Cardiovascular accident

P. Z. lungers, A. Massy, T. K. Nguyen, C. Fumeron, M. Labrunie, B. Lacour, B. Descamps-Latscha and N. K. Man, Incidence and Risk factors of Atherosclerotic Cardiovascular Accidents in Predialysis Chronic Renal Failure Patients A Prospective Study, Nephrology Dialysis and Transplantation 12 (1997) 2597- 2602. 

The initial question must be whether the clinical data point to the emergence of complications of this type. The 1990 International Consensus Meeting found an increase in acute cardiovascular accidents during use of oral contraceptives, but not persisting after they had been discontinued. There is also a great deal of anecdotal evidence, although in view of the massive scale on which oral contraceptives have been used over 40 years, coincidence alone would lead to the accumulation of many reports of adverse events. Other evidence suggesting an increase in arterial thrombotic events has been noted incidentally in... 

A stroke (sometimes termed a cardiovascular accident or CVA) is any occurrence that limits or stops the blood supply to a part of the brain. This can happen by either a cerebrovascular occlusion or a cerebral hemorrhage. An occlusion is the more common event. It is caused by the blockade of a cerebral artery by a thrombus that has formed inside of it. 

The characteristic signs and symptoms of alcohol intoxication are well known. Nevertheless, an erroneous diagnosis of drunkenness may occur with patients who appear inebriated but who have not ingested ethanol. Diabetic coma, for example, may be mistaken for severe alcoholic intoxication. Drug intoxication, cardiovascular accidents, and skull fractures also may be confused with alcohol intoxication. The odor of the breath of a person who has consumed ethanol is due not to ethanol vapor but to impurities in alcoholic beverages. Breath odor in a case of suspected intoxication can be misleading because there can be other causes of breath odor similar to that after alcohol consumption. BALs are necessary to confirm the presence or absence of alcohol intoxication. 

Common toxicological effects of amphetamines include hypertension, arrhythmia, excitability, aggressiveness, psychoses, cardiovascular accidents, coma, and death. Additionally, amphetamines can cause hallucinations. It should be noted, however, that not all adverse effects are observed with all compounds in this class of agents, and some adverse effects, e.g., formication, may be limited to certain amphetamines (5, 6). 

A wide variety of specific and nonspecific pulmonary manifestations are observed in RA but ILD, with or without airway involvement, is probably the predominant and most serious manifestation (Table 1) (1,2,135). Pulmonary fibrosis is the second or third most frequent cause of death (3.9-17.5%), after infection or cardiovascular accidents (136-138). 

The objections against the use of phenformin are important. The risk of lactic acidosis, a state which is often not immediately recognized and which is often fatal, combined with the higher frequency of cardiovascular accidents, seems to lead to the conclusion that prescription of phenformin is accompanied with so many risks that the use of this drug should be discouraged. 

Mast cells are present in the normal human heart and even more abundant in diseased hearts [ 16-18,25,47]. Within heart tissue, mast cells he between myocytes and are in close contact with blood vessels. They are also found in the coronary adventitia and in the shoulder regions of coronary atheroma [20, 21], The density of cardiac mast cells is higher in patients with dilated and ischemic cardiomyopathy than in accident victims without cardiovascular diseases [25], Importantly, in some of these conditions there is in situ evidence of mast cell activation [16,34],... 

Carotenoids and cardiovascular diseases — Numerous epidemiological studies aimed to study the relationship of carotenoids and cardiovascular diseases (CVDs) including coronary accident risk and stroke. It appeared then that observational studies, namely prospective and case-control studies, pointed to a protective effect of carotenoids on myocardial infarct and stroke, but also on some atherosclerosis markers such as intima media thickness (IMT) of the common carotid artery (CCA) and atheromatous plaque formation. 

Poor sleep architecture and fragmented sleep secondary to OSA can cause excessive daytime sleepiness (EDS) and neu-rocognitive deficits. These sequelae can affect quality of life and work performance and may be linked to occupational and motor vehicle accidents. OSA is also associated with systemic disease such as hypertension, heart failure, and stroke.21-23 OSA is likely an independent risk factor for the development of hypertension.24 Further, when hypertension is present, it is often resistant to antihypertensive therapy. Fatal and non-fatal cardiovascular events are two- to threefold higher in male patients with severe OSA.25 OSA is associated with or aggravates biomarkers for cardiovascular disease, including C-reactive protein and leptin.26,27 Patients with sleep apnea often are obese and maybe predisposed to weight gain. Hence, obesity may further contribute to cardiovascular disease in this patient population. 

The main causes of death in hypertensive subjects are cerebrovascular accidents, cardiovascular (CV) events, and renal failure. The probability of premature death correlates with the severity of BP elevation. 

Cardiovascular The hyperdynamic circulation caused by hydralazine may accentuate specific cardiovascular inadequacies. It may reduce the pressor responses to epinephrine. Postural hypotension may result from hydralazine. Use with caution in patients with cerebral vascular accidents. 

The main acute effect is inebriation, which in turn spawns violence, spousal and child abuse, crime, motor vehicle accidents, workplace and home accidents, drowning, suicide, and accidental death. The chronic effects include alcoholism, liver disease, various forms of cancer, brain disorders, cardiovascular disease and other organ system effects, absence from or loss of work, family dysfunction, and malnutrition. 

In the overall US population, cardiovascular disease claims one life every 34 s, or more than the next five most frequent causes of death put together (cancer, chronic lower pulmonary disease, accidents, diabetes, and influenza and pneumonia). In 2002 cardiovascular disease accounted for 38% of all morbid events in the United States—1 of every 2.6 deaths (Figs. 1.1 and 1.2) [6]. It is estimated that approximately half a million people die of heart disease either before reaching the hospital or in the emergency department. 

Alcohol abuse and dependence, widely known as alcoholism, is a major cause of morbidity and mortality. Its acute and chronic toxicity spreads across multiple systems and organs, from child abuse to domestic or public violence to traffic accidents and from cirrhosis to hypertension. Mean life expectancy of alcohol abusers is around 55 years. Alcohol seems involved in several hundred thousand deaths each year in Europe, with considerable added social and health care costs. This is in clear contrast with the little attention paid to the treatment of alcohol dependence and abuse. On the other hand, much is made of the French Paradox , the J curve and the demonstrated cardiovascular benefits of regular moderate wine intake. 

There is an increased risk of cardiovascular events, including Ml and cerebrovascular accident, and serious, potentially life-threatening, G1 bleeding. 

Contraindications Convulsive disorders, cardiovascular impairment, head injury or cerebral vascular accident, severe hypertension, mechanical ventilation disorders, hypersensitivity to doxapram. 

The danger of bupropion overdose is limited to the risk of seizures for the most part. However, seizures are seldom life threatening unless they result in motor vehicle accidents, falls, or other trauma-related events. Bupropion s lack of significant cardiovascular or respiratory toxicity means that it is rarely lethal in overdose. 

Alprazolam has no significant anticholinergic or cardiovascular effects, but in almost all studies reporting adverse effects, alprazolam-induced sedation was comparable with or greater than that of the tertiary amine TCA. In one comparison with desipramine, drowsiness led to motor vehicle accidents in 2 of 16 outpatients taking alprazolam and required discontinuation in another 3 (212, 213). 

Anticoagulants are used to prevent cardiovascular and cerebrovascular accidents. Most patients who are on anticoagulants are elderly people with chronic heart and vascular diseases. From a TCM perspective, the blood becomes thicker and tends to coagulate when heat (often generated by stress and emotional disturbance) consumes the blood, or when phlegm accumulates as a result of Spleen deficiency. Kidney deficiency is a potential cause of this as the Kidney-Qi weakens with age and is unable to maintain the proper functioning of the Spleen and Liver. 

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