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

The course of the illness in a six-year-old boy is reported. His recurrent headaches led to the detection of arterial hypertension (170/135 mmHg). Clinical and histological examination revealed neurofibromatosis von Recklinghausen. A bilateral paraumbilical murmur hinted at a renovascular form. Arteriography showed an aneurysm of the right renal artery and multiple bilateral intrarenal stenoses and aneurysmatic dilatations. Under conservative treatment with Propranolol and Dihydralazine blood pressure remained almost normal over two years. 38 paediatric cases of renovascular hypertension in childhood reported in the literature are analyzed with regard to clinical manifestation, morphology and localisation of the renovascular lesions.
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PMID:[Renovascular hypertension in neurofibromatosis von Recklinghausen (author's transl)]. 41 39

The action, efficient dosage and tolerance of a pure vasodilator, dihydralazine, used for the treatment of severe heart failure were studied in 30 children aged 1 month to 14 years. All of them presented with heart failure from various causes, not controlled by the usual medical treatment. Dihydralazine was administered orally, without interrupting the digoxin-diuretic treatment, with a dose of 34 to 140 mg/m2/day given in 4 equal doses. Clinical efficacy was considered null in 12 cases, low in 12 cases and good in 6 cases, without relationship with the original heart defect. Five of the 6 good results were obtained with doses greater than or equal to 100 mg/m2/day. In the group of 16 children who were given doses greater than or equal to 100 mg/m2/day, a significant improvement of the ECG indexes of left ventricular performance was obtained: decrease in systolic left ventricular internal dimension (p less than 0.05 at day 5), increase of the shortening fraction (p less than 0.05 since day 1) and of velocity of shortening (p less than 0.01 since day 1), while the diastolic left ventricular internal dimension remained unchanged. The only transitory undesirable effects observed were headache, vomiting and/or rash in 9 cases.
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PMID:[Dihydralazine treatment of cardiac insufficiency in children]. 407 3

Antihypertensive vasodilators share the capability of producing vasodilation of arterioles. In addition, two of them, i.e. nitroprussiate and prazosine, also produce vasodilation of veinulae. Both of these agents cause a simultaneous decrease in pre-load and post-load, and may be used in heart failure. The effectiveness of vasodilators is offset by regulatory cardiac and/or renal mechanisms, and the association with a sympatholytic agent and/or a diuretic is generally needed. Consequently, vasodilators are usually the third step in the course of managing a hypertensive patient. Association with a betablocking agent is especially necessary in patients with coronary insufficiency, in order to prevent an increase in myocardial oxygen requirements and worsening of angina pectoris. Vasodilators are active within a fairly wide dosage range, making individualized dosages requisite. In treating hypertension by the oral route, daily doses above 200 mg for dihydralazine, 60 mg for minoxidil and 10 mg for prazosine are only exceptionnaly useful. In emergency treatment of hypertension, diazoxide and nitroprussiate can be used only in patients under continuous cardiovascular monitoring. Nitroprussiate must, in addition, be given through a controlled infusion device, but ensures more flexible and safer control of blood pressure. Dihydralazine may produce headache. This side effect occurs very early and is hardly compatible with continuation of treatment. Long term side effects are very uncommon or strictly biological for dosages below 200 mg/day. With currently used dosages (20 to 60 mg per day) minoxidil consistently produces hypertrichosis, outruling its protacted use in women.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Antihypertensive vasodilators]. 631 28

Hypertensive disorders are among the most common causes of maternal and perinatal mortality. Mild and uncomplicated chronic hypertension has a better prognosis than preeclampsia. The primary aims of therapy are to prevent cerebrovascular complications and to avoid the progression of chronic hypertension into superimposed preeclampsia with worse prognosis. In mild courses of the disease bedrest, whether at home or in the hospital, is commonly recommended. A special diet is not required neither for prevention nor for therapy. This also applies for the use of aspirin. Calcium supplementation during pregnancy seems to be effective in reducing the risk of hypertension and to a smaller extent of preeclampsia. Diuretic therapy is only indicated in exceptional cases. Antihypertensive drugs are recommended, if a sustained blood pressure of diastolic > or = 110 mmHg is recorded, in cases of superimposed preeclampsia even if the diastolic blood pressure is > or = 100 (> or = 90) mmHg. alpha-Methyl-dopa is the initial drug of choice for oral antihypertensive therapy. Neither short-term effects on the fetus or neonate nor long-term effects during infancy have been reported after long-term use of alpha-methyl-dopa in pregnancy. The oral application of beta-adrenergic-antagonist drugs is well-tolerated, but should be avoided in cases of severe fetal growth retardation. Dihydralazine treatment is not suitable for oral therapy, since its medication is associated with maternal side effects such as headache and tachycardia. Administration of drugs that inhibit angiotensin-converting enzyme during pregnancy is contra-indicated. Calcium-channel-blocking drugs are frequently used in the USA and in the UK as "second-line" antihypertensive medication, however there is little experience with the long-term administration of these drugs to pregnant women with hypertension. The indication for hospitalization are of particular clinical importance, since a delay in admission associated with maternal complications may lead to juridical troubles. The antihypertensive treatment is only a symptomatic therapy; the obstetrician must be aware that delivery is the ultimate cure of hypertensive disorders in pregnancy. In women with mild chronic hypertension or mild preeclampsia antihypertensive therapy is unlikely to be beneficial regarding the perinatal results, while in severe forms drug therapy is mandatory to avoid life-threatening maternal complications.
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PMID:[Treatment of hypertensive diseases in pregnancy--general recommendations and long-term oral therapy]. 949 43