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

We have examined the behavior of spontaneously hypertensive (SHR) rats and stroke-prone hypertensive (SP-SHR) male rats during the development and maintenance of elevated blood pressure and compared this pattern with age- and gender-matched normotensive (WKY) rats of the same Wistar-Kyoto strain as controls. Rats of each strain (n = 10/age group) were isolated in individual cages and observed for 60 min at 3,4,6,8,10, or 20 weeks of age using a scan sampling technique. At all ages SHR rats were significantly more active than WKY rats whereas SP-SHR rats were intermediate in level of activity. In a 2nd series, activity of male rats of each strain was monitored continuously for 24 hr in the home cage. No strain differences in amount or pattern of total daily activity were evident at either 4-6 or 16-18 weeks of age. These results indicate that SHR rats are more reactive to environmental change, but the intermediate level of activity of SP-SPHR rats suggests that this response is not related to the degree of blood pressure elevation,
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PMID:Patterns of behavioral development in spontaneously hypertensive rats and Wistar-Kyoto normotensive controls. 57 75

Appreciation of metaphoric and nonmetaphoric alternative word meanings was assessed in 19 aphasic, left (LHD) and 15 non-aphasic, right (RHD) hemisphere brain-damaged stroke patients. With the one exception in the aphasic group, all patients were male. In an unspeeded sorting task, subjects responded on the basis of less frequent, alternative meanings of polysemous target words. Targets were either polysemous adjectives (e.g. "warm") having metaphoric alternative meanings (loving) or polysemous nouns (e.g., "pen") having non-metaphoric alternative meanings (writing implement, cage). Both patient groups performed worse overall than a group of nonbrain-damaged control subjects. Relative to the RHD patients, LHD patients showed a spared appreciation of metaphoric alternative meanings. In addition, LHD, but not RHD, patients performed better on metaphoric adjective trials when there was high similarity between a word's dominant and (metaphoric) alternative meaning. The results suggest a pervasive insensitivity of RHD patients to alternative interpretations of linguistic units, and a special role for the intact right hemisphere in lexical-semantic processes related to metaphor comprehension.
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PMID:Appreciation of metaphoric alternative word meanings by left and right brain-damaged patients. 169 80

Cardiopulmonary responses to prolonged hyperoxia and their relationships to the development of lung pathology have not been fully characterized in primates. In this study, circulatory hemodynamics and pulmonary function, vascular permeability, and leukocyte sequestration were measured in male baboons after 100% O2 exposure and related to ultrastructural changes of lung injury by electron microscopy. Three groups of animals were exposed to 100% O2 in an exposure cage for 40, 66, and 80 h, respectively. A fourth group of animals was exposed in a cage for 80 h and then anesthetized and ventilated with 100% O2 for additional time. These animals were exposed for a total duration of 110 h or until death from the injury. Physiological responses to hyperoxia were characterized by decreases in total lung capacity and inspiratory capacity at 80 and 110 h. A significant increase in pulmonary leukocyte accumulation was noted by 80 h. Extravascular lung water and permeability surface-area product increased at 80 and 110 h. Cardiac output and stroke volume also decreased, and systemic vascular resistance increased after 80 and 110 h of hyperoxia. Histopathological changes were present in the lungs of all but the 40-h exposure group. Animals exposed for 66 h showed endothelial injury and neutrophil accumulation. By 80 h, animals showed endothelial cell destruction, interstitial edema, and type I cell injury. At 110 h, animals showed substantial destruction of endothelial and type I epithelial cells, exposure of alveolar basement membrane, congestion of capillaries, and substantial interstitial edema. The data indicate that histological changes by electron microscopy precede physiological responses to hyperoxic pulmonary injury in baboons by as much as 14 h and that the physiological responses to early hyperoxic injury are relatively insensitive to the pathological injury.
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PMID:Responses of baboons to prolonged hyperoxia: physiology and qualitative pathology. 177 33

To evaluate how necessary and helpful invasive hemodynamic measurements after thoracic surgery are we studied 25 patients after pneumonectomies (n = 5), lobectomies and bilobectomies (n = 10), partial lobectomies (n = 6) and thoracotomies without lung resection (n = 4). Measurements were taken between half an hour and eighteen hours after closure of the rib cage using a preoperatively introduced Swan-Ganz-catheter. Pulmonary resistance was elevated in 12 out of 17 cases. 6 out of 25 patients had a mean pulmonary arterial pressure greater than 20 Torr. The cardiac index was below the lower limit of normal in 16 of 23 cases. 5 patients had an increased stroke work index. There was no correlation between the hemodynamic parameters and the type of surgery. In 7 patients the measurements indicated hypovolemia. Isolated right or left sided cardiac insufficiency was noted in one case each. Four patients received nitroglycerin intravenously resulting in a dose-dependent reduction in pulmonary arterial pressure, pulmonary resistance and heart work. Hemodynamic monitoring with a Swan-Ganz-catheter seems not to be necessary in every case. But it proved to be a safe method which can help in the management of high-risk patients.
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PMID:[Hemodynamics in the early postoperative period after thoracotomy and lung resection]. 323 37

The clinical and pathologic findings in 42 autopsy proved cases of cerebral infarction from cancer-associated non-bacterial thrombotic endocarditis were reviewed. Carcinoma of the lung was the most common malignancy. Most patients had disseminated cancer, but in six patients, the condition was stable or in remission, and six patients had localized cancer; two patients were not known to have cancer until neurologic symptoms developed. Neurologic symptoms were focal, suggesting stroke in 18; diffuse, suggesting metabolic encephalopathy in nine; and mixed in five. Neurologic signs were often the only evidence of thromboembolism. The definitive diagnostic test was cerebral angiography showing multiple arterial occlusions. Anticoagulation with heparin appeared to help some patients and did not promote brain hemorrhage. Early diagnosis and vigorous treatment of non-bacterial endocarditis may prevent severe neurologic disability.
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PMID:Cerebral infarction from non-bacterial thrombotic endocarditis. Clinical and pathological study including the effects of anticoagulation. 367 60

Hemodynamic responses to ventricular defibrillation were studied in anesthetized dogs. Observations were made on arterial, right atrial and left ventricular end-diastolic pressures, on cardiac output (dye dilution), heart rate, and right atrial electrocardiogram. Ventricular fibrillation was induced electrically with a bipolar electrode catheter placed in the right ventricle. Fibrillation was maintained for 15 or 30 sec and terminated with a 400 w sec capacitor discharge across the thoracic cage. Responses lasted 1-10 min after conversion and included a cholinergic and an adrenergic component. The cholinergic component was characterized by sinus bradycardia, periods of sinus arrest, atrioventricular block, and ventricular premature beats. The adrenergic component included increases in arterial pressure, in cardiac output, and in left ventricular stroke work at a time when left ventricular end-diastolic pressure was normal; there was no change in total peripheral resistance. The pH of arterial blood decreased slightly and pCO(2) increased but pO(2) and the concentration of lactate were unchanged. Bilateral vagotomy and intravenous administration of atropine blocked the cholinergic component, unmasked a sinus tachycardia, and accentuated the adrenergic component of the response. The latter was blocked by intravenous administration of propranolol and phenoxybenzamine.THESE RESPONSES WERE RELATED PRIMARILY TO CONVERSION OF VENTRICULAR FIBRILLATION RATHER THAN TO THE ELECTRICAL DISCHARGE OF COUNTERSHOCK BECAUSE COUNTERSHOCK WITHOUT VENTRICULAR FIBRILLATION CAUSED MORE TRANSIENT AND SMALLER RESPONSES THAN THOSE OBSERVED WITH DEFIBRILLATION: furthermore, the hemodynamic effects of defibrillation were augmented by prolongation of the duration of fibrillation. The results suggest that the cholinergic component of the response may be detrimental in that it favors spontaneous recurrence of fibrillation; on the other hand, the adrenergic component may be essential for conversion since only one of six dogs depleted of endogenous catecholamines with reserpine survived ventricular defibrillation.
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PMID:Hemodynamic effects of ventricular defibrillation. 490 40

Static and dynamic lung volumes, maximum respiratory pressures and lung compliance and resistance were registered in 54 subjects with hemiplegia or hemiparesis after stroke. These measures of ventilatory function were related to the degree of motor impairment and to the interval between stroke and investigation. In general ventilatory function, particularly parameters depending upon expiratory force, was restricted. This was most pronounced in subjects with severe hemiplegia while those with hemiparesis had only small changes. Since dynamic lung volumes (corrected for volume loss), lung compliance and resistance were all normal, it is evident that intrinsic lung function was unaffected. Inspiratory capacity - but no other measured variables of respiratory function - was lower six months after the stroke than earlier. It is suggested that expiratory muscle dys-coordination and weakness caused expiratory dysfunction while the less pronounced inspiratory restriction may be caused by muscular dysfunction and, as time goes by, by rib cage contracture.
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PMID:Restrictive ventilatory dysfunction in stroke: its relation to locomotor function. 658 33

The purpose of this work was to study if enriched housing conditions and fetal neocortical transplantation could enhance the functional outcome after focal brain ischemia in adult rats. The right middle cerebral artery (MCA) was ligated in 34 inbred, spontaneously hypertensive male rats, which were then randomly divided into three groups. Groups A and B were transferred to an enriched environment, i.e., a large cage with opportunities for various activities but not forcing the rats to do any particular tasks; group C was kept in standard laboratory cages. Three weeks after the MCA occlusion blocks of fetal neocortical tissue (Embryonic Day 17) were transplanted to the infarct cavity in groups B and C. Rats in group A (n = 11) and group B (n = 11) performed equally well and significantly better than rats in group C (n = 10) when placed on an inclined plane and when traversing a rotating pole 6 and 9 weeks after the MCA occlusion and in a leg placement test at 9, but not 6 and 12 weeks. Skilled forelimb function did not differ between the groups. Infarct size and thalamic atrophy did not differ between the groups and graft size was similar in group B and C. There was no correlation between infarct size and motor function in any of the tests in rats housed in an enriched environment. Since the environment can significantly alter functional outcome without reducing infarct size we suggest that more attention should be given to the role of the laboratory environment and to long term behavioral outcome in experimental stroke.
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PMID:Influence of an enriched environment and cortical grafting on functional outcome in brain infarcts of adult rats. 760 Dec 67

Based upon an anecdotal report of successful resuscitation using a toilet plunger, Cohen and co-workers have developed and investigated a hand-held suction cup as an adjunct to standard manual CPR. This new method, called active compression-decompression cardiopulmonary resuscitation, utilizes a device which is placed over the mid-sternum, approximately 1-2 inches above the lower rib cage border. Active compression-decompression cardiopulmonary resuscitation is then performed in accordance with American Heart Association guidelines at a rate equal to 80-100/min using a 50% duty cycle and compression depth of 1.5-2.0 inches. Initial studies using the ACD device in both models and human subjects late after cardiac arrest have demonstrated improved cardiopulmonary hemodynamics when compared to standard manual CPR. Transophageal echocardiographic studies in human subjects have shown increased left ventricular filling during active decompression suggesting that active chest decompression improves venous return to the heart thus increasing left ventricular volume and stroke volume. Improved resuscitation success has also been documented in human subjects after in-hospital and pre-hospital cardiac arrest. Active compression-decompression cardiopulmonary resuscitation is a simple method which utilizes a hand held suction cup as an interface between rescuer and victim during closed chest circulatory support. This method allows for standard manual cardiopulmonary resuscitation with the addition of active chest wall decompression and appears to be a beneficial adjunct to standard manual cardiopulmonary resuscitation.
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PMID:Clinical and laboratory investigations of active compression-decompression cardiopulmonary resuscitation. 780 80

Increasing emphasis has been placed on the detection and treatment of hazardous and harmful drinking disorders, particularly among patients who are seen in primary care settings. In this review, we summarize the epidemiology and health-related effects of hazardous and harmful drinking and discuss current methods for their detection and treatment. Hazardous drinking is defined as a quantity or pattern of alcohol consumption that places patients at risk for adverse health events, while harmful drinking is defined as alcohol consumption that results in adverse events (e.g., physical or psychological harm). Prevalence estimates range from 4% to 29% for hazardous drinking and from less than 1% to 10% for harmful drinking. Data from several recent large prospective studies suggest that alcohol consumption in quantities consistent with hazardous or harmful drinking may increase risk for adverse health events, such as hemorrhagic stroke and breast cancer. Existing screening instruments, such as the Michigan Alcoholism Screening Test (MAST) or the CAGE questionnaire, while excellent for detecting alcohol abuse or dependence, should not be used alone to screen for hazardous and harmful drinking. The Alcohol Use Disorders Identification Test (AUDIT) is currently the only instrument specifically designed to identify hazardous and harmful drinking. Treatment of these disorders in the form of brief interventions can be successfully accomplished in primary care settings, as demonstrated by a number of well-conducted randomized trials. Given its proven efficacy in the primary care setting, we recommend routine application of this treatment approach.
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PMID:Hazardous and harmful alcohol consumption in primary care. 1044 69


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