Alcohol consumption - a risk factor for hemorrhagic and non-hemorrhagic stroke
Article Abstract:
Stroke is a leading cause of death and disability in most developed countries. They occur when blood vessels in the brain either burst (hemorrhage) or become blocked by a blood clot (thromboembolism). A number of studies have attempted to discover a connection between alcohol consumption and the risk of stroke. Results have been highly variable, although some recent studies have implicated alcohol consumption as a risk factor for stroke. Among the methodological problems with these studies is that the different types of strokes were not accounted for. This study examined the relationship of alcohol consumption and stroke in 621 stroke patients, while accounting for type of stroke. The patients were divided into three groups: subarachnoid hemorrhage, occurring just below tissue covering the brain; intracerebral hemorrhage, occurring inside the cerebrum; and cerebral thromboembolic infarction, in which areas of brain tissue lose their blood supply due to a blocked artery. The class of stroke was carefully diagnosed using computed tomography (CT; scanning X-ray), angiography (X-ray of blood vessels), and by pathologic means in those patients who died. Patients were also divided by alcohol consumption as either abstainers, or low, moderate, or heavy drinkers. Of the 621 patients, 193 suffered subarachnoid hemorrhages, 91 had intracerebral hemorrhages, and 337 had cerebral infarctions. In all three types of stroke, a similar pattern was seen between risk of stroke and alcohol consumption. People with low to moderate alcohol intakes were less likely to suffer strokes than abstainers. Heavy drinkers had a higher risk for stroke than the other three groups. These results suggest that heavy drinking increases the risk for strokes, but moderate to light consumption may actually have a protective effect against stroke. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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Hemorrhagic disorder due to an Isoniazid-associated acquired factor XIII inhibitor in a patient with Waldenstrom's macroglobulinemia
Article Abstract:
Waldenstrom's macroglobulinemia is characterized by an excessive number of plasma cells, which produce immunoglobulin M (IgM), a protein formed in most immune responses. This disease is characterized by anemia (a decrease in red blood cells); disease of the lymph nodes; chronic lymphocytic leukemia (proliferation of lymphocytes, a type of immune cell); and increased thickness of the blood. Patients show lassitude, confusion, and have a tendency to bleed. The bleeding may be related to protein abnormalities and defects in factors and processes involved in blood clotting. A case is described of a 75-year-old woman with Waldenstrom's macroglobulinemia, who developed a bleeding disorder due to the presence of an acquired inhibitor of factor XIII, the fibrin stabilizing factor that helps in blood coagulation. The production of the inhibitor resulted after ingestion of the drug isoniazid, used to treat pulmonary tuberculosis. The patient developed a large abdominal hematoma, or mass of blood in the tissue underlying the skin of the abdomen. Coagulation studies revealed a deficiency in factor XIII activity, and further tests indicated the presence of a factor XIII inhibitor. The development of this inhibitor was related to the production of immunoglobulin G (IgG) antibody after the ingestion of isoniazid. The isoniazid was discontinued and treatment to control bleeding and reduce the levels of inhibitor was started. Factor XIII concentrate was administered to restore factor XIII activity. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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Hemorrhagic fever with renal syndrome imported to Hawaii from West Germany
Article Abstract:
The Puumala virus is endemic to Scandinavia, the Soviet Union west of the Ural mountains, and northwestern Europe. It causes a mild form of hemorrhagic fever with renal syndrome (HFRS), a kidney disorder associated with bleeding and elevated body temperatures, which is also referred to as nephropathica epidemica. The virus is commonly transmitted by the bank vole, Clethrionomys glareolus, or other rodent species. HFRS caused by infection with Puumala virus has never been reported in the United States. A case is described of a 24-year-old United States army pilot who developed HFRS in Hawaii after completing two weeks of field training exercises in Bavaria, West Germany. He had symptoms of restlessness, difficulty sleeping, lack of appetite, and constipation. Twenty-eight days after the field training exercises, the patient was admitted to a hospital with fever, chills, sweats, vomiting, blurred vision, and severe abdominal pain. The patient had bleeding at various sites including the eye, face, mouth, ear, and chest; thrombocytopenia, or decreased numbers of platelets, cells involved in blood clotting; enlargement of the kidneys; the presence of protein and blood in the urine, indicating impaired kidney function; and confirmed infection with Puumala virus. After treatment with intravenous fluids and pain-killing drugs, the patient's symptoms resolved and he was discharged eight days after admission. The epidemiology, etiology, and diagnosis of HFRS are discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
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