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Sample records for stroke und des

  1. Darwin, Engels und die Rolle der Arbeit in der biologischen und kulturellen Evolution des Menschen

    NASA Astrophysics Data System (ADS)

    Reichholf, Josef H.

    Im Jahre 1876, 5 Jahre nach Erscheinen von Darwins Buch über die Evolution des Menschen und die sexuelle Selektion (Darwin 1871), veröffentlichte Friedrich Engels den berühmt gewordenen Essay "Anteil der Arbeit an der Menschwerdung des Affen“ (Engels 1876). Die Kernfrage darin lautet in Kurzform: Warum hat der Mensch eigentlich ein Bedürfnis nach Arbeit? Engels Antwort wird nachfolgend näher betrachtet und vom gegenwärtigen Kenntnisstand aus beurteilt. Wie sich zeigen wird, beantworten seine Überlegungen die Frage nicht wirklich. Sie ist weiterhin offen. Es können lediglich einige zusätzliche Anhaltspunkte zur Diskussion gestellt werden. Angesichts des drängenden Problems millionenfacher Arbeitslosigkeit und der Forderungen nach einem "Grundrecht auf Arbeit“ kommt den Überlegungen zum möglichen Ursprung des Bedürfnisses nach Arbeit mehr als nur akademisches Interesse zu.

  2. Elektrische Phänomene des Körpers und ihre Detektion

    NASA Astrophysics Data System (ADS)

    Bolz, Armin; Kikillus, Nicole; Moor, Claudius

    Im menschlichen Körper verfügen sowohl Nerven- als auch Muskelzellen über die Eigenschaft, intra- und extrazelluläre Ionenkonzentrationen zu verschieben und damit die Potenzialverteilung in ihrer Umgebung zu beeinflussen. Über unterschiedliche Synchronisationsverfahren sind makroskopische Zellverbände zusätzlich in der Lage, koordiniert ihre Felder zu verändern und somit auch signifikante, an der Körperoberfläche messbare elektrische Signale zu erzeugen. Das vorliegende Kapitel beschreibt zunächst die elektrophysiologischen Grundlagen elektrischer Signale des menschlichen Körpers, die Synchronisationsmechanismen und die daraus entstehenden Felder, insbesondere das Elektrokardiogramm (EKG), das Elektroenzephalogramm (EEG) sowie das Elektromyogramm (EMG). Im Anschluss daran werden die wesentlichen Grundlagen der Messtechnik zur Erfassung bioelektrischer Phänomene erläutert. Einige Beispielapplikationen runden diesen Beitrag ab.

  3. Zu einer inhaltsorientierten Theorie des Lernens und Lehrens der biologischen Evolution

    NASA Astrophysics Data System (ADS)

    Wallin, Anita

    Der Zweck dieser Studie (zwecks Überblick siehe dazu Abb. 9.1) war zu untersuchen, wie die Schüler der Sekundarstufe II ein Verständnis von der Theorie der biologischen Evolution entwickeln. Vom Ausgangspunkt "Vorurteile der Schüler“ ausgehend wurden Unterrichtssequenzen entwickelt und drei verschiedene Lernexperimente in einem zyklischen Prozess durchgeführt. Das Wissen der Schüler wurde vor, während und nach den Unterrichtssequenzen mit Hilfe von schriftlichen Tests, Interviews und Diskussionsrunden in kleinen Gruppen abgefragt. Etwa 80 % der Schüler hatten vor dem Unterricht alternative Vorstellungen von Evolution, und in dem Nachfolgetest erreichten circa 75 % ein wissenschaftliches Niveau. Die Argumentation der Schüler in den verschiedenen Tests wurde sorgfältig unter Rücksichtnahme auf Vorurteile, der konzeptionellen Struktur der Theorie der Evolution und den Zielen des Unterrichts analysiert. Daraus konnten Einsichten in solche Anforderungen an Lehren und Lernen gewonnen werden, die Herausforderungen an Schüler und Lehrer darstellen, wenn sie anfangen, evolutionäre Biologie zu lernen oder zu lehren. Ein wichtiges Ergebnis war, dass das Verständnis existierender Variation in einer Population der Schlüssel zum Verständnis von natürlicher Selektion ist. Die Ergebnisse sind in einer inhaltsorientierten Theorie zusammengefasst, welche aus drei verschiedenen Aspekten besteht: 1) den inhaltsspezifischen Aspekten, die einzigartig für jedes wissenschaftliche Feld sind; 2) den Aspekten, die die Natur der Wissenschaft betreffen; und 3) den allgemeinen Aspekten. Diese Theorie kann in neuen Experimenten getestet und weiter entwickelt werden.

  4. Charakterisierung von Sulfotransferasen im Gastrointestinaltrakt von Mensch und Ratte und Aktivierung von Promutagenen in V79-Zellen, die eine intestinale Form (1B1) des Menschen und der Ratte exprimieren

    NASA Astrophysics Data System (ADS)

    Teubner, Wera

    2001-05-01

    Die Ausstattung der gastrointestinalen Mukosa des Menschen und der Ratte mit Sulfotransferasen wurde mit Hilfe von Immunodetektion und Enzymaktivitätsmessungen untersucht. In Proben aus Colon und Rektum von 39 Personen wurden die Formen h1A1, h1A3 und h1B1 identifiziert, wobei in einer weiteren Probe, die als einzige von einem an Colitis Ulcerosa erkrankten Patienten stammte, keine Sulfotransferasen nachgewiesen werden konnten. Bei der Immunblot-Analyse war das Expressionsmuster der einzelnen Formen in allen Proben ähnlich. In wenigen Proben waren die relativen Signalintensitäten der h1A1 und der h1B1 um die Hälfte erniedrigt. Der Gehalt von SULT an zytosolischem Protein zeigte einen bis zu 8 - 10fachen Unterschied, er betrug jedoch bei zwei Dritteln der Proben zwischen 0,15 und 0,3 (h1A1 und h1A3) bzw. 0,6 und 0,8 Promille (h1B1). Die Variation konnte nicht auf Alter, Geschlecht oder Krankheitsbild der Patienten zurückgeführt werden. Auch der für die allelischen Varianten der h1A1 beschriebene Effekt auf die Enzymaktiviät bzw. Stabilität konnte in der Menge an immunreaktivem Protein nicht in diesem Ausma detektiert werden. Die Allelhäufigkeit von h1A1*R und h1A1*H war gegenüber der gesunden Bevölkerung nicht verändert. In den sieben Proben aus dem Dünndarm (Coecum, viermal Ileum, Jejunum) konnten zusätzlich die Formen h1E1 und h2A1 identifiziert werden. Ein möglicherweise der Form h1C1 entsprechendes Protein wurde im Magen detektiert. Im Vergleich zum Menschen war die Expression in der Ratte stärker auf die Leber konzentriert. Während beim Menschen in allen untersuchten Abschnitten Sulfotransferasen in Mengen detektiert wurden, die in zwei Fällen (h1B1 und h1A3) sogar den Gehalt in der Leber überstiegen, beschränkte sich die Expression in der Ratte auf im Vergleich zur Leber geringe Mengen im Magen und Dickdarm. Nachgewiesen wurden die r1B1, r1A1 sowie eine nicht identifizierte Form von 35kD, bei der es sich vermutlich um die r1C2 handelt. Im

  5. IQM-Reifegradmodell für die Bewertung und Verbesserung des Information Lifecycle Management Prozesses

    NASA Astrophysics Data System (ADS)

    Baškarada, Saša; Gebauer, Marcus; Koronios, Andy; Gao, Jing

    Heutige Organisationen produzieren und speichern mehr Informationen als je zuvor. Der resultierende Informationsüberfluss, zusammen mit einem Mangel an Qualitätssicherung für das Information Lifecycle Management, führt zu einem unsicheren Status der Informationsqualität in vielen Organisationen. Weiterhin hat sich herausgestellt, dass das Bewerten, Verbessern und Steuern der Informationsqualität ein offenkundig schwieriges Unterfangen ist. Dieses Kapitel stellt ein Modell zur Bewertung und Verbesserung der Information Quality Management Capability Maturity (IQM-Reifegrad) vor. Es wird ein Satz von Kriterien vorgestellt, der aus Literaturrecherche und Fallstudien abgeleitet wurde. Die Reifegradindikatoren werden validiert und in einem mehrstufigen Reifegradmodell durch eine Delphi-Studie gruppiert. Das abgeleitete IQM-Reifegradmodell hilft Organisationen ihre bestehenden Praktiken im IQM zu bewerten und potentielle Lücken und Verbesserungsstrategien zu ermitteln.

  6. Stroke

    MedlinePlus

    ... emergency. Strokes happen when blood flow to your brain stops. Within minutes, brain cells begin to die. There are two kinds ... blocks or plugs a blood vessel in the brain. The other kind, called hemorrhagic stroke, is caused ...

  7. Das Prinzip Bewegung - Herz und Gehirn als Metaphern des menschlichen Lebens

    NASA Astrophysics Data System (ADS)

    Otis, Laura

    In diesem Jahr, in dem wir Charles Darwins gedenken, möchte ich etwas riskieren und eine Frage erörtern, die für die Literatur ebenso wie für die Biologie zentral ist: Was ist das Leben? Die Antwort auf diese Frage finden wir nicht in der Bibliothek und nicht im Labor, zumindest nicht an diesen erkenntnisproduzierenden Stellen allein. Als Literaturwissenschaftlerin und ehemalige Naturwissenschaftlerin glaube ich, dass wir das Leben nur verstehen werden, wenn wir seinen Wirkungen überall nachforschen, inklusive in der Literatur.

  8. [Stroke].

    PubMed

    Luft, A R; Weller, M

    2009-11-01

    Ischemic stroke is a very frequent neurological disorder. It's incidence is increasing as western societies are aging. Effective therapies that reduce mortality and increase the chances of living symptom-free or, at least, in independence are available. Intravenous or intraarterial thrombolysis is an effective treatment with a number needed to treat of 6 if given within 4.5 hours after symptom onset. The safe use of thrombolysis requires an effective and repeatedly trained workflow established within a team of a neurologist and specialized nursing staff in an optimized environment (admission, imaging facility, laboratory, stroke unit). After peracute treatment, the patient should be transferred to a stroke unit. This unit is a spatially defined intermediate care unit with specifically trained personnel (physicians, nurses, therapists). Treating the patient in a stroke unit is as effective in improving outcome as thrombolysis and also reduces the length of hospital stay. In contrast to thrombolysis, which can be provided, on average, to only 5% of stroke patients, stroke unit care is applicable to most. The organization of medical care in most European countries and in Switzerland separate the acute phase from subacute rehabilitation and chronic stroke treatment. This can be highly confusing for the patient who, during the course of the disease, meets different physicians, nurses and therapists with often diverging opinions about prognosis and therapies. Consistent treatment approaches and patient/caregiver information is necessary and can only be implemented by providing a homogeneous pathway for continuous stroke care. PMID:20029781

  9. Charakterisierung von Sulfotransferasen im Gastrointestinaltrakt von Mensch und Ratte und Aktivierung von Promutagenen in V79-Zellen, die eine intestinale Form (1B1) des Menschen und der Ratte exprimieren

    NASA Astrophysics Data System (ADS)

    Teubner, Wera

    2001-05-01

    Die Ausstattung der gastrointestinalen Mukosa des Menschen und der Ratte mit Sulfotransferasen wurde mit Hilfe von Immunodetektion und Enzymaktivitätsmessungen untersucht. In Proben aus Colon und Rektum von 39 Personen wurden die Formen h1A1, h1A3 und h1B1 identifiziert, wobei in einer weiteren Probe, die als einzige von einem an Colitis Ulcerosa erkrankten Patienten stammte, keine Sulfotransferasen nachgewiesen werden konnten. Bei der Immunblot-Analyse war das Expressionsmuster der einzelnen Formen in allen Proben ähnlich. In wenigen Proben waren die relativen Signalintensitäten der h1A1 und der h1B1 um die Hälfte erniedrigt. Der Gehalt von SULT an zytosolischem Protein zeigte einen bis zu 8 - 10fachen Unterschied, er betrug jedoch bei zwei Dritteln der Proben zwischen 0,15 und 0,3 (h1A1 und h1A3) bzw. 0,6 und 0,8 Promille (h1B1). Die Variation konnte nicht auf Alter, Geschlecht oder Krankheitsbild der Patienten zurückgeführt werden. Auch der für die allelischen Varianten der h1A1 beschriebene Effekt auf die Enzymaktiviät bzw. Stabilität konnte in der Menge an immunreaktivem Protein nicht in diesem Ausma detektiert werden. Die Allelhäufigkeit von h1A1*R und h1A1*H war gegenüber der gesunden Bevölkerung nicht verändert. In den sieben Proben aus dem Dünndarm (Coecum, viermal Ileum, Jejunum) konnten zusätzlich die Formen h1E1 und h2A1 identifiziert werden. Ein möglicherweise der Form h1C1 entsprechendes Protein wurde im Magen detektiert. Im Vergleich zum Menschen war die Expression in der Ratte stärker auf die Leber konzentriert. Während beim Menschen in allen untersuchten Abschnitten Sulfotransferasen in Mengen detektiert wurden, die in zwei Fällen (h1B1 und h1A3) sogar den Gehalt in der Leber überstiegen, beschränkte sich die Expression in der Ratte auf im Vergleich zur Leber geringe Mengen im Magen und Dickdarm. Nachgewiesen wurden die r1B1, r1A1 sowie eine nicht identifizierte Form von 35kD, bei der es sich vermutlich um die r1C2 handelt. Im

  10. Getreide, Brot und Feine Backwaren

    NASA Astrophysics Data System (ADS)

    von Grabowski, Hans-Uwe; Rolfe, Birgit

    Getreide und Getreideerzeugnisse sind ebenso wie Brot und Feine Backwaren nach dem Lebensmittel- und Futtermittel-Gesetzbuch (LFGB) [1] Lebensmittel im Sinne des Artikels 2 der VO (EG) Nr. 178/2002 (BasisVO) (s. auch Kap. 1.6/2.4.1/3.2). Gesetzlich festgelegte Begriffsbestimmungen gibt es für diese Lebensmittel nicht. Man muss sich daher allgemeiner Verkehrsauffassungen bedienen, wie sie von der Deutschen Lebensmittelbuch-Kommission in Form von Leitsätzen erarbeitet und veröffentlicht wurden [2]. Der Gesundheitsschutz und der Schutz des Verbrauchers vor Täuschung sind in der Basis-VO und dem LFGB geregelt.

  11. Peter Andreas Hansen und die astronomische Gemeinschaft - eine erste Auswertung des Hansen-Nachlasses.

    NASA Astrophysics Data System (ADS)

    Schwarz, O.; Strumpf, M.

    The literary assets of Peter Andreas Hansen are deposited in the Staatsarchiv Hamburg, the Forschungs- und Landesbibliothek Gotha and the Thüringer Staatsarchiv Gotha. They were never systematically investigated. The authors present here some results of a first evaluation. It was possible to reconstruct the historical events with regard to the maintenance of the Astronomische Nachrichten and the Altona observatory in 1854. Hansen was a successful teacher for many young astronomers. His way of stimulating the evolution of astronomy followed Zach's tradition.

  12. Elektronenröhrenforschung nach 1945 Telefunkenforscher in Ost und West und das Scheitern des Konzepts der „Gnom-Röhren“ in Erfurt

    NASA Astrophysics Data System (ADS)

    Dörfel, Günter; Tobies, Renate

    Elektronenröhren standen wegen ihrer Rüstungsrelevanz nach Kriegsende unter dem Vorbehalt der Besatzungsmächte. Unter dem Druck eigener materieller Defizite erlaubte und initiierte die sowjetische Besatzungsmacht Entwicklungen dazu eher als die westlichen Alliierten. Daraus resultierten bemerkenswerte Innovationen und Vorsprünge im Gebiet von Miniaturröhren.

  13. Geoinformation und Staat

    NASA Astrophysics Data System (ADS)

    Zypries, Brigitte

    2002-09-01

    Geoinformationen besaßen als Grundlage militärischer Interventionen schon immer einen hohen Stellenwert für den Staat. Im Zeitalter der modernen Informations- und Kommunikationstechnologien wächst in demokratischen Staaten die Bedeutung von Geodaten weit über den Verteidigungsbereich hinaus. Brigitte Zypries, Staatssekretärin im Bundesministerium des Innern (BMI) und Vorsitzende des Interministeriellen Ausschusses für Geoinformationswesen (IMAGI), sprach mit Dipl.-Geogr. Ute C. Bauerüber die Anwendung und Koordinierung von Geodaten in Politik und Staat.

  14. Arzt und Hobby-Astronom in stürmischen Zeiten Der Büchernachlass des Doktor Johannes Häringshauser, Viertelsmedicus in Mistelbach (1630-1641) in der Melker Stiftsbibliothek.

    NASA Astrophysics Data System (ADS)

    Davison, Giles; Glaßner, Gottfried

    2009-06-01

    Auf der Suche nach astronomischer Literatur stieß Giles Davison in der Melker Stiftsbibliothek auf den Namen "Doctor Johannes Häringshauser“ als Besitzer seltener und interessanter astronomischer Werke u.a. von Johannes Regiomontan, Georg von Peuerbach, Michael Mästlin, Johannes Kepler und Daniel Sennert. Weitere in den Jahren 2007-2009 durchgeführte Nachforschungen ergaben, dass es sich um den von 1630-1641 in Mistelbach, Niederösterreich, als Landschaftsarzt tätigen Vater des Melker Konventualen und Bibliothekars Sigismund Häringshauser (1631-1698) handelt. Er wurde 1603 als Sohn des aus Magdeburg stammenden Apothekers Johannes Häringshauser geboren und starb 1642 in Mistelbach. Johannes Häringshauser Sen. bekleidete von 1613-1640 eine Reihe wichtiger Ämter in der Wiener Stadtregierung und starb 1647. Der Studienaufenthalt von Dr. Johannes Häringshauser Jun. in Padua (1624-1626) dürfte das Interesse für Astronomie geweckt haben, das sich in seiner in die Bestände der Melker Stiftsbibliothek eingegangenen Privatbibliothek widerspiegelt. Der Großteil der 10 dem Fachbereich der Astronomie und Astrologie zuzuweisenden Titel wurde von ihm in den Jahren 1636 und 1637 erworben.

  15. Die nuklearen Anlagen von Hanford (1943-1987) Eine Fallstudie über die Schnittstellen von Physik, Biologie und die US-amerikanische Gesellschaft zur Zeit des Kalten Krieges

    NASA Astrophysics Data System (ADS)

    Macuglia, Daniele

    Die Geschichte des Kalten Krieges eröffnet viele Möglichkeiten, sich näher mit den Schnittstellen von Physik und Biologie während des 20. Jahrhunderts zu befassen. Nicht nur das Unglück in Tschernobyl aus dem Jahr 1986, auch das Beispiel der nuklearen Anlagen in Hanford in den Vereinigten Staaten zeigt die biologischen Folgen von nuklearer Physik.

  16. Evolution und Kreationismus im Schulunterricht aus Sicht Großbritanniens. Ist Evolution eine Sache der Akzeptanz oder des Glaubens?

    NASA Astrophysics Data System (ADS)

    Williams, James D.

    Ist Kreationismus eine Weltanschauung oder eine falsche Vorstellung? Ausgehend vom Standpunkt der Naturwissenschaft ist der Unterschied wichtig. Falsche Vorstellungen können herausgefordert und durch gründliche wissenschaftliche Lehre korrigiert werden. Weltanschauungen sind Teil eines etablierten Glaubenssystems, und diese Überzeugungen sind von Natur aus schwer zu verändern (Cohen 1992).

  17. Die neue Kosmologie. Von Dunkelmaterie, GUTs und Superhaufen.

    NASA Astrophysics Data System (ADS)

    Cornell, J.

    This book is a German translation, by M. Röser, of the American original "Bubbles, voids, and bumps in time: the new cosmology", published 1989 (see 49.003.045). Contents: 1. Die Entdeckung des Weltalls: Eine Einleitung (A. P. Lightman). 2. Die Vermessung des Weltalls: Rotverschiebungen und Standardkerzen (R. P. Kirshner). 3. Die Kartierung des Weltalls: Scheiben und Blasen (M. J. Geller). 4. Die Bestimmung der Masse im Weltall: Dunkelmaterie und fehlende Masse (V. C. Rubin). 5. Der Beginn des Weltalls: Urknall und kosmische Inflation (A. H. Guth). 6. Die Ausweitung des Weltalls: Das Weltraumteleskop und Perspektiven für die nächsten 20 Jahre (J. E. Gunn).

  18. Welt und Wirkungsprinzip

    NASA Astrophysics Data System (ADS)

    Landgraf, Werner

    1997-05-01

    Modell einer kausalen Bewirkung der Welt, und logische, geometrische, physikalische Interprätation dieser Kausalmenge und Fortwirkung der frühsten ihrer sukzessiv als echt Neues bewirkten und durch Vorhandenes oder Späteres nicht darstellbaren oder widerrufbaren Ereignisse als Dimensionen und sie verkörpernde primäre Naturkräfte, mit Korrespondenz zur beobachteten Welt und ihrer grundlegendsten Eigenschaften. Wirklich ist nur was wirkt, wo und wie. Entsprechend ist im Bogenelement statt der Eigenzeit die variante Anzahl Wirkungen relevant, 0 ≈ 1/h2 dS2 - 1/tpl2 (dt2 - 1/c2 {dq12 + G02/G2 [dq2,32 - ...]}) mit G0 = c4lpl/Epl ≈ G. Die heutigen Dimensionen und Naturkräfte entstanden in dieser Reihenfolge, haben 'komplementäre' aber gleichwertige statische und dynamische Aspekte, entsprechend ihren Termen in Bogenelement bzw. Vierervektor, aus derem Vergleich sowie mit denen ihrer Nachbarn folgen Grundgleichungen bzw. Erhaltungssätze. Jeweils individuelle Eigenschaften wie ihre Naturkonstante konkretisieren sie und tragen zu gattungsmäßigen wie globale Affinität und Äquivalenzen bei. Ältestes Gebiet oder räumlicher Rand jeder Dimension sind die ersten vom Vorgänger bewirkten Ereignisse, selbst raumzeitlicher Ursprung des Nachfolgers, dort einmalig und ewig maximal rotverschoben fortwirkend und nicht lokalisierbar, um neue Elementareinheiten verschieden und lichtartig mit deren Verhältnis oder dem ihrer globalen Zustandsgrößen als konstanten Anfangsimpuls, Expansion, Längen- oder Ereignisdichte zueinander. Der Übergang vom diskreten Modell weniger Informationen zum Kontinuum und die Korrespondenz zur Physik ist problemlos, Details wie ein kontinuierlicher, abrupter oder ganz fehlender Abfall der Metrik beim ältesten Gebiet sind aber nur durch Beobachtungen entscheidbar. Erörtert werden allgemeine und individuelle Eigenschaften und ihre Konsequenzen der Dimensionen mit ihren Kräften, selbst und im Verhältnis zueinander, etwa ihrer begrenzten

  19. Kometen und Asteroiden

    NASA Astrophysics Data System (ADS)

    Borgeest, Ulf; Staude, Jakob; Hahn, Gerhard; Harris, Alan W.; Jaumann, Ralf; Köhler, Ulrich; Kührt, Ekkehard; Schulz, Rita; Neukum, Gerhard; Arnold, Gabriele; Keller, Horst Uwe; Denk, Tilmann; Müller, Thomas; Wulff, André; Maruhn, Nicolaus; Fischer, Daniel; Trieloff, Mario; Althaus, Tilmann

    Contents: Die Kleinkörper des Sonnensystems. Kern, Koma und Schweife. Ziele der Planetenforschung. ROSETTA: Naherkundung von Kometen. Asteroiden: Trümmer aus planetarer Urzeit. Kleinkörper im Infrarotweltall. Selbs beobachten! Apocalypse - not now! Meteoriten - Boten aus der Urzeit des Sonnensystems.

  20. BOOK REVIEW: Astronomie und Anschaulichkeit. Die Bilder der populaeren Astronomie des 19. Jahrhunderts

    NASA Astrophysics Data System (ADS)

    Duerbeck, H. W.; Utzt, S.

    2004-12-01

    Today, popularisation of science also means "pretty pictures": images that accompany articles in magazines and webpages, or are squeezed between the covers of so-called coffee-table books, and the reviewer pleads guilty to having added to this growing pile. But how did this "disease" came into existence? Susanne Utzt, a manager, journalist and student in the history of sciences, has dedicated her master thesis to the investigation of the growing influence of such pictures in the popularisation of astronomy. She has analyzed French and German popular texts by Arago, Guillemin, Flammarion, as well as Littrow, Maedler and Max Wilhelm Meyer that mainly appeared in the second half of the 19th century. Earlier astronomy books just had a few foldout pages with mathematical figures, as the author exemplifies by Littrow's first edition of "Die Wunder des Himmels" of 1834-36. But Flammarion with his "Astronomie Populaire", changed everything: 51 "art pages" and more than 300 figures in the text made it a true picture book, and about a third of Utzt's work is dedicated to its analysis. (In passing, it should be noted that the first 1880 edition of Flammarion's book did not yet contain the "art pages"; the author quotes such pages and text figures according to a German edition of 1907). Besides sober diagrams illustrating the solar system, and telescope drawings showing planetary surfaces and the structure of the solar photosphere, Flammarion includes poetic illustrations like a couple at the seashore at sunset; a scene showing dying Copernicus, already flanked by two angels, as he receives a copy of his De Revolutionibus; or a painting showing a flock of mammoths in an ancient landscape. In most cases, the images are chosen to illustrate the text, but sometimes the text "makes a detour" to permit the inclusion of a pretty picture. Flammarion's book contains drawings illustrating the sphericity of the earth, which appeared in almost identical form in Apian's Cosmography of

  1. Integument und Anhangsorgane

    NASA Astrophysics Data System (ADS)

    Schliemann, Harald

    Das Integument umhüllt den Wirbeltierkörper lückenlos. In der embryonalen Mundbucht (Stomodaeum) und der Afterbucht (Proctodaeum) grenzt es an die Auskleidung des Darmrohres. Über die generelle Bedeutung einer Haut als Abgrenzung zwischen Körperinnenraum und Außenmedium hinaus hat es bei Schädeltieren ein breites Spektrum von Funktionen. Die wichtigsten sind: Mechanischer Schutz durch Verhornungen und Verknöch erungen; Wundheilung; Schutz vor Wasserverlust; Schutz vor Infektionen durch bakterizide Drüsensekrete und immunkompetente Zellen; Schutz vor kurzwelliger Strahlung durch Pigmente; Schutz vor Überwärmung durch Schweißdrüsensekrete und Schutz vor Wärmeverlust durch Federn und Haare; Ausbildung lokomotorisch wichtiger Strukturen wie Federn, Flug- und Schwimmhäute, Krallen und Hufe; Redukt ion des Strömungswiderstandes durch Dämpfungshaut; Abgabe von Sekreten zur Ernährung (Milch); Ausbildung von Strukturen zu Nahrungserwerb und_-bearbeitung, z. B. Zähne, Barten;

  2. Kernspaltung und Westintegration Beispiel österreich

    NASA Astrophysics Data System (ADS)

    Forstner, Christian

    Während des Kalten Krieges erreichte in Europa sowohl die Verflechtung physikalischer Forschung mit Staat, Politik und Industrie als auch deren öffentliche Verhandlung und Bewertung eine qualitativ neuartige Dimension. Dieser Aspekt tritt am schärfsten in der Geschichte der Kernphysik und Kerntechnik hervor.

  3. Messung und Analyse

    NASA Astrophysics Data System (ADS)

    Bathelt, Hartmut; Scheinhardt, Michael; Sell, Hendrik; Sottek, Roland; Guidati, Sandro; Helfer, Martin

    Für die Beurteilung von Akustik und Fahrkomfort eines Fahrzeugs gilt in der Fahrzeugentwicklung immer noch der alte Grundsatz: "Der Kunde fährt nicht am Prüfstand, sondern auf der Straße“. Daher werden Gesamtbeurteilungen des Entwicklungsstandes und Konkurrenzvergleiche (Benchmarking) nach wie vor auf der Straße durchgeführt, meist auf ausgewählten Fahrbahnen am Prüfgelände oder im Rahmen der regelmäßigen Winter- und Sommererprobungen unter extremen Witterungsverhältnissen.

  4. Neuausrichtung und Konsolidierung

    NASA Astrophysics Data System (ADS)

    Grohmann, Heinz

    Mit der Wahl von Wolfgang Wetzel zum Vorsitzenden der Deutschen Statistischen Gesellschaft im Jahre 1972 begann eine 32jährige Ära, in der die praktische und die theoretische Statistik in einem ausgewogenen Verhältnis gepflegt wurden. Ein regelmäßiger vierjähriger Wechsel im Vorsitz stärkte die Gemeinschaft und die praktische wie die wissenschaftliche Arbeit gleichermaßen. Die jährlichen Hauptversammlungen behandelten gesellschaftlich aktuelle wie zukunftsorientierte Themen, und die Ausschüsse sowie weitere Veranstaltungen gaben Gelegenheit zur Förderung und Pflege einer Vielzahl von Arbeitsgebieten der Statistik. Darüber wird nicht nur in diesem Kapitel, sondern auch in den Teilen II und III des Bandes berichtet.

  5. Falten und fliegen: Papierflieger und ihre Physik

    NASA Astrophysics Data System (ADS)

    Gruber, Werner

    2004-09-01

    Mit Papierfliegern können wichtige Eigenschaften der Aerodynamik anschaulich vermittelt werden: ein Blatt Papier, ein paar Faltungen und schon kann man experimentieren. Allerdings sind beim Trimmen des Fliegers einige Punkte zu beachten. Besonders wichtig ist die Y-Stellung der Flügel, die ihm Flugstabilität verleiht. Ist der Flieger fertig, dann gilt es, die dem Modell am besten angepasste Wurftechnik herauszufinden. Dazu variiert man Wurfgeschwindigkeit und Abwurfwinkel. Den Boden kann ein Papierflieger auf vier prinzipiell verschiedenen Flugkurven erreichen: Optimal ist die Gerade, dann fliegt er am weitesten.

  6. Bewegungsapparat: Postcraniales Skelett und Muskulatur

    NASA Astrophysics Data System (ADS)

    Fischer, Martin S.

    Der Bewegungsapparat bestimmt die Form des Wirbeltierkörpers. So lässt sich z. B. aus der Gestalt eines Fisches auf seine bevorzugt e Schwimmweise schließen (S. 61). Bei den aquatisch en Schädeltieren dominiert die Fortbewegung mit axialem Antrieb; bei den meisten Tetrapoda findet sich eine Kombination aus axialem Antrieb und Bewegung durch Gliedmaßen. Selbst beim höchst spezialisierten Gang, der bipeden Bewegung des Menschen, sind Torsionsbewegungen des Rumpfes noch maßgeblich und bestimmen auch die Grundform des menschlichen Körpers (z. B. die Taille). Obwohl die verschiedenen Antriebsmechanismen eine funktionelle Einheit bilden, werden im Folgenden das Axialskelett sowie der Schulter- und Beckengürtel mit den zugehörigen Extremitäten getrennt besprochen.

  7. Symmetriebrechung und Emergenz in der Kosmologie.

    NASA Astrophysics Data System (ADS)

    Mainzer, K.

    Seit der Antike wird der Aufbau des Universums mit einfachen und regulären (symmetrischen) Grundstrukturen verbunden. Diese Annahme liegt selbst noch den Standardmodellen der relativistischen Kosmologie zugrunde. Demgegenüber läßt sich die Emergenz neuer Strukturen von den Elementarteilchen über Moleküle bis zu den komplexen Systemen des Lebens als Symmetriebrechung verstehen. Symmetriebrechung und strukturelle Komplexität bestimmen die kosmische Evolution. Damit zeichnet sich ein fachübergreifendes Forschungsprogramm von Physik, Chemie und Biologie ab, in dem die Evolution des Universums untersucht werden kann.

  8. Ökophysik: Plaudereien über das Leben auf dem Land, im Wasser und in der Luft

    NASA Astrophysics Data System (ADS)

    Nachtigall, W.

    Prof. em. Dr. rer. nat. Werner Nachtigall, geb. 1934, war als Zoophysiologe und Biophysiker Leiter des Zoologischen Instituts der Universität des Saarlandes in Saarbrücken. In Forschung und Ausbildung hat er sich insbesondere mit Aspekten der Technischen Biologie und Bionik befasst und mit seinen Forschergruppen viele Basisdaten insbesondere zur Ökologie, Physiologie und Physik des Fliegens und Schwimmens aber auch zur Stabilität beispielsweise der Gräser erarbeitet. Lebewesen überraschen immer wieder durch ihre "Biodiversität", ihre hochspezifischen Ausgestaltungen und Anpassungen.

  9. Patentierung und Patentlage

    NASA Astrophysics Data System (ADS)

    Herrmann, Uwe

    Gewerbliche Schutzrechte nehmen in der nationalen Rechts- und Wirtschaftsordnung sowie auch auf internationaler Ebene stetig an Bedeutung zu. Sie dienen dem Schutz geistigen Eigentums und sind für jeden Gewerbetreibenden nicht nur im Hinblick darauf von Bedeutung, eigene Rechte zu sichern, sondern auch insofern von Relevanz, dass ein Verstoß gegen Rechte Dritter zu vermeiden ist. Zu den gewerblichen Schutzrechten gehören unter anderem Kennzeichenrechte, Geschmacksmusterrechte sowie die sogenannten technischen Schutzrechte in Form des Patents sowie des Gebrauchsmusters. Die folgenden Ausführungen befassen sich ausschließlich mit den technischen Schutzrechten und geben eine kurze Einführung in die Voraussetzungen, das Entstehen und den Wegfall sowie in die Wirkungen technischer Schutzrechte. Beleuchtet wird die Situation im Wesentlichen im Hinblick auf nationale technische Schutzrechte, d. h. auf Deutsche Patente und Gebrauchsmuster sowie auf Europäische Patente, die Schutz in Deutschland entfalten. Die Möglichkeit der Erlangung von Schutzrechten im außereuropäischen Ausland wird nur am Rande gestreift.

  10. Zur Elektronenstruktur hochsymmetrischer Verbindungen der f-Elemente 28. Experimentelle Erfassung und Simulation des Kristallfeld-Aufspaltungsmusters von Tris(bis(trimethylsilyl)amido)neodym(III) [Nd(Btmsa)3

    NASA Astrophysics Data System (ADS)

    Amberger, Von H.-D.; Jank, S.; Reddmann Und, H.; Edelstein, N. M.

    Die sigma- und pi-Absorptionsspektren eines orientierten Nd(Btmsa)3-Einkristalls wurden bei Raumtemperatur sowie bei tiefen Temperaturen vermessen. Auf der Basis der beobachteten Spektren wurde das zugrundeliegende partielle Kristallfeld (KF)-Aufspaltungsmuster abgeleitet und durch Anpassung der offenen Operators simuliert. Bei 84 Zuordnungen wurde eine RMS-Abweichung von 35.2cm erzielt. Auf der Grundlage der erhaltenen Wellenfunktionen des KF-Grundzustandes konnte das bei 5K aufgenommene ESR-Spektrum von gelostem Nd(Btmsa)3 erklart werden. Unter Verwendung der berechneten Wellenfunktionen und Eigenwerte sowie eines Orbitalreduktions 2faktors k = 0.975konnte die hangigkeit von eff einer gepulverten Nd(Btmsa)3-Probe reproduziert werden. The sigma and pi absorption spectra of an oriented single crystal of Nd(btmsa)3 were measured at room and low temperatures. From the spectra obtained a truncated crystal field (CF) splitting pattern is derived, and simulated by fitting the fr-e1 e parameters of an empirical Hamiltonian. For 84 assignments an RMS deviation of 35.2cm tions of the CF ground state obtained from these calculations the 5K EPR spectrum of dissolved Nd(btmsa)3 could be explained. Making use of the calculated wav 2efunctions and eigenvalues the experimentally determined temperature dependence of eff of powdered Nd(btmsa)3 could be reproduced by adopting an orbital reduction factor k = 0.975. Parameter eines empirischen H-a 1miltonexperimentell bestimmte Temperaturabis achieved. On the basis of the wavefuncplexe

  11. Physik gestern und heute Das Eiskalorimeter

    NASA Astrophysics Data System (ADS)

    Heering, P.

    2003-07-01

    Kalorimetrische Messungen gehören heute zum experimentellen Standardrepertoire im Bereich der Thermodynamik und der physikalischen Chemie. Das erste Gerät für derartige Messungen entwickelten Ende des 18. Jahrhunderts die französischen Wissenschaftler Antoine Laurent Lavoisier und Pierre Simon de Laplace.

  12. Bildanalyse in Medizin und Biologie

    NASA Astrophysics Data System (ADS)

    Athelogou, Maria; Schönmeyer, Ralf; Schmidt, Günther; Schäpe, Arno; Baatz, Martin; Binnig, Gerd

    Heutzutage sind bildgebende Verfahren aus medizinischen Untersuchungen nicht mehr wegzudenken. Diverse Methoden - basierend auf dem Einsatz von Ultraschallwellen, Röntgenstrahlung, Magnetfeldern oder Lichtstrahlen - werden dabei spezifisch eingesetzt und liefern umfangreiches Datenmaterial über den Körper und sein Inneres. Anhand von Mikroskopieaufnahmen aus Biopsien können darüber hinaus Daten über die morphologische Eigenschaften von Körpergeweben gewonnen werden. Aus der Analyse all dieser unterschiedlichen Arten von Informationen und unter Konsultation weiterer klinischer Untersuchungen aus diversen medizinischen Disziplinen kann unter Berücksichtigung von Anamnesedaten ein "Gesamtbild“ des Gesundheitszustands eines Patienten erstellt werden. Durch die Flut der erzeugten Bilddaten kommt der Bildverarbeitung im Allgemeinen und der Bildanalyse im Besonderen eine immer wichtigere Rolle zu. Gerade im Bereich der Diagnoseunterstützung, der Therapieplanung und der bildgeführten Chirurgie bilden sie Schlüsseltechnologien, die den Forschritt nicht nur auf diesen Gebieten maßgeblich vorantreiben.

  13. Restaurierung von Seen und Renaturierung von Seeufern

    NASA Astrophysics Data System (ADS)

    Grüneberg, Björn; Ostendorp, Wolfgang; Leßmann, Dieter; Wauer, Gerlinde; Nixdorf, Brigitte

    Süßwasserseen haben als ökosysteme und Lebensraum für Pflanzen und Tiere eine herausragende Bedeutung für die Artenvielfalt auf der Erde und prägen als Landschaftselemente unsere natürliche Umwelt. Seen fungieren als natürliche Stoffsenken, vor allem für Kohlenstoff und Nährstoffe, aber auch als Senken für in ihren Einzugsgebieten emittierte gelöste und feste Schadstoffe. Darüber hinaus ist Wasser eine wichtige Naturressource. Süßwasserseen stellen in den meisten Regionen der Erde lebenswichtige Quellen für die Versorgung mit Trinkwasser und tierischem Eiweiß (Fischfang) dar. Sie dienen als Wasserspeicher für die landwirtschaftliche und industrielle Nutzung. Auch für Erholungsaktivitäten des Menschen kommt ihnen eine große Bedeutung zu.

  14. Welt und Wirkungsprinzip (2nd Aufl.)

    NASA Astrophysics Data System (ADS)

    Landgraf, Werner

    2010-03-01

    Modell einer kausalen Bewirkung der Welt, und logische, geometrische, physikalische Interprätation dieser Kausalmenge und Fortwirkung der frühsten ihrer sukzessiv als echt Neues bewirkten und durch Vorhandenes oder Späteres nicht darstellbaren oder widerrufbaren Ereignisse als Dimensionen und sie verkörpernde primäre Naturkräfte, mit Korrespondenz zur beobachteten Welt und ihrer grundlegendsten Eigenschaften. Wirklich ist nur was wirkt, wo und wie. Entsprechend ist im Bogenelement statt der Eigenzeit die variante Anzahl Wirkungen relevant, 0 ≈ 1/h2 dS2 - 1/tpl2 (dt2 - 1/c2 {dq12 + G02/G2 [dq2,32 - ...]}) mit G0 = c4lpl/Epl ≈ G. Die heutigen Dimensionen und Naturkräfte entstanden in dieser Reihenfolge, haben 'komplementäre' aber gleichwertige statische und dynamische Aspekte, entsprechend ihren Termen in Bogenelement bzw. Vierervektor, aus derem Vergleich sowie mit denen ihrer Nachbarn folgen Grundgleichungen bzw. Erhaltungssätze. Jeweils individuelle Eigenschaften wie ihre Naturkonstante konkretisieren sie und tragen zu gattungsmäßigen wie globale Affinität und Äquivalenzen bei. Ältestes Gebiet oder räumlicher Rand jeder Dimension sind die ersten vom Vorgänger bewirkten Ereignisse, selbst raumzeitlicher Ursprung des Nachfolgers, dort einmalig und ewig maximal rotverschoben fortwirkend und nicht lokalisierbar, um neue Elementareinheiten verschieden und lichtartig mit deren Verhältnis oder dem ihrer globalen Zustandsgrößen als konstanten Anfangsimpuls, Expansion, Längen- oder Ereignisdichte zueinander. Der Übergang vom diskreten Modell weniger Informationen zum Kontinuum und die Korrespondenz zur Physik ist problemlos, Details wie ein kontinuierlicher, abrupter oder ganz fehlender Abfall der Metrik beim ältesten Gebiet sind aber nur durch Beobachtungen entscheidbar. Erörtert werden allgemeine und individuelle Eigenschaften und ihre Konsequenzen der Dimensionen mit ihren Kräften, selbst und im Verhältnis zueinander, etwa ihrer begrenzten

  15. Der neue Kosmos. Einführung in die Astronomie und Astrophysik

    NASA Astrophysics Data System (ADS)

    Unsöld, Albrecht; Baschek, Bodo

    Der neue Kosmos bietet in überschaubarem Umfang eine zusammenhängende Einführung in das Gesamtgebiet der Astronomie und Astrophysik. Aus den Bereichen: Klassische Astronomie und Planetensystem, Instrumente und Beobachtungsverfahren, Sonne und Sterne, Milchstraße und Galaxien, Kosmologie, Entstehung des Planetensystems, Entwicklung der Erde und des Lebens werden die Beobachtungsmethoden und die Ergebnisse astronomischer Forschung sowie deren theoretische Grundlagen und wechselseitigen Zusammenhänge vermittelt. Die aktualisierte 7. Auflage berücksichtigt den raschen Fortschritt astronomischer Forschung der letzten drei Jahre von unserem Planetensystem und den Entdeckungen zahlreicher Planeten bei anderen Sternen, über die fernsten Galaxien und Quasare bis zur Entwicklung der modernen Kosmologie.

  16. Mikrostrukturtechnik und Biomaterialien

    NASA Astrophysics Data System (ADS)

    Guber, Andreas E.; Saile, Volker; Weibezahn, Karl-Friedrich

    In der Biomedizintechnik zeichnet sich derzeit ein Trend zu einer verstärkten Miniaturisierung des operativen Instrumentariums und der Peripheriegeräte ab, da zur sicheren Durchführung vieler minimal invasiv auszuführender chirurgischer Eingriffe sehr kleine Instrumente und Zusatzgeräte benötigt werden. Weiterhin werden für verschiedene Anwendungen im Life-Sciences-Bereich, wie z. B. innerhalb der klinischen Diagnostik und der pharmazeutischen Chemie, in zunehmendem Masse Komponenten mit eingearbeiteten Mikrostrukturen benötigt. Mit den inzwischen verfügbaren mikrotechnischen Herstellungsverfahren (siehe Kapitel 40.2) ist man in der Lage, unterschiedliche geometrische Formen von kleinen dreidimensionalen Bauteilen und Baugruppen im Mikrometerbereich zu fertigen. Für spezielle Anwendungen können aber auch Strukturen im Bereich von einigen 100 nm erzeugt werden. Mikrostrukturierte Komponenten und Baugruppen können entweder in Form von Implantaten in den menschlichen Körper gelangen oder in extrakorporal einsetzbaren Geräten zum Einsatz kommen (siehe Kapitel 40.3). Dabei ist zwischen Kurzzeit- und Langzeitimplantaten zu unterscheiden. Typische Kurzzeitimplantate sind beispielsweise Operationsinstrumente während eines operativen Eingriffes und für kurze Zeiträume gelegte Spezialkatheter zur gezielten Entnahme von Körpersäften oder zur temporären Medikamentenapplikation. Zur Kategorie der Langzeitimplantate gehören beispielsweise auf Dauer eingesetzte Gefässendoprothesen (Stents), Herzschrittmacher, Cochleaimplantate, miniaturisierte Medikamentendosiersysteme auf Basis mikrofluidischer Baugruppen (Mikropumpen, Mikrokanäle, etc.), implantierbare Arrays von Mikroelektroden, welche innerhalb der Neurobionik verstärkt Anwendung finden werden, sowie in der Zukunft auch künstliche Organe.

  17. Abdichtungen im Verbund mit Fliesen und Platten

    NASA Astrophysics Data System (ADS)

    Platts, Thomas

    Abdichtungen im Verbund mit Fliesen und Platten, im Folgenden auch als Verbundabdichtungen oder mit Kurzzeichen als AIV bezeichnet, haben sich in der Baupraxis insbesondere in Innenräumen wegen des vereinfachten konstruktiven Aufbaus gegenüber Bahnenabdichtungen nach DIN 18195-5 [14.1] in der Mehrzahl der Ausführungen durchgesetzt und bewährt. Sie können im Innen- und Außenbereich angeordnet werden und sind dadurch gekennzeichnet, dass die Nutzschicht in Boden- und Wandbereichen im Dünnbettverfahren unmittelbar auf die Abdichtung aufgebracht wird. Aufwändige Zwischenschichten oder Einbauteile wie armierter Putz, Telleranker etc. entfallen (Bild 14.1) und es lassen sich geringere Aufbauhöhen realisieren.

  18. Pediatric Stroke

    MedlinePlus

    ... Trials News About Neurology Image Library Search The Internet Stroke Center Patients & Families About Stroke Stroke Diagnosis ... UT Southwestern Medical Center. Copyright © 1997-2016 - The Internet Stroke Center. All rights reserved. The information contained ...

  19. Ischemic Stroke

    MedlinePlus

    A stroke is a medical emergency. There are two types - ischemic and hemorrhagic. Ischemic stroke is the most common type. It is usually ... are at risk for having a more serious stroke. Symptoms of stroke are Sudden numbness or weakness ...

  20. Physik gestern und heute Von der Metallstange zum Hochenergielaser

    NASA Astrophysics Data System (ADS)

    Heering, Peter

    2002-05-01

    Im Mai 1752 wurde in Marly bei Paris auf Anregung des amerikanischen Forschers und Politikers Benjamin Franklin erstmals die elektrische Natur des Blitzes nachgewiesen. Damals beschrieb Franklin auch eine technische Vorrichtung, die als Schutz von Gebäuden vor Blitzschlägen dienen sollte: den Blitzableiter. Diese aus heutiger Sicht scheinbar triviale Vorrichtung wurde aber keineswegs unmittelbar akzeptiert. Und bis heute ist die Forschung zum Schutz von Einrichtungen vor Blitzschlägen nicht abgeschlossen.

  1. Newtons Universum. Materialien zur Geschichte des Kraftbegriffes.

    NASA Astrophysics Data System (ADS)

    Mit einem Vorwort von E. Seibold und einer Einführung von W. Neuser. This book is a selection of 15 articles published in the journal "Spektrum der Wissenschaft". The original English versions of the papers were first published in "Scientific American". Contents: 1. Impetustheorie und Intuition in der Physik (M. McCloskey). 2. Mittelalterliche Ursprünge der industriellen Revolution (T. S. Reynolds). 3. Leonardo da Vincis Beiträge zur theoretischen Mechanik (V. Foley, W. Soedel). 4. Nikolaus Kopernikus und Tycho Brahe (O. Gingerich). 5. Keplers Entdeckung der ersten beiden Planetengesetze (C. Wilson). 6. Galileis Entdeckung des Fallgesetzes (S. Drake). 7. Galileis Beobachtung des Neptun (S. Drake, C. T. Kowal). 8. Galileo Galilei und der Schatten des Giordano Bruno (L. S. Lerner, E. A. Gosselin). 9. Der Fall Galilei (O. Gingerich). 10. Newtons Apfel und Galileis "Dialog" (S. Drake). 11. Newtons Gravitationsgesetz - aus Formeln wird eine Idee (I. B. Cohen). 12. Christopher Wren: Astronom und Architekt (H. Dorn, R. Mark). 13. Atomismus und Kräfte in der Geschichte (L. Holliday). 14. Ein Elitezirkel vor 200 Jahren: Die Lunar Society von Birmingham (L. Ritchie-Calder). 15. Sadi Carnot: Technik und Theorie der Dampfmaschine (S. S. Wilson).

  2. Ischemic Stroke

    MedlinePlus

    ... Spread the Word Advocate Share Spread the Word Contact Us Contact Us 1-800-STROKES (787-6537) 9707 E. ... Stroke En Espanol Stroke Facts Come Back Strong Contact Us 1-800-787-6537 9707 E. Easter ...

  3. Stroke Rehabilitation

    MedlinePlus

    A stroke can cause lasting brain damage. People who survive a stroke need to relearn skills they lost because of ... them relearn those skills. The effects of a stroke depend on which area of the brain was ...

  4. Hemorrhagic Stroke

    MedlinePlus

    A stroke is a medical emergency. There are two types - ischemic and hemorrhagic. Hemorrhagic stroke is the less common type. It happens when ... an artery wall that breaks open. Symptoms of stroke are Sudden numbness or weakness of the face, ...

  5. Stroke - discharge

    MedlinePlus

    ... National Institute of Neurological Disorders and Stroke. Post-stroke rehabilitation fact sheet. Available at: www.ninds.nih.gov/disorders/stroke/poststrokerehab.htm . Accessed September 2, 2014. The American ...

  6. Grundlagen des Tissue Engineering

    NASA Astrophysics Data System (ADS)

    Mayer, Jörg; Blum, Janaki; Wintermantel, Erich

    Die Organtransplantation stellt eine verbreitete Therapie dar, um bei krankheitsoder unfallbedingter Schädigung eines Organs die Gesamtheit seiner Funktionen wieder herzustellen, indem es durch ein Spenderorgan ersetzt wird. Organtransplantationen werden für die Leber, die Niere, die Lunge, das Herz oder bei schweren grossflächigen Verbrennungen der Haut vorgenommen. Der grosse apparative, personelle und logistische Aufwand und die Risiken der Transplantationschirurgie (Abstossungsreaktionen) sowie die mangelnde Verfügbarkeit von immunologisch kompatiblen Spenderorganen führen jedoch dazu, dass der Bedarf an Organtransplantaten nur zu einem sehr geringen Teil gedeckt werden kann. Sind Spenderorgane nicht verfügbar, können in einzelnen Fällen lebenswichtige Teilfunktionen, wie beispielsweise die Filtrationsfunktion der Niere durch die Blutreinigung mittels Dialyse ersetzt oder, bei mangelnder Funktion der Bauchspeicheldrüse (Diabetes), durch die Verabreichung von Insulin ein normaler Zustand des Gesamtorganismus auch über Jahre hinweg erhalten werden. Bei der notwendigen lebenslangen Anwendung apparativer oder medikamentöser Therapie können für den Patienten jedoch häufig schwerwiegende, möglicherweise lebensverkürzende Nebenwirkungen entstehen. Daher werden in der Forschung Alternativen gesucht, um die Funktionen des ausgefallenen Organs durch die Implantation von Zellen oder in vitro gezüchteten Geweben möglichst umfassend wieder herzustellen. Dies erfordert biologisch aktive Implantate, welche die für den Stoffwechsel des Organs wichtigen Zellen enthalten und einen organtypischen Stoffwechsel entfalten.

  7. Dorfentwicklung und Dorferneuerung . Die neuen Bundesländer

    NASA Astrophysics Data System (ADS)

    Bender, Oliver; Richter, Horst P.

    1997-03-01

    Das 1975 in Kraft getretene Bundesraumordnungsprogramm forderte, in allen Landesteilen angemessene und gleichwertige Lebensbedingungen herzustellen. Mit der Novellierung des Flurbereinigungsgesetzes 1976 bzw. dem Zukunftsinvestitionsprogramm 1977 bis 1980 startete die Dorfentwicklung/Dorferneuerung nicht zuletzt als Initiative zur Konjunkturbelebung im ländlichen Raum. Seit 1984 ist sie Bestandteil der von Bund und Ländern getragenen Gemeinschaftsaufgabe "Verbesserung der Agrarstruktur und des Küstenschutzes" (GAK) und liegt im Zuständigkeitsbereich der Landwirtschaftsministerien. Die Dorferneuerungsprogramme der Länder werden aus Mitteln der GAK, der EU und des Landes finanziert. Neben Ortssanierungen nach dem Städtebauförderungsgesetz bzw. Baugesetzbuch stellen sie das wichtigste Instrument zur Förderung von ländlichen Orten und Gemeinden dar. Nach der Vereinigung wurde das Dorferneuerungsrecht auf die neuen Bundesländer übertragen, indem man sich zunächst an den Regelungen der jeweiligen Partnerländer im Westen orientierte. Doch hatten sich die Dörfer in Ost- und Westdeutschland nach dem Zweiten Weltkrieg völlig unterschiedlich entwickelt, so dass sich im Osten ein erweiterter Handlungsbedarf zeigte. Für Fachleute aus Politik, Verwaltung, Wissenschaft und freien Planungsberufen, nicht zuletzt für angewandt arbeitende Geographen, stellten sich neue Herausforderungen.

  8. Supraleitung und Interkontinentalraketen „On-line computing“ zwischen Militär, Industrie und Wissenschaft

    NASA Astrophysics Data System (ADS)

    Knolle, Johannes; Joas, Christian

    Der zweite Weltkrieg und der Kalte Krieg veränderten nicht nur das Verhältnis zwischen Militär, Industrie und Wissenschaft, sondern auch die wissenschaftliche Praxis von Physikern und anderen Wissenschaftlern. In den 1950er Jahren stellte die Entwicklung von Interkontinentalraketen die Auftragnehmer des Militärs in der Industrie vor komplexe Fragestellungen, zu deren Lösung sie auf die Expertise von Wissenschaftlern angewiesen waren. Industrieunternehmen gründeten eigene Forschungseinheiten zur Lösung technischer und wissenschaftlicher Probleme.

  9. Cryptogenic stroke

    PubMed Central

    Yaghi, Shadi

    2014-01-01

    Summary Cryptogenic, or unexplained, stroke is present in about 30%–40% of ischemic stroke patients. Pursuing a stroke mechanism is important in such patients to better choose therapy to reduce the stroke recurrence risk. Intracranial vessel imaging and cardiac evaluation with transesophageal echocardiogram and outpatient cardiac monitoring may help identify the stroke mechanism. This article highlights the diagnostic yield of various tests in identifying a stroke mechanism in stroke patients whose initial diagnostic evaluation is negative, and the implications for treatment. PMID:25317376

  10. Ökologische Grundlagen und limitierende Faktoren der Renaturierung

    NASA Astrophysics Data System (ADS)

    Rosenthal, Gert; Eichberg, Carsten

    In den dicht besiedelten und agrarisch besonders intensiv genutzten Regionen Mittel- und Westeuropas ist seit Ende des Zweiten Weltkrieges ein fortschreitender Verlust an naturnahen ökosystemen mit hoher biologischer Vielfalt zu verzeichnen. Spätestens seit den 1970er-Jahren ist daher die Neuschaffung und Wiederherstellung gefährdeter Lebensräume und Biozönosen zunehmend in den Mittelpunkt von Naturschutzmaßnahmen gerückt (Bakker 1989, Muller et al. 1998, Bakker und Berendse 1999). Aufgrund fehlender wissenschaftlicher Grundlagen und praktischer Erfahrungen wurden Renaturierungsmaßnahmen anfangs fast durchweg nach dem trial and error-Prinzip durchgeführt. Im Vordergrund standen dabei zunächst die Wiederherstellung adäquater abiotischer Standortbedingungen sowie die Reorganisation traditioneller Nutzungsmanagements. Bei Ersterem ging es neben der Wiedervernässung entwässerter Feuchtgebiete (Pfadenhauer und Grootjans 1999) vor allem darum, Eutrophierungseffekte zu beseitigen und die Produktivität des Standortes auf das Niveau der Zielgemeinschaft zurückzuführen (Gough und Marrs 1990, Oomes et al. 1996, Snow et al. 1997, Tallowin et al. 1998).

  11. S1-Leitlinie zur UV-Phototherapie und Photochemotherapie.

    PubMed

    Herzinger, Thomas; Berneburg, Mark; Ghoreschi, Kamran; Gollnick, Harald; Hölzle, Erhard; Hönigsmann, Herbert; Lehmann, Percy; Peters, Thorsten; Röcken, Martin; Scharffetter-Kochanek, Karin; Schwarz, Thomas; Simon, Jan; Tanew, Adrian; Weichenthal, Michael

    2016-08-01

    Die heilsame Wirkung des Sonnenlichts war teilweise schon im Altertum bekannt und fand in der zweiten Hälfte des 19. Jahrhunderts wieder zunehmend Beachtung. Den Beginn der modernen Phototherapien markiert die Entwicklung einer Apparatur zur ultravioletten Bestrahlung der Hauttuberkulose durch Finnsen zu Beginn des zwanzigsten Jahrhunderts. Zur Therapie von Hauterkrankungen finden beinahe ausschließlich die spektralen Bereiche unterhalb des sichtbaren Lichtes (ultraviolett) Anwendung. Seit den 1970er Jahren stehen zunehmend leistungsfähige künstliche Strahlenquellen bereit für die Therapie mit UVB, UVA und die Kombination von UVA mit Photosensibilisatoren (Photochemotherapie). Hohe strukturelle und prozedurale Qualitätsstandards sind unabdingbare Voraussetzung für die Durchführung einer gleichermaßen wirkungsvollen wie auch sicheren Phototherapie. Die Leitlinie formuliert den aktuellen Konsens führender Experten auf dem Gebiet der Phototherapie in Bezug auf die Indikationen für die jeweiligen Therapieverfahren, deren Gegenanzeigen und Nebenwirkungen und insbesondere für die Wahl der korrekten Dosis zu Beginn und im Verlauf einer Therapie sowie das Management von Nebenwirkungen. PMID:27509439

  12. [Cerebellar stroke].

    PubMed

    Paradowski, Michał; Zimny, Anna; Paradowski, Bogusław

    2015-01-01

    Cerebellar stroke belongs to a group of rare diseases of vascular origin. Cerebellum, supplied by three pairs of arteries (AICA, PICA, SCA) with many anastomoses between them is less susceptible for a stroke, especially ischemic one. Diagnosis of the stroke in this region is harder due to lower sensibility of commonly used CT of the head in case of stroke suspicion. The authors highlight clinical symptoms distinguishing between vascular territories or topographical locations of the stroke, diagnostic procedures, classical and surgical treatment, the most common misdiagnoses are also mentioned. The authors suggest a diagnostic and therapeutic algorithm development, including rtPA treatment criteria for ischemic cerebellar stroke. PMID:26181157

  13. Entwicklungsperspektiven von Social Software und dem Web 2.0

    NASA Astrophysics Data System (ADS)

    Raabe, Alexander

    Der Artikel beschäftigt sich zunächst mit dem derzeitigen und zukünftigen Einsatz von Social Software in Unternehmen. Nach dem großen Erfolg von Social Software im Web beginnen viele Unternehmen eigene Social Software-Initiativen zu entwickeln. Der Artikel zeigt die derzeit wahrgenommenen Einsatzmöglichkeiten von Social Software im Unternehmen auf, erörtert Erfolgsfaktoren für die Einführung und präsentiert mögliche Wege für die Zukunft. Nach der Diskussion des Spezialfalles Social Software in Unternehmen werden anschließend die globalen Trends und Zukunftsperspektiven des Web 2.0 in ihren technischen, wirtschaftlichen und sozialen Dimensionen dargestellt. Wie aus den besprochenen Haupttrends hervorgeht, wird die Masse an digital im Web verfügbaren Informationen stetig weiterwachsen. So stellt sich die Frage, wie es in Zukunft möglich sein wird, die Qualität der Informationssuche und der Wissensgenerierung zu verbessern. Mit dem Einsatz von semantischen Technologien im Web wird hier eine revolutionäre Möglichkeit geboten, Informationen zu filtern und intelligente, gewissermaßen verstehende" Anwendungen zu entwerfen. Auf dem Weg zu einem intelligenten Web werden sich das Semantic Web und Social Software annähern: Anwendungen wie Semantic Wikis, Semantic Weblogs, lightweight Semantic Web-Sprachen wie Microformats oder auch kommerzielle Angebote wie Freebase von Metaweb werden die ersten Vorzeichen einer dritten Generation des Webs sein.

  14. Know Stroke

    MedlinePlus

    ... Director, National Institute of Neurological Disorders and Stroke Photo courtesy of NIH/NINDS Welcome to this special section on stroke, the third leading cause of death in the United States. Each year, there are more than 700, ...

  15. Pediatric Stroke

    PubMed Central

    Jeong, Goun; Lim, Byung Chan

    2015-01-01

    Pediatric stroke is relatively rare but may lead to significant morbidity and mortality. Along with the advance of brain imaging technology and clinical awareness, diagnosis of pediatric stroke is increasing wordwide. Pediatric stroke differs from adults in variable risk factor/etiologies, diverse and nonspecific clinical presentation depending on ages. This review will be discussed pediatric stroke focusing on their clinical presentations, diagnosis and etiologies/risk factors. PMID:26180605

  16. „Überholen ohne einzuholen“ Die Entwicklung von Technologien für übermorgen in Kernenergie und Mikroelektronik der DDR

    NASA Astrophysics Data System (ADS)

    Barkleit, Gerhard

    Dem nuklearen Patt zwischen Ostblock und westlichem Staatenbündnis ist es nach weitgehend übereinstimmender Auffassung von Politik und Wissenschaft zu danken, dass der "Kalte Krieg" in der zweiten Hälfte des 20. Jahrhunderts nicht zum weltumfassenden Flächenbrand eskalierte. An der raschen Herstellung dieses Patts waren zwei Dresdner Physiker maßgeblich beteiligt, deren einer im Manhattan-Projekt in den USA gearbeitet hatte und später in England der Spionage für die Sowjetunion und des Verrats des Know-how der Atombombe überführt wurde.

  17. Tycho Brahe - Instrumentenbauer und Meister der Beobachtungstechnik

    NASA Astrophysics Data System (ADS)

    Wolfschmidt, Gudrun

    Vor der Erfindung des Fernrohrs war der dänische Astronom Tycho Brahe (1546 - 1601) der bedeutendste beobachtende Astronom. Von seinem Observatorium Uraniborg auf der - damals dänischen - Insel Hven ist heute noch der Grundriß erkennbar, von Stjerneborg sind die Fundamente erhalten, die Kuppeln in den 1950er Jahren ergänzt. In der Astronomie-Ausstellung im Deutschen Museum gibt es ein Modell der Sternwarte Uraniborg und der zugehörigen Instrumente (Maßstab 1:10); das größere Modell wurde dem Technischen Museum in Malmö geschenkt. Die Instrumente, die er in den Observatorien Uraniborg und Stjerneborg benutzte, sind nicht erhalten. Aber es gibt gute Beschreibungen der Instrumente (Halbkreis, Quadranten, Sextanten, Armillarsphären, Triquetrum, Himmelsglobus) in seinem Buch Astronomiae instauratae mechanica (Wandsbek 1598). Eine Nachbildung des großen hölzernen Quadranten kann man im Runden Turm in Kopenhagen sehen. Zwei Sextanten, hergestellt für Tycho um 1600 von Jost Bürgi und Erasmus Habermel, gibt es noch im Nationalmuseum für Technik in Prag. Ähnlichkeiten von Tychos Instrumenten mit Groß-Instrumenten aus dem islamischen Kulturkreis sind auffällig. Tycho Brahes Meßgeräte markieren einen großen Fortschritt in der Entwicklung astronomischer Instrumente und Meßtechniken und bilden die Grundlage für den weiteren Fortschritt der Positionsastronomie und der damit verbundenen Tabellenwerke. Die Nachwirkungen sind bis ins 17. und 18. Jahrhundert nachweisbar.

  18. Zahlen und Rechenvorgänge auf unterschiedlichen Abstraktionsniveaus

    NASA Astrophysics Data System (ADS)

    Rödler, Klaus

    "Das Verständnis geht langsam vor sich!" Diesen wichtigen Satz hörte ich bei einem Vortrag von Martin Lowsky. Auf die hier behandelte Fragestellung übertragen heißt das: Was eine Zahl ist und wie ich sie im Rechenvorgang einsetzen und interpretieren kann, das erschließt sich erst allmählich. Die Zahl des Rechenanfängers ist nicht dieselbe wie die des kompetenten Rechners und es ist nicht die Zahl des Lehrers oder der Lehrerin. Die Zahlen sind nur auf der Oberfläche der Worte und Zeichen gleich. Im Innern, im Verständnis, sind sie völlig verschieden! Ich glaube, dass die Missachtung dieser Divergenz dazu führt, dass manche Kinder in für den Lehrer und Lehrerin nicht nachvollziehbaren Routinen stecken bleiben, einfachste Informationen nicht wirklich integrieren. Die auf beiden Seiten wachsende Verunsicherung durch die nicht erkannte und daher nicht kommunizierbare Diskrepanz im inneren Zahlkonzept stört den allmählichen Aufbau strukturierter Zahlvorstellungen.

  19. [Leben im Eismeer - Tauchuntersuchungen zur Biologie arktischer Meerespflanzen und Meerestiere

    PubMed

    Lippert; Karsten; Wiencke

    2000-01-01

    Die Maske wird nochmals auf Dichtigkeit überprüft, der Knoten der Sicherungsleine mit zwei halben Schlägen fixiert, dann rutscht die Taucherin von der Eiskante in das kalte Wasser. Eine halbe Stunde vergeht, bevor ihr Kopf wieder aus dem Eisloch auftaucht und sie ein großes Sammelnetz nach oben reicht, gefüllt mit verschiedenen Arten von Makroalgen. Obwohl noch große Flächen des Kongsfjordes im arktischen Spitzbergen zugefroren sind und das Festland von einer dicken Schneedecke bedeckt ist, hat unter Wasser in den Algenwäldern bereits der Sommer und damit die Saison der Meeresbiologen begonnen.

  20. Recovering after stroke

    MedlinePlus

    Stroke rehabilitation; Cerebrovascular accident - rehabilitation; Recovery from stroke; Stroke - recovery; CVA - recovery ... LIVE AFTER A STROKE Most people will need stroke rehabilitation (rehab) to help them recover after they leave ...

  1. Stroke Warning Signs

    MedlinePlus

    ... News Advocate Stroke Warning Signs Quiz Stroke Warning Signs and Symptoms THINK YOU ARE HAVING A STROKE? ... Learn more stroke signs and symptoms >>>> Stroke Warning Signs Hip-Hop F.A.S.T. Video Updated Guidelines ...

  2. Branchen und Unternehmensbereiche

    NASA Astrophysics Data System (ADS)

    Kramer, Regine

    Dieses Kapitel gibt einen Überblick über die Haupteinsatzgebiete von Mathematikern, Informatikern, Naturwissenschaftlern und Ingenieuren in den wichtigsten Wirtschaftsbranchen und Unternehmensbereichen. Dabei werden ausbildungsnahe Aufgabenbereiche ebenso beschrieben wie eher fachferne Tätigkeiten und neben den klassischen Branchen und Berufsbildern auch neue Tätigkeitsfelder für MINT-Fachkräfte beschrieben.

  3. Chaos für die Schule!: Nichtlinearität und Strukturbildung

    NASA Astrophysics Data System (ADS)

    Nordmeier, Volkhard; Schlichting, Hans Joachim

    2003-01-01

    Modellsysteme können Schülern die Grundlagen der nichtlinearen Physik anschaulich vermitteln. Sie schlagen so einen Bogen von der Schulphysik zur aktuellen Forschung. Ein solches Modellsystem ist das chaotische Wasserrad, das Lehrer auf einfache Weise für den Schulunterricht nachbauen können. Im Wesentlichen steuert der Zufluss des Wassers das Verhalten des Wasserrads. Wächst er, so durchläuft das Rad von der geordneten, gleichförmigen Drehung bis zum Chaos verschiedene Phasen von Bewegungsfiguren. Das Experiment kann grundlegende Modelle und Begriffe der Chaostheorie demonstrieren: lokale und globale Bifurkationen und verschiedene Übergänge ins Chaos.

  4. Ischemic Stroke.

    PubMed

    Capriotti, Teri; Murphy, Teresa

    2016-05-01

    Each year, more than 795,000 people in the United States suffer a stroke and by 2030, it is estimated that 4% of the U.S. population will have had a stroke. Home healthcare clinicians will be increasingly called upon to assist stroke survivors and their caregivers adjust to disability and assist the survivor during their reintegration into the community. Therapeutic modalities are changing with advanced technology. Great strides are being made in the treatment of acute stroke; particularly endovascular interventions. More patients are surviving the acute stroke event and therefore will need to learn how to live with various degrees of disability. It is important for home healthcare clinicians to understand the process from acute event to medical stabilization, and from rehabilitation to long-term adaptation.

  5. Ischemic Stroke.

    PubMed

    Capriotti, Teri; Murphy, Teresa

    2016-05-01

    Each year, more than 795,000 people in the United States suffer a stroke and by 2030, it is estimated that 4% of the U.S. population will have had a stroke. Home healthcare clinicians will be increasingly called upon to assist stroke survivors and their caregivers adjust to disability and assist the survivor during their reintegration into the community. Therapeutic modalities are changing with advanced technology. Great strides are being made in the treatment of acute stroke; particularly endovascular interventions. More patients are surviving the acute stroke event and therefore will need to learn how to live with various degrees of disability. It is important for home healthcare clinicians to understand the process from acute event to medical stabilization, and from rehabilitation to long-term adaptation. PMID:27145407

  6. Der Physik-Nobelpreis vor 100 Jahren Die Entdeckung des trägen Gases

    NASA Astrophysics Data System (ADS)

    Jacobi, Manfred

    2004-11-01

    Im Jahr 1904 erhielt der britische Physiker Lord Rayleigh (John William Strutt, 1842 bis 1919) den Nobelpreis für seine Untersuchungen über die Dichte von Gasen und die Entdeckung des Edelgases Argon.

  7. Automatische Lokalisation und hämodynamische Charakterisierung von Gefäßstrukturen bei arteriovenösen Malformationen

    NASA Astrophysics Data System (ADS)

    Forkert, Nils Daniel; Säring, Dennis; Fiehler, Jens; Illies, Till; Handels, Heinz

    Im Beitrag werden Verfahren zur automatischen Detektion des Kerns der Arteriovenösen Malformation (AVM) sowie der zuleitenden (Feeder), ableitenden (Drainagevenen) und en passge" Blutgef äße präsentiert. Als Eingabe hierfür dienen hochaufgelöste 3D- sowie zeitlich-räumliche 4D-MRT-Bildsequenzen. Durch eine kombinierte Analyse der Intensität, der Geschwindigkeit und des relativen Einflusszeitpunktes des Blutes werden Gefäßstrukturen automatisch charakterisiert. Die vorgestellte Methode zur Detektion des Kerns wurde anhand von manuellen Segmentierungen validiert und ergab eine mittlere Volumen- übereinstimmung von ca. 88%. Drainagevenen und Feeder konnten mit einer Genauigkeit von 95% detektiert werden.

  8. Stroke pharmacogenomics.

    PubMed

    Billeci, Antonia M R; Agnelli, Giancarlo; Caso, Valeria

    2009-12-01

    Circulatory disease accounts for fifteen million deaths each year, of which stroke accounts for four and a half million- with an estimated nine million stroke survivors annually. The overall incidence rate of stroke is 2 to 2.5 per thousand adults with an approximate prevalence of 5 per thousand and an estimated 5-year risk of stroke recurrence of 15 to 40 percent. Conventional risk factors for stroke include: increasing age, hypertension, diabetes mellitus, smoking, increased body mass index, ischemic heart disease, heart failure, atrial fibrillation and lack of physical activity. Age is the strongest risk factor for both ischemic and haemorrhagic stroke with its incidence doubling for each successive decade after the age of fifty-five years. However, there is a substantial portion of patients with significant cerebrovascular disease who do not have any of these stroke risk-factors, leading to the speculation that there are other factors that have not been identified yet So as to improve diagnosis and treatment strategies, as well as to reduce the related public health burden, it could be helpful to successfully identify its extremely complex genetic determinants (polygenic, multiple genes play a role). Pharmacogenetics is the field of pharmacology that deals with the influence of genetic variation on drug response by correlating gene expression and gene variants with the efficacy or toxicity of drugs. The principle drugs in stroke medicine are antithrombotics. The aim of this paper was to review the most commonly used drugs for stroke such as rtPA in the acute phase as well as antiplatelets and wafarin for secondary prophylaxis. PMID:19925046

  9. Diagnose und Therapie einer Depression im höheren Lebensalter – Einflüsse von Patienten- und Arztmerkmalen

    PubMed Central

    von dem Knesebeck, Olaf; Bönte, Markus; Siegrist, Johannes; Marceau, Lisa; Link, Carol; McKinlay, John

    2013-01-01

    Zusammenfassung Studienergebnissee aus dem englischsprachigen Raum zeigen, dass diagnostische und therapeutische Entscheidungen von Hausärzten bei der Versorgung von depressiven Patienten systematischen Einflüssen unterliegen, und dass sowohl Merkmale des Arztes als auch des Patienten unabhängig vom Krankheitsbild Einfluss auf diese Entscheidungen haben. In der vorliegenden Arbeit werden Ergebnisse einer deutschen Studie präsentiert, in der die Einflüsse von Patienten- und Arztmerkmalen auf diagnostische und therapeutische ärztliche Entscheidungen bei einer Depression untersucht wurden. Unter Anwendung eines faktoriellen Experimentaldesigns spielten professionelle Schauspieler in Videofilmen die Rolle von Patienten, die Symptome für eine depressive Erkrankung äußern. In den Videofilmen, die alle auf einem identischen Skript basieren, wurden systematisch die Patientenmerkmale Alter (55 vs. 75 Jahre), Geschlecht und sozialer Status (Hausmeister vs. Lehrer) variiert. Die randomisierte Ärztestichprobe wurde nach dem Arztgeschlecht und professioneller Erfahrung (< 5 vs. > 15 Jahre) geschichtet. Der Videofilm wurde insgesamt 128 niedergelassenen Ärzten für Allgemeinmedizin und hausärztlich tätigen Internisten in ihrer Praxis vorgespielt. Danach wurden die Ärzte zu unterschiedlichen Aspekten von Diagnose und Therapie befragt. Es wurde erhoben, ob der Arzt dem Patienten über das gezeigte Gespräch hinausgehende Fragen stellen würde, welche Diagnosen er für wahrscheinlich hält, wie sicher er sich mit seiner Diagnose ist, welche diagnostischen Tests er anordnen würde, ob er den Patienten überweisen würde oder ob er Medikamente verordnen oder ihm Empfehlungen zur Änderung seines Lebensstils geben würde. Die Ergebnisse weisen darauf hin, dass sowohl die Diagnose als auch die Therapie einer Depression durch niedergelassene Hausärzte in Deutschland nur geringfügig durch die untersuchten Merkmale der Patienten und der behandelnden Ärzte beeinflusst wird

  10. Sticktechnologie für medizinische Textilien und Tissue Engineering

    NASA Astrophysics Data System (ADS)

    Karamuk, Erdal; Mayer, Jörg; Wintermantel, Erich

    Textile Strukturen werden in grossem Ausmass als medizinische Implantate eingesetzt, um Weich- und Hartgewebe zu unterstützen oder zu ersetzen. Im Tissue Engineering gewinnen sie an Bedeutung als scaffolds, um biologische Gewebe in vitro zu züchten für anschliessende Implantation oder extrakorporale Anwendungen. Textilien sind gewöhnlich anisotrope zweidimensionale Strukturen mit hoher Steifigkeit in der Ebene und geringer Biegesteifigkeit. Durch eine Vielzahl textiler Prozesse und durch entsprechende Wahl des Fasermaterials ist es möglich, Oberfläche, Porosität und mechanische Anisotropie in hohem Masse zu variieren. Wegen ihrer einzigartigen strukturellen und mechanischen Eigenschaften können faserbasierte Materialien in weitem Masse biologischem Gewebe nachgeahmt werden [1]. Gesticke erweitern das Feld von technischen und besonders medizinischen Textilien, denn sie vereinen sehr hohe strukturelle Variabilität mit der Möglichkeit, mechanische Eigenschaften in einem grossen Bereich einzustellen, um so die mechanischen Anforderungen des Empfängergewebes zu erfüllen (Abb. 42.1).

  11. Stroke - risk factors

    MedlinePlus

    Preventing stroke; Stroke - prevention; CVA - prevention; TIA - prevention ... Biology; Council on Hypertension. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from ...

  12. Stroke Treatments

    MedlinePlus

    ... weakened blood vessels that also cause hemorrhagic stroke: aneurysms and arteriovenous malformations (AVMs). Treatment differs depending on ... the leg or arm, then guided to the aneurysm or AVM ; it then deposits a mechanical agent, ...

  13. Information und Kommunikation

    NASA Astrophysics Data System (ADS)

    Wesoly, Michael; Ohlhausen, Peter; Bucher, Michael; Hichert, Rolf; Korge, Gabriele; Schnabel, Ulrich; Gairola, Arun; Reichwald, Ralf; Habicht, Hagen; Möslein, Kathrin; Schwarz, Torsten; Schönsleben, Paul; Scherer, Eric; Schloske, Alexander; Adlbrecht, Gerald; Federhen, Jens

    Wissen ist mittlerweile unverzichtbar für den entscheidenden Vorsprung auf dem Markt. Unabhängig davon, ob sich das Wissen in Innovationen, neuen Produkten und Dienstleistungen oder in der Verbesserung interner Unternehmensprozesse manifestiert: Wissen ist Treiber von Innovation, Wissen bringt Schnelligkeit und Wissen ist die Voraussetzung für Problemlösungen [40]. Wissensmanagement ist daher der Schlüssel für Unternehmenserfolg und bezeichnet den "bewussten und systematischen Umgang mit der Ressource Wissen und den zielgerichteten Einsatz von Wissen in der Organisation“ [6]. In dieser umfassenden Sichtweise ist Wissensmanagement ein Begriff, der Konzepte, Strategien und Methoden umfasst.

  14. Satellitengeodäsie und Langbasis-Interferometrie auf der Fundamentalstation Wettzell. Kolloquiumsvorträge anläßlich des 60sten Geburtstages von Prof. Manfred Schneider.

    NASA Astrophysics Data System (ADS)

    Ilk, K.-H.

    Contents: Die krumme Geodäte (H. Ruder, M. Ruder). Zur Geschichte der Fundamentalstation Wettzell (H. Seeger et al.). Newtons Philosophiae naturalis principia mathematica (M. Schramm). Von Newton zu Einstein (M. H. Soffel). Geodäsie und Physik (S. Heitz). Erdbebenvorhersage mit SEISMOLAP (J. Zschau).

  15. Healthy Living after Stroke

    MedlinePlus

    ... After Stroke Weight Training After Stroke Tips for Improving Fine Motor Skills Functional Tone Management Arm Training Program Constraint-Induced Movement Therapy Emotional & Behavioral Challenges Self-Esteem after Stroke Post-Stroke Mood Disorders One-side ...

  16. Lymph- und Immunsystem

    NASA Astrophysics Data System (ADS)

    Perry, Steven F.

    Alle Lebewesen müssen sich gegen Eindringlinge wehren. Ihre Abwehrmechanismen wirken auf verschiedenen Ebenen, von übergeordneten Feindvermeidungsstrategien und Putzverhalten bis hin zu molekularen Erkennungs- und Tötungsmechanismen. Da Eindringlinge über Kontaktflächen mit der Außenwelt, wie z.B. Körperoberfläche, Darmwand und Atmungsoberflächen, in den Organismus gelangen, sind an diesen Stellen immer primäre Abwehrmechanismen zu finden. Dazu zählen (1) Schleimabsonderung (Schleimhäute bei allen Schädeltieren, Fischkiemen, epidermale Schleimdrüsen (Fische, Amphibien)), (2) Stoffwechselgifte und antibakteriell wirkende Substanzen in der Haut (Fische, Amphibien) und im Speichel (Amnioten), (3) Flimmerepithelien zum Abtransport von Eindringlingen und (4) starke Keratinbildung in der mehrschichtigen Epidermis und schützende Strukturen wie Schuppen, Federn und Haare (Amnioten) (S. 20). Auch die starke Säurebildung im Magen kann als Schutz gegen Eindringlinge betrachtet werden.

  17. Peter Andreas Hansen and the astronomical community - a first investigation of the Hansen papers. (German Title: Peter Andreas Hansen und die astronomische Gemeinschaft - eine erste Auswertung des Hansen-Nachlasses. )

    NASA Astrophysics Data System (ADS)

    Schwarz, Oliver; Strumpf, Manfred

    The literary assets of Peter Andreas Hansen are deposited in the Staatsarchiv Hamburg, the Forschungs- und Landesbibliothek Gotha and the Thüringer Staatsarchiv Gotha. They were never systematically investigated. We present here some results of a first evaluation. It was possible to reconstruct the historical events with regard to the maintenance of the Astronomische Nachrichten and the Altona observatory in 1854. Hansen was a successful teacher for many young astronomers. His way of stimulating the evolution of astronomy followed Zach's tradition.

  18. Herschel und die Zukunft der Fern-Infrarot-Astronomie

    NASA Astrophysics Data System (ADS)

    Linz, Hendrik

    2015-06-01

    Schon lange ist die beobachtende Astronomie den engen Grenzen des optisch Sichbaren entwachsen und hat fast alle Bereiche des elektromagnetischen Spektrums für sich dienstbar gemacht. Im sogenannten nahen und mittleren Infrarot (Wellenlängen zwischen 1-30 μm) sowie im Millimeter- und Radio-Regime (Wellenlängen zwischen 1 mm und 10 m) ist die Erdatmosphäre relativ gut durchlässig für elektromagnetische Signale oder hat zumindest eine Vielzahl von spektral begrenzten Transmissionsfenstern, die astronomische Beobachtungen zumindest von höheren Bergen aus möglich machen. Allerdings ist das sogenannte Ferne Infrarot (FIR, 30-300 μm Wellenlänge) von der Erde aus fast völlig unzugänglich für astronomische Beobachtungen. Selbst für die besten Beobachtungsplätze der Erde bleibt die atmosphärische Transmission durch die immense Wasserdampf- Absorption auf ein absolutes Minimum beschränkt. Jedoch erlaubt uns das FIR Zugang zu Informationen, die sehr nützlich sind für die astrophysikalische Forschung und komplementär zu anderen Wellenlängen-Bereichen.

  19. Preventing stroke

    MedlinePlus

    ... may ask you to keep track of your blood pressure at home . You should lower it and control it with a healthy diet, exercise, and by taking medicines your health care provider ... the chance of blood clots, which can lead to stroke. Clots are ...

  20. Haptische Modellierung und Deformation einer Kugelzelle

    NASA Astrophysics Data System (ADS)

    Schippritt, Darius; Wiemann, Martin; Lipinski, Hans-Gerd

    Haptische Simulationsmodelle dienen in der Medizin in erster Linie dem Training operativer Eingriffe. Sie basieren zumeist auf physikalischen Gewebemodellen, welche eine sehr genaue Simulation der biomechanischen Eigenschaften des betreffenden Gewebes erlauben, aber gleichzeitig sehr rechenintensiv und damit zeitaufwändig in der Ausführung sind. Die menschliche Wahrnehmung kann allerdings auch eine ungenaue haptische Modellierung psychooptisch ausgleichen. Daher kann es sinnvoll sein, haptische Simulationen auch mit nicht vollständig physikalisch definierten Deformationsmodellen durchzuführen. Am Beispiel der haptischer Simulation einer in-vitro Fertilisation wird gezeigt, dass durch die Anwendung eines geometrischen Deformationsmodells eine künstliche Befruchtung unter realistischen experimentellen Bedingungen in Echtzeit haptisch simuliert und damit trainiert werden kann.

  1. Biochips und ihr Einsatz in der Lebensmittelanalytik

    NASA Astrophysics Data System (ADS)

    Huber, Ingrid; Zeltz, Patric

    Mit der Verbreitung des Begriffes "Biochip“ in den biotechnologischen Medien wurde Ende der 1990er-Jahre zunächst der Eindruck erweckt, dass die Computerelektronik in die molekularbiologischen Anwendungen eingestiegen ist [18]. In nur wenigen Jahren hat sich die Biochiptechnologie zu einem Verfahren entwickelt, das aus der molekularbiologischen Grundlagenforschung nicht mehr wegzudenken ist und über eine Vielzahl von Einsatzbereichen verfügt. Die Biochiptechnologie ermöglicht die Miniaturisierung von DNA-, RNA- bzw. Proteinanalytik in hochparallelen Formaten. Dieser hohe Parallelisierungsgrad ist einer der wesentlichen Vorteile dieser Technik gegenüber klassischen molekularbiologischen Methoden. Sie wird heutzutage vor allem in der Genomforschung eingesetzt, für Genexpressionsstudien, zum Screening von single nucleotide polymorphisms (SNPs), in der pharmakogenetischen Forschung sowie in der Erforschung von Erbkrankheiten und in der Krebsforschung [1, 7, 19]. Neben vielen weiteren Bereichen finden Biochips auch spezielle Anwendungen in der Lebensmittelanalytik.

  2. Reflexionseigenschaften von Windenergieanlagen im Funkfeld von Funknavigations- und Radarsystemen

    NASA Astrophysics Data System (ADS)

    Sandmann, S.; Divanbeigi, S.; Garbe, H.

    2015-11-01

    Die hier behandelte Untersuchung befasst sich mit den Störungen des elektrischen Feldes einer Doppler Very High Frequency Omnidirectional Radio Range Navigationsanlage (DVOR) in der Gegenwart von Windenergieanlagen (WEA). Hierfür wird die Feldstärke auf 25 konzentrischen Kreisbahnen, sog. Orbit Flights verschiedener Höhen und mit verschiedenen Radien rund um die DVOR-Anlage numerisch simuliert. Insbesondere werden die Einflüsse diverser Parameter der WEA wie deren Anzahl, Position, Rotorwinkel, Turmhöhe und Rotordurchmesser auf die Feldverteilung herausgestellt, sowie die Anwendbarkeit der Simulationsmethode Physical Optics (PO) durch Vergleich der Simulationsergebnisse mit denen der Multi Level Fast Multipol Method (MLFMM) untersucht.

  3. Herstellung von Chitosan und einige Anwendungen

    NASA Astrophysics Data System (ADS)

    Struszczyk, Marcin Henryk

    2001-05-01

    1. Die Deacetylierung von crabshell - Chitosan führte gleichzeitig zu einem drastischen Abfall der mittleren viscosimetrischen Molmasse ( Mv), insbesondere wenn die Temperatur und die Konzentration an NaOH erhöht werden. Diese Parameter beeinflussten jedoch nicht den Grad der Deacetylierung (DD). Wichtig ist jedoch die Quelle des Ausgangsmaterials: Chitin aus Pandalus borealis ist ein guter Rohstoff für die Herstellung von Chitosan mit niedrigem DD und gleichzeitig hoher mittlerer Mv, während Krill-Chitin (Euphausia superba) ein gutes Ausgangsmaterial zur Herstellung von Chitosan mit hohem DD und niedrigem Mv ist. Chitosan, das aus Insekten (Calliphora erythrocephala), unter milden Bedingungen (Temperatur: 100°C, NaOH-Konzentration: 40 %, Zeit: 1-2h ) hergestellt wurde, hatte die gleichen Eigenschaften hinsichtlich DD und Mv wie das aus Krill hergestellte Chitosan. Der Bedarf an Zeit, Energie und NaOH ist für die Herstellung von Insekten-Chitosan geringer als für crabshell-Chitosan vergleichbare Resultaten für DD und Mv. 2. Chitosan wurde durch den Schimmelpilz Aspergillus fumigatus zu Chitooligomeren fermentiert. Die Ausbeute beträgt 25%. Die Chitooligomere wurden mit Hilfe von HPLC und MALDI-TOF-Massenspektrmetrie identifiziert. Die Fermentationsmischung fördert die Immunität von Pflanzen gegen Bakterien und Virusinfektion. Die Zunahme der Immunität schwankt jedoch je nach System Pflanze-Pathogen. Die Fermentation von Chitosan durch Aspergillus fumigatus könnte eine schnelle und billige Methode zur Herstellung von Chitooligomeren mit guter Reinheit und Ausbeute sein. Eine partiell aufgereinigte Fermentationsmischung dieser Art könnte in der Landwirtschaft als Pathogeninhibitor genutzt werden. Durch kontrollierte Fermentation, die Chitooligomere in definierter Zusammensetzung (d.h. definierter Verteilung des Depolymerisationsgrades) liefert, könnte man zu Mischungen kommen, die für die jeweilige Anwendung eine optimale Bioaktivität besitzen. 3

  4. Stroke rehabilitation.

    PubMed

    Langhorne, Peter; Bernhardt, Julie; Kwakkel, Gert

    2011-05-14

    Stroke is a common, serious, and disabling global health-care problem, and rehabilitation is a major part of patient care. There is evidence to support rehabilitation in well coordinated multidisciplinary stroke units or through provision of early supported provision of discharge teams. Potentially beneficial treatment options for motor recovery of the arm include constraint-induced movement therapy and robotics. Promising interventions that could be beneficial to improve aspects of gait include fitness training, high-intensity therapy, and repetitive-task training. Repetitive-task training might also improve transfer functions. Occupational therapy can improve activities of daily living; however, information about the clinical effect of various strategies of cognitive rehabilitation and strategies for aphasia and dysarthria is scarce. Several large trials of rehabilitation practice and of novel therapies (eg, stem-cell therapy, repetitive transcranial magnetic stimulation, virtual reality, robotic therapies, and drug augmentation) are underway to inform future practice.

  5. [Hippocampal stroke].

    PubMed

    Rollnik, J D; Traitel, B; Dietrich, B; Lenz, O

    2015-02-01

    Unilateral cerebral ischemia of the hippocampus is very rare. This paper reviews the literature and presents the case of a 59-year-old woman with an amnestic syndrome due to a left hippocampal stroke. The patient suffered from retrograde amnesia which was most severe over the 2 days prior to presenting and a slight anterograde amnesia. In addition, a verbal memory disorder was confirmed 1 week after admission by neurological tests. As risk factors, arterial hypertension and a relative hyper-beta lipoproteinemia were found. This case shows that unilateral amnestic stroke, e.g. in the hippocampus region, may be the cause of an amnestic syndrome and should be included in the differential diagnostics.

  6. Der Kalte Krieg in der Peripherie Griechische Physiker und Atomenergie nach dem Zweiten Weltkrieg

    NASA Astrophysics Data System (ADS)

    Vlahakis, George N.

    Die vorliegende Arbeit analysiert Ansichten griechischer Physiker zur Atomenergie und deren mögliche Anwendung nach dem Zweiten Weltkrieg, insbesondere während des Kalten Kriegs. Einerseits werden Ansichten von Physik- Professoren griechischer Universitäten präsentiert - beispielsweise von Dimitrios Hondros, der Student von Arnold Sommerfeld und Mitarbeiter von Peter Debye in München war, und andererseits wird die Politik der griechischen Regierung für die Etablierung eines Forschungsinstitutes diskutiert, das der Entwicklung der Atomenergie dienen sollte; ebenfalls wird eine öffentliche Meinungsumfrage zu diesen Thema, die in den Tageszeitungen der damaligen Zeit präsentiert wurde, diskutiert.

  7. Atherosclerosis and Stroke

    MedlinePlus

    ... Stroke When the Beat is Off - Atrial Fibrillation Atherosclerosis and Stroke How Cardiovascular & Stroke Risks Relate Problems ... of LDL cholesterol contribute to the development of atherosclerosis as the cholesterol is deposited in artery walls, ...

  8. The "Know Stroke" Campaign

    MedlinePlus

    ... Current Issue Past Issues Special Section The "Know Stroke" Campaign Past Issues / Summer 2007 Table of Contents ... campaign for the U.S. Hispanic community. 1 Know Stroke A stroke occurs when the blood supply to ...

  9. National Stroke Association

    MedlinePlus

    ... Spread the Word Advocate Share Spread the Word Contact Us Contact Us 1-800-STROKES (787-6537) 9707 E. ... Stroke En Espanol Stroke Facts Come Back Strong Contact Us 1-800-787-6537 9707 E. Easter ...

  10. Kernschmelze Der nachhaltige Einfluss von Nuklearwaffen auf Politik und Wirtschaft

    NASA Astrophysics Data System (ADS)

    Greiner, Bernd

    "Was sollen wir von einer Kultur halten, der die Ethik stets als wesentliches Element des menschlichen Lebens galt, die aber - außer in fachlicher oder spieltheoretischer Terminologie - nicht in der Lage war, über die Möglichkeit zu sprechen, nahezu alle Menschen zu töten?" Der Fragesteller gehört zu den berühmtesten Physikern des 20. Jahrhunderts und zu den nach wie vor Umstrittensten. über ihn wurde in den 1960er Jahren ein international viel beachtetes Theaterstück geschrieben, vor wenigen Jahren gar eine Oper.

  11. Milch, Milchprodukte, Analoge und Speiseeis

    NASA Astrophysics Data System (ADS)

    Coors, Ursula

    Die Produktpalette Milch und Erzeugnisse aus Milch beinhaltet Konsummilch, die aus Milch oder Bestandteilen der Milch hergestellten Milcherzeugnisse wie Sauermilch-, Joghurt-, Kefir-, Buttermilch-, Sahne-, Kondensmilch-, Trockenmilch- und Molkenerzeugnisse, Milchmisch- und Molkenmischprodukte (Produkte mit beigegebenen Lebensmitteln), Milchzucker, Milcheiweißerzeugnisse, Milchfette und Käse.

  12. Therapeutisches Management kutaner und genitaler Warzen.

    PubMed

    Ockenfels, Hans Michael

    2016-09-01

    Mindestens 10 % der Bevölkerung erkranken während ihres Lebens an einer Infektion mit humanen Papillomaviren (HPV), welche sich klinisch anhand der Ausbildung kutaner oder genitaler Warzen manifestiert. Obwohl Warzen ubiquitär sind, existieren keine definierten Behandlungen. Warzen zeigen, insbesondere in den ersten sechs Monaten, eine erhöhte Selbstheilungsrate. Dieser Umstand erschwert die Interpretation von Studien, da häufig Patienten mit Neuinfektionen zusammen mit Patienten mit Altinfektionen behandelt werden. Lokalisationen, Größe und Dicke der Warzen sind ebenfalls in den meisten Fällen nicht berücksichtigt. Ziel dieses Übersichtsartikels ist eine Analyse des vorliegenden Studienmaterials, unter der für den klinischen Alltag so wichtigen Berücksichtigung von Subtypen und Lokalisationen. Insbesondere die Abgrenzung zwischen frischen und chronisch-therapieresistenten Verrucae vulgares spiegelt sich in einem Therapiealgorithmus wider. Bei genitalen Warzen wird der Therapiealgorithmus deutlicher durch das Ausmaß der infizierten Fläche als durch das Alter der Warzen bestimmt. Bei immunkompetenten Personen muss es mit den hier aufgezeigten therapeutischen Methoden immer das Ziel sein, eine komplette Abheilung zu erzielen. PMID:27607029

  13. Informationsqualität - Definitionen, Dimensionen und Begriffe

    NASA Astrophysics Data System (ADS)

    Rohweder, Jan Philipp; Kasten, Gerhard; Malzahn, Dirk; Piro, Andrea; Schmid, Joachim

    Die Verbesserung und Sicherstellung der Informationsqualität wird in immer mehr Unternehmen als eigenständige Managementaufgabe von großer Wichtigkeit begriffen. IQ-Management ist ein elementarer Baustein in Systemintegrationsprojekten. Aber auch in bestehenden Prozessen mit heterogenen Datenquellen und Informationsnutzern ist eine hohe Informationsqualität die Grundvoraussetzung für funktionierende betriebliche Abläufe. Voraussetzung für ein effektives IQ-Management ist die Bewertung der Informationsqualität [Lee et al. 2006, S. 13 und S. 27]. In vielen Unternehmen ist Informationsqualität nur ein gefühlter Wert. Die meisten Anwender bringen ein gewisses Misstrauen den Daten gegenüber zum Ausdruck, dies jedoch ohne genaue Angabe der Fehlerart und -häufigkeit. Nicht selten werden kostspielige Projekte angestoßen, um die Informationsqualität zu verbessern, ohne sich vor einer IQ-Maßnahme durch eine Analyse ein genaues Bild über die tatsächlichen Probleme zu verschaffen. Nur auf der Basis einer umfassenden Bewertung der Informationsqualität können die notwendigen Ressourcenentscheidungen herbeigeführt, Ziele gesetzt und der Erfolg des IQ-Management beurteilt werden.

  14. Matthias Falter und die frühe Halbleitertechnik in der DDR

    NASA Astrophysics Data System (ADS)

    Dittmann, Frank

    Nach einer ganzen Reihe von Vorarbeiten weltweit1 konnten im Dezember 1947 die amerikanischen Physiker Walter H. Brattain, John Bardeen und William Shockley in den Bell Laboratories den Transistoreffekt demonstrieren. Damit legten sie den Grundstein für die Mikroelektronik als Basistechnologie des Informationszeitalters.

  15. Schönheit und andere Provokationen - Eine neue evolutionsbiologische Theorie der Kunst

    NASA Astrophysics Data System (ADS)

    Junker, Thomas

    Die Evolution hat viele spektakuläre Phänomene hervorgebracht - von der Eleganz des Vogelflugs über die gigantischen Körper der Dinosaurier und die farbenprächtige Vielfalt der Korallenriffe bis hin zu ihrem jüngsten Geniestreich - der menschlichen Kunst. Die schönen Künste - Malerei, Bildhauerei und Architektur, Theater, Tanz, Oper und Filmkunst, Musik und Literatur - Produkte der Evolution? Diese Vorstellung mutet vielen Menschen fremd an, aber wie könnte es anders sein? Denn wenn Charles Darwin recht hat, dann sind nicht nur die körperlichen Merkmale der Menschen als Antworten auf die Erfordernisse des Lebens entstanden, sondern auch ihre geistigen Fähigkeiten und Verhaltensweisen. Im Jahr 1859 hatte er auf den letzten Seiten seines berühmten Buches über die Entstehung der Arten eine kühne Prophezeiung gemacht: Durch die Evolutionstheorie werde es "zu einer bemerkenswerten Revolution in der Naturwissenschaft kommen […]. Die Psychologie wird auf die neue Grundlage gestellt, dass jede geistige Kraft und Fähigkeit notwendigerweise durch graduelle Übergänge erworben wird“ (Darwin 1859, S. 484, 488; Junker 2008).

  16. Airplane stroke syndrome.

    PubMed

    Humaidan, Hani; Yassi, Nawaf; Weir, Louise; Davis, Stephen M; Meretoja, Atte

    2016-07-01

    Only 37 cases of stroke during or soon after long-haul flights have been published to our knowledge. In this retrospective observational study, we searched the Royal Melbourne Hospital prospective stroke database and all discharge summaries from 1 September 2003 to 30 September 2014 for flight-related strokes, defined as patients presenting with stroke within 14days of air travel. We hypothesised that a patent foramen ovale (PFO) is an important, but not the only mechanism, of flight-related stroke. We describe the patient, stroke, and flight characteristics. Over the study period, 131 million passengers arrived at Melbourne airport. Our centre admitted 5727 stroke patients, of whom 42 (0.73%) had flight-related strokes. Flight-related stroke patients were younger (median age 65 versus 73, p<0.001), had similar stroke severity, and received intravenous thrombolysis more often than non-flight-related stroke patients. Seven patients had flight-related intracerebral haemorrhage. The aetiology of the ischaemic strokes was cardioembolic in 14/35 (40%), including seven patients with confirmed PFO, one with atrial septal defect, four with atrial fibrillation, one with endocarditis, and one with aortic arch atheroma. Paradoxical embolism was confirmed in six patients. Stroke related to air travel is a rare occurrence, less than one in a million. Although 20% of patients had a PFO, distribution of stroke aetiologies was diverse and was not limited to PFO and paradoxical embolism. PMID:26898578

  17. Herstellung von Chitosan und einige Anwendungen

    NASA Astrophysics Data System (ADS)

    Struszczyk, Marcin Henryk

    2001-05-01

    1. Die Deacetylierung von crabshell - Chitosan führte gleichzeitig zu einem drastischen Abfall der mittleren viscosimetrischen Molmasse ( Mv), insbesondere wenn die Temperatur und die Konzentration an NaOH erhöht werden. Diese Parameter beeinflussten jedoch nicht den Grad der Deacetylierung (DD). Wichtig ist jedoch die Quelle des Ausgangsmaterials: Chitin aus Pandalus borealis ist ein guter Rohstoff für die Herstellung von Chitosan mit niedrigem DD und gleichzeitig hoher mittlerer Mv, während Krill-Chitin (Euphausia superba) ein gutes Ausgangsmaterial zur Herstellung von Chitosan mit hohem DD und niedrigem Mv ist. Chitosan, das aus Insekten (Calliphora erythrocephala), unter milden Bedingungen (Temperatur: 100°C, NaOH-Konzentration: 40 %, Zeit: 1-2h ) hergestellt wurde, hatte die gleichen Eigenschaften hinsichtlich DD und Mv wie das aus Krill hergestellte Chitosan. Der Bedarf an Zeit, Energie und NaOH ist für die Herstellung von Insekten-Chitosan geringer als für crabshell-Chitosan vergleichbare Resultaten für DD und Mv. 2. Chitosan wurde durch den Schimmelpilz Aspergillus fumigatus zu Chitooligomeren fermentiert. Die Ausbeute beträgt 25%. Die Chitooligomere wurden mit Hilfe von HPLC und MALDI-TOF-Massenspektrmetrie identifiziert. Die Fermentationsmischung fördert die Immunität von Pflanzen gegen Bakterien und Virusinfektion. Die Zunahme der Immunität schwankt jedoch je nach System Pflanze-Pathogen. Die Fermentation von Chitosan durch Aspergillus fumigatus könnte eine schnelle und billige Methode zur Herstellung von Chitooligomeren mit guter Reinheit und Ausbeute sein. Eine partiell aufgereinigte Fermentationsmischung dieser Art könnte in der Landwirtschaft als Pathogeninhibitor genutzt werden. Durch kontrollierte Fermentation, die Chitooligomere in definierter Zusammensetzung (d.h. definierter Verteilung des Depolymerisationsgrades) liefert, könnte man zu Mischungen kommen, die für die jeweilige Anwendung eine optimale Bioaktivität besitzen. 3

  18. "Das Konkrete ist das Abstrakte, an das man sich schließlich gewöhnt hat." (Laurent Schwartz) Über den Ablauf des mathematischen Verstehens

    NASA Astrophysics Data System (ADS)

    Lowsky, Martin

    Die im Titel genannte Aussage findet sich in den Lebenserinnerungen von Laurent Schwartz (1915-2002), einem der fruchtbarsten Mathematiker, Mitglied der Gruppe Bourbaki. Im Original lautet die Aussage: "un objet concret est un objet abstrait auquel on a fini par s'habituer." Schwartz erläutert sie am Beispiel des Integrals über {e^{-1/2{x^2}}} , das den Wert Wurzel aus 2π hat und in dem sich also die Zahlen e und π verknüpfen. Was Schwartz aber vor allem ausdrücken will, ist dies: Das mathematische Verständnisd geht langsam vor sich und es bedarf der Anstrengung. "Es ist eine Frage der Zeit und der Energie", sagt Schwartz, und gerade dies mache es so schwer, die höhere Mathematik unter das Volk zu bringen. Das Lernen und Lehren von Mathematik laufe eben mühevoll und langsam ab.

  19. [Stroke and aging].

    PubMed

    Ly, J; Maquet, P

    2014-01-01

    Stroke risk increases with aging and one third of ischemic strokes occurs in very elderly (> or = 80 years). These are responsible of two thirds of the overall stroke-related morbi-mortality. Stroke in very elderly differs from younger individuals by sex ratio (more women), risk factors (more atrial fibrillation and hypertension) and usually a worse functional outcome. Very elderly are likely to benefit from stroke unit care and early revascularisation treatments although they have historically been excluded from this urgent management. These issues are likely to worsen in the future with the increasing impact of stroke on our aging societies.

  20. How a Stroke Is Diagnosed

    MedlinePlus

    ... Trials News About Neurology Image Library Search The Internet Stroke Center Patients & Families About Stroke Stroke Diagnosis ... UT Southwestern Medical Center. Copyright © 1997-2016 - The Internet Stroke Center. All rights reserved. The information contained ...

  1. Questions and Answers about Stroke

    MedlinePlus

    ... 30 percent are permanently disabled. What is the cost of stroke for our nation? Stroke places a ... society in terms of mortality, morbidity and economic costs. The National Stroke Association estimates stroke costs the ...

  2. Cardioembolic Stroke and Postmyocardial Infarction Stroke.

    PubMed

    Hornung, Marius; Franke, Jennifer; Gafoor, Sameer; Sievert, Horst

    2016-05-01

    Ischemic stroke following acute myocardial infarction (AMI) is a rare but serious complication due to left ventricular thrombus formation and atrial fibrillation. Early revascularization of the culprit coronary lesion is essential. Treatment trends may affect the risk. Conversely, the greater use of antiplatelet agents to reduce the risk of ischemic stroke could increase the risk of hemorrhagic stroke. The risk of stroke after AMI has decreased significantly with more use of percutaneous coronary intervention and antithrombotic therapies in the acute setting, and statins, antihypertensive medications, and dual antiplatelet therapy as secondary prevention strategies. PMID:27150168

  3. Unternehmens- und Marktstatistik

    NASA Astrophysics Data System (ADS)

    Grömling, Michael; Scheinost, Ulrich

    Deutschland verfügt über ein gut ausgebautes System amtlicher und nicht amtlicher Unternehmens- und Marktstatistiken, das sich in einem fortwährenden Wandel befindet. Wird es sinnvoll genutzt, können für einzelne Marktteilnehmer wie für die gesamte Gesellschaft kostspielige Fehlentwicklungen vermieden werden. Dazu bedarf es eines sachkundigen Überblicks über die Vielfalt der Statistiken und der zwischen ihnen bestehenden Beziehungen sowie einer ständigen Anpassung an die wirtschaftliche Entwicklung. Als eine mögliche Orientierung kann der auf der Güter- und Faktorebene zu beobachtende Wandel dienen. Einer adäquaten Abbildung der ökonomischen Realität stehen in Deutschland mit seiner starken Verrechtlichung der Statistik jedoch mancherlei Schwierigkeiten im Wege. Teilweise tiefgreifende Reformbestrebungen sind vor allem auf europäischer Ebene im Gange. Als eine ergebnisorientierte Innovation für das Gesamtsystem der Unternehmens- und Marktstatistik wird ein modular aufgebautes System vorgestellt, das auch bei unterschiedlichen und sich wandelnden Rahmenbedingungen schrittweise realisiert werden kann.

  4. Datenintegration und Deduplizierung

    NASA Astrophysics Data System (ADS)

    Bleiholder, Jens; Schmid, Joachim

    In Unternehmen liegen viele Daten heutzutage immer seltener vollständig an einem einzigen physikalischen Ort vor, sondern sind weltweit verteilt. Dies liegt zum einen an der immer besser gewordenen Infrastruktur, die eine solche Verteilung auf einfache Art und Weise ermöglicht, und zum anderen an der Tatsache, dass viele Unternehmen weltweit tätig sind. So fallen Daten weltweit an, werden aber jeweils lokal - vor Ort - gespeichert. Daher müssen oft mehrere Datenquellen genutzt werden, um einen aktuellen, vollständigen und genauen Überblick über die vorhandenen Daten zu gewinnen. Datenintegration hilft, indem sie Daten aus mehreren Quellen zusammenführt und einheitlich darstellt. Diese integrierten Daten können genutzt werden, um sich einen Überblick über das Unternehmen zu verschaffen, z.B. wenn Unternehmen fusionieren und nur noch eine Kundendatenbank bestehen bleiben soll, oder wenn zu einem Kunden die Daten aus den verschiedenen Fachabteilungen zusammengeführt werden sollen. Anhand eines solchen Beispiels, der Integration von Kundendaten zu Kfz- und Lebensversicherungen erläutern wir im Folgenden einzelne Techniken.

  5. Des Moines.

    ERIC Educational Resources Information Center

    Gore, Deborah, Ed.

    1988-01-01

    This document, intended for elementary students, contains articles and activities designed to acquaint young people with the history of Des Moines, Iowa. The articles are short, and new or difficult words are highlighted and defined for young readers. "The Raccoon River Indian Agency" discusses the archeological exploration of the indian…

  6. Modulare LDAP-Server-, -Protokoll und - Funktionserweiterungen am Beispiel von OpenLDAP

    NASA Astrophysics Data System (ADS)

    Pluta, Daniel

    In diesem Artikel wird ein Standardisierungsvorschlag für eine LDAP-Protokollerweiterung und deren Referenzimplementierung in Form einer modularen Erweiterung für die LDAP-Software-Suite des OpenLDAPProjektes vorgestellt. Nach einer Einführung in und einem Überblick über die wichtigsten OpenLDAP-Komponenten stellen wir unseren Lösungsansatz vor und gehen auf seine technischen Details ein. Ziel dieses Overlays ist die Implementierung einer neuen Funktionalität, die vom LDAP-Protokoll bisher nicht vorgesehen ist: Der Umfang der Suchergebnismenge soll serverseitig, dezentral und in der Granularität ganzer Objekte in Abhängigkeit von der aktuellen Serverzeit (konfigurierbar) eingeschränkt werden.

  7. Kosteneffiziente Honbearbeitung durch intelligente und flexible Verknüpfung von autarken Honzentren

    NASA Astrophysics Data System (ADS)

    Roth, Günther

    Die Planungsabteilungen in der Automobilindustrie werden vor immer größere Herausforderungen gestsellt. Der zur Verfügung stehende Zeitraum zu einer seriensicheren Umsetzung der entwicklungs- und produktionstechnischen Forderungen wird von Projekt zu Projekt kürzer. Aufgrund des hohen Wettbewerbsdrucks und daraus resultierenden erforderlichen Kostenoptimierungen, die schnelleren Timeto-market-und Innovationszyklen und die vermeintlich zur Kundenbindung erforderlichen, kaum mehr überschaubaren Diversifizierungen in den Modellpaletten lassen den Planungshorizont immer kürzer werden. Die zu beschaffenden Fertigungsanlagen sollen aber in den nächsten 8-12 Jahren all die Varianten produzieren können, die heute nur teilweise oder noch gar nicht bekannt sind.

  8. Stroke program for India

    PubMed Central

    Mishra, Nishant K.; Khadilkar, Satish V.

    2010-01-01

    India is silently witnessing a stroke epidemic. There is an urgent need to develop a national program towards “Fighting Stroke”. This program should be specific to our national needs. In order to recommend on who should lead an Indian fight-stroke program, we examined the published opinions of stroke clinicians and the official documents on stroke care training abroad. We identified the resources that already exist in India and can be utilized to develop a national fight-stroke program. Through a review of published literature, we noted different opinions that exist on who would best manage stroke. We found that because stroke is a cardiovascular disorder of the central nervous system, its management requires a multi-disciplinary approach involving clinicians with background not limited to neurology. India has very few neurologists trained in stroke medicine and they cannot care for all stroke patients of the country. We propose a mechanism that would quickly put in place a stroke care model relevant in Indian context. We recommend for tapping the clinical expertise available from existing pool of non-neurologist physicians who can be trained and certified in stroke medicine (Strokology). We have discussed an approach towards developing a national network for training and research in Strokology hoping that our recommendations would initiate discussion amongst stroke academicians and motivate the national policy makers to quickly develop an “Indian Fight Stroke Program.” PMID:20436743

  9. Stroke: Hope through Research

    MedlinePlus

    ... substantially reduce costs of care. Stroke Hyperglycemia Insulin Network Effort Trial (SHINE) Nearly 40 percent of patients ... Stroke, contact the Institute's Brain Resources and Information Network (BRAIN) at: BRAIN P.O. Box 5801 Bethesda, ...

  10. Stroke Trials Registry

    MedlinePlus

    ... Trials News About Neurology Image Library Search The Internet Stroke Center Trials Registry Clinical Trials Interventions Conditions ... UT Southwestern Medical Center. Copyright © 1997-2011 - The Internet Stroke Center. All rights reserved. The information contained ...

  11. Stroke (For Kids)

    MedlinePlus

    ... is a mix of cholesterol and other fatty stuff that sticks to the walls of blood vessels. ... major stroke can cause big problems with important stuff, like walking and talking. With a major stroke, ...

  12. Two Kinds of Stroke

    MedlinePlus

    ... repair itself to restore important functions after a stroke. New advances in imaging and rehabilitation have shown that the brain can compensate for function lost as a result of stroke. Summer 2007 Issue: Volume 2 Number 3 Page ...

  13. Stroke Fact Sheet

    MedlinePlus

    ... tells you to. Return to top Does taking birth control pills increase my risk for stroke? Taking birth ... your vagina Return to top Does using the birth control patch increase my risk for stroke? The patch ...

  14. [Stroke and neuroplasticity].

    PubMed

    Damulin, I V; Ekusheva, E V

    2014-01-01

    Characteristics of stroke development and processes of restoration of brain function in post stroke period are considered. The dynamics of neuroplasticity and ambiguity of the involvement of the opposite brain hemisphere in the restoration is highlighted. Special attention is drawn to the time from stroke onset and activation of different brain regions in post stroke period. The importance of neurorehabilitation in these patients is emphasized.

  15. Strokes in adults.

    PubMed

    Pearce, Lynne

    2016-06-15

    Essential facts There are two types of stroke - around 85% are ischaemic and 15% are haemorrhagic. According to the Stroke Association's State of the Nation report, published in January 2016, stroke occurs around 152,000 times a year in the UK. It is the fourth largest cause of death in the UK and one of the largest causes of disability. PMID:27305230

  16. Karamell und Schokolade optimal

    NASA Astrophysics Data System (ADS)

    Eichhorn, Andreas

    In verschiedenen Situationen in Technik, Wirtschaft oder Politik ist man daran interessiert unter einer Anzahl von möglichen Entscheidungen die jeweils beste auszuwählen, also die optimale Entscheidung zu treffen, die den größtmöglichen Nutzen bringt. In den meisten Fällen sind Nutzen und Entscheidungsalternativen nicht exakt gegeben, Entscheidungen werden dann entweder sprachlichargumentativ ausgewählt und begründet oder gar aus dem Bauch heraus gefällt. In manchen Fällen ist es aber möglich, Entscheidungsalternativen und Nutzen in Zahlen und Formeln so auszudrücken, dass über diese Beschreibung im Prinzip die optimalen Entscheidungen und der maximale Nutzen festgelegt sind. Dabei ist zu beachten, dass bei mehreren (gleichzeitig oder hintereinander) zu treffenden Entscheidungen gewisse Abhängigkeiten zu berücksichtigen sind, bezüglich der möglichen Alternativen. Wenn beispielsweise die Umsetzung einer bestimmten (Teil-)Entscheidung mit bestimmten Kosten verbunden wäre, so stünde dieser Geldbetrag für andere Entscheidungen nicht mehr zur Verfügung.

  17. Technikwissenschaft - Erfinden und Entdecken

    NASA Astrophysics Data System (ADS)

    Linnemann, Gerhard

    Umrissen wird das allgemeine Ziel der Technikwissenschaft, konstruktiv zu verwerten und nicht-natürlich Entdeckbares zu erfinden. Wir befinden uns in einer Umwälzung der Technik im Verlauf der wissenschaftlich-technischen Revolution, auf dem Wege zu einem neuen Techniktyp. Dieser schafft und nutzt die künstliche Intelligenz. Dazu benötigt der in der Technik tätige Mensch spezielle Kenntnisse und Erfahrungen in kreativ-konstruktiver, -gestalterischer und erfinderischer Sicht mit dem Einsatz spezieller Strukturen und Sprachen. Vorschläge zur Arbeitsweise in der Technik werden gegeben.Translated AbstractTechnological Science-Invent and DiscoverThe general aim of engineering science is outlined to utilize results constructively and to invent something that cannot be discovered in nature. We are now in a period of transformation of technology in the course of scientific-technological revolution, on the way to a new type of technology. This new type creates and utilizes artificial intelligence. For this, man acitive in this field requires special knowledge and experiences in a creative, constructive, design-oriented and ultimately inventive way by deploying special structures and languages. There are also made some proposals concerning the method of working in the field of technology.

  18. Genetic Stroke Syndromes

    PubMed Central

    Barrett, Kevin M.; Meschia, James F.

    2014-01-01

    Purpose of Review: This review describes the clinical and radiographic features, genetic determinants, and treatment options for the most well-characterized monogenic disorders associated with stroke. Recent Findings: Stroke is a phenotype of many clinically important inherited disorders. Recognition of the clinical manifestations of genetic disorders associated with stroke is important for accurate diagnosis and prognosis. Genetic studies have led to the discovery of specific mutations associated with the clinical phenotypes of many inherited stroke syndromes. Summary: Several inherited causes of stroke have established and effective therapies, further underscoring the importance of timely diagnosis. PMID:24699489

  19. Lightning return stroke models

    NASA Technical Reports Server (NTRS)

    Lin, Y. T.; Uman, M. A.; Standler, R. B.

    1980-01-01

    We test the two most commonly used lightning return stroke models, Bruce-Golde and transmission line, against subsequent stroke electric and magnetic field wave forms measured simultaneously at near and distant stations and show that these models are inadequate to describe the experimental data. We then propose a new return stroke model that is physically plausible and that yields good approximations to the measured two-station fields. Using the new model, we derive return stroke charge and current statistics for about 100 subsequent strokes.

  20. Neuropsychiatric sequelae of stroke.

    PubMed

    Ferro, José M; Caeiro, Lara; Figueira, Maria Luísa

    2016-05-01

    Stroke survivors are often affected by psychological distress and neuropsychiatric disturbances. About one-third of stroke survivors experience depression, anxiety or apathy, which are the most common neuropsychiatric sequelae of stroke. Neuropsychiatric sequelae are disabling, and can have a negative influence on recovery, reduce quality of life and lead to exhaustion of the caregiver. Despite the availability of screening instruments and effective treatments, neuropsychiatric disturbances attributed to stroke are currently underdiagnosed and undertreated. Stroke severity, stroke-related disabilities, cerebral small vessel disease, previous psychiatric disease, poor coping strategies and unfavourable psychosocial environment influence the presence and severity of the psychiatric sequelae of stroke. Although consistent associations between psychiatric disturbances and specific stroke locations have yet to be confirmed, functional MRI studies are beginning to unveil the anatomical networks that are disrupted in stroke-associated psychiatric disorders. Evidence regarding biochemical and genetic biomarkers for stroke-associated psychiatric disorders is still limited, and better understanding of the biological determinants and pathophysiology of these disorders is needed. Investigation into the management of these conditions must be continued, and should include pilot studies to assess the benefits of innovative behavioural interventions and large-scale cooperative randomized controlled pharmacological trials of drugs that are safe to use in patients with stroke. PMID:27063107

  1. Sex differences in stroke.

    PubMed

    Haast, Roy A M; Gustafson, Deborah R; Kiliaan, Amanda J

    2012-12-01

    Sex differences in stroke are observed across epidemiologic studies, pathophysiology, treatments, and outcomes. These sex differences have profound implications for effective prevention and treatment and are the focus of this review. Epidemiologic studies reveal a clear age-by-sex interaction in stroke prevalence, incidence, and mortality. While premenopausal women experience fewer strokes than men of comparable age, stroke rates increase among postmenopausal women compared with age-matched men. This postmenopausal phenomenon, in combination with living longer, are reasons for women being older at stroke onset and suffering more severe strokes. Thus, a primary focus of stroke prevention has been based on sex steroid hormone-dependent mechanisms. Sex hormones affect different (patho)physiologic functions of the cerebral circulation. Clarifying the impact of sex hormones on cerebral vasculature using suitable animal models is essential to elucidate male-female differences in stroke pathophysiology and development of sex-specific treatments. Much remains to be learned about sex differences in stroke as anatomic and genetic factors may also contribute, revealing its multifactorial nature. In addition, the aftermath of stroke appears to be more adverse in women than in men, again based on older age at stroke onset, longer prehospital delays, and potentially, differences in treatment.

  2. Zivilisationsdynamik: Treiber Technik, Folgen und Konsequenzen. Civilisation dynamics: driving force technology, results and consequences

    NASA Astrophysics Data System (ADS)

    Jischa, Michael F.

    2010-11-01

    Die Menschheitsgeschichte ist untrennbar mit der Nutzung von Materie, Energie und Information verbunden. Im Laufe der Geschichte sind Produktivität, Bevölkerung und Ressourcenverbrauch ständig angestiegen, seit dem vergangenen Jahrhundert mit zunehmender Beschleunigung. In den früh industrialisierten Ländern entwickelte sich vor wenigen Jahrzehnten eine Bewusstseinswende, die Segnungen der Technik wurden zunehmend kritisch beurteilt. Das führte zur Formulierung des Leitbildes Nachhaltigkeit und unterschiedlichen Ansätzen, dieses zu operationalisieren, aus Sicht der Ingenieure mit dem Konzept Technikbewertung. Nach den Natur- und den Ingenieurwissenschaften haben die Gesellschaftswissenschaften diese Themen aufgegriffen, was zu einer teilweisen Annäherung der Zwei Kulturen geführt hat. Weiter sind Überlegungen entstanden, Lehr- und Forschungsinhalte zu überdenken, um auf die Weltprobleme (in der Sprache des Club of Rome) angemessen reagieren zu können. In jüngerer Zeit wurden Energieszenarien vorgestellt, deren Kernaussage unmissverständlich lautet: Die Zukunft gehört den erneuerbaren Energien.

  3. Der vollständige Brief Brahes an Sørensen über das Erscheinen des Kometen von 1577

    NASA Astrophysics Data System (ADS)

    Kirschner, Stefan

    Es ist erstaunlich, daß sowohl Friis als auch Dreyer in ihrer Ausgabe der Briefe Tycho Brahes den Brief vom 14. November 1577 an Peter Sørensen, die erste bekannte Nachricht Brahes von seiner Entdeckung des Kometen von 1577, nur unvollständig, und zwar ohne den astronomischen Inhalt, ediert haben. Der Brief, dessen Original sehr wahrscheinlich nicht mehr existiert, wurde von dem Kieler Arzt und Medizinprofessor Johann Daniel Major (1634 - 1693) in Kopenhagen in sein Reisetagebuch kopiert. Das Original des Majorschen Reisetagebuches ist verschollen, doch es existieren zwei Abschriften davon (Kopenhagen, Königl. Bibl., Ny Kgl. Sml., 365, Fol. u. Ledreborg, 410, Fol.). Im folgenden wird nach einer kurzen Beschreibung des Stellenwerts, den der Komet von 1577 für Brahe besaß, der Brief nach diesen beiden Abschriften kritisch ediert, mit einer deutschen Übersetzung versehen und kurz kommentiert.

  4. Tanzendes Tier oder exzentrische Positionalität - Philosophische Anthropologie zwischen Darwinismus und Kulturalismus

    NASA Astrophysics Data System (ADS)

    Fischer, Joachim

    Zunächst kurz vorweg zu den Formeln im Titel: "exzentrische Positionalität“ ist der Kategorienvorschlag der Philosophischen Anthropologie (genauer: von Helmuth Plessner) für den Menschen, für seine "Sonderstellung“ unter den Lebewesen - ich werde diesen Begriff erläutern. So viel kann man sagen: Der Terminus ist nicht schwieriger als "Transzendentalität“ oder das "Apriori“ oder "Autopoiesis“, also Begriffe, mit deren Orientierungswert in der intellektuellen Öffentlichkeit bereits gespielt wird, bietet aber möglicherweise mehr Erschließungskraft als die Kunstbegriffe z. B. von Kant, Maturana oder Luhmann. Und "tanzendes Tier“ ist ein glücklicher Anschauungsbegriff, eine Art Übersetzung für "exzentrische Positionalität“ - also ein "verrücktes“ Lebewesen, eine Verrückung im evolutionären Leben, die dieses Lebewesen von Natur aus zu einer bestimmten Art von Lebensführung, nämlich Kultur nötigt. Die Absicht des Beitrages ist es, die Philosophische Anthropologie als eine spezifische Theorietechnik zu präsentieren, um einen adäquaten Begriff des Menschen zu erreichen, und zwar eine Theoriestrategie angesichts des cartesianischen Dualismus - also des Dualismus zwischen Naturalismus und Kulturalismus.

  5. [Post Stroke Dementia].

    PubMed

    Ihara, Masafumi

    2016-07-01

    Post-stroke dementia (PSD) is a clinical entity that encompasses all types of dementia following an index stroke. Current evidence suggests that 25-30% of ischemic stroke survivors develop immediate or delayed vascular cognitive impairment or vascular dementia. The type of stroke can be either ischemic, hemorrhagic or hypoperfusive. There are multiple risk factors for PSD including older age, family history, genetic variants, low educational status, vascular comorbidities, prior transient ischemic attack or recurrent stroke and depressive illness. Pre-stroke dementia refers to the occurrence of cognitive impairment before the index stroke, which may be caused by a vascular burden as well as insidious neurodegenerative changes. Neuroimaging determinants of dementia after stroke include silent brain infarcts, white matter changes, lacunar infarcts and medial temporal lobe atrophy. Published clinical trials have not been promising and there is little information on whether PSD can be prevented using pharmacological agents. Control of vascular disease risk and prevention of recurrent strokes are key to reducing the burden of cognitive decline and post-stroke dementia. Modern imaging and analysis techniques will help to elucidate the mechanism of PSD and establish better treatment. PMID:27395459

  6. Creatio ex zero. Ursprungs-Konzepte in der mathematischen Naturphilosophie des 19. Jahrhunderts.

    NASA Astrophysics Data System (ADS)

    Heuser, M.-L.

    Die Autorin zeigt in ihrem Beitrag, daß Ansätze der heutigen Selbstorganisationstheorien, die diese in Richtung einer vereinheitlichten dynamischen Theorie verallgemeinern wollen, zumindest in konzeptueller Hinsicht, schon in der Mathematik und Naturphilosophie des 19. Jahrhunderts gewisse Vorläufer finden könnten.

  7. Über die Perihelzeit des Halleyschen Kometen bei seiner Erscheinung im Jahre 837

    NASA Astrophysics Data System (ADS)

    Landgraf, Werner

    1983-07-01

    837 erfolgte ein naher Vorübergang des Halleyschen Kometen an der Erde. Bei kleiner Verfrühung oder Verspätung ist aufgrund der Differenz seiner gravitativen Ablenkung seine Bahn vor 837 unterschiedlich. Aus den früheren Beobachtungen ergibt sich daher sehr genau die Zeit von Vorbeiflug und Periheldurchgang 837 .

  8. Tipps und Tricks

    NASA Astrophysics Data System (ADS)

    Häger, Wolfgang; Bauermeister, Dirk

    Hier wollen wir einige uns nützlich erscheinende Hinweise zur Arbeit mit dem Inventor geben. Dabei geht es vor allem darum, das Arbeiten mit dem Inventor zu vereinfachen. Die Beispiele stellen eine unvollständige Aufzählung dar und sollen dazu anregen, nach alternativen Vorgehensweisen zu suchen (hier sei noch einmal ausdrücklich auf das Internet verwiesen).

  9. Herausforderungen und Best Practices bei der Speicherung von multi-valued Attributen in LDAP-basierten Verzeichnisdiensten

    NASA Astrophysics Data System (ADS)

    Hommel, Wolfgang; Pluta, Daniel

    LDAP-basierte Verzeichnisdienste unterscheiden sich von relationalen Datenbankmanagementsystemen unter anderem stark bezüglich der Datenmodellierung. Dieser Artikel vertieft eingangs die Herausforderungen bei der LDAP-spezifischen Abbildung von Relationen zwischen mehreren multivalued Attributen. Die Diskussion erfolgt vor dem Hintergrund, dass einerseits Verzeichnisdienste generell nur bedingt zur Speicherung von Relationen geeignet sind und dass andererseits multi-valued Attribute ein mächtiges LDAP-Instrument sind, zu dem es in relationalen Datenbanksystemen keine direkte Entsprechung gibt. Anschließend werden Lösungskonzepte vorgestellt und mögliche Weiterentwicklungen des IntegraTUM-LDAP-Schemas zu deren Umsetzung skizziert, eine exemplarische Implementierung präsentiert und die Ergebnisse der bisherigen Entwicklung des IntegraTUM-Schemas gegenübergestellt.

  10. European Stroke Science Workshop

    PubMed Central

    Mattle, Heinrich P.; Brainin, Michael; Chamorro, Angel; Diener, Hans Christoph; Hacke, Werner; Leys, Didier; Norrving, Bo; Ward, Nick

    2012-01-01

    The European Stroke Organisation (ESO) held its first European Stroke Science Workshop in Garmisch-Partenkirchen, Germany (15-17 December 2011). Stroke experts based in Europe were invited to present and discuss their current research. The scope of the workshop was to review the most recent findings of selected topics in stroke, to exchange ideas, to stimulate new research and to enhance collaboration between European stroke research groups. Seven scientific sessions were held, each starting with a keynote lecture to review the state of the art of the given topic, followed by 4 or 5 short presentations by experts. They were asked to limit their presentations to 10 slides containing only recent information. The meeting was organized by the executive committee of the ESO (Heinrich Mattle, chairman, Michael Brainin, Angel Chamorro, Werner Hacke, Didier Leys) and supported by the European Stroke Conference (Michael Hennerici). In this article we summarize the main contents of this successful workshop. PMID:22836350

  11. Was leistet ein Sportler? Kraft, Leistung und Energie im Muskel

    NASA Astrophysics Data System (ADS)

    Thaller, Sigrid; Mathelitsch, Leopold

    2006-01-01

    Der Leistungsbegriff ist im Sport weiter gefasst als in der Physik. In beiden Fällen liegt der Fokus jedoch auf einer pro Zeiteinheit erfolgten Energieumsetzung. Allerdings gibt die rein physikalische Leistung nicht immer Auskunft über den Energieumsatz der Muskeln. Die Muskelkraft hängt von der Kontraktionsgeschwindigkeit des Muskels ab. Ein Muskel verhält sich also anders als eine Feder. Für den Hochleistungssport müssen die Energieumsätze der Muskeln durch spezielle Trainings- und Nahrungsprogramme optimiert werden.

  12. Neurorestoration after stroke.

    PubMed

    Azad, Tej D; Veeravagu, Anand; Steinberg, Gary K

    2016-05-01

    Recent advancements in stem cell biology and neuromodulation have ushered in a battery of new neurorestorative therapies for ischemic stroke. While the understanding of stroke pathophysiology has matured, the ability to restore patients' quality of life remains inadequate. New therapeutic approaches, including cell transplantation and neurostimulation, focus on reestablishing the circuits disrupted by ischemia through multidimensional mechanisms to improve neuroplasticity and remodeling. The authors provide a broad overview of stroke pathophysiology and existing therapies to highlight the scientific and clinical implications of neurorestorative therapies for stroke.

  13. Phytochemicals in Ischemic Stroke.

    PubMed

    Kim, Joonki; Fann, David Yang-Wei; Seet, Raymond Chee Seong; Jo, Dong-Gyu; Mattson, Mark P; Arumugam, Thiruma V

    2016-09-01

    Stroke is the second foremost cause of mortality worldwide and a major cause of long-term disability. Due to changes in lifestyle and an aging population, the incidence of stroke continues to increase and stroke mortality predicted to exceed 12 % by the year 2030. However, the development of pharmacological treatments for stroke has failed to progress much in over 20 years since the introduction of the thrombolytic drug, recombinant tissue plasminogen activator. These alarming circumstances caused many research groups to search for alternative treatments in the form of neuroprotectants. Here, we consider the potential use of phytochemicals in the treatment of stroke. Their historical use in traditional medicine and their excellent safety profile make phytochemicals attractive for the development of therapeutics in human diseases. Emerging findings suggest that some phytochemicals have the ability to target multiple pathophysiological processes involved in stroke including oxidative stress, inflammation and apoptotic cell death. Furthermore, epidemiological studies suggest that the consumption of plant sources rich in phytochemicals may reduce stroke risk, and so reinforce the possibility of developing preventative or neuroprotectant therapies for stroke. In this review, we describe results of preclinical studies that demonstrate beneficial effects of phytochemicals in experimental models relevant to stroke pathogenesis, and we consider their possible mechanisms of action. PMID:27193940

  14. Neurological emergencies: acute stroke

    PubMed Central

    Davenport, R.; Dennis, M.

    2000-01-01

    Stroke causes a vast amount of death and disability throughout the world, yet for many healthcare professionals it remains an area of therapeutic nihilism, and thus uninteresting. This negative perception is shared by the general public, who often have a poor understanding of the early symptoms and significance of a stroke. Yet within the past few years there have been many important developments in the approach to caring for stroke patients, for both the acute management and secondary prevention. After the completion of numerous clinical trials, there is now robust evidence to either support or discredit various interventions. Even more exciting is the prospect of yet more data becoming available in the near future, testing a whole array of treatments, as clinical interest in stroke expands exponentially. In this review an evidence based approach to the management of acute stroke within the first few days is presented, including ischaemic and haemorrhagic events, but not subarachnoid haemorrhage. It is explained why stroke is regarded as a medical emergency, and the importance of a rational, methodic approach to the initial assessment, which is the key to accurate diagnosis and subsequent management, is emphasised. The potential early problems associated with stroke are identified and specific interventions for different stroke types are discussed. The review ends with a brief discussion of the implications that the evolving treatments have for the organisation of modern stroke services.

 PMID:10675208

  15. Stroke in Latin America.

    PubMed

    Camargo, Erica C S; Bacheschi, Luiz A; Massaro, Ayrton R

    2005-05-01

    Stroke is one of the leading causes of mortality in Latin America, with variable incidence and prevalence throughout the continent reflecting regional socioeconomic differences. In Latin America, uncontrolled hypertension is one of the major causes of stroke, but other modifiable risk factors also play a role, such as heavy alcohol consumption and smoking. Intracerebral hemorrhage and lacunar stroke are more frequent in Latin America than in North America and Europe. There are multiple causes of stroke that are endemic to Latin America, including neurocysticercosis, Chagas' disease, sickle cell anemia, malaria, hemorrhagic fever, and snake bites.

  16. Neurorestoration after stroke

    PubMed Central

    Azad, Tej D.; Veeravagu, Anand; Steinberg, Gary K.

    2016-01-01

    Recent advancements in stem cell biology and neuromodulation have ushered in a battery of new neurorestorative therapies for ischemic stroke. While the understanding of stroke pathophysiology has matured, the ability to restore patients’ quality of life remains inadequate. New therapeutic approaches, including cell transplantation and neurostimulation, focus on reestablishing the circuits disrupted by ischemia through multidimensional mechanisms to improve neuroplasticity and remodeling. The authors provide a broad overview of stroke pathophysiology and existing therapies to highlight the scientifc and clinical implications of neurorestorative therapies for stroke. PMID:27132523

  17. Stroke Drills for Swimming Instructors.

    ERIC Educational Resources Information Center

    Cahill, Peter J.

    1982-01-01

    Stroke drills to be used by swimming instructors to teach four competitive swim strokes are described. The drills include: one arm swims; (2) alternative kicks; (3) fist swims; and (4) catch-up strokes. (JN)

  18. Wirkstoffe, Medikamente und Mathematische Bildverarbeitung

    NASA Astrophysics Data System (ADS)

    Bauer, Günter J.; Lorenz, Dirk A.; Maaß, Peter; Preckel, Hartwig; Trede, Dennis

    Die Entwicklung neuer Medikamente ist langwierig und teuer. Der erste Schritt ist hierbei die Suche nach neuen Wirkstoffkandidaten, die für die Behandlung bislang schwer therapierbarer Krankheiten geeignet sind. Hierfür stehen der Pharma- und Biotechnologieindustrie riesige Substanzbibliotheken zur Verfügung. In diesen Bibliotheken werden die unterschiedlichsten Substanzen gesammelt, die entweder synthetisch hergestellt oder aus Pilzen, Bakterienkulturen und anderen Lebewesen gewonnen werden können.

  19. Rehabilitation approaches to stroke.

    PubMed

    Aichner, F; Adelwöhrer, C; Haring, H P

    2002-01-01

    This article describes the state of the science in stroke rehabilitation dealing with three main topics: (1) General approach to stroke rehabilitation (stroke services and stroke units), (2) Neurophysiological and pharmacological interventions (facilitation of brain repair mechanisms) and (3) Experimental approaches (neuronal transplantation). Stroke rehabilitation is an active process beginning during acute hospitalisation, progressing to a systematic program of rehabilitation services and continuing after the individual returns to the community. There is world-wide consensus that stroke patients should be treated at specialised stroke unit with specially trained medical and nursing staff, co-ordinated multidisciplinary rehabilitation and education programs for patients and their families. Stroke Unit has been shown to be associated with a long-term reduction of death and of the combined poor outcomes of death and dependency, independent of patients age, sex, or variations in stroke unit organisations. No study has clearly shown to what extent the beneficial effect is due to specific rehabilitation strategies. New imaging studies in stroke patients indicate altered post stroke activation patterns, which suggest some functional reorganisation. Reorganisation may be the principle process responsible for recovery after stroke. It is assumed that different post ischaemic interventions like physiotherapy, occupational therapy, speech therapy, electrical stimulation, etc. facilitates such changes. Scientific evidence demonstrating the values of specific rehabilitation interventions after stroke is limited. Comparisons between different methods in current use have so far mostly failed to show that any particular physiotherapy, occupational therapy, speech therapy or stroke rehabilitation strategy is superior to another. Clinical data are strongly in favour of early mobilisation and training. Pharmacological interventions in animals revealed that norepinephrine

  20. Stroke is an emergency.

    PubMed

    Futrell, N; Millikan, C H

    1996-04-01

    Stroke is an emergency. Ischemic stroke is similar to myocardial infarction in that the pathogenesis is loss of blood supply to the tissue, which can result in irreversible damage if blood flow is not restored quickly. Public education is needed to emphasize the warning signs of stroke. Patients should seek medical help immediately, using emergency transport systems. Therapy geared toward minimizing the damage from an acute stroke should be started without delay in the emergency room. This includes measures to protect brain tissue, support perfusion pressure, and minimize cerebral edema. Strategies for improving recovery should also begin immediately. All major medical centers need stroke teams and stroke units. Stroke prevention should be given high priority as a public health strategy. Risk factor management should be part of general health care and should begin in childhood, with emphasis on nutrition, exercise, weight control, and avoidance of tobacco. Health screening and early treatment of hypertension and hypercholesterolemia has decreased the incidence of stroke and heart disease, but these efforts need to be expanded to reach all segments of the population. Basic research has opened the door to new therapies aimed at re-establishing blood flow and limiting tissue damage. Clinical trials have already led to changes in stroke prevention, including studies of carotid endarterectomy and ticlopidine and warfarin therapy (for patients with atrial fibrillation). Trials in progress are testing the usefulness of ancrod, neuroprotective agents, antioxidant agents, anti-inflammatory agents, low-molecular-weight heparin, thrombolytic drugs, and angioplasty. Any delay starting therapy after an acute stroke will result in progressive, irreversible loss of brain tissue. Clinicians should remember that for a stroke patient, time is brain tissue.

  1. [Stroke management in Germany].

    PubMed

    Fritze, J

    2001-12-01

    Stroke is a leading cause of morbidity and mortality (rank 3) and thus a mass disease. Therefore, immediate access for everybody to stroke treatment services is indispensible. Therapeutic efficacy has been shown for lysis therapy and early rehabilitation in stroke units, respectively. The British-Scandinavian stroke unit concept focusses on immediately starting rehabilitation over 4-6 weeks by a specifically trained and motivated team. Since 1995, so-called stroke units are established in Germany adhering to a specific concept of the German Society for Neurology (DGN). Although referring to the British-Scandinavian concept in terms of efficacy the German concept differs fundamentally by focussing on monitoring as well as lysis therapy and neuroprotection in a short (3-5 days) stay. This is an intensive care unit approach for which scientific evidence is lacking. More essential are reasonable doubts that this concept can ever expand sufficiently to ensure comprehensive care. At least presently, stroke care is provided unevenly, thus contravening legislation (section 70 Social Security Act Vol. V). Acknowledging the restrictions the DGN adapted its concept, now advocating a two-step model comprising intensive care stroke units plus rehabilitative stroke units. PMID:11761782

  2. Relational Processing Following Stroke

    ERIC Educational Resources Information Center

    Andrews, Glenda; Halford, Graeme S.; Shum, David; Maujean, Annick; Chappell, Mark; Birney, Damian

    2013-01-01

    The research examined relational processing following stroke. Stroke patients (14 with frontal, 30 with non-frontal lesions) and 41 matched controls completed four relational processing tasks: sentence comprehension, Latin square matrix completion, modified Dimensional Change Card Sorting, and n-back. Each task included items at two or three…

  3. Die Struktur von schlankem Materialfluss mit Lean Production Kanban und Innovationen

    NASA Astrophysics Data System (ADS)

    Scheid, Wolf-Michael

    In der Literatur wird Materialfluss überwiegend in Spezialdisziplinen betrachtet, etwa der Steuerungslogik, der Logistiktechnik oder dem Supply Chain Management. Ein charakterisierendes Merkmal des Materialflusses ist jedoch, dass er sich aus vielfältigen Einzelbausteinen zusammensetzt, die alle harmonisch abgestimmt sein müssen. Die maximal erreichbare Effizienz wird nicht durch Höchstleistungen in dem einen oder anderen Spezialthema bestimmt, sondern durch das schwächste Glied im gesamten komplexen Netzwerk. Den Schnittstellen zwischen den betroffenen Fachbereichen in einem Unternehmen kommt hier eine ganz besondere Bedeutung zu: Erst ein harmonischer Einklang ermöglicht hohe Effektivität. Dies setzt umfassendes Verständnis für interdisziplinäre Notwendigkeiten, ein hohes Maß an Abstimmung mit den operativen Prozessen und letztlich einen einvernehmlichen Umgang und den Respekt vor den Problemstellungen des Anderen voraus.

  4. Campus Single Sign-On und hochschulübergreifendes Identity Management

    NASA Astrophysics Data System (ADS)

    Hommel, Wolfgang

    Das im Rahmen von IntegraTUM für die TUM geschaffene Identity & Access Management System setzt das Paradigma unified login um, d. h. ein Benutzer kann alle für ihn relevanten Dienste innerhalb der Hochschule mit derselben Loginname-/Passwortkombination nutzen. Dieser Artikel zeigt, wie auf Basis der Software Shibboleth und der deutschlandweiten Hochschulföderation DFN-AAI als weitere Mehrwerte das campusweite web single sign-on und die nahtlose Nutzung zahlreicher externer Web-Anwendungen erreicht werden. Als Beispiel für die Abläufe bei der Erschließung neuer Dienste für die hochschulübergreifende Nutzung wird die Anbindung von Learning Management Systemen auf Basis des DFN-AAI E-Learning-Profils diskutiert. Den umfassenden Vorteilen werden schließlich die aktuellen technischen Grenzen bei der Umsetzung des hochschulübergreifenden Identity Management gegenübergestellt.

  5. Acute ischemic stroke update.

    PubMed

    Baldwin, Kathleen; Orr, Sean; Briand, Mary; Piazza, Carolyn; Veydt, Annita; McCoy, Stacey

    2010-05-01

    Stroke is the third most common cause of death in the United States and is the number one cause of long-term disability. Legislative mandates, largely the result of the American Heart Association, American Stroke Association, and Brain Attack Coalition working cooperatively, have resulted in nationwide standardization of care for patients who experience a stroke. Transport to a skilled facility that can provide optimal care, including immediate treatment to halt or reverse the damage caused by stroke, must occur swiftly. Admission to a certified stroke center is recommended for improving outcomes. Most strokes are ischemic in nature. Acute ischemic stroke is a heterogeneous group of vascular diseases, which makes targeted treatment challenging. To provide a thorough review of the literature since the 2007 acute ischemic stroke guidelines were developed, we performed a search of the MEDLINE database (January 1, 2004-July 1, 2009) for relevant English-language studies. Results (through July 1, 2009) from clinical trials included in the Internet Stroke Center registry were also accessed. Results from several pivotal studies have contributed to our knowledge of stroke. Additional data support the efficacy and safety of intravenous alteplase, the standard of care for acute ischemic stroke since 1995. Due to these study results, the American Stroke Association changed its recommendation to extend the time window for administration of intravenous alteplase from within 3 hours to 4.5 hours of symptom onset; this recommendation enables many more patients to receive the drug. Other findings included clinically useful biomarkers, the role of inflammation and infection, an expanded role for placement of intracranial stents, a reduced role for urgent carotid endarterectomy, alternative treatments for large-vessel disease, identification of nontraditional risk factors, including risk factors for women, and newly published pediatric stroke guidelines. In addition, new devices for

  6. Cocaine use and stroke

    PubMed Central

    Treadwell, Sean D; Robinson, Tom G

    2007-01-01

    Stroke is the third most common cause of death in developed countries. In England and Wales, 1000 people under the age of 30 have a stroke each year. Cocaine is the most commonly used class A drug, and the first report of cocaine‐induced stroke was in 1977. Since the development of alkaloidal “crack” cocaine in the 1980s, there has been a significant rise in the number of case reports describing both ischaemic and haemorrhagic stroke associated with cocaine use. Cocaine is a potent central nervous system stimulant, and acts by binding to specific receptors at pre‐synaptic sites preventing the reuptake of neurotransmitters. The exact mechanism of cocaine‐induced stroke remains unclear and there are likely to be a number of factors involved including vasospasm, cerebral vasculitis, enhanced platelet aggregation, cardioembolism, and hypertensive surges associated with altered cerebral autoregulation. The evidence surrounding each of these factors will be considered here. PMID:17551070

  7. Biologie statt Philosophie? Evolutionäre Kulturerklärungen und ihre Grenzen

    NASA Astrophysics Data System (ADS)

    Illies, Christian

    Vor über siebzig Jahren fand man in einer Höhle nahe Hohlenstein-Stadel, im heutigen Baden-Württemberg, eine Frau, die keiner bekannten Spezies und nicht einmal eindeutig den Hominiden zugeordnet werden konnte. Wegen ihres Aussehens wurde sie schon bald als "Löwenfrau“ bekannt (unterdessen wird sie als "Löwenmensch“ bezeichnet, da die in solchen Fragen Klarheit schaffenden Geschlechtsteile bei der Figur fehlen und in Zeiten von gender mainstreaming derartige Festlegungen gerne vermieden werden), denn sie hatte eine menschlich-aufrechte, unbehaarte Gestalt mit weiblichen Rundungen, aber zugleich eine Mähne, sowie Augen, Ohren und Schnauze eines Löwen. Eine sehr weitläufige Verwandte des Minotaurus, so schien es, und doch wesentlich älter als alle Bewohner des Olymps, denn vermutlich wurde die knapp 30 cm große Skulptur bereits in der Altsteinzeit vor etwa 32.000 Jahren aus Mammut-Elfenbein geschnitzt. Wir wissen nicht, ob sie kultischen Zwecken diente oder ein Kind mit ihr spielte, ob sie als Glücksbringer für die Jagd oder als Schamanin mit Löwenmaske verehrt und gefürchtet wurde. Aber die Löwenfrau legt nahe, dass der Mensch schon im Morgendämmern seiner Kultur über die eigene Nähe, aber auch Distanz zum Tier nachgedacht haben muss. Die Frage nach der menschlichen Selbstverortung begegnet uns in dieser Figur, und sie bestimmt viele Zeugnisse menschlichen Nachdenkens, welche uns die Altertumswissenschaften vorlegen. Mit dem Begriff "animal rationale“, wie er unter Bezug auf Aristoteles geprägt wurde, findet sie schließlich ihre klassische, für das Abendland lange Zeit maßgebliche Antwort: Der Mensch als Tier, dessen spezifisches Merkmal die Vernunftbegabtheit ist, die ihn zugleich von allen anderen Tieren abgrenzt und über sie stellt. Aber wo genau verläuft die Grenze? Und wie kann der Mensch beides zugleich sein? Die aristotelische Definition beantwortet diese Fragen nach der Doppelnatur nicht, sondern erhebt das offene R

  8. Cerebrorenal interaction and stroke.

    PubMed

    Toyoda, Kazunori

    2013-01-01

    Beyond the original meaning of chronic kidney disease (CKD) as high-risk state for future dialysis, CKD is now known as an established risk factor for cardiovascular diseases. Stroke is a major player of cardiovascular disease and has deep two-way relationships with CKD. CKD is an evident risk factor for stroke. Meta-analyses of cohort studies and trials indicate that proteinuria/albuminuria increases the risk of stroke by 71-92%, and reduced glomerular filtration rate increases the risk by 43%. In addition, CKD has a strong relationship with subclinical brain damage including white matter changes, microbleeds, cognitive impairment, and carotid atherosclerosis. CKD is prevalent in acute stroke patients; patients with estimated glomerular filtration rate <60 ml/min/1.73 m(2) or proteinuria amounted to 46% of total ischemic stroke patients and 39% of total intracerebral hemorrhage patients in our institute. Acute and chronic management of stroke are influenced by CKD. Therapeutic effects of several antithrombotic and thrombolytic agents, including recently-developed novel oral anticoagulants, are affected by renal function. Moreover, reduced glomerular filtration rate is independently associated with increased 1- and 10-year mortalities in the end. Stroke also has deep relationships with end-stage kidney disease. Stroke occurs much more commonly in dialysis patients than general population or CKD patients without need for dialysis. The triggers of ischemic and hemorrhagic stroke in patients with end-stage kidney disease include special characteristics unique to dialysis, such as drastic hemodynamic change, dialysate and anticoagulants, and vascular calcification. As cohorts of dialysis patients become older, more hypertensive, and more diabetic than before, stroke become more prevalent and more serious events in dialysis clinics. Now, clinicians should have much interest in the association between CKD and cerebrovascular diseases, so-called the cerebro

  9. Physik gestern und heute Die Messung elektrostatischer Kräfte

    NASA Astrophysics Data System (ADS)

    Heering, Peter

    2002-11-01

    Im Jahre 1785 veröffentlichte der französische Militäringenieur Charles Augustin Coulomb das Kraft-Abstand-Gesetz für elektrische Ladungen. Bereits zuvor hatte Henry Cavendish auf andere Art und Weise diese Beziehung nachgewiesen, aber nicht publiziert. Entsprechende Experimente wurden auch noch in jüngerer Zeit ausgeführt, da sie eine obere Abschätzung für die Ruhemasse des Photons erlauben.

  10. Workflow-Management für organisationsübergreifende Datenübertragung am Beispiel des E-Learning-Systems der TUM

    NASA Astrophysics Data System (ADS)

    Boursas, Latifa

    In diesem Paper werden im ersten Schritt die Voraussetzungen und Anforderungen für Workflow-Management zur Bereitstellung einer organisationsübergreifenden Datenübertragung ausgeführt. Weiter werden auf einfache Art und Weise die Grundlagen des Identity Managements (IDM) und der Provisionierung von Zielsystemen erläutert sowie die technischen Lösungsideen für die genannten Anforderungen eingeführt. Am Beispiel des E-Learning-Systems der TU München zeigen wir zwei Lösungsansätze. Zu jedem Lösungsansatz werden die technischen Workflows genauer betrachtet und der Funktionsumfang erläutert. Ein paar Uses Cases bei den Datenkonvertierungen, die sich auf die verschiedenen Identity-Management-Schnittstellen beziehen werden auch präsentiert. Am Ende schließt ein Vergleich der beiden Lösungsansätze die Analyse ab.

  11. Pyropheophorbide und a as a catabolite of ethylene-induced chlorophyll und a degradation

    SciTech Connect

    Shimokawa, Keishi; Hashizume, Akihito ); Shioi, Yuzo )

    1990-05-01

    An enzyme extract prepared from ethylene-induced degreening Citrus fruits contains chlorophyll (Chl) degrading enzymes. The fate of Chl carbons during an enzymatic degradation was investigated using Chl {und a}-{sup 14}C. Accompanying the disappearance of labelled Chl {und a}, pheophorbide {und a} and pyropheophorbide {und a} appeared and accumulation of pyropheophorbide {und a} was observed. HydroxyChl {und a} was also detected, but this is thought to be an artifact during chromatography. Unlike ethylene-induced Citrus fruits (in vivo), further degradation of pyropheophorbide {und a} did not occur in vitro enzyme system. This suggests that there is a lack of enzyme(s) and/or cofactor(s) for further degradation. It is concluded that Chl {und a} degraded enzymatically by the following order: Chl {und a}, chlorophyllide {und a}, pheophorbide {und a} and pyropheophorbide {und a}.

  12. Stroke and High Blood Pressure

    MedlinePlus

    ... Blood Pressure Tools & Resources Stroke More Stroke and High Blood Pressure Updated:Jan 6,2015 Stroke is a leading ... to heart disease and stroke. Start exploring today ! High Blood Pressure • Home • About High Blood Pressure (HBP) • Why HBP ...

  13. Imaging acute ischemic stroke.

    PubMed

    González, R Gilberto; Schwamm, Lee H

    2016-01-01

    Acute ischemic stroke is common and often treatable, but treatment requires reliable information on the state of the brain that may be provided by modern neuroimaging. Critical information includes: the presence of hemorrhage; the site of arterial occlusion; the size of the early infarct "core"; and the size of underperfused, potentially threatened brain parenchyma, commonly referred to as the "penumbra." In this chapter we review the major determinants of outcomes in ischemic stroke patients, and the clinical value of various advanced computed tomography and magnetic resonance imaging methods that may provide key physiologic information in these patients. The focus is on major strokes due to occlusions of large arteries of the anterior circulation, the most common cause of a severe stroke syndrome. The current evidence-based approach to imaging the acute stroke patient at the Massachusetts General Hospital is presented, which is applicable for all stroke types. We conclude with new information on time and stroke evolution that imaging has revealed, and how it may open the possibilities of treating many more patients. PMID:27432672

  14. Prehospital stroke care

    PubMed Central

    Saver, Jeffrey L.; Starkman, Sidney; Lees, Kennedy R.; Endres, Matthias

    2013-01-01

    Brain cells die rapidly after stroke and any effective treatment must start as early as possible. In clinical routine, the tight time–outcome relationship continues to be the major limitation of therapeutic approaches: thrombolysis rates remain low across many countries, with most patients being treated at the late end of the therapeutic window. In addition, there is no neuroprotective therapy available, but some maintain that this concept may be valid if administered very early after stroke. Recent innovations have opened new perspectives for stroke diagnosis and treatment before the patient arrives at the hospital. These include stroke recognition by dispatchers and paramedics, mobile telemedicine for remote clinical examination and imaging, and integration of CT scanners and point-of-care laboratories in ambulances. Several clinical trials are now being performed in the prehospital setting testing prehospital delivery of neuroprotective, antihypertensive, and thrombolytic therapy. We hypothesize that these new approaches in prehospital stroke care will not only shorten time to treatment and improve outcome but will also facilitate hyperacute stroke research by increasing the number of study participants within an ultra-early time window. The potentials, pitfalls, and promises of advanced prehospital stroke care and research are discussed in this review. PMID:23897876

  15. The Migraine–Stroke Connection

    PubMed Central

    Lee, Mi Ji; Lee, Chungbin; Chung, Chin-Sang

    2016-01-01

    Migraine and stroke are common neurovascular disorders which share underlying physiological processes. Increased risks of ischemic stroke, hemorrhagic stroke, and subclinical ischemic lesions have been consistently found in migraineurs. Three possible associations are suggested. One is that underlying pathophysiology of migraine can lead to ischemic stroke. Second, common comorbidities between migraine and stroke can be present. Lastly, some syndromes can manifest with both migraine-like headache and cerebrovascular disease. Future studies should be targeted on bidirectional influence of migraine on different stroke mechanisms and optimal prevention of stroke in migraine patients. PMID:27283278

  16. Entwicklung und methodische Verbesserung der Arbeitssicherheit in der Instandhaltung

    NASA Astrophysics Data System (ADS)

    Galinski, Marek

    Die Hüttenwerke Krupp Mannesmann gehören zu den führenden Stahlherstellern in Europa. Die Instandhaltung ist einerseits den Anlagen vor Ort zugeordnet, andererseits gibt es für werksweite bzw. spezielle Themen eine zentrale Instandhaltung. Die im Folgenden beschriebenen Methoden wurden für das gesamte Unternehmen entwickelt, jedoch je nach Organisationseinheit unterschiedlich adaptiert und unterschiedlich intensiv verfolgt. Die zentrale Instandhaltung hat insbesondere in den letzten 12 Jahren der Arbeitssicherheit einen hohen Stellenwert beigemessen, und hervorragende Ergebnisse erzielt. So ist die Unfallhäufigkeit in der zentralen Instandhaltung von ca. 30 anzeigepflichtigen Unfällen pro eine Million verfahrener Stunden vor ca. 15 Jahren auf Null in 2007 gesunken! In 2008 konnte dieses hervorragende Ergebnis gehalten werden. Zwei Jahre unfallfrei! Wer hätte das vor 15 Jahren gedacht? Der Schwerpunkt des Beitrags liegt auf der Erläuterung der Ansatzpunkte mit denen dieses Ergebnis erreicht wurde und der Darstellung der Methoden incl. der Anpassung an die veränderten Ansatzpunkte in den betroffenen Bereichen. Die beschriebenen Methoden sind in der zentralen Instandhaltung so angewendet worden.

  17. Hyponatremia in stroke

    PubMed Central

    Saleem, Sheikh; Yousuf, Irfan; Gul, Azhara; Gupta, Satish; Verma, Sawan

    2014-01-01

    Introduction: Hyponatremia is a common electrolyte disorder encountered in patients of neurological disorders which is usually either due to inappropriate secretion of Antidiuretic hormone (SIADH) or cerebral salt wasting syndrome (CSWS). We conducted this study in a tertiary care hospital to determine the incidence and etiology of hyponatremia in patients of stroke admitted in the hospital. Materials and Methods: It was a prospective study done over a period of two years that included established cases of stroke diagnosed on the basis of clinical history, examination and neuroimaging. 1000 stoke patients were evaluated for hyponatremia (serum sodium <130 meq/l). The data was analysed using Chi-square test using SPSS (Statistical package for social science) software. Results: Out of 1000 patients, 353 patients had hyponatremia. Out of this 353 patients, 238 (67%) had SIADH and 115 (33%) had CSWS. SIADH was seen in 83 patients who had ischemic stroke and 155 patients of hemorrhagic stroke. CSWS was found in 38 patients with ischemic stroke and 77 patients with hemorrhagic stroke. Statistical analysis revealed that hyponatremia significantly affects the outcome of stroke especially when it is due to CSWS rather than SIADH. Conclusion: Incidence of hyponatremia in our study population was 35%. In patients of hyponatremia 67% were having SIADH and 33% were having CSWS. Overall hyponatremia affected the outcome of stroke especially when caused by CSWS. Therefore close monitoring of serum sodium must be done in all patients who are admitted with stroke and efforts must be made to determine the cause of hyponatremia, in order to properly manage such patients thereby decreasing the mortality rate. PMID:24753660

  18. Methodik der Erfassung und Bewertung von Biodiversitätsschäden aus ökologischer Sicht

    NASA Astrophysics Data System (ADS)

    Wiegleb, Gerhard; Krawczynski, René; Wagner, Hans-Georg

    Mit der Verabschiedung des Umweltschadensgesetzes (USchadG) hat der Schutz der Biodiversität in Deutschland ein neues Stadium erreicht. Zum ersten Male wird selbst die Vermeidung und Restitution der nichtintendierten Schädigung der Biodiversität in Gestalt bestimmter Arten und Lebensräume in ein umfassendes Naturschutzkonzept einbezogen. Das USchadG geht damit über die bisherigen Ansätze zum Schutz der belebten Natur hinaus, da es gleichzeitig neben der Erhaltung eines als günstig erkannten Ist-Zustandes der Biodiversität der Vermeidung vorhersehbarer Schäden sowie auch der Restitution nach einem eingetretenen Schaden verpflichtet ist. Naturschutzsystematisch gehört es wegen der Betonung der Vermeidung und Sanierung zum Bereich des reaktiven Naturschutzes (Gefahrenabwehr und Gefahrenbeseitigung), dem auch die Eingriffsregelung des Bundesnaturschutzgesetzes (BNatSchG), die Umweltverträglichkeitsprüfung nach Umweltverträglichkeitsprüfungsgesetz (UVPG) sowie die FFH-Verträglichkeitsprüfung nach Fauna-Flora-Habitat-Richtlinie (FFH-RL) zuzurechnen sind. Stärker noch als in den genannten Regelungen tritt im USchadG das Verursacherprinzip gegenüber der allgemeinen Umweltvorsorge in den Vordergrund.

  19. [Obesity Paradox and Stroke].

    PubMed

    Baumgartner, Ralf; Oesch, Lisa; Sarikaya, Hakan

    2016-07-01

    The obesity paradox suggests that overweight and obese patients of older age may have higher survival rates after stroke as compared to normalweight patients. However, the results need a cautious interpretation due to selection bias, treatment bias and different patients’ characteristics. Moreover, randomized studies that prove a benefit of weight reduction are still lacking. As obesity is an independet risk factor for stroke, weight reduction should still be recommended in overweight patients. Randomized-controlled studies are needed to prove the effect of weight reduction on morbidity and mortality after stroke. PMID:27381308

  20. Bestimmung thermischer Eigenschaften der Gesteine des Unteren und Mittleren Buntsandsteins

    NASA Astrophysics Data System (ADS)

    Franz, Claudia; Schulze, Marcellus

    2016-03-01

    For accurate planning of vertical borehole heat exchanger systems, knowledge of thermo-physical ground parameters is critical. This study reports laboratory-measured thermal conductivity and diffusivity values of Mesozoic sandstones (Lower and Middle Buntsandstein) from four wells. The measurements were made on drill core using an optical scanning method. The mean thermal conductivities of the sandstones range between 2.6 ± 0.3 W / (m · K) and 3.1 ± 0.4 W / (m · K) for dry conditions and between 3.6 ± 0.3 W / (m · K) and 4.1 ± 0.6 W / (m · K) after saturation with water. The mean thermal diffusivity values range between (1.6 ± 0.2) · 10- 6 m2 / s for dry and (2.0 ± 0.6) · 10- 6 m2 / s for water-saturated sandstones. Thermal properties are closely related to the petrography and lithostratigraphy of the sandstones. Additionally, three temperature correction methods were applied for the purpose of evaluating the comparative accuracy and the correction schemes with respect to local in-situ conditions. The results show that the temperature corrections proposed by Somerton (Thermal properties on temperature-related behavior of rock/fluid systems, Elsevier, New York, S 257, 1992) and Sass et al. (J Geophys Res, 97:5017-5030, 1992) are most suited for the respective sandstone data set.

  1. Pediatric Stroke: A Review

    PubMed Central

    Tsze, Daniel S.; Valente, Jonathan H.

    2011-01-01

    Stroke is relatively rare in children, but can lead to significant morbidity and mortality. Understanding that children with strokes present differently than adults and often present with unique risk factors will optimize outcomes in children. Despite an increased incidence of pediatric stroke, there is often a delay in diagnosis, and cases may still remain under- or misdiagnosed. Clinical presentation will vary based on the child's age, and children will have risk factors for stroke that are less common than in adults. Management strategies in children are extrapolated primarily from adult studies, but with different considerations regarding short-term anticoagulation and guarded recommendations regarding thrombolytics. Although most recommendations for management are extrapolated from adult populations, they still remain useful, in conjunction with pediatric-specific considerations. PMID:22254140

  2. Endocarditis and stroke.

    PubMed

    Grecu, Nicolae; Tiu, Cristina; Terecoasa, Elena; Bajenaru, Ovidiu

    2014-12-01

    Endocarditis is an important, although less common, cause of cerebral embolism. All forms of endocarditis share an initial common pathophysiologic pathway, best illustrated by the non-bacterial thrombotic form, but also a final potential for embolization. Stroke associated with endocarditis has signifficant mortality and morbidity rates, especially due to the frequent concomitant multiple sites of brain embolization. In this article we aim to briefly review endocarditis with a focus on stroke as a complication, while also presenting case correlates from our department.

  3. Neuropsychology of acute stroke.

    PubMed

    Sinanović, Osman

    2010-06-01

    Neuropsychology includes both the psychiatric manifestations of neurological illness (primary brain-based disorders) and neurobiology of "idiopathic" psychiatric disorders. Neurological primary brain disorders provoke broad spectrum of brain pathophysiology that cause deficit sin human behaviour, and the magnitude of neurobehavioral-related problems is a world wide health concern. Speech disorders of aphasic type, unilateral neglect, anosognosia (deficit disorders), delirium and mood disorders (productive disorders) in urgent neurology, first of all in acute phase of stroke are more frequent disorders then it verified in routine exam, not only in the developed and large neurological departments. Aphasia is common consequence of left hemispheric lesion and most common neuropsychological consequence of stroke, with prevalence of one third of all stroke patients in acute phase although exist reports on greater frequency. Unilateral neglect is a disorder that mostly effects the patient after the lesion of the right hemisphere, mostly caused by a cerebrovascular insult (infarct or haemorrhage affecting a large area - up to two thirds of the right hemisphere), and in general the left-side neglect is the most widespread neuropsychological deficit after the lesion of the right cerebral hemisphere. Reports on the incidence of visual neglect vary and they range from 13 to 85%. Anosognosia is on the second place as neuropsychological syndrome of stroke in right hemisphere, characterized by the denial of the motor, visual or cognitive deficit. This syndrome, defined as denial of hemiparesis or hemianopsia, is a common disorder verified in 17-28% of all patents with acute brain stoke. There are different reports on frequency of delirium in acute stroke, from 24 to 48%, and it is more frequent in hemorrhagic then ischemic stoke. Post stroke depression (PSD) is one of the more frequent consequences on the stroke, and the prevalence of PSD has ranged from 5 to 63% of patients in

  4. Beschallungstechnik, Beschallungsplanung und Simulation

    NASA Astrophysics Data System (ADS)

    Ahnert, Wolfgang; Goertz, Anselm

    Die primäre Aufgabe einer Lautsprecheranlage ist es, Musik, Sprache oder auch Signaltöne und Geräusche wiederzugeben. Diese können von einem Tonträger kommen (CD, Sprachspeicher), von einem anderen Ort übertragen (Zuspielung über Radio, TV, Telefon) oder vor Ort erzeugt werden. Letzteres umfasst Konzerte, Ansprachen, Durchsagen oder künstlerische Darbietungen, bei denen es meist darum geht, eine bereits vorhandene Quelle einer größeren oder weiter verteilten Anzahl von Personen zugänglich zu machen.

  5. Molekulare Methoden zum Nachweis, zur Quantifizierung und zum Monitoring der Mykotoxinbildung lebensmittelrelevanter Pilze

    NASA Astrophysics Data System (ADS)

    Geisen, Rolf

    Schimmelpilze kommen ubiquitär vor und spielen besonders bei pflanzlichen Lebensmitteln und Rohprodukten eine besondere Rolle als Verderbsorganismen. Es wird geschätzt, dass 20-25 % der jährlichen Produktion an pflanzlichen Produkten durch Schimmelpilze verdorben werden (Smith et al., 1994). Viele der lebensmittelrelevanten Schimmelpilze sind zudem in der Lage, Mykotoxine, toxische Sekundärmetabolite, zu bilden, was das Ausmaß des Problems deutlich macht. Die wichtigsten mykotoxinbildenden Spezies gehören zu den Fusarien (Trichothecene, Fumonisine, Zearalenon), Aspergillen (Aflatoxin, Ochratoxin, Cyclopiazonsäure) und Penicillien (Patulin, Ochratoxin). Für viele Mykotoxine, wie die Aflatoxine, Ochratoxin, Fumonisine und Trichothecene sind Grenzwerte erlassen worden, die die Verkehrsfähigkeit betroffener Produkte regeln. Die Einhaltung der Grenzwerte kann sehr genau durch offizielle chemisch-analytische Methoden, wie HPLC, GC-MS etc. kontrolliert werden. Diese analytischen Methoden sind aber für die Anwendung eines HACCP-Ansatzes zur Kontrolle der Mykotoxinbildung nur bedingt geeignet, da sie Endpunktkontrollen darstellen und nur das über eine längere Zeit gebildete Mykotoxin bestimmen. Sie sagen daher nichts über die biologischen Bedingungen zur Zeit der Bildung durch den Pilz aus.

  6. Renaturierung von Feuchtgrünland, Auengrünland und mesophilem Grünland

    NASA Astrophysics Data System (ADS)

    Rosenthal, Gert; Hölzel, Norbert

    Grünland stellt in Mitteleuropa fast ausschließlich eine Kulturformation dar, die in der Naturlandschaft abgesehen von extremen Trocken- und Nassstandorten sowie klimatisch ungünstigen Gebieten oberhalb der alpinen Waldgrenze nur kleinflächig vertreten war.Die natürlichen Standorte der heutigen Grünlandarten waren in Mitteleuropa bis in das Atlantikum hinein Wälder oder natürlicherweise waldfreie ökosysteme, wie z.B. Röhricht- und Ufervegetation sowie Biberwiesen in Flussauen, Niedermoore, Randlaggs von Regenmooren, Waldlichtungen oder Lawinenbahnen (Ellenberg 1952, 1996). Die Naturlandschaft der heutigen Grünlandstandorte war durch die natürliche Dynamik der vorherrschenden Waldökosysteme mit ihren Entwicklungsstadien und natürlichen Störungsereignissen (Stürme, überschwemmungen etc.) geprägt. Der Flächenanteil des Grünlandes vergrößerte sich erst durch Beweidung und Heumahd durch den Menschen und seine Haustiere.

  7. Die Deutsche Statistische Gesellschaft in der Weimarer Republik und während der Nazidiktatur

    NASA Astrophysics Data System (ADS)

    Wilke, Jürgen

    Nach anfänglichen Schwierigkeiten durch den 1. Weltkrieg erlangte die Deutsche Statistische Gesellschaft (DStatG) unter dem renommierten Statistiker und Vorsitzenden der DStatG, Friedrich Zahn, durch eine Vielzahl von Aktivitäten hohes Ansehen. Es gab Bestrebungen, Statistiker aus allen Arbeitsfeldern der Statistik in die DStatG zu integrieren, wobei die "Mathematische Statistik" nur zögerlich akzeptiert wurde (Konjunkturforschung, Zeitreihenanalyse). Nach der Machtübernahme 1933 durch Adolf Hitler geriet die DStatG in das Fahrwasser nationalsozialistischer Ideologie und Politik (Führerprinzip, Gleichschaltung des Vereinswesens). Damit war eine personelle Umstrukturierung in der DStatG verbunden. Politisch Missliebige und rassisch Verfolgte mussten die DStatG verlassen (Bernstein, Freudenberg, Gumbel u.a.). Unter den Statistikern gab es alle Abstufungen im Verhalten zum Regime von Ablehnung und zwangsweiser Anpassung über bereitwilliges Mitläufertum bis zu bewusster Täterschaft. Besonders die Bevölkerungsstatistik wurde durch die NS- Rassenpolitik auf lange Sicht diskreditiert. Im Rahmen von Wirtschaftsplanung und Aufrüstung wurden neue zukunftsträchtige statistische Modelle (Grünig, Bramstedt, Leisse) entwickelt.

  8. Lipoprotein (a) and stroke

    PubMed Central

    Milionis, H.; Winder, A.; Mikhailidis, D.

    2000-01-01

    Strokes are one of the most common causes of mortality and long term severe disability. There is evidence that lipoprotein (a) (Lp(a)) is a predictor of many forms of vascular disease, including premature coronary artery disease. Several studies have also evaluated the association between Lp(a) and ischaemic (thrombotic) stroke. Several cross sectional (and a few prospective) studies provide contradictory findings regarding Lp(a) as a predictor of ischaemic stroke. Several factors might contribute to the existing confusion—for example, small sample sizes, different ethnic groups, the influence of oestrogens in women participating in the studies, plasma storage before Lp(a) determination, statistical errors, and selection bias. This review focuses on the Lp(a) related mechanisms that might contribute to the pathogenesis of ischaemic stroke. The association between Lp(a) and other cardiovascular risk factors is discussed. Therapeutic interventions that can lower the circulating concentrations of Lp(a) and thus possibly reduce the risk of stroke are also considered. Key Words: atherothrombosis • fibrinogen • homocysteine • lipids • lipoprotein a • stroke PMID:10961170

  9. World Stroke Organization global stroke services guidelines and action plan.

    PubMed

    Lindsay, Patrice; Furie, Karen L; Davis, Stephen M; Donnan, Geoffrey A; Norrving, Bo

    2014-10-01

    Every two seconds, someone across the globe suffers a symptomatic stroke. 'Silent' cerebrovascular disease insidiously contributes to worldwide disability by causing cognitive impairment in the elderly. The risk of cerebrovascular disease is disproportionately higher in low to middle income countries where there may be barriers to stroke care. The last two decades have seen a major transformation in the stroke field with the emergence of evidence-based approaches to stroke prevention, acute stroke management, and stroke recovery. The current challenge lies in implementing these interventions, particularly in regions with high incidences of stroke and limited healthcare resources. The Global Stroke Services Action Plan was conceived as a tool to identifying key elements in stroke care across a continuum of health models. At the minimal level of resource availability, stroke care delivery is based at a local clinic staffed predominantly by non-physicians. In this environment, laboratory tests and diagnostic studies are scarce, and much of the emphasis is placed on bedside clinical skills, teaching, and prevention. The essential services level offers access to a CT scan, physicians, and the potential for acute thrombolytic therapy, however stroke expertise may still be difficult to access. At the advanced stroke services level, multidisciplinary stroke expertise, multimodal imaging, and comprehensive therapies are available. A national plan for stroke care should incorporate local and regional strengths and build upon them. This clinical practice guideline is a synopsis of the core recommendations and quality indicators adapted from ten high quality multinational stroke guidelines. It can be used to establish the current level of stroke services, target goals for expanding stroke resources, and ensuring that all stages of stroke care are being adequately addressed, even at the advanced stroke services level. This document is a start, but there is more to be done

  10. World Stroke Organization global stroke services guidelines and action plan.

    PubMed

    Lindsay, Patrice; Furie, Karen L; Davis, Stephen M; Donnan, Geoffrey A; Norrving, Bo

    2014-10-01

    Every two seconds, someone across the globe suffers a symptomatic stroke. 'Silent' cerebrovascular disease insidiously contributes to worldwide disability by causing cognitive impairment in the elderly. The risk of cerebrovascular disease is disproportionately higher in low to middle income countries where there may be barriers to stroke care. The last two decades have seen a major transformation in the stroke field with the emergence of evidence-based approaches to stroke prevention, acute stroke management, and stroke recovery. The current challenge lies in implementing these interventions, particularly in regions with high incidences of stroke and limited healthcare resources. The Global Stroke Services Action Plan was conceived as a tool to identifying key elements in stroke care across a continuum of health models. At the minimal level of resource availability, stroke care delivery is based at a local clinic staffed predominantly by non-physicians. In this environment, laboratory tests and diagnostic studies are scarce, and much of the emphasis is placed on bedside clinical skills, teaching, and prevention. The essential services level offers access to a CT scan, physicians, and the potential for acute thrombolytic therapy, however stroke expertise may still be difficult to access. At the advanced stroke services level, multidisciplinary stroke expertise, multimodal imaging, and comprehensive therapies are available. A national plan for stroke care should incorporate local and regional strengths and build upon them. This clinical practice guideline is a synopsis of the core recommendations and quality indicators adapted from ten high quality multinational stroke guidelines. It can be used to establish the current level of stroke services, target goals for expanding stroke resources, and ensuring that all stages of stroke care are being adequately addressed, even at the advanced stroke services level. This document is a start, but there is more to be done

  11. Adapting the Home After a Stroke

    MedlinePlus

    ... Trials News About Neurology Image Library Search The Internet Stroke Center Patients & Families About Stroke Stroke Diagnosis ... PROFILE→ Credits This section was developed by the Internet Stroke Center and the Program in Occupational Therapy ...

  12. Stroke Survivors Often Struggle with Depression

    MedlinePlus

    ... federal policy. More Health News on: Depression Stroke Stroke Rehabilitation Recent Health News Related MedlinePlus Health Topics Depression Stroke Stroke Rehabilitation About MedlinePlus Site Map FAQs Contact Us Get ...

  13. Pre-stroke living situation and depression contribute to initial stroke severity and stroke recovery

    PubMed Central

    Aron, Abraham W.; Staff, Ilene; Fortunato, Gilbert; McCullough, Louise D.

    2014-01-01

    Substantial evidence from both experimental and clinical studies has demonstrated that social isolation can increase stroke incidence and impair recovery. Social isolation leads to higher rates of recurrent stroke but is often not reported as a risk factor. We examined prospectively collected stroke center database variables, which included pre-stroke living situation, to determine if social isolation could be determined from existing data using living arrangement as a proxy. Patients were categorized into 4 groups hypothesized to represent increasing levels of social isolation: Living with Spouse, Living with Family, Living alone with visiting services and Living Alone. Initial stroke severity and recovery were measured using the National Institutes of Health Stroke Scale and Barthel Index, respectively. A multivariate model was used to determine the relationship between pre-stroke living situation, stroke severity and functional outcome. Patients living alone had less severe strokes on admission and better recovery at 3 months compared to the other cohorts. Patients living alone or those that lived with a spouse had less severe strokes on presentation and better recovery at both 3 and 12 months after stroke compared to the other cohorts. However, upon detailed examination, it was found that these patients also had significantly higher pre-stroke function. Pre-existing depression was significantly higher in women and depressed patients had poorer outcomes 3 months after stroke. Information regarding isolation is notably absent from most large stroke databases. A more comprehensive evaluation of social interaction should be obtained to more accurately measure social isolation. PMID:25524014

  14. Faszination Weltall. Sehen und Verstehen.

    NASA Astrophysics Data System (ADS)

    Humphrey, C.

    This book is a German translation, by T. Bührke, of the English original "The amateur astronomer's pathfinder" published in 1992. Contents: 1. Die Erde im Universum. 2. Der Nachthimmel. 3. Die Erforschung von Raum und Zeit.

  15. Renaturierung und Management von Heiden

    NASA Astrophysics Data System (ADS)

    Härdtle, Werner; Assmann, Thorsten; van Diggelen, Rudy; von Oheimb, Goddert

    Heiden zählen zu den ältesten und besonders reizvollen Kulturlandschaften Nordwesteuropas. Sie sind bezeichnend für nährstoffarme Böden in wintermilden Gebieten mit hohen Sommerniederschlägen. Während Heiden vor wenigen Jahrhunderten noch weit verbreitet und für manche Landschaften sogar prägend waren, hat sich ihr Areal heute auf wenige, meist in Naturschutzgebieten gelegene Restbestände verkleinert. Zu diesem Rückgang haben maßgeblich Änderungen der Landnutzung, aber auch Nährstoffeinträge aus umgebenden Agrarflächen und atmogene Depositionen beigetragen. In den meisten Ländern der Europäischen Union sind Heiden heute gesetzlich geschützte Ökosysteme, da diese, neben ihrem Erholungswert für den Menschen, Pflanzen- und Tierarten beherbergen, die außerhalb von Heiden nicht oder kaum überlebensfähig sind.

  16. Komet Halley: Bahnelemente und Perihelzeiten

    NASA Astrophysics Data System (ADS)

    Landgraf, Werner

    1985-02-01

    Verbesserte Bahnelemente und Perihelzeiten -2316 bis 2284 für Komet Halley. Zusammenfassung der für ein breiteres Publikum relevantesten Ergebnisse von "On the Motion of Comet Halley". ESTEC EP/14.7/6184 Final Report

  17. Strömungs- und Tracer-Transportmodellierung am Natural Attenuation-Standort Zeitz

    NASA Astrophysics Data System (ADS)

    Gödeke, Stefan; Weiß, Holger; Geistlinger, Helmut; Fischer, Anko; Richnow, Hans Herrmann; Schirmer, Mario

    Kurzfassung Numerische Modelle spielen bei der Bewertung von Natural-Attenuation-Prozessen an Feldstandorten eine bedeutende Rolle. Daher ist es wichtig diese mit Felddaten zu überprüfen und gegebenenfalls erneut zu kalibrieren. Die Modellierung des Transports eines konservativen Tracers auf der Grundlage von Felddaten ergab eine zuverlässigere Abschätzung der Kf-Werte des numerischen Strömungsmodells für den Standort, als es mit anderen Methoden (z. B. Analyse der Siebwerte) möglich war. Die Kf-Werte berechnet aus Siebanalysen führten zu einer deutlichen Unterschätzung der Tracerausbreitungsgeschwindigkeit. Zwischen beobachteten und berechneten Durchbruchskurven wurde eine gute Übereinstimmung erzielt, sodass das Modell für die Planung weiterer Feldexperimente und als Grundlage für eine reaktive Transportmodellierung genutzt werden kann. Die hydraulischen Leitfähigkeiten im Untersuchungsgebiet ändern sich in vertikaler und horizontaler Richtung im Bereich weniger Dezimeter z. T. stark, was von dem numerischen Modell nur begrenzt wiedergegeben werden kann. Für die Modellierung der Tracerausbreitung ist die Kenntnis der Kf-Wert-Verteilung im Bereich des Infiltrationsbrunnens besonders wichtig, weil sie die Struktur der Tracerfahne im Abstrom wesentlich beeinflusst. Die Wahl des numerischen Verfahrens für die Lösung der Transportgleichung hatte bei der Kalibrierung des Strömungsmodells einen großen Einfluss. Während mit dem in MT3DMS vorhandenen TVD (〝Total Variation Diminishing``)-Algorithmus eine akzeptable Lösung gefunden wurde, zeigten sich bei der Verwendung des MOC (〝Method of Characteristics``)-Verfahrens signifikante Fehler in der Massenbilanz. Reliable numerical models are of primary importance for the evaluation of Natural-Attenuation processes at field sites. Modelling the flow and transport of a conservative tracer, a more realistic distribution of the hydraulic conductivity values for the numerical model was achieved and a good

  18. Variabilität des Reviergesangs des Buchfinken (Fringilla coelebs) zur Raum-Zeit-Beschreibung von Metapopulationen

    NASA Astrophysics Data System (ADS)

    Nolte, Björn

    2003-10-01

    Der Buchfinkengesang wurde in Potsdam in zwei Hauptpopulationen über drei Jahre aufgenommen. Jedes Individuum wurde eindeutig am individuellen Strophentypenrepertoire identifiziert. Ein weiterer Punkt der die individuelle Wiedererkennung bestätigt ist die hohe Standorttreue der adulten Männchen. Die beschriebene Methode eignet sich für die Untersuchung von gesamten Populationen, um den Wandel des Gesangs von Populationen in Raum und Zeit zu beschreiben. Die Haupterkenntnisse der Arbeit sind: - Die Gesamtanzahl der Grundstrophentypen innerhalb einer Population bleibt über Jahre konstant. - Die relative Häufigkeit jedes einzelnen Strophentyps variiert von Jahr zu Jahr und von Population zu Population. - Gesangslernen erfolgt exakt mit einem Korrektheitsgrad von mindestens 96%. - Das Song-Sharing ist innerhalb der Population hoch. Die diskutierten Mechanismen für das Song-Sharing sind: Die Lebenserwartung, das Zugverhalten, das Lernverhalten, die Etabliertheit von Strophentypen, Weibchenpräferenzen und die Reaktionen der territorialen Männchen. - Weiterhin wurde ein Modell zur kulturellen Evolution des Buchfinkengesangs programmiert, um die Rolle der Einflussfaktoren, wie Fehlerquote, Abwanderungsrate und Laufzeit zu ermitteln. Der Wandel des Dialektes erfolgt graduell in Raum und Zeit. Daher sind keine scharfen Dialektgrenzen anzutreffen. Trotz dieser Tatsache markieren die etablierten Strophentypen die Population. 50 % der Juvenilen siedeln am Geburtsort, auf diese Weise bleibt der Dialekt erhalten und Inzest wird vermieden. -Analysiert man das Repertoire benachbarten Männchen bei isolierten Alleen, so entspricht die Gesangsangleichung in etwa dem Zufall. -Intraindividuelle Vergleiche der quantitativen Parameter des jeweiligen Strophentyps wurden saisonal und annuell durchgeführt. Saisonal konnten für einen Strophentyp ein Trend ermittelt werden. Bei jährlichen Vergleichen konnten intraindividuell ausschließlich nicht signifikante Ergebnisse ermittelt

  19. Variabilität des Reviergesangs des Buchfinken (Fringilla coelebs) zur Raum-Zeit-Beschreibung von Metapopulationen

    NASA Astrophysics Data System (ADS)

    Nolte, Björn

    2003-10-01

    Der Buchfinkengesang wurde in Potsdam in zwei Hauptpopulationen über drei Jahre aufgenommen. Jedes Individuum wurde eindeutig am individuellen Strophentypenrepertoire identifiziert. Ein weiterer Punkt der die individuelle Wiedererkennung bestätigt ist die hohe Standorttreue der adulten Männchen. Die beschriebene Methode eignet sich für die Untersuchung von gesamten Populationen, um den Wandel des Gesangs von Populationen in Raum und Zeit zu beschreiben. Die Haupterkenntnisse der Arbeit sind: - Die Gesamtanzahl der Grundstrophentypen innerhalb einer Population bleibt über Jahre konstant. - Die relative Häufigkeit jedes einzelnen Strophentyps variiert von Jahr zu Jahr und von Population zu Population. - Gesangslernen erfolgt exakt mit einem Korrektheitsgrad von mindestens 96%. - Das Song-Sharing ist innerhalb der Population hoch. Die diskutierten Mechanismen für das Song-Sharing sind: Die Lebenserwartung, das Zugverhalten, das Lernverhalten, die Etabliertheit von Strophentypen, Weibchenpräferenzen und die Reaktionen der territorialen Männchen. - Weiterhin wurde ein Modell zur kulturellen Evolution des Buchfinkengesangs programmiert, um die Rolle der Einflussfaktoren, wie Fehlerquote, Abwanderungsrate und Laufzeit zu ermitteln. Der Wandel des Dialektes erfolgt graduell in Raum und Zeit. Daher sind keine scharfen Dialektgrenzen anzutreffen. Trotz dieser Tatsache markieren die etablierten Strophentypen die Population. 50 % der Juvenilen siedeln am Geburtsort, auf diese Weise bleibt der Dialekt erhalten und Inzest wird vermieden. -Analysiert man das Repertoire benachbarten Männchen bei isolierten Alleen, so entspricht die Gesangsangleichung in etwa dem Zufall. -Intraindividuelle Vergleiche der quantitativen Parameter des jeweiligen Strophentyps wurden saisonal und annuell durchgeführt. Saisonal konnten für einen Strophentyp ein Trend ermittelt werden. Bei jährlichen Vergleichen konnten intraindividuell ausschließlich nicht signifikante Ergebnisse ermittelt

  20. Verfahrenstechnische Grundlagen des Coatings

    NASA Astrophysics Data System (ADS)

    Mörl, Lothar

    Die Ummantelung von Feststoffteilchen mit Hüllsubstanzen hat in verschiednen Industriezweigen in der letzten Zeit an Bedeutung gewonnen. Eine wichtige Ursache dafür dürfte in den immer höheren Anforderungen begründet sein, die an Feststoffformulierungen gestellt werden. Neben den hohen Ansprüchen an die Rezepturgenauigkeit wird es immer interessanter, die Freisetzung bestimmter in den Feststoffformulierungen enthaltener Wirkstoffe voraussagen zu können. So ist es zum Beispiel insbesondere in der pharmazeutischen Industrie von entscheidender Bedeutung, wann und unter welchem Milieu die in einer Tablette oder in einem Dragee enthaltenen Wirkstoffe freigesetzt werden und wie schnell diese Freisetzung geschieht. Aber auch in anderen Industriezweigen wie z. B. der Landwirtschaft können durch die Ummantelung von pflanzlichen Samen (Samenpillierung) mit Herbiziden, Fungiziden, Wachstumsstimulatoren, Düngemitteln und anderen Substanzen erhebliche Effekte bei der Einsparung von Schädlingsbekämpfungsmitteln und beim Schutz der Keimlinge bei gleichzeitiger Optimierung der Gestalt der Samenpille erreicht werden. Auch die Entwicklung von sphärisch aufgebauten Düngemittelgranulaten mit definierter Wirkstofffreisetzung und optimalen Eigenschaften der Partikel für die Ausbringung in der Landwirtschaft ist auf diese Art möglich. Auch in der Nahrungs- und Genussmittelindustrie lassen sich eine Reihe von Anwendungsgebieten nennen, wie zum Beispiel die Kandierung von Bohnenkaffe, die Verkapselung von Vitaminen u. a [1].

  1. Diskrepanzen und Kongruenzen: Das Dilemma des afrikanischen Kindes zwischen Familie und Schule

    NASA Astrophysics Data System (ADS)

    Bauer, Annemarie

    1986-03-01

    This article expounds the theory that the failure of school is due to the incompatibility of the educational goals of school and traditional upbringing in Africa. The thesis is put forward by adherents of the psychoanalytical model of child development and seeks to emphasize the discrepancies between the childhood where children are not frustrated and where their needs are cared for and the school education which represses the drives and its socialization of children. Finding a number of anthropological studies are discussed and reinterpretations of the ethno-psychoanalytical materials attempted. Neither the evaluation of childhood in Africa nor the theory that with school come wholly new expectations of behaviour (e.g., a performance requirement) can no longer be maintained. In conclusion, other explanations for the difficulties encountered by school in Africa are offered.

  2. [Secondary stroke prevention].

    PubMed

    Ferro, J M; Correia, M; Freire, A; Perez y Sanchez, J; Abrunhosa, M A; Perez y Sanchez, M F

    1998-11-01

    The guidelines for secondary stroke prevention, graded following available scientific evidence, are presented. Stroke and TIA are defined and the indications for referral established. Basic assessment of stroke patients should include laboratory evaluation, ECG, brain CT, ultrasound examination of the extracranial vessels for events in the carotid distribution, and transthoracic or transesophageal echocardiogram if cardioembolism is suspected. The pharmacological and non-pharmacological reduction of blood pressure and serum cholesterol, stopping smoking and reducing alcohol intake are general measures recommended for secondary stroke prevention, together with healthier life-style changes (eating a Mediterranean type diet and performing regular moderate physical exercise). Concerning antithrombotic therapy, oral anticoagulants are recommended for patients with atrial fibrillation and other high to medium emboligenic cardiac risk conditions. Antiplatelet drugs are recommended for all other survivors of an ischemic cerebral event. Aspirin (75-325 mg/day) is the drug of choice. Alternative antiplatelet agents are clopidrogrel, ticlopidine, dipiridamol or triflusal. They can be used in patients with intolerance or contraindication to aspirin or in high-risk subjects. Endarterectomy of the symptomatic carotid is an additional procedure recommended for patients with ischemic stroke or TIA and carotid stenosis > 80% on the side of the symptomatic cerebral hemisphere. PMID:10021804

  3. Die Amtliche Sammlung von Untersuchungsverfahren nach § 64 LFGB, § 35 Vorläufiges Tabakgesetz und § 28b Gentechnikgesetz - ein Instrument der amtlichen Lebensmittelüberwachung

    NASA Astrophysics Data System (ADS)

    Renger, Silke; Stachel, Carolin

    Immer wieder werden Skandale in Zusammenhang mit Lebensmitteln bekannt. Schlagworte wie BSE, Gammelfleisch, Acrylamid, Cumarin oder auch Melamin, Dioxin sind den Verbrauchern geläufig und erschüttern das Vertrauen in ein gesundes und ernährungsphysiologisch wertvolles Lebensmittel. Das Bewusstsein des Verbrauchers hinsichtlich der Ernährung und der Auswahl beim Kauf der Lebensmittel hat sich in den vergangenen Jahren deutlich verändert. Bei der Auswahl seiner Lebensmittel liegt sein Augenmerk verstärkt auf gesunden, qualitativ hochwertigen und vor allem sicheren Lebensmitteln. Dies wurde insbesondere bei dem verhaltenen Kauf von Fleisch und Fleischerzeugnissen während der BSE-Krise oder auch dem kürzlich aufgetretenen Gammelfleischskandal deutlich.

  4. Education in stroke: strategies to improve stroke patient care.

    PubMed

    Gompertz, Patrick; Slack, Andrew; Vogel, Mira; Burrows, Sharon; Clark, Philippa

    2002-07-01

    'Stroke units save lives', but organized care requires expert staff and regular training to be effective. However, the quality of inpatient care for stroke remains poor, and stroke education is often fragmented between the health-care professions. This review describes some national and local strategies aimed at ensuring that all patients are cared for by expert staff.

  5. An Economic Evaluation Comparing Stroke Telemedicine to Conventional Stroke Medicine

    ERIC Educational Resources Information Center

    Budhram, Stanley Chandra

    2011-01-01

    Stroke is not only a serious medical problem, but it also poses an enormous economic burden on society. Stroke ranks the third as the leading cause of death in the United States behind heart disease and cancer. The survivors of stroke suffer from various degrees of long-term disability which create a severe financial burden on society. University…

  6. Stroke rehabilitation and discharge planning.

    PubMed

    Kerr, Peter

    Nurses play a pivotal role in the rehabilitation and discharge planning process of patients who have had a stroke. The nurse's role in the wider stroke multidisciplinary team is complex and diverse and, as such, stroke nurses may find it hard to describe their role and how it fits into the rehabilitation and discharge planning process. A definition of the stroke nurse role in prominent publications such as those of the Scottish Intercollegiate Guidelines Network and the Royal College of Physicians is lacking. This article emphasises the role of the stroke nurse in the rehabilitation and discharge planning process in the stroke unit, while highlighting the complexity, diversity and importance of this role in providing holistic care and support for patients who have survived a stroke. The author draws on his clinical experience of stroke nursing practice in primary, secondary and tertiary care in west central Scotland.

  7. Plotting Lightning-Stroke Data

    NASA Technical Reports Server (NTRS)

    Tatom, F. B.; Garst, R. A.

    1986-01-01

    Data on lightning-stroke locations become easier to correlate with cloudcover maps with aid of new graphical treatment. Geographic region divided by grid into array of cells. Number of lightning strokes in each cell tabulated, and value representing density of lightning strokes assigned to each cell. With contour-plotting routine, computer draws contours of lightning-stroke density for region. Shapes of contours compared directly with shapes of storm cells.

  8. Microwave hemorrhagic stroke detector

    DOEpatents

    Haddad, Waleed S.; Trebes, James E.

    2002-01-01

    The microwave hemorrhagic stroke detector includes a low power pulsed microwave transmitter with a broad-band antenna for producing a directional beam of microwaves, an index of refraction matching cap placed over the patients head, and an array of broad-band microwave receivers with collection antennae. The system of microwave transmitter and receivers are scanned around, and can also be positioned up and down the axis of the patients head. The microwave hemorrhagic stroke detector is a completely non-invasive device designed to detect and localize blood pooling and clots or to measure blood flow within the head or body. The device is based on low power pulsed microwave technology combined with specialized antennas and tomographic methods. The system can be used for rapid, non-invasive detection of blood pooling such as occurs with hemorrhagic stroke in human or animal patients as well as for the detection of hemorrhage within a patient's body.

  9. Stroke and Episodic Memory Disorders

    ERIC Educational Resources Information Center

    Lim, Chun; Alexander, Michael P.

    2009-01-01

    Memory impairments are common after stroke, and the anatomical basis for impairments may be quite variable. To determine the range of stroke-related memory impairment, we identified all case reports and group studies through the Medline database and the Science Citation Index. There is no hypothesis about memory that is unique to stroke, but there…

  10. Stroke and Stroke-like Episodes in Muscle Disease

    PubMed Central

    Finsterer, Josef

    2012-01-01

    Background: Though not obvious at a first glance, myopathies may be associated with ischemic stroke. Stroke-like episodes resemble ischemic stroke only to some extent but are a unique feature of certain mitochondrial disorders with a pathogenesis at variance from that of ischemic stroke. Only limited data are available about ischemic stroke in pri-mary myopathies and the management of stroke-like episodes in mitochondrial disorders. This review aims to summarize and discuss current knowledge about stroke in myopathies and to delineate stroke-like episodes from ischemic stroke. Methods: Literature review via PubMED using the search terms “stroke”, “cerebrovascular”, “ischemic event”, “stroke-like episode”, “stroke-mimic”, “mitochondrial disorder”. Results: Stroke in myopathies is most frequently cardioembolic due to atrial fibrillation or atrial flutter, dilated cardio-myopathy, or left-ventricular hypertrabeculation (noncompaction). The second most frequent cause of stroke in myopathies is angiopathy from atherosclerosis or vasculitis, which may be a feature of inflammatory myopathies. Athero-sclerosis may either result from classical risk factors, such as diabetes, arterial hypertension, hyperlpidemia, or smoking, associated with muscle disease, or may be an inherent feature of a mitochondrial disorder. In case of severe heart failure from cardiomyopathy as a manifestation of muscle disease low flow infarcts may occur. Thrombophilic stroke has been described in polymyositis and dermatomyositis in association with anti-phospholipid syndrome. Stroke-like episodes occur particularly in mitochondrial encephalopathy, lactacidosis and stroke-likeepisode syndrome but rarely also in Leigh-syndrome and other mitochondrial disorders. Stroke-like episodes are at variance from ischemic stroke, pathogenically, clinically and on imaging. They may be the manifestation of a vascular, metabolic or epileptic process and present with predominantly vasogenic

  11. The stroke rehabilitation paradigm.

    PubMed

    Kelly, Brian M; Pangilinan, Percival H; Rodriguez, Gianna M

    2007-11-01

    The matrix of stroke rehabilitation is evolving as we look outside the box of traditional therapy type, timing, and intensity of rehabilitation techniques. For inpatient wards, the goal of medical stability and prompt resolution of complications to maximize participation in therapy remains paramount. In the current medical model, we focus on teaching compensatory strategies and rarely on restorative approaches because of time and financial limitations. Researchers aim to identify new technologic and molecular approaches to improve functional outcomes and more accurately predict disability. This article examines different concepts surrounding the comprehensive rehabilitation paradigm of stroke survivors.

  12. Endocarditis and Stroke

    PubMed Central

    GRECU, Nicolae; TIU, Cristina; TERECOASA, Elena; BAJENARU, Ovidiu

    2014-01-01

    Endocarditis is an important, although less common, cause of cerebral embolism. All forms of endocarditis share an initial common pathophysiologic pathway, best illustrated by the non-bacterial thrombotic form, but also a final potential for embolization. Stroke associated with endocarditis has signifficant mortality and morbidity rates, especially due to the frequent concomitant multiple sites of brain embolization. In this article we aim to briefly review endocarditis with a focus on stroke as a complication, while also presenting case correlates from our department. PMID:25705308

  13. Biotherapies in stroke.

    PubMed

    Detante, O; Jaillard, A; Moisan, A; Barbieux, M; Favre, I M; Garambois, K; Hommel, M; Remy, C

    2014-12-01

    Stroke is the second leading cause of death worldwide and the most common cause of severe disability. Neuroprotection and repair mechanisms supporting endogenous brain plasticity are often insufficient to allow complete recovery. While numerous neuroprotective drugs trials have failed to demonstrate benefits for patients, they have provided interesting translational research lessons related to neurorestorative therapy mechanisms in stroke. Stroke damage is not limited to neurons but involve all brain cell type including the extracellular matrix in a "glio-neurovascular niche". Targeting a range of host brain cells, biotherapies such as growth factors and therapeutic cells, currently hold great promise as a regenerative medical strategy for stroke. These techniques can promote both neuroprotection and delayed neural repair through neuro-synaptogenesis, angiogenesis, oligodendrogliogenesis, axonal sprouting and immunomodulatory effects. Their complex mechanisms of action are interdependent and vary according to the particular growth factor or grafted cell type. For example, while "peripheral" stem or stromal cells can provide paracrine trophic support, neural stem/progenitor cells (NSC) or mature neurons can act as more direct neural replacements. With a wide therapeutic time window after stroke, biotherapies could be used to treat many patients. However, guidelines for selecting the optimal time window, and the best delivery routes and doses are still debated and the answers may depend on the chosen product and its expected mechanism including early neuroprotection, delayed neural repair, trophic systemic transient effects or graft survival and integration. Currently, the great variety of growth factors, cell sources and cell therapy products form a therapeutic arsenal that is available for stroke treatment. Their effective clinical use will require prior careful considerations regarding safety (e.g. tumorgenicity, immunogenicity), potential efficacy, cell

  14. Verkehrsdynamik und -simulation

    NASA Astrophysics Data System (ADS)

    Treiber, Martin; Kesting, Arne

    In diesem Lehrbuch geht es um die Beschreibung der Dynamik des Straßenverkehrs mit Hilfe mathematischer Modelle. Der mathematische Zugang ist im Bereich der quantitativen Naturwissenschaften außerordentlich erfolgreich. Bereits Isaac Newton bemerkte, dass das Buch der Natur in der Sprache der Mathematik geschrieben sei. In der jüngeren Zeit wurde eine mathematische Herangehensweise verstärkt auch zur Beschreibung menschlichen Handelns genutzt. Dies erscheint auf den ersten Blick paradox, da der Mensch als Individuum mit seinen Entscheidungen sicherlich nicht schematisch durch mathematische Formeln beschreibbar ist.

  15. Transplantation for stroke.

    PubMed

    Roitberg, Ben

    2004-04-01

    Stroke is the most common cause of disability in the United States, and one of the leading causes of mortality and disability in the world. The hope that damage to the CNS can be reversed or at least ameliorated is the central idea behind the research into neural repair. The ultimate repair for the brain should restore the entire lost structure and it's function. However, partial benefit is possible from addressing some of the needs of the injured brain. These partial solutions are the basis of current research into brain repair after stroke. An opportunity arises for two kinds of intervention: (1) replacement of neurons; (2) support of existing neurons, to prevent excessive degeneration and promote rewiring and plasticity. Transplantation for stroke in the rat model was regularly reported starting in 1992, demonstrating graft survival and even evidence of connection with the host brain. These studies determined several parameters for future work in stroke models, but ultimately had limited efficacy and did not progress to clinical experiments. A variety of cell types have been tried for restoration of brain function after stroke, mostly in rodent models. Human fetal cells had shown some promise in clinical studies for the treatment of Parkinson's disease. The technical and ethical difficulties associated with these cells promoted a search for alternatives. These include porcine fetal cells, human cultured stem cells, immortalized cell lines, marrow stromal cells, Sertoli cells pineal cells, and other sources. Human clonal cell lines have few ethical limitations, but some questions remain regarding their safety and efficacy. Autologous somatic stem cells are a very attractive source--there are no ethical concerns and graft rejection is not an issue. However, it is not clear that somatic cells can are plastic enough and can be safely induced to a neural fate. Restorative treatment for stroke is a new field of study. Naturally, new ideas abound and many strategies

  16. Zweistufige Segmentierung des Tracheobronchialbaums mittels iterativen adaptiven Bereichswachstumsverfahren

    NASA Astrophysics Data System (ADS)

    Gergel, Ingmar; Wegner, Ingmar; Tetzlaff, Ralf; Meinzer, Hans-Peter

    Die Segmentierung des Tracheobronchialbaums aus medizinischen Bilddaten ist essentiell für unterschiedliche Anwendungen, beispielsweise der navigierten Bronchoskopie. Hierbei liegt das Hauptaugenmerk auf einer möglichst detaillierten Segmentierung der Bronchien bei möglichst geringer Laufzeit des Algorithmus. Dieser Beitrag beschreibt ein Verfahren, welches in zwei Schritten den Tracheobronchi-albaum anhand eines adaptiven Bereichswachstumsverfahrens aus CT-Aufnahmen segmentiert. Im ersten Schritt werden die großen Atemwege und im zweiten Schritt die kleinen Atemwege getrennt segmentiert. Insgesamt wird dadurch die Anzahl der Voxel, die von rechenaufwändigeren Algorithmen (bspw. Gefäß-Tracking) verarbeitet werden müssen, verringert. Die Ergebnisse zeigen bei minimaler Laufzeiterhöhung eine deutliche Steigerung der Anzahl sowie Tiefe der segmentierten Bronchien.

  17. Sterblichkeit: der paradoxe Kunstgriff des Lebens - Eine Betrachtung vor dem Hintergrund der modernen Biologie

    NASA Astrophysics Data System (ADS)

    Verbeek, Bernhard

    Leben gibt es auf der Erde seit fast 4 Mio. Jahren, trotz allen Katastrophen. Die Idee des Lebens scheint unsterblich. Der Tod aber offenbar auch. Jedes Lebewesen ist davon bedroht, ja für Menschen und andere "höhere“ Lebewesen ist er im Lebensprogramm eingebaut - todsicher. Diese Tatsache ist alles andere als selbstverständlich. Ist sie überhaupt kompatibel mit dem Prinzip der Evolution, nach dem der am besten Angepasste überlebt?

  18. Cryptogenic postpartum stroke.

    PubMed

    Bereczki, Dániel; Szegedi, Norbert; Szakács, Zoltán; Gubucz, István; May, Zsolt

    2016-01-01

    An estimated 25-40% of ischemic strokes are classified as cryptogenic, which means the cause of the cerebral infarction remains unidentified. One of the potential pathomechanisms - especially among young patients with no cardiovascular risk factors - is paradoxical embolism through a patent foramen ovale. Pregnancy, cesarean delivery and the postpartum period are associated with an increased risk of cerebrovascular events. Factors that may contribute to ischemic strokes during gestation and puerperium include classic cardiovascular risk factors, changes in hemostaseology/hemodynamics, and pregnancy-specific disorders such as pre-eclampsia, eclampsia, postpartum cerebral angiopathy or peripartum cardiomyopathy. In this case report, we present a 36-year-old thrombolysis candidate undergoing mechanical thrombectomy 3 weeks after a cesarean section due to HELLP-syndrome. After evaluation of anamnestic and diagnostic parameters, closure of the patent foramen ovale has been performed. In the absence of specific guidelines, diagnostic work-up for cryptogenic stroke should be oriented after the suspected pathomechanism based on patient history and clinical picture. As long as definite evidences emerge, management of cryptogenic stroke patients with pathogenic right-to-left shunt remains individual based on the mutual decision of the patient and the multidisciplinary medical team. PMID:27591063

  19. Rehabilitation After Stroke

    PubMed Central

    Kottke, Frederic J.

    1970-01-01

    The more severely involved the stroke patient is or the greater is the pre-existing physical disability, the greater is the need for special rehabilitation services to restore him to his optimal level of performance. The availability of resources in the family and community are important factors in determining whether or not the patient will need to be treated in a rehabilitation center. There is no contraindication to early initiation of rehabilitation and those patients for whom rehabilitation is initiated immediately after the stroke have the most rapid and optimal recovery. Ninety to 95 percent of hemiplegics can learn to walk. Forty percent of hemiplegics get good return of function in their upper extremity. Sixty-five percent of hemiplegics become independent in self-care and ambulation. For the stroke patient who does not have complicating disabilities independence in self-care and ambulation can be accomplished in 4 to 8 weeks. Intellectual or emotional problems indicate the need for a carefully planned rehabilitation program. The families of stroke patients need counseling and training regarding their responsibilities and duties to the patient. Imagesp47-aFigure 2Figure 3Figure 6Figure 8 PMID:20468595

  20. Technische Systeme für den Herzersatz und die Herzunterstützung

    NASA Astrophysics Data System (ADS)

    Schöb, Reto; Loree, Howard M.

    Herzkrankheiten verursachen allein in den Vereinigten Staaten jährlich mehr als 700’000 Todesfälle. Ungefähr 3 Millionen Patienten in den U.S.A. leiden gemäss der American Heart Association (AHA) und dem National Heart, Lung and Blood Institute (NHLBI) an kongestivem Herzversagen (Congestive Heart Failure, CHF), welches eine chronische, sehr entkräftende und degenerative Krankheit ist: Das Herz ist dabei unfähig, hinreichend Blut zu den Organen des Körpers zu pumpen. Über 400’000 Fälle von CHF werden jedes Jahr diagnostiziert. Ähnliche Zahlen werden für Europa und Japan zusammen geschätzt. Basierend auf Daten vom AHA und NHLBI beträgt die fünfjährige Überlebensrate für CHF-Patienten lediglich etwa 50% [1]. 70’000-120’000 dieser Patienten könnten von einer Herzverpflanzung profitieren. 1999 wurden in den USA aber nur 2185 Herztransplantationen durchgeführt während die Warteliste über 4000 Patienten beträgt [2]. Ein akuter Mangel an Spenderherzen und die enormen Kosten (250’000-400’000 USD pro Patient) sind die begrenzenden Faktoren für Herztransplantationen [3]. Dies bedeutet, dass eine riesige Anzahl von Patienten durch ein zuverlässiges und verschleissfreies, nichtthrombotisches, total implantierbares, künstliches Herz gerettet werden könnten. Bis heute jedoch kein derartiges Implantat kommerziell verfügbar.

  1. [Evidenzbasierte Leitlinien, Anspruch und Wirklichkeit].

    PubMed

    Gutsch, Johannes; Reif, Marcus; Müller-Hübenthal, Boris; Matthiessen, Peter F

    2016-01-01

    Mit der Konzeption der «Evidenzbasierten Medizin» und den «Evidenzbasierten Leitlinien» soll mithilfe von Formalisierungsprozeduren die ärztliche Irrtumsanfälligkeit kalkulierbar gemacht werden. Quantifizierte objektive Aussagen über die therapeutische Wirksamkeit einer Behandlung sollen die individuelle ärztliche Beurteilung der therapeutischen Wirksamkeit überflüssig machen. Damit kommt der Befolgung von formalen Regeln die entscheidende Rolle bei der Beantwortung der Frage nach dem Wahrheitsgehalt und dem Wirklichkeitsbezug zu. Im Rahmen evidenzbasierter Leitlinien werden vorrangig die Ergebnisse randomisierter kontrollierter Studien (RCT) oder Meta-Analysen solcher Studien herangezogen. Am Beispiel der S3-Leitlinie «Malignes Melanom» wird hier eine evidenzbasierte Urteilsbildung zur Wirksamkeit einer unkonventionellen Therapie - hier mit einem Mistelpräparat - analytisch nachvollzogen. Die für die Beurteilung dieser unkonventionellen Therapie herangezogene randomisierte Studie wird genauer methodisch analysiert. Obwohl sie keine statistisch basierte Aussage zulässt, wurde eine Leitlinienempfehlung auf Basis dieser Studie abgeleitet. Es wird gezeigt, dass 1) allein die Existenz einer einzigen RCT mit hoher Evidenz gleichgesetzt wird, 2) die Ergebnisse trotz beträchtlicher Fehlinterpretationen in eine S3-Leitlinie einfließen und 3) Meinungen anstelle kritischer wissenschaftlicher Analysen verarbeitet werden. Unsere Untersuchung zeigt, dass noch so ausgefeilte epistemologische und methodologische Formalien den Arzt nicht von der Pflicht entbinden, auf Basis seiner ärztlichen Erfahrung und professionellen Kompetenz den Realitätswert der ihm zur Verfügung stehenden Information zu beurteilen. PMID:27161555

  2. Identifizierung der Nitratabbauprozesse und Prognose des Nitratabbaupotenzials in den Sedimenten des Hessischen Rieds

    NASA Astrophysics Data System (ADS)

    Kludt, Christoph; Weber, Frank-Andreas; Bergmann, Axel; Knöller, Kay; Berthold, Georg; Schüth, Christoph

    2016-03-01

    Microbial denitrification contributes significantly to the mitigation of nitrate contamination in sedimentary aquifers by reducing nitrate coupled to the consumption of organic carbon (heterotrophic) and iron sulphides like pyrite (autotrophic). However, these phases are often only present in trace amounts and can become depleted, so that denitrification will eventually cease. In order to implement measures within the EC-Water Framework Directive, we investigated the denitrification potential and the denitrification processes in the sediments of the Hessian Ried. The reduction potential was quantified and characterized by solid-phase analyses of drill core samples. Depth-oriented investigations of hydrochemistry (i.e. stable isotopes, N2Excess) allowed determining nitrate input, reduction progress and average reduction kinetics upstream of selected wells. Despite low sulphide contents (max. 123 mg-S/kg), autotrophic denitrification was typically the dominant process. The results can be used to delineate risk areas, downstream of which denitrification can be expected to cease in the near future.

  3. Identifizierung der Nitratabbauprozesse und Prognose des Nitratabbaupotenzials in den Sedimenten des Hessischen Rieds

    NASA Astrophysics Data System (ADS)

    Kludt, Christoph; Weber, Frank-Andreas; Bergmann, Axel; Knöller, Kay; Berthold, Georg; Schüth, Christoph

    2016-09-01

    Microbial denitrification contributes significantly to the mitigation of nitrate contamination in sedimentary aquifers by reducing nitrate coupled to the consumption of organic carbon (heterotrophic) and iron sulphides like pyrite (autotrophic). However, these phases are often only present in trace amounts and can become depleted, so that denitrification will eventually cease. In order to implement measures within the EC-Water Framework Directive, we investigated the denitrification potential and the denitrification processes in the sediments of the Hessian Ried. The reduction potential was quantified and characterized by solid-phase analyses of drill core samples. Depth-oriented investigations of hydrochemistry (i.e. stable isotopes, N2Excess) allowed determining nitrate input, reduction progress and average reduction kinetics upstream of selected wells. Despite low sulphide contents (max. 123 mg-S/kg), autotrophic denitrification was typically the dominant process. The results can be used to delineate risk areas, downstream of which denitrification can be expected to cease in the near future.

  4. [Vegetarische und vegane Ernährung bei Kindern - Stand der Forschung und Forschungsbedarf].

    PubMed

    Keller, Markus; Müller, Stine

    2016-01-01

    Die Praxis vegetarischer Ernährungsformen ist in Deutschland im letzten Jahrzehnt deutlich angestiegen. Allerdings ist der Anteil vegetarischer und veganer Kinder dabei unbekannt. Studien mit Erwachsenen zeigen das präventive Potenzial, aber auch potenzielle Schwachstellen pflanzenbasierter Kostformen. Die Vorteile und Risiken einer vegetarischen bzw. veganen Ernährung im Kindesalter wurden bisher jedoch relativ selten untersucht. Außerdem lassen das unterschiedliche Alter der Kinder, das heterogene Studiendesign sowie die teilweise geringe Probandenzahl der Studien keine verbindlichen Aussagen zu. In dieser Übersichtsarbeit werden die Ergebnisse der wenigen Studien zu vegetarisch und vegan ernährten Kindern (< 12 Jahren) in Nordamerika und Europa zusammengefasst. Demnach lag die Zufuhr von Nahrungsenergie und Makronährstoffen vegetarischer und veganer Kinder meist näher an den Empfehlungen der Fachgesellschaften als die Ernährung gleichaltriger Mischkostkinder. Ebenso wiesen vegetarisch und vegan ernährte Kinder eine höhere Zufuhr von und bessere Versorgung mit verschiedenen Vitaminen und Mineralstoffen auf. Häufiger zeigten sich jedoch Defizite bei Vitamin B12, Zink, Kalzium, Eisen und Vitamin D. Das Wachstum und die Entwicklung vegetarisch und vegan ernährter Kinder entsprachen weitgehend den Referenzstandards, wobei sie dazu tendierten, leichter, schlanker und (< 5 Jahren) auch kleiner zu sein. Aufgrund der unzureichenden Studienlage besteht erheblicher Forschungsbedarf zu den Auswirkungen einer vegetarischen und veganen Ernährung im Kindesalter.

  5. [Vegetarische und vegane Ernährung bei Kindern - Stand der Forschung und Forschungsbedarf].

    PubMed

    Keller, Markus; Müller, Stine

    2016-01-01

    Die Praxis vegetarischer Ernährungsformen ist in Deutschland im letzten Jahrzehnt deutlich angestiegen. Allerdings ist der Anteil vegetarischer und veganer Kinder dabei unbekannt. Studien mit Erwachsenen zeigen das präventive Potenzial, aber auch potenzielle Schwachstellen pflanzenbasierter Kostformen. Die Vorteile und Risiken einer vegetarischen bzw. veganen Ernährung im Kindesalter wurden bisher jedoch relativ selten untersucht. Außerdem lassen das unterschiedliche Alter der Kinder, das heterogene Studiendesign sowie die teilweise geringe Probandenzahl der Studien keine verbindlichen Aussagen zu. In dieser Übersichtsarbeit werden die Ergebnisse der wenigen Studien zu vegetarisch und vegan ernährten Kindern (< 12 Jahren) in Nordamerika und Europa zusammengefasst. Demnach lag die Zufuhr von Nahrungsenergie und Makronährstoffen vegetarischer und veganer Kinder meist näher an den Empfehlungen der Fachgesellschaften als die Ernährung gleichaltriger Mischkostkinder. Ebenso wiesen vegetarisch und vegan ernährte Kinder eine höhere Zufuhr von und bessere Versorgung mit verschiedenen Vitaminen und Mineralstoffen auf. Häufiger zeigten sich jedoch Defizite bei Vitamin B12, Zink, Kalzium, Eisen und Vitamin D. Das Wachstum und die Entwicklung vegetarisch und vegan ernährter Kinder entsprachen weitgehend den Referenzstandards, wobei sie dazu tendierten, leichter, schlanker und (< 5 Jahren) auch kleiner zu sein. Aufgrund der unzureichenden Studienlage besteht erheblicher Forschungsbedarf zu den Auswirkungen einer vegetarischen und veganen Ernährung im Kindesalter. PMID:27160086

  6. Etiologic Ischemic Stroke Phenotypes in the NINDS Stroke Genetics Network

    PubMed Central

    Ay, Hakan; Arsava, Ethem Murat; Andsberg, Gunnar; Benner, Thomas; Brown, Robert D.; Chapman, Sherita N.; Cole, John W.; Delavaran, Hossein; Dichgans, Martin; Engström, Gunnar; Giralt-Steinhauer, Eva; Grewal, Raji P.; Gwinn, Katrina; Jern, Christina; Jimenez-Conde, Jordi; Jood, Katarina; Katsnelson, Michael; Kissela, Brett; Kittner, Steven J.; Kleindorfer, Dawn O.; Labovitz, Daniel L.; Lanfranconi, Silvia; Lee, Jin-Moo; Lehm, Manuel; Lemmens, Robin; Levi, Chris; Li, Linxin; Lindgren, Arne; Markus, Hugh S.; McArdle, Patrick F.; Melander, Olle; Norrving, Bo; Peddareddygari, Leema Reddy; Pedersén, Annie; Pera, Joanna; Rannikmäe, Kristiina; Rexrode, Kathryn M.; Rhodes, David; Rich, Stephen S.; Roquer, Jaume; Rosand, Jonathan; Rothwell, Peter M.; Rundek, Tatjana; Sacco, Ralph L.; Schmidt, Reinhold; Schürks, Markus; Seiler, Stephan; Sharma, Pankaj; Slowik, Agnieszka; Sudlow, Cathie; Thijs, Vincent; Woodfield, Rebecca; Worrall, Bradford B.; Meschia, James F.

    2014-01-01

    Background and Purpose NINDS Stroke Genetics Network (SiGN) is an international consortium of ischemic stroke studies that aims to generate high quality phenotype data to identify the genetic basis of etiologic stroke subtypes. This analysis characterizes the etiopathogenetic basis of ischemic stroke and reliability of stroke classification in the consortium. Methods Fifty-two trained and certified adjudicators determined both phenotypic (abnormal test findings categorized in major etiologic groups without weighting towards the most likely cause) and causative ischemic stroke subtypes in 16,954 subjects with imaging-confirmed ischemic stroke from 12 US studies and 11 studies from 8 European countries using the web-based Causative Classification of Stroke System. Classification reliability was assessed with blinded re-adjudication of 1509 randomly selected cases. Results The distribution of etiologic categories varied by study, age, sex, and race (p<0.001 for each). Overall, only 40% to 54% of cases with a given major ischemic stroke etiology (phenotypic subtype) were classified into the same final causative category with high confidence. There was good agreement for both causative (kappa 0.72, 95%CI:0.69-0.75) and phenotypic classifications (kappa 0.73, 95%CI:0.70-0.75). Conclusions This study demonstrates that etiologic subtypes can be determined with good reliability in studies that include investigators with different expertise and background, institutions with different stroke evaluation protocols and geographic location, and patient populations with different epidemiological characteristics. The discordance between phenotypic and causative stroke subtypes highlights the fact that the presence of an abnormality in a stroke patient does not necessarily mean that it is the cause of stroke. PMID:25378430

  7. Kosmologie und Teilchenphysik.

    NASA Astrophysics Data System (ADS)

    Appenzeller, I.

    This book is a selection of 17 articles published in the journal "Spektrum der Wissenschaft". The original English versions of the papers were first published in "Scientific American". Contents: 1. Einführung (I. Appenzeller). 2. Sehr große Strukturen im Universum (J. O. Burns). 3. Die großräumigen Eigenbewegungen der Galaxien (A. Dressler). 4. Dunkle Materie im Universum (L. M. Krauss). 5. Der doppelte Beta-Zerfall (M. K. Moe, S. P. Rosen). 6. Quark-Lepton Familien (D. B. Cline). 7. Beschleunigerexperimente testen kosmologische Theorien (D. N. Schramm, G. Steigman). 8. Das Rätsel der kosmologischen Konstanten (L. Abbott). 9. Das Higgs-Boson (M. J. G. Veltman). 10. Die Suche nach dem Protonenzerfall (J. M. LoSecco, F. Reines, D. Sinclair). 11. Das inflationäre Universum (A. H. Guth, P. J. Steinhardt). 12. Die fünfte Dimension (E. Schmutzer). 13. Die verborgenen Dimensionen der Raumzeit (D. Z. Freedman, P. van Nieuwenhuizen). 14. Ist die Natur supersymmetrisch? (H. E. Haber, G. L. Kane). 15. Schwerkraft und Antimaterie (T. Goldman, R. J. Hughes, M. M. Nieto). 16. Superstrings (M. B. Green). 17. Kosmische Strings (A. Vilenkin).

  8. Hyperacute management of ischemic stroke.

    PubMed

    Song, Sarah

    2013-11-01

    Stroke is a devastating disease and currently the fourth leading cause of death in this country. Acute ischemic stroke is an emergency and requires effective triage, diagnosis, and critical management. The hyperacute management of ischemic stroke begins in the field, with recognition of stroke symptoms by emergency medical systems (EMS) personnel. The EMS is an important component to an effective stroke system of care, which also includes primary stroke centers, routing protocols for acute ischemic stroke, and telemedicine. Following the arrival of a potential stroke patient to the emergency room setting, patients should be stabilized and undergo assessment for potential intravenous alteplase (IV tPA) treatment. Assessments include diagnostic tests, neuroimaging, and standardized stroke evaluations. After these assessments have been performed, IV tPA, the only medication for acute stroke approved by the U.S. Food and Drug Administration, can be considered using a variety of inclusion and exclusion criteria. Previously time restrictions limited the usage of IV tPA to 3 hours, but this time window has now been extended for eligible candidates to 4.5 hours. The administration of IV tPA has specific requirements for monitoring and should be standardized via protocol across hospitals.

  9. Ischemic Stroke after Heart Transplantation

    PubMed Central

    Acampa, Maurizio; Lazzerini, Pietro Enea; Guideri, Francesca; Tassi, Rossana; Martini, Giuseppe

    2016-01-01

    Cerebrovascular complications after orthotopic heart transplantation (OHT) are more common in comparison with neurological sequelae subsequent to routine cardiac surgery. Ischemic stroke and transient ischemic attack (TIA) are more common (with an incidence of up to 13%) than intracranial hemorrhage (2.5%). Clinically, ischemic stroke is manifested by the appearance of focal neurologic deficits, although sometimes a stroke may be silent or manifests itself by the appearance of encephalopathy, reflecting a diffuse brain disorder. Ischemic stroke subtypes distribution in perioperative and postoperative period after OHT is very different from classical distribution, with different pathogenic mechanisms. Infact, ischemic stroke may be caused by less common and unusual mechanisms, linked to surgical procedures and to postoperative inflammation, peculiar to this group of patients. However, many strokes (40%) occur without a well-defined etiology (cryptogenic strokes). A silent atrial fibrillation (AF) may play a role in pathogenesis of these strokes and P wave dispersion may represent a predictor of AF. In OHT patients, P wave dispersion correlates with homocysteine plasma levels and hyperhomocysteinemia could play a role in the pathogenesis of these strokes with multiple mechanisms increasing the risk of AF. In conclusion, stroke after heart transplantation represents a complication with considerable impact not only on mortality but also on subsequent poor functional outcome. PMID:26915504

  10. IntegraTUM Teilprojekt E-Mail: Aufbau eines mandantenfähigen Groupware-Services und seine Integration in Identity Management und E-Mail Infrastruktur der Technischen Universität München

    NASA Astrophysics Data System (ADS)

    Diehn, Max

    Die E-Mail-Infrastruktur an der Technischen Universität München (TUM) ist historisch bedingt sehr heterogen und komplex. Viele Einrichtungen müssen wertvolle Arbeitskraft auf die Administration eigener Mailserver verwenden. Auf der anderen Seite wird bei einigen Einrichtungen der Ruf nach Groupware-Funktionalitäten wie z.B. gemeinsame Kalender immer lauter. Das Teilprojekt E-Mail stellt einen zentralen Mail- und Groupware-Service bereit, der den Einrichtungen ermöglichen soll, den Betrieb eigener Server und zugehöriger Systeme (etwa lokaler Benutzerverwaltungen) für diesen Zweck aufzugeben und diese Dienste an das Teilprojekt E-Mail zu migrieren, ohne ihre Verwaltungshoheit oder ihre Maildomains aufgeben zu müssen. Dieser Service versteht sich als eine Ergänzung zur bestehenden Grundversorgung der TUM mit den Maildiensten des myTUM-Mailers, ist mandantenfähig aufgebaut und kann daher künftig neben der TUM auch weiteren Organisationen im Münchner Wissenschaftsnetz zur Verfügung gestellt werden.

  11. Checkpoint-Inhibitoren in der Immuntherapie: Ein Meilenstein in der Behandlung des malignen Melanoms.

    PubMed

    Wilden, Sophia M; Lang, Berenice M; Mohr, Peter; Grabbe, Stephan

    2016-07-01

    Seit Jahrzehnten ist bekannt, dass Tumoren vom Immunsystem erkannt und zerstört werden können. Diese, vor allem in Tierversuchen gewonnene Erkenntnis konnte jedoch in der Vergangenheit nicht zum Nutzen unserer Patienten umgesetzt werden, da immunonkologische Therapieansätze in den letzten Jahrzehnten in der Anwendung beim Menschen stets versagt haben. Daher hat, mit Ausnahme der adjuvanten Interferontherapie, keines dieser Verfahren den Einzug in die klinische Versorgung gefunden. Langzeitüberleben unter guter Lebensqualität war dabei sehr wenigen Patienten vorbehalten. Mit den neuen immunologischen Therapieansätzen wird jedoch sowohl das Langzeitüberleben als auch die Lebensqualität onkologischer Patienten neu definiert. Auf die neuen "Immun-Checkpoint-Inhibitoren" spricht erstmals ein relevanter Teil der behandelten Patienten an und diese zeigen in der Regel langandauernde Remissionen bis hin zur Heilung. Schon jetzt ist klar, dass die Immuntherapie in Zukunft eine der wesentlichen Therapiesäulen bei der Behandlung des metastasierten Melanoms und auch vieler anderer fortgeschrittener Tumoren bilden wird. In dieser Übersicht werden die wichtigsten neuen Therapiemodalitäten besprochen und sowohl deren Wirkprinzip als auch klinische Daten zum Therapieansprechen und zu erwartenden Nebenwirkungen der Therapie referiert. PMID:27373243

  12. Microwave hemorrhagic stroke detector

    DOEpatents

    Haddad, Waleed S.; Trebes, James E.

    2007-06-05

    The microwave hemorrhagic stroke detector includes a low power pulsed microwave transmitter with a broad-band antenna for producing a directional beam of microwaves, an index of refraction matching cap placed over the patients head, and an array of broad-band microwave receivers with collection antennae. The system of microwave transmitter and receivers are scanned around, and can also be positioned up and down the axis of the patients head. The microwave hemorrhagic stroke detector is a completely non-invasive device designed to detect and localize blood pooling and clots or to measure blood flow within the head or body. The device is based on low power pulsed microwave technology combined with specialized antennas and tomographic methods. The system can be used for rapid, non-invasive detection of blood pooling such as occurs with hemorrhagic stoke in human or animal patients as well as for the detection of hemorrhage within a patient's body.

  13. Des ballons pour demain

    NASA Astrophysics Data System (ADS)

    Régipa, R.

    A partir d'une théorie sur la détermination des formes et des contraintes globales d'un ballon de révolution, ou s'en rapprochant, une nouvelle famille de ballons a été définie. Les ballons actuels, dits de ``forme naturelle'', sont calculés en général pour une tension circonférencielle nulle. Ainsi, pour une mission donnée, la tension longitudinale et la forme de l'enveloppe sont strictement imposées. Les ballons de la nouvelle génération sont globalement cylindriques et leurs pôles sont réunis par un câble axial, chargé de transmettre une partie des efforts depuis le crochet (pôle inférieur), directement au pôle supérieur. De plus, la zone latérale cylindrique est soumise à un faible champ de tensions circonférencielles. Ainsi, deux paramètres permettent de faire évoluer la distribution des tensions et la forme de l'enveloppe: - la tension du câble de liaison entre pôles (ou la longueur de ce câble) - la tension circonférencielle moyenne désirée (ou le rayon du ballon). On peut donc calculer et réaliser: - soit des ballons de forme adaptée, comme les ballons à fond plat pour le bon fonctionnement des montgolfières infrarouge (projet MIR); - soit des ballons optimisés pour une bonne répartition des contraintes et une meilleure utilisation des matériaux d'enveloppe, pour l'ensemble des programmes stratosphériques. Il s'ensuit une économie sensible des coûts de fabrication, une fiabilité accrue du fonctionnement de ces ballons et une rendement opérationnel bien supérieur, permettant entre autres, d'envisager des vols à très haute altitude en matériaux très légers.

  14. Danger signals in stroke.

    PubMed

    Gelderblom, Mathias; Sobey, Christopher G; Kleinschnitz, Christoph; Magnus, Tim

    2015-11-01

    Danger molecules are the first signals released from dying tissue after stroke. These danger signals bind to receptors on immune cells that will result in their activation and the release of inflammatory and neurotoxic mediators, resulting in amplification of the immune response and subsequent enlargement of the damaged brain volume. The release of danger signals is a central event that leads to a multitude of signals and cascades in the affected and neighbouring tissue, therefore providing a potential target for therapy.

  15. Connector Mechanism Has Smaller Stroke

    NASA Technical Reports Server (NTRS)

    Milam, M. Bruce

    1992-01-01

    System for connecting electrical and/or fluid lines includes mechanism reducing length of stroke necessary to make or break connections. Feature enables connection and disconnection in confined space, and compensates for misalignment between connectors. Connector in active member moves upward at twice the speed of downward stroke of passive member. Stroke amplified within connector system. Applications include connections between modular electronic units, coupled vehicles, and hydraulic systems.

  16. [Pregnancy and acute ischemic stroke].

    PubMed

    Bereczki, Dániel

    2016-05-15

    Pregnancy-related ischemic strokes play an important role in both maternal and fetal morbidity and mortality. Changes in hemostaseology and hemodynamics as well as risk factors related to or independent from pregnancy contribute to the increased stroke-risk during gestation and the puerperium. Potential teratogenic effects make diagnostics, acute therapy and prevention challenging. Because randomized, controlled trials are not available, a multicenter registry of patients with gestational stroke would be desirable. Until definite guidelines emerge, management of acute ischemic stroke during pregnancy remains individual, involving experts and weighing the risks and benefits.

  17. Radiological Portrait of Embolic Strokes.

    PubMed

    Sachdeva, Gautam; Saeed, Ali; Jani, Vishal; Razak, Anmar

    2016-05-01

    Stroke is the leading cause of adult disability and the fifth leading cause of death in the United States. In 2010, the cost of stroke to the health care system in the United States was estimated to be $71.55 billion, and it is projected to double over the next 20 years. Cardioembolism is a leading pathophysiologic cause of stroke. Along with a careful review of the presenting history and clinical symptomatology, early radiographic studies including computed tomography (CT) and MRI, may demonstrate certain characteristics that may be suggestive of a cardioembolic origin to a stroke of concern. PMID:27150175

  18. Stroke and the female brain.

    PubMed

    Bushnell, Cheryl D

    2008-01-01

    Stroke is a major public health problem. The female population carries a higher stroke burden than the male population, both because females have a longer life expectancy and because most stroke deaths occur in women. Differences between the sexes in relation to stroke are increasingly being recognized; for example, among stroke survivors, women tend to have worse outcomes than men, as indicated by more-severe disability and an increased likelihood of institutionalization in women. Women and men with stroke also differ in their risk factor profiles, and they respond differently to primary-prevention and acute stroke treatment. Women experience variations in endogenous estrogens throughout their life cycle and might also be exposed to exogenous estrogens, both of which markedly affect the brain. An understanding of the effects of endogenous and exogenous estrogens on cerebral hemodynamics could guide research into explaining how hormone therapy increases the risk of stroke in postmenopausal women. This Review summarizes the sex differences related to stroke, and the effect of endogenous and exogenous hormones on the cerebrovasculature of the female brain. It also proposes potential research approaches, the results of which could fill in gaps in our knowledge regarding the mechanism of action of estrogen in the brain.

  19. Quantenexperimente zwischen Photon und Fulleren

    NASA Astrophysics Data System (ADS)

    Zeilinger, Anton

    2000-09-01

    Die Quantenphysik hat zu Beginn des zwanzigsten Jahrhunderts unser Weltbild revolutioniert. Jetzt scheint sie sich zur Grundlage einer völlig neuen Informationstechnolgie mit unabsehbaren Folgen zu entwickeln.

  20. Stroke mood screening on an inpatient stroke unit.

    PubMed

    Gurr, Birgit

    Psychological problems, and post-stroke depression in particular, are common following stroke. This article describes the development and evaluation of a mood screening pathway on a hospital-based stroke unit. The pathway is evaluated against the criteria of the national stroke guidelines, particularly the National Stroke Sentinel Audit (Royal College of Physicians, 2008a). The outcome reveals that the Stroke Mood Screening pathway meets the target of assessing every patient in 88.9% of cases. This places the performance of this procedure within the top quarter of stroke units in the UK. The Stroke Mood Screening pathway enabled the rehabilitation team to identify mood disturbances very early following patients' admission to the unit. Good communication pathways between rehabilitation staff and easy referral routes to neuropsychology made rapid and efficient responses to emerging mood problems possible. The outcomes of this evaluation also give useful guidance for service improvements and consequently, could optimize the provision of psychological support for the patients on the unit.

  1. Stroke: advances in medical therapy and acute stroke intervention.

    PubMed

    Barrett, Kevin M; Lal, Brajesh K; Meschia, James F

    2015-10-01

    Evidence-based therapeutic options for stroke continue to emerge based on results from well-designed clinical studies. Ischemic stroke far exceeds hemorrhagic stroke in terms of prevalence and incidence, both in the USA and worldwide. The public health effect of reducing death and disability related to ischemic stroke justifies the resources that have been invested in identifying safe and effective treatments. The emergence of novel oral anticoagulants for ischemic stroke prevention in atrial fibrillation has introduced complexity to clinical decision making for patients with this common cardiac arrhythmia. Some accepted ischemic stroke preventative strategies, such as carotid revascularization for asymptomatic carotid stenosis, require reassessment, given advances in risk factor management, antithrombotic therapy, and surgical techniques. Intra-arterial therapy, particularly with stent retrievers after intravenous tissue plasminogen activator, has recently been demonstrated to improve functional outcomes and will require investment in system-based care models to ensure that effective treatments are received by patients in a timely fashion. The purpose of this review is to describe recent advances in medical and surgical approaches to ischemic stroke prevention and acute treatment. Results from recently published clinical trials will be highlighted along with ongoing clinical trials addressing key questions in ischemic stroke management and prevention where equipoise remains.

  2. [Neglect rehabilitation after stroke].

    PubMed

    Jehkonen, Mervi; Yliranta, Aino; Rasimus, Susanna; Saunamäki, Tiia

    2013-01-01

    Neglect is a common neuropsychological disorder after right hemisphere stroke. Neglect worsens the prognosis of functional recovery but responds well to targeted neuropsychological rehabilitation. Several methods for rehabilitation have been developed and research to-date lends best support to visual scanning training, prism adaptation, limb activation and feedback training. Core features of effective neglect rehabilitation include early initiation, daily held sessions at acute and subacute stages, increasing awareness of deficit and considering the psychosocial status of the patient as well as that of the family.

  3. [Sports and heat stroke].

    PubMed

    Yuzawa, Itsuki; Miyake, Yasufumi; Aruga, Tohru

    2012-06-01

    We described Characteristic of the heat stroke in the sports activity in Japan. It was common in teenage men, and 15 years old had a peak with a man, the woman. Most patients did not need specific treatment. Many happened from the end of July on the outdoors around 3:00 p.m. in mid-August. There are many in order of baseball, football, tennis, and a basketball. Running and cycling had high severity of illness. Probably, grasp of an environmental condition, suitable sportswear, suitable hydration, and condition management are the best things as preventive measures.

  4. Stroke and episodic memory disorders.

    PubMed

    Lim, Chun; Alexander, Michael P

    2009-12-01

    Memory impairments are common after stroke, and the anatomical basis for impairments may be quite variable. To determine the range of stroke-related memory impairment, we identified all case reports and group studies through the Medline database and the Science Citation Index. There is no hypothesis about memory that is unique to stroke, but there are several important facets of memory impairment after stroke: (1) Every node of the limbic system implicated in memory may be damaged by stroke but very rarely in isolation and the combination of amnesia with the associated deficits often illuminates additional aspects of memory functions. (2) Stroke produces amnesia by damage to critical convergence white matter connections of the limbic system, and stroke is the only etiology of amnesia that can delineate the entire pathway of memory and critical convergence points. (3) Stroke also impairs memory, without causing classical amnesia, by damaging brain regions responsible for cognitive processes, some modality specific and some more generally strategic, that are essential for normal learning and recall.

  5. Stroke-Related Translational Research

    PubMed Central

    Caplan, Louis R.; Arenillas, Juan; Cramer, Steven C.; Joutel, Anne; Lo, Eng H.; Meschia, James; Savitz, Sean; Tournier-Lasserve, Elizabeth

    2013-01-01

    Stroke-related translational research is multifaceted. Herein, we highlight genome-wide association studies and genetic studies of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, COL4A1 mutations, and cerebral cavernous malformations; advances in molecular biology and biomarkers; newer brain imaging research; and recovery from stroke emphasizing cell-based and other rehabilitative modalities. PMID:21555605

  6. One Stroke at a Time

    ERIC Educational Resources Information Center

    Hollibaugh, Molly

    2012-01-01

    At first glance, a Zentangle creation can seem intricate and complicated. But, when you learn how it is done, you realize how simple it is. Zentangles are patterns, or "tangles," that have been reduced to a simple sequence of elemental strokes. When you learn to focus on each stroke you find yourself capable of things that you may have once…

  7. Oxidative phosphorylation and lacunar stroke

    PubMed Central

    Anderson, Christopher D.; Hurford, Robert; Bevan, Steve; Markus, Hugh S.

    2016-01-01

    Objective: We investigated whether oxidative phosphorylation (OXPHOS) abnormalities were associated with lacunar stroke, hypothesizing that these would be more strongly associated in patients with multiple lacunar infarcts and leukoaraiosis (LA). Methods: In 1,012 MRI-confirmed lacunar stroke cases and 964 age-matched controls recruited from general practice surgeries, we investigated associations between common genetic variants within the OXPHOS pathway and lacunar stroke using a permutation-based enrichment approach. Cases were phenotyped using MRI into those with multiple infarcts or LA (MLI/LA) and those with isolated lacunar infarcts (ILI) based on the number of subcortical infarcts and degree of LA, using the Fazekas grading. Using gene-level association statistics, we tested for enrichment of genes in the OXPHOS pathway with all lacunar stroke and the 2 subtypes. Results: There was a specific association with strong evidence of enrichment in the top 1% of genes in the MLI/LA (subtype p = 0.0017) but not in the ILI subtype (p = 1). Genes in the top percentile for the all lacunar stroke analysis were not significantly enriched (p = 0.07). Conclusions: Our results implicate the OXPHOS pathway in the pathogenesis of lacunar stroke, and show the association is specific to patients with the MLI/LA subtype. They show that MRI-based subtyping of lacunar stroke can provide insights into disease pathophysiology, and imply that different radiologic subtypes of lacunar stroke subtypes have distinct underlying pathophysiologic processes. PMID:26674331

  8. Musculoskeletal problems in stroke survivors.

    PubMed

    Kendall, Richard

    2010-01-01

    Musculoskeletal problems in stoke survivors are common reasons for disability and pain. Shoulder pain is present in 24% of stroke survivors among all complications, second only to depression in 26%. Diagnosis and treatment of the various shoulder pain etiologies can significantly improve quality of life in these patients. This article reviews the common etiologies and treatments of shoulder and hip pain in stroke survivors.

  9. Stroke education in the Philippines.

    PubMed

    Navarro, Jose C; Baroque, Alejandro C; Lokin, Johnny K

    2013-10-01

    Education is paramount in effectively reducing the significant burden of stroke in the Philippines. Dedicated academic institutions and dynamic professional organizations in the Philippines have collaborated to involve themselves in the plight against stroke through systematic curriculum development for undergraduates, continuous regulation of quality residency and fellowship training program, hosting up-to-date Continuing Medical Education (CME) activities for local and international audience, and active participation in clinical stroke trials. Most recently, the University of Santo Tomas Faculty of Medicine & Surgery and the Department of Neurology & Psychiatry offered a 72-hour Certification Course in Stroke Medicine that commenced in 2011 in anticipation of the Master on Health Sciences in Stroke Medicine course being prepared for 2013. PMID:23506562

  10. Acute Stroke Imaging Research Roadmap

    PubMed Central

    Wintermark, Max; Albers, Gregory W.; Alexandrov, Andrei V.; Alger, Jeffry R.; Bammer, Roland; Baron, Jean-Claude; Davis, Stephen; Demaerschalk, Bart M.; Derdeyn, Colin P.; Donnan, Geoffrey A.; Eastwood, James D.; Fiebach, Jochen B.; Fisher, Marc; Furie, Karen L.; Goldmakher, Gregory V.; Hacke, Werner; Kidwell, Chelsea S.; Kloska, Stephan P.; Köhrmann, Martin; Koroshetz, Walter; Lee, Ting-Yim; Lees, Kennedy R.; Lev, Michael H.; Liebeskind, David S.; Ostergaard, Leif; Powers, William J.; Provenzale, James; Schellinger, Peter; Silbergleit, Robert; Sorensen, Alma Gregory; Wardlaw, Joanna; Wu, Ona; Warach, Steven

    2009-01-01

    The recent “Advanced Neuroimaging for Acute Stroke Treatment” meeting on September 7 and 8, 2007 in Washington DC, brought together stroke neurologists, neuroradiologists, emergency physicians, neuroimaging research scientists, members of the National Institute of Neurological Disorders and Stroke (NINDS), the National Institute of Biomedical Imaging and Bioengineering (NIBIB), industry representatives, and members of the US Food and Drug Administration (FDA) to discuss the role of advanced neuroimaging in acute stroke treatment. The goals of the meeting were to assess state-of-the-art practice in terms of acute stroke imaging research and to propose specific recommendations regarding: (1) the standardization of perfusion and penumbral imaging techniques, (2) the validation of the accuracy and clinical utility of imaging markers of the ischemic penumbra, (3) the validation of imaging biomarkers relevant to clinical outcomes, and (4) the creation of a central repository to achieve these goals. The present article summarizes these recommendations and examines practical steps to achieve them. PMID:18477656

  11. Stroke education in the Philippines.

    PubMed

    Navarro, Jose C; Baroque, Alejandro C; Lokin, Johnny K

    2013-10-01

    Education is paramount in effectively reducing the significant burden of stroke in the Philippines. Dedicated academic institutions and dynamic professional organizations in the Philippines have collaborated to involve themselves in the plight against stroke through systematic curriculum development for undergraduates, continuous regulation of quality residency and fellowship training program, hosting up-to-date Continuing Medical Education (CME) activities for local and international audience, and active participation in clinical stroke trials. Most recently, the University of Santo Tomas Faculty of Medicine & Surgery and the Department of Neurology & Psychiatry offered a 72-hour Certification Course in Stroke Medicine that commenced in 2011 in anticipation of the Master on Health Sciences in Stroke Medicine course being prepared for 2013.

  12. [Heat stroke. Standarized treatment plan].

    PubMed

    García-Velasco Sánchez-Morago, Santiago; Monzón Ferrer, Adrián

    2008-05-01

    Heat stroke, or sun stroke, is defined as an emergency situation characterized by an increase in central body temperature above 40 degrees C and alterations in the central nervous system where encephalopathy predominates and coma is typical. A precocious diagnosis is essential and if the initial opportune measures are not taken, the death rate is very high, up to 70%. Due to climate changes, the number of heat stroke cases has increased since the 2003 heat wave. Although at first symptoms these cases are treated in hospital emergency wards or outpatient wards, when the severity of a person stricken by heat stroke becomes life-threatening or advanced medical care is warranted, patients are placed in Intensive Medical Care Wards. Even though cases of heat stroke are low, its lethalness converts it to a serious life-threatening circumstance due to thermal regulation deterioration, adverse neurological effects, and secondary multi-organ dysfunction.

  13. First aid in acute stroke

    PubMed Central

    Reitmayer, Michael; Raschick, Marlitt; Erbguth, Frank; Neundörfer, Bernhard; Babjar, Elisabeth

    2006-01-01

    Objective First aid training is well established to teach the public how to recognize a medical emergency and take appropriate action. Though it is now handled as a high priority emergency stroke is not among the main topics of first aid. We investigated if first aid training may be useful for enhancing stroke awareness. Methods We developed a 15–20 minute teaching session about stroke as an emergency including signs and symptoms and first hands-on measures. The session was integrated in standard first aid training of the St John Ambulance of Germany and participants were asked to fill out a questionnaire regarding their knowledge about stroke. Subjects were questioned before the stroke lesson and again at the end of the training. Results 532 participants of the training responded to the questionnaire (mean age 28.6 years, 53.6% male). There was a significant increase in proportion of subjects correctly defining what stroke is (28.4% vs. 69.9%, p < 0,001) and in the mean number of stroke symptoms listed (1.52 vs. 3.35, p < 0,001) by the participants. The number of participants unable to list at least 1 symptom decreased significantly (12.8 vs. 3.6%, p<0.001). Conclusions In our study a teaching lesson integrated in first aid training was effective in improving stroke knowledge of participants. First aid training should be used for stroke information complementary to other activities like mass media campaigns as it is effective, could reach younger people that are not primarily interested in stroke and provides connections to other health topics. PMID:16896518

  14. Basic Land Drills for Swimming Stroke Acquisition

    ERIC Educational Resources Information Center

    Zhang, Peng

    2014-01-01

    Teaching swimming strokes can be a challenging task in physical education. The purpose of the article is to introduce 12 on land drills that can be utilized to facilitate the learning of swimming strokes, including elementary back stroke, sidestroke, front crawl, back stroke, breaststroke, and butterfly. Each drill consists of four components…

  15. Early seizures in acute stroke

    PubMed Central

    Mohamed, Chraa; Kissani, Najib

    2015-01-01

    Early seizures (ES) may complicate the clinical course of patients with acute stroke. The aim of this study was to assess the frequency and the predictive factors for early seizures as well the clinical outcome in patients with first-ever stroke. A total of 352 consecutive patients with first-ever stroke, admitted to our department, were included in this retrospective study. Early seizures were defined as seizures occurring within 7 days from acute stroke. Patients with history of epilepsy were excluded. About 47 patients (13%) had early seizure, and 8 had a status epilepticus. We had 28 women and 19 men. The mean age was 71.6 ± 14.6. They were significantly more common in patients with cortical involvement, severe and large stroke, and in patient with cortical associated hemorrhage. ES were associated with an increase in adverse outcome (mortality and disability). Early seizures occured in about 13% of patients with acute stroke. In these patients hemorrhagic transformation is a predictive factor for ES. ES seem to be associated with a worse outcome after acute stroke. PMID:26097640

  16. Genetic susceptibility to ischemic stroke

    PubMed Central

    Meschia, James F.; Worrall, Bradford B.; Rich, Stephen S.

    2014-01-01

    Clinicians who treat patients with stroke need to be aware of several single-gene disorders that have ischemic stroke as a major feature, including sickle cell disease, Fabry disease, cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, and retinal vasculopathy with cerebral leukodystrophy. The reported genome-wide association studies of ischemic stroke and several related phenotypes (for example, ischemic white matter disease) have shown that no single common genetic variant imparts major risk. Larger studies with samples numbering in the thousands are ongoing to identify common variants with smaller effects on risk. Pharmacogenomic studies have uncovered genetic determinants of response to warfarin, statins and clopidogrel. Despite increasing knowledge of stroke genetics, incorporating this new knowledge into clinical practice remains a challenge. The goals of this article are to review common single-gene disorders relevant to ischemic stroke, summarize the status of candidate gene and genome-wide studies aimed at discovering genetic stroke risk factors, and to briefly discuss pharmacogenomics related to stroke treatment. PMID:21629240

  17. Stroke rehabilitation: an international perspective.

    PubMed

    Teasell, Robert; Meyer, Matthew J; McClure, Andrew; Pan, Cheng; Murie-Fernandez, Manuel; Foley, Norine; Salter, Katherine

    2009-01-01

    There is a revolution underway in stroke rehabilitation. International comparative studies coupled with an impressive evidence base have provided a platform from which an ideal system for stroke rehabilitation can be envisioned. Using the concepts of structure and process of care, different systems of stroke rehabilitation can be compared and evaluated against best evidence. Two structures of care are examined: specialized interdisciplinary stroke rehabilitation units and outpatient programs. Although specialized interdisciplinary stroke rehabilitation units remain the "gold standard" of care, access to them is often limited. Outpatient programs are essential to stroke rehabilitation systems of care; however, while some countries are investing in outpatient programs, others are scaling back. Even though structures of care have been shown to affect processes of care, it is the processes of care that have proven to be more influential in altering patient outcomes. Four key processes of care are examined: time to admission, intensity of therapy, task-specific therapy, and discharge planning. Within international stroke rehabilitation systems, differences in these processes have resulted in significant differences in outcomes. This allows for "real-world" comparisons of how differing processes affect patient outcomes. Those systems whose structures and processes of care best reflect current best evidence appear to achieve better outcomes.

  18. Imaging of prehospital stroke therapeutics

    PubMed Central

    Lin, Michelle P; Sanossian, Nerses; Liebeskind, David S

    2016-01-01

    Despite significant quality improvement efforts to streamline in-hospital acute stroke care in the conventional model, there remain inherent layers of treatment delays, which could be eliminated with prehospital diagnostics and therapeutics administered in a mobile stroke unit. Early diagnosis using Telestroke and neuroimaging while in the ambulance may enable targeted routing to hospitals with specialized care, which will likely improve patient outcomes. Key clinical trials in Telestroke, mobile stroke units with prehospital neuroimaging capability, prehospital ultrasound and co-administration of various classes of neuroprotectives, antiplatelets and antithrombin agents with intravenous thrombolysis are discussed in this article. PMID:26308602

  19. [Cerebrolysin for acute ischemic stroke].

    PubMed

    iganshina, L E; Abakumova, T R

    2013-01-01

    The review discusses existing evidence of benefits and risks of cerebrolysin--a mixture of low-molecular-weight peptides and amino acids derived from pigs' brain tissue with proposed neuroprotective and neurotrophic properties, for acute ischemic stroke. The review presents results of systematic search and analysis of randomised clinical trials comparing cerebrolysin with placebo in patients with acute ischemic stroke. Only one trial was selected as meeting quality criteria. No difference in death and adverse events between cerebrolysin and placebo was established. The authors conclude about insufficiency of evidence to evaluate the effect of cerebrolysin on survival and dependency in people with acute ischemic stroke.

  20. Stroke Rehabilitation Using Virtual Environments.

    PubMed

    Fu, Michael J; Knutson, Jayme S; Chae, John

    2015-11-01

    This review covers the rationale, mechanisms, and availability of commercially available virtual environment-based interventions for stroke rehabilitation. It describes interventions for motor, speech, cognitive, and sensory dysfunction. Also discussed are the important features and mechanisms that allow virtual environments to facilitate motor relearning. A common challenge is the inability to translate success in small trials to efficacy in larger populations. The heterogeneity of stroke pathophysiology has been blamed, and experts advocate for the study of multimodal approaches. Therefore, this article also introduces a framework to help define new therapy combinations that may be necessary to address stroke heterogeneity.

  1. Spiritual Topics in Stroke Rehabilitation.

    PubMed

    Kyllo, D O

    1996-01-01

    The person who experiences a stroke realizes a change in every area of life. The spiritual life of each individual is affected by stroke and goes through a period of adjustment. It is also the area of life that gives support and strength to cope and hope through the changes, allowing feelings and frustrations to be expressed without recourse. The perceived presence of the Divine gives a sense of love, purpose, power, and belongingness. The spiritual is an integral part in recovery from and rehabilitation following a stroke. PMID:27620151

  2. Stroke Rehabilitation using Virtual Environments

    PubMed Central

    Fu, Michael J.; Knutson, Jayme; Chae, John

    2015-01-01

    Synopsis This review covers the rationale, mechanisms, and availability of commercially available virtual environment-based interventions for stroke rehabilitation. It describes interventions for motor, speech, cognitive, and sensory dysfunction. Also discussed are the important features and mechanisms that allow virtual environments to facilitate motor relearning. A common challenge facing the field is inability to translate success in small trials to efficacy in larger populations. The heterogeneity of stroke pathophysiology has been blamed and experts advocate for the study of multimodal approaches. Therefore, this article also introduces a framework to help define new therapy combinations that may be necessary to address stroke heterogeneity. PMID:26522910

  3. Stroke and the american presidency.

    PubMed

    Meschia, J; Safirstein, B E; Biller, J

    1997-01-01

    Eight past presidents of the United States have suffered at least one stroke: John Quincy Adams, John Tyler, Millard Fillmore, Andrew Johnson, Chester Arthur, Woodrow Wilson, Franklin Delano Roosevelt, and Richard Milhous Nixon. Survival from time of last stroke was greater than one month in only President John Tyler. Nixon represents the first president to be on scientifically validated prophylaxis (warfarin). He was also the first president to be considered for a controlled therapeutic trial in acute stroke and the first to have had an advanced directive regarding terminal care. PMID:17894986

  4. [Post-stroke apathy].

    PubMed

    López-Dóriga Bonnardeaux, Pedro; Andrino Díaz, Nuria

    2016-01-01

    Apathy is a motivational disturbance that can be defined as a quantitative reduction of goal-directed behaviour. Patients present with loss of motivation, concern, interest, and emotional response, resulting in a loss of initiative, decreased interaction with their environment, and a reduced interest in social life. Apathy not only appears to be common in stroke patients, but it has also been related to a wide range of negative consequences for the patients and their caregivers, including poor functional recovery, loss of social independence, and caregiver distress. Clear definition and consensus diagnostic criteria for apathy are needed to accomplish an accurate assessment and an individualised treatment plan. Although there have been reports of successful behavioural therapy treatment of apathetic states, there is a paucity of controlled clinical trials on the efficacy of apathetic behaviours using pharmacotherapy. PMID:26522489

  5. Strokes in young adults: epidemiology and prevention

    PubMed Central

    Smajlović, Dževdet

    2015-01-01

    Strokes in young adults are reported as being uncommon, comprising 10%–15% of all stroke patients. However, compared with stroke in older adults, stroke in the young has a disproportionately large economic impact by leaving victims disabled before their most productive years. Recent publications report an increased incidence of stroke in young adults. This is important given the fact that younger stroke patients have a clearly increased risk of death compared with the general population. The prevalence of standard modifiable vascular risk factors in young stroke patients is different from that in older patients. Modifiable risk factors for stroke, such as dyslipidemia, smoking, and hypertension, are highly prevalent in the young stroke population, with no significant difference in geographic, climatic, nutritional, lifestyle, or genetic diversity. The list of potential stroke etiologies among young adults is extensive. Strokes of undetermined and of other determined etiology are the most common types among young patients according to TOAST (Trial of Org 10172 in Acute Stroke Treatment) criteria. Prevention is the primary treatment strategy aimed at reducing morbidity and mortality related to stroke. Therefore, primary prevention is very important with regard to stroke in young adults, and aggressive treatment of risk factors for stroke, such as hypertension, smoking, and dyslipidemia, is essential. The best form of secondary stroke prevention is directed toward stroke etiology as well as treatment of additional risk factors. However, there is a lack of specific recommendations and guidelines for stroke management in young adults. In conclusion, strokes in young adults are a major public health problem and further research, with standardized methodology, is needed in order to give us more precise epidemiologic data. Given the increasing incidence of stroke in the young, there is an objective need for more research in order to reduce this burden. PMID:25750539

  6. Das Universum der Sterne. Himmelsbeobachtungen und Streifzüge durch die moderne Astronomie.

    NASA Astrophysics Data System (ADS)

    Rowan-Robinson, M.

    This book is a German translation, by M. Röser, of the English original published in 1990 (see 52.003.046). Contents: 1. Der Halleysche Komet. 2. Alpha Centauri - Der sonnennächste Stern. 3. Sirius und sein Begleiter, ein Weißer Zwerg. 4. Polaris - Der Polarstern. 5. Wega - Ein Planetensystem im Entstehen? 6. Mira - Der erste bekannte veränderliche Stern. 7. Der Ring-Nebel - "Todeskampf" eines sonnenähnlichen Sterns. 8. Der Orion-Nebel - Die Geburt neuer Sterne. 9. Delta Cephei - Die Meßlatte des Weltalls. 10. Algol - Der Teufelsstern. 11. Nova Aquilae - Der neue Stern von 1918. 12. Der Krebs-Nebel - Die Supernova des Jahres 1054. 13. Die Hyaden und Plejaden - Sternhaufen. 14. Die Milchstraße - Unsere Galaxis. 15. Die Magellanschen Wolken - Unsere Nachbarn im Weltall. 16. Der Andromeda-Nebel - Zwilling unserer Galaxis. 17. Messier 87 - Eine Radiogalaxie. 18. 3C 273 - Rätselhafter Quasar. 19. Messier 82 - Eine "Starburst"-Galaxie. 20. Der Virgo-Haufen - Ein reicher Galaxienhaufen. 21. Das Universum.

  7. Global specialized stroke care delivery models.

    PubMed

    Theofanidis, Dimitrios; Savopoulos, Christos; Hatzitolios, Apostolos

    2016-03-01

    Stroke services still vary enormously from country to country, with many countries providing no special services at all. The aim of this article is to provide a concise overview of the various types of acute stroke delivery systems at present available and critically describe merits and shortcomings. A systematic literature review was undertaken from 1990 to July 2014. Several models for stroke services have been developed mostly in the past 3 decades, mainly in the Western world. These include state-of-the-art stroke services ranging from highly specialized stroke centers to mobile stroke units for the community. In this light, the recommendations of the structure and organization of stroke units and stroke centers by the European Stroke Organization were recently published. What differentiates the various models of stroke care delivery across the globe is the diversity of services ranging from low key conventional care to highly sophisticated facilities with life saving interventional features via integrated stroke care infrastructure. Effective in-hospital care for stroke should start in the emergency department where a swift and appropriate diagnosis should be made. The role of all brain neuroimaging procedures should have a defined a priori and proper demarcation between actions according to updated stroke care pathways and clinical protocols, which should be followed closely. These essential actions initiated by well-trained staff in the emergency department, should then be carried on in dedicated stroke facilities that is, a stroke unit.

  8. Des Vents et des Jets Astrophysiques

    NASA Astrophysics Data System (ADS)

    Sauty, C.

    well expected result from the theory. Although, collimation may be conical, paraboloidal or cylindrical (Part 4), cylindrical collimation is the more likely to occur. The shape of outflows may then be used as a tool to predict physical conditions on the flows or on their source. L'éjection continue de plasma autour d'objets massifs est un phénomène largement répandu en astrophysique, que ce soit sous la forme du vent solaire, de vents stellaires, de jets d'étoiles en formation, de jets stellaires autour d'objets compacts ou de jets extra-galactiques. Cette zoologie diversifiée fait pourtant l'objet d'un commun effort de modélisation. Le but de cette revue est d'abord de présenter qualitativement le développement, depuis leur origine, des diverses théories de vents (Partie 1) et l'inter disciplinarité dans ce domaine. Il s'agit d'une énumération, plus ou moins exhaustive, des idées proposées pour expliquer l'accélération et la morphologie des vents et des jets, accompagnée d'une présentation sommaire des aspects observationnels. Cette partie s'abstient de tout aspect faisant appel au formalisme mathématique. Ces écoulements peuvent être décrits, au moins partiellement, en résolvant les équations magnétohydrodynamiques, axisymétriques et stationnaires. Ce formalisme, à la base de la plupart des théories, est exposé dans la Partie 2. Il permet d'introduire quantitativement les intégrales premières qu'un tel système possède. Ces dernières sont amenées à jouer un rôle important dans la compréhension des phénomènes d'accélération ou de collimation, en particulier le taux de perte de masse, le taux de perte de moment angulaire ou l'énergie du rotateur magnétique. La difficulté de modélisation réside dans l'existence de points critiques, propres aux équations non linéaires, qu'il faut franchir. La nature physique et la localisation de ces points critiques fait l'objet d'un débat important car ils sont la clef de voute de la r

  9. Prothrombotic lipoprotein patterns in stroke.

    PubMed

    Podrez, Eugene A; Byzova, Tatiana V

    2016-03-10

    The importance of research focused on the final events of atherothrombosis cannot be overestimated. Platelet hyperreactivity leading to thrombosis is the main reason for mortality and morbidity in patients with cardiovascular disease and stroke, which together remain a leading cause of death in developed countries. In this issue of Blood, Shen et al1 establish another functional link between proatherogenic lipoproteins and platelet-mediated thrombus formation with a specific focus on stroke. In their model, the initiating component is L5, the electronegative subfraction of low-density lipoproteins (LDLs), which was shown to be substantially elevated in patients with ischemic stroke. L5 was shown to activate platelets via its receptor, lectin-like oxidized LDL receptor-1 (LOX-1), and αβ amyloid peptide, which together contribute to platelet hyperreactivity and stroke complications. PMID:26965920

  10. Risks for Heart Disease & Stroke

    MedlinePlus

    ... Jamal A, Homa DH, O’Connor E, Babb SD, Caraballo RS, Singh T, et al. Current cigarette ... Heart Disease Stroke High Blood Pressure Cholesterol Salt Video: Know Your Risk Factors Difficulty Swallowing After Stroke (Dysphagia)

    MedlinePlus

    ... can reduce sensation. After a stroke, food or liquid could enter the airway/lungs without the survivor ... working. The survivor may be given food and liquid to swallow. Efforts to make sure survivors with ...

  11. Arterial ischemic stroke in HIV

    PubMed Central

    Bryer, Alan; Lucas, Sebastian; Stanley, Alan; Allain, Theresa J.; Joekes, Elizabeth; Emsley, Hedley; Turnbull, Ian; Downey, Colin; Toh, Cheng-Hock; Brown, Kevin; Brown, David; Ison, Catherine; Smith, Colin; Corbett, Elizabeth L.; Nath, Avindra; Heyderman, Robert S.; Connor, Myles D.; Solomon, Tom

    2016-01-01

    HIV infection, and potentially its treatment, increases the risk of an arterial ischemic stroke. Multiple etiologies and lack of clear case definitions inhibit progress in this field. Several etiologies, many treatable, are relevant to HIV-related stroke. To fully understand the mechanisms and the terminology used, a robust classification algorithm to help ascribe the various etiologies is needed. This consensus paper considers the strengths and limitations of current case definitions in the context of HIV infection. The case definitions for the major etiologies in HIV-related strokes were refined (e.g., varicella zoster vasculopathy and antiphospholipid syndrome) and in some instances new case definitions were described (e.g., HIV-associated vasculopathy). These case definitions provided a framework for an algorithm to help assign a final diagnosis, and help classify the subtypes of HIV etiology in ischemic stroke. PMID:27386505

  12. Diabetes, Heart Disease, and Stroke

    MedlinePlus

    ... Disease, and Other Dental Problems Diabetic Eye Disease Diabetes, Heart Disease, and Stroke Having diabetes or prediabetes ... can help prevent future health problems. What is diabetes? Diabetes is a disorder of metabolismthe way our ...

  13. Barrier mechanisms in neonatal stroke

    PubMed Central

    Kratzer, Ingrid; Chip, Sophorn; Vexler, Zinaida S.

    2014-01-01

    Clinical data continue to reveal that the incidence of perinatal stroke is high, similar to that in the elderly. Perinatal stroke leads to significant morbidity and severe long-term neurological and cognitive deficits, including cerebral palsy. Experimental models of cerebral ischemia in neonatal rodents have shown that the pathophysiology of perinatal brain damage is multifactorial. Cerebral vasculature undergoes substantial structural and functional changes during early postnatal brain development. Thus, the state of the vasculature could affect susceptibility of the neonatal brain to cerebral ischemia. In this review, we discuss some of the most recent findings regarding the neurovascular responses of the immature brain to focal arterial stroke in relation to neuroinflammation. We also discuss a possible role of the neonatal blood-CSF barrier in modulating inflammation and the long-term effects of early neurovascular integrity after neonatal stroke on angiogenesis and neurogenesis. PMID:25426016

  14. Injectabilite des coulis de ciment dans des milieux fissures

    NASA Astrophysics Data System (ADS)

    Mnif, Thameur

    Le travail presente ici est un bilan du travaux de recherche effectues sur l'injectabilite des coulis de ciment dans lu milieux fissures. Un certain nombre de coulis a base de ciment Portland et microfin ont ete selectionnes afin de caracteriser leur capacite a penetrer des milieux fissures. Une partie des essais a ete menee en laboratoire. L'etude rheologique des differents melanges a permis de tester l'influence de l'ajout de superplastifiant et/ou de fumee de silice sur la distribution granulometrique des coulis et par consequent sur leur capacite a injecter des colonnes de sable simulant un milieu fissure donne. La classe granulometrique d'un coulis, sa stabilite et sa fluidite sont apparus comme les trois facteurs principaux pour la reussite d'une injection. Un facteur de finesse a ete defini au cours de cette etude: base sur la classe granulometrique du ciment et sa stabilite, il peut entrer dans la formulation theorique du debit d'injection avant application sur chantier. La deuxieme et derniere partie de l'etude presente les resultats de deux projets de recherche sur l'injection realises sur chantier. L'injection de dalles de beton fissurees a permis le suivi de l'evolution des pressions avec la distance au point d'injection. L'injection de murs de maconnerie a caractere historique a montre l'importance de la definition de criteres de performance des coulis a utiliser pour traiter un milieu donne et pour un objectif donne. Plusieurs melanges peuvent ainsi etre predefinis et mis a disposition sur le chantier. La complementarite des ciments traditionnels et des ciments microfins devient alors un atout important. Le choix d'utilisation de ces melanges est fonction du terrain rencontre. En conclusion, cette recherche etablit une methodologie pour la selection des coulis a base de ciment et des pressions d'injection en fonction de l'ouverture des fissures ou joints de construction.

  15. Stroke in Canon of Medicine

    PubMed Central

    Alorizi, Seyed Morteza Emami; Nimruzi, Majid

    2016-01-01

    Background: Stroke has a huge negative impact on the society and more adversely affect women. There is scarce evidence about any neuroprotective effects of commonly used drug in acute stroke. Bushnell et al. provided a guideline focusing on the risk factors of stroke unique to women, including reproductive factors, metabolic syndrome, obesity, atrial fibrillation, and migraine with aura. The ten variables cited by Avicenna in Canon of Medicine would compensate for the gaps mentioned in this guideline. The prescribed drugs should be selected qualitatively opposite to Mizaj (warm-cold and wet-dry qualities induced by disease state) of the disease and according to ten variables, including the nature of the affected organ, intensity of disease, sex, age, habit, season, place of living, occupation, stamina and physical status. Methods: Information related to stroke was searched in Canon of Medicine, which is an outstanding book in traditional Persian medicine written by Avicenna. Results: A hemorrhagic stroke is the result of increasing sanguine humor in the body. Sanguine has warm-wet quality, and should be treated with food and drugs that quench the abundance of blood in the body. An acute episode of ischemic stroke is due to the abundance of phlegm that causes a blockage in the cerebral vessels. Phlegm has cold-wet quality and treatment should be started with compound medicines that either solve the phlegm or eject it from the body. Conclusion: Avicenna has cited in Canon of Medicine that women have cold and wet temperament compared to men. For this reason, they are more prone to accumulation of phlegm in their body organs including the liver, joints and vessels, and consequently in the risk of fatty liver, degenerative joint disease, atherosclerosis, and stroke especially the ischemic one. This is in accordance with epidemiological studies that showed higher rate of ischemic stroke in women rather than hemorrhagic one. PMID:26722147

  16. Does cholesterol lowering prevent stroke?

    PubMed

    Henry, R Y; Kendall, M J

    1998-10-01

    The importance of lowering plasma cholesterol to reduce the incidence of coronary events is well established. However, in the prevention of stroke disease, control of hypertension has been the main aim of treatment and lipid lowering therapy has not hitherto been considered to be desirable or necessary. In this review, the evidence from large multicentre trials, imaging studies and meta-analyses is presented. It shows convincingly that HMG-CoA reductase inhibitors (Statins) reduce stroke risk. PMID:9875681

  17. [Principles of post stroke rehabilitation].

    PubMed

    Lyseniuk, V P; Symonenko, H H

    2012-01-01

    Clinical management of patients with acute cerebral blood flow depends on the cause and location of violation, clinical manifestations of the disease. Acute stroke patients during the course conducted in specialized intensive care and neurological departments of hospitals. The most frequent problems in patients who have had a stroke, is a violation of the motor and koordinatornye functions, language, vision and sensitivity, loss of skills and self-service moves. It is with these effects occur patients after discharge from hospital. PMID:23350135

  18. Stroke prevention in atrial fibrillation.

    PubMed

    Freedman, Ben; Potpara, Tatjana S; Lip, Gregory Y H

    2016-08-20

    Atrial fibrillation is found in a third of all ischaemic strokes, even more after post-stroke atrial fibrillation monitoring. Data from stroke registries show that both unknown and untreated or under treated atrial fibrillation is responsible for most of these strokes, which are often fatal or debilitating. Most could be prevented if efforts were directed towards detection of atrial fibrillation before stroke occurs, through screening or case finding, and treatment of all patients with atrial fibrillation at increased risk of stroke with well-controlled vitamin K antagonists or non-vitamin K antagonist anticoagulants. The default strategy should be to offer anticoagulant thromboprophylaxis to all patients with atrial fibrillation unless defined as truly low risk by simple validated risk scores, such as CHA2DS2-VASc. Assessment of bleeding risk using the HAS-BLED score should focus attention on reversible bleeding risk factors. Finally, patients need support from physicians and various other sources to start anticoagulant treatment and to ensure adherence to and persistence with treatment in the long term. PMID:27560276

  19. Mercaptursäure und Nukleosidaddukt im Harn als Biomarker in 1-Hydroxymethylpyren-exponierten Ratten

    NASA Astrophysics Data System (ADS)

    Ma, Lan

    2002-01-01

    1-Methylpyren (MP) ist hepatokanzerogen in neugeborenen männlichen Mäusen. Durch Hydroxylierung an der benzylischen Stelle und anschließende Sulfonierung wird MP zu DNA-reaktivem 1-Sulfooxymethylpyren (SMP) aktiviert. In der Ratte führt die Exposition des benzylischen Alkohols, 1-Hydroxymethylpyren (HMP), zur DNA-Adduktbildung in verschiedenen Geweben. Eventuelle Konsequenz der Toxifizierung ist die Ausscheidung entsprechender Mercaptursäure und Nukleosidaddukt im Harn, welche aufgrund ihrer Herkunft als Biomarker eignen könnten. In dieser Arbeit wird die Ausscheidung der Mercaptursäure und des N2-Desoxyguanosinadduktes in HMP-exponierten Ratten untersucht. Nach der Applikation von HMP bzw. MP wurden weniger als 1 % der Dosis als MPMA über Urin und Faeces ausgeschieden (0 - 48 h). Die Ausscheidung erfolgt hauptsächlich in den ersten 24 h nach der Applikation. MPdG konnte weder in Urin noch in Faeces der HMP-behandelten Tieren identifiziert werden. Nach direkter SMP-Applikation wurde MPdG nur in sehr geringe Menge (weniger als 0,9 ppm in 12 h) im Urin gefunden. Aufgrund der geringen Menge eignet sich MPdG nicht als Biomarker. MPMA dagegen, lässt sich analytisch gut erfassen. Es sollte daher untersucht werden, ob MPMA die Toxifizierung des HMP wiederspiegelt. Die Voraussetzung dafür ist die Kenntnisse über das Metabolismusmuster von HMP. Es wurde daher umfassende Untersuchungen zum Metabolismus des HMP durchgeführt. Die Ergebnisse zeigten, dass mehr als 80 % der Metaboiten in ihrer oxidierten Form (PCS, deren Glucuronsäure-Konjugate sowie phenolische Sulfatester der PCS) ausgeschieden wurden. Demnach spielt die Oxidation des HMP zu PCS eine sehr wichtige Rolle bei der Detoxifizierung und Ausscheidung von HMP. Ferne konnte nachgewiesen werden, dass die Enzyme Alkohol- und Aldehyd-Dehydrogenase an der Oxidation von HMP beteiligt waren. Die Inhibitoren Disulfiram und Ethanol der o. g. Enzyme wurde daher zur Modulation der Detoxifizierung in vivo eingesetzt

  1. Stroke injury, cognitive impairment and vascular dementia.

    PubMed

    Kalaria, Raj N; Akinyemi, Rufus; Ihara, Masafumi

    2016-05-01

    The global burden of ischaemic strokes is almost 4-fold greater than haemorrhagic strokes. Current evidence suggests that 25-30% of ischaemic stroke survivors develop immediate or delayed vascular cognitive impairment (VCI) or vascular dementia (VaD). Dementia after stroke injury may encompass all types of cognitive disorders. States of cognitive dysfunction before the index stroke are described under the umbrella of pre-stroke dementia, which may entail vascular changes as well as insidious neurodegenerative processes. Risk factors for cognitive impairment and dementia after stroke are multifactorial including older age, family history, genetic variants, low educational status, vascular comorbidities, prior transient ischaemic attack or recurrent stroke and depressive illness. Neuroimaging determinants of dementia after stroke comprise silent brain infarcts, white matter changes, lacunar infarcts and medial temporal lobe atrophy. Until recently, the neuropathology of dementia after stroke was poorly defined. Most of post-stroke dementia is consistent with VaD involving multiple substrates. Microinfarction, microvascular changes related to blood-brain barrier damage, focal neuronal atrophy and low burden of co-existing neurodegenerative pathology appear key substrates of dementia after stroke injury. The elucidation of mechanisms of dementia after stroke injury will enable establishment of effective strategy for symptomatic relief and prevention. Controlling vascular disease risk factors is essential to reduce the burden of cognitive dysfunction after stroke. This article is part of a Special Issue entitled: Vascular Contributions to Cognitive Impairment and Dementia edited by M. Paul Murphy, Roderick A. Corriveau and Donna M. Wilcock. PMID:26806700

  2. Stroke injury, cognitive impairment and vascular dementia☆

    PubMed Central

    Kalaria, Raj N.; Akinyemi, Rufus; Ihara, Masafumi

    2016-01-01

    The global burden of ischaemic strokes is almost 4-fold greater than haemorrhagic strokes. Current evidence suggests that 25–30% of ischaemic stroke survivors develop immediate or delayed vascular cognitive impairment (VCI) or vascular dementia (VaD). Dementia after stroke injury may encompass all types of cognitive disorders. States of cognitive dysfunction before the index stroke are described under the umbrella of pre-stroke dementia, which may entail vascular changes as well as insidious neurodegenerative processes. Risk factors for cognitive impairment and dementia after stroke are multifactorial including older age, family history, genetic variants, low educational status, vascular comorbidities, prior transient ischaemic attack or recurrent stroke and depressive illness. Neuroimaging determinants of dementia after stroke comprise silent brain infarcts, white matter changes, lacunar infarcts and medial temporal lobe atrophy. Until recently, the neuropathology of dementia after stroke was poorly defined. Most of post-stroke dementia is consistent with VaD involving multiple substrates. Microinfarction, microvascular changes related to blood–brain barrier damage, focal neuronal atrophy and low burden of co-existing neurodegenerative pathology appear key substrates of dementia after stroke injury. The elucidation of mechanisms of dementia after stroke injury will enable establishment of effective strategy for symptomatic relief and prevention. Controlling vascular disease risk factors is essential to reduce the burden of cognitive dysfunction after stroke. This article is part of a Special Issue entitled: Vascular Contributions to Cognitive Impairment and Dementia edited by M. Paul Murphy, Roderick A. Corriveau and Donna M. Wilcock. PMID:26806700

  3. Estrogen Replacement Therapy for Stroke

    PubMed Central

    Pabon, Mibel; Tamboli, Cyrus; Tamboli, Sarosh; Acosta, Sandra; De La Pena, Ike; Sanberg, Paul R.; Tajiri, Naoki; Kaneko, Yuji; Borlongan, Cesar V.

    2014-01-01

    Stroke is the third most common cause of death and severe disability among Western populations. Overall, the incidence of stroke is uniformly higher in men than in women. Stroke is rare in women during the reproductive years and rapidly increases after menopause, strongly suggesting that estrogen (E2) plays an important role in the prevention of stroke. Ongoing studies are currently evaluating both the benefits and the risks associated with E2 replacement therapy and hormone replacement therapy in stroke. Equally important is the role of E2 receptor (ER), as studies indicate that ER populations in several tissue sites may significantly change during stress and aging. Such changes may affect the patient’s susceptibility to neurological disorders including stroke and greatly affect the response to selective E2 receptor modulators (SERMs). Replacement therapies may be inefficient with low ER levels. The goal of this review paper is to discuss an animal model that will allow investigations of the potential therapeutic effects of E2 and its derivatives in stroke. We hypothesize that E2 neuroprotection is, in part, receptor mediated. This hypothesis is a proof-of-principle approach to demonstrate a role for specific ER subtypes in E2 neuroprotection. To accomplish this, we use a retroviral-mediated gene transfer strategy that expresses subtypes of the ER gene in regions of the rat brain most susceptible to neuronal damage, namely, the striatum and the cortex. The animal model is exposed to experimental stroke conditions involving middle cerebral artery occlusion (MCAo) method, and eventually the extent of neuronal damage will be evaluated. A reduction in neuronal damage is expected when E2 is administered with specific ER subtypes. From this animal model, an optimal E2 dose and treatment regimen can be determined. The animal model can help identify potential E2-like therapeutics in stroke and screen for beneficial or toxic additives present in commercial E2

  4. [MR investigations in stroke].

    PubMed

    Kenéz, József; Barsi, Péter

    2002-03-20

    In the article digital imaging methods are presented with special emphasis on the use on diagnostics of cerebral circulation studies. Recently, fundamental changes have happened in this field, concerning especially the MR investigations. These changes have influenced the therapeutic strategies of ischaemic stroke. Authors give the theoretical background on the diffusion and perfusion MR imaging, emphasising the importance of their "mismatch" and its impact in the estimation of the outcome of ischaemic events. More recently, new, controversial facts arose, regarding the reasons of the introduction of the theory of so called "negative" and "positive" mismatches. As a consequence, a level of uncertainty took place in the judgement of prognostics. The leading institutions are searching the way to solve the problem which seems to be the quantitative evaluation of the diffusion, perfusion and mismatch data. The advent of the multislice spiral CT with very fast imaging and the importance of CT investigations increased. With this new kind of equipment, even perfusion studies can be performed using iodinated contrast medium.

  5. [MR investigations in stroke].

    PubMed

    Kenéz, József; Barsi, Péter

    2002-03-20

    In the article digital imaging methods are presented with special emphasis on the use on diagnostics of cerebral circulation studies. Recently, fundamental changes have happened in this field, concerning especially the MR investigations. These changes have influenced the therapeutic strategies of ischaemic stroke. Authors give the theoretical background on the diffusion and perfusion MR imaging, emphasising the importance of their "mismatch" and its impact in the estimation of the outcome of ischaemic events. More recently, new, controversial facts arose, regarding the reasons of the introduction of the theory of so called "negative" and "positive" mismatches. As a consequence, a level of uncertainty took place in the judgement of prognostics. The leading institutions are searching the way to solve the problem which seems to be the quantitative evaluation of the diffusion, perfusion and mismatch data. The advent of the multislice spiral CT with very fast imaging and the importance of CT investigations increased. With this new kind of equipment, even perfusion studies can be performed using iodinated contrast medium. PMID:12122985

  6. Vergleich von rekombinanten Vaccinia- und DNA-Vektoren zur Tumorimmuntherapie im C57BL/6-Mausmodell

    NASA Astrophysics Data System (ADS)

    Johnen, Heiko

    2002-10-01

    In der vorliegenden Arbeit wurden Tumorimpfstoffe auf der Basis des Plasmid-Vektors pCI, modified vaccinia virus Ankara (MVA) und MVA-infizierten dendritischen Zellen entwickelt und durch Sequenzierung, Western blotting und durchflußzytometrische Analyse überprüft. Die in vivo Wirksamkeit der Vakzinen wurde in verschiedenen Tumormodellen in C57BL/6 Mäusen verglichen. Die auf dem eukaryotischen Expressionsvektor pCI basierende DNA-Vakzinierung induzierte einen sehr wirksamen, antigenspezifischen und langfristigen Schutz vor Muzin, CEA oder beta-Galactosidase exprimierenden Tumoren. Eine MVA-Vakzinierung bietet in den in dieser Arbeit durchgeführten Tumormodellen keinen signifikanten Schutz vor Muzin oder beta-Galactosidase exprimierenden Tumoren. Sowohl humane, als auch murine in vitro generierte dendritische Zellen lassen sich mit MVA – im Vergleich zu anderen viralen Vektoren – sehr gut infizieren. Die Expressionsrate der eingefügten Gene ist aber gering im Vergleich zur Expression in permissiven Wirtszellen des Virus (embryonale Hühnerfibroblasten). Es konnte gezeigt werden, daß eine MVA-Infektion dendritischer Zellen ähnliche Auswirkungen auf den Reifezustand humaner und muriner dendritischer Zellen hat, wie eine Infektion mit replikationskompetenten Vakzinia-Stämmen, und außerdem die Hochregulation von CD40 während der terminalen Reifung von murinen dendritischen Zellen inhibiert wird. Die während der langfristigen in vitro Kultur auf CEF-Zellen entstandenen Deletionen im MVA Genom führten zu einer starken Attenuierung und dem Verlust einiger Gene, die immunmodulatorische Proteine kodieren, jedoch nicht zu einer Verminderung des zytopathischen Effekts in dendritischen Zellen. Die geringe Expressionsrate und die beobachtete Inhibition der Expression kostimulatorischer Moleküle auf dendritischen Zellen kann für eine wenig effektive Induktion einer Immunantwort in MVA vakzinierten Tieren durch cross priming oder die direkte Infektion

  7. Vergleich von rekombinanten Vaccinia- und DNA-Vektoren zur Tumorimmuntherapie im C57BL/6-Mausmodell

    NASA Astrophysics Data System (ADS)

    Johnen, Heiko

    2002-10-01

    In der vorliegenden Arbeit wurden Tumorimpfstoffe auf der Basis des Plasmid-Vektors pCI, modified vaccinia virus Ankara (MVA) und MVA-infizierten dendritischen Zellen entwickelt und durch Sequenzierung, Western blotting und durchflußzytometrische Analyse überprüft. Die in vivo Wirksamkeit der Vakzinen wurde in verschiedenen Tumormodellen in C57BL/6 Mäusen verglichen. Die auf dem eukaryotischen Expressionsvektor pCI basierende DNA-Vakzinierung induzierte einen sehr wirksamen, antigenspezifischen und langfristigen Schutz vor Muzin, CEA oder beta-Galactosidase exprimierenden Tumoren. Eine MVA-Vakzinierung bietet in den in dieser Arbeit durchgeführten Tumormodellen keinen signifikanten Schutz vor Muzin oder beta-Galactosidase exprimierenden Tumoren. Sowohl humane, als auch murine in vitro generierte dendritische Zellen lassen sich mit MVA – im Vergleich zu anderen viralen Vektoren – sehr gut infizieren. Die Expressionsrate der eingefügten Gene ist aber gering im Vergleich zur Expression in permissiven Wirtszellen des Virus (embryonale Hühnerfibroblasten). Es konnte gezeigt werden, daß eine MVA-Infektion dendritischer Zellen ähnliche Auswirkungen auf den Reifezustand humaner und muriner dendritischer Zellen hat, wie eine Infektion mit replikationskompetenten Vakzinia-Stämmen, und außerdem die Hochregulation von CD40 während der terminalen Reifung von murinen dendritischen Zellen inhibiert wird. Die während der langfristigen in vitro Kultur auf CEF-Zellen entstandenen Deletionen im MVA Genom führten zu einer starken Attenuierung und dem Verlust einiger Gene, die immunmodulatorische Proteine kodieren, jedoch nicht zu einer Verminderung des zytopathischen Effekts in dendritischen Zellen. Die geringe Expressionsrate und die beobachtete Inhibition der Expression kostimulatorischer Moleküle auf dendritischen Zellen kann für eine wenig effektive Induktion einer Immunantwort in MVA vakzinierten Tieren durch cross priming oder die direkte Infektion

  8. [Reducing the burden of stroke in Israel].

    PubMed

    Tanne, David; Goldbourt, Uri

    2008-11-01

    Stroke is the third most common cause of death in Israel. Stroke is a leading cause of severe long-term disability and is associated with staggering economic costs. Ethnic variations observed in stroke mortality rates support that undetermined inherent genetic or sociocultural differences act to increase stroke mortality rates in immigrants from Asia and North Africa over that predicted from their profile of traditional risk factors. In accordance with other Western countries, there has been a decline in mortality rates from stroke, concomitantly with a decline observed in coronary heart disease mortality. With the aging of the population, the burden of stroke is projected to further increase. Moreover, brain infarcts detected by brain imaging are 5-times more common than the clinical syndrome of acute stroke, detected in about 20% of healthy elderly and up to 50% of high risk patients. Estimates of the incidence of stroke, characteristics of patients, management and outcome became available from the tri-annual national acute stroke Israeli survey (NASIS) program, initiated during 2004. The annual incidence of hospitalized acute cerebrovascular events is approximately 13,000 and rates, particularly in women, seem even higher than those observed for acute myocardial infarction. Findings also highlight critical deficiencies in acute stroke units and systems for urgent evaluation and intervention in acute stroke. Action plans are urgently required, in accordance with the experience from other countries, in order to upgrade the stroke infrastructure nationwide for more effective prevention and management of acute stroke.

  9. Relevance of stroke code, stroke unit and stroke networks in organization of acute stroke care--the Madrid acute stroke care program.

    PubMed

    Alonso de Leciñana-Cases, María; Gil-Núñez, Antonio; Díez-Tejedor, Exuperio

    2009-01-01

    Stroke is a neurological emergency. The early administration of specific treatment improves the prognosis of the patients. Emergency care systems with early warning for the hospital regarding patients who are candidates for this treatment (stroke code) increases the number of patients treated. Currently, reperfusion via thrombolysis for ischemic stroke and attention in stroke units are the bases of treatment. Healthcare professionals and health provision authorities need to work together to organize systems that ensure continuous quality care for the patients during the whole process of their disease. To implement this, there needs to be an appropriate analysis of the requirements and resources with the objective of their adjustment for efficient use. It is necessary to provide adequate information and continuous training for all professionals who are involved in stroke care, including primary care physicians, extrahospital emergency teams and all physicians involved in the care of stroke patients within the hospital. The neurologist has the function of coordinating the protocols of intrahospital care. These organizational plans should also take into account the process beyond the acute phase, to ensure the appropriate application of measures of secondary prevention, rehabilitation, and chronic care of the patients that remain in a dependent state. We describe here the stroke care program in the Community of Madrid (Spain).

  10. Stroke prevention in atrial fibrillation--an Asian stroke perspective.

    PubMed

    Tse, Hung-Fat; Wang, Yong-Jun; Ahmed Ai-Abdullah, Moheeb; Pizarro-Borromeo, Annette B; Chiang, Chern-En; Krittayaphong, Rungroj; Singh, Balbir; Vora, Amit; Wang, Chun-Xue; Zubaid, Mohammad; Clemens, Andreas; Lim, Paul; Hu, Dayi

    2013-07-01

    Despite relatively lower prevalence of atrial fibrillation (AF) in Asians (~1%) than in Caucasians (~2%), Asia has a much higher overall disease burden because of its proportionally larger aged population. For example, on the basis of reported age-adjusted prevalence rates and projected population figures in China, there will be an estimated 5.2 million men and 3.1 million women with AF older than 60 years by year 2050. Stroke is a disabling complication of AF that is of increasing cause for concern in Asians patients. Implementing consensus expert recommendations for managing stroke risk in patients with AF can considerably reduce stroke rates. However, caution is necessary when aligning management of Asian patients with AF to that of their Caucasian counterparts. Current international guidelines and risk stratification tools for AF management are based on findings in predominantly Caucasian populations and may therefore have limited relevance, in certain respects, to Asian patients. Oral anticoagulants play an important role in preventing AF-related stroke. The vitamin K antagonist warfarin is recommended for reducing the risk of stroke and thromboembolism in high-risk patients with nonvalvular AF; however, warfarin interacts with many drugs and food ingredients, which may pose significant challenges in administration and monitoring among Asian patients. Further research is needed to inform specific guidance on the implications of different stroke and bleeding profiles in Asians vs Caucasians. Moreover, there is scope to improve physician perceptions and patient knowledge, as well as considering alternative new oral anticoagulants, for example, direct thrombin inhibitors or factor Xa inhibitors.

  11. Sensory syndromes in parietal stroke.

    PubMed

    Bassetti, C; Bogousslavsky, J; Regli, F

    1993-10-01

    We studied 20 patients with an acute parietal stroke with hemisensory disturbances but no visual field deficit and no or only slight motor weakness, without thalamic involvement on CT or MRI and found three main sensory syndromes. (1) The pseudothalamic sensory syndrome consists of a faciobrachiocrural impairment of elementary sensation (touch, pain, temperature, vibration). All patients have an inferior-anterior parietal stroke involving the parietal operculum, posterior insula, and, in all but one patient, underlying white matter. (2) The cortical sensory syndrome consists of an isolated loss of discriminative sensation (stereognosis, graphesthesia, position sense) involving one or two parts of the body. These patients show a superior-posterior parietal stroke. (3) The atypical sensory syndrome consists of a sensory loss involving all modalities of sensation in a partial distribution. Parietal lesions of different topography are responsible for this clinical picture, which probably represents a minor variant of the two previous sensory syndromes. Neuropsychological dysfunction was present in 17 patients. The only constant association was between conduction aphasia and right-sided pseudothalamic sensory deficit. We conclude that parietal stroke can cause different sensory syndromes depending on the topography of the underlying lesion. Sensory deficits can be monosymptomatic but never present as a "pure sensory stroke" involving face, arm, leg, and trunk together.

  12. Satellitenbewegung, band III: Natiirliche und gesteuerte bewegung.

    NASA Astrophysics Data System (ADS)

    Jochim, E. F.

    2014-12-01

    Im dritten Band der Satellitenbewegung werden in fortlaufender Nummerierung einige für Untersuchungen der Bewegung der künstlichen Satelliten wichtige Grundlagen der Astrodynamik mit ausführlichen mathematischen Formelsystemen behandelt. Dazu zählen die unterschiedlichen Aspekte der Bewegung der natürlichen Himmelskörper, die Steuerung und Kontrolle von künstlichen Objekten, und insbesondere die für eine Satellitenbahnanalyse wichtigen physikalischen Beeinflussungen einer Satellitenbewegung. Mathematisch entscheidend ist die Wahl geeigneter Bahnparameter, die ein bestimmtes Bewegungsproblem widerspruchsfrei und singularitätenfrei zu behandeln gestatten. Für die Behandlung routinemäßiger Aufgabenstellungen der Satellitenbewegung, in erster Linie einer präzisen Bahnbestimmung und Bahnverbesserung, kann auf eine Fülle von lehrbuchartigen Monographien verwiesen werden, so dass diese Problematik in der vorliegenden Arbeit nur angedeutet werden soll.

  13. Simulation und virtuelle Realität

    NASA Astrophysics Data System (ADS)

    von Estorff, Otto; Markiewicz, Marian; Özkan, Ali; Zaleski, Olgierd; Blumrich, Reinhard; Genuit, Klaus; Fiebig, André

    Mit Hilfe akustischer Berechnungen ist es möglich, aufwendige Messungen an Fahrzeugprototypen deutlich zu reduzieren. Dieses Kapitel gibt einen kurzen Überblick über die wichtigsten derzeit verfügbaren Methoden. Dabei wird zunächst auf Elementverfahren, wie die Finite-Elemente-Methode (FEM) und die Boundary-Elemente-Methode (BEM), näher eingegangen. Während diese vor allem im tieffrequenten Bereich eingesetzt werden, kommen bei höheren Frequenzen vermehrt Verfahren zum Einsatz, die auf Energieformulierungen beruhen. Exemplarisch wird hier die Funktionsweise und der Einsatz der Statistischen-Energie-Analyse (SEA) erläutert. Anhand von repräsentativen Beispielen werden die Einsatzmöglichkeiten und Grenzen der verschiedenen Verfahren aufgezeigt, wobei vor allem auch auf Vergleiche zwischen Rechnung und Messung eingegangen wird.

  14. Hochschule fur Film und Fernsehen (Babelsberg).

    ERIC Educational Resources Information Center

    Neumann, Roland

    1992-01-01

    Describes the Hochschule fur Film und Fernsehen, an institution of higher education for the study of film and television production in Babelsberg, Germany (formerly the German Democratic Republic). Discusses the major reorientations in the school caused by Germany's reunification. (SR)

  15. Kosmische Katastrophen und der Ursprung der Religion.

    NASA Astrophysics Data System (ADS)

    Hoyle, F.

    This book is a German translation, by V. Delavre, from the English original "The origin of the Universe and the origin of religion", published in 1993. Contents: E. Sens: Die unterbrochene Musikstunde. Einleitung zur deutschen Ausgabe. C. Ryskamp: Einführung. R. N. Anshen: Vorwort. F. Hoyle: Kosmische Katastrophen und der Ursprung der Religion - Die Folgen der Respektabilität; Eiszeiten und Kometen; Die allgemeine Situation in den Nacheiszeiten; Kometen und der Ursprung der Religionen; Der Übergang zu Mittelalter und Neuzeit. Diskussionsbeiträge: Ruth Nanda Anshen, Freeman Dyson, Paul Oscar Kristeller, John Archibald Wheeler, James Schwartz, Roger Shinn, Milton Gatch, Philip Solomon, Norman Newell. F. Hoyle: Schlußwort. A. Tollmann: Nachwort zur deutschen Ausgabe.

  16. Air Pollution and Heart Disease, Stroke

    MedlinePlus

    ... Pressure High Blood Pressure Tools & Resources Stroke More Air Pollution and Heart Disease, Stroke Updated:Aug 30,2016 ... or Longer-Term Acute short-term effects of air pollution tend to strike people who are elderly or ...

  17. African-Americans and Heart Disease, Stroke

    MedlinePlus

    ... more about African-Americans and stroke at our Power To End Stroke website This content was last reviewed July 2015. ... Attack • Heart Failure (HF) • Heart Valve Problems and Disease • High Blood ...

  18. Anemia Boosts Stroke Death Risk, Study Finds

    MedlinePlus

    ... page: https://medlineplus.gov/news/fullstory_160476.html Anemia Boosts Stroke Death Risk, Study Finds Blood condition ... 2016 (HealthDay News) -- Older stroke victims suffering from anemia -- a lack of red blood cells -- may have ...

  19. Worldwide under-funding of stroke research.

    PubMed

    Pendlebury, Sarah T

    2007-05-01

    The clinical and financial burdens of stroke are considerable. Stroke is the leading cause of death and disability in the developed world and incidence is rapidly increasing in the developing world. However, investment in research to combat stroke has been remarkably poor. Studies from the United Kingdom, Europe and the United States have shown a highly consistent picture, with considerably lower levels of funding for stroke research compared with cancer and heart disease. Without better funding for stroke research, it is unlikely that progress in prevention and treatment will offset the projected increases in the burden of stroke. Stroke physicians and public interest groups need to be active advocates in securing increased funding for stroke research.

  20. Stroke Rehabilitation: What Research is Being Done?

    MedlinePlus

    ... this page please turn Javascript on. Feature: Stroke Rehabilitation What Research is Being Done? Past Issues / Spring ... of Contents To Find Out More MedlinePlus: Stroke Rehabilitation medlineplus.gov/strokerehabilitation.html National Institute of Neurological ...

  1. Recovery Potential After Acute Stroke

    PubMed Central

    Seitz, Rüdiger J.; Donnan, Geoffrey A.

    2015-01-01

    In acute stroke, the major factor for recovery is the early use of thrombolysis aimed at arterial recanalization and reperfusion of ischemic brain tissue. Subsequently, neurorehabilitative training critically improves clinical recovery due to augmention of postlesional plasticity. Neuroimaging and electrophysiology studies have revealed that the location and volume of the stroke lesion, the affection of nerve fiber tracts, as well as functional and structural changes in the perilesional tissue and in large-scale bihemispheric networks are relevant biomarkers of post-stroke recovery. However, associated disorders, such as mood disorders, epilepsy, and neurodegenerative diseases, may induce secondary cerebral changes or aggravate the functional deficits and, thereby, compromise the potential for recovery. PMID:26617568

  2. Multisensory stimulation in stroke rehabilitation.

    PubMed

    Johansson, Barbro Birgitta

    2012-01-01

    The brain has a large capacity for automatic simultaneous processing and integration of sensory information. Combining information from different sensory modalities facilitates our ability to detect, discriminate, and recognize sensory stimuli, and learning is often optimal in a multisensory environment. Currently used multisensory stimulation methods in stroke rehabilitation include motor imagery, action observation, training with a mirror or in a virtual environment, and various kinds of music therapy. Non-invasive brain stimulation has showed promising preliminary results in aphasia and neglect. Patient heterogeneity and the interaction of age, gender, genes, and environment are discussed. Randomized controlled longitudinal trials starting earlier post-stroke are needed. The advance in brain network science and neuroimaging enabling longitudinal studies of structural and functional networks are likely to have an important impact on patient selection for specific interventions in future stroke rehabilitation. It is proposed that we should pay more attention to age, gender, and laterality in clinical studies.

  3. Multisensory Stimulation in Stroke Rehabilitation

    PubMed Central

    Johansson, Barbro Birgitta

    2012-01-01

    The brain has a large capacity for automatic simultaneous processing and integration of sensory information. Combining information from different sensory modalities facilitates our ability to detect, discriminate, and recognize sensory stimuli, and learning is often optimal in a multisensory environment. Currently used multisensory stimulation methods in stroke rehabilitation include motor imagery, action observation, training with a mirror or in a virtual environment, and various kinds of music therapy. Non-invasive brain stimulation has showed promising preliminary results in aphasia and neglect. Patient heterogeneity and the interaction of age, gender, genes, and environment are discussed. Randomized controlled longitudinal trials starting earlier post-stroke are needed. The advance in brain network science and neuroimaging enabling longitudinal studies of structural and functional networks are likely to have an important impact on patient selection for specific interventions in future stroke rehabilitation. It is proposed that we should pay more attention to age, gender, and laterality in clinical studies. PMID:22509159

  4. Spousal caregiving for stroke survivors.

    PubMed

    Coombs, Ursula Eileen

    2007-04-01

    Caregiving for a spouse who has survived a stroke has multidimensional implications for both the partner and the spousal caregiver. A phenomenological study was conducted to examine the experiences of spousal caregivers for stroke survivors. Eight spouses who met the inclusion criteria participated in the study. van Manen's (1997) approach was used to examine the spousal caregivers' experiences. Data were collected through audiotapes from semistructured interviews. The interviews were transcribed to form textual descriptions of the caregivers' experiences. Six interrelated themes emerged through data analysis: experiencing a profound sense of loss, adjusting to a new relationship with a spouse, taking on new responsibilities, feeling the demands of caregiving, having to depend on the support of others, and maintaining hope and optimism. This study contributes to healthcare providers' understanding and knowledge of spousal caregivers for stroke survivors, and supports the need for continued research in this area. PMID:17477226

  5. Reticulation des fibres lignocellulosiques

    NASA Astrophysics Data System (ADS)

    Landrevy, Christel

    Pour faire face à la crise économique la conception de papier à valeur ajoutée est développée par les industries papetières. Le but de se projet est l'amélioration des techniques actuelles de réticulation des fibres lignocellulosiques de la pâte à papier visant à produire un papier plus résistant. En effet, lors des réactions de réticulation traditionnelles, de nombreuses liaisons intra-fibres se forment ce qui affecte négativement l'amélioration anticipée des propriétés physiques du papier ou du matériau produit. Pour éviter la formation de ces liaisons intra-fibres, un greffage sur les fibres de groupements ne pouvant pas réagir entre eux est nécessaire. La réticulation des fibres par une réaction de « click chemistry » appelée cycloaddition de Huisgen entre un azide et un alcyne vrai, catalysée par du cuivre (CuAAC) a été l'une des solutions trouvée pour remédier à ce problème. De plus, une adaptation de cette réaction en milieux aqueux pourrait favoriser son utilisation en milieu industriel. L'étude que nous désirons entreprendre lors de ce projet vise à optimiser la réaction de CuAAC et les réactions intermédiaires (propargylation, tosylation et azidation) sur la pâte kraft, en milieu aqueux. Pour cela, les réactions ont été adaptées en milieu aqueux sur la cellulose microcristalline afin de vérifier sa faisabilité, puis transférée à la pâte kraft et l'influence de différents paramètres comme le temps de réaction ou la quantité de réactifs utilisée a été étudiée. Dans un second temps, une étude des différentes propriétés conférées au papier par les réactions a été réalisée à partir d'une série de tests papetiers optiques et physiques. Mots Clés Click chemistry, Huisgen, CuAAC, propargylation, tosylation, azidation, cellulose, pâte kraft, milieu aqueux, papier.

  6. Positive Emotion following a Stroke

    PubMed Central

    Ostir, Glenn V.; Berges, Ivonne; Ottenbacher, Margaret; Graham, James E.; Ottenbacher, Kenneth J.

    2008-01-01

    OBJECTIVES As populations age, interest in exploring the emotional health of adults has increased. In the current study we were interested in investigating the positive emotion of adults with stroke at discharge from in-patient medical rehabilitation and 3 months post discharge. DESIGN A longitudinal study using information from the Stroke Recovery in Underserved Patients database. SETTING Information was collected during in-patient medical rehabilitation stay and approximately 3 months post discharge. PARTICIPANTS The study included 856 persons aged 55 or older with stroke admitted to in-patient medical rehabilitation in the U.S. MEASUREMENTS Positive emotion. RESULTS The average age was 72.5 years, 78.7% were non-Hispanic white and 51.9% were women. The average length of in-patient hospital stay was 20.2 (SD 10.1) days. More than a third (35.6%) reported higher positive emotion over the 3 month follow-up, while 29.7% reported lower positive emotion. In addition to discharge positive emotion, three factors including depression (b = −0.05, SE .02, p = .0001), level of education (b = 0.08, SE .04, p = .04) and functional status (b = 0.04, SE .006, p = .001) significantly predicted higher positive emotion at 3 month follow-up. CONCLUSION A large percentage of adults report high positive emotion in the initial months following a stroke. This finding adds to work on stroke recovery and indicates the resilience of adults when faced with a health challenge. Understanding the role of positive emotion in persons living with stroke may provide critical insight into long-term recovery. PMID:18509564

  7. Epidemiology of childhood stroke in Estonia.

    PubMed

    Laugesaar, Rael; Kolk, Anneli; Uustalu, Ulle; Ilves, Pilvi; Tomberg, Tiiu; Talvik, Inga; Köbas, Kristel; Sander, Valentin; Talvik, Tiina

    2010-02-01

    We investigated the incidence and 30-day case-fatality of childhood stroke in Estonia, and clinical signs and risk factors of childhood stroke. A retrospective (1995-2003) and prospective study (2004-2006) of childhood stroke (arterial ischemic, hemorrhagic, and sinovenous thrombosis) and transient ischemic attack was conducted. Stroke-incidence calculation was based on the prospective study. Clinical diagnoses of stroke were confirmed by neuroradiology. The incidence rate of childhood stroke in Estonia was 2.73/100,000 person-years for children aged 30 days to 18 years: 1.61/100,000 for arterial ischemic stroke, 0.87/100,000 for hemorrhagic stroke, 0.25/100,000 for sinovenous thrombosis, and 0.37/100,000 for transient ischemic attack. No arterial ischemic stroke patients died within 30 days, but case-fatality for intracerebral hemorrhage was 46%. Focal signs occurred in 100% of arterial ischemic strokes and 64% of intracerebral hemorrhage cases. Risk factors were identified in 35/48 (73%) children with cerebrovascular attacks. Six children with arterial ischemic stroke (6/24, 25%) manifested more than one risk factor. The incidence rate of childhood stroke in Estonia is similar to that in earlier data.

  8. Stroke and Native Hawaiians/Pacific Islanders

    MedlinePlus

    ... Other Pacific Islander > Stroke Stroke and Native Hawaiians/Pacific Islanders Native Hawaiians/Pacific Islanders were four times more likely than non- ... a stroke in 2010. In general, Native Hawaiian/Pacific Islander adults have developed several of the high ...

  9. An overview of antithrombotics in ischemic stroke.

    PubMed

    Schweickert, Patricia A; Gaughen, John R; Kreitel, Elizabeth M; Shephard, Timothy J; Solenski, Nina J; Jensen, Mary E

    2016-06-19

    The use of antithrombotic medications is an important component of ischemic stroke treatment and prevention. This article reviews the evidence for best practices for antithrombotic use in stroke with focused discussion on the specific agents used to treat and prevent stroke. PMID:27153001

  10. Patient's Guide to Antithrombotic Therapy in Stroke

    MedlinePlus

    ... have had ischemic strokes. 5. How important is aspirin for a new stroke? ! Aspirin is a drug that “thins” the blood by ... cases, it is recommended that patients start taking aspirin within 48 hours of an ischemic stroke. While ...

  11. Long-Term Sequelae of Stroke

    PubMed Central

    Teasell, Robert W.

    1992-01-01

    Scant attention has been paid to the long-term consequences and complications resulting from a stroke. Many stroke survivors go on to develop a variety of medical, musculoskeletal, and psychosocial complications, years after the acute stroke. The family physician is regularly called upon to deal with these problems, but is often hampered by a lack of resources. PMID:21221264

  12. Post-emergency department management of stroke.

    PubMed

    Brown, Devin L; Haley, E Clarke

    2002-08-01

    All stroke patients ideally should be admitted to a stroke unit in which personnel are familiar with strategies for taking care of stroke patients. Prevention of worsening cerebral ischemia by appropriate blood pressure and serum glucose management, fever control, and supplemental oxygen for hypoxemic patients is recommended. Recognition of common complications, such as aspiration pneumonia and deep venous thrombosis, highlights the need for swallowing evaluation and the use of pneumatic compression devices or subcutaneous heparin. Patients should be monitored closely for deterioration in their neurologic status and should have complications appropriately addressed. After evaluation of stroke etiology, appropriate secondary stroke prophylaxis should be selected and initiated before hospital discharge.

  13. Recurrent stroke: what have we learnt?

    PubMed

    Rabia, K; Khoo, Em

    2007-01-01

    Stroke is the third leading cause of death, a major cause of disability in adults, and is frequently more disabling than fatal. With a decline in mortality from initial cerebral infarction and an increase in the life expectancy of the population, the number of patients with recurrent stroke and ensuing cardiovascular events will become greater. Thus it is important to find out those patients at high risk of stroke recurrence. This case report illustrates the process of recurrent stroke and the resulting disabilities and morbidities in a 42-year- old man. The role of integrated stroke rehabilitation programme is described. PMID:25606084

  14. Atrial Septal Defects and Cardioembolic Strokes.

    PubMed

    Leppert, Michelle; Poisson, Sharon N; Carroll, John D

    2016-05-01

    Atrial septal defects (ASDs) can be complicated by cardioembolic strokes, but the exact incidence is unknown. Patients with large and small shunts may present with a cardioembolic stroke. Patients with cryptogenic strokes should have cardiac ultrasound to see if an ASD is present. Cardioembolic strokes associated with ASD principally occur with 2 mechanisms. The first is paradoxic embolism involving a venous-based source of thrombus, which may subsequently pass through the ASD by right-to-left shunting, causing a cardioembolic stroke. The second is atrial fibrillation that can complicate the course of patients with ASDs, especially as they age. PMID:27150170

  15. Acupuncture therapy for stroke patients.

    PubMed

    Li, Xin; Wang, Qiang

    2013-01-01

    Acupuncture is one of the most important parts of Traditional Chinese Medicine, has been used for more than 3000 years as prevention and treatment for various diseases in China as well as in adjacent regions, and is widely accepted in western countries in recent years. More and more clinical trials revealed that acupuncture shows positive effect in stroke, not only as a complementary and alternative medicine for poststroke rehabilitation but also as a preventive strategy which could induce cerebral ischemic tolerance, especially when combined with modern electrotherapy. Acupuncture has some unique characteristics, which include acupoint specificity and parameter-dependent effect. It also involves complicated mechanism to exert the beneficial effect on stroke. Series of clinical trials have shown that acupuncture primarily regulates the release of neurochemicals, hemorheology, cerebral microcirculation, metabolism, neuronal activity, and the function of specific brain region. Animal studies showed that the effects of acupuncture therapy on stroke were possibly via inhibition of postischemic inflammatory reaction, stimulation of neurogenesis and angiogenesis, and influence on neural plasticity. Mechanisms for its preconditioning effect include activity enhancement of antioxidant, regulation of the endocannabinoid system, and inhibition of apoptosis. Although being controversial, acupuncture is a promising preventive and treatment strategy for stroke, but further high-quality clinical trials would be needed to provide more confirmative evidence.

  16. Attention function after childhood stroke.

    PubMed

    Max, Jeffrey E; Robin, Donald A; Taylor, H Gerry; Yeates, Keith O; Fox, Peter T; Lancaster, Jack L; Manes, Facundo F; Mathews, Katherine; Austermann, Shannon

    2004-11-01

    We investigated attentional outcome after childhood stroke and orthopedic diagnosis in medical controls. Twenty-nine children with focal stroke lesions and individually matched children with clubfoot or scoliosis were studied with standardized attention and neuroimaging assessments. Stroke lesions were quite varied in location and commonly involved regions implicated in Posner's model of attention networks. Children with stroke lesions performed significantly more poorly regarding attention function compared with controls. Performance on the Starry Night, a test demanding alerting and sensory-orienting but not executive attention function, was significantly associated with lesion size in the alerting and sensory-orienting networks but not the executive attention network. Furthermore, earlier age at lesion acquisition was significantly associated with poorer attention function even when lesion size was controlled. These findings support the theory of dissociable networks of attention and add to evidence from studies of children with diffuse and focal brain damage that early insults are associated with worse long-term outcomes in many domains of neuropsychological function. In addition, these results may provide clues towards the understanding of mechanisms underlying attention in children.

  17. Sequelae and rehabilitation of stroke.

    PubMed

    Ueda, S

    1991-10-01

    During rehabilitation after stroke, evaluation and treatment are carried out for sensorimotor impairments such as hemiplegia or dysphagia, perceptual-cognitive impairments such as unilateral spatial neglect, disabilities such as dependence in activities of daily living, as well as various types of handicaps. Research into these problems is reviewed.

  18. Haemodilution for acute ischaemic stroke

    PubMed Central

    Chang, Timothy S; Jensen, Matthew B

    2014-01-01

    Background Ischaemic stroke interrupts the flow of blood to part of the brain. Haemodilution is thought to improve the flow of blood to the affected areas of the brain and thus reduce infarct size. Objectives To assess the effects of haemodilution in acute ischaemic stroke. Search methods We searched the Cochrane Stroke Group Trials Register (February 2014), the Cochrane Central Register of Controlled Trials (Issue 1, 2014), MEDLINE (January 2008 to October 2013) and EMBASE (January 2008 to October 2013). We also searched trials registers, scanned reference lists and contacted authors. For the previous version of the review, the authors contacted manufacturers and investigators in the field. Selection criteria Randomised trials of haemodilution treatment in people with acute ischaemic stroke. We included only trials in which treatment was started within 72 hours of stroke onset. Data collection and analysis Two review authors assessed trial quality and one review author extracted the data. Main results We included 21 trials involving 4174 participants. Nine trials used a combination of venesection and plasma volume expander. Twelve trials used plasma volume expander alone. The plasma volume expander was plasma alone in one trial, dextran 40 in 12 trials, hydroxyethyl starch (HES) in five trials and albumin in three trials. Two trials tested haemodilution in combination with another therapy. Evaluation was blinded in 14 trials. Five trials probably included some participants with intracerebral haemorrhage. Haemodilution did not significantly reduce deaths within the first four weeks (risk ratio (RR) 1.10; 95% confidence interval (CI) 0.90 to 1.34). Similarly, haemodilution did not influence deaths within three to six months (RR 1.05; 95% CI 0.93 to 1.20), or death and dependency or institutionalisation (RR 0.96; 95% CI 0.85 to 1.07). The results were similar in confounded and unconfounded trials, and in trials of isovolaemic and hypervolaemic haemodilution. No

  19. Sleep-disordered breathing and stroke.

    PubMed

    Ali, Latisha K; Avidan, Alon Y

    2008-01-01

    Sleep and stroke have an important and fascinating interaction. Patients with sleep-disordered breathing present with cardiovascular heart disease, cognitive decline, and increased risk of stroke. Stroke adversely affects sleep and factors such as prolonged immobilization, chronic pain, nocturnal hypoxia, and depression, which can also adversely impact sleep quality. Obstructive sleep apnea (OSA), one of the most common and serious sleep disturbances, manifests itself in almost 50% of all stroke patients. Sleep apnea patients who experience a stroke may be at a greater impairment in their rehabilitation potential and have increased risk of secondary stroke and mortality. Given these factors, the practicing neurologist should possess the skills to appropriately recognize, rapidly diagnose, and properly manage stroke patients with OSA.

  20. Two-stroke engine diagnostics and design

    SciTech Connect

    Not Available

    1992-01-01

    This paper focuses on research and development efforts on two-stroke cycle engines for automotive applications. Partial contents include: Velocity Field Characteristics in Motored Two-Stroke Ported Engines; Flow Vector Measurements at the Scavenging Ports in a Fired Two-Stroke Engine; A Study on Exhaust Dynamic Effect of Two-Stroke Motorcycle Petrol Engine; Characterization of Ignition and Parametric Study of a Two-Stroke-Cycle Direct-Injected Gasoline Engine; LDV Measurements of Intake Port Flow in a Two-Stroke Engine with and without Combustion; Appraisal of Regenerative Blowers for Scavenging of Small 2T S.I. Powerplants; and Development Experience of a Poppet-Valved Two-Stroke Flagship Engine.

  1. [Non-pharmacological methods of stroke prevention].

    PubMed

    Planjar-Prvan, Miljenka

    2010-03-01

    Stroke is a major health problem and the leading cause of functional disability, so that effective primary prevention remains the best, easiest and most cost-effective approach to reduce serious consequences of stroke. It is well known that prevention includes pharmacological and non-pharmacological methods. However, it seems that non-pharmacological methods of stroke prevention are generally neglected and placed in an inferior position in relation to pharmacological prevention. Therefore, the objective of this review is to present the most relevant literature data on non-pharmacological methods of stroke prevention and highlight their effectiveness with the use of quantitative parameters of evidence-based medicine. The main sources of data were the American, European and Croatian guidelines for stroke prevention, along with recent research results. Literature data have shown the relative risk of stroke to be greater than 2.0 in the group with unhealthy lifestyle; in fact, healthy lifestyle predicts more than twofold difference in the incidence of stroke. It is important to emphasize the public health value of non-pharmacological stroke prevention and to underline that it should be constant, irrespective of taking pharmacotherapy for stroke prevention or not. Healthy lifestyle is fundamental for non-pharmacological stroke prevention and includes healthy diet, regular physical activity, low-normal body mass index, smoking abstinence, and moderate drinking of alcohol. It is essential to inform patients on the importance, value and benefits of non-pharmacological stroke prevention, in particular when it remains the only therapeutic option in case of adverse side effects of pharmacotherapy prevention. Numerous studies demonstrated that even small lifestyle modifications could significantly reduce the risk of stroke. Therefore, it is necessary that physicians promote moderate and healthy lifestyle and habits in primary and secondary stroke prevention because there is

  2. Leitbilder und Handlungsstrategien für die Raumentwicklung in Deutschland. Entwicklungs-, Umsetzungs- und Fortschreibungsprozess der Bund-Länder-Strategie für Städte und Regionen

    NASA Astrophysics Data System (ADS)

    Issaoui, Mariam; Sinz, Manfred

    2010-09-01

    Die Ministerkonferenz für Raumordnung stellte im Mai 2010 fest, dass sich die „Leitbilder und Handlungsstrategien für die Raumentwicklung in Deutschland“ (2006) bewährt haben und bei der Gestaltung der räumlichen Entwicklung umgesetzt werden. Um die Leitbilder den sich verändernden wirtschaftlichen, sozialen und naturräumlichen Rahmenbedingungen anzupassen und die Erkenntnisse aus dem bisherigen Diskussions- und Umsetzungsprozess in Politik und Praxis einzubeziehen, sind sie zu ergänzen und weiterzuentwickeln. Im Mittelpunkt der Fortschreibung werden die Themen „Partnerschaften und Strategien für Stadtregionen und ländliche Räume“, „Mobilität und Logistik“ sowie „Klimaschutz und Energieversorgung“ stehen.

  3. EC Driver - 41" Stroke Hydraulic Cylinder

    SciTech Connect

    Jaques, A.; /Fermilab

    1990-05-24

    rod, a 2 inch bore and 10,000 psi capacity, the maximum return (retraction) force is: ({pi}/4)(2{sup 2}-1.52) x (10,000) = 13,744 lbs. (return force). This meets the desired design capacity of the cylinder. On the extension of the cylinder, the pressure will be limited such to produce only the 13,000 lb. design capacity. Through the use of a regulator on the cylinder extension inlet, the pressure will be limited to: 13,000/[({pi}/4)(2){sup 2}] {approx_equal} 4,200 psi. (regulator setting) and 4,200 x ({pi}/4)(2){sup 2} = 13,195 lbs. (thrust force). Another reference used by some Fermi engineers in designing hydraulic cylinders is the 'Design Engineers Handbook', Bulletin 0224-B1 published by the Parker-Hannifin Corporation. The piston rod-stroke selection table on page b-5 is used to determine the stroke factor. Our setup most approximates Case II of the table which gives a stroke factor of 0.70. Multiplying this by the actual stroke (41-inch) gives us a basic length of 28.7-inch. Using the piston rodstroke selection graph on page b-6, the 1-1/2 inch rod and 28.7-inch basic length indicate an allowable thrust of approximately 13,000 lbs. According to the Chief Application Engineer at the Parker-Hannifin regional sales office in Des Plaines, IL, a min imum safety factor of 4 can be assumed in the piston rod-stroke selection graph, possibly even higher. This would be at least twice as high as our initial safety factor of 2. Thus we feel our cylinder design falls well within the acceptable region of this reference.

  4. Médecine des voyages

    PubMed Central

    Aw, Brian; Boraston, Suni; Botten, David; Cherniwchan, Darin; Fazal, Hyder; Kelton, Timothy; Libman, Michael; Saldanha, Colin; Scappatura, Philip; Stowe, Brian

    2014-01-01

    Résumé Objectif Définir la pratique de la médecine des voyages, présenter les éléments fondamentaux d’une consultation complète préalable aux voyages à des voyageurs internationaux et aider à identifier les patients qu’il vaudrait mieux envoyer en consultation auprès de professionnels de la médecine des voyages. Sources des données Les lignes directrices et les recommandations sur la médecine des voyages et les maladies liées aux voyages publiées par les autorités sanitaires nationales et internationales ont fait l’objet d’un examen. Une recension des ouvrages connexes dans MEDLINE et EMBASE a aussi été effectuée. Message principal La médecine des voyages est une spécialité très dynamique qui se concentre sur les soins préventifs avant un voyage. Une évaluation exhaustive du risque pour chaque voyageur est essentielle pour mesurer avec exactitude les risques particuliers au voyageur, à son itinéraire et à sa destination et pour offrir des conseils sur les interventions les plus appropriées en gestion du risque afin de promouvoir la santé et prévenir les problèmes médicaux indésirables durant le voyage. Des vaccins peuvent aussi être nécessaires et doivent être personnalisés en fonction des antécédents d’immunisation du voyageur, de son itinéraire et du temps qu’il reste avant son départ. Conclusion La santé et la sécurité d’un voyageur dépendent du degré d’expertise du médecin qui offre le counseling préalable à son voyage et les vaccins, au besoin. On recommande à ceux qui donnent des conseils aux voyageurs d’être conscients de l’ampleur de cette responsabilité et de demander si possible une consultation auprès de professionnels de la médecine des voyages pour tous les voyageurs à risque élevé.

  5. Stroke: New Developments and Their Application in Clinical Practice.

    PubMed

    Kelly, Peter J; Kavanagh, Eoin; Murphy, Sean

    2016-08-01

    Significant advances have been made in recent years in primary stroke prevention, improved stroke outcomes in high-income populations, emergency stroke therapy, and stroke prevention. In this article, we review recent trends in stroke epidemiology, improvements in delivery of intravenous thrombolysis (via stroke system-wide approaches, application of 'Lean Principles' to improve workflow processes, and re-evaluation of exclusion criteria), recent stroke thrombectomy trials, and new developments in stroke prevention, with emphasis on risk prediction in transient ischemic attack, choice and timing of anticoagulation therapy for secondary stroke prevention, and emerging concepts in risk stratification for management of symptomatic carotid stenosis. PMID:27643898

  6. Stroke Knowledge in Spanish-speaking populations

    PubMed Central

    Hawkes, Maximiliano A; Ameriso, Sebastián F; Willey, Joshua Z

    2015-01-01

    Background Spanish is the second most spoken language in the world. Spanish-speaking populations (SSP) have heterogeneous cultural backgrounds, racial and ethnical origins, economic status, and access to health care systems. There are no published reviews about stroke knowledge in SSP. We reviewed the existing literature addressing stroke knowledge among SSP and propose future directions for research. Summary We identified 18 suitable studies by searching PubMed, Lilacs, Scopus, Embase, Cochrane and Scielo databases, and looking at reference lists of eligible articles. We also included 2 conference abstracts. Data related to stroke knowledge from studies of Spanish-speakers was analyzed. Key messages Little is known about stroke knowledge in SSP, especially in Latin America. Information is poor even among subjects at risk, stroke patients, stroke survivors, and health care providers. “Ictus”, the word used for stroke in Spanish, is largely unrecognized among subjects at risk. Furthermore, access to medical care and presence of neurologists are suboptimal in many regions. There are several potential issues to solve regarding stroke knowledge and stroke care in SSP. Programs to educate the general population and non-neurologists medical providers in stroke and telemedicine may be suitable options to improve the present situation. PMID:25871697

  7. Benchmarks for acute stroke care delivery

    PubMed Central

    Hall, Ruth E.; Khan, Ferhana; Bayley, Mark T.; Asllani, Eriola; Lindsay, Patrice; Hill, Michael D.; O'Callaghan, Christina; Silver, Frank L.; Kapral, Moira K.

    2013-01-01

    Objective Despite widespread interest in many jurisdictions in monitoring and improving the quality of stroke care delivery, benchmarks for most stroke performance indicators have not been established. The objective of this study was to develop data-derived benchmarks for acute stroke quality indicators. Design Nine key acute stroke quality indicators were selected from the Canadian Stroke Best Practice Performance Measures Manual. Participants A population-based retrospective sample of patients discharged from 142 hospitals in Ontario, Canada, between 1 April 2008 and 31 March 2009 (N = 3191) was used to calculate hospital rates of performance and benchmarks. Intervention The Achievable Benchmark of Care (ABC™) methodology was used to create benchmarks based on the performance of the upper 15% of patients in the top-performing hospitals. Main Outcome Measures Benchmarks were calculated for rates of neuroimaging, carotid imaging, stroke unit admission, dysphasia screening and administration of stroke-related medications. Results The following benchmarks were derived: neuroimaging within 24 h, 98%; admission to a stroke unit, 77%; thrombolysis among patients arriving within 2.5 h, 59%; carotid imaging, 93%; dysphagia screening, 88%; antithrombotic therapy, 98%; anticoagulation for atrial fibrillation, 94%; antihypertensive therapy, 92% and lipid-lowering therapy, 77%. ABC™ acute stroke care benchmarks achieve or exceed the consensus-based targets required by Accreditation Canada, with the exception of dysphagia screening. Conclusions Benchmarks for nine hospital-based acute stroke care quality indicators have been established. These can be used in the development of standards for quality improvement initiatives. PMID:24141011

  8. Secondary stroke prevention: challenges and solutions.

    PubMed

    Esenwa, Charles; Gutierrez, Jose

    2015-01-01

    Stroke is the leading cause of disability in the USA and a major cause of mortality worldwide. One out of four strokes is recurrent. Secondary stroke prevention starts with deciphering the most likely stroke mechanism. In general, one of the main goals in stroke reduction is to control vascular risk factors such as hypertension, diabetes, dyslipidemia, and smoking cessation. Changes in lifestyle like a healthy diet and aerobic exercise are also recommended strategies. In the case of cardioembolism due to atrial fibrillation, mechanical valves, or cardiac thrombus, anticoagulation is the mainstay of therapy. The role of anticoagulation is less evident in the case of bioprosthetic valves, patent foramen ovale, and dilated cardiomyopathy with low ejection fraction. Strokes due to larger artery atherosclerosis account for approximately a third of all strokes. In the case of symptomatic extracranial carotid stenosis, surgical intervention as close as possible in time to the index event seems highly beneficial. In the case of intracranial large artery atherosclerosis, the best medical therapy consists of antiplatelets, high-dose statins, aggressive controls of vascular risk factors, and lifestyle modifications, with no role for intracranial arterial stenting or angioplasty. For patients with small artery occlusion (ie, lacunar stroke), the therapy is similar to that used in patients with intracranial large artery atherosclerosis. Despite the constant new evidence on how to best treat patients who have suffered a stroke, the risk of stroke recurrence remains unacceptably high, thus evidencing the need for novel therapies. PMID:26300647

  9. Patent foramen ovale (PFO), stroke and pregnancy.

    PubMed

    Chen, Lei; Deng, Wenjun; Palacios, Igor; Inglessis-Azuaje, Ignacio; McMullin, David; Zhou, Dong; Lo, Eng H; Buonanno, Ferdinando; Ning, MingMing

    2016-06-01

    Patent foramen ovale (PFO)-related stroke is increasingly recognized as an important etiology of ischemic embolic stroke-accounting for up to 50% of strokes previously considered 'cryptogenic' or with an unknown mechanism. As a 'back door to the brain,' PFO can allow venous clots to enter arterial circulation via interatrial right-to-left shunting, potentially resulting in ischemic stroke. We observe that clinically, PFO-related stroke affects women of childbearing age, and that pregnancy-owing to major changes in hemocoagulative, hormonal, and cardiovascular parameters-can enhance stroke risks. However, no systematic study has been performed and little is known regarding complications, pregnancy outcomes and treatment for PFO-related stroke during pregnancy. To identify and characterize the complications and clinical outcomes related to PFOs during pregnancy, we performed a literature review and analysis from all reported cases of pregnancy with PFO-related complications in the medical literature from 1970 to 2015. We find that during pregnancy and post-partum, PFO is associated with complications affecting multiple organs, including the brain, heart and lung. The three principal complications reported are stroke, pulmonary emboli and myocardial infarction. In contrast to other pregnancy-related stroke etiologies, which peak during later pregnancy and postpartum, PFO-related stroke peaks during early pregnancy (first and second trimester-60%), and most patients had good neurological outcome (77%). In patients with PFO with recurrent stroke during pregnancy, additional key factors include high-risk PFO morphology (atrial septal aneurysm), larger right-to-left shunt, multiple gestation and concurrent hypercoagulability. Compared to strokes of other etiologies during pregnancy, most PFO stroke patients experienced uneventful delivery (93%) of healthy babies with a good clinical outcome. We conclude with recommended clinical treatment strategies for pregnant patients

  10. Sex Disparities in Stroke: Women Have More Severe Strokes but Better Survival Than Men

    PubMed Central

    Dehlendorff, Christian; Andersen, Klaus Kaae; Olsen, Tom Skyhøj

    2015-01-01

    Background Uncertainty remains about whether stroke affects men and women similarly. We studied differences between men and women with regard to stroke severity and survival. Methods and Results We used the Danish Stroke Registry, with information on all hospital admissions for stroke in Denmark between 2003 and 2012 (N=79 617), and the Danish Register of Causes of Death. Information was available on age, sex, marital status, stroke severity, stroke subtype, socioeconomic status, and cardiovascular risk profile. We studied only deaths due to the index stroke, with the assumption that death reported on death certificates as due to stroke was related to the index stroke if death occurred within the first week or month after stroke. Multivariate Cox regression analysis and multiple imputation were applied. Stroke was the cause of death for 4373 and 5512 of the 79 617 patients within 1 week (5.5%) or 1 month (6.9%), respectively. After the age of 60 years, women had more severe strokes than men. Up to ages in the mid-60s, no difference in the risk of death from stroke was seen between the 2 sexes. For people aged >65 years, however, the risk gradually became greater in men than in women and significantly so (>15%) from the mid-70s (adjusted for age, marital status, stroke severity, stroke subtype, socioeconomic status, and cardiovascular risk factors). Results were essentially the same when analyzing deaths within 1 week, 1 month and ischemic and hemorrhagic stroke separately. Conclusions Stroke affects women and men differently. Elderly women were affected more severely than elderly men but were more likely to survive. PMID:26150479

  11. Hip Hop Stroke: Study Protocol for a Randomized Controlled Trial to Address Stroke Literacy

    PubMed Central

    Williams, Olajide; Leighton-Herrmann, Ellyn; DeSorbo, Alexandra; Hecht, Mindy; Hedmann, Monique; Huq, Saima; Gerin, William; Chinchilli, Vernon; Ogedegbe, Gbenga; Noble, James

    2015-01-01

    Objective Stroke is the fifth leading cause of death and the leading cause of serious long-term adult disability in the US. Acute stroke treatments with intravenous thrombolysis and endovascular therapy are proven to reduce disability, however a critical limitation on their effectiveness is the narrow time window for administration, which is 4.5 hours and 6 hours respectively from the onset of symptoms. Our overarching goal is to reduce pre-hospital delays to acute stroke treatments in economically disadvantaged minority communities where the greatest delays exist, using Hip Hop Stroke. Methods Hip Hop Stroke (HHS) is a school-based, child-mediated, culturally-tailored stroke communication multimedia intervention developed using validated models of behavior change and designed to improve stroke literacy (knowledge of stroke symptoms, the urgent need to call 911, and prevention measures) of 4th, 5th and 6th grade students and their parents residing in poor urban communities. Children in the intervention arm will receive the HHS intervention, while those in the attentional control arm will receive standardized nutrition education based on the USDA's MyPyramid program. Children will be trained and motivated to share stroke information with their parents or other adult caregiver. Both children and parents will complete a stroke knowledge assessment at baseline, immediately following the program, and at 3-months post-program. The primary outcome is the effect of the child mediation on parental stroke literacy. Conclusion Stroke literate children, a captive audience in school systems, may represent a viable channel for spreading stroke information into households of poor urban communities where mass media stroke campaigns have shown the lowest penetration. These children may also call 911 when witnessing a stroke in their homes or communities. The HHS program may highlight the potential role of children in the chain of stroke recovery as a strategy for reducing

  12. Velocity, stroke rate, and distance per stroke during elite swimming competition.

    PubMed

    Craig, A B; Skehan, P L; Pawelczyk, J A; Boomer, W L

    1985-12-01

    The mean velocity of 9 out of 10 women's events during the U.S. Olympic Swimming Trials was greater in 1984 as compared to 1976. Three of the 10 men's events showed improvement. In 9 out of these 12 events, the increased velocity was accounted for by increased distance per stroke (range, -3 to -13%). In the women's 100-m butterfly and 100-m backstroke, increased velocity was due solely to faster stroke rates. The finalists in each event were compared to those whose velocities were 3-7% slower. In almost all events and stroke styles, the finalists achieved greater distances per stroke than did the slower group. In the men's events increased distance per stroke was associated with decreased stroke rate, except in the backstroke, in which both were increased for the finalists. Although the faster women swimmers generally had greater distances per stroke, they were more dependent than men on faster stroke rates to achieve superiority. The profile of velocity for races of 200 m and longer indicated that as fatigue developed the distance per stroke decreased. The faster swimmers compensated for this change by maintaining or increasing stroke rate more than did their slower competitors. This study indicates that improvements and superiority in stroke mechanics are reflected in the stroke rate and distance per stroke used to swim a race. PMID:4079732

  13. Zwischen Web 2.0, virtuellen Welten und Game-based Learning - Einsatzszenarien und Prototypen im Hochschulumfeld

    NASA Astrophysics Data System (ADS)

    Pongratz, Hans

    Web 2.0, virtuelle Welten und Game-based Learning werden als Allheilmittel moderner Wissensvermittlung an Hochschulen genannt. Dieser Artikel beschreibt nach einer Einführung in die Thematik Einsatzszenarien und Prototypen im Hochschulumfeld anhand ausgewählter Web 2.0-Dienste, der virtuellen Welt Second Life, eines an der TUM entwickelten Frameworks für Gamebased Learning Applikationen und eines Lernspiels. Diese werden anhand von konkreten Lehr- und Lernszenarien vorgestellt und anhand der bisherigen Erfahrungen in diesem Bereich kritisch beleuchtet.

  14. Post-stroke language disorders.

    PubMed

    Sinanović, Osman; Mrkonjić, Zamir; Zukić, Sanela; Vidović, Mirjana; Imamović, Kata

    2011-03-01

    Post-stroke language disorders are frequent and include aphasia, alexia, agraphia and acalculia. There are different definitions of aphasias, but the most widely accepted neurologic and/or neuropsychological definition is that aphasia is a loss or impairment of verbal communication, which occurs as a consequence of brain dysfunction. It manifests as impairment of almost all verbal abilities, e.g., abnormal verbal expression, difficulties in understanding spoken or written language, repetition, naming, reading and writing. During the history, many classifications of aphasia syndromes were established. For practical use, classification of aphasias according to fluency, comprehension and abilities of naming it seems to be most suitable (nonfluent aphasias: Broca's, transcortical motor, global and mixed transcortical aphasia; fluent aphasias: anomic, conduction, Wernicke's, transcortical sensory, subcortical aphasia). Aphasia is a common consequence of left hemispheric lesion and most common neuropsychological consequence of stroke, with a prevalence of one-third of all stroke patients in acute phase, although there are reports on even higher figures. Many speech impairments have a tendency of spontaneous recovery. Spontaneous recovery is most remarkable in the first three months after stroke onset. Recovery of aphasias caused by ischemic stroke occurs earlier and it is most intensive in the first two weeks. In aphasias caused by hemorrhagic stroke, spontaneous recovery is slower and occurs from the fourth to the eighth week after stroke. The course and outcome of aphasia depend greatly on the type of aphasia. Regardless of the fact that a significant number of aphasias spontaneously improve, it is necessary to start treatment as soon as possible. The writing and reading disorders in stroke patients (alexias and agraphias) are more frequent than verified on routine examination, not only in less developed but also in large neurologic departments. Alexia is an acquired

  15. Post-stroke language disorders.

    PubMed

    Sinanović, Osman; Mrkonjić, Zamir; Zukić, Sanela; Vidović, Mirjana; Imamović, Kata

    2011-03-01

    Post-stroke language disorders are frequent and include aphasia, alexia, agraphia and acalculia. There are different definitions of aphasias, but the most widely accepted neurologic and/or neuropsychological definition is that aphasia is a loss or impairment of verbal communication, which occurs as a consequence of brain dysfunction. It manifests as impairment of almost all verbal abilities, e.g., abnormal verbal expression, difficulties in understanding spoken or written language, repetition, naming, reading and writing. During the history, many classifications of aphasia syndromes were established. For practical use, classification of aphasias according to fluency, comprehension and abilities of naming it seems to be most suitable (nonfluent aphasias: Broca's, transcortical motor, global and mixed transcortical aphasia; fluent aphasias: anomic, conduction, Wernicke's, transcortical sensory, subcortical aphasia). Aphasia is a common consequence of left hemispheric lesion and most common neuropsychological consequence of stroke, with a prevalence of one-third of all stroke patients in acute phase, although there are reports on even higher figures. Many speech impairments have a tendency of spontaneous recovery. Spontaneous recovery is most remarkable in the first three months after stroke onset. Recovery of aphasias caused by ischemic stroke occurs earlier and it is most intensive in the first two weeks. In aphasias caused by hemorrhagic stroke, spontaneous recovery is slower and occurs from the fourth to the eighth week after stroke. The course and outcome of aphasia depend greatly on the type of aphasia. Regardless of the fact that a significant number of aphasias spontaneously improve, it is necessary to start treatment as soon as possible. The writing and reading disorders in stroke patients (alexias and agraphias) are more frequent than verified on routine examination, not only in less developed but also in large neurologic departments. Alexia is an acquired

  16. Saving Strokes with Space Technology

    NASA Technical Reports Server (NTRS)

    1980-01-01

    Inventor Dave Pelz developed a space spinoff Teacher Alignment Computer for Sunmark Preceptor Golf Ltd. which helps golfers learn proper putting aim. The light beam, reflected into the computer, measures putter alignment and lights atop the box tell the golfer he is on target or off to either side and how much. A related putting aid idea is to stroke the ball at the putter's "sweet spot," which is bracketed by metal prongs. Regular practice develops solid impacts for better putting.

  17. Understanding Stroke - Know Stroke • Know the Signs • Act in Time

    MedlinePlus

    ... Stroke Know Stroke • Know the Signs • Act in Time Past Issues / Summer 2007 Table of Contents For ... control my high blood pressure for the first time in my life. I hope people realize they ...

  18. Assessment of stroke risk in southern Arizona, the pairing of acculturation and stroke risk factor development.

    PubMed

    Nokes, Brandon; Sim, Yeeck; Gibson, Blake; Byreddy, Seenu; Labiner, David M; Coull, Bruce; Chong, Jenny

    2015-04-01

    Stroke is a leading cause of mortality in the United States. Hispanics have the same incidence of stroke, but are more likely to have subsequent strokes than non-Hispanic whites. This difference in outcome may be attributable to differences in stroke risk factor awareness. Patients at a community health center in Tucson, AZ completed an anonymous survey regarding existing and perceived health issues. Patient responses were compared in terms of ethnicity and acculturation, as indicated by language preference. Patient responses (n = 301, Spanish: 150, English: 151) indicated that proportionately fewer non-acculturated Hispanics than acculturated Hispanic and non-Hispanic patients indicated that they were at risk for stroke. Acculturated Hispanics and non-Hispanics displayed similar morbidity trends, including increased obesity, hypertension, diabetes, heart problems, depression, and previous stroke. These findings suggest that Hispanics become less healthy and more at risk for stroke and stroke risk factors as they become acculturated. PMID:24173570

  19. Wilhelm Julius Foerster und die "Vereinigung von Freunden der Astronomie und kosmischen Physik" (1891 bis 1914).

    NASA Astrophysics Data System (ADS)

    Tiemann, K.-H.

    Am 19. Mai 1891 wurde ins Leben gerufen die "Vereinigung von Freunden der Astronomie und der kosmischen Physik (nachfolg.: V.A.P.) - eine der beiden institutionellen Vorläufer der sich 1953 konstituierenden "Vereinigung der Sternfreunde".

  20. Direct Thrombus Imaging in Stroke

    PubMed Central

    Kim, Jongseong; Park, Jung E.; Nahrendorf, Matthias; Kim, Dong-Eog

    2016-01-01

    There is an emergent need for imaging methods to better triage patients with acute stroke for tissue-plasminogen activator (tPA)-mediated thrombolysis or endovascular clot retrieval by directly visualizing the size and distribution of cerebral thromboemboli. Currently, magnetic resonance (MR) or computed tomography (CT) angiography visualizes the obstruction of blood flow within the vessel lumen rather than the thrombus itself. The present visualization method, which relies on observation of the dense artery sign (the appearance of cerebral thrombi on a non-enhanced CT), suffers from low sensitivity. When translated into the clinical setting, direct thrombus imaging is likely to enable individualized acute stroke therapy by allowing clinicians to detect the thrombus with high sensitivity, assess the size and nature of the thrombus more precisely, serially monitor the therapeutic effects of thrombolysis, and detect post-treatment recurrence. This review is intended to provide recent updates on stroke-related direct thrombus imaging using MR imaging, positron emission tomography, or CT. PMID:27733029

  1. Menopause and Stroke: An Epidemiologic Review

    PubMed Central

    Lisabeth, Lynda; Bushnell, Cheryl

    2012-01-01

    Although women have a lower risk of stroke during middle age, the menopausal transition is a time when many women develop cardiovascular risk factors. In addition, during the 10 years after menopause, the risk of stroke roughly doubles in women. Endogenous estrogen levels decline by 60% during the menopausal transition, leading to a relative androgen excess, which could contribute to the increased cardiovascular risk factors in women. Earlier onset of menopause may influence the risk of stroke, but the data are not clear. Because of the stroke risk associated with hormone therapy, this is only indicated for treatment of vasomotor symptoms, but some formulations may be safe than others. More research is needed to understand which women are at greatest stroke risk during midlife and to determine the safest formulation, dose, and duration of hormone therapy that will treat vasomotor symptoms without increasing the risk for stroke. PMID:22172623

  2. Fifty years of stroke researches in India

    PubMed Central

    Banerjee, Tapas Kumar; Das, Shyamal Kumar

    2016-01-01

    Currently, the stroke incidence in India is much higher than Western industrialized countries. Large vessel intracranial atherosclerosis is the commonest cause of ischemic stroke in India. The common risk factors, that is, hypertension, diabetes, smoking, and dyslipidemia are quite prevalent and inadequately controlled; mainly because of poor public awareness and inadequate infrastructure. Only a small number of ischemic stroke cases are able to have the benefit of thrombolytic therapy. Benefits from stem cell therapy in established stroke cases are under evaluation. Presently, prevention of stroke is the best option considering the Indian scenario through control and/or avoiding risk factors of stroke. Interventional studies are an important need for this scenario. PMID:27011621

  3. Rethinking the continuum of stroke rehabilitation.

    PubMed

    Teasell, Robert W; Murie Fernandez, Manuel; McIntyre, Amanda; Mehta, Swati

    2014-04-01

    Suffering a stroke can be a devastating and life-changing event. Although there is a large evidence base for stroke rehabilitation in the acute and subacute stages, it has been long accepted that patients with stroke reach a plateau in their rehabilitation recovery relatively early. We have recently published the results of a systematic review designed to identify all randomized controlled trials (RCTs) where a rehabilitation intervention was initiated more than 6 months after the onset of the stroke. Of the trials identified, 339 RCTs met inclusion criteria, demonstrating an evidence base for stroke rehabilitation in the chronic phase as well. This seems at odds with the assumption that further recovery is unlikely and the subsequent lack of resources devoted to chronic stroke rehabilitation and management.

  4. Role of echocardiography in patients with stroke.

    PubMed

    Nakanishi, Koki; Homma, Shunichi

    2016-08-01

    Investigation of potential embolic source is an important diagnostic step in treating patients with ischemic stroke and transient ischemic attack. Cardiogenic embolism has been estimated to be the causative factor in 15-30% of all cases of ischemic stroke. Cardioembolic strokes are generally severe and recurrence and mortality rate high. Various cardiac disorders including atrial fibrillation, ventricular thrombus, valvular heart disease, cardiac tumors, and structural heart defects can cause cardioembolic stroke. Although the aortic arch is not a cardiac structure, it is usually considered under source of cardiac embolism (cardioaortic source) and is reviewed in this article. Echocardiography (both transthoracic and transesophageal) is a widely used and versatile technique that can provide comprehensive information of thromboembolic risk in patients with stroke. This article reviews potential cardiac sources of stroke and discusses the role of echocardiography in clinical practice. PMID:27256218

  5. Turbocharged two-stroke internal combustion engine with four-stroke capability

    SciTech Connect

    Burrahm, R.W.

    1990-03-13

    This patent describes, in a turbocharged two-stroke internal combustion engine without crankcase scavenging and having means for operating the exhaust valves in accordance with either two-stroke or four-stroke operation, a means for enabling the intake of combustible gas into cylinders of the engine during four-stroke operation through a port in each cylinder from a combustible gas source. It comprises: a valve mounted on each port responsive to pressure within the cylinder.

  6. Hemodynamic findings in patients with brain stroke

    PubMed Central

    Siebert, Janusz; Molisz, Andrzej; Trzeciak, Bartosz; Nyka, Walenty

    2012-01-01

    Introduction Standard procedures carried out at a stroke department in patients after a cerebral event may prove insufficient for monitoring hemodynamic indices. Impedance cardiography enables hemodynamic changes to be monitored non-invasively. The aim of the work was to describe hemodynamic parameters in patients with acute phase of ischemic and hemorrhagic stroke and to analyse the correlation between the type of hemodynamic response and long-term prognosis. Material and methods The 45 consecutive subjects with ischemic stroke and 16 with a hemorrhagic stroke were examined additionally with impedance cardiography during the first day of hospitalization. The heart contractility, pump performance, afterload and preload indices were recorded and calculated automatically and the data analyzed in terms of 6-month mortality. Results We found a significant association between the systemic vascular resistance index, Heather index, stroke index, heart rate, systolic and diastolic and mean arterial blood pressure and mortality in patients with ischemic stroke (p = 0.002, p = 0.008, p = 0.012, p = 0.005, p = 0.007, p = 0.009, p = 0.002 respectively). Logistic regression analysis identified the thoracic fluid content as the most significant variable correlating with the non-survival of the patients with ischemic stroke and in the whole group (ischemic and hemorrhagic stroke). The significant parameters were also mean arterial pressure and stroke index in ischemic stroke (the correct answer ratio was 86.67%) and heart rate in the whole group (the correct answer ratio was 80.33%). There were no significant associations in hemorrhagic stroke. Conclusions The hemodynamic parameters correlate with long term prognosis in patients with ischemic brain stroke. PMID:22662014

  7. Adiposity and ischemic and hemorrhagic stroke

    PubMed Central

    Kroll, Mary E.; Green, Jane; Beral, Valerie; Sudlow, Cathie L.M.; Brown, Anna; Kirichek, Oksana; Price, Alison; Yang, TienYu Owen

    2016-01-01

    Objective: To compare associations of body mass index (BMI) with ischemic stroke and hemorrhagic stroke risk, and to review the worldwide evidence. Methods: We recruited 1.3 million previously stroke-free UK women between 1996 and 2001 (mean age 57 years [SD 5]) and followed them by record linkage for hospital admissions and deaths. We used Cox regression to estimate adjusted relative risks for ischemic and hemorrhagic (intracerebral or subarachnoid hemorrhage) stroke in relation to BMI. We conducted a meta-analysis of published findings from prospective studies on these associations. Results: During an average follow-up of 11.7 years, there were 20,549 first strokes, of which 9,993 were specified as ischemic and 5,852 as hemorrhagic. Increased BMI was associated with an increased risk of ischemic stroke (relative risk 1.21 per 5 kg/m2 BMI, 95% confidence interval 1.18–1.23, p < 0.0001) but a decreased risk of hemorrhagic stroke (relative risk 0.89 per 5 kg/m2 BMI, 0.86–0.92, p < 0.0001). The BMI-associated trends for ischemic and hemorrhagic stroke were significantly different (heterogeneity: p < 0.0001) but were not significantly different for intracerebral hemorrhage (n = 2,790) and subarachnoid hemorrhage (n = 3,062) (heterogeneity: p = 0.5). Published data from prospective studies showed consistently greater BMI-associated relative risks for ischemic than hemorrhagic stroke with most evidence (prior to this study) coming from Asian populations. Conclusions: In UK women, higher BMI is associated with increased risk of ischemic stroke but decreased risk of hemorrhagic stroke. The totality of the available published evidence suggests that BMI-associated risks are greater for ischemic than for hemorrhagic stroke. PMID:27605176

  8. FACTOR V LEIDEN AND ISCHEMIC STROKE RISK: THE GENETICS OF EARLY ONSET STROKE (GEOS) STUDY

    PubMed Central

    Hamedani, Ali G.; Cole, John W.; Cheng, Yuching; Sparks, Mary J.; O'Connell, Jeffrey R.; Stine, Oscar C.; Wozniak, Marcella A.; Stern, Barney J.; Mitchell, Braxton D.; Kittner, Steven J.

    2011-01-01

    Background and Purpose Factor V Leiden (FVL) has been associated with ischemic stroke in children, but not in adults. Although the FVL mutation is associated with increased risk for venous thrombosis, its association with ischemic stroke in young adults remains uncertain. Therefore, we examined the association between FVL and ischemic stroke in participants of the Genetics of Early Onset Stroke (GEOS) Study. Methods A population-based case-control study identified 354 women and 476 men aged 15–49 years with first-ever ischemic stroke, and 907 controls. Participant-specific data included vascular risk factors, FVL genotype and, for cases, the ischemic stroke subtype by modified TOAST criteria. Logistic regression was used to calculate odds ratios for the entire population and for subgroups stratified by risk factors and ischemic stroke subtype. Results The frequency of the FVL mutation was similar between ischemic stroke patients (3.6%, 95% CI: 2.5%–5.1%) and non-stroke controls (3.8%, 95% CI: 2.7%–5.2%). This frequency did not change significantly when cases were restricted to patients with stroke of undetermined etiology (4.1%, 95% CI: 2.6%–6.4%). Conclusions Among young adults, we found no evidence for an association between Factor V Leiden and either all ischemic stroke or the subgroup with stroke of undetermined etiology. PMID:22100829

  9. Analysis of speed, stroke rate, and stroke distance for world-class breaststroke swimming.

    PubMed

    Garland Fritzdorf, Stephen; Hibbs, Angela; Kleshnev, Valery

    2009-02-15

    Speed in aquatic locomotion is determined by stroke distance and stroke rate, but it does not always follow that an increase in stroke rate will lead to an increase in speed. Kleshnev (2006) developed a method to evaluate the relationship between speed and stroke rate during rowing - the effective work per stroke. In this case study, the effective work per stroke was determined for a male world-class 100-m breaststroke swimmer for seven races in major championships and compared between: each of the seven races; each quarter within each race; and the best swims of this case study and seven other world-class swimmers. The effective work per stroke was related to race performance, with the fastest race having the highest effective work per stroke and lowest stroke rate, with slower races having low effectiveness and high stroke rate (R(2) = 0.85). The effective work per stroke was reduced in a race as the swimmer fatigued. The within-race standard deviation of effectiveness was lower in fast swims (R(2) = 0.84). This analysis has identified some characteristics of fast swimming: high effectiveness, optimal stroke rate, and a flat effectiveness profile. Training and racing strategies can now be devised to improve performance by increasing the sensitivity of assessment of strengths and weaknesses in individuals. PMID:19235006

  10. Stroke in Children With Cardiac Disease: Report From the International Pediatric Stroke Study Group Symposium

    PubMed Central

    Sinclair, Adriane J.; Fox, Christine K.; Ichord, Rebecca N.; Almond, Christopher S.; Bernard, Timothy J.; Beslow, Lauren A.; Chan, Anthony K.C.; Cheung, Michael; deVeber, Gabrielle; Dowling, Michael M.; Friedman, Neil; Giglia, Therese M.; Guilliams, Kristin P.; Humpl, Tilman; Licht, Daniel J.; Mackay, Mark T.; Jordan, Lori C.

    2016-01-01

    BACKGROUND Cardiac disease is a leading cause of stroke in children, yet limited data support the current stroke prevention and treatment recommendations. A multidisciplinary panel of clinicians was convened in February 2014 by the International Pediatric Stroke Study group to identify knowledge gaps and prioritize clinical research efforts for children with cardiac disease and stroke. RESULTS Significant knowledge gaps exist, including a lack of data on stroke incidence, predictors, primary and secondary stroke prevention, hyperacute treatment, and outcome in children with cardiac disease. Commonly used diagnostic techniques including brain computed tomography and ultrasound have low rates of stroke detection, and diagnosis is frequently delayed. The challenges of research studies in this population include epidemiologic barriers to research such as small patient numbers, heterogeneity of cardiac disease, and coexistence of multiple risk factors. Based on stroke burden and study feasibility, studies involving mechanical circulatory support, single ventricle patients, early stroke detection strategies, and understanding secondary stroke risk factors and prevention are the highest research priorities over the next 5-10 years. The development of large-scale multicenter and multispecialty collaborative research is a critical next step. The designation of centers of expertise will assist in clinical care and research. CONCLUSIONS There is an urgent need for additional research to improve the quality of evidence in guideline recommendations for cardiogenic stroke in children. Although significant barriers to clinical research exist, multicenter and multispecialty collaboration is an important step toward advancing clinical care and research for children with cardiac disease and stroke. PMID:25532775

  11. Cognitive impairment and memory dysfunction after a stroke diagnosis: a post-stroke memory assessment.

    PubMed

    Al-Qazzaz, Noor Kamal; Ali, Sawal Hamid; Ahmad, Siti Anom; Islam, Shabiul; Mohamad, Khairiyah

    2014-01-01

    Cognitive impairment and memory dysfunction following stroke diagnosis are common symptoms that significantly affect the survivors' quality of life. Stroke patients have a high potential to develop dementia within the first year of stroke onset. Currently, efforts are being exerted to assess stroke effects on the brain, particularly in the early stages. Numerous neuropsychological assessments are being used to evaluate and differentiate cognitive impairment and dementia following stroke. This article focuses on the role of available neuropsychological assessments in detection of dementia and memory loss after stroke. This review starts with stroke types and risk factors associated with dementia development, followed by a brief description of stroke diagnosis criteria and the effects of stroke on the brain that lead to cognitive impairment and end with memory loss. This review aims to combine available neuropsychological assessments to develop a post-stroke memory assessment (PSMA) scheme based on the most recognized and available studies. The proposed PSMA is expected to assess different types of memory functionalities that are related to different parts of the brain according to stroke location. An optimal therapeutic program that would help stroke patients enjoy additional years with higher quality of life is presented. PMID:25228808

  12. Gravitation und Kosmologie. Eine Einführung in die allgemeine Relativitätstheorie.

    NASA Astrophysics Data System (ADS)

    Sexl, R. U.; Urbantke, H. K.

    Contents: 1. Physikalische Grundlagen. 2. Riemannsche Geometrie. 3. Gravitationstheorie. 4. Experimentelle Tests. 5. Kosmologie. 6. Gravitationswellen. 7. Neue differentialgeometrische Methoden. 8. Sternbau und Gravitationskollaps. 9. Felder im Riemannschen Raum. 10. Gravitation und Feldtheorie. 11. Gravitation und Eichtheorie.

  13. Stroke: Working toward a Prioritized World Agenda

    PubMed Central

    Hachinski, Vladimir; Donnan, Geoffrey A.; Gorelick, Philip B.; Hacke, Werner; Cramer, Steven C.; Kaste, Markku; Fisher, Marc; Brainin, Michael; Buchan, Alastair M.; Lo, Eng H.; Skolnick, Brett E.; Furie, Karen L.; Hankey, Graeme J.; Kivipelto, Miia; Morris, John; Rothwell, Peter M.; Sacco, Ralph L.; Smith, Sidney C.; Wang, Yulun; Bryer, Alan; Ford, Gary A.; Iadecola, Costantino; Martins, Sheila C.O.; Saver, Jeff; Skvortsova, Veronika; Bayley, Mark; Bednar, Martin M.; Duncan, Pamela; Enney, Lori; Finklestein, Seth; Jones, Theresa A.; Kalra, Lalit; Kleim, Jeff; Nitkin, Ralph; Teasell, Robert; Weiller, Cornelius; Desai, Bhupat; Goldberg, Mark P.; Heiss, Wolf-Dieter; Saarelma, Osmo; Schwamm, Lee H.; Shinohara, Yukito; Trivedi, Bhargava; Wahlgren, Nils; Wong, Lawrence K.; Hakim, Antoine; Norrving, Bo; Prudhomme, Stephen; Bornstein, Natan M.; Davis, Stephen M.; Goldstein, Larry B.; Leys, Didier; Tuomilehto, Jaakko

    2013-01-01

    Background and Purpose The aim of the Synergium was to devise and prioritize new ways of accelerating progress in reducing the risks, effects, and consequences of stroke. Methods Preliminary work was performed by 7 working groups of stroke leaders followed by a synergium (a forum for working synergistically together) with approximately 100 additional participants. The resulting draft document had further input from contributors outside the synergium. Results Recommendations of the Synergium are: Basic Science, Drug Development and Technology: There is a need to develop: (1) New systems of working together to break down the prevalent ‘silo’ mentality; (2) New models of vertically integrated basic, clinical, and epidemiological disciplines; and (3) Efficient methods of identifying other relevant areas of science. Stroke Prevention: (1) Establish a global chronic disease prevention initiative with stroke as a major focus. (2) Recognize not only abrupt clinical stroke, but subtle subclinical stroke, the commonest type of cerebrovascular disease, leading to impairments of executive function. (3) Develop, implement and evaluate a population approach for stroke prevention. (4) Develop public health communication strategies using traditional and novel (e.g., social media/marketing) techniques. Acute Stroke Management: Continue the establishment of stroke centers, stroke units, regional systems of emergency stroke care and telestroke networks. Brain Recovery and Rehabilitation: (1) Translate best neuroscience, including animal and human studies, into poststroke recovery research and clinical care. (2) Standardize poststroke rehabilitation based on best evidence. (3) Develop consensus on, then implementation of, standardized clinical and surrogate assessments. (4) Carry out rigorous clinical research to advance stroke recovery. Into the 21st Century: Web, Technology and Communications: (1) Work toward global unrestricted access to stroke-related information. (2) Build

  14. Recognition and Management of Threatened Stroke

    PubMed Central

    McCormick, C. W.

    1983-01-01

    Completed stroke may often be prevented by early recognition and appropriate management of the stroke-threatened patient. About 80% of strokes are ischemic, the remainder hemorrhagic. Roughly half of ischemic strokes are heralded by transient ischemic attacks (TIA). The clinical picture of TIA depends upon which part of the brain is involved. The investigation of such patients is outlined, together with current approaches to medical and surgical therapy. Intracerebral hemorrhage rarely provides any advanced warning, but occasionally subarachnoid hemorrhage may be preceded by a warning leak, the clinical picture of which is described. PMID:21286581

  15. Stroke findings in the Women's Health Initiative.

    PubMed

    Wassertheil-Smoller, Sylvia; Kaplan, Robert C; Salazar, Christian R

    2014-11-01

    The Women's Health Initiative (WHI) clinical trials of estrogen with or without progestin versus placebo in 27,341 postmenopausal women are the largest randomized, placebo-controlled, double-blind clinical trials to look at the effect of hormone therapy on the outcomes of stroke, dementia, and cognition. Data from a parallel prospective observational study of 93,676 women examine biomarkers and risk factors associated with stroke. We summarize the results of 29 published articles in the WHI with stroke or cognition as outcomes of interest. Estrogen alone or in combination with progestin resulted in approximately 50% excess risk of ischemic stroke and in a 76% excess risk of dementia in women 65 years or older. Other risk factors for stroke identified in the WHI were panic attacks, depression, use of antidepressants (particularly selective serotonin reuptake inhibitors for hemorrhagic but not ischemic stroke), high triglycerides, low walking speed, long sleep duration, certain inflammatory factors, and systolic blood pressure variability. Hormone therapy has adverse effects on the brain as manifested by higher risks of stroke and dementia. Additional risk factors for stroke identified in WHI should be followed up to determine if reversing them would result in lower stroke rates.

  16. Two stroke engine with deflector valve

    SciTech Connect

    Weiland, C.

    1987-06-09

    The patent describes two stroke internal combustion engine comprising cylinder with cylinder head closure at one end, piston with crankshaft driven means for reciprocating within the cylinder to compress a fuel air mixture during its compression stroke and to deliver power upon ignition during its power stroke; a plurality of circumferentially spaced exhaust ports in the wall of the cylinder uncovered by the piston near the end of its power stroke, port means in the cylinder head closure with valve means for controlling port communication with the cylinder, compressor means for delivering supercharged air to one of the port means.

  17. Ischemic perinatal stroke: challenge and opportunities.

    PubMed

    Raju, Tonse N K

    2008-08-01

    The second highest risk group for developing a cerebral stroke is the perinatal period, generally defined as 20 weeks of gestation through 28th postnatal day of age. In this commentary, a brief overview of ischemic perinatal strokes is presented. Ischemic perinatal stroke (IPS) occurs at a rate of 1 : 2300 to 1 : 5000 births, accounting for 30% of children with hemiplegic cerebral palsy (CP). Thus, IPS is the most common known cause for CP [1-3]. Although they occur frequently, much remains to be studied about perinatal strokes in general and the ischemic variety in particular. PMID:18705894

  18. Caspase-3 modulates regenerative response after stroke.

    PubMed

    Fan, Wenying; Dai, Yiqin; Xu, Haochen; Zhu, Ximin; Cai, Ping; Wang, Lixiang; Sun, Chungang; Hu, Changlong; Zheng, Ping; Zhao, Bing-Qiao

    2014-02-01

    Stroke is a leading cause of long-lasting disability in humans. However, currently there are still no effective therapies available for promoting stroke recovery. Recent studies have shown that the adult brain has the capacity to regenerate neurons after stroke. Although this neurogenic response may be functionally important for brain repair after injury, the mechanisms underlying stroke-induced neurogenesis are not known. Caspase-3 is a major executioner and has been identified as a key mediator of neuronal death in the acute stage of stroke. Recently, however, accumulating data indicate that caspase-3 also participates in various biological processes that do not cause cell death. Here, we show that cleaved caspase-3 was increased in newborn neuronal precursor cells (NPCs) in the subventricular zone (SVZ) and the dentate gyrus during the period of stroke recovery, with no evidence of apoptosis. We observed that cleaved caspase-3 was expressed by NPCs and limited its self-renewal without triggering apoptosis in cultured NPCs from the SVZ of ischemic mice. Moreover, we revealed that caspase-3 negatively regulated the proliferation of NPCs through reducing the phosphorylation of Akt. Importantly, we demonstrated that peptide inhibition of caspase-3 activity significantly promoted the proliferation and migration of SVZ NPCs and resulted in a significant increase in subsequent neuronal regeneration and functional recovery after stroke. Together, our data identify a previously unknown caspase-3-dependent mechanism that constrains stroke-induced endogenous neurogenesis and should revitalize interest in targeting caspase-3 for treatment of stroke.

  19. The Christchurch earthquake stroke incidence study.

    PubMed

    Wu, Teddy Y; Cheung, Jeanette; Cole, David; Fink, John N

    2014-03-01

    We examined the impact of major earthquakes on acute stroke admissions by a retrospective review of stroke admissions in the 6 weeks following the 4 September 2010 and 22 February 2011 earthquakes. The control period was the corresponding 6 weeks in the previous year. In the 6 weeks following the September 2010 earthquake there were 97 acute stroke admissions, with 79 (81.4%) ischaemic infarctions. This was similar to the 2009 control period which had 104 acute stroke admissions, of whom 80 (76.9%) had ischaemic infarction. In the 6 weeks following the February 2011 earthquake, there were 71 stroke admissions, and 61 (79.2%) were ischaemic infarction. This was less than the 96 strokes (72 [75%] ischaemic infarction) in the corresponding control period. None of the comparisons were statistically significant. There was also no difference in the rate of cardioembolic infarction from atrial fibrillation between the study periods. Patients admitted during the February 2011 earthquake period were less likely to be discharged directly home when compared to the control period (31.2% versus 46.9%, p=0.036). There was no observable trend in the number of weekly stroke admissions between the 2 weeks leading to and 6 weeks following the earthquakes. Our results suggest that severe psychological stress from earthquakes did not influence the subsequent short term risk of acute stroke, but the severity of the earthquake in February 2011 and associated civil structural damages may have influenced the pattern of discharge for stroke patients.

  20. Determining Optimal Post-Stroke Exercise (DOSE)

    ClinicalTrials.gov

    2016-10-04

    Cerebrovascular Accident; Stroke; Cerebral Infarction; Brain Infarction; Brain Ischemia; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases

  1. Guidelines for the Primary Prevention of Stroke

    PubMed Central

    Meschia, James F.; Bushnell, Cheryl; Boden-Albala, Bernadette; Braun, Lynne T.; Bravata, Dawn M.; Chaturvedi, Seemant; Creager, Mark A.; Eckel, Robert H.; Elkind, Mitchell S.V.; Fornage, Myriam; Goldstein, Larry B.; Greenberg, Steven M.; Horvath, Susanna E.; Iadecola, Costantino; Jauch, Edward C.; Moore, Wesley S.; Wilson, John A.

    2016-01-01

    The aim of this updated statement is to provide comprehensive and timely evidence-based recommendations on the prevention of stroke among individuals who have not previously experienced a stroke or transient ischemic attack. Evidence-based recommendations are included for the control of risk factors, interventional approaches to atherosclerotic disease of the cervicocephalic circulation, and antithrombotic treatments for preventing thrombotic and thromboembolic stroke. Further recommendations are provided for genetic and pharmacogenetic testing and for the prevention of stroke in a variety of other specific circumstances, including sickle cell disease and patent foramen ovale. PMID:25355838

  2. Predictors of Functional Outcome Following Stroke.

    PubMed

    Harvey, Richard L

    2015-11-01

    Predicting functional outcome in stroke is challenging to most clinicians, partly because of the complexity of the condition and also because of the lack of validated prognostic models. The strongest predictors of functional outcome are age and motor function at stroke onset. There is a growing literature on predicting recovery of upper limb after stroke; however, literature on prediction of language recovery remains sparse. This review covers the current status of predicting functional outcome after stroke focusing on recovery of activities of daily living, ambulation, upper limb use, and aphasia. Use of clinical factors, imaging, and neurophysiological measures are discussed.

  3. The Epidemiology of Atrial Fibrillation and Stroke.

    PubMed

    Pistoia, Francesca; Sacco, Simona; Tiseo, Cindy; Degan, Diana; Ornello, Raffaele; Carolei, Antonio

    2016-05-01

    The burden of stroke is increasing due to aging population and unhealthy lifestyle habits. The considerable rise in atrial fibrillation (AF) is due to greater diffusion of risk factors and screening programs. The link between AF and ischemic stroke is strong. The subtype most commonly associated with AF is cardioembolic stroke, which is particularly severe and shows the highest rates of mortality and permanent disability. A trend toward a higher prevalence of cardioembolic stroke in high-income countries is probably due to the greater diffusion of AF and the control of atherosclerotic of risk factors. PMID:27150174

  4. Stroke findings in the Women's Health Initiative.

    PubMed

    Wassertheil-Smoller, Sylvia; Kaplan, Robert C; Salazar, Christian R

    2014-11-01

    The Women's Health Initiative (WHI) clinical trials of estrogen with or without progestin versus placebo in 27,341 postmenopausal women are the largest randomized, placebo-controlled, double-blind clinical trials to look at the effect of hormone therapy on the outcomes of stroke, dementia, and cognition. Data from a parallel prospective observational study of 93,676 women examine biomarkers and risk factors associated with stroke. We summarize the results of 29 published articles in the WHI with stroke or cognition as outcomes of interest. Estrogen alone or in combination with progestin resulted in approximately 50% excess risk of ischemic stroke and in a 76% excess risk of dementia in women 65 years or older. Other risk factors for stroke identified in the WHI were panic attacks, depression, use of antidepressants (particularly selective serotonin reuptake inhibitors for hemorrhagic but not ischemic stroke), high triglycerides, low walking speed, long sleep duration, certain inflammatory factors, and systolic blood pressure variability. Hormone therapy has adverse effects on the brain as manifested by higher risks of stroke and dementia. Additional risk factors for stroke identified in WHI should be followed up to determine if reversing them would result in lower stroke rates. PMID:25321421

  5. Stroke: Working toward a Prioritized World Agenda

    PubMed Central

    Hachinski, Vladimir; Donnan, Geoffrey A.; Gorelick, Philip B.; Hacke, Werner; Cramer, Steven C.; Kaste, Markku; Fisher, Marc; Brainin, Michael; Buchan, Alastair M.; Lo, Eng H.; Skolnick, Brett E.; Furie, Karen L.; Hankey, Graeme J.; Kivipelto, Miia; Morris, John; Rothwell, Peter M.; Sacco, Ralph L.; Smith, Jr., Sidney C.; Wang, Yulun; Bryer, Alan; Ford, Gary A.; Iadecola, Costantino; Martins, Sheila C.O.; Saver, Jeff; Skvortsova, Veronika; Bayley, Mark; Bednar, Martin M.; Duncan, Pamela; Enney, Lori; Finklestein, Seth; Jones, Theresa A.; Kalra, Lalit; Kleim, Jeff; Nitkin, Ralph; Teasell, Robert; Weiller, Cornelius; Desai, Bhupat; Goldberg, Mark P.; Heiss, Wolf-Dieter; Saarelma, Osmo; Schwamm, Lee H.; Shinohara, Yukito; Trivedi, Bhargava; Wahlgren, Nils; Wong, Lawrence K.; Hakim, Antoine; Norrving, Bo; Prudhomme, Stephen; Bornstein, Natan M.; Davis, Stephen M.; Goldstein, Larry B.; Leys, Didier; Tuomilehto, Jaakko

    2010-01-01

    Background and Purpose The aim of the Synergium was to devise and prioritize new ways of accelerating progress in reducing the risks, effects, and consequences of stroke. Methods Preliminary work was performed by 7 working groups of stroke leaders followed by a synergium (a forum for working synergistically together) with approximately 100 additional participants. The resulting draft document had further input from contributors outside the synergium. Results Recommendations of the Synergium are: Basic Science, Drug Development and Technology: There is a need to develop: (1) New systems of working together to break down the prevalent ‘silo’ mentality; (2) New models of vertically integrated basic, clinical, and epidemiological disciplines; and (3) Efficient methods of identifying other relevant areas of science. Stroke Prevention: (1) Establish a global chronic disease prevention initiative with stroke as a major focus. (2) Recognize not only abrupt clinical stroke, but subtle subclinical stroke, the commonest type of cerebrovascular disease, leading to impairments of executive function. (3) Develop, implement and evaluate a population approach for stroke prevention. (4) Develop public health communication strategies using traditional and novel (e.g., social media/marketing) techniques. Acute Stroke Management: Continue the establishment of stroke centers, stroke units, regional systems of emergency stroke care and telestroke networks. Brain Recovery and Rehabilitation: (1) Translate best neuroscience, including animal and human studies, into poststroke recovery research and clinical care. (2) Standardize poststroke rehabilitation based on best evidence. (3) Develop consensus on, then implementation of, standardized clinical and surrogate assessments. (4) Carry out rigorous clinical research to advance stroke recovery. Into the 21st Century: Web, Technology and Communications: (1) Work toward global unrestricted access to stroke-related information. (2) Build

  6. Stroke: Working Toward a Prioritized World Agenda

    PubMed Central

    Hachinski, Vladimir; Donnan, Geoffrey A.; Gorelick, Philip B.; Hacke, Werner; Cramer, Steven C.; Kaste, Markku; Fisher, Marc; Brainin, Michael; Buchan, Alastair M.; Lo, Eng H.; Skolnick, Brett E.; Furie, Karen L.; Hankey, Graeme J.; Kivipelto, Miia; Morris, John; Rothwell, Peter M.; Sacco, Ralph L.; Smith, Sidney C.; Wang, Yulun; Bryer, Alan; Ford, Gary A.; Iadecola, Costantino; Martins, Sheila C.O.; Saver, Jeff; Skvortsova, Veronika; Bayley, Mark; Bednar, Martin M.; Duncan, Pamela; Enney, Lori; Finklestein, Seth; Jones, Theresa A.; Kalra, Lalit; Kleim, Jeff; Nitkin, Ralph; Teasell, Robert; Weiller, Cornelius; Desai, Bhupat; Goldberg, Mark P.; Heiss, Wolf-Dieter; Saarelma, Osmo; Schwamm, Lee H.; Shinohara, Yukito; Trivedi, Bhargava; Wahlgren, Nils; Wong, Lawrence K.; Hakim, Antoine; Norrving, Bo; Prudhomme, Stephen; Bornstein, Natan M.; Davis, Stephen M.; Edin, FRCP; Goldstein, Larry B.; Leys, Didier; Tuomilehto, Jaakko

    2013-01-01

    Background and Purpose The aim of the Synergium was to devise and prioritize new ways of accelerating progress in reducing the risks, effects, and consequences of stroke. Methods Preliminary work was performed by 7 working groups of stroke leaders followed by a synergium (a forum for working synergistically together) with approximately 100 additional participants. The resulting draft document had further input from contributors outside the synergium. Results Recommendations of the Synergium are: Basic Science, Drug Development and Technology: There is a need to develop: (1) New systems of working together to break down the prevalent “silo” mentality; (2) New models of vertically integrated basic, clinical, and epidemiological disciplines; and (3) Efficient methods of identifying other relevant areas of science. Stroke Prevention: (1) Establish a global chronic disease prevention initiative with stroke as a major focus. (2) Recognize not only abrupt clinical stroke, but subtle subclinical stroke, the commonest type of cerebrovascular disease, leading to impairments of executive function. (3) Develop, implement and evaluate a population approach for stroke prevention. (4) Develop public health communication strategies using traditional and novel (eg, social media/marketing) techniques. Acute Stroke Management: Continue the establishment of stroke centers, stroke units, regional systems of emergency stroke care and telestroke networks. Brain Recovery and Rehabilitation: (1) Translate best neuroscience, including animal and human studies, into poststroke recovery research and clinical care. (2) Standardize poststroke rehabilitation based on best evidence. (3) Develop consensus on, then implementation of, standardized clinical and surrogate assessments. (4) Carry out rigorous clinical research to advance stroke recovery. Into the 21st Century: Web, Technology and Communications: (1) Work toward global unrestricted access to stroke-related information. (2) Build

  7. Let's Talk about High Blood Pressure and Stroke

    MedlinePlus

    ... Tools & Resources Stroke More Let's Talk About High Blood Pressure and Stroke Updated:Dec 9,2015 What is ... Blood Pressure? How Can I Reduce High Blood Pressure? High Blood Pressure and Stroke What Is Diabetes and How ...

  8. Solving the Issue of Restenosis After Stenting of Intracranial Stenoses: Experience with Two Thin-Strut Drug-Eluting Stents (DES)—Taxus Element™ and Resolute Integrity™

    SciTech Connect

    Kurre, Wiebke Aguilar-Pérez, Marta; Fischer, Sebastian; Arnold, Guy; Schmid, Elisabeth; Bäzner, Hansjörg; Henkes, Hans

    2015-06-15

    PurposeThin-strut, flexible DES are suitable for intracranial stenting and may improve long-term vessel patency. The purpose of this study was to report our experience with two new-generation DES for the treatment of intracranial atherosclerotic disease.Patients and MethodsWe retrospectively reviewed all patients treated with Taxus Element™ or Resolute Integrity™ stent for an intracranial atherosclerotic stenosis between March 2011 and August 2013. Technical success was defined as the ability to deploy the device at the desired location and reduce the degree of stenosis below 50 %. All procedure-related strokes were recorded. Control angiography was scheduled after 6 weeks, 3, 6, and 12 months and yearly thereafter. A luminal narrowing ≥50 % was regarded as a restenosis. Stroke recurrence in the territory of the treated artery was reported.ResultsIn the defined period we treated 101 patients harboring 117 intracranial stenoses. The procedure was successful in 100 (85.5 %) lesions. Procedure-related strokes occurred in 10 (9.9 %) patients with a permanent morbidity in 3 (3.0 %). Follow-up angiography was available for 83 of 100 (83.0 %) successfully treated lesions with an average of 355 days (IQR 153–482 days). Three (3.6 %) asymptomatic restenoses were detected. All occurred after treatment with Resolute Integrity™, none after Taxus Element™ (p = 0.059). New strokes in the territory of the treated artery were encountered in 2 (2.6 %) occasions.ConclusionThin-strut DES improve long-term patency and reduce the risk of subsequent stroke. Differences between devices may exist. Feasibility is comparable to bare-metal balloon-mounted stents and procedure-related strokes occurred within the expected range.

  9. Clinical study of 222 patients with pure motor stroke.

    PubMed

    Arboix, A; Padilla, I; Massons, J; García-Eroles, L; Comes, E; Targa, C

    2001-08-01

    The objective was to assess the frequency of pure motor stroke caused by different stroke subtypes and to compare demographic, clinical, neuroimaging, and outcome data of pure motor stroke with those of patients with other lacunar stroke as well as with those of patients with non-lacunar stroke. Data from 2000 patients with acute stroke (n=1761) or transient ischaemic attack (n=239) admitted consecutively to the department of neurology of an acute care 350 bed teaching hospital were prospectively collected in the Sagrat Cor Hospital of Barcelona stroke registry over a 10 year period. For the purpose of the study 222 (12.7%) patients with pure motor stroke were selected. The other study groups included 218 (12.3%) patients with other lacunar strokes and 1321 (75%) patients with non-lacunar stroke. In relation to stroke subtype, lacunar infarcts were found in 189 (85%) patients, whereas ischaemic lacunar syndromes not due to lacunar infarcts occurred in 23 (10.4%) patients (atherothrombotic stroke in 12, cardioembolic stroke in seven, infarction of undetermined origin in three, and infarction of unusual aetiology in one) and haemorrhagic lacunar syndromes in 10 (4.5%). Patients with pure motor stroke showed a better outcome than patients with non-lacunar stroke with a significantly lower number of complications and in hospital mortality rate, shorter duration of hospital stay, and a higher number of symptom free patients at hospital discharge. After multivariate analysis, hypertension, diabetes, obesity, hyperlipidaemia, non-sudden stroke onset, internal capsule involvement, and pons topography seemed to be independent factors of pure motor stroke in patients with acute stroke. In conclusion, about one of every 10 patients with acute stroke had a pure motor stroke. Pure motor stroke was caused by a lacunar infarct in 85% of patients and by other stroke subtypes in 15%. Several clinical features are more frequent in patients with pure motor stroke than in patients

  10. Quality Improvement in Acute Ischemic Stroke Care in Taiwan: The Breakthrough Collaborative in Stroke

    PubMed Central

    Chern, Chang-Ming; Lee, Tsong-Hai; Tang, Sung-Chun; Tsai, Li-Kai; Liao, Hsun-Hsiang; Chang, Hang; LaBresh, Kenneth A.; Lin, Hung-Jung; Chiou, Hung-Yi; Chiu, Hou-Chang; Lien, Li-Ming

    2016-01-01

    In the management of acute ischemic stroke, guideline adherence is often suboptimal, particularly for intravenous thrombolysis or anticoagulation for atrial fibrillation. We sought to improve stroke care quality via a collaborative model, the Breakthrough Series (BTS)-Stroke activity, in a nationwide, multi-center activity in Taiwan. A BTS Collaborative, a short-term learning system for a large number of multidisciplinary teams from hospitals, was applied to enhance acute ischemic stroke care quality. Twenty-four hospitals participated in and submitted data for this stroke quality improvement campaign in 2010–2011. Totally, 14 stroke quality measures, adopted from the Get With The Guideline (GWTG)-Stroke program, were used to evaluate the performance and outcome of the ischemic stroke patients. Data for a one-year period from 24 hospitals with 13,181 acute ischemic stroke patients were analyzed. In 14 hospitals, most stroke quality measures improved significantly during the BTS-activity compared with a pre-BTS-Stroke activity period (2006–08). The rate of intravenous thrombolysis increased from 1.2% to 4.6%, door-to-needle time ≤60 minutes improved from 7.1% to 50.8%, symptomatic hemorrhage after intravenous thrombolysis decreased from 11.0% to 5.6%, and anticoagulation therapy for atrial fibrillation increased from 32.1% to 64.1%. The yearly composite measures of five stroke quality measures revealed significant improvements from 2006 to 2011 (75% to 86.3%, p<0.001). The quarterly composite measures also improved significantly during the BTS-Stroke activity. In conclusion, a BTS collaborative model is associated with improved guideline adherence for patients with acute ischemic stroke. GWTG-Stroke recommendations can be successfully applied in countries besides the United States. PMID:27487190

  11. Quality Improvement in Acute Ischemic Stroke Care in Taiwan: The Breakthrough Collaborative in Stroke.

    PubMed

    Hsieh, Fang-I; Jeng, Jiann-Shing; Chern, Chang-Ming; Lee, Tsong-Hai; Tang, Sung-Chun; Tsai, Li-Kai; Liao, Hsun-Hsiang; Chang, Hang; LaBresh, Kenneth A; Lin, Hung-Jung; Chiou, Hung-Yi; Chiu, Hou-Chang; Lien, Li-Ming

    2016-01-01

    In the management of acute ischemic stroke, guideline adherence is often suboptimal, particularly for intravenous thrombolysis or anticoagulation for atrial fibrillation. We sought to improve stroke care quality via a collaborative model, the Breakthrough Series (BTS)-Stroke activity, in a nationwide, multi-center activity in Taiwan. A BTS Collaborative, a short-term learning system for a large number of multidisciplinary teams from hospitals, was applied to enhance acute ischemic stroke care quality. Twenty-four hospitals participated in and submitted data for this stroke quality improvement campaign in 2010-2011. Totally, 14 stroke quality measures, adopted from the Get With The Guideline (GWTG)-Stroke program, were used to evaluate the performance and outcome of the ischemic stroke patients. Data for a one-year period from 24 hospitals with 13,181 acute ischemic stroke patients were analyzed. In 14 hospitals, most stroke quality measures improved significantly during the BTS-activity compared with a pre-BTS-Stroke activity period (2006-08). The rate of intravenous thrombolysis increased from 1.2% to 4.6%, door-to-needle time ≤60 minutes improved from 7.1% to 50.8%, symptomatic hemorrhage after intravenous thrombolysis decreased from 11.0% to 5.6%, and anticoagulation therapy for atrial fibrillation increased from 32.1% to 64.1%. The yearly composite measures of five stroke quality measures revealed significant improvements from 2006 to 2011 (75% to 86.3%, p<0.001). The quarterly composite measures also improved significantly during the BTS-Stroke activity. In conclusion, a BTS collaborative model is associated with improved guideline adherence for patients with acute ischemic stroke. GWTG-Stroke recommendations can be successfully applied in countries besides the United States. PMID:27487190

  12. Canadian stroke best practice recommendations: Stroke rehabilitation practice guidelines, update 2015.

    PubMed

    Hebert, Debbie; Lindsay, M Patrice; McIntyre, Amanda; Kirton, Adam; Rumney, Peter G; Bagg, Stephen; Bayley, Mark; Dowlatshahi, Dar; Dukelow, Sean; Garnhum, Maridee; Glasser, Ev; Halabi, Mary-Lou; Kang, Ester; MacKay-Lyons, Marilyn; Martino, Rosemary; Rochette, Annie; Rowe, Sarah; Salbach, Nancy; Semenko, Brenda; Stack, Bridget; Swinton, Luchie; Weber, Valentine; Mayer, Matthew; Verrilli, Sue; DeVeber, Gabrielle; Andersen, John; Barlow, Karen; Cassidy, Caitlin; Dilenge, Marie-Emmanuelle; Fehlings, Darcy; Hung, Ryan; Iruthayarajah, Jerome; Lenz, Laura; Majnemer, Annette; Purtzki, Jacqueline; Rafay, Mubeen; Sonnenberg, Lyn K; Townley, Ashleigh; Janzen, Shannon; Foley, Norine; Teasell, Robert

    2016-06-01

    Stroke rehabilitation is a progressive, dynamic, goal-orientated process aimed at enabling a person with impairment to reach their optimal physical, cognitive, emotional, communicative, social and/or functional activity level. After a stroke, patients often continue to require rehabilitation for persistent deficits related to spasticity, upper and lower extremity dysfunction, shoulder and central pain, mobility/gait, dysphagia, vision, and communication. Each year in Canada 62,000 people experience a stroke. Among stroke survivors, over 6500 individuals access in-patient stroke rehabilitation and stay a median of 30 days (inter-quartile range 19 to 45 days). The 2015 update of the Canadian Stroke Best Practice Recommendations: Stroke Rehabilitation Practice Guidelines is a comprehensive summary of current evidence-based recommendations for all members of multidisciplinary teams working in a range of settings, who provide care to patients following stroke. These recommendations have been developed to address both the organization of stroke rehabilitation within a system of care (i.e., Initial Rehabilitation Assessment; Stroke Rehabilitation Units; Stroke Rehabilitation Teams; Delivery; Outpatient and Community-Based Rehabilitation), and specific interventions and management in stroke recovery and direct clinical care (i.e., Upper Extremity Dysfunction; Lower Extremity Dysfunction; Dysphagia and Malnutrition; Visual-Perceptual Deficits; Central Pain; Communication; Life Roles). In addition, stroke happens at any age, and therefore a new section has been added to the 2015 update to highlight components of stroke rehabilitation for children who have experienced a stroke, either prenatally, as a newborn, or during childhood. All recommendations have been assigned a level of evidence which reflects the strength and quality of current research evidence available to support the recommendation. The updated Rehabilitation Clinical Practice Guidelines feature several

  13. Canadian stroke best practice recommendations: Stroke rehabilitation practice guidelines, update 2015.

    PubMed

    Hebert, Debbie; Lindsay, M Patrice; McIntyre, Amanda; Kirton, Adam; Rumney, Peter G; Bagg, Stephen; Bayley, Mark; Dowlatshahi, Dar; Dukelow, Sean; Garnhum, Maridee; Glasser, Ev; Halabi, Mary-Lou; Kang, Ester; MacKay-Lyons, Marilyn; Martino, Rosemary; Rochette, Annie; Rowe, Sarah; Salbach, Nancy; Semenko, Brenda; Stack, Bridget; Swinton, Luchie; Weber, Valentine; Mayer, Matthew; Verrilli, Sue; DeVeber, Gabrielle; Andersen, John; Barlow, Karen; Cassidy, Caitlin; Dilenge, Marie-Emmanuelle; Fehlings, Darcy; Hung, Ryan; Iruthayarajah, Jerome; Lenz, Laura; Majnemer, Annette; Purtzki, Jacqueline; Rafay, Mubeen; Sonnenberg, Lyn K; Townley, Ashleigh; Janzen, Shannon; Foley, Norine; Teasell, Robert

    2016-06-01

    Stroke rehabilitation is a progressive, dynamic, goal-orientated process aimed at enabling a person with impairment to reach their optimal physical, cognitive, emotional, communicative, social and/or functional activity level. After a stroke, patients often continue to require rehabilitation for persistent deficits related to spasticity, upper and lower extremity dysfunction, shoulder and central pain, mobility/gait, dysphagia, vision, and communication. Each year in Canada 62,000 people experience a stroke. Among stroke survivors, over 6500 individuals access in-patient stroke rehabilitation and stay a median of 30 days (inter-quartile range 19 to 45 days). The 2015 update of the Canadian Stroke Best Practice Recommendations: Stroke Rehabilitation Practice Guidelines is a comprehensive summary of current evidence-based recommendations for all members of multidisciplinary teams working in a range of settings, who provide care to patients following stroke. These recommendations have been developed to address both the organization of stroke rehabilitation within a system of care (i.e., Initial Rehabilitation Assessment; Stroke Rehabilitation Units; Stroke Rehabilitation Teams; Delivery; Outpatient and Community-Based Rehabilitation), and specific interventions and management in stroke recovery and direct clinical care (i.e., Upper Extremity Dysfunction; Lower Extremity Dysfunction; Dysphagia and Malnutrition; Visual-Perceptual Deficits; Central Pain; Communication; Life Roles). In addition, stroke happens at any age, and therefore a new section has been added to the 2015 update to highlight components of stroke rehabilitation for children who have experienced a stroke, either prenatally, as a newborn, or during childhood. All recommendations have been assigned a level of evidence which reflects the strength and quality of current research evidence available to support the recommendation. The updated Rehabilitation Clinical Practice Guidelines feature several

  14. Differences Between US and UK Adults in Stroke Preparedness

    PubMed Central

    Ford, Gary A.; Morgenstern, Lewis B.; White, Martin; Sniehotta, Falko F.; Mackintosh, Joan E.; Gellert, Paul; Skolarus, Lesli E.

    2015-01-01

    Background and Purpose— Although time-dependent treatment is available, most people delay contacting emergency medical services for stroke. Given differences in the healthcare system and public health campaigns, exploring between-country differences in stroke preparedness may identify novel ways to increase acute stroke treatment. Methods— A survey was mailed to population-based samples in Ingham County, Michigan, US (n=2500), and Newcastle upon Tyne, UK (n=2500). Surveys included stroke perceptions and stroke/nonstroke scenarios to assess recognition and response to stroke. Between-country differences and associations with stroke preparedness were examined using t tests and linear mixed models. Results— Overall response rate was 27.4%. The mean age of participants was 55 years, and 58% were female. US participants were better in recognizing stroke (70% versus 63%, d=0.27) and were more likely to call emergency medical services (55% versus 52%, d=0.11). After controlling for demographics and comorbidities, US participants remained more likely to recognize stroke but were not more likely to respond appropriately. A greater belief that medical treatment can help with stroke and understanding of stroke was associated with improved stroke recognition and response. Conclusions— Overall, stroke recognition and response were moderate. US participants were modestly better at recognizing stroke, although there was little difference in response to stroke. Future stroke awareness interventions could focus more on stroke outcome expectations and developing a greater understanding of stroke among the public. PMID:26419968

  15. Cardiorespiratory fitness after stroke: a systematic review.

    PubMed

    Smith, Alexandra C; Saunders, David H; Mead, Gillian

    2012-08-01

    Cardiorespiratory fitness programs are increasingly used in stroke rehabilitation. Maximal oxygen uptake is the gold standard measurement of cardiorespiratory fitness; however, no recent publications have collated evidence about maximal oxygen uptake levels following stroke. We therefore performed a systematic review of maximal oxygen uptake in stroke survivors, aiming to observe changes in levels over time, and associations with severity of stroke. We searched Medline and Embase until April 2011, and included cross-sectional studies, longitudinal studies, and baseline data from intervention trials. Studies had to recruit at least 10 stroke survivors, and report direct measurement of maximal/peak oxygen uptake. We then compared maximal oxygen uptake with published data from age and gender-matched controls. The search identified 3357 articles. Seventy-two full texts were retrieved, of which 41 met the inclusion criteria. Time since stroke ranged from 10 days to over seven-years. Peak oxygen uptake ranged from 8 to 22 ml/kg/min, which was 26-87% of that of healthy age- and gender-matched individuals. Stroke severity was mild in most studies. Three studies reported longitudinal changes; there was no clear evidence of change in peak oxygen uptake over time. Most studies recruited participants with mild stroke, and it is possible that cardiorespiratory fitness is even more impaired after severe stroke. Maximal oxygen uptake might have been overestimated, as less healthy and older stroke survivors may not tolerate maximal exercise testing. More studies are needed describing mechanisms of impaired cardiorespiratory fitness and longitudinal changes over time to inform the optimal 'prescription' of cardiorespiratory fitness programs for stroke survivors. PMID:22568786

  16. Long Sleep Duration and Risk of Ischemic Stroke and Hemorrhagic Stroke: the Kailuan Prospective Study.

    PubMed

    Song, Qiaofeng; Liu, Xiaoxue; Zhou, Wenhua; Wang, Ling; Zheng, Xiang; Wang, Xizhu; Wu, Shouling

    2016-01-01

    The objective of this study was to examine the relationship between sleep duration and ischemic and hemorrhagic stroke in a community-based cohort. The current analysis included 95,023 Chinese participants who were free of stroke at the baseline survey (2006-2007). Cox proportional hazards models were used to calculate hazard ratios (HRs) and their confidence intervals (CIs) for stroke, according to sleep duration. After a mean follow-up period of 7.9 years, 3,135 participants developed stroke (2,504 ischemic stroke and 631 hemorrhagic stroke). The full adjusted hazard ratio (95% CI) of total stroke (with 6-8 hours of night sleep being considered for the reference group) for individuals reporting greater than 8 hours was 1.29 (1.01-1.64). More significant association between long sleep duration and total stroke was found in the elderly (HR, 1.47; 95% CI, 1.05-2.07). Compared with participants getting 6-8 hours of sleep, only women who reported sleeping more than 8 hours per night were associated with hemorrhagic stroke (HR, 3.58; 95% CI, 1.28-10.06). This study suggested that long sleep duration might be a potential predictor/ marker for total stroke, especially in the elderly. And long sleep duration increased the risk of hemorrhagic stroke only in women. PMID:27633270

  17. Long Sleep Duration and Risk of Ischemic Stroke and Hemorrhagic Stroke: the Kailuan Prospective Study

    PubMed Central

    Song, Qiaofeng; Liu, Xiaoxue; Zhou, Wenhua; Wang, Ling; Zheng, Xiang; Wang, Xizhu; Wu, Shouling

    2016-01-01

    The objective of this study was to examine the relationship between sleep duration and ischemic and hemorrhagic stroke in a community-based cohort. The current analysis included 95,023 Chinese participants who were free of stroke at the baseline survey (2006–2007). Cox proportional hazards models were used to calculate hazard ratios (HRs) and their confidence intervals (CIs) for stroke, according to sleep duration. After a mean follow-up period of 7.9 years, 3,135 participants developed stroke (2,504 ischemic stroke and 631 hemorrhagic stroke). The full adjusted hazard ratio (95% CI) of total stroke (with 6–8 hours of night sleep being considered for the reference group) for individuals reporting greater than 8 hours was 1.29 (1.01–1.64). More significant association between long sleep duration and total stroke was found in the elderly (HR, 1.47; 95% CI, 1.05–2.07). Compared with participants getting 6–8 hours of sleep, only women who reported sleeping more than 8 hours per night were associated with hemorrhagic stroke (HR, 3.58; 95% CI, 1.28–10.06). This study suggested that long sleep duration might be a potential predictor/ marker for total stroke, especially in the elderly. And long sleep duration increased the risk of hemorrhagic stroke only in women. PMID:27633270

  18. Power and energy dissipation in subsequent return strokes as predicted by a new return stroke model

    NASA Technical Reports Server (NTRS)

    Cooray, Vernon

    1991-01-01

    Recently, Cooray introduced a new return stroke model which is capable of predicting the temporal behavior of the return stroke current and the return stroke velocity as a function of the height along the return stroke channel. The authors employed this model to calculate the power and energy dissipation in subsequent return strokes. The results of these calculations are presented here. It was concluded that a large fraction of the total energy available for the dart leader-subsequent stroke process is dissipated in the dart leader stage. The peak power per unit length dissipated in a subsequent stroke channel element decreases with increasing height of that channel element from ground level. For a given channel element, the peak power dissipation increases with increasing current in that channel element. The peak electrical power dissipation in a typical subsequent return stroke is about 1.5 times 10(exp 11) W. The energy dissipation in a subsequent stroke increases with increasing current in the return stroke channel, and for a typical subsequent stroke, the energy dissipation per unit length is about 5.0 times 10(exp 3) J/m.

  19. Prestroke living situation and depression contribute to initial stroke severity and stroke recovery.

    PubMed

    Aron, Abraham W; Staff, Ilene; Fortunato, Gilbert; McCullough, Louise D

    2015-02-01

    Substantial evidence from both experimental and clinical studies has demonstrated that social isolation can increase stroke incidence and impair recovery. Social isolation leads to higher rates of recurrent stroke but is often not reported as a risk factor. We examined prospectively collected stroke center database variables, which included prestroke living situation, to determine if social isolation could be determined from existing data using living arrangement as a proxy. Patients were categorized into 4 groups hypothesized to represent increasing levels of social isolation: living with spouse, living with family, living alone with visiting services, and living alone. Initial stroke severity and recovery were measured using the National Institutes of Health Stroke Scale and Barthel Index, respectively. A multivariate model was used to determine the relationship among prestroke living situation, stroke severity, and functional outcome. Patients living alone had less severe strokes on admission and better recovery at 3 months compared with the other cohorts. Patients living alone or those who lived with a spouse had less severe strokes on presentation and better recovery at both 3 and 12 months after stroke compared with the other cohorts. However, on detailed examination, it was found that these patients also had significantly higher prestroke function. Pre-existing depression was significantly higher in women, and depressed patients had poorer outcomes 3 months after stroke. Information regarding isolation is notably absent from most large stroke databases. A more comprehensive evaluation of social interaction should be obtained to more accurately measure social isolation.

  20. Activated Protein C Resistance Does Not Increase Risk for Recurrent Stroke or Death in Stroke Patients

    PubMed Central

    Thaler, Christoph; Sonntag, Natalie; Schleef, Michael; Rondak, Ina-Christine; Poppert, Holger

    2016-01-01

    Background Activated protein C (APC) resistance is the most common inherited prothrombotic disorder. The role of APC resistance in ischemic stroke is controversially discussed. Objectives The aim of this single center follow up study was to investigate the effect of APC resistance on stroke recurrence and survival in stroke patients. Patients/Methods We retrospectively identified 966 patients who had had an ischemic stroke or transitory ischemic attack (TIA) and in whom laboratory tests for APC resistance had been conducted. These patients were contacted to determine the primary outcomes of recurrent ischemic stroke or death. Results A total of 858 patients with an average follow up time of 8.48 years were included. APC resistance did not influence cumulative incidence functions for stroke free and total survival. In multivariate analyses, crude and adjusted hazard ratios for recurrent stroke as well as for death where not significantly increased in patients with APC resistance. This also applies to the subgroups of young patients, patients with cryptogenic stroke and patients with atrial fibrillation. Conclusion APC-resistance is not a risk factor for subsequent stroke or death in patients with a first ischemic stroke or TIA. Testing for APC-resistance in stroke patients therefore cannot be routinely recommended. PMID:27508300

  1. Peste des petits ruminants.

    PubMed

    Parida, S; Muniraju, M; Mahapatra, M; Muthuchelvan, D; Buczkowski, H; Banyard, A C

    2015-12-14

    Peste des petits ruminants virus causes a highly infectious disease of small ruminants that is endemic across Africa, the Middle East and large regions of Asia. The virus is considered to be a major obstacle to the development of sustainable agriculture across the developing world and has recently been targeted by the World Organisation for Animal Health (OIE) and the Food and Agriculture Organisation (FAO) for eradication with the aim of global elimination of the disease by 2030. Fundamentally, the vaccines required to successfully achieve this goal are currently available, but the availability of novel vaccine preparations to also fulfill the requisite for differentiation between infected and vaccinated animals (DIVA) may reduce the time taken and the financial costs of serological surveillance in the later stages of any eradication campaign. Here, we overview what is currently known about the virus, with reference to its origin, updated global circulation, molecular evolution, diagnostic tools and vaccines currently available to combat the disease. Further, we comment on recent developments in our knowledge of various recombinant vaccines and on the potential for the development of novel multivalent vaccines for small ruminants.

  2. Peste des petits ruminants.

    PubMed

    Parida, S; Muniraju, M; Mahapatra, M; Muthuchelvan, D; Buczkowski, H; Banyard, A C

    2015-12-14

    Peste des petits ruminants virus causes a highly infectious disease of small ruminants that is endemic across Africa, the Middle East and large regions of Asia. The virus is considered to be a major obstacle to the development of sustainable agriculture across the developing world and has recently been targeted by the World Organisation for Animal Health (OIE) and the Food and Agriculture Organisation (FAO) for eradication with the aim of global elimination of the disease by 2030. Fundamentally, the vaccines required to successfully achieve this goal are currently available, but the availability of novel vaccine preparations to also fulfill the requisite for differentiation between infected and vaccinated animals (DIVA) may reduce the time taken and the financial costs of serological surveillance in the later stages of any eradication campaign. Here, we overview what is currently known about the virus, with reference to its origin, updated global circulation, molecular evolution, diagnostic tools and vaccines currently available to combat the disease. Further, we comment on recent developments in our knowledge of various recombinant vaccines and on the potential for the development of novel multivalent vaccines for small ruminants. PMID:26443889

  3. Peste des petits ruminants

    PubMed Central

    Parida, S.; Muniraju, M.; Mahapatra, M.; Muthuchelvan, D.; Buczkowski, H.; Banyard, A.C.

    2015-01-01

    Peste des petits ruminants virus causes a highly infectious disease of small ruminants that is endemic across Africa, the Middle East and large regions of Asia. The virus is considered to be a major obstacle to the development of sustainable agriculture across the developing world and has recently been targeted by the World Organisation for Animal Health (OIE) and the Food and Agriculture Organisation (FAO) for eradication with the aim of global elimination of the disease by 2030. Fundamentally, the vaccines required to successfully achieve this goal are currently available, but the availability of novel vaccine preparations to also fulfill the requisite for differentiation between infected and vaccinated animals (DIVA) may reduce the time taken and the financial costs of serological surveillance in the later stages of any eradication campaign. Here, we overview what is currently known about the virus, with reference to its origin, updated global circulation, molecular evolution, diagnostic tools and vaccines currently available to combat the disease. Further, we comment on recent developments in our knowledge of various recombinant vaccines and on the potential for the development of novel multivalent vaccines for small ruminants. PMID:26443889

  4. Clinicoanatomical correlation in stroke related aphasia

    PubMed Central

    Bohra, Vikram; Khwaja, Geeta Anjum; Jain, Sneh; Duggal, Ashish; Ghuge, Vijay Vishwanath; Srivastava, Abhilekh

    2015-01-01

    Context: With advances in neuroimaging, traditional views regarding the clinicoanatomic correlation in stroke patients with aphasia are being challenged and it has been observed that lesions at a given cortical or subcortical site may manifest with different aphasia profiles. Aims: To study as to whether there is a strict clinicoanatomical correlation between the type of aphasia and lesion site in patients with first ever stroke. Settings and Design: Observational study, based in a tertiary care center. Materials and Methods: Stroke patient's ≥18 years of age were screened and those with first ever stroke and aphasia were subjected to a detailed stroke workup and language assessment using the Hindi version of Western Aphasia Battery (WAB). Statistical analysis was done with χ2 test with Yates correction and Kruskal-Wallis test. The level of significance was set at P < 0.05. Results: Overall aphasia was detected in 27.9% of the 260 screened cases with stroke. Amongst 60 cases with first ever stroke and aphasia, the aphasia type was: Global (33.33%), Broca's (28.3%), transcortical motor (13.33%), transcortical sensory (10%), Wernicke's (8.33%), anomic (5%), and conduction (1.67%) aphasia. A definite correlation between the lesion site and the type of aphasia as per the traditional classification was observed in 35% cases only. Conclusions: No absolute correlation exists between the lesion site and the type of clinical aphasia syndrome in majority of the patients with cortical and subcortical stroke. PMID:26713015

  5. Cerebral ischemic stroke: is gender important?

    PubMed Central

    Gibson, Claire L

    2013-01-01

    Cerebral stroke continues to be a major cause of death and the leading cause of long-term disability in developed countries. Evidence reviewed here suggests that gender influences various aspects of the clinical spectrum of ischemic stroke, in terms of influencing how a patients present with ischemic stroke through to how they respond to treatment. In addition, this review focuses on discussing the various pathologic mechanisms of ischemic stroke that may differ according to gender and compares how intrinsic and hormonal mechanisms may account for such gender differences. All clinical trials to date investigating putative neuroprotective treatments for ischemic stroke have failed, and it may be that our understanding of the injury cascade initiated after ischemic injury is incomplete. Revealing aspects of the pathophysiological consequences of ischemic stroke that are gender specific may enable gender relevant and effective neuroprotective strategies to be identified. Thus, it is possible to conclude that gender does, in fact, have an important role in ischemic stroke and must be factored into experimental and clinical investigations of ischemic stroke. PMID:23756694

  6. Defining and Measuring Dysphagia Following Stroke

    ERIC Educational Resources Information Center

    Daniels, Stephanie K.; Schroeder, Mae Fern; DeGeorge, Pamela C.; Corey, David M.; Foundas, Anne L.; Rosenbek, John C.

    2009-01-01

    Purpose: To continue the development of a quantified, standard method to differentiate individuals with stroke and dysphagia from individuals without dysphagia. Method: Videofluoroscopic swallowing studies (VFSS) were completed on a group of participants with acute stroke (n = 42) and healthy age-matched individuals (n = 25). Calibrated liquid…

  7. Painting as Language for a Stroke Patient.

    ERIC Educational Resources Information Center

    Carmi, Shulamit; Mashiah, Tonni

    1996-01-01

    Painting may provide an outlet for self-expression for stroke patients experiencing physical, emotional, and social difficulties during rehabilitation. A case study of a stroke patient demonstrates the value of the artistic process as a vehicle for integration and communication. (LSR)

  8. Sleep Apnea and Heart Disease, Stroke

    MedlinePlus

    ... Pressure High Blood Pressure Tools & Resources Stroke More Sleep Apnea and Heart Disease, Stroke Updated:Sep 16,2015 Plain old snoring ... evidence is very strong for the relationship between sleep apnea and hypertension and cardiovascular disease generally, so people really need to know that,” ...

  9. Bemerkungen zur Relativitätstheorie und zu den Quanten

    NASA Astrophysics Data System (ADS)

    Bergmann, Peter G.

    Die theoretischen und experimentellen Grundlagen von Gravitations- und Quantenphysik, die Beziehung beider Theorien und die Bedeutung wesentlicher Begriffe, wie Observable, werden diskutiert.Translated AbstractRemarks on Relativity and on Quantum TheoryThe theoretical and experimental foundations of gravitation and quantum physics are discussed as well as the relation of these two theories and the role of basic notions like observables.

  10. Vom Urknall zum Zerfall. Die Welt zwischen Anfang und Ende.

    NASA Astrophysics Data System (ADS)

    Fritzsch, H.

    Contents: Der Tanz mit dem Ozean. Galaktische Landkarte. Das Maß der Dinge. Der würfelnde Gott der Quantenphysik. Geheimnisvolle Felder. Materie und Antimaterie. Quarks - Urstoff unserer Welt. Zerfallende Protonen und die Einheit der Physik. Der Zauberofen. Das überschaubare Universum. Das explodierende Universum. Nachhall der Schöpfung. Der achtfache Weg der kosmischen Entwicklung. Das Ende der Welt. Einheit in der Vielfalt. Das geistige Universum. Gott und das absurde Universum.

  11. Stroke Recovery: Surprising Influences and Residual Consequences

    PubMed Central

    Hillis, Argye E.; Tippett, Donna C.

    2014-01-01

    There is startling individual variability in the degree to which people recover from stroke and the duration of time over which recovery of some symptoms occurs. There are a variety of mechanisms of recovery from stroke which take place at distinct time points after stroke and are influenced by different variables. We review recent studies from our laboratory that unveil some surprising findings, such as the role of education in chronic recovery. We also report data showing that the consequences that most plague survivors of stroke and their caregivers are loss of high level cortical functions, such as empathy or written language. These results have implications for rehabilitation and management of stroke. PMID:25844378

  12. Seven Questions About Stroke and Epilepsy

    PubMed Central

    Bleck, Thomas P.

    2012-01-01

    Seizures and stroke are both common neurologic conditions, but when they occur in close temporal proximity they produce much more concern than either does alone. The stroke specialist (and the family) fear that convulsions will worsen the stroke because of acute hypertension and airway compromise, and the epileptologist is concerned that these acute seizures are the harbingers of later epilepsy. Other less commonly recognized but important aspects of this relationship are that subclinical seizures worsen some forms of stroke, and some anticonvulsants may have more adverse effects on stroke patients than they do in other groups. In surveying the connections between these two conditions, I have attempted to address seven questions. For some questions, there are data to help provide an answer; for others, there is only opinion; and for a maddening few, newer research is making older suggestions less certain. PMID:23447718

  13. Seven questions about stroke and epilepsy.

    PubMed

    Bleck, Thomas P

    2012-11-01

    Seizures and stroke are both common neurologic conditions, but when they occur in close temporal proximity they produce much more concern than either does alone. The stroke specialist (and the family) fear that convulsions will worsen the stroke because of acute hypertension and airway compromise, and the epileptologist is concerned that these acute seizures are the harbingers of later epilepsy. Other less commonly recognized but important aspects of this relationship are that subclinical seizures worsen some forms of stroke, and some anticonvulsants may have more adverse effects on stroke patients than they do in other groups. In surveying the connections between these two conditions, I have attempted to address seven questions. For some questions, there are data to help provide an answer; for others, there is only opinion; and for a maddening few, newer research is making older suggestions less certain. PMID:23447718

  14. Dialectical tensions in stroke survivor relationships.

    PubMed

    Brann, Maria; Himes, Kimberly Leezer; Dillow, Megan R; Weber, Keith

    2010-06-01

    Stroke is an unpredictable and life-altering medical occurrence that causes immediate change in survivors' relationships. This study unearthed dialectical tensions expressed by spouses of stroke survivors and examined how those dialectical tensions compare to those experienced by stroke survivors themselves. Sixteen spouses of stroke survivors participated in interviews, and four tensions ultimately emerged: self-orientation-partner-orientation, realism-idealism, uncertainty-acceptance, and emotional release-emotional reservation. Three dialectical tensions (i.e., uncertainty-acceptance, realism-idealism, self-orientation-partner-orientation) were similar to those communicated by stroke survivors. Recognizing dialectical tensions experienced and shared can open communication lines and ultimately improve the health of individuals and their relationships. PMID:20512714

  15. Neuroprotection in stroke: past, present, and future.

    PubMed

    Majid, Arshad

    2014-01-01

    Stroke is a devastating medical condition, killing millions of people each year and causing serious injury to many more. Despite advances in treatment, there is still little that can be done to prevent stroke-related brain damage. The concept of neuroprotection is a source of considerable interest in the search for novel therapies that have the potential to preserve brain tissue and improve overall outcome. Key points of intervention have been identified in many of the processes that are the source of damage to the brain after stroke, and numerous treatment strategies designed to exploit them have been developed. In this review, potential targets of neuroprotection in stroke are discussed, as well as the various treatments that have been targeted against them. In addition, a summary of recent progress in clinical trials of neuroprotective agents in stroke is provided.

  16. Neuroprotection in Stroke: Past, Present, and Future

    PubMed Central

    Majid, Arshad

    2014-01-01

    Stroke is a devastating medical condition, killing millions of people each year and causing serious injury to many more. Despite advances in treatment, there is still little that can be done to prevent stroke-related brain damage. The concept of neuroprotection is a source of considerable interest in the search for novel therapies that have the potential to preserve brain tissue and improve overall outcome. Key points of intervention have been identified in many of the processes that are the source of damage to the brain after stroke, and numerous treatment strategies designed to exploit them have been developed. In this review, potential targets of neuroprotection in stroke are discussed, as well as the various treatments that have been targeted against them. In addition, a summary of recent progress in clinical trials of neuroprotective agents in stroke is provided. PMID:24579051

  17. The effects of estrogen in ischemic stroke.

    PubMed

    Koellhoffer, Edward C; McCullough, Louise D

    2013-08-01

    Stroke is a leading cause of death and the most common cause of long-term disability in the USA. Women have a lower incidence of stroke compared with men throughout most of the lifespan which has been ascribed to protective effects of gonadal steroids, most notably estrogen. Due to the lower stroke incidence observed in pre-menopausal women and robust preclinical evidence of neuroprotective and anti-inflammatory properties of estrogen, researchers have focused on the potential benefits of hormones to reduce ischemic brain injury. However, as women age, they are disproportionately affected by stroke, coincident with the loss of estrogen with menopause. The risk of stroke in elderly women exceeds that of men and it is clear that in some settings estrogen can have pro-inflammatory effects. This review will focus on estrogen and inflammation and its interaction with aging.

  18. The NLRP3 inflammasome and stroke.

    PubMed

    Tong, Yeqing; Ding, Zhi-Hong; Zhan, Fa-Xian; Cai, Li; Yin, Xiaoxv; Ling, Jin-Lian; Ye, Jian-Jun; Hou, Shuang-Yi; Lu, Zuxun; Wang, Zhi-Hong; Liu, Jia-Fa

    2015-01-01

    Inflammasome pattern recognition receptors, which belong to the family of multi-meric proteins, play an important role in innate immunity, including NLRPs, NLRC, and NAIP. Among these receptors, NLRP3 (nucleotide-binding domain (NOD)-like receptor protein 3) inflammasome may activate the inflammation and participate in atherosclerosis, pathophysiology of myocardial infarction, resultin ischemia/reperfusion injury and stroke and other cardiovascular diseases. Effective regulation of NLRP3 may help prevent or even treat stroke. In recent years, the role of inflammation in stroke has attracted much attention, and the in-depth study of its mechanism of action is gradually clear. This mini-review focuses on the association of regulatory mechanisms of NLRP3 inflammasome with the development of stroke, which may supply some clues for future therapies and novel drug targets for stroke. PMID:26131053

  19. The association of migraine with ischemic stroke.

    PubMed

    Kurth, Tobias

    2010-03-01

    Migraine is a common, chronic-intermittent primary headache disorder affecting mostly women. The migraine pathophysiology involves both the neuronal and vascular systems, and in some patients, transient neurologic symptoms occur, which are known as migraine aura. A large body of literature supports an association between migraine and ischemic stroke, which is apparent mostly in young women with migraine with aura. Further increased risks have been observed particularly in smokers and women who use oral contraceptives. The vast majority of individual studies, as well as a recent meta-analysis, did not find an association between migraine without aura and ischemic stroke. Although there are several hypotheses about potential biological mechanisms linking migraine with aura to ischemic stroke, the precise causes remain unclear. Because the absolute risk of stroke is considerably low in patients with migraine, the vast majority of migraine patients will not experience a stroke event because of the migraine.

  20. Severe stroke: which medicine for which results?

    PubMed

    Woimant, F; Biteye, Y; Chaine, P; Crozier, S

    2014-02-01

    In face of any severe stroke, the questions for health professionals in charge of the patient are: will the handicap be acceptable for the patient? But can we predict an acceptable handicap for the patient? For his family? When we know that the cognitive disorders, consequences of severe stroke often modify, in a major way, the behaviour of these patients? Given these difficulties for estimate vital and functional prognosis and even more the quality of life of patients with severe stroke, collective reflexions between physicians and nurses are essential, reflexions taking into account preferences and values of patients. Use of resuscitation resources for severe stroke patients implies to offer them the best rehabilitation. So, questions about health pathways for severe stroke are essential: which structures for these patients, which technologies, which medical, medico-social and social supports, which human accompaniment the society can propose to the patients and to their family, so that they have an acceptable quality of life.

  1. Sinn und Möglichkeiten der Theoretischen Physik. Zum 300. Jahrestag von Newtons Philosophiae Naturalis Principia Mathematica

    NASA Astrophysics Data System (ADS)

    Rompe, R.; Thiessen, P. A.; Treder, H.-J.

    Die Newtonschen Prinzipien und die aus ihnen gewonnene Erkenntnis der Existenz von Elementarkonstanten nach Planck, Einstein und Bohr erweisen sich zunehmend als tragfähiges Fundament nicht nur der Physik und ihrer Anwendung in der Technik, sondern überhaupt aller exakten Wissenschaften in breitestem Sinne des Wortes.Die physikalisch inhaltliche Klärung der Begriffe erfolgt seit Newton in engem Verbund mit der Entwicklung mathematischer Methoden. Diese Kombination erweist sich weiterhin als produktiv und sichert den Fortschritt der Physik und der exakten Wissenschaften.Wohl alle Probleme, die im Bereich der Technik Bedeutung haben können, lassen sich bei entsprechendem Aufwand bereits mit dem vorhandenen Fundus an Erkenntnissen und Methoden erfolgreich angehen.Der in der Wirklichkeit verankerte Zusammenhang von Gesetz und Zufall erweist sich als eine Manifestation der Dialektik in der Natur. Es gibt keinen absoluten Zufall. Sie kommt in allen Zweigen der Physik, nicht nur in der Thermodynamik und Quantenphysik, zutage, und muß bereits auf dem Niveau der Newtonschen Prinzipien und der Elementarkonstanten behandelt werden.Die theoretische Physik, so wie sie von Newton initiiert worden ist, wurde so angelegt, daß sie alle Seiten der Wirklichkeit, so weit sie in die Kompetenz der Physik fallen, umfaßt. Es besteht darum kein Gegensatz zwischen der klassischen Physik und der Quantenphysik. Es handelt sich lediglich um eine Differenzierung nach den unterschiedlichen physikalischen Inhalten und den angemessenen mathematischen Methoden, die natürlich von der Wahl der Probleme abhängen.Die theoretische Physik stellt eine allgemein zugängliche Zusammenfassung des gesicherten Wissens der Physik dar, das zugleich das Fundament der exakten Wissenschaften ist.Die theoretische Physik ist damit das Mittel der Verständigung innerhalb der Kooperation, die notwendig ist zur Lösung der großen komplexen Aufgaben der Wissenschaft und Technik.

  2. Sex differences in stroke: a socioeconomic perspective

    PubMed Central

    Delbari, Ahmad; Keyghobadi, Farzane; Momtaz, Yadollah Abolfathi; Keyghobadi, Fariba; Akbari, Reza; Kamranian, Houman; Yazdi, Mohammad Shouride; Tabatabaei, Sayed Shahaboddin; Fereshtehnejad, Seyed-Mohammad

    2016-01-01

    Background A number of studies have explored the issue of sex differences in stroke from biomedical perspective; however, there are still large gaps in the existing knowledge. The purpose of this study was to assess whether the differences in socioeconomic status and living conditions between men and women may explain the part of the sex differences in incidence and outcomes of stroke. Methods All stroke participants aged ≥60 years admitted in Vaseie Hospital in Sabzevar, Iran, from March 21, 2013, until March 20, 2014, were included in this study. Computerized tomography and magnetic resonance imaging were used to confirm stroke. A series of χ2 tests were performed and Statistical Program for Social Sciences, Version 21.0, was used to investigate the potential differences between older men and women in stroke incidence and outcomes. Results A total of 159 incident stroke cases were documented during 1 year. The annual rate of stroke was statistically significantly higher in elderly women than in elderly men (401 vs 357 per 100,000; P<0.001). Female elderly participants had significantly lower socioeconomic status, poorer living conditions, and higher lifetime history of depression, hypertension, and diabetes mellitus than their male counterparts. Conclusion The findings from this study showed that elderly women are more adversely affected by stroke in terms of incidence and outcomes of stroke than elderly men. The most noticeable result is that sex differences in socioeconomic status and living conditions may result in increased incidence of stroke and poorer outcomes in elderly women. Therefore, it is imperative to identify vulnerable elderly women and provide them appropriate treatment and services.

  3. Sex differences in stroke: a socioeconomic perspective

    PubMed Central

    Delbari, Ahmad; Keyghobadi, Farzane; Momtaz, Yadollah Abolfathi; Keyghobadi, Fariba; Akbari, Reza; Kamranian, Houman; Yazdi, Mohammad Shouride; Tabatabaei, Sayed Shahaboddin; Fereshtehnejad, Seyed-Mohammad

    2016-01-01

    Background A number of studies have explored the issue of sex differences in stroke from biomedical perspective; however, there are still large gaps in the existing knowledge. The purpose of this study was to assess whether the differences in socioeconomic status and living conditions between men and women may explain the part of the sex differences in incidence and outcomes of stroke. Methods All stroke participants aged ≥60 years admitted in Vaseie Hospital in Sabzevar, Iran, from March 21, 2013, until March 20, 2014, were included in this study. Computerized tomography and magnetic resonance imaging were used to confirm stroke. A series of χ2 tests were performed and Statistical Program for Social Sciences, Version 21.0, was used to investigate the potential differences between older men and women in stroke incidence and outcomes. Results A total of 159 incident stroke cases were documented during 1 year. The annual rate of stroke was statistically significantly higher in elderly women than in elderly men (401 vs 357 per 100,000; P<0.001). Female elderly participants had significantly lower socioeconomic status, poorer living conditions, and higher lifetime history of depression, hypertension, and diabetes mellitus than their male counterparts. Conclusion The findings from this study showed that elderly women are more adversely affected by stroke in terms of incidence and outcomes of stroke than elderly men. The most noticeable result is that sex differences in socioeconomic status and living conditions may result in increased incidence of stroke and poorer outcomes in elderly women. Therefore, it is imperative to identify vulnerable elderly women and provide them appropriate treatment and services. PMID:27660426

  4. Rhetoric and reality in stroke patient care.

    PubMed

    Pound, P; Ebrahim, S

    2000-11-01

    The aim of this study was to identify aspects of the process of care that might help explain the improved outcomes associated with stroke units. Three different care settings for stroke patients, an elderly care unit and general medical ward in an inner-city teaching hospital and a stroke unit in another teaching hospital in the same city, were compared using non-participant observational methods. Nurses on the stroke unit and general medical ward usually engaged in standardised and functional interaction with patients, while nurses on the elderly care unit were observed to adopt a more personal and attentive approach with patients. Rehabilitation nursing was rarely observed on the stroke unit, never on the general medical ward but always on the elderly care unit. There was evidence of effective communication between nurses and therapists on the elderly care unit but this was not observed on the stroke unit. On the elderly care unit the team appeared divided, with therapists and nurses on one side and medicine on the other, while on the stroke unit the divide was between doctors and therapists on one hand and nurses the other. On the general medical ward there was no team working. The observed lack of rehabilitation nursing, nurses' disengagement from the team and nurses' observed lack of warmth towards patients on the stroke unit were all surprising findings. Further research needs to examine whether such findings would be reproduced in stroke units elsewhere. If so, it might be that the better outcomes achieved on stroke units are despite rather than because of the nursing they receive there. PMID:11077948

  5. Das menschliche Gehör und Grundlagen der Psychoakustik

    NASA Astrophysics Data System (ADS)

    Genuit, Klaus; Sottek, Roland

    Das menschliche Gehör ist ein äußerst komplexes Empfangs- und Signalverarbeitungssystem. Es ist als Schallanalysator in Leistungsfähigkeit und Vielseitigkeit von technisch-analytischen Verfahren nach wie vor unerreicht. Die Signalverarbeitung läuft auf Grundlage komplexer Prozesse ab, die in ihrer Gesamtheit bislang nicht vollständig erfasst sind. Verschiedene Modelle zur gehörgerechten Zeit- und Frequenzanalyse ahmen jene komplexen Prozesse und Verarbeitungsmechanismen nach, die im menschlichen Gehör vollzogen werden.

  6. Etude des Abondances de MG et de fe dans la Composante Stellaire des Disques des Galaxies Spirales

    NASA Astrophysics Data System (ADS)

    Beauchamp, Dominique

    Je presente ici une technique d'observation par imagerie des disques stellaires des galaxies spirales. Je tente, a l'aide d'un modele evolutif multiphase, de determiner les abondances de fer et de magnesium dans les disques. Dans ce but, je mesure les indices Mg2 et Fe5270 du systeme de Lick. Ces elements representent un choix judicieux d'indicateurs car ils sont formes par des supernovae de deux types differents ayant des durees de vie differentes. Le rapport d'abondances de ces deux elements est un indicateur du taux de formation des populations stellaires. Je decris, en premier lieu, les observations, la technique de mesure, ainsi que son application. J'analyse ensuite les indices mesures. A partir du modele multiphase, j'explore differents parametres physiques des spirales comme le taux de formation stellaire, l'evolution des abondances, les effets possibles de la presence de la barre, etc.

  7. Role of sleep-disordered breathing and sleep-wake disturbances for stroke and stroke recovery

    PubMed Central

    2016-01-01

    Background: Sleep-disordered breathing (SDB) and sleep-wake disturbances (SWD) are highly prevalent in stroke patients. Recent studies suggest that they represent both a risk factor and a consequence of stroke and affect stroke recovery, outcome, and recurrence. Methods: Review of literature. Results: Several studies have proven SDB to represent an independent risk factor for stroke. Sleep studies in TIA and stroke patients are recommended in view of the very high prevalence (>50%) of SDB (Class IIb, level of evidence B). Treatment of obstructive SDB with continuous positive airway pressure is recommended given the strength of the increasing evidence in support of a positive effect on outcome (Class IIb, level of evidence B). Oxygen, biphasic positive airway pressure, and adaptive servoventilation may be considered in patients with central SDB. Recently, both reduced and increased sleep duration, as well as hypersomnia, insomnia, and restless legs syndrome (RLS), were also suggested to increase stroke risk. Mainly experimental studies found that SWD may in addition impair neuroplasticity processes and functional stroke recovery. Treatment of SWD with hypnotics and sedative antidepressants (insomnia), activating antidepressants or stimulants (hypersomnia), dopaminergic drugs (RLS), and clonazepam (parasomnias) are based on single case observations and should be used with caution. Conclusions: SDB and SWD increase the risk of stroke in the general population and affect short- and long-term stroke recovery and outcome. Current knowledge supports the systematic implementation of clinical procedures for the diagnosis and treatment of poststroke SDB and SWD on stroke units. PMID:27488603

  8. Numbers of Stroke Patients and Stroke Subtypes According to Highest and Lowest Daily Temperatures in Seoul

    PubMed Central

    Shin, Dong-Won; Yoon, Jee-Eun; Hwang, Hye-Won; Kim, Ji-Sun; Park, Sukh-Que; Roh, Hakjae; Ahn, Moo-Young

    2016-01-01

    Background and Purpose There is conflicting evidence for whether or not the incidence of stroke is influenced by the daily temperature. The association between daily temperature and incidence of stroke is largely unknown in Korea. This study attempted to evaluate whether the maximum or minimum daily temperature is associated with increased numbers of strokes and stroke subtypes among Seoul residents. Methods We obtained the maximum and minimum daily temperatures in Seoul from the Korean Meteorological Administration between January 2005 and December 2014. Consecutive patients with acute stroke were registered who visited the emergency room or outpatient clinic in Soonchunhyang University Hospital, Seoul. The residential addresses of cases were restricted to within a 2-kilometer radius of this hospital. The stroke events were prospectively recorded with onset time, and were classified by subtypes. The categories of daily temperature were divided by 10℃ from the mean temperature. The mean daily number of strokes was calculated during the study period. One-way analysis of variance and Duncan's post-hoc test were applied to compare the number of strokes among the temperature groups. Results In total, 2,313 acute strokes were identified during the period: 1,643 ischemic strokes and 670 hemorrhagic strokes. The number of cases was significantly higher when the maximum daily temperature was >32℃ or ≤3℃ (p=0.048) or the minimum daily temperature was ≤-11.0℃ (p=0.020). The lowest maximum daily temperature was associated with increased instances of intracerebral hemorrhage (p=0.029) and small-vessel occlusion (p=0.013), while the highest maximum daily temperature was associated with an increased instance of large-artery atherosclerosis (p=0.045). Conclusions The daily temperature had measurable and different associations with the number of strokes and strokes subtypes in Seoul, Korea.

  9. Returning to Paid Employment after Stroke: The Psychosocial Outcomes In StrokE (POISE) Cohort Study

    PubMed Central

    Hackett, Maree L.; Glozier, Nick; Jan, Stephen; Lindley, Richard

    2012-01-01

    Objectives To determine which early modifiable factors are associated with younger stroke survivors' ability to return to paid work in a cohort study with 12-months of follow-up conducted in 20 stroke units in the Stroke Services NSW clinical network. Participants Were aged >17 and <65 years, recent (within 28 days) stroke, able to speak English sufficiently to respond to study questions, and able to provide written informed consent. Participants with language or cognitive impairment were eligible to participate if their proxy provided consent and completed assessments on the participants' behalf. The main outcome measure was return to paid work during the 12 months following stroke. Results Of 441 consented participants (average age 52 years, 68% male, 83% with ischemic stroke), 218 were in paid full-time and 53 in paid part-time work immediately before their stroke, of whom 202 (75%) returned to paid part- or full-time work within 12 months. Being male, female without a prior activity restricting illness, younger, independent in activities of daily living (ADL) at 28 days after stroke, and having private health insurance was associated with return to paid work, following adjustment for other illnesses and a history of depression before stroke (C statistic 0·81). Work stress and post stroke depression showed no such independent association. Conclusions Given that independence in ADL is the strongest predictor of return to paid work within 12 months of stroke, these data reinforce the importance of reducing stroke-related disability and increasing independence for younger stroke survivors. Trial Registration Australian New Zealand Clinical Trials Registry ANZCTRN 12608000459325 PMID:22848610

  10. Circadian rhythm of onset of stroke - in 50 cases of ischemic stroke.

    PubMed

    Uddin, M S; Hoque, M I; Uddin, M K; Kamol, S A; Chowdhury, R H

    2015-01-01

    Stroke is a leading cause of death and disability worldwide. While the immediate consequence of stroke include permanent cognitive deficits, paralysis, visual impairment and sensory disturbances; stroke also results in long term dysregulation of sleep and mood, which may be equally disabling. The influence of ischemic stroke on circadian rhythm regulation, which is strongly linked to sleep and mood, may thus potentially influence long term recovery in stroke patients. Stroke induces immediate changes in the timing of pineal melatonin secretion, indicating that cortical and basal ganglia infarction impacts the timing of melatonin rhythms. This study was done to find out the time of onset of most of the ischemic stroke attack and to determine the outcome of ischemic stroke during hospital stay. All ischemic stroke patients admitted in Medicine wards in Comilla Medical College Hospital during the period of 1st November 2010 to 30th April 2011 included in this study. After admission, a careful history and a thorough clinical examination was carried out. Data collection was done on a preset questionnaire which involved to identify the risk factors, the time of onset of ischemic stroke, and outcome during hospital stay. All the cases were investigated. Among the 50 ischemic stroke patients, 68% were male and 32% female. Maximum age groups were 61-70 years (50%). By occupational category, maximum were retired persons (46%); 68% were hypertensive, 38% smoker and 16% had diabetes. Dyslipidemia was present in 44% patients. Most of the ischemic stroke (44%) occurred in the morning to late morning (6:01AM-12:00PM) and majority (80%) of the patients was discharged with residual neurological dysfunction. This study supports the presence of a circadian pattern in the onset of ischemic stroke, with higher risk in the morning to late morning. Most of the patients were discharged with residual neurological dysfunction. PMID:25725678

  11. Classification of 20 DES Supernova with OzDES

    NASA Astrophysics Data System (ADS)

    Davis, T. M.; Kim, A. G.; Macualay, E.; Lidman, C.; Sharp, R.; Tucker, B. E.; Yuan, F.; Zhang, B.; Lewis, G. F.; Sommer, N. E.; Martini, P.; Mould, J.; Ahn, E.; Finley, D. A.; Frieman, J.; Marriner, J.; Wester, W.; Aldering, G.; Thomas, R. C.; Barbary, K.; Bloom, J. S.; Goldstein, D.; Nugent, P.; Perlmutter, S.; Foley, R. J.; Pan, Y.-C.; Casas, R.; Castander, F. J.; Desai, S.; Paech, K.; Smith, R. C.; Schubnell, M.; Kessler, R.; Lasker, J.; Scolnic, D.; Brout, D. J.; Gladney, L.; Sako, M.; Wolf, R. C.; Brown, P. J.; Krisciunas, K.; Suntzeff, N.; Nichol, R.; Papadopoulos, A.; Childress, M.; D'Andrea, C.; Smith, M.; Sullivan, M.; Maartens, R.; Gupta, R.; Kovacs, E.; Kuhlmann, S.; Spinka, H.

    2015-12-01

    We report new spectroscopic classifications by OzDES of supernovae discovered by the Dark Energy Survey (ATEL #4668). The spectra (370-885nm) were obtained with the AAOmega Spectrograph (Saunders et al. 2004, SPIE, 5492, 389) and the 2dF fibre positioner at the Anglo-Australian Telescope (AAT).

  12. Classification of 8 DES Supernova with OzDES

    NASA Astrophysics Data System (ADS)

    King, A.; Moller, A.; Sommer, N. E.; Tucker, B. E.; Childress, M. J.; Lewis, G. F.; Lidman, C.; OâNeill, C.; Casas, R.; Castander, F. J.; Desai, S.; Paech, K.; Smith, R. C.; Schubnell, M.; Kessler, R.; Lasker, J.; Scolnic, D.; Brout, D. J.; Gladney, L.; Sako, M.; Wolf, R. C.; Brown, P. J.; Krisciunas, K.; Suntzeff, N.; Nichol, R.; Papadopoulos, A.; D'Andrea, C.; Prajs, S.; Smith, M.; Sullivan, M.; Maartens, R.; Gupta, R.; Kovacs, E.; Kuhlmann, S.; Spinka, H.; Ahn, E.; Finley, D. A.; Frieman, J.; Marriner, J.; Wester, W.; Aldering, G.; Kim, A. G.; Thomas, R. C.; Barbary, K.; Bloom, J. S.; Goldstein, D.; Nugent, P.; Perlmutter, S.; Foley, R. J.; Pan, Y.-C.

    2016-09-01

    We report new spectroscopic classifications by OzDES of supernovae discovered by the Dark Energy Survey (ATEL #4668). The spectra (370-885nm) were obtained with the AAOmega Spectrograph (Saunders et al. 2004, SPIE, 5492, 389) and the 2dF fibre positioner at the Anglo-Australian Telescope (AAT).

  13. Classification of 13 DES supernova with OzDES

    NASA Astrophysics Data System (ADS)

    Sommer, N.; Tucker, B. E.; Moller, A.; Zhang, B.; Macualay, E.; Lidman, C.; Gshwend, J.; Martini, P.; Foley, R. J.; Pan, Y.-C.; Casas, R.; Castander, F. J.; Desai, S.; Paech, K.; Smith, R. C.; Schubnell, M.; Kessler, R.; Lasker, J.; Scolnic, D.; Brout, D. J.; Gladney, L.; Sako, M.; Wolf, R. C.; Brown, P. J.; Krisciunas, K.; Suntzeff, N.; Nichol, R.; Papadopoulos, A.; Childress, M.; D'Andrea, C.; Prajs, S.; Smith, M.; Sullivan, M.; Maartens, R.; Gupta, R.; Kovacs, E.; Kuhlmann, S.; Spinka, H.; Ahn, E.; Finley, D. A.; Frieman, J.; Marriner, J.; Wester, W.; Aldering, G.; Kim, A. G.; Thomas, R. C.; Barbary, K.; Bloom, J. S.; Goldstein, D.; Nugent, P.; Perlmutter, S.

    2016-09-01

    We report new spectroscopic classifications by OzDES of supernovae discovered by the Dark Energy Survey (ATEL #4668). The spectra (370-885nm) were obtained with the AAOmega Spectrograph (Saunders et al. 2004, SPIE, 5492, 389) and the 2dF fibre positioner at the Anglo-Australian Telescope (AAT).

  14. Classification of 3 DES Supernovae with OzDES

    NASA Astrophysics Data System (ADS)

    Moller, A.; Tucker, B. E.; Yuan, F.; Lewis, G.; Lidman, C.; Macaulay, E.; Nichol, R.; Papadopoulos, A.; Childress, M.; D'Andrea, C.; Smith, M.; Sullivan, M.; Maartens, R.; Gupta, R.; Kovacs, E.; Kuhlmann, S.; Spinka, H.; Ahn, E.; Finley, D. A.; Frieman, J.; Marriner, J.; Wester, W.; Aldering, G.; Kim, A. G.; Thomas, R. C.; Barbary, K.; Bloom, J. S.; Goldstein, D.; Nugent, P.; Perlmutter, S.; Foley, R. J.; Pan, Y.-C.; Casas, R.; Castander, F. J.; Desai, S.; Paech, K.; Smith, R. C.; Schubnell, M.; Kessler, R.; Lasker, J.; Scolnic, D.; Brout, D. J.; Gladney, L.; Sako, M.; Wolf, R. C.; Brown, P. J.; Krisciunas, K.; Suntzeff, N.

    2016-02-01

    We report new spectroscopic classifications by OzDES of supernovae discovered by the Dark Energy Survey (ATEL #4668). The spectra (370-885nm) were obtained with the AAOmega Spectrograph (Saunders et al. 2004, SPIE, 5492, 389) and the 2dF fibre positioner at the Anglo-Australian Telescope (AAT).

  15. Classification of 2 DES supernova with OzDES

    NASA Astrophysics Data System (ADS)

    O'Neill, C. R.; Moller, A.; Sommer, N. E.; Tucker, B. E.; Childress, M. J.; Lewis, G. F.; Lidman, C.; Desai, S.; Paech, K.; Smith, R. C.; Schubnell, M.; Kessler, R.; Lasker, J.; Scolnic, D.; Brout, D. J.; D'Andrea, C.; Gladney, L.; March, M.; Sako, M.; Wolf, R. C.; Brown, P. J.; Krisciunas, K.; Suntzeff, N.; Macaulay, E.; Nichol, R.; Prajs, S.; Smith, M.; Sullivan, M.; Maartens, R.; Kovacs, E.; Kuhlmann, S.; Spinka, H.; Ahn, E.; Finley, D. A.; Frieman, J.; Marriner, J.; Wester, W.; Aldering, G.; Kim, A. G.; Thomas, R. C.; Barbary, K.; Bloom, J. S.; Goldstein, D.; Gupta, R.; Nugent, P.; Perlmutter, S.; Foley, R. J.; Pan, Y.-C.; Casas, R.; Castander, F. J.; Papadopoulos, A.; Morganson, E.

    2016-10-01

    We report new spectroscopic classifications by OzDES of supernovae discovered by the Dark Energy Survey (ATEL #4668). The spectra (370-885nm) were obtained with the AAOmega Spectrograph (Saunders et al. 2004, SPIE, 5492, 389) and the 2dF fibre positioner at the Anglo-Australian Telescope (AAT).

  16. Acoustic Analysis of Voice in Dysarthria following Stroke

    ERIC Educational Resources Information Center

    Wang, Yu-Tsai; Kent, Ray D.; Kent, Jane Finley; Duffy, Joseph R.; Thomas, Jack E.

    2009-01-01

    Although perceptual studies indicate the likelihood of voice disorders in persons with stroke, there have been few objective instrumental studies of voice dysfunction in dysarthria following stroke. This study reports automatic analysis of sustained vowel phonation for 61 speakers with stroke. The results show: (1) men with stroke and healthy…

  17. Highly efficient 6-stroke engine cycle with water injection

    SciTech Connect

    Szybist, James P; Conklin, James C

    2012-10-23

    A six-stroke engine cycle having improved efficiency. Heat is recovered from the engine combustion gases by using a 6-stroke engine cycle in which combustion gases are partially vented proximate the bottom-dead-center position of the fourth stroke cycle, and water is injected proximate the top-dead-center position of the fourth stroke cycle.

  18. Stroke

    MedlinePlus

    ... Weakness or paralysis on one side of the body Problems with speech and language Poor balance or clumsy movement Ignoring or being unaware of one side of the body Trouble swallowing Problems with bladder or bowel control ...

  19. Stroke

    MedlinePlus

    ... fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines ... Council on Peripheral Vascular Disease; Council on Clinical Cardiology. Guidelines for the early management of patients with ...

  20. Stroke

    MedlinePlus Videos and Cool Tools

    ... body and lodges within an artery in the brain. When an internal arterial wall becomes damaged, various ... internal carotid artery, breaks loose, travels towards the brain and lodges in a cerebral artery. The blocked ...

  1. Stroke

    MedlinePlus

    ... a clot within a blood vessel of the brain or neck, called thrombosis the movement of a clot from ... body, such as from the heart to the neck or brain, called an embolism a severe narrowing of an ...

  2. Prevention of stroke: a strategic global imperative.

    PubMed

    Feigin, Valery L; Norrving, Bo; George, Mary G; Foltz, Jennifer L; Roth, Gregory A; Mensah, George A

    2016-09-01

    The increasing global stroke burden strongly suggests that currently implemented primary stroke prevention strategies are not sufficiently effective, and new primary prevention strategies with larger effect sizes are needed. Here, we review the latest stroke epidemiology literature, with an emphasis on the recently published Global Burden of Disease 2013 Study estimates; highlight the problems with current primary stroke and cardiovascular disease (CVD) prevention strategies; and outline new developments in primary stroke and CVD prevention. We also suggest key priorities for the future, including comprehensive prevention strategies that target people at all levels of CVD risk; implementation of an integrated approach to promote healthy behaviours and reduce health disparities; capitalizing on information technology to advance prevention approaches and techniques; and incorporation of culturally appropriate education about healthy lifestyles into standard education curricula early in life. Given the already immense and fast-increasing burden of stroke and other major noncommunicable diseases (NCDs), which threatens worldwide sustainability, governments of all countries should develop and implement an emergency action plan addressing the primary prevention of NCDs, possibly including taxation strategies to tackle unhealthy behaviours that increase the risk of stroke and other NCDs. PMID:27448185

  3. Prevention of stroke: a strategic global imperative.

    PubMed

    Feigin, Valery L; Norrving, Bo; George, Mary G; Foltz, Jennifer L; Roth, Gregory A; Mensah, George A

    2016-09-01

    The increasing global stroke burden strongly suggests that currently implemented primary stroke prevention strategies are not sufficiently effective, and new primary prevention strategies with larger effect sizes are needed. Here, we review the latest stroke epidemiology literature, with an emphasis on the recently published Global Burden of Disease 2013 Study estimates; highlight the problems with current primary stroke and cardiovascular disease (CVD) prevention strategies; and outline new developments in primary stroke and CVD prevention. We also suggest key priorities for the future, including comprehensive prevention strategies that target people at all levels of CVD risk; implementation of an integrated approach to promote healthy behaviours and reduce health disparities; capitalizing on information technology to advance prevention approaches and techniques; and incorporation of culturally appropriate education about healthy lifestyles into standard education curricula early in life. Given the already immense and fast-increasing burden of stroke and other major noncommunicable diseases (NCDs), which threatens worldwide sustainability, governments of all countries should develop and implement an emergency action plan addressing the primary prevention of NCDs, possibly including taxation strategies to tackle unhealthy behaviours that increase the risk of stroke and other NCDs.

  4. White matter injury in ischemic stroke.

    PubMed

    Wang, Yuan; Liu, Gang; Hong, Dandan; Chen, Fenghua; Ji, Xunming; Cao, Guodong

    2016-06-01

    Stroke is one of the major causes of disability and mortality worldwide. It is well known that ischemic stroke can cause gray matter injury. However, stroke also elicits profound white matter injury, a risk factor for higher stroke incidence and poor neurological outcomes. The majority of damage caused by stroke is located in subcortical regions and, remarkably, white matter occupies nearly half of the average infarct volume. Indeed, white matter is exquisitely vulnerable to ischemia and is often injured more severely than gray matter. Clinical symptoms related to white matter injury include cognitive dysfunction, emotional disorders, sensorimotor impairments, as well as urinary incontinence and pain, all of which are closely associated with destruction and remodeling of white matter connectivity. White matter injury can be noninvasively detected by MRI, which provides a three-dimensional assessment of its morphology, metabolism, and function. There is an urgent need for novel white matter therapies, as currently available strategies are limited to preclinical animal studies. Optimal protection against ischemic stroke will need to encompass the fortification of both gray and white matter. In this review, we discuss white matter injury after ischemic stroke, focusing on clinical features and tools, such as imaging, manifestation, and potential treatments. We also briefly discuss the pathophysiology of WMI and future research directions. PMID:27090751

  5. Simulation training for hyperacute stroke unit nurses.

    PubMed

    Roots, Angela; Thomas, Libby; Jaye, Peter; Birns, Jonathan

    National clinical guidelines have emphasized the need to identify acute stroke as a clinical priority for early assessment and treatment of patients on hyperacute stroke units. Nurses working on hyperacute stroke units require stroke specialist training and development of competencies in dealing with neurological emergencies and working in multidisciplinary teams. Educational theory suggests that experiential learning with colleagues in real-life settings may provide transferable results to the workplace with improved performance. Simulation training has been shown to deliver situational training without compromising patient safety and has been shown to improve both technical and non-technical skills (McGaghie et al, 2010). This article describes the role that simulation training may play for nurses working on hyperacute stroke units explaining the modalities available and the educational potential. The article also outlines the development of a pilot course involving directly relevant clinical scenarios for hyperacute stroke unit patient care and assesses the benefits of simulation training for hyperacute stroke unit nurses, in terms of clinical performance and non-clinical abilities including leadership and communication.

  6. White matter injury in ischemic stroke.

    PubMed

    Wang, Yuan; Liu, Gang; Hong, Dandan; Chen, Fenghua; Ji, Xunming; Cao, Guodong

    2016-06-01

    Stroke is one of the major causes of disability and mortality worldwide. It is well known that ischemic stroke can cause gray matter injury. However, stroke also elicits profound white matter injury, a risk factor for higher stroke incidence and poor neurological outcomes. The majority of damage caused by stroke is located in subcortical regions and, remarkably, white matter occupies nearly half of the average infarct volume. Indeed, white matter is exquisitely vulnerable to ischemia and is often injured more severely than gray matter. Clinical symptoms related to white matter injury include cognitive dysfunction, emotional disorders, sensorimotor impairments, as well as urinary incontinence and pain, all of which are closely associated with destruction and remodeling of white matter connectivity. White matter injury can be noninvasively detected by MRI, which provides a three-dimensional assessment of its morphology, metabolism, and function. There is an urgent need for novel white matter therapies, as currently available strategies are limited to preclinical animal studies. Optimal protection against ischemic stroke will need to encompass the fortification of both gray and white matter. In this review, we discuss white matter injury after ischemic stroke, focusing on clinical features and tools, such as imaging, manifestation, and potential treatments. We also briefly discuss the pathophysiology of WMI and future research directions.

  7. Nut consumption and risk of stroke.

    PubMed

    Zhang, Zhizhong; Xu, Gelin; Wei, Yongyue; Zhu, Wusheng; Liu, Xinfeng

    2015-03-01

    Nut consumption has been inconsistently associated with risk of stroke. Our aim was to carry out a meta-analysis of prospective studies to assess the relation between nut consumption and stroke risk and mortality. Pertinent studies were identified by a search of PubMed and Embase through June 2014 and by reviewing the references of retrieved articles. Prospective cohort studies that reported relative risks (RRs) with 95% confidence intervals (CIs) for the association between nut consumption and risk of stroke were included. Six articles including nine independent prospective cohorts with 476,181 participants were included in the meta-analysis. The pooled RR of stroke was 0.90 (95% CI 0.83-0.98) comparing the highest with the lowest nut consumption. Stratifying by gender, significant inverse association was observed for females (RR 0.88; 95% CI 0.78-0.98). Sensitivity analysis restricted to studies with adjustment for common confounding factors showed similar results, strengthening the association between nut consumption and stroke risk. Moreover, we observed a trend toward an inverse association between higher nut consumption and stroke mortality (RR 0.86; 95% CI 0.69-1.06), although it is not significant. Current evidence indicated that nut consumption is inversely associated with risk of stroke.

  8. Stroke in young women: An interpretative phenomenological analysis.

    PubMed

    Leahy, Dorothy M; Desmond, Deirdre; Coughlan, Tara; O'Neill, Des; Collins, D Rónán

    2016-05-01

    Stroke among adults of working age is increasing. We aimed to explore the experience of stroke among young women in Ireland. In total, 12 women (aged between 18 and 50 years) participated in semi-structured interviews. Data were analysed using interpretative phenomenological analysis. Four super-ordinate themes were identified: stroke as an illness of later life ('obviously it's for older people'), post-stroke selves, a desire for peer support and the impact of stroke on relationships. Findings indicate the importance of addressing the specific needs of younger stroke patients from admission to recovery through provision of inclusive all-age acute stroke services with tailored rehabilitation.

  9. Fast Food and Neighborhood Stroke Risk

    PubMed Central

    Morgenstern, Lewis B.; Escobar, James D.; Sánchez, Brisa N.; Hughes, Rebecca; Zuniga, Belinda G.; Garcia, Nelda; Lisabeth, Lynda D.

    2009-01-01

    Objective To investigate the association between the number of fast food restaurants and ischemic stroke in neighborhoods. Methods This work was a pre-specified part of the Brain Attack in Corpus Christi (BASIC) project. Ischemic stroke cases were prospectively ascertained in Nueces County, Texas. Home addresses were geocoded and used to establish the census tract for each stroke case. Census tracts were used as proxies for neighborhoods (n=64). Using a standard definition, fast food restaurants were identified from a commercial list. Poisson regression was used to study the association between the number of fast food restaurants in the neighborhood, using a 1-mile buffer around each census tract, and the risk of stroke in the neighborhood. Models were adjusted for demographics and neighborhood socioeconomic status (SES). Results There were 1,247 completed ischemic strokes from January 2000 through June 2003 and 262 fast food restaurants. The median number of fast food restaurants per census tract including buffer was 22 (IQR 12–33). Adjusting for neighborhood demographics and SES, the association of fast food restaurants with stroke was significant (p=0.02). The association suggested that the risk of stroke in a neighborhood increased by 1% for every fast food restaurant (RR 1.01 95% CI: 1.00–1.01). The relative risk of stroke comparing neighborhoods in the 75th to the 25th percentile of the distribution of fast food restaurants was 1.13 (95% CI: 1.02–1.25). Interpretation Controlling for demographic and SES factors, there was a significant association between fast food restaurants and stroke risk in neighborhoods in this community-based study. PMID:19743456

  10. Chinese Herbal Products for Ischemic Stroke.

    PubMed

    Hung, I-Ling; Hung, Yu-Chiang; Wang, Lin-Yi; Hsu, Sheng-Feng; Chen, Hsuan-Ju; Tseng, Ying-Jung; Kuo, Chun-En; Hu, Wen-Long; Li, Tsai-Chung

    2015-01-01

    Traditional Chinese herbal products (CHPs) have been described in ancient medicine systems as treatments for various stroke-associated ailments. This study is aimed to investigate the prescription patterns and combinations of CHPs for ischemic stroke in Taiwan. Prescriptions of CHPs for ischemic stroke were obtained from the National Health Insurance Research Database (NHIRD) of Taiwan. Every prescription with a leading diagnosis of ischemic stroke made during 2000-2010 was analyzed. Descriptive statistics were applied to the pattern of co-prescriptions. Multiple logistic regression models were used to assess demographic and risk factors that are correlated with CHP use. The dataset of inpatient claims data contained information on 15,896 subjects who experienced ischemic stroke from 2000 to 2010. There was an average of 5.82 CHPs in a single prescription for subjects with ischemic stroke. Bu-yang-huan-wu-tang (BYHWT) (40.32%) was by far the most frequently prescribed formula CHP for ischemic stroke, and the most commonly used combination of two-formula-CHP was BYHWT with Shu-jin-huo-xue-tang (SJHXT) (4.40%). Dan Shen (16.50%) was the most commonly used single CHP for ischemic stroke, and the most commonly used combination of two single CHPs was Shi Chang Pua with Yuan Zhi (4.79%). We found that BYHWT and Dan Shen were the most frequently prescribed formula and single CHP for ischemic stroke, respectively. These results provide information about individualized therapy and may contribute to further pharmacologic experiments and clinical trials. PMID:26477801

  11. Elektronische Citizen Cards in Deutschland und Europa

    NASA Astrophysics Data System (ADS)

    Kowalski, Bernd

    Meine sehr geehrten Damen und Herren, der Bedarf an elektronischen Identitäten entsteht durch die wachsende Mobilität der Gesellschaft bei einem gleichzeitig steigenden Bedarf an Onlinepräsenz. Diese elektronischen Identitäten machen natürlich auch vor den staatlichen Ausweisen nicht halt, wie zum Beispiel dem Reisepass, aber auch dem Personalausweis und weiteren Ausweisdokumenten. Wobei es bei den staatlich herausgegebenen oder kontrollierten Ausweisen immer um zwei verschiedene Dinge geht: Einmal um die hoheitliche Funktion, wie zum Beispiel beim Reisepass. Hier geht es zum Beispiel darum, in einem Europa mit gefallenen Grenzen und bei freiem Reiseverkehr für alle Personen, die in diesem Raum wohnen, insbesondere auch im Schengener Raum, die Möglichkeit zu schaffen, auch künftig noch Personenkontrollen durchzuführen. Auch der Reiseverkehr über die europäischen Grenzen hinaus ist insofern ein Problem, da die Identitätenprüfung an den Grenzkontrollen immer schwieriger wird. Deswegen braucht man an dieser Stelle Möglichkeiten, um eine Personenüberprüfung durchzuführen, um feststellen zu können, dass diese Person auch zum Dokument gehört.

  12. The real stroke burden in the Philippines.

    PubMed

    Navarro, Jose C; Baroque, Alejandro C; Lokin, Johnny K; Venketasubramanian, Narayanaswamy

    2014-07-01

    Stroke is the Philippines' second leading cause of death. It has a prevalence of 0·9%; ischemic stroke comprises 70% while hemorrhagic stroke comprises 30%. Age-adjusted hypertension prevalence is 20·6%, diabetes 6·0%, dyslipidemia 72·0%, smoking 31%, and obesity 4·9%. The neurologist-to-patient ratio is 1:330·000, with 67% of neurologists practicing in urban centers. Health care is largely private and the cost is borne out-of-pocket by patients and their families. Challenges include delivering adequate support to the rural communities and to the underprivileged sectors. PMID:24844610

  13. Transcranial Direct Current Stimulation in Stroke Recovery

    PubMed Central

    Schlaug, Gottfried; Renga, Vijay; Nair, Dinesh

    2009-01-01

    TDCS - Transcranial Direct Current Stimulation - is an emerging technique of non-invasive brain stimulation that has been found useful in examining cortical function in normal subjects and in facilitating treatments of various neurological disorders. A better understanding of adaptive as well as maladaptive post-stroke neuroplasticity and its modulation through non-invasive brain stimulation has opened up experimental treatment options using TDCS for patients recovering from stroke. We will review TDCS’s role as a facilitator of stroke recovery, the different modes of transcranial direct current stimulation, and the potential mechanisms underlying the neural effects of TDCS. PMID:19064743

  14. Determining Polarities Of Distant Lightning Strokes

    NASA Technical Reports Server (NTRS)

    Blakeslee, Richard J.; Brook, Marx

    1990-01-01

    Method for determining polarities of lightning strokes more than 400 km away. Two features of signal from each stroke correlated. New method based on fact each stroke observed thus far for which polarity determined unambiguously, initial polarity of tail same as polarity of initial deflection before initial-deflection signal altered by propagation effects. Receiving station equipped with electric-field-change antenna coupled to charge amplifier having time constant of order of 1 to 10 seconds. Output of amplifier fed to signal-processing circuitry, which determines initial polarity of tail.

  15. [ESUS (embolic stroke of undetermined sources)].

    PubMed

    Kitagawa, Kazuo

    2016-04-01

    Cryptogenic stroke is one-fourth among cerebral infarction, but most of them could be ascribed to embolic stroke. ESUS was proposed for unifying embolic stroke of undetermined sources by Hart et al. in 2014. The etiologies underlying ESUS included minor-risk potential cardioembolic sources, covert paroxysmal atrial fibrillation, cancer-associated coagulopathy and embolism, arteriogenic emboli, and paroxysmal embolism. Extensive evaluation including transesophageal echocardiography and cardiac monitoring for long time could identify the etiology of these patients. Although anti-platelet drug is recommended in ESUS in the current guideline, clinical trials are ongoing to determine the efficacy of non-vitamin K antagonist oral anticoagulant in ESUS patients. PMID:27333746

  16. Erste Erkenntnisse zur Prospektion und Charakterisierung des Aquifers der Aroser Dolomiten, Schweiz

    NASA Astrophysics Data System (ADS)

    Regli, Christian; Kleboth, Peter; Eichenberger, Urs; Schmassmann, Silvia; Nyfeler, Peter; Bolay, Stephan

    2014-03-01

    In urban areas of the Swiss Alps the use of geothermal energy from several hundred meters depth becomes increasingly important. For this mainly open systems have priority. This work presents the first insights in the prospection and characterisation of the so far unexplored, utilizable, and abundant Aquifer of the Arosa Dolomites. Besides the use of established methods and techniques, such as seismic measurements, an exploration drilling, borehole geophysical measurements, and pumping tests, the application of the KARSYS-approach for geological and conceptual hydrogeological 3D-modelling of the aquifer is illustrated. In addition, the development of a viewer for 3D-visualization of drillings is documented. The hydrogeological and metrological approaches allow a lithological facies differentiation of the Arosa Dolomites, and a differentiation of the fractured and karstified areas within the aquifer. The results represent the basis for advanced findings optimizing and risks minimising exploration and drilling planning, and for sustainable utilization planning.

  17. Zum Auf und Ab des Meeresspiegels in Skandinavien: Langer Streit um Eustasie oder Isostasie

    NASA Astrophysics Data System (ADS)

    Seibold, Eugen; Seibold, Ilse

    2012-03-01

    The phenomenon of the rise of the Scandinavian shield during the Holocene and the concomitant fall in level of the Baltic Sea has been investigated for centuries. Already in medieval times, there were reports about the coastlines of the Gulf of Bothnia that are full of relevant observations. During the eighteenth century, scientists such as Celsius and Linnaeus collected observations such as these. The result was that the search for the possible explanations of this rise-and-fall phenomenon intensified. The generally favoured explanation was that there was an active sinking of sea level in the Baltic rather than an active rising of the land surface in Fennoscandia. This was because water was seen as mobile, in contrast to a „terra firma". The relevant discussion was often emotional, and here, we try to illustrate it using material from the Geologenarchiv Freiburg (von Hoff, von Buch and Goethe). No more than a few decades later, it became obvious by the theory of Ice Age that both the sea level and the land could be mobile (eustatic sea level changes—glacial isostasy). Additionally, of course, plate tectonics had some influence: Norway is situated at the western end of the Eurasian plate and is part of a passive continental margin. There are still open research problems, many of which can be addressed using modern methods of satellite-based geophysics and geodesy. Some other aspects as the permanent uplift trend of Scandinavia since the Cambrium or the rhythmic to and fro of magma in the upper mantle during the Pleistocene are mentioned.

  18. Neue Erkenntnisse auf dem Gebiete der Parasitologie und der parasitären Erkrankungen des Menschen

    NASA Astrophysics Data System (ADS)

    Piekarski, G.

    1980-01-01

    The increasing interest in the parasites of man in the Federal Republic of Germany is connected with the unbounded keenness of German people to travel. They favor southern regions with warm climates which are usually infested with parasites. Thus the general practitioner is nowadays confronted in his daily routine with “imported” pathogenic organisms and diseases as yet unknown to him or with which he need not have reckoned in the past. Furthermore, new information now exists on the development of well-known parasites of our regions, which can be pathogenic to man. Fortunately, new reliable drugs have come on the market, rendering some parasitic diseases harmless.

  19. Siblings with Ischemic Stroke Study (SWISS): Results of a Genome-wide Scan for Stroke Loci

    PubMed Central

    Meschia, James F.; Nalls, Michael; Matarin, Mar; Brott, Thomas G.; Brown, Robert D.; Hardy, John; Kissela, Brett; Rich, Stephen S.; Singleton, Andrew; Hernandez, Dena; Ferrucci, Luigi; Pearce, Kerra; Keller, Margaret; Worrall, Bradford B.

    2011-01-01

    Background and Purpose Ischemic stroke has a strong familial component to risk. The Siblings with Ischemic Stroke Study (SWISS) is a genome-wide family-based analysis that included use of imputed genotypes. SWISS was conducted to examine associations between SNPs and risk of stroke and stroke subtypes within pairs. Methods SWISS enrolled 312 probands with ischemic stroke across 70 US and Canadian centers. Affected siblings were ascertained by centers and confirmed by central record review; unaffected siblings were ascertained by telephone contact. Ischemic stroke was subtyped using TOAST criteria. Genotyping was performed using an Illumina 610 quad array (probands) and an Illumina linkage V array (affected siblings). SNPs were imputed using 1000 Genomes Project data and MACH software. Family-based association analyses were conducted using the sibling-transmission disequilibrium test. Results For all pairs, the correlation of age at stroke within pairs of affected siblings was r = 0.83 (95%CI, 0.78 to 0.86; P < 2.2×10−16). The correlation did not differ substantially by subtype. The concordance of stroke subtypes among affected pairs was 33.8% (kappa = 0.13; P = 5.06×10−4) and did not differ by age at stroke in the proband. Although no SNP achieved genome-wide significance for risk of ischemic stroke, there was clustering of the most associated SNPs on chromosomes 3p (NOS1) and 6p. Conclusions Stroke subtype and age at stroke in affected sibling pairs exhibit significant clustering. No individual SNP reached genome-wide significance. However, two promising candidate loci were identified, including one that contains NOS1, though these risk loci warrant further examination in larger sample collections. PMID:21940970

  20. Phenotyping Stroke in sub-Saharan Africa: Stroke Investigative Research and Education Network (SIREN) Phenomics Protocol

    PubMed Central

    Akpalu, Albert; Sarfo, Fred Stephen; Ovbiagele, Bruce; Akinyemi, Rufus; Gebregziabher, Mulugeta; Obiako, Reginald; Owolabi, Lukman; Sagoe, Kwamena; Jenkins, Carolyn; Arulogun, Oyedunni; Adamu, Sheila; Appiah, Lambert T.; Adadey, Martin A.; Agyekum, Francis; Quansah, Joseph A.; Mensah, Yaw B.; Adeoye, Abiodun M.; Singh, Arti; Tosin, Aridegbe O.; Ohifemen, Osimhiarherhuo; Sani, Abubakar A.; Tabi-Ajayi, Eric; Phillip, Ibinaiye O.; Isah, Suleiman Y.; Tabari, Nasir A.; Mande, Aliyu; Agunloye, Atinuke M.; Ogbole, Godwin I.; Akinyemi, Joshua O.; Akpa, Onoja M.; Laryea, Ruth; Melikam, Sylvia Ezinne; Adinku, Dorcas; Uvere, Ezinne; Burkett, Nina-Serena; Adekunle, Gregory F.; Kehinde, Salaam I.; Azuh, Paschal C.; Dambatta, Abdu H.; Ishaq, Naser A.; Arnett, Donna; Tiwari, Hemant; Lackland, Dan; Owolabi, Mayowa

    2015-01-01

    Background As the second leading cause of death and the leading cause of adult-onset disability, stroke is a major public health concern particularly pertinent in sub-Saharan Africa (SSA) where nearly 80% of all global stroke mortalities occur, and stroke burden is projected to increase in the coming decades. However, the traditional and emerging risk factors for stroke in SSA have not been well characterized thus limiting efforts at curbing its devastating toll. The Stroke Investigative Research and Education Network (SIREN) project is aimed at comprehensively evaluating the key environmental and genomic risk factors for stroke (and its subtypes) in SSA while simultaneously building capacities in phenomics, biobanking, genomics, biostatistics and bioinformatics for brain research. Methods SIREN is a transnational, multicentre, hospital and community-based study involving 3000 cases and 3000 controls recruited from 8 sites in Ghana and Nigeria. Cases will be hospital-based patients with first stroke within 10 days of onset in whom neurovascular imaging will be performed. Etiological and topographical stroke subtypes will be documented for all cases. Controls will be hospital- and community-based participants, matched for gender, ethnicity and age (± 5 years) to cases. Information will be collected on known and proposed emerging risk factors for stroke. Study Significance SIREN is the largest study of stroke in Africa to date. It is anticipated that it will shed light on the phenotypic characteristics and risk factors of stroke and ultimately provide evidence base for strategic interventions to curtail the burgeoning burden of stroke on the sub-continent. PMID:26304844

  1. L'astronomie des Anciens

    NASA Astrophysics Data System (ADS)

    Nazé, Yaël

    2009-04-01

    Quelle que soit la civilisation à laquelle il appartient, l'être humain cherche dans le ciel des réponses aux questions qu'il se pose sur son origine, son avenir et sa finalité. Le premier mérite de ce livre est de nous rappeler que l'astronomie a commencé ainsi à travers les mythes célestes imaginés par les Anciens pour expliquer l'ordre du monde et la place qu'ils y occupaient. Mais les savoirs astronomiques passés étaient loin d'être négligeables et certainement pas limités aux seuls travaux des Grecs : c'est ce que l'auteur montre à travers une passionnante enquête, de Stonehenge à Gizeh en passant par Pékin et Mexico, fondée sur l'étude des monuments anciens et des sources écrites encore accessibles. Les tablettes mésopotamiennes, les annales chinoises, les chroniques médiévales, etc. sont en outre d'une singulière utilité pour les astronomes modernes : comment sinon remonter aux variations de la durée du jour au cours des siècles, ou percer la nature de l'explosion qui a frappé tant d'observateurs en 1054 ? Ce livre offre un voyage magnifiquement illustré à travers les âges, entre astronomie et archéologie.

  2. Innovation in Stroke Care Quality: NIH Stroke Scale Change and Shewhart Charts.

    PubMed

    Dobbs, Michael R; Krishnamohan, Prashanth; Jicha, Gregory; Cohen, Amy P

    2015-01-01

    Stroke care, admission through discharge, is a process that should lead to symptomatic improvement. Improvement or decline in conditions of patients with acute stroke during hospitalization can be measured by the National Institutes of Health Stroke Scale (NIH Stroke Scale or NIHSS) at both admission and discharge and may indicate the overall quality of acute stroke care for a patient and the stability of care in the system. Shewhart control charts were analyzed for 98 patients with stroke admissions in a random sample at a tertiary care stroke center to determine the feasibility of examining the NIHSS score change to detect statistical control or identify excess variance in outcomes. The study sample showed a mean improvement of 1.33 points from admission to discharge on the NIHSS. Three statistical outliers were found. Excess statistical variation clustered within a specific stroke team's tenure suggested a need for targeted education and examination for process redesign. Using the NIHSS and the Shewhart control charts identified a systematic process flaw that could be targeted to improve stroke outcomes and move the delivery system toward statistical control.

  3. Management of acute stroke: impact of registration studies.

    PubMed

    Adams, Harold P

    2010-09-01

    Stroke is a life-threatening or life-changing disease that is expensive in health care costs and lost productivity. Stroke also is a leading cause of human suffering. While the risk of stroke may be reduced with advances in prevention, recent advances in acute care can limit the consequences of stroke. In particular, the success of reperfusion therapies including intra-arterial interventions and intravenous administration of thrombolytic agents means that some patients with stroke may be cured. Still, the time window for effective treatment of stroke is relatively short. As a result, modern stroke management requires the close collaboration of the public, health care providers, administrators, insurance companies, and the government. Potential strategies to extend modern stroke care to as many patients as possible include 1) educational programs to train community emergency medical service personnel and physicians, 2) development of stroke care plans at community hospitals, 3) an integrated community-comprehensive stroke center program based on consultation, and telemedicine. The goal is to have a highly integrated approach to provide emergency treatment of the stroke that provides key emergency treatment, including intravenous administration of thrombolytic medications, at a community hospital (primary stroke center) with evacuation to a comprehensive stroke center that has resources and expertise that are not available in the primary stroke center. Taiwan is an ideal location for the development of such regional stroke programs.

  4. The Stroke Riskometer™ App: Validation of a data collection tool and stroke risk predictor

    PubMed Central

    Parmar, Priya; Krishnamurthi, Rita; Ikram, M Arfan; Hofman, Albert; Mirza, Saira S; Varakin, Yury; Kravchenko, Michael; Piradov, Michael; Thrift, Amanda G; Norrving, Bo; Wang, Wenzhi; Mandal, Dipes Kumar; Barker-Collo, Suzanne; Sahathevan, Ramesh; Davis, Stephen; Saposnik, Gustavo; Kivipelto, Miia; Sindi, Shireen; Bornstein, Natan M; Giroud, Maurice; Béjot, Yannick; Brainin, Michael; Poulton, Richie; Narayan, K M Venkat; Correia, Manuel; Freire, António; Kokubo, Yoshihiro; Wiebers, David; Mensah, George; BinDhim, Nasser F; Barber, P Alan; Pandian, Jeyaraj Durai; Hankey, Graeme J; Mehndiratta, Man Mohan; Azhagammal, Shobhana; Ibrahim, Norlinah Mohd; Abbott, Max; Rush, Elaine; Hume, Patria; Hussein, Tasleem; Bhattacharjee, Rohit; Purohit, Mitali; Feigin, Valery L

    2015-01-01

    Background The greatest potential to reduce the burden of stroke is by primary prevention of first-ever stroke, which constitutes three quarters of all stroke. In addition to population-wide prevention strategies (the ‘mass’ approach), the ‘high risk’ approach aims to identify individuals at risk of stroke and to modify their risk factors, and risk, accordingly. Current methods of assessing and modifying stroke risk are difficult to access and implement by the general population, amongst whom most future strokes will arise. To help reduce the burden of stroke on individuals and the population a new app, the Stroke Riskometer™, has been developed. We aim to explore the validity of the app for predicting the risk of stroke compared with current best methods. Methods 752 stroke outcomes from a sample of 9501 individuals across three countries (New Zealand, Russia and the Netherlands) were utilized to investigate the performance of a novel stroke risk prediction tool algorithm (Stroke Riskometer™) compared with two established stroke risk score prediction algorithms (Framingham Stroke Risk Score [FSRS] and QStroke). We calculated the receiver operating characteristics (ROC) curves and area under the ROC curve (AUROC) with 95% confidence intervals, Harrels C-statistic and D-statistics for measure of discrimination, R2 statistics to indicate level of variability accounted for by each prediction algorithm, the Hosmer-Lemeshow statistic for calibration, and the sensitivity and specificity of each algorithm. Results The Stroke Riskometer™ performed well against the FSRS five-year AUROC for both males (FSRS = 75·0% (95% CI 72·3%–77·6%), Stroke Riskometer™ = 74·0(95% CI 71·3%–76·7%) and females [FSRS = 70·3% (95% CI 67·9%–72·8%, Stroke Riskometer™ = 71·5% (95% CI 69·0%–73·9%)], and better than QStroke [males – 59·7% (95% CI 57·3%–62·0%) and comparable to females = 71·1% (95% CI 69·0%–73·1%)]. Discriminative

  5. Renaturierung von subalpinen und alpinen Ökosystemen

    NASA Astrophysics Data System (ADS)

    Krautzer, B.; Klug, Brigitte

    Die große Vielfalt an alpinen und subalpinen Ökosystemen auf waldfreien Standorten stellt besonders hohe Anforderungen an Planung und Durchführung von Renaturierungsmaßnahmen. Zunehmende Meereshöhe, starke Hangneigungen und extreme klimatische Verhältnisse im Gebirge bedingen zudem seit jeher natürliche Erosionsprozesse. Die zahllosen menschlichen Aktivitäten der letzten Jahrzehnte, gepaart mit unzureichenden Begrünungsmaßnahmen, erhöhen dieses Risiko noch um ein Vielfaches: Geländekorrekturen im Zuge von Skipistenbauten, Almrevitalisierungen, Forst- und Almwegebauten, Maßnahmen zur Verbesserung der touristischen Infrastruktur oder Wildbach- und Lawinenverbauungen. Nur durch Verwendung von hochwertigem, dem Standort angepasstem Pflanzen-oder Saatgutmaterial in Kombination mit der passenden Begrünungstechnik kann dieser Bedrohung dauerhaft entgegengewirkt werden. Dabei sind folgende limitierende Faktoren besonders zu beachten.

  6. Aspirin resistant patients with recent ischemic stroke.

    PubMed

    Castilla-Guerra, L; Navas-Alcántara, M S; Fernández-Moreno, M C

    2014-04-01

    Some patients with a recent ischemic stroke who are being treated with aspirin as an antiaggregant suffer a new ischemic stroke. These patients (15-25%) have been called unresponsive to aspirin or aspirin resistant. The aspirin-resistant patients have a four-time greater risk of suffering a stroke. Furthermore, these strokes are generally more severe, with increased infarct volume and greater risk of recurrence. There is currently no ideal laboratory test to detect the resistance to the antiaggregant effect of aspirin. The study of resistance to aspirin would only be indicated in selected cases. In these patients, one should first rule out any "pseudo-resistance" to aspirin (lack of compliance, concomitant treatments that interfere with the action of the aspirin). PMID:24211052

  7. Recovery of motor function after stroke.

    PubMed

    Sharma, Nikhil; Cohen, Leonardo G

    2012-04-01

    The human brain possesses a remarkable ability to adapt in response to changing anatomical (e.g., aging) or environmental modifications. This form of neuroplasticity is important at all stages of life but is critical in neurological disorders such as amblyopia and stroke. This review focuses upon our new understanding of possible mechanisms underlying functional deficits evidenced after adult-onset stroke. We review the functional interactions between different brain regions that may contribute to motor disability after stroke and, based on this information, possible interventional approaches to motor stroke disability. New information now points to the involvement of non-primary motor areas and their interaction with the primary motor cortex as areas of interest. The emergence of this new information is likely to impact new efforts to develop more effective neurorehabilitative interventions using transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) that may be relevant to other neurological disorders such as amblyopia.

  8. Guide to Choosing Stroke Rehabilitation Services

    MedlinePlus

    ... complete stroke program (acute rehab, home care, outpatient)? CUSTOMER SERVICE & SATISFACTION YES NO NOTES Does the program collect information from  patients and their families about satisfaction with ...

  9. Retinal fractals and acute lacunar stroke.

    PubMed

    Cheung, Ning; Liew, Gerald; Lindley, Richard I; Liu, Erica Y; Wang, Jie Jin; Hand, Peter; Baker, Michelle; Mitchell, Paul; Wong, Tien Y

    2010-07-01

    This study aimed to determine whether retinal fractal dimension, a quantitative measure of microvascular branching complexity and density, is associated with lacunar stroke. A total of 392 patients presenting with acute ischemic stroke had retinal fractal dimension measured from digital photographs, and lacunar infarct ascertained from brain imaging. After adjusting for age, gender, and vascular risk factors, higher retinal fractal dimension (highest vs lowest quartile and per standard deviation increase) was independently and positively associated with lacunar stroke (odds ratio [OR], 4.27; 95% confidence interval [CI], 1.49-12.17 and OR, 1.85; 95% CI, 1.20-2.84, respectively). Increased retinal microvascular complexity and density is associated with lacunar stroke.

  10. Diabetes - preventing heart attack and stroke

    MedlinePlus

    Diabetes complications - heart; Coronary artery disease - diabetes; CAD - diabetes; Cerebrovascular disease - diabetes ... People with diabetes have a higher chance of having heart attacks and strokes. Smoking and having high blood pressure and high ...

  11. Therapeutic hypothermia for stroke: Where to go?

    PubMed

    Han, Ziping; Liu, Xiangrong; Luo, Yumin; Ji, Xunming

    2015-10-01

    Ischemic stroke is a major cause of death and long-term disability worldwide. Thrombolysis with recombinant tissue plasminogen activator is the only proven and effective treatment for acute ischemic stroke; however, therapeutic hypothermia is increasingly recognized as having a tissue-protective function and positively influencing neurological outcome, especially in cases of ischemia caused by cardiac arrest or hypoxic-ischemic encephalopathy in newborns. Yet, many aspects of hypothermia as a treatment for ischemic stroke remain unknown. Large-scale studies examining the effects of hypothermia on stroke are currently underway. This review discusses the mechanisms underlying the effect of hypothermia, as well as trends in hypothermia induction methods, methods for achieving optimal protection, side effects, and therapeutic strategies combining hypothermia with other neuroprotective treatments. Finally, outstanding issues that must be addressed before hypothermia treatment is implemented at a clinical level are also presented. PMID:26057949

  12. Two-stroke engines; Cleaner and meaner

    SciTech Connect

    Siuru, B.

    1990-06-01

    This article discusses how advanced technologies such as direct fuel injection and stratified charge combustion have turned the two-stroke engine into a clean, gasoline conserving powerhouse. The testing of prototype automotive designs is discussed.

  13. Emerging Treatments for Motor Rehabilitation After Stroke

    PubMed Central

    Krishnan, Chandramouli; Khot, Sandeep P.

    2015-01-01

    Although numerous treatments are available to improve cerebral perfusion after acute stroke and prevent recurrent stroke, few rehabilitation treatments have been conclusively shown to improve neurologic recovery. The majority of stroke survivors with motor impairment do not recover to their functional baseline, and there remains a need for novel neurorehabilitation treatments to minimize long-term disability, maximize quality of life, and optimize psychosocial outcomes. In recent years, several novel therapies have emerged to restore motor function after stroke, and additional investigational treatments have also shown promise. Here, we familiarize the neurohospitalist with emerging treatments for poststroke motor rehabilitation. The rehabilitation treatments covered in this review will include selective serotonin reuptake inhibitor medications, constraint-induced movement therapy, noninvasive brain stimulation, mirror therapy, and motor imagery or mental practice. PMID:25829989

  14. Ischemia-Reperfusion Injury in Stroke

    PubMed Central

    Nour, May; Scalzo, Fabien; Liebeskind, David S.

    2013-01-01

    Despite ongoing advances in stroke imaging and treatment, ischemic and hemorrhagic stroke continue to debilitate patients with devastating outcomes at both the personal and societal levels. While the ultimate goal of therapy in ischemic stroke is geared towards restoration of blood flow, even when mitigation of initial tissue hypoxia is successful, exacerbation of tissue injury may occur in the form of cell death, or alternatively, hemorrhagic transformation of reperfused tissue. Animal models have extensively demonstrated the concept of reperfusion injury at the molecular and cellular levels, yet no study has quantified this effect in stroke patients. These preclinical models have also demonstrated the success of a wide array of neuroprotective strategies at lessening the deleterious effects of reperfusion injury. Serial multimodal imaging may provide a framework for developing therapies for reperfusion injury. PMID:25187778

  15. Intensive risk factor control in stroke prevention

    PubMed Central

    2013-01-01

    Stroke prevention is an urgent priority because of the aging of the population and the steep association of age and risk of stroke. Direct costs of stroke are expected to more than double in the US between 2012 and 2030. By getting everything right, patients can reduce the risk of stroke by 80% or more; however, getting everything right is a tall order. Roughly in order of importance, this requires smoking cessation, maintenance of a healthy weight, a Cretan Mediterranean diet, blood pressure control, lipid-lowering drugs, appropriate use of antiplatelet agents and anticoagulants, and appropriate carotid endarterectomy and stenting. A new approach called “treating arteries instead of targeting risk factors” appears promising but requires validation in randomized trials. PMID:24167723

  16. National stroke audit: a tool for change?

    PubMed Central

    Rudd, A; Lowe, D; Irwin, P; Rutledge, Z; Pearson, M

    2001-01-01

    Objectives—To describe the standards of care for stroke patients in England, Wales and Northern Ireland and to determine the power of national audit, coupled with an active dissemination strategy to effect change. Design—A national audit of organisational structure and retrospective case note audit, repeated within 18 months. Separate postal questionnaires were used to identify the types of change made between the first and second round and to compare the representativeness of the samples. Setting—157 trusts (64% of eligible trusts in England, Wales, and Northern Ireland) participated in both rounds. Participants—5589 consecutive patients admitted with stroke between 1 January 1998 and 31 March 1998 (up to 40 per trust) and 5375 patients admitted between 1 August 1999 and 31 October 1999 (up to 40 per trust). Audit tool—Royal College of Physicians Intercollegiate Working Party stroke audit. Results—The proportion of patients managed on stroke units rose between the two audits from 19% to 26% with the proportion managed on general wards falling from 60% to 55% and those managed on general rehabilitation wards falling from 14% to 11%. Standards of assessment, rehabilitation, and discharge planning improved equally on stroke units and general wards, but in many aspects remained poor (41% formal cognitive assessment, 46% weighed once during admission, 67% physiotherapy assessment within 72 hours, 24% plan documented for mood disturbance, 36% carers' needs assessed separately). Conclusions—Nationally conducted audit linked to a comprehensive dissemination programme was effective in stimulating improvements in the quality of care for patients with stroke. More patients are being managed on stroke units and multidisciplinary care is becoming more widespread. There remain, however, many areas where standards of care are low, indicating a need for investment of skills and resources to achieve acceptable levels. Key Words: stroke; clinical audit PMID:11533421

  17. [Stunned myocardium after acute ischemic stroke].

    PubMed

    Varela, Daniel; Díaz, Fernanda; Hlavnicka, Alejandro; Wainsztein, Néstor; Leiguarda, Ramón

    2006-01-01

    The so-called stunned myocardium, defined as transitory myocardial contractile dysfunction, has been clearly demonstrated in diverse clinical situations. However, stunned myocardium related to ischemic stroke has been poorly identified. We describe two patients with diagnosis of acute ischemic stroke who developed eletrocardiographic changes, cardiac enzyme increasing levels and myocardial dysfunction secondary to abnormal cardiac wall motion. At the same time the patients developed acute lung injury with rapid resolution, perhaps as a consequence of neurocardiogenic components.

  18. Pneumonia in stroke patients: a retrospective study.

    PubMed

    Ding, R; Logemann, J A

    2000-01-01

    This is a retrospective study of 378 consecutive stroke patients who were referred between June 1994 and June 1997 for videofluorographic study of oropharyngeal swallow. Patients who had radiation therapy, brain tumor, brain surgery, head and/or spinal cord trauma, oral-pharyngeal disease or surgery, or other neurologic diseases in addition to the stroke were excluded from the study. Patients were assigned to two groups: one with pneumonia and one without pneumonia. One hundred one patients were included in the pneumonia group, and 277 patients were included in the nonpneumonia group. Within the pneumonia group, patients were assigned to an acute pneumonia group (pneumonia within 6 months poststroke) and a chronic pneumonia group (pneumonia more than 6 months poststroke). Variables examined in the study included patients' medical history and the findings from the videofluorographic studies. Pearson chi-square analysis was used to identify those variables that were significantly different between the pneumonia and nonpneumonia patient groups and between the acute and chronic pneumonia groups. Results showed that stroke patients who developed pneumonia had a significantly higher incidence of multiple-location and unspecified lesion strokes, chronic airway disease in their medical history, and aspiration during the videofluorographic studies when compared with patients who did not develop pneumonia. Within the pneumonia group, the acute pneumonia group was found to have a significantly higher incidence of hypertension and diabetes in their medical history and a significantly higher incidence of aspiration and reduced laryngeal elevation during the videofluorographic studies. Between 48% and 55% of all stroke patients in the study aspirated. Patients who suffered multiple strokes, brainstem stroke, or subcortical stroke had the greatest frequency of aspiration.

  19. Strahlen-und kinetische Waffen: Neue Waffentechniken und Rüstungskontrolle

    NASA Astrophysics Data System (ADS)

    Neuneck, Götz

    Laserstrahlen, Mikrowellen oder elektromagnetische Beschleuniger lassen sich nicht nur für zivile, sondern für militärische Zwecke einsetzen. Die Aufgabe einer vorbeugenden Rüstungskontrolle wäre es, diese wie andere künftige Waffentechnologien auf ihren destabilisierenden Charakter hin zu untersuchen und ihre Stationierung zu beschränken oder zu verhindern.

  20. Does Stroke Impair Learning in Children?

    PubMed Central

    Rodrigues, Sonia das Dores; Ciasca, Sylvia Maria; Guimarães, Inês Elcione; da Freiria Elias, Karla Maria Ibraim; Oliveira, Carolina Camargo; de Moura-Ribeiro, Maria Valeriana Leme

    2011-01-01

    Objective. To assess cognitive development and learning in children who have had strokes. Method. Twenty-nine stroke patients and 18 children with no brain lesions and no learning impairments were evaluated. For the cognitive assessment, Piaget's clinical method was used. Writing, arithmetic, and reading abilities were assessed by the school performance test. Results. The mean age at evaluation was 9.6 years. Among the 29 children, 20 had early lesions (mean of 2.4 years old). The stroke was ischemic in 18 subjects; there were 7 cases of recurrence. Six children could not answer the tests. A high index of cognitive delay and low performance in writing, arithmetic, and reading were verified. Comparison with the control group revealed that the children who have had strokes had significantly lower performances. Conclusion. In this sample, strokes impaired cognitive development and learning. It is important that children have access to educational support and cognitive rehabilitation after injury. These approaches may minimise the effects of strokes on learning in children. PMID:21776360

  1. Mechanisms of perinatal arterial ischemic stroke

    PubMed Central

    Fernández-López, David; Natarajan, Niranjana; Ashwal, Stephen; Vexler, Zinaida S

    2014-01-01

    The incidence of perinatal stroke is high, similar to that in the elderly, and produces a significant morbidity and severe long-term neurologic and cognitive deficits, including cerebral palsy, epilepsy, neuropsychological impairments, and behavioral disorders. Emerging clinical data and data from experimental models of cerebral ischemia in neonatal rodents have shown that the pathophysiology of perinatal brain damage is multifactorial. These studies have revealed that, far from just being a smaller version of the adult brain, the neonatal brain is unique with a very particular and age-dependent responsiveness to hypoxia–ischemia and focal arterial stroke. In this review, we discuss fundamental clinical aspects of perinatal stroke as well as some of the most recent and relevant findings regarding the susceptibility of specific brain cell populations to injury, the dynamics and the mechanisms of neuronal cell death in injured neonates, the responses of neonatal blood–brain barrier to stroke in relation to systemic and local inflammation, and the long-term effects of stroke on angiogenesis and neurogenesis. Finally, we address translational strategies currently being considered for neonatal stroke as well as treatments that might effectively enhance repair later after injury. PMID:24667913

  2. Evaluation of stroke performance in tennis.

    PubMed

    Vergauwen, L; Spaepen, A J; Lefevre, J; Hespel, P

    1998-08-01

    In the present studies, the Leuven Tennis Performance Test (LTPT), a newly developed test procedure to measure stroke performance in match-like conditions in elite tennis players, was evaluated as to its value for research purposes. The LTPT is enacted on a regular tennis court. It consists of first and second services, and of returning balls projected by a machine to target zones indicated by a lighted sign. Neutral, defensive, and offensive tactical situations are elicited by appropriately programming the machine. Stroke quality is determined from simultaneous measurements of error rate, ball velocity, and precision of ball placement. A velocity/precision (VP) an a velocity/precision/error (VPE) index are also calculated. The validity and sensitivity of the LTPT were determined by verifying whether LTPT scores reflect minor differences in tennis ranking on the one hand and the effects of fatigue on the other hand. Compared with lower ranked players, higher ones made fewer errors (P < 0.05). In addition, stroke velocity was higher (P < 0.05), and lateral stroke precision, VP, and VPE scores were better (P < 0.05) in the latter. Furthermore, fatigue induced by a prolonged tennis load increased (P < 0.05) error rate and decreased (P < 0.05) stroke velocity and the VP and VPE indices. It is concluded that the LTPT is an accurate, reliable, and valid instrument for the evaluation of stroke quality in high-level tennis players. PMID:9710870

  3. Impaired Hyperemic Response to Exercise Post Stroke

    PubMed Central

    Durand, Matthew J.; Murphy, Spencer A.; Schaefer, Kathleen K.; Hunter, Sandra K.; Schmit, Brian D.; Gutterman, David D.; Hyngstrom, Allison S.

    2015-01-01

    Individuals with chronic stroke have reduced perfusion of the paretic lower limb at rest; however, the hyperemic response to graded muscle contractions in this patient population has not been examined. This study quantified blood flow to the paretic and non-paretic lower limbs of subjects with chronic stroke after submaximal contractions of the knee extensor muscles and correlated those measures with limb function and activity. Ten subjects with chronic stroke and ten controls had blood flow through the superficial femoral artery quantified with ultrasonography before and immediately after 10 second contractions of the knee extensor muscles at 20, 40, 60, and 80% of the maximal voluntary contraction (MVC) of the test limb. Blood flow to the paretic and non-paretic limb of stroke subjects was significantly reduced at all load levels compared to control subjects even after normalization to lean muscle mass. Of variables measured, increased blood flow after an 80% MVC was the single best predictor of paretic limb strength, the symmetry of strength between the paretic and non-paretic limbs, coordination of the paretic limb, and physical activity. The impaired hemodynamic response to high intensity contractions was a better predictor of lower limb function than resting perfusion measures. Stroke-dependent weakness and atrophy of the paretic limb do not explain the reduced hyperemic response to muscle contraction alone as the response is similarly reduced in the non-paretic limb when compared to controls. These data may suggest a role for perfusion therapies to optimize rehabilitation post stroke. PMID:26630380

  4. Cognitive impairment and stroke in elderly patients.

    PubMed

    Lo Coco, Daniele; Lopez, Gianluca; Corrao, Salvatore

    2016-01-01

    We reviewed current knowledge about the interaction between stroke and vascular risk factors and the development of cognitive impairment and dementia. Stroke is increasingly recognized as an important cause of cognitive problems and has been implicated in the development of both Alzheimer's disease and vascular dementia. The prevalence of cognitive impairment after stroke is high, and their combined effects significantly increase the cost of care and health resource utilization, with reflections on hospital readmissions and increased mortality rates. There is also substantial evidence that vascular risk factors (such as hypertension, diabetes, obesity, dyslipidemia, and tobacco smoking) are independently associated with an increased risk of cognitive decline and dementia. Thus, a successful management of these factors, as well as optimal acute stroke management, might have a great impact on the development of cognitive impairment. Notwithstanding, the pathological link between cognitive impairment, stroke, and vascular risk factors is complex and still partially unclear so that further studies are needed to better elucidate the boundaries of this relationship. Many specific pharmacological treatments, including anticholinergic drugs and antihypertensive medications, and nonpharmacological approaches, such as diet, cognitive rehabilitation, and physical activity, have been studied for patients with vascular cognitive impairment, but the optimal care is still far away. Meanwhile, according to the most recent knowledge, optimal stroke care should also include cognitive assessment in the short and long term, and great efforts should be oriented toward a multidisciplinary approach, including quality-of-life assessment and support of caregivers. PMID:27069366

  5. Age-specific transcriptional response to stroke.

    PubMed

    Sieber, Matthias W; Guenther, Madlen; Jaenisch, Nadine; Albrecht-Eckardt, Daniela; Kohl, Matthias; Witte, Otto W; Frahm, Christiane

    2014-07-01

    Increased age is a major risk factor for stroke incidence and post-ischemic mortality. To develop age-adjusted therapeutic interventions, a clear understanding of the complexity of age-related post-ischemic mechanisms is essential. Transient occlusion of the middle cerebral artery--a model that closely resembles human stroke--was used to induce cerebral infarction in mice of 4 different ages (2, 9, 15, 24 months). By using Illumina cDNA microarrays and quantitative PCR we detected a distinct age-dependent response to stroke involving 350 differentially expressed genes. Our analyses also identified 327 differentially expressed genes that responded to stroke in an age-independent manner. These genes are involved in different aspects of the inflammatory and immune response, oxidative stress, cell cycle activation and/or DNA repair, apoptosis, cytoskeleton reorganization and/or astrogliosis, synaptic plasticity and/or neurotransmission, and depressive disorders and/or dopamine-, serotonin-, GABA-signaling. In agreement with our earlier work, aged brains displayed an attenuated inflammatory and immune response (Sieber et al., 2011) and a reduced impairment of post-stroke synaptic plasticity. Our data also revealed a distinct age-related susceptibility for post-ischemic depression, the most common neuropsychiatric consequence of stroke, which has a major influence on functional outcome.

  6. Cognitive impairment and stroke in elderly patients.

    PubMed

    Lo Coco, Daniele; Lopez, Gianluca; Corrao, Salvatore

    2016-01-01

    We reviewed current knowledge about the interaction between stroke and vascular risk factors and the development of cognitive impairment and dementia. Stroke is increasingly recognized as an important cause of cognitive problems and has been implicated in the development of both Alzheimer's disease and vascular dementia. The prevalence of cognitive impairment after stroke is high, and their combined effects significantly increase the cost of care and health resource utilization, with reflections on hospital readmissions and increased mortality rates. There is also substantial evidence that vascular risk factors (such as hypertension, diabetes, obesity, dyslipidemia, and tobacco smoking) are independently associated with an increased risk of cognitive decline and dementia. Thus, a successful management of these factors, as well as optimal acute stroke management, might have a great impact on the development of cognitive impairment. Notwithstanding, the pathological link between cognitive impairment, stroke, and vascular risk factors is complex and still partially unclear so that further studies are needed to better elucidate the boundaries of this relationship. Many specific pharmacological treatments, including anticholinergic drugs and antihypertensive medications, and nonpharmacological approaches, such as diet, cognitive rehabilitation, and physical activity, have been studied for patients with vascular cognitive impairment, but the optimal care is still far away. Meanwhile, according to the most recent knowledge, optimal stroke care should also include cognitive assessment in the short and long term, and great efforts should be oriented toward a multidisciplinary approach, including quality-of-life assessment and support of caregivers.

  7. Cognitive impairment and stroke in elderly patients

    PubMed Central

    Lo Coco, Daniele; Lopez, Gianluca; Corrao, Salvatore

    2016-01-01

    We reviewed current knowledge about the interaction between stroke and vascular risk factors and the development of cognitive impairment and dementia. Stroke is increasingly recognized as an important cause of cognitive problems and has been implicated in the development of both Alzheimer’s disease and vascular dementia. The prevalence of cognitive impairment after stroke is high, and their combined effects significantly increase the cost of care and health resource utilization, with reflections on hospital readmissions and increased mortality rates. There is also substantial evidence that vascular risk factors (such as hypertension, diabetes, obesity, dyslipidemia, and tobacco smoking) are independently associated with an increased risk of cognitive decline and dementia. Thus, a successful management of these factors, as well as optimal acute stroke management, might have a great impact on the development of cognitive impairment. Notwithstanding, the pathological link between cognitive impairment, stroke, and vascular risk factors is complex and still partially unclear so that further studies are needed to better elucidate the boundaries of this relationship. Many specific pharmacological treatments, including anticholinergic drugs and antihypertensive medications, and nonpharmacological approaches, such as diet, cognitive rehabilitation, and physical activity, have been studied for patients with vascular cognitive impairment, but the optimal care is still far away. Meanwhile, according to the most recent knowledge, optimal stroke care should also include cognitive assessment in the short and long term, and great efforts should be oriented toward a multidisciplinary approach, including quality-of-life assessment and support of caregivers. PMID:27069366

  8. Early Neurologic Deterioration after Stroke Depends on Vascular Territory and Stroke Etiology

    PubMed Central

    Siegler, James E.; Samai, Alyana; Semmes, Eleanor; Martin-Schild, Sheryl

    2016-01-01

    Background and Purpose Early neurologic deterioration (END) occurs in up to one-third of patients with ischemic stroke and is associated with poor outcomes. The purpose of the present study was to determine which stroke etiologies and vascular distributions pose a greater threat of END in stroke patients. Methods Using a single-center registry of prospectively maintained clinical data, adult ischemic stroke patients admitted (July 2008 to June 2014) within 48 hours of symptom onset were evaluated according to stroke etiology and vascular distribution using diffusion-weighted MRI. Major stroke etiologies were divided into cardioembolic, large vessel, small vessel, other, unknown source, and multiple possible etiologies. END was defined as a worsening of 2 or more points on the National Institutes of Health Stroke Scale during a 24-hour period of hospitalization. Crude and backward stepwise regression models were generated to associate stroke etiology and vascular distribution with END. Results Of the included 961 patients (median age 65 years, 47% female, 72% non-White), 323 (34%) experienced END. Strokes involving the internal carotid artery (ICA) were associated with a threefold higher odds of END in stepwise regression models (OR 3.0, 95% CI 1.4-6.6, P=0.006). Among stroke etiologies, those with unclear mechanisms had the lowest odds of END in the fully adjusted model (OR 0.6, 95% CI 0.4-1.0, P=0.029). Conclusions In our single-center cohort of patients, ICA infarctions were independently associated with END whereas strokes of unknown etiology were least often associated with END. Larger cohorts are necessary to determine which steps, if any, can be taken to prevent END in these vulnerable populations. PMID:27283280

  9. Secondary prevention of stroke--results from the Southern Africa Stroke Prevention Initiative (SASPI) study.

    PubMed Central

    Thorogood, M.; Connor, M. D.; Lewando-Hundt, G.; Tollman, S.; Ngoma, B.

    2004-01-01

    OBJECTIVE: To describe the prevalence of risk factors and experience of preventive interventions in stroke survivors, and identilfy barriers to secondary prevention in rural South Africa. METHODS: A clinician visited individuals in the Agincourt field site (in South Africa's rural north east) who were identified in a census as possible stroke victims to confirm the diagnosis of stroke. We explored the impact of stroke on the individual's family, and health-seeking behaviour following stroke by conducting in-depth interviews in the households of 35 stroke survivors. We held two workshops to understand the knowledge, experience, and views of primary care nurses, who provide the bulk of professional health care. FINDINGS :We identified 103 stroke survivors (37 men), 73 (71%) of whom had hypertension, but only 8 (8%) were taking anti-hypertensive treatment. Smoking was uncommon; 8 men and 1 woman smoked a maximum of ten cigarettes daily. 94 (91%) stroke survivors had sought help, which involved allopathic health care for most of them (81; 79%). 42 had also sought help from traditional healers and churches, while another 13 people had sought help only from those sources. Of the 35 survivors who were interviewed, 29 reported having been prescribed anti-hypertensive pills after their stroke. Barriers to secondary prevention included cost of treatment, reluctance to use pills, difficulties with access to drugs, and lack of equipment to measure blood pressure. A negative attitude to allopathic care was not an important factor. CONCLUSION: In this rural area hypertension is the most important modifiable risk factor in stroke survivors. Effective secondary prevention may reduce the incidence of recurrent strokes, but there is no system to deliver such care. New strategies for care are needed involving both allopathic and non-allopathic-health care providers. PMID:15500283

  10. Assessment of beginners' front-crawl stroke efficiency.

    PubMed

    Madureira, Fabrício; Bastos, Flavio Henrique; Corrêa, Umberto Cesar; Rogel, Thiago; Freudenheim, Andrea Michele

    2012-08-01

    Efficiency in front-crawl stroke has been inferred primarily by means of the analysis of arm actions, specifically, stroke frequency and stroke length. The objective of the present study was to investigate whether swimming efficiency could be better assessed in children still learning the front-crawl stroke by analyzing the movement pattern as a whole. Forty-two children enrolled in private swimming programs volunteered to participate in the study. The task consisted of swimming 30 m as fast as possible. Three experts analyzed the movement pattern of the participants using a checklist. Both stroke frequency and stroke length were calculated. The correlation coefficients between the time taken to swim and both the stroke frequency and stroke length were not significant, but the total and components of the checklist scores were. Results indicate that the swimming efficiency of children learning the front-crawl stroke can be better assessed by analyzing their whole movement pattern. PMID:23033764

  11. Treatment of hyperglycaemia in patients with acute stroke.

    PubMed

    Castilla-Guerra, L; Fernández-Moreno, M C; Hewitt, J

    2016-03-01

    The proportion of diabetic patients who are hospitalised for stroke has been increasing in recent years, currently reaching almost a third of all cases of stroke. In addition, about half of patients with acute stroke present hyperglycaemia in the first hours of the stroke. Although hyperglycaemia in the acute phase of stroke is associated with a poor prognosis, its treatment is currently a topic of debate. There is no evidence that the adminstration of intravenous insulin to these patients offers benefits in terms of the evolution of the stroke. New studies in development, such as the SHINE study (Stroke Hyperglycemia Insulin Network Effort), may contribute to clarifying the role of intensive control of glycaemia during the acute phase of the stroke. Ultimately, patients who have presented with stroke should be screened for diabetes. PMID:26189890

  12. Post-stroke depression therapy: where are we now?

    PubMed

    Nabavi, Seyed Fazel; Turner, Alyna; Dean, Olivia; Sureda, Antoni; Mohammad, Seyed

    2014-01-01

    Post-stroke depression is an important psychological consequence of ischemic stroke, and affects around one third of stroke patients at any time post-stroke. It has a negative impact on patient morbidity and mortality, and as such development of effective post-stroke recognition and treatment strategies are very important. There are several therapeutic strategies for post-stroke depression, including both pharmacological and non-pharmacological approaches. In this review, we present evidence regarding the underlying biology of post-stroke depression, commonalities between post-stroke depression and Major Depressive Disorder and explore several treatment approaches, including antidepressant therapy, psychotherapy, surgical therapy, electroconvulsive therapy, acupuncture, music therapy and natural products. Further experimental and clinical studies are required, particularly in emerging fields such as the role of nutraceuticals in the treatment of stroke.

  13. Acute isolated capsular stroke. A clinical study of 148 cases.

    PubMed

    Arboix, Adrià; Martínez-Rebollar, María; Oliveres, Montserrat; García-Eroles, Luis; Massons, Joan; Targa, Cecilia

    2005-02-01

    The objectives of the study were to assess differential features between capsular stroke of ischemic and hemorrhagic origin, and to compare capsular strokes with all other (non-capsular) strokes. Data of 148 patients with isolated capsular stroke were collected from a prospective hospital-based stroke registry in which 2000 consecutive acute stroke patients were included. Isolated capsular stroke accounted for 8.4% of strokes included in the registry (8.4% of ischemic strokes and 10.5% of intracerebral hemorrhages). Capsular stroke of hemorrhagic origin (n = 24) was more severe than ischemic capsular stroke (n = 124) as determined by a significantly higher in-hospital mortality, length of stay, and lower number of patients free of functional deficit at discharge. After multivariate analysis, limb weakness, sudden onset, and sensory symptoms were independently associated with capsular hemorrhage, whereas pure motor hemiparesis appeared to be associated with capsular infarction. In summary, one of each 12 patients with acute ischemic stroke and one of each 10 patients with acute intracerebral hemorrhage had an isolated capsular stroke. Lacunar syndrome was the most frequent clinical presentation being more common (particularly pure motor hemiparesis) in ischemic than in hemorrhagic capsular stroke. Capsular hemorrhage and capsular infarction showed identical risk factor profiles suggesting the same underlying vascular pathology for both conditions.

  14. Effekt einer ad libitum verzehrten fettreduzierten Kost, reich an Obst, Gemüse und Milchprodukten auf den Blutdruck bei Borderline-Hypertonikern

    NASA Astrophysics Data System (ADS)

    Möseneder, Jutta M.

    2002-01-01

    In der randomisierten, multizentrischen DASH-Studie (Dietary Approaches to Stop Hy-pertension), die unter kontrollierten Bedingungen stattfand, führte eine fettreduzierte Mischkost, reich an Obst, Gemüse und Milchprodukten, bei Borderline-Hypertonikern zu einer signifikanten Blutdrucksenkung. Während der Studienphase wurden Körpermasse, Natrium-Aufnahme sowie Alkoholzufuhr aufgrund der bekannten Einflussnahme auf den Blutdruck konstant gehalten. In der eigenen Pilot-Studie sollte untersucht werden, ob das Ergebnis der DASH-Studie (i) mit deutschen Hypertonikern und (ii) unter habituellen Ernährungs- und Lebensbedingungen mit regelmäßig durchgeführter Ernährungsberatung und ad libitum Verzehr anstelle des streng kontrollierten Studienansatzes bestätigt werden kann. Eine Konstanz der Körpermasse, der Natrium-Urinausscheidung (unter diesem Studienansatz valider als die Aufnahme) und des Alkoholkonsums wurde vorausgesetzt. Die Studienpopulation setzte sich aus 53 übergewichtigen Probanden mit einer nicht medikamentös therapierten Borderline-Hypertonie und ohne Stoffwechselerkrankungen zusammen. Die Studienteilnehmer wurden randomisiert entweder der Idealgruppe mit einer fettarmen Kost reich an Milchprodukten, Obst und Gemüse (ähnlich der DASH-Idealgruppe) oder der Kontrollgruppe mit habitueller Ernährungsweise zugeteilt. Über einen Zeitraum von fünf Wochen wurde den Probanden etwa 50% ihres täglichen Lebensmittelbedarfes entsprechend ihrer Gruppenzugehörigkeit kostenfrei zur Verfügung gestellt. Gelegenheitsblutdruckmessungen und 24h-Blutdruckmessungen, Ernährungs- und Aktivitätsprotokolle, Blut- und Urinproben sowie anthropometrische Messungen wurden vor, während und fünf Wochen nach der Interventionsphase durchgeführt. Die Ergebnisse zeigen, dass in der Idealgruppe keine signifikante Blutdrucksenkung beobachtet werden konnte. Dies lässt sich durch die Tatsache erklären, dass die Lebens-mittel- und Nährstoffaufnahme der deutschen

  15. Effekt einer ad libitum verzehrten fettreduzierten Kost, reich an Obst, Gemüse und Milchprodukten auf den Blutdruck bei Borderline-Hypertonikern

    NASA Astrophysics Data System (ADS)

    Möseneder, Jutta M.

    2002-01-01

    In der randomisierten, multizentrischen DASH-Studie (Dietary Approaches to Stop Hy-pertension), die unter kontrollierten Bedingungen stattfand, führte eine fettreduzierte Mischkost, reich an Obst, Gemüse und Milchprodukten, bei Borderline-Hypertonikern zu einer signifikanten Blutdrucksenkung. Während der Studienphase wurden Körpermasse, Natrium-Aufnahme sowie Alkoholzufuhr aufgrund der bekannten Einflussnahme auf den Blutdruck konstant gehalten. In der eigenen Pilot-Studie sollte untersucht werden, ob das Ergebnis der DASH-Studie (i) mit deutschen Hypertonikern und (ii) unter habituellen Ernährungs- und Lebensbedingungen mit regelmäßig durchgeführter Ernährungsberatung und ad libitum Verzehr anstelle des streng kontrollierten Studienansatzes bestätigt werden kann. Eine Konstanz der Körpermasse, der Natrium-Urinausscheidung (unter diesem Studienansatz valider als die Aufnahme) und des Alkoholkonsums wurde vorausgesetzt. Die Studienpopulation setzte sich aus 53 übergewichtigen Probanden mit einer nicht medikamentös therapierten Borderline-Hypertonie und ohne Stoffwechselerkrankungen zusammen. Die Studienteilnehmer wurden randomisiert entweder der Idealgruppe mit einer fettarmen Kost reich an Milchprodukten, Obst und Gemüse (ähnlich der DASH-Idealgruppe) oder der Kontrollgruppe mit habitueller Ernährungsweise zugeteilt. Über einen Zeitraum von fünf Wochen wurde den Probanden etwa 50% ihres täglichen Lebensmittelbedarfes entsprechend ihrer Gruppenzugehörigkeit kostenfrei zur Verfügung gestellt. Gelegenheitsblutdruckmessungen und 24h-Blutdruckmessungen, Ernährungs- und Aktivitätsprotokolle, Blut- und Urinproben sowie anthropometrische Messungen wurden vor, während und fünf Wochen nach der Interventionsphase durchgeführt. Die Ergebnisse zeigen, dass in der Idealgruppe keine signifikante Blutdrucksenkung beobachtet werden konnte. Dies lässt sich durch die Tatsache erklären, dass die Lebens-mittel- und Nährstoffaufnahme der deutschen

  16. Ischemic Strokes: Observations from a Hospital Based Stroke Registry in Bangladesh

    PubMed Central

    Saifuddin, Mohammad; Islam, Md. Rashedul; Habib, Rumana; Rahman, Aminur; Haque, Md. Amirul; Hassan, Zahid; Wasay, Mohammad

    2016-01-01

    Background. Stroke is an important morbidity for low and middle income countries like Bangladesh. We established the first stroke registry in Bangladesh. Methods. Data was collected from stroke patients who were admitted in Department of Neurology of BIRDEM with first ever stroke, aged between 30 and 90 years. Patients with intracerebral hemorrhage, subarachnoid and subdural hemorrhage, and posttrauma features were excluded. Results. Data was gathered from 679 stroke patients. Mean age was 60.6 years. Almost 68% of patients were male. Small vessel strokes were the most common accounting for 45.4% of all the patients followed by large vessel getting affected in 32.5% of the cases. Only 16 (2.4%) died during treatment, and 436 (64.2%) patients had their mRS score of 3 to 5. Age greater than 70 years was associated with poor outcome on discharge [OR 1.79 (95% CI: 1.05 to 3.06)] adjusting for gender, duration of hospital stay, HDL, and pneumonia. Age, mRS, systolic blood pressure, urinary tract infection, pneumonia, and stroke severity explained the Barthel score. Conclusion. Mortality was low but most of patient had moderate to severe disability at discharge. Age, mRS, systolic blood pressure, urinary tract infection, pneumonia, and stroke severity influenced the Barthel score. PMID:27688924

  17. Ischemic Strokes: Observations from a Hospital Based Stroke Registry in Bangladesh.

    PubMed

    Bhowmik, Nirmalendu Bikash; Abbas, Aamir; Saifuddin, Mohammad; Islam, Md Rashedul; Habib, Rumana; Rahman, Aminur; Haque, Md Amirul; Hassan, Zahid; Wasay, Mohammad

    2016-01-01

    Background. Stroke is an important morbidity for low and middle income countries like Bangladesh. We established the first stroke registry in Bangladesh. Methods. Data was collected from stroke patients who were admitted in Department of Neurology of BIRDEM with first ever stroke, aged between 30 and 90 years. Patients with intracerebral hemorrhage, subarachnoid and subdural hemorrhage, and posttrauma features were excluded. Results. Data was gathered from 679 stroke patients. Mean age was 60.6 years. Almost 68% of patients were male. Small vessel strokes were the most common accounting for 45.4% of all the patients followed by large vessel getting affected in 32.5% of the cases. Only 16 (2.4%) died during treatment, and 436 (64.2%) patients had their mRS score of 3 to 5. Age greater than 70 years was associated with poor outcome on discharge [OR 1.79 (95% CI: 1.05 to 3.06)] adjusting for gender, duration of hospital stay, HDL, and pneumonia. Age, mRS, systolic blood pressure, urinary tract infection, pneumonia, and stroke severity explained the Barthel score. Conclusion. Mortality was low but most of patient had moderate to severe disability at discharge. Age, mRS, systolic blood pressure, urinary tract infection, pneumonia, and stroke severity influenced the Barthel score. PMID:27688924

  18. Acute Stroke Care at Rural Hospitals in Idaho: Challenges in Expediting Stroke Care

    ERIC Educational Resources Information Center

    Gebhardt, James G.; Norris, Thomas E.

    2006-01-01

    Context: Thrombolytics are currently the most effective treatment for stroke. However, the National Institute for Neurological Disorders and Stroke criteria for initiation of thrombolytic therapy, most notably the 3-hour time limit from symptom onset, have proven challenging for many rural hospitals to achieve. Purpose: To provide a snapshot of…

  19. Ischemic Strokes: Observations from a Hospital Based Stroke Registry in Bangladesh

    PubMed Central

    Saifuddin, Mohammad; Islam, Md. Rashedul; Habib, Rumana; Rahman, Aminur; Haque, Md. Amirul; Hassan, Zahid; Wasay, Mohammad

    2016-01-01

    Background. Stroke is an important morbidity for low and middle income countries like Bangladesh. We established the first stroke registry in Bangladesh. Methods. Data was collected from stroke patients who were admitted in Department of Neurology of BIRDEM with first ever stroke, aged between 30 and 90 years. Patients with intracerebral hemorrhage, subarachnoid and subdural hemorrhage, and posttrauma features were excluded. Results. Data was gathered from 679 stroke patients. Mean age was 60.6 years. Almost 68% of patients were male. Small vessel strokes were the most common accounting for 45.4% of all the patients followed by large vessel getting affected in 32.5% of the cases. Only 16 (2.4%) died during treatment, and 436 (64.2%) patients had their mRS score of 3 to 5. Age greater than 70 years was associated with poor outcome on discharge [OR 1.79 (95% CI: 1.05 to 3.06)] adjusting for gender, duration of hospital stay, HDL, and pneumonia. Age, mRS, systolic blood pressure, urinary tract infection, pneumonia, and stroke severity explained the Barthel score. Conclusion. Mortality was low but most of patient had moderate to severe disability at discharge. Age, mRS, systolic blood pressure, urinary tract infection, pneumonia, and stroke severity influenced the Barthel score.

  20. Perception of Kinematic Characteristics of Tennis Strokes for Anticipating Stroke Type and Direction

    ERIC Educational Resources Information Center

    Shim, Jaeho; Carlton, Les G.; Kwon, Young-Hoo

    2006-01-01

    The purpose of this study was to determine the sources of visual information used by highly skilled tennis players in anticipating their opponent's shots. In Experiment 1, motion analysis of the strokes showed that the relative motion between the racquet and forearm was different between the ground strokes and lobs, but there were no reliable…

  1. Depression Increases Stroke Hospitalization Cost: An Analysis of 17,010 Stroke Patients in 2008 by Race and Gender

    PubMed Central

    Husaini, Baqar; Levine, Robert; Sharp, Linda; Cain, Van; Novotny, Meggan; Hull, Pamela; Orum, Gail; Sampson, Uchechukwu; Moonis, Majaz

    2013-01-01

    Objective. This analysis focuses on the effect of depression on the cost of hospitalization of stroke patients. Methods. Data on 17,010 stroke patients (primary diagnosis) were extracted from 2008 Tennessee Hospital Discharge Data System. Three groups of patients were compared: (1) stroke only (SO, n = 7,850), (2) stroke + depression (S+D, n = 3,965), and (3) stroke + other mental health diagnoses (S+M, n = 5,195). Results. Of all adult patients, 4.3% were diagnosed with stroke. Stroke was more prevalent among blacks than whites (4.5% versus 4.2%, P < 0.001) and among males than females (5.1% versus 3.7%, P < 0.001). Nearly one-quarter of stroke patients (23.3%) were diagnosed with depression/anxiety. Hospital stroke cost was higher among depressed stroke patients (S+D) compared to stroke only (SO) patients ($77,864 versus $47,790, P < 0.001), and among S+D, cost was higher for black males compared to white depressed males ($97,196 versus $88,115, P < 0.001). Similar racial trends in cost emerged among S+D females. Conclusion. Depression in stroke patients is associated with increased hospitalization costs. Higher stroke cost among blacks may reflect the impact of comorbidities and the delay in care of serious health conditions. Attention to early detection of depression in stroke patients might reduce inpatient healthcare costs. PMID:23555070

  2. Sex differences in predictors of ischemic stroke: current perspectives

    PubMed Central

    Samai, Alyana A; Martin-Schild, Sheryl

    2015-01-01

    Globally, stroke is a significant public health concern affecting more than 33 million individuals. Of growing importance are the differences between males and females in the predictors and overall risk of stroke. Given that women have a higher lifetime risk for stoke and account for more than half of all stroke deaths, sex-specific stroke risk factors merit investigation and may help target public health interventions. This review aims to discuss the current body of knowledge regarding sex-specific predictors of ischemic stroke including both modifiable and non-modifiable risk factors, as well as specific pathologies known to increase stroke risk. PMID:26251609

  3. Clinical Neuroprotective Drugs for Treatment and Prevention of Stroke

    PubMed Central

    Kikuchi, Kiyoshi; Uchikado, Hisaaki; Morioka, Motohiro; Murai, Yoshinaka; Tanaka, Eiichiro

    2012-01-01

    Stroke is an enormous public health problem with an imperative need for more effective therapies. In therapies for ischemic stroke, tissue plasminogen activators, antiplatelet agents and anticoagulants are used mainly for their antithrombotic effects. However, free radical scavengers, minocycline and growth factors have shown neuroprotective effects in the treatment of stroke, while antihypertensive drugs, lipid-lowering drugs and hypoglycemic drugs have shown beneficial effects for the prevention of stroke. In the present review, we evaluate the treatment and prevention of stroke in light of clinical studies and discuss new anti-stroke effects other than the main effects of drugs, focusing on optimal pharmacotherapy. PMID:22837724

  4. Personalized approach to primary and secondary prevention of ischemic stroke

    PubMed Central

    2014-01-01

    Primary and secondary prevention of ischemic stroke represents a significant part of stroke management and health care. Although there are official guidelines concerning stroke management, new knowledge are introduced to them with a slight delay. This article provides an overview of current information on primary and secondary prevention of ischemic stroke. It summarizes information especially in the field of cardioembolic stroke, the use of new anticoagulants and the management of carotid stenosis based on the results of recent clinical studies. The optimal approach in stroke management is to follow these recommendations, to know new strategies and to apply an individual personalized approach in our clinical decisions. PMID:24949113

  5. Stroke care using a hub and spoke model with telemedicine.

    PubMed

    Huddleston, Penny; Zimmermann, Mary Beth

    2014-12-01

    Stroke is the fourth leading cause of death in the United States. On average, someone has a stroke every 40 seconds. The gaps for patients diagnosed with a stroke are the availability of physicians who specialize in stroke care and access to evidence-based stroke care. Telemedicine has assisted in bridging this gap to provide effective stroke treatment. The purpose of this article is to describe how the implementation of a hub and spoke model using telemedicine has assisted in increasing patient access to neurology expertise and receiving evidence-based treatment of recombinant tissue plasminogen activator, thereby improving patient outcomes.

  6. Clinical study of 222 patients with pure motor stroke

    PubMed Central

    Arboix, A; Padilla, I; Massons, J; Garcia-Eroles, L; Comes, E; Targa, C

    2001-01-01

    The objective was to assess the frequency of pure motor stroke caused by different stroke subtypes and to compare demographic, clinical, neuroimaging, and outcome data of pure motor stroke with those of patients with other lacunar stroke as well as with those of patients with non-lacunar stroke.
Data from 2000 patients with acute stroke (n=1761) or transient ischaemic attack (n=239) admitted consecutively to the department of neurology of an acute care 350 bed teaching hospital were prospectively collected in the Sagrat Cor Hospital of Barcelona stroke registry over a 10 year period. For the purpose of the study 222 (12.7%) patients with pure motor stroke were selected. The other study groups included 218 (12.3%) patients with other lacunar strokes and 1321 (75%) patients with non-lacunar stroke.
In relation to stroke subtype, lacunar infarcts were found in 189 (85%) patients, whereas ischaemic lacunar syndromes not due to lacunar infarcts occurred in 23 (10.4%) patients (atherothrombotic stroke in 12, cardioembolic stroke in seven, infarction of undetermined origin in three, and infarction of unusual aetiology in one) and haemorrhagic lacunar syndromes in 10 (4.5%). Patients with pure motor stroke showed a better outcome than patients with non-lacunar stroke with a significantly lower number of complications and in hospital mortality rate, shorter duration of hospital stay, and a higher number of symptom free patients at hospital discharge. After multivariate analysis, hypertension, diabetes, obesity, hyperlipidaemia, non-sudden stroke onset, internal capsule involvement, and pons topography seemed to be independent factors of pure motor stroke in patients with acute stroke.
In conclusion, about one of every 10 patients with acute stroke had a pure motor stroke. Pure motor stroke was caused by a lacunar infarct in 85% of patients and by other stroke subtypes in 15%. Several clinical features are more frequent in patients with pure motor stroke than in

  7. Novel Stroke Therapeutics: Unraveling Stroke Pathophysiology and Its Impact on Clinical Treatments

    PubMed Central

    George, Paul M.; Steinberg, Gary K.

    2016-01-01

    Stroke remains a leading cause of death and disability in the world. Over the past few decades our understanding of the pathophysiology of stroke has increased, but greater insight is required to advance the field of stroke recovery. Clinical treatments have improved in the acute time window, but long-term therapeutics remain limited. Complex neural circuits damaged by ischemia make restoration of function after stroke difficult. New therapeutic approaches, including cell transplantation or stimulation, focus on reestablishing these circuits through multiple mechanisms to improve circuit plasticity and remodeling. Other research targets intact networks to compensate for damaged regions. This review highlights several important mechanisms of stroke injury and describes emerging therapies aimed at improving clinical outcomes. PMID:26182415

  8. Cardiovascular risk factors for acute stroke: Risk profiles in the different subtypes of ischemic stroke.

    PubMed

    Arboix, Adrià

    2015-05-16

    Timely diagnosis and control of cardiovascular risk factors is a priority objective for adequate primary and secondary prevention of acute stroke. Hypertension, atrial fibrillation and diabetes mellitus are the most common risk factors for acute cerebrovascular events, although novel risk factors, such as sleep-disordered breathing, inflammatory markers or carotid intima-media thickness have been identified. However, the cardiovascular risk factors profile differs according to the different subtypes of ischemic stroke. Atrial fibrillation and ischemic heart disease are more frequent in patients with cardioembolic infarction, hypertension and diabetes in patients with lacunar stroke, and vascular peripheral disease, hypertension, diabetes, previous transient ischemic attack and chronic obstructive pulmonary disease in patients with atherothrombotic infarction. This review aims to present updated data on risk factors for acute ischemic stroke as well as to describe the usefulness of new and emerging vascular risk factors in stroke patients.

  9. Continual Gram-negative bacterial challenge accelerates stroke onset in stroke-prone spontaneously hypertensive rats.

    PubMed

    Kawato, Takayuki; Tanaka, Hideki; Tabuchi, Masaki; Ooshima, Kana; Nakai, Kumiko; Yamashita, Yoshihisa; Maeno, Masao

    2013-01-01

    This study examined the effects of continual Gram-negative bacterial challenge on stroke onset. Stroke onset occurred significantly earlier in stroke-prone spontaneously hypertensive rats (SHRSP) injected with a bacterial cell suspension of Gram-negative rods or lipopolysaccharides (LPSs) than in uninjected controls. Paralysis of the hindlimb, piloerection, hypokinesis, and hyperkinesis were observed in LPS-injected SHRSP but not in uninjected controls during stroke onset. The serum levels of NOx, thiobarbituric acid reactive substance, and 8-hydroxydeoxyguanosine increased in LPS-injected SHRSP. These results suggest that continual Gram-negative bacterial challenge induces accelerated stroke onset in SHRSP, probably caused by oxidative stress responses derived from LPSs. PMID:22630606

  10. Cardiovascular risk factors for acute stroke: Risk profiles in the different subtypes of ischemic stroke.

    PubMed

    Arboix, Adrià

    2015-05-16

    Timely diagnosis and control of cardiovascular risk factors is a priority objective for adequate primary and secondary prevention of acute stroke. Hypertension, atrial fibrillation and diabetes mellitus are the most common risk factors for acute cerebrovascular events, although novel risk factors, such as sleep-disordered breathing, inflammatory markers or carotid intima-media thickness have been identified. However, the cardiovascular risk factors profile differs according to the different subtypes of ischemic stroke. Atrial fibrillation and ischemic heart disease are more frequent in patients with cardioembolic infarction, hypertension and diabetes in patients with lacunar stroke, and vascular peripheral disease, hypertension, diabetes, previous transient ischemic attack and chronic obstructive pulmonary disease in patients with atherothrombotic infarction. This review aims to present updated data on risk factors for acute ischemic stroke as well as to describe the usefulness of new and emerging vascular risk factors in stroke patients. PMID:25984516

  11. Cardiovascular risk factors for acute stroke: Risk profiles in the different subtypes of ischemic stroke

    PubMed Central

    Arboix, Adrià

    2015-01-01

    Timely diagnosis and control of cardiovascular risk factors is a priority objective for adequate primary and secondary prevention of acute stroke. Hypertension, atrial fibrillation and diabetes mellitus are the most common risk factors for acute cerebrovascular events, although novel risk factors, such as sleep-disordered breathing, inflammatory markers or carotid intima-media thickness have been identified. However, the cardiovascular risk factors profile differs according to the different subtypes of ischemic stroke. Atrial fibrillation and ischemic heart disease are more frequent in patients with cardioembolic infarction, hypertension and diabetes in patients with lacunar stroke, and vascular peripheral disease, hypertension, diabetes, previous transient ischemic attack and chronic obstructive pulmonary disease in patients with atherothrombotic infarction. This review aims to present updated data on risk factors for acute ischemic stroke as well as to describe the usefulness of new and emerging vascular risk factors in stroke patients. PMID:25984516

  12. [Hemorrhagic stroke associated to neurocysticercosis].

    PubMed

    Tellez-Zenteno, J F; Negrete-Pulido, O; Cantú, C; Márquez, C; Vega-Boada, F; García Ramos, G

    2003-06-01

    A well-known complication of neurocysticercosis is cerebral arteritis, which is usually manifested by cerebral ischemia. Only anecdotal cases of hemorrhagic stroke associated to this parasitosis have been described. Previously there are only two reported cases of this association. One of these cases had an intracystic hemorrhage confirmed by autopsy without cerebrovascular risk factors. Autopsy revealed an inflammatory arteriopathy adjacent to the cyst intracystic hemorrhage. The second case had a subarachnoidal hemorrhage secondary to the rupture of an aneurysm in the right anteroinferior cerebellar artery. At surgery, the aneurysm was found to be surrounded by a thickened-leptomeninges, which histologically showed the presence of cysticercous with dense inflammation. Our first patient was a 32 year-old female developed a lenticulo-capsular hemorrhage around a cysticercotic lesion. The second patient was a 34 year-old male developed an intracystic hemorrhage. As cerebral angiography was normal in both patients, cerebral hemorrhages were considered to be related to cysticercotic arteritis of small penetrating vessels. We conclude that cysticercosis is associated with differenttypes of intracranial hemorrhage, as documented the present cases. In neurocysticercosis endemic areas, cysticercotic arteritis should be added to the list of causes of intracranial hemorrhage in young people. PMID:12768515

  13. Darwinische Kulturtheorie - Evolutionistische und "evolutionistische`` Theorien sozialen Wandels

    NASA Astrophysics Data System (ADS)

    Antweiler, Christoph

    Evolutionistische Argumentationen außerhalb der Biologie sind weit verbreitet. Wenn sie vertreten werden, heißt das mitnichten, dass sie notwendigerweise von darwinischen Argumenten geprägt sind. Wenn man Evolution und Kultur aus explizit darwinischer Perspektive zusammen bringt, bedeutet das noch lange nicht unbedingt Soziobiologie. Und es bedeutet sicherlich nicht Sozialdarwinismus. Dieser Beitrag soll einen Überblick der so genannten evolutionären Ansätze bzw. evolutionistischen Ansätze zu menschlichen Gesellschaften bzw. Kulturen geben. Es soll gezeigt werden, was in den Ansätzen analytisch zu trennen ist und was synthetisch zusammen gehört. Mein Beitrag ist nicht wissenschaftsgeschichtlich angelegt, sondern systematisch ausgerichtet und hat zwei Schwerpunkte (Antweiler 2008; Antweiler 2009b). Zum einen geht es um kausale Zusammenhänge von organischer Evolution und gesellschaftlichem Wandel. Auf der anderen Seite werden Analogien zwischen biotischer und kultureller Evolution erläutert, die als spezifische Ähnlichkeiten dieser beiden als grundsätzlich verschieden gesehenen Prozesse aufgefasst werden. Dadurch wird die Frage aufgeworfen, ob die Evolution von Organismen einerseits und die Transformation von Gesellschaften bzw. Kulturen andererseits, spezielle Fälle eines allgemeinen Modells von Evolution darstellen.

  14. Das CARNOTsche Paradigma und seine erkenntnistheoretischen Implikationen

    NASA Astrophysics Data System (ADS)

    Schöpf, Hans-Georg

    Der vorliegende historisch-kritische Essay führt die Eigentümlichkeiten der klassischen phänomenologischen Thermodynamik auf das von CARNOT geschaffene Paradigma zurück und greift einige damit zusammenhängende Fragen auf.Translated AbstractCARNOT's Paradigm and its Epistemological ImplicationsThe present historic-critical essay traces the pecularities of classical phenomenological thermodynamics back to the paradigm, created by CARNOT, and takes up some questions to which this paradigm gives rise.

  15. Heart Failure in Acute Ischemic Stroke

    PubMed Central

    Cuadrado-Godia, Elisa; Ois, Angel; Roquer, Jaume

    2010-01-01

    Heart failure (HF) is a complex clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood. Due to the aging of the population it has become a growing public health problem in recent decades. Diagnosis of HF is clinical and there is no diagnostic test, although some basic complementary testing should be performed in all patients. Depending on the ejection fraction (EF), the syndrome is classified as HF with low EF or HF with normal EF (HFNEF). Although prognosis in HF is poor, HFNEF seems to be more benign. HF and ischemic stroke (IS) share vascular risk factors such as age, hypertension, diabetes mellitus, coronary artery disease and atrial fibrillation. Persons with HF have higher incidence of IS, varying from 1.7% to 10.4% per year across various cohort studies. The stroke rate increases with length of follow-up. Reduced EF, independent of severity, is associated with higher risk of stroke. Left ventricular mass and geometry are also related with stroke incidence, with concentric hypertrophy carrying the greatest risk. In HF with low EF, the stroke mechanism may be embolism, cerebral hypoperfusion or both, whereas in HFNEF the mechanism is more typically associated with chronic endothelial damage of the small vessels. Stroke in patients with HF is more severe and is associated with a higher rate of recurrence, dependency, and short term and long term mortality. Cardiac morbidity and mortality is also high in these patients. Acute stroke treatment in HF includes all the current therapeutic options to more carefully control blood pressure. For secondary prevention, optimal control of all vascular risk factors is essential. Antithrombotic therapy is mandatory, although the choice of a platelet inhibitor or anticoagulant drug depends on the cardiac disease. Trials are ongoing to evaluate anticoagulant therapy for prevention of embolism in patients with low EF who are at

  16. Developing the Stroke Exercise Preference Inventory (SEPI)

    PubMed Central

    Bonner, Nicholas S.; O’Halloran, Paul D.; Bernhardt, Julie; Cumming, Toby B.

    2016-01-01

    Background Physical inactivity is highly prevalent after stroke, increasing the risk of poor health outcomes including recurrent stroke. Tailoring of exercise programs to individual preferences can improve adherence, but no tools exist for this purpose in stroke. Methods We identified potential questionnaire items for establishing exercise preferences via: (i) our preliminary Exercise Preference Questionnaire in stroke, (ii) similar tools used in other conditions, and (iii) expert panel consultations. The resulting 35-item questionnaire (SEPI-35) was administered to stroke survivors, along with measures of disability, depression, anxiety, fatigue and self-reported physical activity. Exploratory factor analysis was used to identify a factor structure in exercise preferences, providing a framework for item reduction. Associations between exercise preferences and personal characteristics were analysed using multivariable regression. Results A group of 134 community-dwelling stroke survivors (mean age 64.0, SD 13.3) participated. Analysis of the SEPI-35 identified 7 exercise preference factors (Supervision-support, Confidence-challenge, Health-wellbeing, Exercise context, Home-alone, Similar others, Music-TV). Item reduction processes yielded a 13-item version (SEPI-13); in analysis of this version, the original factor structure was maintained. Lower scores on Confidence-challenge were significantly associated with disability (p = 0.002), depression (p = 0.001) and fatigue (p = 0.001). Self-reported barriers to exercise were particularly prevalent in those experiencing fatigue and anxiety. Conclusions The SEPI-13 is a brief instrument that allows assessment of exercise preferences and barriers in the stroke population. This new tool can be employed by health professionals to inform the development of individually tailored exercise interventions. PMID:27711242

  17. Approaches to economic evaluations of stroke rehabilitation.

    PubMed

    Craig, Louise E; Wu, Olivia; Bernhardt, Julie; Langhorne, Peter

    2014-01-01

    Many stroke rehabilitation services and interventions are complex in that they involve a number of components, interactions, and outcomes. Much of the onus of stroke care lies with rehabilitation services and because stroke rehabilitation is highly resource intensive, it is important for policy makers to consider the potential trade-offs between all relevant costs and benefits. The primary aim of this systematic review was to assess the methods used to conduct economic evaluations of stroke rehabilitation. Studies that compared two or more alternative stroke rehabilitation interventions or services with the costs and outcomes being examined for each alternative were included. EMBASE, MEDLINE In-Process, and National Health Service's Economic Evaluation Database were searched using search strategies. The methodological quality of the included studies was appraised using a checklist for the conduct and reporting of economic evaluations. Twenty-one studies met the selection criteria. The economic evaluations in the majority of these studies were inadequate based on their ability to identify, measure, and value all resources and benefits pertinent to the complexity of stroke rehabilitation. This study highlights that complex interventions such as stroke rehabilitation have widespread effects, which may not be represented by the changes on a single outcome. This study recommends the adoption of a wider cost and benefit perspective in the economic evaluations of complex interventions. It supports a move away from conventional economic evaluation and decision making, based purely on cost-effectiveness, toward multicriteria decision analysis frameworks for complex interventions, where a broader range of criteria may be assessed by policy makers.

  18. Picturing the Size and Site of Stroke With an Expanded National Institutes of Health Stroke Scale

    PubMed Central

    Agis, Daniel; Goggins, Maria B.; Oishi, Kumiko; Oishi, Kenichi; Davis, Cameron; Wright, Amy; Kim, Eun Hye; Sebastian, Rajani; Tippett, Donna C.; Faria, Andreia

    2016-01-01

    Background and Purpose— The National Institutes of Health Stroke Scale (NIHSS) includes minimal assessment of cognitive function, particularly in right hemisphere (RH) stroke. Descriptions of the Cookie Theft picture from the NIHSS allow analyses that (1) correlate with aphasia severity and (2) identify communication deficits in RH stroke. We hypothesized that analysis of the picture description contributes valuable information about volume and location of acute stroke. Methods— We evaluated 67 patients with acute ischemic stroke (34 left hemisphere [LH]; 33 RH) with the NIHSS, analysis of the Cookie Theft picture, and magnetic resonance imaging, compared with 35 sex- and age-matched controls. We evaluated descriptions for total content units (CU), syllables, ratio of left:right CU, CU/minute, and percent interpretive CU, based on previous studies. Lesion volume and percent damage to regions of interest were measured on diffusion-weighted imaging. Multivariable linear regression identified variables associated with infarct volume, independently of NIHSS score, age and sex. Results— Patients with RH and LH stroke differed from controls, but not from each other, on CU, syllables/CU, and CU/minute. Left:right CU was lower in RH compared with LH stroke. CU, syllables/CU, and NIHSS each correlated with lesion volume in LH and RH stroke. Lesion volume was best accounted by a model that included CU, syllables/CU, NIHSS, left:right CU, percent interpretive CU, and age, in LH and RH stroke. Each discourse variable and NIHSS score were associated with percent damage to different regions of interest, independently of lesion volume and age. Conclusions— Brief picture description analysis complements NIHSS scores in predicting stroke volume and location. PMID:27217502

  19. Persistent post-stroke depression in mice following unilateral medial prefrontal cortical stroke

    PubMed Central

    Vahid-Ansari, F; Lagace, D C; Albert, P R

    2016-01-01

    Post-stroke depression (PSD) is a common outcome following stroke that is associated with poor recovery. To develop a preclinical model of PSD, we targeted a key node of the depression–anxiety circuitry by inducing a unilateral ischemic lesion to the medial prefrontal cortex (mPFC) stroke. Microinjection of male C57/BL6 mice with endothelin-1 (ET-1, 1600 pmol) induced a small (1 mm3) stroke consistently localized within the left mPFC. Compared with sham control mice, the stroke mice displayed a robust behavioral phenotype in four validated tests of anxiety including the elevated plus maze, light–dark, open-field and novelty-suppressed feeding tests. In addition, the stroke mice displayed depression-like behaviors in both the forced swim and tail suspension test. In contrast, there was no effect on locomotor activity or sensorimotor function in the horizontal ladder, or cylinder and home cage activity tests, indicating a silent stroke due to the absence of motor abnormalities. When re-tested at 6 weeks post stroke, the stroke mice retained both anxiety and depression phenotypes. Surprisingly, at 6 weeks post stroke the lesion site was infiltrated by neurons, suggesting that the ET-1-induced neuronal loss in the mPFC was reversible over time, but was insufficient to promote behavioral recovery. In summary, unilateral ischemic lesion of the mPFC results in a pronounced and persistent anxiety and depression phenotype with no evident sensorimotor deficits. This precise lesion of the depression circuitry provides a reproducible model to study adaptive cellular changes and preclinical efficacy of novel interventions to alleviate PSD symptoms. PMID:27483381

  20. Primary and Comprehensive Stroke Centers: History, Value and Certification Criteria

    PubMed Central

    2013-01-01

    In the United States (US) stroke care has undergone a remarkable transformation in the past decades at several levels. At the clinical level, randomized trials have paved the way for many new stroke preventives, and recently, several new mechanical clot retrieval devices for acute stroke treatment have been cleared for use in practice by the US Federal Drug Administration. Furthermore, in the mid 1990s we witnessed regulatory approval of intravenous recombinant tissue plasminogen activator for administration in acute ischemic stroke. In the domain of organization of medical care and delivery of health services, stroke has transitioned from a disease dominated by neurologic consultation services only to one managed by vascular neurologists in geographical stroke units, stroke teams and care pathways, primary stroke center certification according to The Joint Commission, and most recently comprehensive stroke center designation under the aegis of The Joint Commission. Many organizations in the US have been involved to enhance stroke care. To name a few, the American Heart Association/American Stroke Association, Brain Attack Coalition, and National Stroke Association have been on the forefront of this movement. Additionally, governmental initiatives by the US Centers for Disease Control and Prevention and legislative initiatives such as the Paul Coverdell National Acute Stroke Registry program have paved the way to focus on stroke prevention, acute treatment and quality improvement. In this invited review, we discuss a brief history of organized stroke care in the United States, evidence to support the value of primary and comprehensive stroke centers, and the certification criteria and process to become a primary or comprehensive stroke center. PMID:24324943

  1. Stroke and migraine is there a possible comorbidity?

    PubMed

    Spalice, Alberto; Del Balzo, Francesca; Papetti, Laura; Zicari, Anna Maria; Properzi, Enrico; Occasi, Francesca; Nicita, Francesco; Duse, Marzia

    2016-04-26

    The association between migraine and stroke is still a dilemma for neurologists. Migraine is associated with an increased stroke risk and it is considered an independent risk factor for ischaemic stroke in a particular subgroup of patients. The pathogenesis is still unknown even if several studies report some common biochemical mechanisms between these two diseases. A classification of migraine-related stroke that encompasses the full spectrum of the possible relationship between migraine and stroke includes three main entities: coexisting stroke and migraine, stroke with clinical features of migraine, and migraine-induced stroke. The concept of migraine-induced stroke is well represented by migrainous infarction and it is described in the revised classification of the International Headache Society (IHS), representing the strongest demonstration of the relationship between ischaemic stroke and migraine. A very interesting common condition in stroke and migraine is patent foramen ovale (PFO) which could play a pathogenetic role in both disorders. The neuroradiological evidence of subclinical lesions most typical in the white matter and in the posterior artery territories in patients with migraine, opens a new field of research. In conclusion the association between migraine and stroke remains an open question. Solving the above mentioned issues is fundamental to understand the epidemiologic, pathogenetic and clinical aspects of migraine-related stroke.

  2. Stroke rehabilitation in Canada: a work in progress.

    PubMed

    Teasell, Robert; Meyer, Matthew J; Foley, Norine; Salter, Katherine; Willems, Deb

    2009-01-01

    Stroke rehabilitation in Canada continues to function under models and practices that have changed little in the last four decades and struggles to implement new evidence-based or best practices. Ontario, Canada's largest province, has had a coordinated stroke strategy since 2000. The Ontario Stroke System has developed an extensive infrastructure of research syntheses, consensus panel recommendations, practice guidelines, standards of care, and centralized data collection across the continuum of stroke care. This has produced a solid foundation upon which an evidence-based stroke rehabilitation system can be developed. However, failure to invest in stroke rehabilitation or provide incentives to implement change has resulted in the stroke rehabilitation system and critical outcomes remaining largely unchanged. Improvements in time to admission have been countered by rising admission FIM scores such that severe stroke patients often cannot access the stroke rehabilitation system. Many stroke patients are still rehabilitated on general rehabilitation units, therapy intensities remain unacceptably low, and many outpatient programs are being reduced or even closed. Although there are pockets of innovation, the stroke rehabilitation system continues to function more according to traditional ways of practicing. The hope is that with appropriate investments and incentives, Canadians and Ontarians can build upon the existing infrastructure to ensure stroke patients receive optimal rehabilitative care based on best evidence. In the meantime, stroke rehabilitation in Canada remains a work in progress.

  3. Transport quantique dans des nanostructures

    NASA Astrophysics Data System (ADS)

    Naud, C.

    2002-09-01

    structure des oscillations de conductance en fonction du flux du champ magnétique de période h/e dont l'amplitude est beaucoup plus importante que celle mesurée sur un réseau carré de même dimension. Cette différence constitue une signature d'un effet de localisation induit par le champ magnétique sur la topologie mathcal{T}3. Pour des valeurs spécifiques du champ magnétique, du fait des interférences destructives Aharonov-Bohm, la propagation des fonctions d'ondes est limitée à un ensemble fini de cellule du réseau appelé cage. De la dépendance en température des oscillations de période h/e mesurées sur le réseau mathcal{T}3 nous avons tiré une longueur caractéristique qui peut être rattachée au périmètre des cages. Un phénomène inattendu fut l'observation, pour des champs magnétiques plus importants, d'un doublement de fréquence des oscillations. Ces oscillations de période h/2e pouvant avoir une amplitude supérieure aux oscillations de période h/e, une interprétation en terme d'harmonique n'est pas possible. Enfin, l'influence de la largeur électrique des fils constituant le réseau et donc celle du nombre de canaux par brin a été étudiée en réalisant des grilles électrostatique. Les variations de l'amplitude des signaux en h/e et h/2e en fonction de la tension de grille ont été mesurés.

  4. Clinical Outcome of First- vs Second-Generation DES According to DAPT Duration: Results of ARCTIC-Generation.

    PubMed

    Collet, Jean-Philippe; Silvain, Johanne; Kerneis, Mathieu; Cuisset, Thomas; Meneveau, Nicolas; Boueri, Ziad; Barthélémy, Olivier; Rangé, Grégoire; Cayla, Guillaume; Belle, Eric Van; Elhadad, Simon; Carrié, Didier; Caussin, Christophe; Rousseau, Hélène; Aubry, Pierre; Monségu, Jacques; Sabouret, Pierre; O'Connor, Stephen A; Abtan, Jérémie; Saint-Etienne, Christophe; Beygui, Farzin; Vicaut, Eric; Montalescot, Gilles

    2016-04-01

    There is an apparent benefit with extension of dual antiplatelet therapy (DAPT) beyond 1 year after implantation of drug-eluting stents (DES). Assessment by a Double Randomization of a Conventional Antiplatelet Strategy vs a Monitoring-Guided Strategy for Drug-Eluting Stent Implantation, and of Treatment Interruption vs Continuation One Year After Stenting (ARCTIC)-Generation assessed whether there is a difference of outcome between first- vs second-generation DES and if there is an interaction with DAPT duration in the ARCTIC-Interruption study. ARCTIC-Interruption randomly allocated 1259 patients 1 year after stent implantation to a strategy of interruption of DAPT (n = 624), in which aspirin antiplatelet treatment only was maintained, or DAPT continuation (n = 635) for 6 to 18 additional months. The primary endpoint was the composite of death, myocardial infarction, stent thrombosis, stroke, or urgent revascularization. A total of 520 and 722 patients received a first- and a second-generation DES, respectively. After a median follow-up of 17 months (interquartile range, 15-18 months) after randomization, the primary endpoint occurred in 32 (6.2%) and 19 (2.6%) patients with first- and second-generation DES, respectively (hazard ratio: 2.31, 95% confidence interval: 1.31-4.07, P = 0.004). This was observed irrespective of the strategy of interruption or continuation of DAPT and timing of study recruitment. Major bleeding events occurred in 4 (0.8%) and 3 patients (0.4%) with first- and second-generation DES, respectively (hazard ratio: 1.79, 95% confidence interval: 0.40-8.02, P = 0.44). Results did not change after multiple adjustments for potential confounding variables. ARCTIC-Generation showed worse clinical outcome with first- vs second-generation DES, a difference that appeared to persist even with prolonged DAPT. PMID:26880570

  5. Impact de la preparation des anodes crues et des conditions de cuisson sur la fissuration dans des anodes denses

    NASA Astrophysics Data System (ADS)

    Amrani, Salah

    La fabrication de l'aluminium est realisee dans une cellule d'electrolyse, et cette operation utilise des anodes en carbone. L'evaluation de la qualite de ces anodes reste indispensable avant leur utilisation. La presence des fissures dans les anodes provoque une perturbation du procede l'electrolyse et une diminution de sa performance. Ce projet a ete entrepris pour determiner l'impact des differents parametres de procedes de fabrication des anodes sur la fissuration des anodes denses. Ces parametres incluent ceux de la fabrication des anodes crues, des proprietes des matieres premieres et de la cuisson. Une recherche bibliographique a ete effectuee sur tous les aspects de la fissuration des anodes en carbone pour compiler les travaux anterieurs. Une methodologie detaillee a ete mise au point pour faciliter le deroulement des travaux et atteindre les objectifs vises. La majorite de ce document est reservee pour la discussion des resultats obtenus au laboratoire de l'UQAC et au niveau industriel. Concernant les etudes realisees a l'UQAC, une partie des travaux experimentaux est reservee a la recherche des differents mecanismes de fissuration dans les anodes denses utilisees dans l'industrie d'aluminium. L'approche etait d'abord basee sur la caracterisation qualitative du mecanisme de la fissuration en surface et en profondeur. Puis, une caracterisation quantitative a ete realisee pour la determination de la distribution de la largeur de la fissure sur toute sa longueur, ainsi que le pourcentage de sa surface par rapport a la surface totale de l'echantillon. Cette etude a ete realisee par le biais de la technique d'analyse d'image utilisee pour caracteriser la fissuration d'un echantillon d'anode cuite. L'analyse surfacique et en profondeur de cet echantillon a permis de voir clairement la formation des fissures sur une grande partie de la surface analysee. L'autre partie des travaux est basee sur la caracterisation des defauts dans des echantillons d'anodes crues

  6. Newer Oral Anticoagulants: Stroke Prevention and Pitfalls

    PubMed Central

    Patel, Anand; Goddeau Jr, Richard P.; Henninger, Nils

    2016-01-01

    Warfarin is very effective in preventing stroke in patients with atrial fibrillation. However, its use is limited due to fear of hemorrhagic complications, unpredictable anticoagulant effects related to multiple drug interactions and dietary restrictions, a narrow therapeutic window, frequent difficulty maintaining the anticoagulant effect within a narrow therapeutic window, and the need for inconvenient monitoring. Several newer oral anticoagulants have been approved for primary and secondary prevention of stroke in patients with non-valvular atrial fibrillation. These agents have several advantages relative to warfarin therapy. As a group, these direct oral anticoagulants (DOAC), which include the direct thrombin inhibitor, dabigatran, and the factor Xa inhibitors (rivaroxaban, apixaban, and edoxaban), are more effective than dose adjusted warfarin for prevention of all-cause stroke (including both ischemic and hemorrhagic stroke), and have an overall more favorable safety profile. Nevertheless, an increased risk of gastrointestinal bleeding (with the exception of apixaban), increased risk for thrombotic complication with sudden discontinuation, and inability to accurately assess and reverse anticoagulant effect require consideration prior to therapy initiation, and pose a challenge for decision making in acute stroke therapy. PMID:27347226

  7. [Management of blood pressure for stroke prevention].

    PubMed

    Tanahashi, Norio

    2016-04-01

    Hypertension is a major risk factor for both cerebral infarction and intracerebral hemorrhage. The relationship between blood pressure (BP) and stroke risk is strong and continuous. Throughout the usual range of BPs, including the nonhypertensive range, the higher the BP is, the greater the risk of stroke. Regular BP screening and appropriate treatment of patients with hypertension, including life style modification and pharmacotherapy, are recommended. Patients who have hypertension should be treated with antihypertensive drugs to a target BP of < 140/90 mmHg. Successful reduction of BP is more important in reducing stroke risk than the choice of a specific agent, and treatment should be individualized on the basis of other patient characteristics and medication tolerance. In hypertensive patients with stroke, subjects to be treated with antihypertensive drugs and the target level of BP control are determined on the basis of clinical disease type, interval after onset, severity, age, and the use of antithrombotic. drugs. According to the guideline of the Japanese Society of Hypertension (JSH 2014), in the chronic phase of cerebral infarction, cerebral hemorrhage and subarachnoid hemorrhage, target BP should be < 140/ 90 mmHg. In patients with lacunar infarction, those taking antithrombotic drugs, cerebral hemorrhage and subarachnoid hemorrhage, a lower level, < 130/80 mmHg should be targeted if possible. Oral antihypertensive drugs such as Ca channel blockers, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers and diuretics are recommended for patients with stroke. PMID:27333760

  8. Antithrombotic Medication for Cardioembolic Stroke Prevention

    PubMed Central

    Font, M. Àngels; Krupinski, Jerzy; Arboix, Adrià

    2011-01-01

    Embolism of cardiac origin accounts for about 20% of ischemic strokes. Nonvalvular atrial fibrillation is the most frequent cause of cardioembolic stroke. Approximately 1% of population is affected by atrial fibrillation, and its prevalence is growing with ageing in the modern world. Strokes due to cardioembolism are in general severe and prone to early recurrence and have a higher long-term risk of recurrence and mortality. Despite its enormous preventive potential, continuous oral anticoagulation is prescribed for less than half of patients with atrial fibrillation who have risk factors for cardioembolism and no contraindications for anticoagulation. Available evidence does not support routine immediate anticoagulation of acute cardioembolic stroke. Anticoagulation therapy's associated risk of hemorrhage and monitoring requirements have encouraged the investigation of alternative therapies for individuals with atrial fibrillation. New anticoagulants being tested for prevention of stroke are low-molecular-weight heparins (LMWH), unfractionated heparin, factor Xa inhibitors, or direct thrombin inhibitors like dabigatran etexilate and rivaroxaban. The later exhibit stable pharmacokinetics obviating the need for coagulation monitoring or dose titration, and they lack clinically significant food or drug interaction. Moreover, they offer another potential that includes fixed dosing, oral administration, and rapid onset of action. There are several concerns regarding potential harm, including an increased risk for hepatotoxicity, clinically significant bleeding, and acute coronary events. Therefore, additional trials and postmarketing surveillance will be needed. PMID:21822469

  9. Real-time optoacoustic monitoring of stroke

    NASA Astrophysics Data System (ADS)

    Kneipp, Moritz; Turner, Jake; Hambauer, Sebastian; Krieg, Sandro M.; Lehmberg, Jens; Lindauer, Ute; Razansky, Daniel

    2014-03-01

    Characterizing disease progression and identifying possible therapeutic interventions in stroke is greatly aided by the use of longitudinal function imaging studies. In this study, we investigate the applicability of real-time multispectral optoacoustic tomography (MSOT) as a tool for non-invasive monitoring of the progression of stroke in the whole brain. The middle cerebral artery occlusion (MCAO) method was used to induce stroke. Mice were imaged under isoflurane anesthesia preoperatively and at several time points during and after the 60-minute occlusion. The animals were sacrificed after 24 hours and their excised brains frozen at -80°C for sectioning. The cryosection were stained using H&E staining to identify the ischemic lesion. Major vessels are readily identifiable in the whole mouse head in the in vivo optoacoustic scans. During ischemia, a reduction in cerebral blood volume is detectable in the cortex. Post ischemia, spectral unmixing of the optoacoustic signals shows an asymmetry of the deoxygenated hemoglobin in the hemisphere affected by MCAO. This hypoxic area was mainly located around the boundary of the ischemic lesion and was therefore identified as the ischemic penumbra. Non-invasive functional MSOT imaging is able to visualize the hypoxic penumbra in brains affected by stroke. Stopping the spread of the infarct area and revitalizing the penumbra is central in stroke research, this new imaging technique may therefore prove to be a valuable tool in the monitoring and developing new treatments.

  10. Structural mechanism of the dynein power stroke.

    PubMed

    Lin, Jianfeng; Okada, Kyoko; Raytchev, Milen; Smith, Maria C; Nicastro, Daniela

    2014-05-01

    Dyneins are large microtubule motor proteins required for mitosis, intracellular transport and ciliary and flagellar motility. They generate force through a power-stroke mechanism, which is an ATP-consuming cycle of pre- and post-power-stroke conformational changes that cause relative motion between different dynein domains. However, key structural details of dynein's force generation remain elusive. Here, using cryo-electron tomography of intact, active (that is, beating), rapidly frozen sea urchin sperm flagella, we determined the in situ three-dimensional structures of all domains of both pre- and post-power-stroke dynein, including the previously unresolved linker and stalk of pre-power-stroke dynein. Our results reveal that the rotation of the head relative to the linker is the key action in dynein movement, and that there are at least two distinct pre-power-stroke conformations: pre-I (microtubule-detached) and pre-II (microtubule-bound). We provide three-dimensional reconstructions of native dyneins in three conformational states, in situ, allowing us to propose a molecular model of the structural cycle underlying dynein movement.

  11. Vertigo due to posterior circulation stroke.

    PubMed

    Kim, Ji Soo; Lee, Hyung

    2013-07-01

    Stroke in the distribution of the posterior circulation may present as acute onset spontaneous vertigo and imbalance. Although vertigo due to posterior circulation stroke is usually associated with other neurologic symptoms or signs, small infarcts in the cerebellum or brainstem can present with vertigo without other localizing symptoms. Approximately 17% of patients with isolated posterior inferior cerebellar artery territory infarction presented with isolated vertigo, nystagmus, and postural unsteadiness. A head impulse test can differentiate acute isolated vertigo associated with cerebellar stroke from more benign disorders involving the inner ear. Sometimes acute isolated audiovestibular loss can be the initial symptom of impending posterior circulation ischemic stroke (particularly within the territory of the anterior inferior cerebellar artery). In this case, evaluation of isolated audiovestibular loss may prevent the progression of acute vertigo and hearing loss into more widespread areas of infarction in the posterior circulation. In this article, the clinical syndromes and signs of acute vestibular syndrome due to posterior circulation stroke involving the brainstem and cerebellum are summarized.

  12. [Primary and secondary prevention of stroke].

    PubMed

    Trenkwalder, Peter; Rüchardt, Andreas

    2015-10-01

    The basis for primary and secondary prevention of stroke (and also TIA) are both a healthy lifestyle with a healthy diet, non smoking, weight reduction and regular exercise, and consistent treatment of arterial hypertension with a target of < 140 /90 mmHg. The choice of the antihypertensive is depending on concomitant diseases, more important than the class of antihypertensive is treatment to target. Reduction of cholesterol with statins in primary prevention is dependant on total cardiovascular risk, in secondary prevention statins are integral part of modern treatment in non cardioembolic stroke. Atrial fibrillation is one of the major causes of stroke and should be treated with anticoagulation depending on the CHA2DS2-VASc score. Platelet inhibition is mandatory lifelong in all non cardioembolic strokes, in primary prevention only for patients with high total cardiovascular risk. Treatment of asymptomatic carotid artery stenosis should be determined on an individual basis. Symptomatic carotid artery stenosis should be treated immediately after the index stroke. PMID:26488098

  13. Predictors of Return to Driving After Stroke

    PubMed Central

    Aufman, Elyse L.; Bland, Marghuretta D.; Barco, Peggy P.; Carr, David B.; Lang, Catherine E.

    2013-01-01

    Objective While returning to driving is a major concern for many stroke survivors, predicting who will return to driving after a stroke is often difficult for rehabilitation professionals. The primary aim of this study was to identify patient factors present at admission to an inpatient rehabilitation hospital that can be used to identify which patients with acute stroke will and will not return to driving. Design After comparing returners and non-returners on demographic and clinical characteristics, a logistic regression model with return to driving as the outcome variable was built using the backward stepwise method. Results Thirty-one percent (48/156) of patients who had been driving before their stroke had returned to driving six months post-stroke. The final regression model, using FIM cognition and lower extremity Motricity Index scores, predicted the driving outcome with an accuracy of 75% (107/143). Conclusions Patients with lower FIM cognition and lower extremity Motricity Index scores at admission to inpatient rehabilitation are less likely to return to driving at six months. This model could be used by rehabilitation professionals to help counsel patients and their families and focus treatment goals. PMID:23370577

  14. Perspectives on telemedicine to improve stroke treatment.

    PubMed

    Stewart, S F; Switzer, J A

    2011-02-01

    Stroke is the number three cause of death and the most common cause of adult disability in the United States. Few patients receive the only established effective therapy, intravenous tissue plasminogen activator. Failure to treat may occur due to several reasons, a crucial one being the lack of acute neurologic coverage, particularly in rural settings. In this article we review the difficulties encountered by patients needing immediate care to access stroke specialists. To overcome this delay in patient care, telemedicine technology for acute stroke care is recommended. We track the emergence and evolution of "telestroke" from initial telephone consultation, to point-to-point, hub-and-spoke networks, to web-based site-independent telestroke systems. We detail the emerging evidence for the safety and efficacy of these remote telestroke systems through observational studies (TEMPiS and REACH). Lastly, we discuss areas where telestroke could potentially expand to provide more complete stroke care beyond the acute thrombolysis phase, as well as its potential to improve clinical research and the need for cost-effective research. We conclude that telestroke is currently the most practical solution to any setback faced by stroke specialists with respect to low thrombolytic rates.

  15. A Retrospective Cohort Study Comparing Stroke Recurrence Rate in Ischemic Stroke Patients With and Without Acupuncture Treatment.

    PubMed

    Shih, Chun-Chuan; Liao, Chien-Chang; Sun, Mao-Feng; Su, Yi-Chang; Wen, Chi-Pang; Morisky, Donald E; Sung, Fung-Chang; Hsu, Chung Y; Lin, Jaung-Geng

    2015-09-01

    Little was known about the effects of acupuncture on stroke recurrence. The aim of this study is to investigate whether ischemic stroke patients receiving acupuncture treatment have a decreased risk of stroke recurrence. A retrospective cohort study of 30,058 newly diagnosed cases of ischemic stroke in 2000 to 2004 was conducted based on the claims of Taiwan National Health Insurance Research Database. The use of acupuncture treatment and stroke recurrence were identified during the follow-up period from 2000 to 2009. This study compared the risk of stroke recurrence between ischemic stroke cohorts with and without acupuncture treatment by calculating adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of acupuncture associated with stroke recurrence in the Cox proportional hazard model. The stroke recurrence rate per 1000 person-years decreased from 71.4 without to 69.9 with acupuncture treatment (P < 0.001). Acupuncture treatment was associated with reduced risk of stroke recurrence (HR 0.88; 95% CI 0.84-0.91). The acupuncture effect was noted in patients with or without medical treatment for stroke prevention but its impact decreased with aging of stroke patients. Compared with stroke patients without acupuncture treatment and medication therapy, the hazard ratios of stroke recurrence for those had medication therapy only, acupuncture only, and both were 0.42 (95% CI 0.38-0.46), 0.50 (95% CI 0.43-0.57), and 0.39 (95% CI 0.35-0.43), respectively. This study raises the possibility that acupuncture might be effective in lowering stroke recurrence rate even in those on medications for stroke prevention. Results suggest the need of prospective sham-controlled and randomized trials to establish the efficacy of acupuncture in preventing stroke. PMID:26426630

  16. Endoglin Deficiency Impairs Stroke Recovery

    PubMed Central

    Shen, Fanxia; Vincent, Degos; Chu, Pei-Lun; Han, Zhenying; Westbroek, Erick M.; Choi, Eun-Jung; Marchuk, Douglas; Kim, Helen; Lawton, Michael T.; Maze, Mervyn; Young, William L.; Su, Hua

    2014-01-01

    Background and Purpose Endoglin (ENG) deficiency causes hereditary hemorrhagic telangiectasia-1 (HHT1) and impairs myocardial repair. Pulmonary arteriovenous malformations (AVM) in HHT1 patients are associated with a high incidence of paradoxical embolism in the cerebral circulation and ischemic brain injury. We hypothesized that ENG deficiency impairs stroke recovery. Methods Eng heterozygous (Eng+/−) and wild-type (WT) mice underwent permanent distal middle cerebral artery occlusion (pMCAO). Pial collateral vessels were quantified before pMCAO. Infarct/atrophic volume, vascular density and macrophages were quantified in various days after pMCAO; and behavioral function was assessed using corner and adhesive removal tests on days 3, 15, 30 and 60 after pMCAO. The association between ENG 207G>A polymorphism and brain AVM rupture and surgery outcome was analyzed using logistic regression analysis in 256 ruptured and 157 unruptured patients. Results After pMCAO, Eng+/− mice showed larger infarct/atrophic volumes at all time points (P<0.05), and worse behavior performance (p<0.05) at 15, 30 and 60 days compared to WT mice. Eng+/− mice had fewer macrophages on day 3 (P=0.009) and more macrophages on day 60 (P=0.02) in the peri-infarct region. Although Eng+/− and WT mice had similar numbers of pial collateral vessels before pMCAO, Eng+/− mice had lower vascular density in the peri-infarct region (p=0.05) on day 60 after pMCAO. In humans, ENG 207A allele has been associated with worse outcomes after AVM rupture or surgery of unruptured AVM patients. Conclusions ENG deficiency impairs brain injury recovery. Reduced angiogenesis, impaired macrophage homing, and delayed inflammation resolution could be the underlying mechanism. PMID:24876084

  17. Air pollution and stroke - an overview of the evidence base.

    PubMed

    Maheswaran, Ravi

    2016-08-01

    Air pollution is being increasingly recognized as a significant risk factor for stroke. There are numerous sources of air pollution including industry, road transport and domestic use of biomass and solid fuels. Early reports of the association between air pollution and stroke come from studies investigating health effects of severe pollution episodes. Several daily time series and case-crossover studies have reported associations with stroke. There is also evidence linking chronic air pollution exposure with stroke and with reduced survival after stroke. A conceptual framework linking air pollution exposure and stroke is proposed. It links acute and chronic exposure to air pollution with pathways to acute and chronic effects on stroke risk. Current evidence regarding potential mechanisms mainly relate to particulate air pollution. Whilst further evidence would be useful, there is already sufficient evidence to support consideration of reduction in air pollution as a preventative measure to reduce the stroke burden globally.

  18. Questions and Answers about Treating Arterial Stenosis and Preventing Stroke

    MedlinePlus

    ... context of stroke, “stenosis” is usually caused by atherosclerosis, a condition where a blood vessel supplying blood ... high cholesterol. How does stenosis contribute to stroke? Atherosclerosis can activate cells involved in blood clotting. As ...

  19. Air pollution and stroke - an overview of the evidence base.

    PubMed

    Maheswaran, Ravi

    2016-08-01

    Air pollution is being increasingly recognized as a significant risk factor for stroke. There are numerous sources of air pollution including industry, road transport and domestic use of biomass and solid fuels. Early reports of the association between air pollution and stroke come from studies investigating health effects of severe pollution episodes. Several daily time series and case-crossover studies have reported associations with stroke. There is also evidence linking chronic air pollution exposure with stroke and with reduced survival after stroke. A conceptual framework linking air pollution exposure and stroke is proposed. It links acute and chronic exposure to air pollution with pathways to acute and chronic effects on stroke risk. Current evidence regarding potential mechanisms mainly relate to particulate air pollution. Whilst further evidence would be useful, there is already sufficient evidence to support consideration of reduction in air pollution as a preventative measure to reduce the stroke burden globally. PMID:27494962

  20. [Epidemiology of stroke in Japan and comparison with the world].

    PubMed

    Furuta, Yoshihiko; Ninomiya, Toshiharu

    2016-04-01

    Stroke was the leading cause of death in Japan until 1980s. The results from the Hisayama study, which is a population-based study in Japan, showed that incidence and mortality of stroke decreased with time owing to the improved management of hypertension. Although the incidence of hemorrhagic stroke decreased markedly, the proportion of hemorrhagic stroke among the incident cases of stroke in Japan is higher than in European countries. Among the incident cases of ischemic stroke, the proportion of lacunar infarction decreased significantly, whereas the proportion of atherothrombotic and cardioembolic stroke increased. These changes may be caused by elevating prevalence of metabolic disorders-namely, diabetes and hypercholesterolemia. Effective prevention and management of the metabolic disorder are necessary for further prevention of stroke.