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)

The authors report their experience regarding the identification of Apo-E alleles on atheroma carotid plaques in 20 patients of both sexes diagnosed as suffering from severe carotid stenosis using Doppler tests. A DNA hybridization and amplification method was used to identify Apo E-2, Apo E-3 and Apo E-4 alleles and their various phenotypical combinations. The following results were obtained in the 20 plaques examined: Apo E-3/E-4 in 114 patients (70%), 2 diabetic patients Apo E-4/E-3, one vascular demented patient Apo E-2/E-3, and 3 plaques defined as severely calcified Apo E-2/E-2. It can therefore be seen that the majority of plaques (70%), considered a risk for future stroke due to altered carotid Doppler tests, does not differ greatly by the homozygote allele Apo E-3/E-3 commonly found in the blood of the so-called "normal" population. It is difficult to draw any conclusions from the alleles found in the other 5 patients due to their scarce statistical value and the limited number of carotid plaques examined, but there appears to be some sort of correlation between calcified plaque, hyperlipidemia and the allele Apo E-2/E-2, with an interchange of position between cysteine arginine amino acids in the Apo E sequences.
 ...
PMID:[Atheroma plaque and Apo E alleles]. 876 17

The purpose of this study was to evaluate the efficiency and place of noninvasive ventilation of the lungs (NVL) in the treatment of hypoxemic acute respiratory failure (ARF) in patients with tumorous diseases of the blood. The study was carried out in 12 patients (3 men and 9 women) with tumorous diseases of the blood system, in whom NVL was used for treating ARF. Central hemodynamic and oxygen transport parameters were studied using Swan-Hanz catheter. NVL was uneventfully carried out in 5 (41.7%) of 12 patients (group 1). Group 2 consisted of 7 patients intubated after the beginning of NVL: 2 had to be transferred to forced ventilation of the lungs (FVL) because of loss of consciousness and 5 because of augmenting severity of ARD. All patients transferred to FVL died. During the first 3 h of NVL, oxygen delivery increased from 371.3 +/- 84.9 to 443.9 +/- 92.7 gm/m2 and oxygen consumption from 123.9 +/- 35.9 to 173.5 +/- 34 m/m2, oxygen alveolar-arterial difference decreased from 400.8 +/- 165.3 to 210 +/- 57.5 mm Hg, pulmonary shunt from 41.8 +/- 11.9 to 19 +/- 7.9%, PaO2/FiO2 from 140.4 +/- 210 +/- 84.9, left-ventricular stroke index increased from 38.2 +/- 14.9 to 50.6 +/- 21.8 ml/m2, left-ventricular output index from 37 +/- 19.5 to 47.4 +/- 23.7 gm/m2, and heart rate decreased from 119.2 +/- 17.5 to 111.4 +/- 23.8 min-1. In group 2 greater fraction of inhaled oxygen and higher positive pressure at the end of inspiration were required than in group 1. Heart rate and oxygen alveolar-arterial difference were higher in group 2. Side effects of NVL were skin maceration, hematomas on the bridge of the nose, and conjunctivitis. A specific complication associated with thrombocytopenia was the hemorrhagic syndrome (nasal bleeding, hemorrhagic stomatitis). Hence, NVL is the first stage of respiratory support in hypoxemic ARF. In immunocompromised patients NVL is effective only in cases when the cause of damage to the lung is rapidly diagnosed and effective pathogenetic therapy promptly started.
 ...
PMID:[Noninvasive ventilation of the lungs in the treatment of acute respiratory failure in immunocompromised patients]. 1151 Mar 52

Surgical management of patients with concomitant carotid and coronary artery stenosis remains controversial. Our policy was always to perform at the same time carotid endarterectomy (CE) and coronary artery bypass grafting (CABG), but it was also considered that extracorporeal circulation (ECC), because of full heparinization, hemodilution, pulsatile flow, and hypothermia could provide better cerebral protection during CE. Retrospective data of 124 patients undergoing simultaneous CE and CABGs between January 1994 and December 2001 were reviewed. CE was performed prior to ECC in 65 patients (Group 1-mean age: 70.4 years; sex ratio: 49 male/16 female) and under ECC, prior to CABGs in 59 patients (Group 2-mean age: 69.9 years; sex ratio: 46 male/13 female). Overall hospital mortality was 7.3% (9/124): cardiac-related in 5 patients, or due to septicemia (1 patient), or ARD syndrome (1 patient), or stroke in two others. Univariate analysis demonstrated overweight, unstable angina, and emergency to be significant risk factors. Bilateral carotid stenosis was a significant risk factor of neurologic event when CE was performed prior to ECC (p < 0.05). In Group 1, mortality was 9.2% (6/65), and the incidence of neurologic events was 10.7% (7/65), and was responsible for two of the early deaths in patients with bilateral carotid stenosis. In Group 2, mortality was 5.1% (3/59) but never related to CE, while the neurologic morbidity was 1.7% (1 transient ischemic attack). It is concluded that (1) hospital mortality in patients undergoing simultaneous CE and CABGs was mainly cardiac-related. (2) The combined approach of both localizations appears to be mandatory, when carotid stenosis, even asymptomatic, was hemodynamically significant, or with ulcerative lesions likely to be responsible for embolism. (3) CE, first performed under ECC, appears to be a safe procedure, combining, in terms of cerebral protection, the benefits previously called up. This approach is all the more interesting when carotid stenosis is bilateral; hypothermia < or = 28 degrees C during the carotid clamping time is obviously the optimal method for cerebral protection when ipsilateral or contralateral supply is reduced, or even absent.
 ...
PMID:Extracorporeal circulation as an additional method for cerebral protection in simultaneous carotid endarterectomy and coronary artery surgical revascularization. 1538 52