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

From 250 patients suffering from cerebral ischemia who were subjected to microsurgical anastomosis STA-MCA between 1979 and 1986 there was chosen a group of patients who were examined retrospectively at a period of 1-7 years after surgery. Some patients were examined clinically at average post-operation periods of 10-20 days, several months, 1.5 year and 4 years. Results of angiography and CT examination both before and after operation were also taken into consideration. From patients examined in this way there was selected a group with less severe forms of the disease, mainly Prolonged Reversible Ischaemic Neurological Deficit, with a Completed Stroke, and next a group of patients who showed worsening of the neurological condition after operation--transient or permanent and a group of patients who died some time after operation. The results of examination were subjected to statistical analysis. On the base of this the author attempts to answer the question whether, with present diagnostic technique limited to clinical examination, angiography and CT examination, groups of patients can be selected in which operative risk will be reduced to a minimum and the result of operation will be advantageous to the patient.
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PMID:An assessment of the results of treatment of cerebral ischaemia by microsurgical anastomosis of STA-MCA on the basis of catamnestic examination. 264 31

Hypertension can be ameliorated by certain concomitant disease states, especially those in which serum globulin is elevated. Blood pressure has been reduced in cases of cirrhosis of the liver, chronic alcoholism, congestive heart failure, arthritis, hypothyroidism, and myeloma. These clinical findings were confirmed experimentally when animals with various models of hypertension became normotensive after the development of a modest degree of liver damage with hyperglobulinemia. Other diseases, not associated with hyperglobulinemia, that can lower blood pressure are stroke, uremia, hyperparathyroidism, and malnutrition. When any of these diseases occur in hypertensive patients, their influence on blood pressure must be considered when determining treatment and prognosis.
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PMID:Disease states in which blood pressure is lowered. 261 Jul 59

The nervous system is particularly susceptible to the harmful effects of alcohol. These include Wernicke-Korsakoff syndrome, which is related to thiamine deficiency secondary to chronic alcohol abuse. Other neurotoxic effects of alcohol with cognitive impairments include delirium tremens, alcoholic seizures or "rum fits," and alcoholic neuropathies. It has become recognized in recent years that alcohol and its metabolites directly damage the nervous system even in the absence of nutritional deficiencies. Cerebral blood flow (CBF) measurements provide a noninvasive indirect monitor of cerebral metabolic activity. It has been shown conclusively that CBF measured by the 133Xe inhalation method is decreased in chronic alcoholism, correlating well with the amount of alcohol consumed. With abstinence, CBF returns toward normal levels provided the neurotoxic effects of chronic alcoholism are of recent onset. Clinical and pathological studies show significant loss of brain volume with ventricular dilatation after alcohol abuse even among young "social" drinkers. This toxic effect of alcohol is accompanied by varying degrees of cognitive impairments ranging from slight memory loss to frank dementia. Both the decrease in brain volume and the cognitive impairments, which occur with or without nutritional deficiency, are to a large extent reversible with abstinence and nutritional supplementation. Alcohol appears to accelerate age-related declines in CBF while nutritional deficiencies enhance the neurotoxic effects of alcohol. Measurements of local CBF (LCBF) and partition coefficients (L lambda) in deep cerebral structures, including the hypothalamus, thalamus, forebrain nuclei, and limbic system, can be achieved utilizing three-dimensional methods after inhalation of stable xenon as a contrast medium combined with serial computed tomographic imaging of the brain. Among chronic alcoholics, there are significant and diffuse reductions in cortical and subcortical gray matter CBF that are especially remarkable in hypothalamus and substantia innominata, which includes the nucleus basalis of Meynert, a major source of cholinergic input to neocortex and hippocampus. Reductions in LCBF are measurable in cognitively impaired patients with and without Wernicke-Korsakoff syndrome. Reductions of CBF include white matter and are more severe in patients with Wernicke-Korsakoff syndrome. Both types of encephalopathy improve with treatment, but recovery is usually more rapid and complete if nutritional deficiency is absent. Alcohol also appears to be a risk factor for stroke, possibly by depleting neuronal reserves and unfavorably influencing cardiovascular risks.
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PMID:Cerebral hemodynamic and metabolic effects of chronic alcoholism. 270 68

Twenty-one dogs underwent instrumentation of the left ventricle with ultrasonic dimension to study the effects of acute protein-calorie malnutrition on the adrenergic responsiveness of the heart. This study allowed a chronic and dynamic measurement of the major cardiac axes and the ventricular wall thickness, which in turn can be used to derive sophisticated measurements of global and intrinsic left ventricular function. Of the 21 dogs, 11 received a protein- and calorie-deficient diet designed to achieve a mean weight loss from a baseline of 20-25% over a 4-week period. The other 10 dogs received a normal diet. Dogs were also randomized to receive either acute propranolol beta-receptor blockade (n = 9) or acute isoproterenol beta-receptor stimulation (n = 12) during their baseline studies. Of the nine dogs given propranolol, five were subsequently malnourished and four served as controls. Of the 12 given isoproterenol, six were rendered malnourished and six were controls. All dogs were studied at both baseline and 4 weeks and received drugs in an identical fashion during both studies. The significant changes with malnutrition consisted of decreases in heart rate, cardiac mass, and left ventricular wall thickness. The degree of change in stroke volume, ejection fraction, cardiac output, dp/dt, and Emax (index of left ventricular contractility), with the administration of propranolol or isoproterenol was unaltered by malnutrition. These data support the contention that moderate protein-calorie malnutrition is well tolerated in instrumented, unstessed dogs and that the left ventricle's capacity to respond to beta-stimulation and to tolerate beta-blockade is largely unimpaired.
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PMID:Cardiac beta-adrenergic responsiveness is well preserved in moderate protein calorie malnutrition from semistarvation. 285 28

Effects of streptozotocin-induced diabetes (8 weeks) on the performance of perfused hearts from spontaneously hypertensive (SH) rats were compared with effects on normotensive Wistar-Kyoto (WK) and Sprague-Dawley (SD) rat hearts. Diabetes markedly decreased systolic arterial pressure (SAP) of SH rats in vivo but did not affect SAP of either of the normotensive strains. Diabetes also reduced heart size of SH and normotensive rats and reversed absolute left ventricular hypertrophy (wall-to-lumen ratios and left-to-right ventricular weight ratios) of SH rats. Heart perfusion at the end of the 8-week period revealed that diabetes (i) reduced hydraulic work at high pressure loads and efficiency of contraction (work/mu LO2 consumed) of SH rat hearts but not of WK or SD hearts, and (ii) depressed left ventricular pulse pressure development (LVPP) and contractility (LV + dP/dt) of SH hearts more extensively than it reduced these variables in either of the normotensive control groups. Effects of diabetes which were similar in hypertensive and normotensive hearts were reductions in stroke work at high volume loads and depressions in LV-dP/dt. Attendant hypothyroidism probably contributed to the reductions in SAP, heart size, LVPP, LV+ and -dP/dt, and stroke work but not to the decreased efficiency or reversal of hypertrophy of SH rat hearts. Malnutrition of SH rats, like hypothyroidism, also decreased heart size without reversing hypertrophy but had no effect on SAP and only reduced LV-dP/dt. The results show that diabetes reversed hypertrophy and selectively reduced contraction efficiency, contractility, and LVPP of SH hearts, but otherwise the effects of diabetes in hypertensive and normotensive rat strains were similar to each other.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Depressor effect of diabetes in the spontaneously hypertensive rat: associated changes in heart performance. 294 85

The recent passage and implementation of the prospective payment system (PPS) for Medicare inpatient services have had a strong impact on dietitians practicing in southern Florida. Because several local hospitals service regions in which 90% of the population is 65 years old or older, the annual revenues from Medicare have been reduced. The hospitals still have to meet basic overhead costs and profit margins. This has resulted in the elimination of several dietetic positions. Therefore, dietitians need to establish a cost-benefit justification for the nutrition care and support of patients. This study is the initial phase of a plan to define the nutrition care services the dietitian provides and to identify the most frequently occurring diagnosis related grouping (DRG) categories. For 3 weeks, 31 dietitians maintained logs that detailed dietetic intervention and treatment for each of the 3,827 patients seen. The nutrition care activities reported most frequently by dietitians were basic services, hospital visit and reassessment, initial consultation, and screening to rule out malnutrition. The mean time spent in all nutrition care activities ranged from 13 to 33 minutes. The most frequently occurring DRGs were those for diabetes, heart failure, circulatory disorders, specific cerebrovascular accident, and transient ischemic attacks. Overall, the type of nutrition care activities and the time spent in those activities were significantly different among the hospitals studied. The differences reflect the philosophies of each facility. The types of DRG categories observed reflect the age of the population served.
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PMID:Nutrition care activities and DRGs. 311 66

By a retrospective relative risk analysis for conditions associated with urinary tract infection over a four-year period in a defined teaching nursing home population (n = 97), we reached the following conclusions: (1) UTI was associated with cerebrovascular accident (relative risk 2.2, 95% confidence interval 1.4 to 3.2), decreased activities of daily living (relative risk 2.6 to 3.2, 95% confidence interval 1.4 to 4.7), decreased mental status (relative risk 2.2, 95% confidence interval 1.2 to 3.1), urinary catheterization (relative risk 2.5, 95% confidence interval 1.3 to 3.7), and antibiotic prophylaxis (relative risk 2.1, 95% confidence interval 1.2 to 3.0). (2) Risk of UTI from urinary catheterization and antibiotic prophylaxis was additive for these functionally impaired patients. (3) Renal insufficiency, diabetes, anemia, malnutrition, age, and incontinence (without catheterization) were not related to risk of UTI.
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PMID:Antecedent factors in urinary tract infections among nursing home patients. 337 79

While deficient exercise performance of sick children results from hypoactivity and detraining, it can also be caused by specific pathophysiological factors. These can affect one or more components of physical fitness. A low maximal aerobic power will result from a low maximal stroke volume, as in aortic stenosis or cardiomyopathy; a low maximal heart rate, as in congenital complete heart block or intake of beta-blockers; a low O2 content of the arterial blood, as in anemia or advanced cystic fibrosis; and a high O2 content of mixed-venous blood, as in muscle atrophy or severe malnutrition. A high O2 cost of locomotion, as in advanced obesity or cerebral palsy, will cause the patient to exert at a high percentage of his maximal aerobic power and thus fatigue easily. A subnormal muscle strength, as in progressive muscular dystrophy or juvenile rheumatoid arthritis, is sometimes the primary factor that limits the walking ability or other daily functions. Recent data suggest that local muscle endurance, as assessed by the Wingate anaerobic test, is particularly deficient in some neuromuscular diseases. Examples are muscular dystrophies and spastic cerebral palsy. The ratio of peak anaerobic power to peak aerobic power seems lower in such patients than in able-bodied controls.
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PMID:Pathophysiological factors which limit the exercise capacity of the sick child. 372 7

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

Estimated prevalence of diabetes mellitus in Malaysia was about 2%. Diabetes was most common in Indians especially males and least common in Chinese. There was a slight male preponderance seen in Malays and Indians. Positive family history was obtained in 14% of cases most commonly in Malays, almost 1/3 of whom had more than one family member with diabetes. Familial association was uncommon in Chinese. Over 50% of patients were overweight. Obesity was noted in nearly 70% of female Malays and Indians while the majority of Chinese were not overweight. More than 80% of patients were non insulin requiring. Youth onset diabetes was considered rare; those 10 years and below were estimated to be only 0.4% and below 20 years of age between 2%-4% of the diabetic population. Females were twice as common than males in this type of diabetes and familial association was greater. Malnutrition-related diabetes and pancreatic calcification were not well-documented but youth-onset non insulin requiring diabetics with mild symptoms but strong family history of diabetes were observed. More than half of hospital-based patients had evidence of complications, mainly amongst Malays and Indians. Hypertension was the most frequent associated disease followed by foot ulcers and ischaemic heart disease. Hypertension usually associated with chronic renal failure was most common amongst Malays while gangrenic ulcers and heart diseases were seen mainly in Indians. The major causes of death were chronic renal failure, myocardial infarction, ketoacidosis, stroke and septicaemia related to gangrene.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Diabetes mellitus in peninsular Malaysia: ethnic differences in prevalence and complications. 403 85


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