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

The purpose of this study was to determine the pattern and frequency of CNS abnormalities in the offspring of cocaine-abusing mothers. The study group consisted of a retrospective review of all neonates born or admitted to our neonatal intensive care unit over a 1-year period who met criteria for maternal cocaine abuse (43 patients). A control group (62 patients) was obtained from patients seen during the same interval and the cases were matched for gestational age and race. The radiologic studies were analyzed by two independent reviewers, and CNS abnormalities were assessed by means of sonography, CT, or MR. By matching the study and control groups for gestational age, we eliminated the higher frequency of prematurity. This allowed us to determine if maternal cocaine use was associated with any intracranial abnormalities other than those seen with prematurity. The frequency of intracranial hemorrhage, ventricular enlargement, and periventricular leukomalacia was not significantly different between the study and control groups. The frequency of cortical infarction was 17% in the study group and 2% in the control group. The frequency of major congenital malformation was 12% in the study group and 0% in the control group. All five of the congenital malformations seen were midline CNS abnormalities, particularly neural tube defects. It is postulated that the higher statistically significant frequency of stroke and congenital malformations in the babies of maternal cocaine abusers is related to vasospasm caused by cocaine when used in the third and first trimesters, respectively.
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PMID:Maternal cocaine abuse: the spectrum of radiologic abnormalities in the neonatal CNS. 163 52

A case-controlled epidemiologic study on the risk factors leading to prematurity and IUGR was carried out in 7 rural areas in Shunyi County, Beijing. 88 prematures, 83 IUGR and 509 normal controls were included in this study and 142 factors have been taken into consideration. The result revealed that strong or abrupt physical and psychic stroke to the gravidae were the main risk factors for prematurity while maternal poor health and malnutrition played a leading role in IUGR. Deficient in-take of various diet constituents might also play a part in both prematurity and IUGR Preventive measures, based on this study are postulated.
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PMID:[An epidemiologic study of the risk factors leading to prematurity and intrauterine growth retardation]. 262 May 77

For the hypertrophic obstructive cardiomyopathy with left-ventricular pressure gradient in rest a causal therapy is nowadays not yet known. Therefore, it should be tested, in what respect from former observations over reductions of the pressure gradient by an untimely foreign excitation of the ventricles from the apex of the right ventricle a therapy principle can be derived. For this purpose out of a group of 84 patients by left-right heart catheterization, coronarography, computer cardio-tomography and scintigraphy of the myocardium 23 test persons with typical hypertrophic obstructive cardiomyopathy and a left-ventricular gradient in rest greater than or equal to 30 mm Hg were selected for the transitory electrostimulation. After placing of one electrode in the right atrium and another one in the right ventricle one after another a VOO-, VAT- and DOO-pacing were used. For the two last mentioned forms of stimulation as electronic atrio-ventricular retardation times 100, 40, 20, 10 and 5 ms were selected. With all three kinds of stimulation in 5 of the patients (group A) reductions of gradients greater than or equal to 51% and in 12 cases of hypertrophic obstructive cardiomyopathy (group B) diminishments between 30 and 50% could be obtained. Only in 6 patients (group C) reductions of less than or equal to 29% were registered. The optimum of prematurity necessary for obtaining maximum pressure reductions is individually different, but is almost in every case between 5 and 20 ms. Further seven parameters measured during the stimulation phases showed that these reductions are not caused by a decrease of the stroke volume, but by an enlargement of the effective opening of the outlet. Apparently, in a part of the patients with hypertrophic obstructive cardiomyopathy by the foreign excitation from the apex of the ventricle a temporary and spatial course of excitation can be induced, by means of which the degree of functional stenosing is decreased. Since for several patients the removal of the disturbance of the systolic function is to be regarded as therapeutically reasonable partial success, the transitory diagnostic pacing is recommended for all patients with typical hypertrophic obstructive cardiomyopathy and a gradient in rest greater than or equal to 30 mm Hg. The indications and technical prerequisites for a permanent electrostimulation with suitable systems are represented.
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PMID:[Atrial synchronous ventricular stimulation with reduced a.v. delay time as a therapeutic principle in hypertrophic obstructive cardiomyopathy]. 654 81

The potentially adverse influence of premature ectopic beats or tachyarrhythmias on cardiac performance was studied by assessing the echocardiographic left ventricular stroke volume in 21 patients with cardiac rhythm disturbances. The beat to beat stroke volume correlated closely with end-diastolic volume in each patient (average R = .9). Premature ventricular contractions decreased stroke volume by an average of 48 +/- 8 ml (-71%) compared with sinus beats; whereas the postextrasystolic beats, although preceded by a pause and higher end-diastolic volume, increased stroke volume by only 16 +/- 7 ml (18%) over the sinus beats. Those postextrasystolic beats with equivalent timing and end-diastolic volume to the sinus beats had a mean stroke volume only 8 ml higher, suggesting that postextrasystolic potentiation plays only a minor role in augmenting stroke volume. Transient aberrant ventricular conduction of intermittent left bundle branch block, ectopic beats or atrial fibrillation failed to alter stroke volume. Ventricular bigeminy, trigeminy and quadrigeminy lowered cardiac output by 1.3, .9 and .7 l/min. The onset of tachyarrhythmias was oftentimes associated with a continuously changing end-diastolic volume and stroke volume, with either alternation or progressive increment of these variables. It is apparent that premature contractions decrease stroke volume by virtue of their infringement on diastolic filing, the principle beat to be determinant of stroke volume in arrhythmias being left ventricular end-diastolic volume. Since premature beats decrease stroke volume to an extent greater than postextrasystolic beats increase it, they may reduce cardiac output by a substantial degree, depending on their frequency of occurrence and degree of prematurity.
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PMID:The influence of ectopic beats and tachyarrhythmias on stroke volume and cardiac output. 726 99

To test the hypothesis that increasing survival of infants at highest risk for long-term neurological sequelae has strengthened the associations between perinatal events and subsequent cerebral palsy (CP), we compared the prevalence rates for prematurity, low birthweight, congenital malformations, and perinatal asphyxia from a current population of children with CP with those reported nearly 30 years ago by the National Collaborative Perinatal Project (NCPP, 1959-1966) of the National Institute of Neurologic and Communicative Disorders and Stroke. Although we saw no differences in the proportion of children who were born prematurely, we did find a significant shift in the birthweight and gestational age distribution, with a nearly threefold greater prevalence of births less than 1501 g in our population (31.1% and 95% confidence interval [CI] of 20.6 to 41.7% vs 9.1% and 95% CI of 5.0 to 13.2%). Nearly half (43.5%) of these very low birthweight infants had evidence of brain injury (intraventricular hemorrhage), a diagnosis not commonly recognized in the NCPP. On the other hand, birth asphyxia and congenital malformations occurred no more frequently in our population than that reported earlier. Furthermore, the majority (60%) of full-term infants who develop CP continue to be the products of normal pregnancies and have no perinatal events that may have caused their neurological impairment. The increasing prevalence of births less than 1501 g among children with CP may well reflect the improving survival of very small infants over the last 30 years.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Prevalence of prematurity, low birthweight, and asphyxia as perinatal risk factors in a current population of children with cerebral palsy. 785 25

Human immunodeficiency virus type-1 (HIV-1)-associated neurologic disease, known as "HIV-1-associated progressive encephalopathy" (PE), is a common concomitant in the progression towards AIDS. PE, characterized by a triad of symptoms including impaired brain growth, progressive motor dysfunction, and loss or plateau of developmental milestones, is believed to result from both direct and indirect effects of HIV-1 infection on the central nervous system (CNS). Consequent to the hallmark systemic immune deficiency of HIV infection, the CNS becomes susceptible to opportunistic infections which add further morbidity and mortality, and may contribute either directly or indirectly to neurologic symptoms which can often mimic PE. Static encephalopathies (SE) represent fixed, nonprogressive neurologic or neurodevelopmental deficits in HIV-infected children. SE may or may not be caused by HIV infection but are often associated with such identifiable insults as prematurity, in utero exposure to toxins or infectious agents, or head trauma. Additional neurological manifestations of HIV infection are seizures, cerebrovascular complications (i.e., stroke), myelopathies, neuromuscular syndromes, and CNS complications of opportunistic infections. Neurobehavioral aberrations have also been observed in pediatric HIV infection. In addition to the neuropathogenesis, theories regarding the timing and detection of the neurological problems associated with pediatric HIV infection are discussed along with a presentation of current treatment paradigms and their rationales. The importance of identifying the numerous environmental factors, including nutritional status, that may confound the ability to discriminate between a primary or secondary role of HIV infection in the various neurological problems of HIV infection is discussed.
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PMID:Neurological and developmental problems in pediatric HIV infection. 886 30

A retrospective study of cesarean hysterectomies at the Department of Obstetrics and Gynecology in Novi Sad was conducted for the period 1968-1993. There were 129,127 deliveries, whereas cesarean section was performed in 10,485 (8.12%) cases. There were 55 cesarean hysterectomies (0.042%), while in 0.52% they were performed during cesarean section. Elective hysterectomy was performed in 7 (12.73%) cases because of neoplastic process and uterine myoma, while in 48 (87.27%) cases it was performed for heavy bleeding. Most often bleeding occurred due to complications of placenta previa, uteroplacental apoplexy, premature placental ablation, uterine rupture and atony. Total hysterectomy was performed in 30 (54.54%) cases and subtotal hysterectomy in 25 (45.45%) cases. Bilateral adnexectomy was performed in 3 (5.45%) cases. Urinary bladder injury occurred in 4 (7.27%) patients, wound infection in 11 (20.00%) patients, urinary infection in 3 (5.45%) and pelvic peritonitis in 1 (1.82%) patient. One maternal death (1.82%) occurred due to DIC (disseminated intravascular coagulation). Out of 57 delivered newborns 20 (35.10%) died in the perinatal period. There were 13 stillbirths (22.80%), whereas 7 newborns (12.30%) died in the early neonatal period due to prematurity and RDS (respiratory distress syndrome).
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PMID:[Cesarean hysterectomy im modern obstetrical practice from 1968 to 1993]. 947 33

The clinical features of a probably autosomal recessive syndrome ("CARASIL"), yet to be confined in Japan and characterized by prematurity of vascular dementia, alopecia and spondylosis deformans are reviewed through comparison with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), which has been reported in Europe and North America, and recently in Japan. These two syndromes have many common features, such as familiality, encephalopathy of Binswanger type, and absence of vascular risk factors. There exists, however, a number of differences as follows: (1) Onset of encephalopathy is 32 years of age in "CARASIL" vs. 45 in CADASIL. (2) Male to female ratio is 3.2: 1 vs. 2:1.(3) Two thirds of "CARASIL" patients show stroke and/or stepwise deterioration, while almost all CADASIL patients have stroke. (4) Associated psychiatric features are euphoria, emotional lability and loss of spontaneity vs. severe mood disorders. (5) Migraine is a cardinal feature of CADASIL and vasospasm may occur during cerebral angiography. (6) White matter lesions on MRI are diffuse and homogeneous vs. punctuated and nodular. The latter four differences may mirror the difference in the pathology of arteriopathies. "CARASIL" is clearly different from CADASIL and reflect a second genetic condition with a seemingly direct effect upon the cerebral vasculature.
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PMID:[Young-adult-onset hereditary subcortical vascular dementia: cerebral autosomal recessive arteriosclerosis with subcortical infarcts and leukoencephalopathy (CARASIL)]. 1037

Coronary artery diseases is rapidly increasing in our part of the world. The South Asian ethnic groups are especially vulnerable to coronary artery disease. The two most striking features of coronary artery disease in the South Asian population are extreme prematurity and severity of the disease, both resulting from the malignant atherosclerosis that begins at an earlier age than in other population. Triple vessel disease and complicated lesions are not common even in young people and follow a malignant course. The most important aspect of prevention is to identify individuals with high risk of coronary artery disease at an early age and aggressive modification of risk factors. Tobacco smoking and hypertension are the two most important risk factors for coronary heart disease and stroke. Both of these risk factors have very high prevalence in India, Nepal and other countries of this region. There is a synergistic interaction of tobacco smoking with hypertension and high blood cholesterol which greatly increase coronary heart disease risk as well as sudden death and stroke.
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PMID:Tobacco smoking and hypertension. 1063 83

Prematurely born children have reduced peak VO2 compared with their peers, inferentially attributed to ventilatory limitation. The primary purpose of this study was to compare exercise ventilation and cardiac output in a sample of childhood survivors of lung disease of prematurity with those of a control group to elucidate reasons for lower peak VO2. A secondary aim was to describe and compare the ventilatory response to incremental exercise. Thirty-two children, aged 8-9 y, were recalled for lung function and progressive exercise tests. Fifteen of them also performed submaximal exercise with measurement of cardiac output (indirect [CO2] Fick) and physiologic dead space. Results were compared with those of term-born, age- and sex-matched, control children. Pulmonary function tests showed mild airflow limitation. Peak VO2 was lower in prematurely born children compared with control children, and was correlated with lean body mass. Their heart rate-VO2 relationship and stroke volume were similar to that of term-born control children. Children with a history of bronchopulmonary dysplasia and hyaline membrane disease as infants exhibited greater exercise hyperpnea than did healthy control children, because of higher breathing frequency, and maintained lower end-tidal PCO2 during submaximal exercise. Physiologic dead space normalized for body weight was similar in preterm and term-born children. Lower peak VO2 in this population is not caused by cardiopulmonary factors, but is best predicted by lean body mass. Ventilation did not limit exercise performance, although it appears that breathing during exercise is regulated differently in prematurely born children than in term-born children.
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PMID:Cardiopulmonary exercise performance in prematurely born children. 1081 92


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