Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Researchers analyzed data on 47 black, pregnant women of more than 33 weeks gestation who had preeclampsia with diastolic blood pressure of at least 110 mm Hg and 1+ of proteinuria and were in the delivery department of King Edward VIII Hospital in Durban, South Africa to compare antihypertensive effects of dihydralazine infusion with that of epoprostenol sodium infusion. Overall, both treatments reduced the patient's systolic and diastolic blood pressures. No significant differences in the hypertensive effects existed between the 2 groups. Yet the reduction in blood pressures occurred much more quickly in the epoprostenol group than in the dihydralazine group (51.1 minutes vs. 86.8 minutes;p=.0072). Epoprostenol reduced high blood pressure in all 22 patients while dihydralazine did not adequately control blood pressure in 2 of 25 patients. Physicians had to perform a cesarean section in these 2 cases due to considerable deceleration of the fetal heart rate. They had to 1st administer the rapidly acting ganglion blocking agent, trimetaphan, before placing the women under general anesthesia. Their blood pressures returned to normal after delivery. Even though both groups experienced tachycardia after treatment, the pulse rate of dihydralazine patients was significantly higher than that of epoprostenol patients (102.68/minute vs. 88.36/minute; p=.0024). Only 2 women suffered from side effects. The epoprostenol patient experienced nausea and vomiting. The other patient received dihydralazine and experienced a severe headache. The researchers concluded that physicians should use epoprostenol in patients with severe hypertension and tachycardia and those who need acute control of severe hypertension on the operating table before endotracheal intubation (which tends to cause considerable increases in blood pressure) and administration of general anesthesia.
 ...
PMID:A comparative study of the use of epoprostenol and dihydralazine in severe hypertension in pregnancy. 142 10

HELLP-syndrome (H - haemolysis, EL - elevated liver enzymes, LP - low platelet count) is a serious complication of pregnancy. It can be considered as a variant of severe preeclampsia, where haemolysis, hepatic damage (elevated liver enzymes) and thrombocytopenia (low platelets) are all present. Four case reports of HELLP-syndrome are described. HELLP-syndrome may develop within a few hours. It can be seen pre-, intra- and postpartum. Many patients do not exhibit a clinical picture of severe preeclampsia. Patients who develop HELLP-syndrome usually complain of malaise, nausea, epigastric pain and headache. The diagnosis is confirmed when haemolysis, elevated liver enzymes and thrombocytopenia are demonstrated. Patients with HELLP-syndrome require intensive care by a team of obstetricians, anaesthesiologists and haematologists.
 ...
PMID:[HELLP syndrome--4 case reports]. 849 85

Hypertensive encephalopathy is a syndrome consisting of headache, seizures, visual changes, and other neurologic disturbances in patients with elevated systemic blood pressure. The purpose of this study was to analyze the imaging findings in 14 patients with hypertensive encephalopathy. CT (n = 13), MR (n = 12), and single-photon emission computed tomography (n = 2) examinations performed in these patients before and after resolution of symptoms were reviewed. Eight had the preeclampsia-eclampsia syndrome, and six had hypertensive encephalopathy due to other causes. CT and MR findings in all patients having these examinations were indicative of edema in the cortex and subcortical white matter in the occipital lobes. Two of the 14 patients also had similar findings in the cerebellum and frontal lobes. Single-photon emission computed tomography showed increased vascular perfusion adjacent to areas that appeared abnormal on CT and MR. The findings on the imaging studies resolved on follow-up examinations performed after the hypertension was corrected. Our results suggest that the radiologic findings associated with hypertensive encephalopathy may be useful in establishing the diagnosis in the appropriate clinical setting.
 ...
PMID:Hypertensive encephalopathy: findings on CT, MR imaging, and SPECT imaging in 14 cases. 163 61

A 23-year-old woman who had an uneventful prenatal course and normal delivery developed severe, generalized headache and blurred vision on postpartum day four. The patient was noted to have generalized hyperreflexia and sustained ankle clonus. The blood pressure was 170/100 mm Hg, there was no edema, and the urine showed trace proteinuria. The visual disturbance rapidly progressed to complete blindness with preserved pupillary reactions. The patient then had a generalized tonic-clonic seizure lasting about one minute. Treatment was initiated with intravenous diazepam and phenytoin, and there was no recurrence of seizure activity. Vision returned to normal and the patient made a complete recovery. This case is presented to demonstrate progressive postpartum pre-eclampsia and the importance of early recognition and treatment. Pathophysiologic mechanisms and treatment options are discussed.
 ...
PMID:Cortical blindness in postpartum preeclampsia progressing to eclampsia: case report. 173 43

Ten women with severe pre-eclampsia, i.e. a blood pressure greater than or equal to 150/110 mmHg or 140/90 mmHg and proteinuria greater than 3 g/24 h were, after initial antihypertensive treatment, centrally monitored with a pulmonary artery catheter (Swan-Ganz). All had been normotensive in early pregnancy. Mean age was 29 years (range 23-37). Mean gestational age upon admission was 29 weeks (range 23-36) and 7 of the women were nulliparous. Nine of the 10 patients had subjective symptoms, e.g. headache and/or epigastric pain. All were considered in need of intensive care. Two patients were found to have an abnormal coagulation and liver function. All patients had normal serum creatinine values despite proteinuria. Hypertension was treated with dihydralazine and/or labetalol. Volume substitution was carried out with plasma and albumin. The women could be divided into two groups: 5 patients where progress of the disease despite therapy led to delivery within 24 h, and 5 patients whose diastolic blood pressure could be stabilized around 100 mmHg after treatment and pregnancy could be prolonged by 5-13 days. Common for all patients was a hyperkinetic circulation with an increased cardiac output despite a variety of central pressures. Invasive monitoring of central pressures with a Swan-Ganz catheter demonstrated that the clinical status could be stabilized and the pregnancy prolonged in 5 of the 10 women with severe pre-eclampsia. The variety of the central hemodynamic values illustrates clearly that treatment has to be individualized regarding antihypertensive medication, fluids and diuretics.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Hemodynamic measurements with Swan-Ganz catheter in women with severe proteinuric gestational hypertension (pre-eclampsia). 192 95

Neurologic manifestations of pregnancy-induced hypertension (PIH) vary from diffuse symptoms such as headache and confusion to focal signs such as paralysis and visual loss. Recognition of the neurologic symptoms associated with PIH is essential for early diagnosis of severe preeclampsia and eclampsia. The recent advances in neuroradiologic imaging, including the use of computed tomography (CT) scans and magnetic resonance imaging (MRI), have greatly enhanced our understanding of the correlation between neurologic complaints and neuroanatomic pathological changes characteristic of preeclampsia and eclampsia. The aim of this review is to summarize the current knowledge on the pathophysiologic changes in the central nervous system (CNS) caused by PIH. The diagnostic possibilities offered by new imaging techniques are emphasized.
 ...
PMID:Neurologic involvement in hypertensive disease of pregnancy. 194 96

A 32-year-old primigravida showed signs of pre-eclampsia before delivery of a healthy boy at term. The CSF-space was accidentally punctured during epidural anaesthesia in labour. One day later hypertension was noted and the patient had a single generalized fit. For the next three weeks she had postural headaches, fluctuating hypertension, intermittent hearing loss and double-vision. On the 22nd day of postpartum, the patient had the first of a series of partial and later generalized seizures, followed by hemiparesis, alteration of consciousness, and finally slow recovery with corticosteroid therapy. Bilateral subdural effusions and generalized meningeal thickening were found on MR scans. Repeated MRI excluded sinus thrombosis and documented the response to treatment.
 ...
PMID:Neurological cause of late postpartum seizures. 201 11

The antihypertensive efficacy of acute treatment with the serotonin receptor antagonist, ketanserin, in women with preeclampsia has been recently documented. The purpose of this study was to determine the safety and efficacy of chronic ketanserin treatment in a group of 20 hypertensive pregnant women: 10 received daily oral doses of ketanserin (20-80 mg), and 10 were treated with oral alpha-methyldopa (500-2000 mg). This study includes (a) patients with a sustained elevation of systolic blood pressure higher than 159 mm Hg and/or diastolic blood pressure higher than 99 mm Hg at bed rest, and (b) hypertensive patients with systolic blood pressure higher than 140 mm Hg or diastolic blood pressure higher than 90 mm Hg with superimposed symptoms such as headaches, stomach aches, and neurological disturbances. A significant and comparable decrease in blood pressure was noted in both groups, in relation with pretreatment levels; no adverse affects were observed in mother or fetus from the ketanserin and alpha-methyldopa groups.
 ...
PMID:Ketanserin versus alpha-methyldopa in the treatment of hypertension during pregnancy: a preliminary report. 244 54

Urapidil is a postsynaptic alpha 1-adrenoceptor antagonist with a pharmacodynamic profile similar to prazosin. Unlike prazosin, however, urapidil also has some central activity which may explain the apparent improved tolerability of urapidil, including the absence of first-dose syncope. In clinical trials urapidil therapy resulted in significant reductions in blood pressure in patients with mild to severe essential hypertension, with little influence on heart rate. It is an effective antihypertensive when administered as monotherapy or in combination with beta-blockers and thiazide diuretics. In the few patients with cardiac dysfunction who have been studied to date, urapidil has improved myocardial oxygen consumption, systemic vascular resistance, left ventricular function, cardiac output and pulmonary capillary wedge pressure; however, further study is needed to assess the full therapeutic potential of urapidil in these patients. Urapidil has also been used successfully in the treatment of hypertensive emergencies, including eclampsia and pre-eclampsia, hypertensive crisis and hypertension occurring during general and cardiac surgery, rapidly lowering blood pressure without altering heart rate. Urapidil does not affect lipid or glucose metabolism, nor does it impair renal function. In addition, urapidil may be beneficial to patients with pulmonary hypertension, in whom it dilates pulmonary vascular beds to a greater extent than systemic vasculature, although therapeutic trials have not examined this effect. The most common adverse effects associated with urapidil therapy are dizziness, nausea, headache, fatigue and palpitations; however, these tend to be mild and transient and usually do not require discontinuation of treatment. Thus, urapidil offers a useful alternative to currently available drugs for the treatment of mild to severe hypertension, either as monotherapy or in combination with other antihypertensive drugs.
 ...
PMID:Urapidil. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in the treatment of hypertension. 269 46

Seven patients with acute preeclampsia and six with superimposed preeclampsia were infused intravenously with incremental doses of prostacyclin (up to 8 ng/min/kg during 80 minutes). Prostacyclin infusion was accompanied by significant decreases in maternal blood pressure and consistent rises in maternal plasma or urinary 6-keto-prostaglandin F1 alpha, but it caused no changes in maternal or fetal pulse rate or uterine contractility. Moreover, prostacyclin did not change the placental and umbilical blood flow, which were measured before and at the end of infusion. All women experienced facial flushing and two complained of headache during infusion. There was no difference in prostacyclin effects between women with acute or superimposed preeclampsia. These results may be taken as evidence that intravenous prostacyclin is not a specific therapy to increase placental or umbilical blood flow in preeclampsia.
 ...
PMID:Failure of exogenous prostacyclin to change placental and fetal blood flow in preeclampsia. 388 81


1 2 3 4 5 6 7 8 9 10 Next >>