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

Patients who developed major depression within two years following stroke (n = 13) were compared with patients who did not become depressed in the same period (n = 13) but who did have a similar size and location of lesion as in the depressed group. Although the depressed patients were not significantly different from the nondepressed patients in background characteristics, history of depressive disorder, neurological impairment, or social functioning, the depressed group had greater cognitive impairment as measured by Mini-Mental State score. In addition, the depressed group had significantly larger lateral and third ventricular to brain ratios than nondepressed patients on computed tomographic scan analysis. The results suggest that poststroke depression itself may produce an intellectual impairment; subcortical atrophy, which likely preceded the stroke lesion, may produce a vulnerability for depression following stroke.
Arch Gen Psychiatry 1988 Mar
PMID:Comparison of patients with and without poststroke major depression matched for size and location of lesion. 334 79

The occurrence of fever and the clinical profile of febrile patients on the medical service of a teaching hospital were studied prospectively. Thirty-six per cent of 972 patients developed fever (temperature exceeding 38 degrees C). Their 13% mortality rate and 13.2-day average hospital stay exceeded the 3% mortality and seven-day hospitalization for afebrile patients (p less than 0.0001 for both). Most fever episodes occurred during the first two hospital days. Approximately 30% of first and subsequent fever episodes were caused by bacterial infections; illnesses involving tissue necrosis (e.g., stroke, myocardial infarction) accounted for 20%. Five conditions comprised 53% of diagnoses: respiratory and urinary tract infections, neoplasm, myocardial infarction, and drug reaction. Only one patient had a fever of uncertain origin. Several clinical clues used frequently to identify bacterial infections were reevaluated. Patients with bacterial infections had higher temperatures on the first febrile day (mean 38.9 degrees C) and were more likely to have had prior infections than those with other causes of fever (mean 38.3 degrees C, p less than 0.001). Older patients (greater than 75 years) had a lower febrile response to bacterial infections than younger patients. Fever in hospitalized medical patients is a common and important concomitant of increased mortality and length of hospitalization.
J Gen Intern Med
PMID:Fever in hospitalized medical patients: characteristics and significance. 335 68

A patient's appraisal of symptom significance is important to the timeliness with which care is sought. Little is known, however, about the variations in patients' responses to symptoms and the factors determining variations. To assess lay individuals' perception of the importance of symptoms, 75 private and 75 clinic outpatients and 73 inpatients were surveyed on 13 sets of hypothetical symptoms to determine whether they would seek care immediately, call for an appointment, or wait and see. All sets of symptoms were adjudged to be clinically significant by a panel of three physicians. Twenty-one other physicians were surveyed using the same questionnaire. Weighted mean responses of patients and physicians differed on seven symptoms. Physicians recommended more immediate care for symptoms suggestive of impending heart attack and stroke than did patients, and patients indicated that they would seek care earlier than physicians for less serious symptoms. Clinic patients would seek immediate care for symptoms more often than other patient groups. Nonwhites and those with less formal education reported greater urgency in seeking care for six symptoms. The results indicate that patients may not agree with physicians in the way they interpret symptoms of disease and that symptom appraisal may differ depending on patients' sociodemographic characteristics.
J Gen Intern Med
PMID:Urgency in seeking medical care for specific symptoms: perceptions of physicians and patients. 337 93

A diagnosis of malignant hypertension was recorded for 165 patients in the national morbidity study between 1970 and 1973. Three patients with benign hypertension were selected as age- and sex-matched controls for each case. The general practitioners in the study were asked to complete a further questionnaire about the patients and 66% of the practices agreed to take part. Information about the retinal findings for the patients was requested and less than half of those in the national morbidity study proved to have a strict diagnosis of accelerated or malignant hypertension although they were originally recorded as patients with malignant hypertension. Of those patients originally classified as having benign hypertension 5% had the retinal appearance of accelerated or malignant hypertension.Patients had been diagnosed as having hypertension for a mean of more than five years prior to entry into the national morbidity study and the survival of patients with both benign and accelerated or malignant hypertension was good. Thirtyfour per cent of those with confirmed benign hypertension and 62% of those with definite accelerated or malignant hypertension died in the follow-up period which was on average 10 years from entry into the national morbidity study.The survival of patients registered with doctors who did not collaborate and of patients whose clinical details were missing was similar to the survival of patients for whom full details were provided.Blood pressure control was only fair with a mean of 172/101 mmHg for the group with benign hypertension and 177/107 mmHg for the group with accelerated or malignant hypertension. Blood pressure control was the poorest for those who died from a stroke. A high proportion (78%) of deaths in association with accelerated or malignant hypertension were from cardiovascular or renal causes.
J R Coll Gen Pract 1985 Oct
PMID:Malignant hypertension in general practice. 407 97

In Elliptio complanatus lateral cilia, two distinct patterns of filament termination can be discerned. In one case, all nine filaments are present and all are single; in the second, at least one filament is missing but doublets are still present. These probably represent different configurations within one cilium in different stroke positions; to get from one to the other, some peripheral filaments must move with respect to others. The data are consistent with the hypothesis that the filaments themselves do not change length, but rather slide past one another to accommodate increasing curvature. The bent regions of the cilium are in the form of circular arcs. In a few cases, apparent displacement of filaments at the tip (Deltal) can be shown to be accounted for if we assume that all differences are generated within these arcs. The displacement per degree of bend is 35 A. Regions of bent arc are initially confined to the base of the cilium but move up the shaft as straight regions appear below them. From the relationship between arc length and radius of curvature, a shaft length that is the unit that initially bends and slides may be defined. Quantal displacements of the length of one 14S dynein may perhaps occur at sites between filaments at opposite sides of such a unit as sliding occurs.
J Gen Physiol 1967 Jul
PMID:Morphological aspects of ciliary motility. 605 May 97

1. Cerebral ischemia of 5 min duration was induced in unanesthetized gerbils by bilateral occlusion of the carotid arteries. 2. The extent of cerebral damage was assessed by the elevation of motor activity in comparison with pre-ischemic levels and by a histological assessment of the extent of neuronal degeneration of the CA1 area of the hippocampus. 3. The GABA transport inhibitor CI-966 (10 mg/kg i.p.) was tested for cerebroprotective activity in a gerbil stroke model. CI-966 reduced the extent of stroke injury as assessed by locomotor activity and measurement of hippocampal CA1 pyramidal cell injury. 4. It is proposed that enhancement of extracellular GABA levels during ischemia accounts for the cerebroprotective actions of CI-966.
Gen Pharmacol 1995 Sep
PMID:CI-966, a GABA uptake inhibitor, antagonizes ischemia-induced neuronal degeneration in the gerbil. 755 51

Randomized clinical trials on the efficacy of carotid endarterectomy have assisted in the selection of patients for operative intervention. Three such trials involving symptomatic carotid stenosis have confirmed the value of endarterectomy in patients with stenoses 70% or greater. Patients with recent transient ischemic attack or nondisabling stroke should be referred for noninvasive testing. If the patient's stenosis exceeds a threshold level (50% to 70% diameter-reducing lesion), arteriography should be performed and prompt endarterectomy scheduled, rather than antiplatelet therapy, as the primary means of treatment. Furthermore, the results of one clinical trial on asymptomatic stenosis have demonstrated benefits for operative intervention in reducing neurologic events (transient ischemic attack plus stroke). These data require additional confirmation in the analysis of stroke alone, which should be available within the next year from another clinical trial. These trials help to define indications for operation, and the thorough knowledge of their results has become essential to our practices.
Curr Opin Gen Surg 1994
PMID:Randomized clinical trial results define operative indications in symptomatic and asymptomatic carotid endarterectomy patients. 758 88

Cardiovascular responses to synthetic eel [Asn1, Val5, Gly9]-ANG-I, ANG-III (2-8), and ANG-I (1-7) were measured in conscious and resting freshwater North American eels. Indwelling Doppler flow probes were placed on the ventral and dorsal aortas, a pressure catheter in the lienomesenteric artery, and a peptide delivery catheter in the caudal vein. Twenty-five and 150 ng.kg-1 ANG-III increased baseline cardiac output (CO) (15.23 +/- 0.31 ml.min-1.kg-1; n = 5) by 23 and 47%, respectively, by increasing stroke volume (SV) but not heart rate (HR). ANG-I (150 ng.kg-1) also elevated CO (62%) by increasing both SV (44%) and HR (14%). Estimated branchial shunting (BS) was increased by 150 ng.kg-1 ANG-I and -III suggesting that more blood perfused the arteriovenous pathway in the gills. Dorsal aortic blood pressure (PDA) (3.08 +/- 0.12 kPa) was elevated by 150 ng.kg-1 ANG-I (67%) and -III (52%). Pressor responses temporally preceded the blood flow increases and there was a significant increase in systemic vascular resistance (RSYS) at the peak pressor responses. At the peak flow responses, increased CO was solely responsible for the increase in PDA; RSYS had returned to baseline values. Pressor responses to ANG-III decayed more rapidly (18.6 min) compared with those of ANG-I and -II (36 min). ANG-I (1-7) had no measurable effect on cardiovascular function indicating that the carboxyl-terminal 8-phenylalanine is an absolute requirement for the hormonal activity of angiotensin in fishes.
Gen Comp Endocrinol 1995 Feb
PMID:Angiotensin-I- and -III-mediated cardiovascular responses in the freshwater North American eel, Anguilla rostrata: effect of Phe8 deletion. 762 20

1. The cardiovascular effects of SRT6b in control and BQ-123, a specific ETA receptor antagonist, pretreated rats were determined in anesthetized rats using a radioactive microsphere technique. 2. Infusion of SRT6b produced an increase in blood pressure and total peripheral resistance, decrease in cardiac output and stroke volume, and no change in heart rate of control or BQ-123 treated rats. 3. SRT6b induced a decrease in blood flow to the heart which was completely blocked by BQ-123 pretreatment. The decrease in blood flow to other organs by SRT6b was not affected by BQ-123 pretreatment. 4. This study indicates that ET receptors in the coronary blood vessels are of a different type (neither ETA nor ETB) to those in other vascular beds.
Gen Pharmacol 1995 Jan
PMID:Endothelin ETA receptor antagonist, BQ-123, blocks the vasoconstriction induced by sarafotoxin 6b in the heart but not in other vascular beds. 771 59

1. Adenosine is an endogenous neuroprotective agent; stimulation of A1 receptors decreases excitatory amino acid neurotransmission and stimulation of A2 receptors inhibits platelet and neutrophil activation and promotes vasodilation. 2. Post-ischemic administration of propentofylline (HWA 285) reduces neuronal damage in gerbils and improves glucose metabolism in all regions of brain in acute stroke patients. 3. Propentofylline inhibits the transport of adenosine into cultured cells and increases extracellular adenosine concentrations in ischemic brain. Thus, enhanced stimulation of adenosine receptors may account for some of the neuroprotective effects of this compound. 4. Propentofylline inhibits free radical production by cultivated microglia cells, stimulates nerve growth factor production and inhibits cAMP-phosphodiesterase activity. These effects may also be important for neuroprotection.
Gen Pharmacol 1994 Oct
PMID:Propentofylline: a nucleoside transport inhibitor with neuroprotective effects in cerebral ischemia. 787 26


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