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)

Blood pressure response in 75 patients with primary hypertension to a readjusted treatment regimen was studied. The patients were given 13 antihypertensive drugs in 18 combinations. Since they all suffered from severe hypertension, the first choice was a combination of beta-blocker and diuretic. A vasodilator (hydralazine or prazosin) was added when necessary to control blood pressure. During a three-year follow-up study the patients' systolic and diastolic blood pressures were significantly lowered, from 174 (SD, +/- 25)/113 (SD, +/- 12) to 154 (SD, +/- 19)/98 (SD, +/- 8) mmHg. There was a significant decrease in serum creatinine levels, but body weight, heart volume, and serum lipid levels remained unchanged. In 62 (83%) patients diastolic blood pressure was reduced below 100 mmHg, and in 13 (17%) it remained above 100 mmHg. During the three-year follow-up study no patients with a diastolic blood pressure below 100 mmHg had a stroke, while three patients with a diastolic blood pressure above 100 mmHg did. This study demonstrates that heterogeneous drug combinations might fail to adequately control blood pressure and reducing the number of combinations might improve control.
 ...
PMID:Readjustment of antihypertensive treatment in patients with unsatisfactory blood pressure control. 646 77

Hemodynamic measurements were made at rest and during submaximal and maximal exercise in 12 patients with chronic congestive heart failure before and after oral endralazine (EN). After acute assessment, patients received endralazine, twice daily, for a mean of 2.8 months, when hemodynamic measurements were repeated. The drug was withdrawn for 3 to 4 days and subsequently reintroduced. Three patients with greatly elevated pulmonary wedge pressures were assessed after 30 mg of isosorbide dinitrate, which was also chronically administered. Resting mean cardiac and stroke volume indexes increased by 44 and 33%, respectively (p less than 0.01), with concomitant reduction of the systemic resistance. This improvement was maintained on a long-term basis in 8 of the 11 surviving patients. Withdrawal and subsequent reintroduction of EN confirmed that there was worsening of left ventricular dysfunction in the other 3 subjects. Chronic but not acute therapy produced a modest reduction in wedge pressure. At maximal exercise, cardiac and stroke volume indexes increased by 29 and 18%, respectively (p less than 0.01), after EN; the duration of exercise increased in 7 of the 10 subjects after acute therapy and this was maintained on a long-term basis. Mean creatinine clearance increased by 34% (p less than 0.01). The results confirm that EN produces acute and long-term hemodynamic and functional improvement without tolerance in congestive heart failure.
 ...
PMID:Long-term beneficial effects of endralazine, a new arteriolar vasodilator at rest and during exercise capacity in chronic congestive heart failure. 649 23

Cardiac catheterisation was performed to evaluate cardiac function in 12 patients with various stages of renal failure. All patients were studied at rest and during supine exercise to subjective exhaustion. Eight patients had a normal arteriovenous oxygen difference at rest and during exercise whereas three had a low arteriovenous oxygen difference and one a high arteriovenous oxygen difference. Left ventricular stroke work did not increase normally at transition from rest to exercise in most patients with serum creatinine concentrations greater than 500 mumol/l. The left ventricular end diastolic pressure was abnormally raised during exercise in all patients (range 20-42 mm Hg) and also at rest in most of them (range 8-36 mm Hg), indicating myocardial dysfunction. These observations suggest that patients have abnormal cardiac performance at a relatively early stage of renal failure.
 ...
PMID:Cardiac performance in various stages of renal failure. 650 67

A cross-sectional study of 1084 Caucasoid diabetic subjects in rural Western Australia revealed a high rate of clinical macrovascular disease (46%), including coronary heart disease (13%), stroke (8%), and peripheral vascular disease (38%). Age was the major time-related variable for total macrovascular disease and for peripheral vascular disease, with identical prevalence rates in Type 1 (insulin-dependent) and Type 2 (non-insulin-dependent) diabetes when age was taken into account. In 179 Type 1 diabetic subjects, logistic regression analysis showed no associated risk factors other than age. In 905 Type 2 diabetic subjects the independent risk factors for total macrovascular disease, identified by a forward step-wise selection procedure, were age as the major contributor, with plasma creatinine levels and plasma glucose levels (all p less than 0.001), high-density lipoprotein cholesterol levels, serum total cholesterol levels, and the (supine-erect) systolic blood pressure difference (all p less than 0.05). There were no direct associations with percentage desirable weight, cigarette smoking or male sex. Type 2 diabetic subjects demonstrated a very strong negative association between high-density lipoprotein cholesterol levels and coronary heart disease, and significant associations were found also between plasma glucose levels and coronary heart disease (p less than 0.01), and glycosylated haemoglobin levels and peripheral vascular disease (p less than 0.001).
 ...
PMID:Clinical macrovascular disease in Caucasoid diabetic subjects: logistic regression analysis of risk variables. 653 52

A 47-year-old patient with severe decompensated alcoholic liver disease developed a progressive deterioration of her renal function (serum creatinine 4.0 mg/dL) with a renal failure index (RFI: UNa/U/PCr) consistently less than 1.0. In the absence of other causes of renal failure, these values supported the diagnosis of hepatorenal syndrome (HRS). A five-hour head-out water immersion (HWI) in a sitting position was carried out to increase the patient's "effective" blood volume (EBV) in an attempt to reverse the HRS. Hemodynamic monitoring (Swan-Ganz) was performed during the entire HWI procedure. Cardiac index increased by 64% during HWI (2.57 to 4.22 L/min/m2). Stroke volume index doubled (32.9 to 65.0 mL/m2) and systemic vascular resistance decreased by 48% (1426 to 754 dyne sec/cm). Increases in right atrium (RA) pressure (7.5 to 17.5 mm Hg) and pulmonary wedge (PW) capillary pressure (7.5 to 16.3 mm Hg) also occurred. Hemoglobin, hematocrit, and plasma protein concentrations decreased by 18% during HWI. Only a modest improvement in creatinine, urea, inulin, and para-aminohippurate (PAH) clearances was observed during HWI, and the RFI remained below 1.0. Plasma levels of antidiuretic hormone (ADH), aldosterone, and renin activity decreased during HWI. The patient's renal function progressively deteriorated over the next 15 days, but tubular function, as assessed by an RFI less than 1.0, was still intact seven days after our study. Our results indicate that a considerable increase in effective blood volume does not restore renal function in HRS.
 ...
PMID:Effect of head-out water immersion on hepatorenal syndrome. 669 41

Six patients with alcoholic liver disease and massive ascites were treated by dialytic ultrafiltration and peritoneal reinfusion of their ascitic fluid. Immediately after the procedure there was significant improvement in cardiac output (5.2 +/- 0.4 to 5.9 +/- 0.4 L/m, p less than 0.05) and stroke volume (53 +/- 5.5 to 62 +/- 4.7 ml/beat, p less than 0.02) with no change in heart rate or blood pressure, right atrial, pulmonary artery, or wedge pressures. Serum creatinine and serum electrolytes were stable. Ascitic fluid albumin rose significantly immediately after the procedure (1.5 +/- 0.2 to 2.9 +/- 0.5 g/dl, p less than 0.001) with gradual improvement in serum albumin (2.9 +/- 0.3 to 4.1 +/- 0.2 g/dl, p less than 0.05) in 3 months. Plasma renin (26.9 +/- 9.6 to 17.9 +/- 6.3 ng/ml/h, p less than 0.05) and plasma aldosterone (67 +/- 18 to 39 +/- 11 ng/dl, p less than 0.01) fell significantly immediately after the procedure. No serious side effects were noted and liver function remained stable. Four of six patients followed for 3-14 months could be managed on lower doses of diuretics.
 ...
PMID:The effects of dialytic ultrafiltration and peritoneal reinfusion in the management of diuretic resistant ascites. 671 32

Tumoricidal reactions in dogs with spontaneous breast carcinoma occur after perfusion of plasma over protein A derived from Staphylococcus aureus and immobilized in collodion charcoal. When this treatment was extended to humans with breast cancer, hemodynamic and physiologic changes were noted. The evolution and spectrum of these reactions were evaluated during 47 plasma infusions in five patients. Initial treatment conditions consisting of rapid perfusion of plasma over high quantities of immobilized protein A were employed for 12 treatments in two patients. Within 30 minutes after treatments were begun, mean blood pressure, systemic vascular resistance, and stroke volume increased, as did heart rate, cardiac output, and rectal temperature; however, mean pulmonary artery pressure and total pulmonary resistance did not change. At 90 minutes, hypotension developed (lowest mean blood pressure was 59 +/- 14 mm Hg) that was associated with a decrease in systemic vascular resistance and total pulmonary resistance (536 +/- 66 and 146 +/- 44 dynes . second . cm-5, respectively). Cardiac output increased, tachycardia developed, stroke volume decreased, and rectal temperature increased. During the hypotensive phase, values of creatinine clearance and fractional excretion of sodium diminished. Noncardiogenic pulmonary edema appeared occasionally, with bronchospasm noted once. No hemodynamic changes were seen when saline solution was passaged over protein A immobilized in collodion charcoal or when autologous plasma was given without passage over protein A immobilized in collodion charcoal. Treatment conditions were modified by diminishing protein A quantity and plasma volume and slowing plasma perfusion rate, which resulted in significant attenuation of all cardiopulmonary responses. This report, then, defines for the first time the physiologic basis of the cardiopulmonary toxicity in humans after plasma perfusion over immobilized protein A.
 ...
PMID:Cardiopulmonary toxicity in patients with breast carcinoma during plasma perfusion over immobilized protein A. Pathophysiology of reaction and attenuating methods. 688 Nov 80

Creatinine clearance values were determined by duplicate urine collections in 18 patients with spinal cord injury, cerebrovascular accident, or multiple sclerosis. Measured creatinine clearance values were compared with estimates predicted by a urine-free mathematical method for estimation of renal function. Measured creatinine clearance values were considerably lower than would be ordinarily expected on the basis of patient body size, age, sex, and serum creatinine. In addition, creatinine clearances calculated using the urine-free method were considerably higher than measured values, suggesting that techniques for the prediction of creatinine clearance may not be routinely applicable in patients with these conditions.
 ...
PMID:Assessment and predictability of renal function in spinal cord injury patients. 707 29

In canine veterinary medicine, both acute and chronic renal failure occur relatively frequently, from a variety of causes similar to those in man. However, the normal dog has a very high protein catabolic rate and high endogenous kidney function, and, therefore, requires frequent and highly efficient dialysis, for maintenance during renal failure. We have developed techniques to support the uremic dog with hemodialysis. An experimentally anephric dog, and two dogs with clinically occurring acute renal failure (caused by ethylene glycol intoxication and heat stroke) have been supported with frequent use of hollow fiber dialyzers, using a carotid artery to jugular vein shunt. Patency of shunts was maintained by administration of oral aspirin. A very high urea and creatinine generation rate necessitated daily dialysis during much of the clinical course of renal failure. The experimentally anuric animal was supported for 35 days. The ethylene glycol-induced renal failure animal was euthanized on the 21st day, and the heat stress-induced renal failure animal recovered sufficient intrinsic renal function after 16 days of dialysis for maintenance of life without dialysis.
 ...
PMID:Dialytic support of dogs with clinically occurring renal failure: a realistic model of acute renal failure in man. 709 13

General medical examinations were performed in two rural areas of Shimane Prefecture in Japan, one was a farming village and the other a fishing village where incidences of death due to stroke differed, higher in the former and lower in the latter. Comparisons were made on salt and protein intake by analyzing the fasting single spot urine collected in the morning and by blood tests. Urine samples were analyzed for sodium (Na), potassium (K), urea nitrogen (UN), inorganic sulfate (SO4) and creatinine (Cr) and blood samples for cholesterol (Chl), triglyceride (TG), hematocrit (Ht) and hemoglobin (Hb). Blood pressure, Na/Cr, Na/K and Ht were higher in the farming village and K/Cr, UN/Cr, SO4/Cr, SO4/UN, Chl and TG were higher in the fishing village. These findings indicate the higher salt intake and lower intake of K, animal protein and fat in the farming village. This typical dietary pattern of the Japanese may explain the higher incidence of hypertension and stroke in the farming village.
 ...
PMID:Dietary risk factors of stroke and hypertension in Japan -- Part 3: Comparative study on risk factors between farming and fishing villages in japan. 710 11


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