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

A sample of people aged 65 and over were interviewed at home and asked a series of questions aimed at identifying episodes of possible transient neurological dysfunction. During follow-up of respondents initially free from manifest cerebrovascular disease, no relationship was found between subsequent stroke and reported episodes of diplopia, transient numbness or weakness, non-rotatory dizziness or blackouts. There was an association of stroke with reported blurring or dimming of vision, statistically significant only for the sexes combined (relative incidence ratio 1.5), and a consistently increased risk in men and women reporting rotatory vertigo (relative incidence ratio 2.5). This relationship remained significant when adjusted for the association of rotatory vertigo with ECG evidence of heart disease. Thus rotatory vertigo is a risk factor for stroke but non-rotatory dizziness is not. Conversely a previous study of falling in the same population sample had shown an association with rotatory vertigo but not with non-rotatory dizziness.
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PMID:Transient neurological dysfunction and risk of stroke in an elderly English population: the different significance of vertigo and non-rotatory dizziness. 231 24

Recent experience at the Merseyside Regional Pacemaker Centre has emphasized that many junior doctors are unfamiliar with numerous important facts regarding permanent pacemakers. It is important to detect quickly a fault in a permanent pacemaker if, for example, a patient presents with recurrent dizziness, blackouts or a cerebrovascular accident.
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PMID:Pacemaker assessment for junior doctors. 374 33

Embolic and thrombotic infarction in the territory of the posterior cerebral artery (PCA) is described with emphasis on the stroke and cerebrovascular features rather than special neurological syndromes. Of 47 cases of obstruction at the distal bifurcation of the basilar artery, 43 (95%) were consistent with embolism. The clinical categories and pathological findings are presented. Local embolism, vertebral distal-stump embolism, the dynamics of hemorrhagic infarction and embolus-in-transit are briefly described. The prodromal manifestations of PCA thrombotic occlusion include photopsias, hemianopic blackouts, headache, transient episodes of numbness, episodic lightheadedness, spells of bewilderment and rarely tinnitus. Recognition of these may allow prevention of a stroke. Prodromal photopsias did not closely resemble the scintillating displays of migraineurs. When the stroke occurred, visual complaints usually predominated. A sensory deficit occurred in one-third of cases. In 25 cases of memory impairment the dominant hemisphere was involved in 24. The kinds of visual hallucinations, simple and formed, are described.
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PMID:The posterior cerebral artery syndrome. 374 39

In 2793 respondents aged 65 and over in a survey of a geographically defined community, who were asked about falls in the preceding twelve months, the estimated annual prevalence rate (persons) of falls was 28.0%. Standardized for age, the rate was twice as high in women as in men. Rates increased with age but more steeply in men than in women. Compared with non-fallers, fallers had been in more recent contact with their general practitioner, showed higher prevalence of problems with mobility and daily living, a more frequent history of stroke and heart disease, and had more episodes of non-rotatory vertigo, double vision, faints and blackouts and episodes of weakness or numbness. Fallers also showed more frequent evidence suggestive of cognitive impairment. More fallers than non-fallers were taking diuretics and tranquilizers and these associations merit further study.
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PMID:Factors associated with falls in the elderly: a community study. 727 Mar 21

Diabetes devastates lives and burdens society. Hypoglycemic (low glucose) episodes cause blackouts, and severe ones are life-threatening. Periods of hyperglycemia (high glucose) cause circulatory disease, stroke, amputations, blindness, kidney failure and nerve degeneration. In this Account, we describe the founding of TheraSense, now a major part of Abbott Diabetes Care, and the development of two products that have improved the lives of people with diabetes. The first, a virtually painless microcoulometer (300 nL volume), the FreeStyle blood glucose monitoring system, was approved by the FDA and became available in 2000. In 2009, this system was used in more than one billion blood assays. The second, the enzyme-wiring based, subcutaneously-implanted FreeStyle Navigator continuous glucose monitoring system, was approved by the FDA and became available in the United States in 2008. The strips of the FreeStyle blood glucose monitoring system comprise a printed parallel plate coulometer, with a 50 microm gap between two facing printed electrodes, a carbon electrode and a Ag/AgCl electrode. The volume of blood between the facing plates is accurately controlled. The glucose is electrooxidized through catalysis by a glucose dehydrogenase (GDH) and an Os(2+/3+) redox mediator, which is reduced by the glucose-reduced enzyme and is electrooxidized on the carbon electrode. Initially the system used pyrroloquinoline quinone (PQQ)-dependent GDH but now uses flavin adenine dinucleotide (FAD)-dependent GDH. Because the facing electrodes are separated by such a small distance, shuttling of electrons by the redox couple could interfere with the coulometric assay. However, the Os(2+/3+) redox mediator is selected to have a substantially negative formal potential, between 0.0 and -0.2 V, versus that of the facing Ag/AgCl electrode. This makes the flow of a shuttling current between the two electrodes virtually impossible because the oxidized Os(3+) complex cannot be appreciably reduced at the more positively poised Ag/AgCl electrode. The FreeStyle Navigator continuous glucose monitoring system uses a subcutaneously implanted miniature plastic sensor connected to a transmitter to measure glycemia amperometrically and sends the information to a PDA-like device every minute. The sensor consists of a narrow (0.6 mm wide) plastic substrate on which carbon-working, Ag/AgCl reference, and carbon counter electrodes are printed in a stacked geometry. The active wired enzyme sensing layer covers only about 0.1 mm(2) of the working electrode and is overlaid by a flux-limiting membrane. It resides at about 5 mm depth in the subcutaneous adipose tissue and monitors glucose concentrations over the range 20-500 mg/dL. Its core component, a miniature, disposable, amperometric glucose sensor, has an electrooxidation catalyst made from a crosslinked adduct of glucose oxidase (GOx) and a GOx wiring redox hydrogel containing a polymer-bound Os(2+/3+) complex. Because of the selectivity of the catalyst for glucose, very little current flows in the absence of glucose. That feature, either alone or in combination with other features of the sensor, facilitates the one-point calibration of the system. The sensor is implanted subcutaneously and replaced by the patient after 5 days use with minimal pain. The wearer does not feel its presence under the skin.
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PMID:Electrochemistry in diabetes management. 2038 99

Arrhythmias (abnormal heartbeats) are common but can be life threatening. Symptoms can be severe and include palpitations, dizziness, blackouts, breathlessness and even chest pain. These can be highly distressing for patients, causing them severe anxiety and depression if they are not well supported. Early diagnosis is essential to reduce mortality and improve quality of life--the most common arrhythmia--atrial fibrillation--can cause a stroke if left untreated or inadequately treated. While sudden cardiac death is less common in a young person, it is usually due to an inherited cardiac condition that has resulted in a critical arrhythmia. Screening family members at risk can provide timely assessment, psychological support through counselling and treatment with the implantation of a cardioverter defibrillator if necessary. In 2005, a chapter setting out best practice for arrhythmia care was added to the National Service Framework for Coronary Heart Disease. This highlights the need for early diagnosis and expert patient support. In response, the British Heart Foundation launched a pilot programme to fund specialist nurses as arrhythmia care coordinators. Its aim was to develop and improve care pathways, and provide continuity and support for patients diagnosed with an arrhythmia to improve clinical care and emotional wellbeing. An independent evaluation by the University of York showed that these posts significantly improved patients' experiences of arrhythmia services, prevented thousands of readmissions and cut costs for the NHS. This article explains how the new role was successfully implemented.
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PMID:Benefits of arrhythmia care coordinators. 2399 34

Ancient and medieval theories on the causes and signs of stroke are presented in a translation of the relevant chapters of the Canon of Medicine by Avicenna (908-1037 A.D.), which was one of the main books studied by doctors for nearly 500 years. Recognised aetiologic factors included vascular occlusion, cerebral abscess, trauma, and repeated blood-letting. Motor and sensory deficits were described, as was the occasional association with facial palsy, respiratory difficulty, and coma. Warning symptoms such as severe headache and blackout were known, as was the poor prognosis associated with stroke that follows severe headache. Obesity as a risk factor was identified.
J Stroke Cerebrovasc Dis 1992
PMID:Avicenna on the causes and signs of stroke. 2648 77

A diagnosis of alcohol use disorder is associated with a higher risk of dementia, but a dose-response relationship between alcohol intake consumption and cognitive impairment remains unclear. Alcohol is associated with a range of effects on the central nervous system at different doses and acts on a number of receptors. Acute disorders include Wernicke's encephalopathy (WE), traumatic brain injury, blackouts, seizures, stroke and hepatic encephalopathy. The most common manifestations of chronic alcohol consumption are Korsakoff's syndrome (KS) and alcohol-related dementia (ARD). There is limited evidence for benefit from memantine in the treatment of ARD, but stronger evidence for the use of high-dose parenteral thiamine in the progression of neuropsychiatric symptoms for WE. Accumulating evidence exists for pharmacological treatment in the prevention of hepatic encephalopathy. Rehabilitation of people with ARD may take several years, and requires an approach that addresses physical and psychosocial factors.
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PMID:Alcohol use disorders and the brain. 3211 74