to improve compliance. 838 53

In Spain in recent years two studies have been carried out into the prevalence of stroke. In the study made in Girona of the rural population over 64 years of age, the prevalence for stroke was 4,012 cases per 100,000 inhabitants. The figure was higher for women- 5,072 -than for men 2,675 cases. Transient Ischaemic Attacks (TIA) had a prevalence rate of 679 cases per 100,000 population of those aged over sixty-nine, being higher for men (1,161 cases) than for women (371 cases). The results from Girona differ from the findings in other Spanish regions in that the former are lower but at the same time are similar to those obtained in other western countries. The greatest risk factors for those over 69 years old were arterial hypertension, earlier episodes of TIA, diabetes, auricular fibrillation, congestive cardiac insufficiency, chronic bronchitis, myocardial infarction peripheral vascular-diseases, arteriosclerosis, heart disease with embolization and alcohol abuse.
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PMID:[Prevalence of cerebrovascular disease in Spain: a study in a rural area of Girona]. 855 97

In Spain in recent years several studies have been carried out into the incidence of acute stroke among the population at large. The average figure for incidence in these studies was 227 cases per 100,000 inhabitants, ranging from a low of 163 to a high of 323 cases. In the study made among the rural population of Girona the incidence rate was 257 cases per 100,000 inhabitants which was reduced to 134 cases when adjustment was made with world population. The overall incidence rate for stroke was 193 cases per 100,000 inhabitants, with that for first stroke being 174 cases per 100,000 inhabitants. The incidence of Transient Ischaemic Attacks (TIA) was 64 cases per 100,000 inhabitants. Acute stroke incidence was greater in men (364 per 100,000) than in women (149 per 100,000). The fatality rate for acute stroke in the first month was 38 cases per 100,000 inhabitants. Significant risk factors in acute stroke were alcohol abuse, hypertension, valvulopathy, earlier episodes of stroke and TIA and emboligenous source of cardiac origin.
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PMID:[Incidence of cerebrovascular disease in Spain: a study in a rural area of Girona]. 855 96

Secondary hyperlipoproteinemias are found in connection with other primary organic diseases. Typical examples are those seen with diabetes mellitus, liver and kidney diseases. In addition there are changes induced by hormonal dysfunctions such as hypothyroidism, by the use of oral contraceptives or in postmenopausal women. During pregnancy there is a physiological transient increase in lipoproteins. In addition to primary organic diseases there are a number of exogenous factors such as obesity, malnutrition and alcohol abuse causing hyperlipidemia. The relation between hypertension and hyperlipidemia described as familial dyslipidemic hypertension is less well known. Obesity, hypertension, dyslipidemia, hyperuricemia and impaired glucose tolerance are the basic conditions of the metabolic syndrome. Familial combined hyperlipidemia is a genetically determined, dyslipidemic syndrome with a high prevalence among patients with coronary artery disease and stroke. As there are some links between familial combined hyperlipidemia and secondary hyperlipoproteinemias, this disease entity is discussed together in this paper. Familial combined hyperlipidemia is metabolically, genetically and by this on a molecular level closely linked to familial dyslipidemic hypertension as well as the metabolic syndrome. The exact mechanism of this disease is currently unknown.
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PMID:[Secondary disorders of lipid metabolism, metabolic syndrome and familial combined hyperlipidemia]. 865 Sep 33

Stroke (cerebrovascular accident, CVA) is the third leading cause of death and an important cause of hospital admission and long-term disability in England and Wales. Atherosclerotic lesions at the bifurcation of the common carotid artery are the most common cause of stroke. On occasion, these lesions are partially calcified and visible on a conventional panoramic dental radiograph. The atheroma may appear either as a nodular radiopaque mass or as two radiopaque vertical lines within the soft tissues of the neck at the level of the lower margin of the third cervical vertebra (C3). These opacities are separate and distinct from the hyoid bone and variably appear above or below it. Dentists should scrupulously review the panoramic radiographs of all individuals over the age 55 with medical histories (hypertension, diabetes mellitus, hypercholesterolaemia, coronary artery disease) and behaviours (smoking, alcohol abuse, dietary indiscretion, overweight, sedentary life-style) known to be associated with atherosclerosis and stroke.
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PMID:Panoramic dental radiography: an aid in detecting individuals prone to stroke. 875 17

In China, health care delivery follows a three-tiered structure set up in the 1950s for rural and urban areas. In 1990, China set baseline criteria for primary health care in rural areas which is largely funded by a reestablished rural cooperative medical care financing system. Financing reform efforts in urban areas are using a model through which contributions are collected from salaries and from local governments and other public organizations. The overall incidence of infectious diseases is more than 500/100,000 people, but associated mortality has declined. Diseases covered by the Expanded Programme of Immunology have been controlled, but China is at high risk for viral hepatitis (epidemics of hepatitis A infections occurred in 1988), and incidence of tuberculosis has increased. In addition, the HIV/AIDS epidemic is spreading rapidly with an estimated 50,000-100,000 infected. Parasitic diseases are also widespread, and causes of death seen in developed countries (hypertension, stroke, coronary health disease, cancer, and diabetes) are increasing. With 510 million people living in iodine-deficient areas, iodine deficiency diseases have disabled an estimated 8 million people. China has promised to eradicate iodine-deficiency by the year 2000. The disabling Kaschin-Beck disease is also endemic in China. Occupational diseases threaten nearly 20 million Chinese people, and the prevalence of smoking and alcohol abuse is increasing, especially among young people. By the year 2000, 10% of the population will be older than 60, and 30% of this group will have health problems requiring care. The health care system is, thus, undergoing rapid change to meet its new challenges.
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PMID:Health care delivery system and major health issues in China. 898 46


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