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)

This study was undertaken to identify variables that could explain the association between low albumin and a 9- to 12-year mortality follow-up among 287 community- dwelling and 176 institutionalized people aged 60 years and over. A wide array of nutrition assessment variables was simultaneously examined in this population to identify confounders of the association. The results show that the risk of mortality for subjects with albumin values of 40 g/liter and over was 0.46 of the risk for those with albumin values below 40 g/liter, after controlling for the confounders age, blood urea nitrogen, triglyceride, history of diseases, and inability to shop owing to medical conditions. Similarly, albumin was also inversely associated with mortality among institutionalized subjects even after controlling for the confounders age, sex, blood urea nitrogen, transferrin, and history of stroke. However, the association was no longer significant among the institutionalized population once the deaths that occurred within the first 3 years after study participation were eliminated. The results indicate that albumin is a long-term predictor of mortality among noninstitutionalized subjects and increased mortality is not only a result of age, history of chronic diseases, medication use, or protein intake. Among institutionalized subjects, albumin appeared to be a short-term predictor of mortality.
 ...
PMID:Use of albumin as a predictor of mortality in community dwelling and institutionalized elderly populations. 925

The purpose was 1) to prospectively determine the prevalence of adverse events necessitating intensive care unit (ICU) monitoring in gallstone pancreatitis (GP) and 2) To identify admission prognostic indicators that predict the need for ICU unit monitoring. Prospective laboratory data, physiologic parameters, and APACHE II scores were gathered on 102 patients with GP over 14 months. Adverse events were defined as cardiac, respiratory, or renal failure, gastrointestinal bleeding, stroke, sepsis, and necrotizing pancreatitis. Patients were divided into Group 1 (no adverse events, n=95) and Group 2 (adverse events, n=7). There were no deaths and 7 (7%) adverse events, including necrotizing pancreatitis (3), cholangitis (2), and cardiac (2). APACHE 11 > or = 5 (P < 0.005), blood urea nitrogen (BUN) > or = 12 mmol/L (P < 0.005), white blood cell count (WBC) > or = 14.5 x 10(9)/L, (P < 0.001), heart rate > or = 100 bpm (P < 0.001), and glucose > or = 150 mg/dL (P < 0.005) were each independent predictors of adverse events. The sensitivity and specificity of these criteria for predicting severe complications requiring ICU care varied from 71 to 86 per cent and 78 to 87 per cent, respectively. The prevalence of adverse events necessitating ICU care in GP patients is low. Glucose, BUN, WBC, heart rate, and APACHE II scores are independent predictors of adverse events necessitating ICU care. Single criteria predicting the need for ICU care on admission are readily available on admission.
 ...
PMID:Admission factors can predict the need for ICU monitoring in gallstone pancreatitis. 881 62

The impact of perioperative complications on clinical outcomes and resource utilization was assessed for 8702 veterans who, during fiscal years 1991-1994, underwent vascular surgery procedures in DRGs 110 and 111, which include aortic and peripheral aneurysm repairs as well as renal artery and some peripheral vascular reconstructions. In-hospital mortality rate was 6.2% (537/8702). Mortality was 9.8% with any ICD-9-CM-coded complication vs 4.9% without (P < 0.001). Mortality was 28.9% in those with both cardiac and pulmonary complications, 11.0% with either cardiac or pulmonary complications, and 3.7% with neither cardiac nor pulmonary complications. Length of stay (LOS) was 25.8 +/- 21.9 days with any ICD-9-CM-coded complication vs 18.9 +/- 14.1 days without (P < 0.001). Further, RIS (Resource Intensity Scale), a measure of intensity of resource utilization, was greater in those with (3.01 +/- 0.81) vs without (2.76 +/- 0.70; P < 0.001) a complication. Pulmonary complications impacted LOS and RIS more adversely than cardiac. A logistic regression model of mortality indicated that increasing age [odds ratio (OR) 1.065], arrhythmia (OR 1.31), pneumonia (OR 2.52), surgical complications of the heart (OR 2.8), respiratory insufficiency (OR 4.75), stroke (OR 5.48), MI (OR 5.78), and acute renal failure (ARF, OR 9.58) were associated with increasing likelihood for death, whereas treatment in the largest, academically affiliated VAMCs (RPM 5) was associated with reduced mortality (OR 0.795). Increasing age, treatment in the largest affiliated (RPM 5) hospitals, arrhythmia, MI, CHF, any ICD-9-CM-coded complication, acute renal failure, respiratory insufficiency, pneumonia, and stroke progressively increased LOS by linear regression analysis, whereas surgical complications of the heart and postoperative death reduced LOS. Complications after vascular surgery have an adverse impact on perioperative mortality, length of stay, and utilization of resources.
 ...
PMID:The impact of complications after vascular surgery in Veterans Affairs Medical Centers. 907 Jan 83

1. We previously reported that hypertension in stroke-prone spontaneously hypertensive rats (SHRSP) caused renal membrane phospholipid degradation. Renal phospholipase A2 activity increased and membranous phospholipids decreased along with age in SHRSP. Membranous abnormalities induced by membrane fluidity and calcium permeability changes may contribute to the elevation of blood pressure in SHRSP. DHA, a major component of fish oil, constitutes a part of membrane phospholipid acylchains. 2. The purpose of this study was to clarify the effect of DHA on the relationship between the renal function and the development of hypertension in SHRSP. 3. Six week old male SHRSP were fed a semi-purified diet supplemented with DHA (0, 1 and 5%) for 14 weeks. 4. The systolic blood pressure of control SHRSP (DHA 0%) significantly increased from 120.2 mmHg to 202.9 mmHg. This increase in systolic blood pressure was significantly inhibited in a dose-dependent manner by 1 and 5% DHA diet to 167.8 to 149.8 mmHg, respectively. 5. Serum creatinine concentration and blood urea nitrogen (BUN) were significantly lower in DHA (5%)-treated SHRSP than in the control SHRSP. 6. These results indicate that DHA prevents the development of hypertension in SHRSP, which is associated with changes in renal function.
 ...
PMID:Dietary docosahexaenoic acid (22: 6n-3) prevents the development of hypertension in SHRSP. 907 5

Effects of a newly developed Ca2+ channel antagonist, (4R)-(-)-2-(nicotinoylamino)ethyl 3 nitrooxypropyl 1,4-dihydro-2,6-dimethyl-4-(3-nitrophenyl) 3,5-pyridine-dicarboxylate (CD-832), on hypertensive complications in stroke-prone spontaneously hypertensive rats (SHRSPs) were compared with effects of diltiazem. We examined changes in histological and hematological parameters in SHRSPs given the following treatments at 8 to 20 weeks of age: (a) CD-832; (b) diltiazem; (c) no treatment. CD-832 and diltiazem were added to the diet, in doses of 0.05 and 0.15% (approximately 30 and 100 mg/kg per day), respectively, throughout the experimental period. In untreated control SHRSPs, systolic blood pressure increased and severe renal lesions such as fibrinoid necrosis, smooth muscle proliferation, glomerular and tubular lesions and some cardiac fibrosis were observed at age 20 weeks. 12-week repeated-administration of CD-832 and diltiazem led to a comparable hypotension and decreased heart rate. CD-832 and diltiazem decreased the ratios of weights of kidney and heart to body weight and the concentration of blood urea nitrogen and creatinine in serum, compared to values in controls. In SHRSPs treated with CD-832 and diltiazem, the incidence of renal lesions and myocardial fibrosis was significantly reduced when compared with control SHRSPs. These results suggest that 12-week repeated-administration of CD-832 prevents the development of hypertension and the incidence of organ damage in SHRSPs. CD-832 and diltiazem were equally efficacious in preventing organ damage but this organ-protective effect was obtained at a lower dose for CD-832 (30 mg/kg per day) than that of diltiazem (100 mg/kg per day).
 ...
PMID:Protective effects of CD-832 on organ damage in stroke-prone spontaneously hypertensive rats. 927 79

Stroke-like episodes with hemiparesis have been described in children with different inherited metabolic diseases. We report the novel observation of a severe stroke as the presenting sign in an 18-month-old girl with carbamyl phosphate synthetase (CPS) deficiency. MRI revealed infarction within the territory of the right middle cerebral artery. Localized 1H-NMR spectroscopy showed elevation of glutamine (at 2.0-2.5 and 3.7 ppm) and lactate within the region of infarction. CPS activity in the liver was reduced (2.5 mU/ mg protein, n = 12-35). On a protein-restricted diet including arginine supplementation, the child has developed well with moderate mental retardation: no neurologic relapses have been observed over a period of 4 years. CPS deficiency has to be added to the list of metabolic diseases that may lead to stroke-like episodes. In every case of unclear hemiparesis in childhood, urea cycle defects should be included in the differential diagnosis.
 ...
PMID:Metabolic stroke in carbamyl phosphate synthetase deficiency. 930 14

Renal function was assessed in prestroke and poststroke Kyoto-Wistar stroke-prone spontaneously hypertensive rats (SHRsp) fed high-K+ (2.11%) and low-K+ (0.75%) diets containing 4% NaCl and in stroke-resistant SHR (srSHR) fed a low-K+ diet. Elevations in dietary K+ retarded the onset of stroke development in SHRsp, but did not alter the life-span of SHRsp between the onset of stroke and death. At ages < 12 weeks, renal function, measured by serum urea and creatinine levels and urinary protein loss, was comparable in high and low K+ fed prestroke SHRsp, and age-matched srSHR. At ages > 12 weeks, hemorrhagic stroke rapidly developed in SHRsp. When compared with srSHR, prestroke SHRsp exhibited higher serum creatinine and urea levels, a greater excretion of protein into the urine, and lower serum albumin levels. The severity of the above indices of renal failure was amplified in similar-aged poststroke SHRsp. Poststroke SHRsp also had elevated levels of hemoglobin in the urine. Increases in dietary K+ did not significantly decrease the severity of uremia and proteinuria in age-matched prestroke or poststroke SHRsp. It was concluded that a decrease in glomerular filtration, uremia, and proteinuria preceded stroke development in SHRsp. The onset of proteinuria and uremia in SHRsp could potentiate stroke development. The latter indices of renal function were not altered by modifications in dietary K+ that retard stroke development in SHRsp.
 ...
PMID:Renal function in stroke-prone rats fed a high-K+ diet. 931 46

Previous studies have suggested that one-third of women of childbearing age who develop malignant phase hypertension (MHT) are likely to be taking oral contraceptives (OC). We surveyed 104 women with a history of MHT. None of the 65 aged > 45 years were taking OC or other sex hormones. Thirty-nine (mean age 34.9 years, SD 8.0) were aged 15-44 years at presentation: 22 Caucasian, 10 Black/Afro-Caribbean and seven Indo-Asian. Of these 39, 22 had a history of hypertension in pregnancy (group 1), and 17 did not (group 2). Three of group 1 also had a history of OC-induced hypertension. None were pregnant, but one was taking an OC at presentation with MHT. Blood pressures at presentation and follow-up, and mean serum urea and creatinine at presentation were similar between groups, as was median survival (96 vs. 47 months, Lee-Desu statistic 0.75, p = 0.38). There was a trend towards poorer renal function at follow-up in group 1 patients, with higher mean serum urea and creatinine levels. The causes of death were renal failure (5), stroke (4) and heart disease (2). The OC was not a common cause of MHT-amongst our sample of women of childbearing age, but a past history of hypertension in pregnancy was important. Such patients also had a longer duration of hypertension and poorer renal function at follow-up.
 ...
PMID:Malignant hypertension in young women is related to previous hypertension in pregnancy, not oral contraception. 934 49

Calpain I, an intracellular cysteine protease, has been implicated in the neurodegeneration following an episode of stroke. In this paper, we report on a series of potent dipeptide fluoromethyl ketone inhibitors of recombinant human calpain I (rh calpain I). SAR studies revealed that while calpain I tolerates a variety of hydrophobic groups at the P1 site, Leu at P2 is preferred. However, the nature of the N-terminal capping group has a significant effect on the inhibitory activity of this series of compounds. Compound 4e [(1,2,3,4-tetrahydroisoquinolin-2-yl)carbonyl-Leu-D,L-Phe-CH2F+ ++], having a tetrahydroisoquinoline containing urea as the N-terminal capping group, is the most potent dipeptide fluoromethyl ketone inhibitor of calpain I (with a second-order rate constant for inactivation of 276,000 M-1 s-1) yet reported; tripeptide 4k (Cbz-Leu-Leu-D,L-Phe-CH2F) is equipotent. A number of compounds presented in this study displayed excellent selectivity for calpain I over cathepsins B and L, two related cysteine proteases. Compounds which exhibited good inhibitory activity in the assay against isolated rh calpain I also inhibited intracellular calpain I in a human cell line. Thus, in an intact cell assay, compounds 4e and 4k inhibited calpain I with IC50 values of 0.2 and 0.1 microM, respectively. Finally, we also disclose the first example of fluorination of a dipeptide enol silyl ether to generate the corresponding dipeptide fluoromethyl ketone.
 ...
PMID:Synthesis and biological activity of a series of potent fluoromethyl ketone inhibitors of recombinant human calpain I. 937 Dec 47

Natriuretic peptides (NP) constitute hormonal systems of great clinical impact. This report deals with Urodilatin (URO), a renal natriuretic peptide type A. From the gene of NP type A, a message for the preprohormone is transcribed in heart and kidney. The cardiac prohormone CDD/ANP-1-126 is synthesized in the heart atrium and processed during exocytosis forming the circulating hormone CDD/ANP-99-126. URO (CDD/ANP 95-126) is a product from the same gene, but differentially processed in the kidney and detected only in urine. Physiologically, URO acts in a paracrine fashion. After release from distal tubular kidney cells into the tubular lumen, URO binds to luminal receptors (NPR-A) in the collecting duct resulting in a cGMP-dependent signal transduction. cGMP generation is followed by an interaction with the amiloriode-sensitive sodium channel which induces diuresis and natriuresis. In this way, URO physiologically regulates fluid balance and sodium homeostasis. Moreover, URO excretion and natriuresis are in turn dependent on several physiological states, such as directly by sodium homeostasis. Pharmacologically, URO at low dose administered intravenously shows a strong diuretic and natriuretic effect and a low hypotensive effect. Renal, pulmonary, and cardiovascular effects evoked by pharmacological doses indicate that URO is a putative drug for several related diseases. Clinical trials show promising results for various clinical indications. However, the reduction in hemodialysis/hemofiltration in patients suffering from ARF following heart and liver transplantation, derived from preliminary trials recruiting a small number of patients, was not confirmed by a multicenter phase II study. In contrast, data for the prophylactic use of URO in this clinical setting suggest a better outcome for the patients. Furthermore, treatment of asthmatic patients showed a convincingly beneficial effect of URO on pulmonary function. Patients with congestive heart failure may also profit from URO treatment, as it increases stroke volume and PCWP. Moreover, preliminary results from recent studies indicate that URO may also be effective in patients suffering from hepato-renal syndrome.
 ...
PMID:Urodilatin, a natriuretic peptide with clinical implications. 951 77


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