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

Neuropsychiatry represents a field of medicine situated at the crossroads of neurology and psychiatry, and deals with the interface of behavioral phenomena driven by brain dysfunction. Psychiatric symptoms are highly prevalent in these conditions, are a major source of disability and diminished quality of life, and potentially represent the target of treatment interventions that stand to significantly decrease the suffering they generate. In this article, the disease paradigm is explained, with particular attention to its role as an organizing principle for the field. Specific diseases including traumatic brain injury, stroke, Parkinson's disease, Alzheimer's disease, multiple sclerosis, and epilepsy are explored in relation to the presentation of multiple psychiatric phenotypes in each, associations with underlying brain pathology, and existing treatment approaches. Finally the article explores the inherent complexities in this area of research and proposes a framework for future work based on the understanding of phenomenology and associated risk factors, the involvement of the rapidly advancing field of neuroscience, and targeted treatment development to serve as a road map for advancement in the field..
 ...
PMID:Psychiatric manifestations of neurologic disease: where are we headed? 1772 11

Cerebral dysfunction and injury in the ICU presents as focal neurologic deficits, seizures, coma, and delirium. These syndromes may result from a primary brain insult, such as stroke or trauma, but commonly are a complication of a systemic insult, such as cardiac arrest, hypoxemia, sepsis, metabolic derangements, and pharmacologic exposures. Many survivors of critical illness have cognitive impairment, which is believed to underlie the poor long-term functional status and quality of life observed in many critical illness survivors. Although progress has been made in characterizing the epidemiology of cerebral dysfunction in the ICU, more research is needed to elucidate underlying mechanisms that might represent targets for therapeutic intervention.
 ...
PMID:Types of brain dysfunction in critical illness. 1851 22

Dementia represents a heterogeneous term that has evolved to describe the behavioral syndromes associated with a variety of clinical and neuropathological changes during continuing degenerative disease of the brain. As such, there lacks a clear consensus regarding the neuropsychological and other constituent characteristics associated with various cerebrovascular changes in this disease process. But increasing this knowledge has given more insights into memory deterioration in patients suffering from Alzheimer's disease and other subtypes of dementia. The author reviews current knowledge of the physiological coupling between cerebral blood flow and metabolism in the light of state-of-the-art-imaging methods and its changes in dementia with special reference to Alzheimer's disease. Different imaging techniques are discussed with respect to their visualizing effect of biochemical, cellular, and/or structural changes in dementia. The pathophysiology of dementia in advanced age is becoming increasingly understood by revealing the underlying basis of neuropsychological changes with current imaging techniques, genetic and pathological features, which suggests that alterations of (neuro) vascular regulatory mechanisms may lead to brain dysfunction and disease. The current view is that cerebrovascular deregulation is seen as a contributor to cerebrovascular pathologies, such as stroke, but also to neurodegenerative conditions, such as Alzheimer's disease. The better understanding of these (patho) physiological mechanisms may open an approach to new interventional strategies in dementia to enhance neurovascular repair and to protect neurovascular coupling.
 ...
PMID:Strategies for molecular imaging dementia and neurodegenerative diseases. 1883 Mar 91

1. Stroke is the second most common cause of death and a major cause of disability worldwide. Despite increasing knowledge of the cellular and molecular mechanisms that occur in stroke, there are still large gaps in our understanding that are impeding therapeutic progress. In addition, there are no drugs yet that can be used effectively in stroke patients. 2. In recent years, it has been recognized that stroke is a brain dysfunction that involves multiple cell types and that a purely neurocentric focus or targeting a single point in a single pathway fails to yield sufficient protection. Thus, the concept of the 'neurovascular unit' has emerged as a new paradigm for stroke investigation and therapy. 3. ATP-sensitive potassium (K(ATP)) channels are unique channel proteins that directly couple the metabolic state of a cell to its electrical activity. These channels are found throughout the brain, being found in neurons, glial cells and in the brain vasculature. It is well documented that K(ATP) channels play multifactorial roles in protecting against brain injury induced by hypoxia, ischaemia or metabolic inhibition. 4. In the present review, we focus on the function of the neurovascular units in stroke and review current knowledge regarding K(ATP) channels, with a focus on their potential role in the remodelling of the neurovascular units.
 ...
PMID:ATP-sensitive potassium channels: a promising target for protecting neurovascular unit function in stroke. 1941

Stroke is a heterogeneous syndrome caused by multiple mechanisms, all of which result in disruption of normal cerebral blood flow and thereby cause cerebral dysfunction. Its early diagnosis is important as its treatment is dependent on the time elapsed since ictus. Delay in diagnosis and treatment translates into increase neuronal loss and thereby increased morbidity. CT scan, and in particular perfusion CT, has helped greatly in the early diagnosis of stroke. This article is an endeavor to explain the pathophysiology of cerebral ischemia and the role of CT perfusion in detecting it.
 ...
PMID:CT perfusion in acute stroke. 1977 81

Here in we report the case of a patient who displayed a classic heat stroke with multiple organ dysfunction and hypercoagulable state resistant to conventional whole body cooling and antipyretic therapy, and necessitating the use of hyperbaric oxygen therapy (HBOT) to rescue him from death. A 49-year-old male laborer, suffering from heat stroke syndromes (e.g., hyperpyrexia, seizure and coma, and hypotension), was admitted to an emergency unit of a medical center hospital. The patient displayed multiple organ dysfunction with rhabdomyolysis, hepatic, renal, respiratory, and cerebral dysfunction, and disseminated intravascular coagulation (DIC). Both hyperpyrexia and multiple organ dysfunction were resistant to conventional treatment measures. HBOT was adopted to rescue the patient from heat stroke-induced death. Before HBOT, analyses of serum revealed hypercoagulable state or DIC as well as signs of rhabdomyolysis, and renal and hepatic failure. In addition, pulmonary edema, coma, hypotension, and hyperpyrexia occurred. HBOT was used successfully to combat these syndromes and to rescue the patient from heat stroke death. This case suggests that HBOT is useful for treatment of heat stroke with multiple organ dysfunction.
 ...
PMID:A hyperbaric oxygen therapy approach to heat stroke with multiple organ dysfunction. 1977 3

Safety in cardiac surgery should be evaluated in the context of the other elements of quality in healthcare (timeliness, effectiveness, efficiency, equity, and most importantly, patient-centeredness). Mortality alone is not an adequate index of safety: Stroke is particularly feared by patients and prolonged periods of hospitalization can be very difficult for families to cope with. Advances in knowledge, technology, and medications have improved outcomes, but pharmacological means of reducing cerebral dysfunction after cardiopulmonary bypass remain elusive. Clear differences can be demonstrated between the results of different surgeons and also between different anesthesiologists. The World Health Organization's recently introduced Surgical Safety Checklist provides a validated and inexpensive cognitive aid to reduce human error and improve teamwork and communication in the operating room. Patient selection is very important, and patients should be given clear information on the relative merits of alternative treatments (for example, coronary surgery, percutaneous intervention, and medical treatment in the case of coronary artery disease). In the end, outcomes that the patients themselves desire are the most meaningful endpoint of the pursuit of safer cardiac surgery.
 ...
PMID:Safer cardiac surgery. 2009 87

Japanese medical care systems suffered from a number of long-term problems associated with emergency neurological medicine; moreover, with decreasing birthrate and aging society, these problems are rapidly worsening. The problems include shortage and uneven distribution of the necessary convalescent beds required for the treatment of stroke patients, scarcity of beds for treatment heavy work load of in-house healthcare staff, and shortage of human resources, furthermore, back-up emergency wards for acute treatment have not been developed. Medical facilities should be easily available to the general public; however, in a free economy, it is difficult to modify these facilities according to social needs. Moreover, presently, patients with higher brain dysfunction are supported only through nationwide system. It is necessary to recognize the current situation in which many patients have no other choice but to stay at home. In the light of this situation, the medical doctors in charge of emergency neurological medicine should discuss their future mode of action.
 ...
PMID:[Long-term problems associated with emergency neurological medicine]. 2011 92

We performed this study to elucidate whether a newly developed liposome-encapsulated hemoglobin, TRM-645 (TRM), can prevent cerebral dysfunction resulting from acute ischemic stroke when used as an oxygen carrier. Hippocampal long-term potentiation (LTP) in the perforant path-dentate gyrus synapses and anxiety-related behaviors in the elevated plus-maze test were evaluated as indices of cerebral functional outcomes in the rat with two-vessel occlusion (2VO), which was induced by 10-min clamping of bilateral common carotid arteries. Saline or TRM (hemoglobin concentration of 6 g/dl: 2.5 or 5 ml/kg) was administered via the tail vein immediately after ischemic insult. Hippocampal LTP formation was markedly impaired and the open arm durations in the elevated plus-maze decreased significantly 4 days after 2VO, compared to those of sham-operated (control) rats, suggesting the hippocampal synaptic dysfunction and anxiogenic properties in 2VO rats. TRM (5 ml/kg) restored the hippocampal LTP formation and normalized the anxiety-related behavior. TRM also improved the decreased tissue oxygen partial pressure in the 2VO rat hippocampus, possibly due to oxygen delivery to ischemic regions. Liposome-encapsulated hemoglobin TRM might have therapeutic potentials for protecting the brain from neurological complications associated with acute ischemic stroke, as a promising blood substitute for oxygen therapy.
 ...
PMID:Therapeutic potentials of an artificial oxygen-carrier, liposome-encapsulated hemoglobin, for ischemia/reperfusion-induced cerebral dysfunction in rats. 2083 27

Endogenous adenosine is a widely distributed upstream regulator of a broad spectrum of neurotransmitters, receptors, and signaling pathways that converge to contribute to the expression of an array of important brain functions. Over the past decade, the generation and characterization of genetic knockout models for all four G-protein coupled adenosine receptors, the A1 and A2A receptors in particular, has confirmed and extended the neuromodulatory and integrated role of adenosine receptors in the control of a broad spectrum of normal and abnormal brain functions. After a brief introduction of the available adenosine receptor knockout models, this review focuses on findings from the genetic knockout approach, placing particular emphasis on the most recent findings. This review is organized into two sections to separately address (i) the role of adenosine receptors in normal brain processes including neuroplasticity, sleep-wake cycle, motor function, cognition, and emotion-related behaviors; and (ii) their role in the response to various pathologic insults to brain such as ischemic stroke, neurodegeneration, or brain dysfunction/disorders. We largely limit our overview to the prominent adenosine receptor subtypes in brain-the A1 and A2A receptors-for which numerous genetic knockout studies on brain function are available. A1 and A2A receptor knockouts have provided significant new insights into adenosine's control of complex physiologic (e.g., cognition) and pathologic (e.g., neuroinflammation) phenomena. These findings extend and strengthen the support for A1 and A2A receptors in brain as therapeutic targets in several neurologic and psychiatric diseases. However, they also emphasize the importance of considering the disease context-dependent effect when developing adenosine receptor-based therapeutic strategies.
 ...
PMID:Normal and abnormal functions of adenosine receptors in the central nervous system revealed by genetic knockout studies. 2118 58


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>