Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Studies of 11 patients with haemorrhagic stroke revealed no significant change in kaolin cephalin clotting time, prothrombin time, thrombin time, PF 3 availability, platelet count and factor V and VIII during the first week. Plasma fibrinogen was significantly increased while factors VII + X were decreased (borderline significance). Prolongation of plasma recalcification time and decrease in heparin tolerance reached borderline significance. There was moderate, but significant, increase in serum antithrombin activity and plasma (euglobulin fraction) fibrinolytic activity.
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PMID:Blood coagulation and fibrinolysis in haemorrhagic stroke. 58 May 8

We reported the first case of angiotropic lymphoma diagnosed by adrenal biopsy in Japan. Immunohistochemical study and southern blot hybridization analysis proved it to be B-lymphocyte origin. A 61-year-old man with history of mild hypertension and diabetes mellitus was admitted to our department because of recurrent minor stroke. On admission, general physical findings were normal. Laboratory investigations showed an elevated erythrocyte sedimentation rate and increased serum lactic dehydrogenase (LDH) level. The serial computed tomographic (CT) scan of the brain showed multifocal abnormal density lesions in bilateral hemispheres. Magnetic resonance imaging (MRI) of the brain demonstrated multiple lesions of increased signal intensity in the brainstem and bilateral hemispheres. A subsequent CT scan of the abdomen revealed swelling of bilateral adrenal glands. Adrenal biopsy was performed. Biopsy samples showed the intravascular proliferation of malignant lymphoma cells, non-Hodgkin, diffuse large cell type. These cells had the immunophenotype of a B cell lymphoma (reactive with the antileukocyte common antigen, anti-MB-1, anti-MB-2 and anti-MX-pan B, and unreactive with the anti-MT-1, anti-UCHL, anti-Ki, anti-kappa, anti-lambda and antifactor-VIII). Southern blot hybridization analysis showed monoclonal rearrangements of the immunoglobulin heavy-chain gene, which strongly suggested a B-lymphocyte origin. Thus, a diagnosis of angiotropic lymphoma was made. As soon as chemotherapy was begun, the patient fell into deep coma. A repeat CT scan of the brain was normal. His clinical status gradually deteriorated, and he died 18 months after his initial symptom. Autopsy, which was limited to the body, revealed characteristic systemic intravascular stagnation of lymphoma cells.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of angiotropic lymphoma diagnosed by adrenal biopsy]. 129 Nov 69

Ten cases of cerebral hemorrhage and one of intraspinal subdural hematoma after thrombolytic therapy are reported. Six patients were treated with streptokinase, four with rt-PA and one with a combination of both drugs. The incidence was 0.5 to 2% and was higher in case of rt-PA therapy (3.7%). In all cases, CT scan showed primary hemorrhage rather than hemorrhagic infarction. Four patients died of stroke. Among the survivors, residual disability was severe in one and mild in five. Only one patient recovered completely. In patients treated with streptokinase, the hemorrhage was probably due to a more than 80% decrease in plasma fibrinogen. In those receiving rt-PA, either excessive dosage (2 cases in our series) or lysis of cerebral microthrombi are thought to be responsible for the hemorrhagic complications. Treatment consists of infection of aprotinin (an anti-fibrinolytic drug), cryoprecipitates with factors V and VIII and protamine sulfate.
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PMID:[Hemorrhage of the brain after therapeutic fibrinolysis. 11 cases]. 143 52

Researchers have found that oral contraceptives (OCs) change carbohydrate and lipoprotein metabolism and these changes are like those linked with increased risk of cardiovascular (CV) disease, especially myocardial infarction and stroke. Since CV disease is the major cause of death in US women, it is important that OCs not induce changes in carbohydrate and lipoprotein metabolism. A new progestin, norgestimate, has an advantage over other progestins in that it tends not to induce male traits. This is beneficial because androgenicity is related to atherosclerosis which increases the risk of myocardial infarction. Further studies show that the new combined OC (250 mcg norgestimate/35 mcg ethinyl estradiol) does not influence serum glucose tolerance levels. It also does not affect the physiologic regulating system of prostacyclin, the inhibitor of platelet aggregation, by high density lipoprotein (HDL). In addition, it increases prostacyclin metabolites and HDL which may indeed decrease the risk of occlusive thrombotic vascular diseases. Moreover a study in Germany demonstrates that it causes no changes in fibrinopeptide A,m the anticoagulation factors antithrombin III and protein C, or coagulation promoting factors fibrinogen, factor VII, and the components of VIII. In women, it is absorbed well and metabolized extensively before the body eliminates it. Moreover this new combined OC has an overall Pearl index of 0.25. Studies to data indicate that norgestimate/ethinyl estradiol may be more advantageous than other OC formulations. Yet only long term epidemiologic studies can determine if it can indeed decrease the risk of CV diseases linked with older OCs.
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PMID:Norgestimate: a clinical overview of a new progestin. 160 87

Plasma protein C exerts anticoagulatory effects by inactivating factors V and VIII. Hereditary protein C deficiency is transmitted as an autosomal dominant disorder. Homozygous individuals usually develop purpura fulminans as newborns; heterozygous protein C-deficient individuals are at increased risk for venous thrombosis and pulmonary embolism. However, arterial thrombosis has been only rarely observed. We describe a young patient with heterozygous protein C deficiency who experienced a severe stroke due to thrombotic occlusion of the left middle cerebral artery.
Stroke 1990 Jul
PMID:Ischemic stroke due to protein C deficiency. 219 15

The goal of this study was to investigate the neuroanatomic correlations of the late waves (VI-VIII) of the BAEP. Patients (N = 55) with clinical evidence of a CVA were compared to a normal control group (N = 85). Latencies of greater than 3 S.D. from the means of the normal group were considered abnormal. CT and MRI scans provided evidence of the lesions. For the 14 patients who had normal BAEPs, the sizes of lesions were significantly smaller than for those with abnormal tests. Evidence shows that an abnormal wave VI was related to an ipsilateral cortical lesion and an abnormal wave VIII was related to a lesion in the internal capsule-corpus striatum.
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PMID:Neuroanatomic correlations with the late waves of the brain-stem auditory evoked potential. 245 88

Pentastarch is a hydroxyethyl starch similar to hetastarch, but with a lower average molecular weight (264,000 versus 450,000) and fewer hydroxyethyl groups (molar substitution ratio = 0.45 versus 0.70). These characteristics result in enhanced enzymatic hydrolysis, faster renal elimination (initial intravascular half-life = 2.5 versus 25.5 hours), and less effect on coagulation. We report on a randomized clinical trial comparing the clinical efficacy and safety of 10% pentastarch (group P) for plasma volume expansion after cardiac operations with that of 5% serum albumin (group A). During the first 24 hours after arrival of the patient in the intensive care unit, colloid was infused to maintain a cardiac index of 2.0 L/m2 or more and a mean arterial pressure within 10% of the preinduction value. Group P (n = 50) received 1706 +/- 393 ml of colloid (mean +/- standard deviation) during this period, and group A (n = 44), 1794 +/- 341 ml (p = no significant difference). Hemodynamic responses to infusion were similar for both groups, although in group P a greater increase in both cardiac index (0.5 +/- 0.5 versus 0.3 +/- 0.5 L/min/m2 in group A, p less than 0.01) and left ventricular stroke work index (10.8 +/- 8.0 versus 5.8 +/- 6.0 gm-m/m2, p less than 0.01) was observed during infusion of the first 500 ml. There were no significant differences in any of the measured respiratory parameters (alveolar-arterial oxygen gradient, estimated shunt fraction, and effective pulmonary compliance). Hemodilution with colloid significantly reduced serum protein levels in group P by 24 hours postoperatively (4.0 +/- 0.6 versus 5.0 +/- 0.7 gm/dl in group A, p less than 0.05), although mean serum colloid osmotic pressure was similar (15.4 +/- 2.6 [P] versus 15.5 +/- 2.7 mmHg [A], p = no significant difference). There were no significant between-group differences in prothrombin time, activated partial thromboplastin time, platelet count, bleeding time, or coagulation factors (fibrinogen, V, VII, VIII, or IX) on postoperative days 1 and 7. Perioperative fluid balance, weight change, chest tube output, red blood, platelet, or fresh frozen plasma usage, reexploration for bleeding, and clinical outcome were also similar. These findings indicate that pentastarch is as safe and effective s 5% albumin for plasma volume expansion after cardiac operations with no apparent adverse effects on coagulation. If commercially available at a lower cost than albumin, it would appear to be a reasonable first choice for colloid therapy in this setting.
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PMID:A randomized clinical trial of 10% pentastarch (low molecular weight hydroxyethyl starch) versus 5% albumin for plasma volume expansion after cardiac operations. 246 78

This study carried out at a type "C" hospital, analyses the actual pathology of 1,052 patients attended to at the internal medicine department during a period of one year. The sex distribution did not show any differences. The median age (64 years) was significantly superior in women. The more frequent diseases were from group VII (cardiovascular: 512 cases) and group VIII (respiratory: 471 cases) according to the 9th edition of the who international diseases classification. The most frequent causes for admission were: respiratory infection (19.5%), cardiac insufficiency (13.8%) and CVA (10.6%). The most frequent baseline diseases were cardiomyopathy (20.4%), chronic obstructive airways syndrome (16%), malignant neoplasia (8.5%) and hepatopathy (7.6%). The risk factors and toxic habits observed were: Chronic bronchitis (19.6%), blood hypertension (15.5%), diabetes (13.5%) and high alcohol intake (10%).
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PMID:[A morbidity study in a general internal medicine service in a third-level hospital]. 195 89

A prospective study was made in the years 1973 through 1983 on mortality among 4591 patients (2095 men and 2469 women) with usually noninsulin dependent diabetes, of 1-10 years duration. The anamnestic data and examination parameters obtained during a cross-sectional investigation served as the prognostic changeables (risk factors) to assess the mortality due the most frequent circulatory diseases. The applied model of the logistic regression allowed an attempt of the assessment of their independent effect. Analysis regarding the sex and the methods of diabetes treatment was done in four groups of mortality causes classified according to the VIII Revision of the International Classification of Disease. Injuries and Causes of Death: 1. Cardiovascular system diseases. 2. Ischaemic heart diseases. 3. Other diseases of the cardiovascular system. 4. Vascular diseases of the brain. The quantitative and qualitative effect of the arbitrarily chosen factor of death risk was of varying importance and was related to the sex and the methods of the hypoglycemising treatments. The effect of ageing was an independent factor of death risk among all analysed causes of mortality in both sexes independent from the methods of the hypoglycemising treatment with the one exception of women treated with insulin who died of stroke. Generally however, the ageing factor showed a greater prognostic value in patients treated with insulin. Hypertension, especially if marked, showed to have the most prognostic value among the all analysed factors of death-risk especially in patients on oral antidiabetics. The risk in this group was due mainly to the cerebral stroke, to a lesser degree to the "other" diseases of the circulatory system, and to the all diseases of the circulatory system but to the least degree it was related to the ischaemic heart disease, in both sexes. Among insulin treated diabetics the hypertension was a death-risk of most importance in men usually due to the vascular brain disease and other diseases of the cardiovascular system but to a lesser degree to the circulatory diseases, as a whole. In women however the marked hypertension increased the death-risk in patients with coexisting circulatory disease, not a particular one, but as a whole. Albuminuria had a pronounced prognostic value, especially if massive, in both types of diabetes, mainly, however, among women who died of any cardiovascular causes.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Mortality risk factors in cardiovascular diseases in patients with diabetes mellitus in Warsaw--a 10-year prospective study]. 262 54

PARD is a prospective study sponsored by the German research council with the aim to establish whether spontaneously enhanced platelet aggregation or changes of other hemostatic parameters are risk factors for new vascular occlusion in diabetic patients. Hemostatic parameters have been measured in diabetic patients at 3 month-intervals (363 patients aged 45-65 at recruitment). Of the 232 men, 53 were on diet, 104 on oral antidiabetic drugs and 75 on insulin. Of 131 women 16 were on diet, 46 on oral antidiabetic drugs and 69 on insulin. Baseline data and preliminary results obtained between May 1977 and December 31, 1983 are presented. 22 patients have died. 17 diet from cardiovascular disease, 3 from pancreatic cancer and 2 from other causes. 51 patients suffered a myocardial infarction, stroke or peripheral arterial occlusions. The mean levels of spontaneous aggregation (angle alpha-PAT III), F VIIIC, F VIII R:AG, fibrinogen, antithrombin III and plasminogen were higher in men who died or suffered cardiovascular occlusions than in those without these events. In women this difference is less pronounced or absent. In women the mean values of several hemostatic parameters at baseline were higher than in men and the incidence of cardiovascular occlusions was lower. The interim results lead to the hypothesis that spontaneous aggregation, high levels of F VIIIC, F VIII R:AG and to some extent also high levels of fibrinogen, antithrombin III and plasminogen may be indicators of progressive vascular disease and could be useful as predictors of vascular occlusions.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:PARD: platelet aggregation as a risk factor in diabetics: results of a prospective study. 293 12


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