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Biomedical subjects

C H Tegeler

Publications and source records attributed to C H Tegeler.

11 recordsLinked to original sources
PubMed1991

The bleeding time effects of a single dose of aspirin in subjects receiving omega-3 fatty acid dietary supplementation.

Dietary supplementation with omega-3 fatty acids reduces platelet aggregation in subjects who usually eat a diet low in these fatty acids. Aspirin also has an antiplatelet effect. The clinical effects of the concomitant administration of these agents were examined in this double-blind controlled crossover trial. Twelve healthy adults were randomized to supplement their diet for 21 days with 8 g of omega-3 fatty acids or identical-looking olive oil capsules. At the end of each treatment period, bleeding times were obtained before and after the administration of one 325-mg aspirin tablet. Overall, percent change in bleeding time after omega-3 fatty acid supplementation was significantly prolonged compared with olive oil supplementation before aspirin administration but not after. Bleeding times were influenced significantly by the order of randomization in the two treatment groups. Changes in post-aspirin bleeding time varied in subjects after they received olive oil. Post-aspirin bleeding times after omega-3 fatty acid supplementation were prolonged compared with baseline values but not significantly prolonged when compared with those after olive oil administration. The authors concluded that the concomitant administration of a single dose of aspirin does not prolong bleeding time in subjects who eat a diet enriched by omega-3 fatty acids versus a diet enriched by olive oil.

Aspirin↗
PubMed1991

Thrombosis and the heart.

The heart is an important site for thrombus formation and cardioembolic events are a frequent cause of stroke. Many cardiac factors may contribute to the risk of cardioembolism. Clinicians must be mindful that those cardiac disorders most likely to cause cardioembolic events include atrial fibrillation, left ventricular dysfunction, valvular heart disease, and structural cardiac abnormalities. The presence of many such conditions mandates the use of specific preventive therapies. Improved diagnostic methods, particularly TEE, now allow more accurate identification and follow-up of potential cardiac sources. Embolus detection monitoring has the potential to allow in vivo identification of embolic events and offers the possibility of objective longitudinal assessment of the impact of therapy. Intravascular ultrasound is an invasive test, but it may eventually allow the most accurate evaluation of the cardiac chambers. New therapies, and new combinations of currently available compounds, may ultimately offer more specific and efficacious alternatives to prevent formation of cardiac thrombus and subsequent cardioembolism. The importance of the heart-brain relationship in stroke has finally been appreciated. Improved understanding of this complex interrelationship will have great impact on clinical practice in the future.

Heart Diseases↗
PubMed1991

Carotid stenosis in lacunar stroke.

The prevalence of extracranial carotid stenosis in patients with a clinical syndrome of lacunar stroke has not been extensively studied using noninvasive methods. We performed carotid duplex sonography on 168 patients referred to the neurosonology laboratory with a diagnosis of ischemic stroke. Strokes were independently classified as lacunar or nonlacunar hemispheric infarction without knowledge of the ultrasound results. We excluded patients with infarcts that were clearly vertebrobasilar, presumed to be cardioembolic, or had occurred greater than 1 year earlier, and patients for whom classification of the nature and location of the event was not possible. Fifty-five patients had lacunar and 54 had nonlacunar stroke. No differences in age, sex, distribution, or prevalence of hypertension, diabetes, prior ischemia, or Hispanic surname existed between the two groups. Tobacco use was more frequent in the nonlacunar group (p less than 0.01). The prevalence of important extracranial carotid stenosis (greater than or equal to 50% diameter reduction) in the lacunar stroke group was 13% (seven of 55) in the ipsilateral and 4% (two of 55) in the contralateral carotid artery. Of the 54 patients with nonlacunar hemispheric stroke, 41% (22) had ipsilateral (p less than 0.01) and 26% (14) had contralateral (p less than 0.01) carotid stenosis. This study suggests that important carotid stenosis is infrequent among patients presenting with a clinical syndrome of lacunar stroke. These data impact on decisions regarding cerebrovascular work-up in such patients.

Adult↗
PubMed1990

Antiphospholipid antibodies and cerebral ischemia in young people.

The importance of a prothrombotic state as a cause of ischemic stroke in young adults is ill defined. We examined 46 unselected patients under age 50 years with cerebral ischemia for anticardiolipin antibody (aCL) and lupus anticoagulants (LA), over a 3-year-period. Age- and sex-matched patients with other neurologic diseases served as a noncerebral ischemia comparison group to test whether (1) stroke/transient ischemic attacks (TIA) in young people is associated with aCL and/or LA, and (2) their presence is specific to cerebral ischemia. In the stroke/TIA group, 21 patients had aCL or LA and 25 had neither, whereas in the control group, 2 patients had aCL and 24 had neither. Equal numbers of stroke/TIA patients with and without antiphospholipid antibodies (aPL) had other stroke risk factors. Patients with aPL and cerebral ischemia, however, had a more frequent history of multiple events than those without them. These antibodies occur with undue frequency in young patients with stroke/TIA and are not associated with a concurrent diagnosis of systemic lupus in most cases. A coexistent aPL-associated prothrombotic state may be a key determinant of whether patients with atherosclerosis, mitral valve prolapse, or other structural lesions experience recurrent ischemia.

Adult↗
PubMed1989

Stroke in the People's Republic of China.

Recent epidemiologic studies confirm that stroke is the most frequent cause of death in the People's Republic of China, with an incidence (219/100,000 people) more than fivefold that of myocardial infarction. Intracerebral hemorrhage causes about one third of all strokes, nearly three times the frequency in North American stroke registries. A marked regional variation in stroke incidence exists, with a threefold higher stroke incidence in northern than in southern Chinese cities, suggesting important environmental or dietary influences. Stroke treatment often involves a combination of modern and traditional herbal medicine; the latter may modify platelet aggregation and blood viscosity. Stroke, particularly intracerebral hemorrhage, is the most frequent and important vascular disorder in the People's Republic of China.

Cerebral Hemorrhage↗
PubMed1987

Vascular headache.

Vascular headache is an extremely common disorder. Current evidence points to an underlying neurogenic etiology, and the associated vascular changes are believed to be epiphenomena. Vascular headache tends to begin at a young age, is more common in women, and is frequently associated with a positive family history. Characteristics of the headache frequently suggest the diagnosis. The history and physical examination are keys to the diagnostic evaluation. A computed tomography scan when indicated is the single test with the highest yield of information. Non-narcotic analgesics, ergot compounds, and metoclopramide are the most commonly used agents for acute attacks. Beta blockers and amitriptyline are the most widely used prophylactic medications. Nonpharmacologic measures are occasionally of great benefit.

Adolescent↗