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

Clinical events following cerebral angiography were prospectively evaluated in 1,002 procedures. The ischemic event rate between 0 and 24 hours was 1.3% (0.1% permanent). This incidence was higher (2.5%) in patients investigated for cerebrovascular disease, but the difference was not significant. In addition, 1.8% of the patients suffered ischemia (0.3% permanent) between 24 and 72 hours after angiography. Cerebral ischemic events occurred as a recurrence or worsening of a preexisting phenomenon. twice as often as de novo. All permanent ischemia was a worsening of a preexisting phenomenon. There was a significant increase in the incidence of neurologic events between 0 and 24 hours when the procedure lasted longer than 60 minutes and when there was systolic hypertension. Trends toward higher incidence were noted with the use of increased volume of contrast, with increased serum creatinine, when transient ischemic attacks or stroke were the indications, and when 3 or more catheters were used. The incidence of neurologic events between 24 and 72 hours increased significantly with the increase in the amount of contrast used, with age, and with diabetes. The occurrence of nonneurologic events (mostly hematomas) was significantly increased by multiple factors. This study shows that events can and do occur beyond the usual observation period of 24 hours but confirms the low risk of cerebral angiography when performed judiciously.
Stroke
PMID:Clinical events following neuroangiography: a prospective study. 368 97

The chronic toxicity of potassium clavulanate (CVA-K) and BRL28500 were evaluated using dogs in 26-week intravenous administration studies followed by a 5-week off-dose period. The doses for CVA-K and BRL28500 were 10, 20, 50 and 100 mg/kg (p.f.a.), and 80, 160, 320 and 800 mg/kg (p.f.a.) respectively. There were no deaths in either of the groups. For general condition, dogs dosed with CVA-K at 100 mg/kg showed reddening of the skin and mucous membranes, shaking of the head, facial oedema, a decrease in food intake and a reduction in body weight. Also some dogs of the same group showed decreased spontaneous activity, emaciation and signs of dehydration. In the BRL28500 treatment groups, there was reddening of the skin and mucous membranes, vomiting and salivation at 800 mg/kg. Urinalysis of dogs dosed with CVA-K showed occasional dark yellow coloration of the urine. There was also a very weak and equivocal response or positive reaction for protein, occult blood, and urine sugar in some animals at 100 mg/kg. Some dogs dosed with BRL28500 also showed either a very weak and equivocal response or slight positive reaction for occult blood at 320 mg/kg and above, and dark yellow coloration of the urine at 800 mg/kg. Haematological examination of the CVA-K groups showed increases in leukocyte count and platelet count at the highest dose of 100 mg/kg. No haematological abnormalities were noted in any of the BRL28500 groups. Serum biochemical studies of dogs dosed with CVA-K revealed a decrease in total protein at 50 mg/kg and above, and increases in Al-P, total bilirubin, GPT, BUN and creatinine at 100 mg/kg. In the BRL28500 treatment groups, there were increases in total cholesterol and triglyceride at 160 mg/kg and above. In dogs dosed with CVA-K there was an increase in liver weight at 100 mg/kg. Histopathological examination showed a ground glass-like appearance of the hepatocyte cytoplasm and also altered distribution of PAS positive material at 50 mg/kg and above. In the BRL28500 groups, there was an increase in liver weight at 320 mg/kg and above. There were the same ground glass-like appearance in hepatocytes and altered distribution of PAS positive material at 800 mg/kg. In view of the above results, the maximum non-effect dose levels in the present studies were considered to be 20 mg/kg for CVA-K and 80 mg/kg for BRL28500.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Chronic intravenous toxicity studies of potassium clavulanate and BRL28500 in dogs]. 382 May 67

A prospective high performance liquid chromatography (HPLC) study was performed in eighteen patients with head injury and stroke and four control volunteers to evaluate creatinine and purine metabolites concentration (adenosine, inosine, hypoxanthine, uric acid) in cerebrospinal fluid (CSF). The present HPLC method is rapid, accurate and sensitive in the same isocratic run and no specimen pretreatment of 0.02 ml CSF is necessary. The creatinine level in CSF was increased from 122 to 169 mumol/l in some patients, and was found unrelated to that of serum. The uric acid levels varied between 5.8 and 121 mumol/l and were associated with decrease in Glasgow Coma Scale score and had a critical point of 30 mumol/l. We present initial results in application of HPLC method to measure the creatinine and purine metabolites in CSF. This preliminary report presents that these high levels in CSF of head injury and stroke patients probably reflect tissue damage and an increased tissue catabolism.
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PMID:[Cerebrospinal fluid concentrations of creatinine and purine metabolites determined by high performance liquid chromatography: preliminary report on head injury and stroke patients]. 382 64

The effects of long-term (10 years) management at a special out-patient hypertension clinic with respect to dropout rate, side effects, blood pressure (BP) control, target organ involvement, prognostic factors and cardiovascular morbidity have been studied in 686 middle-aged male hypertensives. The impact of antihypertensive treatment, as one ingredient of multiple risk factor intervention, on mortality and morbidity in an urban, male population have been analysed. The hypertensive patients were derived from a random sample of men, aged 47-54 years at entry, constituting the intervention group (n = 7,455) of a multifactorial primary prevention trail. The whole population sample was studied regarding the effect of treatment on morbidity. The 10-year drop-out rate (declined follow-up/unknown reasons) was low (5%) being highest during the first year. The frequency of severe adverse drug effects was low (3% per year) after the initial period when treatment was started. An acceptable BP reduction was achieved in the majority of patients, but in many cases first after a few years' treatment and requiring combination drug therapy. Two-thirds of the patients achieved the goal BP (i.e. less than 160/95 mm Hg). These results are attributed to the organisation of the clinic and emphasise the need for frequent check-ups during the early phase of treatment and an easy accessibility to nurses and physicians. Except for a significant regression of ST- and T-wave changes on the conventional ECG during the first treatment year signs of heart (conventional ECG, chest X-ray) and kidney (albuminuria, serum creatinine) involvement remained unchanged or increased slightly during follow-up. Angina pectoris (AP), intermittent claudication (IC) and congestive heart failure (CHF) were common complications. The prevalence increased steadily with an average annual incidence of 1.3% (AP), 0.6% (IC) and 0.6% (CHF). ECG signs indicating subclinical heart disease were risk factor for AP and CHF. Smoking was an independent risk factor for any one of these cardiovascular disorders. The 10-year incidence of total mortality was 11.1%, and of CHD and stroke morbidity 12.2% and 4.1%, respectively. Independent risk factors (entry variables) for CHD were diastolic BP, smoking, serum cholesterol, AP and proteinuria. A previous stroke, smoking and proteinuria were independently associated with stroke morbidity. Hence, the risk factor pattern was similar to that known to operate in the general population.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Hypertension in middle-aged men. Management, morbidity and prognostic factors during long-term hypertensive care. 386 85

Adriamycin (Adriablastine), administered weekly at the dose of 5 mg/kg i.p. for 3 weeks in rats, produced a general decrease of vitality associated with a decrease of body weight, hypothermia, decreases of stroke volume and cardiac output. Hematocrit was decreased. Renal blood flow decreased whereas pulmonary blood flow increased. Mean blood pressure and heart rate remained unaffected. Biochemical evaluations revealed a decrease of blood urea and serum creatinine, which might be related to decreased food intake and protein metabolism. Morphological changes in the heart tissue could not be appreciated. Venoruton (HR), administered at the dose of 300 mg/kg p.o. daily for 28 days (5 days before and 23 days after the first injection of adriamycin), improved adriamycin-induced clinical signs and symptoms (loss of body weight, hypothermia and decreased general vitality). It tended to increase cardiac output and stroke volume.
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PMID:Protective effects of O-(beta-hydroxyethyl)-rutosides (HR) against adriamycin-induced toxicity in rats. 400 21

Clinical and laboratory abnormalities were examined in relation to diabetes mellitus in a retrospective study of the 120 patients with acute stroke admitted to our medical unit between January 1, 1981 and March 31, 1984, inclusive. Paretic stroke was defined without clinical evidence of alternative diagnosis. We have examined: age, serum levels of glucose, urea, creatinine, cholesterol, triglycerides, albumin, globulins, ratio albumin/globulins and also a white and red blood-cells count, haemoglobin, erythrocyte sedimentation rate and blood pressure. The routine electrocardiogram (ECG) obtained on admission was examined for atrial fibrillation. The high prevalence of risk factors associated with diabetes mellitus in stroke patients indicate the need for further studies of stroke prevention and treatment particularly in this disease.
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PMID:[Risk factors and acute cerebral infarct in patients selected on the basis of blood sugar levels]. 402 27

Clinical and laboratory abnormalities and the presence of atrial fibrillation on admission were examined in relation to hospital mortality in a retrospective study of the 320 patients with acute stroke admitted to a medical unit in a 5-year period. Of clinical factors, only increasing age and the presence of coma were associated with mortality. Atrial fibrillation, present in 25% of all patients, was associated with an increased mortality in patients aged 60-79 years (67% vs 44%, p less than 0.01). In patients under 75 years the mortality associated with raised haematocrit (0.50 or more), present in 11% of all patients, was more than twice as high as it was in those with lower haematocrit (71% vs 31%, p less than 0.005). Other laboratory variables associated with a high mortality were increased levels of mean red cell volume, white cell count, erythrocyte sedimentation rate, globulin, and blood urea and creatinine; and decreased levels of albumin. The high prevalence of and increased mortality associated with atrial fibrillation and raised haematocrit in stroke patients indicate the need for further studies of stroke prevention and treatment in these patients.
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PMID:Relation of atrial fibrillation and high haematocrit to mortality in acute stroke. 613 30

Minoxidil in combination with propranolol and diuretics was used in the treatment of 41 patients with severe refractory hypertension due to a spectrum of causes. These etiologies included essential hypertension, advanced renal failure, renovascular hypertension, and kidney transplant rejection. All patients had evidence of renal and cardiac damage prior to therapy and had failed to respond to all standard medications. The study included patients treated for periods of 3--42 months. Forty of the 41 patients responded most impressively to this therapy. Minoxidil was given in a dose of 7.5--40 mg daily. No tolerance to minoxidil was observed. Side effects were minimal. Three myocardial infarcts were observed. Two of these patients had had previous infarcts. One patient suffered a fatal cerebrovascular accident after he had deliberately stopped all medications. Nine patients showed sodium retention, which was easily controlled in 8 cases. Mild hirsutism was occasionally seen. Mean serum creatinine levels showed a slight decrease in the essential hypertension group after treatment. Best long-term results were seen in the essential hypertension and renovascular groups, although several cases with advanced renal disease and with kidney transplant rejection hypertension showed very impressive and encouraging outcomes.
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PMID:Minoxidil in the treatment of refractory hypertension due to a spectrum of causes. 615 48

A prospective study of 1,517 consecutive cerebral angiographic examinations is reported. The incidence of all complications was 8.5%, and the incidence of all neurologic complications was 2.6%. The overall incidence of permanent neurologic deficit was 0.33%. The incidence of permanent neurologic deficit in patients referred for evaluation of symptomatic cerebrovascular disease was 0.63%. Older age, increased serum creatinine concentration, and the use of more than one catheter all were significantly associated with serious neurologic complications. Although patients with a recent stroke or frequent transient ischemic attacks had a higher incidence of serious neurologic complications, this increase was not statistically significant for this sample.
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PMID:Complications of cerebral angiography: prospective assessment of risk. 1849 88

The effect of positive end-expiratory pressure (PEEP) on plasma renin activity (PRA), renal function, and cardiovascular (CV) hemodynamics during high frequency jet ventilation (HFJV) was observed in 7 patients. The addition of PEEP during HFJV increased PRA while decreasing stroke index (SI) and cardiac index (CI). These changes were associated with decreased urinary flow, creatinine clearance, and fractional excretion of sodium. In contrast, HFJV at zero end-expiratory pressure (ZEEP) maintained normal PRA, renal function, and CV hemodynamics. The authors conclude that the alteration of renal function during HFJV is a function of airway pressure rather than the effects of the ventilatory frequency. The deterioration of renal function may have been due to changes in PRA or CV dynamics.
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PMID:Renal function and renin secretion during high frequency jet ventilation at varying levels of airway pressure. 635 35


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