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

This study was aimed at determining the haemodynamic effects of various flow resistances in the anaesthetic breathing system in 15 patients under induced hypotension. The breathing pattern, arterial blood gases and haemodynamics were analysed during spontaneous breathing with three systems with different flow resistance as compared with a low-resistance control system. One was made up of a Digby-Leigh valve with an inspiratory resistance of 7 cmH2O l-1s and a high expiratory resistance of 25 cmH2O l-1s (DLS); the other two had an added inspiratory resistive load of 12 cmH2O l-1s (IRS1) and 25 cmH2O l-1s (IRS2) respectively. Whichever system was used, blood gases did not change. With DLS, pulmonary arterial and wedge pressures increased. With the two high inspiratory resistance systems, stroke volume (SV) increased and heart rate (HR) decreased. In six patients, SV was increased only with IRS2, whereas the increase seen with IRS1 in the other nine subjects disappeared with IRS2. It is concluded that the expiratory resistance should be as low as possible in order to avoid pulmonary haemodynamic consequences. An inspiratory resistive load, carefully adapted to each individual case, produced an increase in SV probably by enhancing the venous return. This latter effect could be beneficial in reducing bleeding during middle ear micro-surgery.
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PMID:Haemodynamic effects of inspiratory and expiratory resistances in anaesthetic breathing systems during induced hypotension. 408 68

The relationship between the hypertension and the aging process of hearing organ was investigated. Twenty Wistar 3-month old rats and 20 Wistar 12-month old rats, 20 spontaneously hypertensive rat stroke-prone (SHRSP) 3-month old rats and 20 SHRSP 12-month old rats free of middle ear infections as observed under otomicroscopy, with normal tympanic membrane and auricle reflex, were selected to be divided into two experimental groups and two control groups respectively. The tail artery blood pressure was measured non-invasively. The threshold of auditory brain-stem response (ABR) was measured by Spirit evoked potential meter. The LDH and ChE staining in the inner ear was performed and the optical density was analyzed by the HPIAS analysis system. The results showed that there was no difference in the ABR thresholds, the activities of LDH and ChE between Wistar 3-month old group and SHRSP 3-month old group (P > 0.05). The mean value of ABR threshold and the activities of LDH and ChE in the Wistar 12-month old group at relevant sections were significantly greater than those in the two 3-month old groups (P < 0.05), whereas the mean value of ABR threshold and the activities of LDH and ChE in the SHRSP 12-month old group at relevant sections were significantly higher than those in the 3-month old control group (P < 0.01). It was concluded that presbycusis existed in the Wistar 12-month old group rats. The glycogenosis and the abnormal secretion of neural transmitter were discerned after hypertension. All the above factors may worsen the aging of the hearing system.
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PMID:Effect of hypertension on hearing function, LDH and ChE of the cochlea in older rats. 1452 43

Barotrauma is pressure-induced injury. The application of direct pressure to the body may cause trauma, including positive pressure from artificial ventilation. Trauma may also be caused by the effects of pressure changes on gas-containing body spaces, not in communication with the environment. This can include the external ear, the middle ear (and, indirectly, the inner ear), the para-nasal sinuses, the lungs, the gut, and abscess cavities (for example, in the teeth). Gas may penetrate tissues adjoining the affected space (such as the anterior cranial fossa, via the ethmoid sinus), or may embolise via the blood stream. The most severe expression of this is cerebral arterial gas embolism, which may present as a stroke. The management of these problems includes prevention, the use of pressure-equalizing techniques, vasoconstrictor drugs, surgery, and hyperbaric oxygen therapy.
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PMID:Barotrauma. 1503 70

In these experiments we define an effective means of pulsed magnetic stimulation of the facial nerve for the purpose of increasing cerebral blood flow (CBF). In normal anesthetized dog and sheep, a focal magnetic field was directed toward the facial nerve within the temporal bone by placing a 6.5 cm figure-8 stimulation coil over the ear. In an initial set of experiments, CBF was measured by laser Doppler flowmetry and the cerebral vasculature was visualized by angiography. The effect of facial nerve stimulation was found to be dependent on stimulation power, frequency, and the precise positioning of the stimulation coil. Furthermore, an increase in CBF was not observed after direct electrical stimulation in the middle ear space, indicating that non-specific stimulation of the tympanic plexus, an intervening neural structure with vasoactive effects, was not responsible for the increase in CBF after pulsed magnetic stimulation. Subsequent experiments using perfusion MRI demonstrated reproducible increases in CBF throughout the forebrain that manifested bilaterally, albeit with an ipsilateral predominance. These experiments support the development of a non-invasive pulsed magnetic facial nerve stimulator that will increase CBF as a treatment of ischemic stroke.
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PMID:Effect of pulsed magnetic stimulation of the facial nerve on cerebral blood flow. 2385 Jun 47

Stroke, also known as cerebrovascular disease, is a common and serious neurological disease, which is also the fourth leading cause of death in the United States so far. Hyperbaric medicine, as an emerging interdisciplinary subject, has been applied in the treatment of cerebral vascular diseases since the 1960s. Now it is widely used to treat a variety of clinical disorders, especially hypoxia-induced disorders. However, owing to the complex mechanisms of hyperbaric oxygen (HBO) treatment, the therapeutic time window and the undefined dose as well as some common clinical side effects (such as middle ear barotrauma), the widespread promotion and application of HBO was hindered, slowing down the hyperbaric medicine development. In August 2013, the US Food and Drug Administration declared artery occlusion as one of the 13 specific indications for HBO therapy. This provides opportunities, to some extent, for the further development of hyperbaric medicine. Currently, the mechanisms of HBO therapy for ischemic stroke are still not very clear. This review focuses on the potential mechanisms of HBO therapy in acute ischemic stroke as well as the time window.
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PMID:Hyperbaric oxygen therapy in acute ischemic stroke: a review. 2533 89

Exposure to secondhand smoke from burning tobacco products causes stroke, lung cancer, and coronary heart disease in adults (1,2). Children who are exposed to secondhand smoke are at increased risk for sudden infant death syndrome, acute respiratory infections, middle ear disease, more severe asthma, respiratory symptoms, and slowed lung growth (1,2). Secondhand smoke exposure contributes to approximately 41,000 deaths among nonsmoking adults and 400 deaths in infants each year (2). This report updates a previous CDC report that evaluated state smoke-free laws in effect from 2000-2010 (3), and estimates the proportion of the population protected by comprehensive smoke-free laws. The number of states, including the District of Columbia (DC), with comprehensive smoke-free laws (statutes that prohibit smoking in indoor areas of worksites, restaurants, and bars) increased from zero in 2000 to 26 in 2010 and 27 in 2015. The percentage of the U.S. population that is protected increased from 2.72% in 2000 to 47.8% in 2010 and 49.6% in 2015. Regional disparities remain in the proportions of state populations covered by state or local comprehensive smoke-free policies, as no state in the southeast has a state comprehensive law. In addition, nine of the 24 states that lack state comprehensive smoke-free laws also lack any local comprehensive smoke-free laws. Opportunities exist to accelerate the adoption of smoke-free laws in states that lack local comprehensive smoke-free laws, including those in the south, to protect nonsmokers from the harmful effects of secondhand smoke exposure.
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PMID:State and Local Comprehensive Smoke-Free Laws for Worksites, Restaurants, and Bars - United States, 2015. 2733 12

This article describes the aberrant course of the internal carotid artery (ICA) through the middle ear as an extremely rare vascular anomaly. On the basis of a case report, the findings of magnetic resonance imaging, computed tomography imaging, and especially color-coded duplex sonography are presented. The diagnosis of an aberrant ICA is important to avoid severe surgical complications of a retrotympanic mass as well as unnecessary diagnostic or therapeutic approaches in expectation of a stroke.
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PMID:Ultrasonographic, CTI and MRI of Aberrant Internal Carotid Artery: Infrequent but Important to Know. 2803 80

Exposure to secondhand smoke from burning tobacco products causes premature death and disease, including coronary heart disease, stroke, and lung cancer among nonsmoking adults and sudden infant death syndrome, acute respiratory infections, middle ear disease, exacerbated asthma, respiratory symptoms, and decreased lung function in children (1,2). The U.S. Surgeon General has concluded that there is no risk-free level of exposure to secondhand smoke (1). Previous CDC reports on airport smoke-free policies found that most large-hub airports in the United States prohibit smoking (3); however, the extent of smoke-free policies at airports globally has not been assessed. CDC assessed smoke-free policies at the world's 50 busiest airports (airports with the highest number of passengers traveling through an airport in a year) as of August 2017; approximately 2.7 billion travelers pass through these 50 airports each year (4). Among these airports, 23 (46%) completely prohibit smoking indoors, including five of the 10 busiest airports. The remaining 27 airports continue to allow smoking in designated smoking areas. Designated or ventilated smoking areas can cause involuntary secondhand smoke exposure among nonsmoking travelers and airport employees. Smoke-free policies at the national, city, or airport authority levels can protect employees and travelers from secondhand smoke inside airports.
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PMID:Smoke-Free Policies in the World's 50 Busiest Airports - August 2017. 2916 67

This short review focuses on pulmonary injury in breath-hold (BH) divers. When practicing their extreme leisure sport, they are exposed to increased pressure on pulmonary gas volumes, hypoxia, and increased partial gas pressures. Increasing ambient pressures do present a serious problem to BH deep divers, because the semi-rigid thorax prevents the deformation required by the Boyle-Mariotte law. As a result, a negative-pressure barotrauma (lung squeeze) with acute hemoptysis is not uncommon. Respiratory maneuvers such as glossopharyngeal insufflation (GI) and glossopharyngeal exsufflation (GE) are practiced to prevent lung squeeze and to permit equalizing the paranasal sinuses and the middle ear. GI not only impairs venous return, thereby provoking hypotension and even fainting, but also produces intrathoracic pressures likely to induce pulmonary barotrauma that is speculated to induce long-term injury. GE, in turn, further increases the already negative intrapulmonary pressure, thereby favoring alveolar collapse (atelectasis). Finally, hypoxia seemingly not only induces brain injury but initiates the opening of intrapulmonary shunts. These pathways are large enough to permit transpulmonary passage of venous N2 bubbles, making stroke-like phenomena in deep BH divers possible.
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PMID:Effects of Breath-Hold Deep Diving on the Pulmonary System. 3078 70