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Query: UMLS:C0020538 (hypertension)
170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Prostaglandins are highly potent derivatives of unsaturated fatty acids with multiple biological activities. They are synthesized and metabolized in almost all tissues studied so far. The E- und F-type prostaglandins may be regarded as local modulators of hormonal effects on cell function and--in some cases (kidney, uterus-corpus luteum)--as regional or tissue hormones. Thus they seem to be involved in the regulation of neurotransmission, kidney function, triglyceride metabolism in adipose tissue and progesterone biosynthesis. Apart from their influence on renal blood flow prostaglandins of the A-type possibly have an additional function as circulatory hormones regulating blood pressure. Second messenger-systems (cAMP, Ca++-cGMP) which mediate the effects of most non-steroidal hormones are also involved in the action of prostaglandins, at least of the E-and F-types. Disturbances in prostaglandin metabolism (increased or decreased biosynthesis) are discussed to play a role in the pathogenesis of inflammation, pain, fever, hypertension, bronchial asthma and gastric or duodenal ulcer formation. Drugs with antiinflammatory, analgesic and antipyretic activity have been shown to be potent inhibitors of prostaglandin formation. The correlation of a local prostaglandin deficit or the therapeutic use of single effects of prostaglandins by administration of exogenous compounds (natural prostaglandins or modified derivatives) has so long been less satisfactory because of their large number of biological actions which lead to undesired side effects. Extensive experience have been obtained in the successful induction of therapeutic abortion. This effect is based on the stimulatory action of E- and F-type prostaglandins on the smooth muscles of the pregnant uterus which is resistent to the influence of other stimuli, e. g. oxytocin. Here the incidence of side effects could be reduced by local administration of low doses of prostaglandins into the uterine cavity. A general improvement of the therapeutic usefulness of prostaglandins will however only be achieved, if modified derivatives with more specific actions on the desired "target" tissues are available.
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PMID:[Biology of prostaglandins with reference to therapeutic aspects]. 16

We assessed the effect of "healed" childhood renal disease on subsequent pregnancies by following-up a cohort of 224 children initially hospitalized with kidney disease. The pregnancy experience in this cohort was compared to two "control" cohorts comprising 81 female siblings and 191 age-matched female patients hospitalized contemporaneously for respiratory infection. The incidence of spontaneous abortion, stillbirth, and pregnancy-associated hypertension was not different among the cohorts; however, the incidence of infants with low birth weights was significantly greater in the renal and respiratory disease groups. Childhood kidney disease followed by impaired renal function (serum creatinine greater than 1.5 mg/dL) was associated with greater maternal and fetal morbidity. Kidney disease in childhood followed by apparent healing and no functional renal impairment does not have an adverse effect on maternal welfare, although the incidence of infants with low birth weight is apparently increased.
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PMID:Antecedent renal disease and the outcome of pregnancy. 43 73

It has long been known or suspected that phenytoin and probably phenobarbitone prescribed in pregnancy may lead to fetal malformations. The use of troxidone for epileptic women during pregnancy was reported in 1970 to lead to malformations. Over 50 instances of pregnancy in women taking troxidone have since been reported. In 8 of these the drug was used alone. 13 pregnancies resulted in abortion and 33 of the 40 survivors had a minor congenital anomaly, leading to death in 14. Complex congenital heart lesions with patent ductus, septal defects and aortic hypoplasia were apparent in half the survivors. Malformed or low-set ears were seen in nearly half the cases, palatal deformities were less common and evidence intrauterine growth retardation was frequently present. A 29-year-old mother taking troxidon and carbamazepine, and with a history of hypertension and proteinuria dating back to adolescence, delivered her first child prematurely. The child was small, showed deformed ears, displayed feeding problems and was found to be in cardiac failure with a systolic murmur and absent femoral pulses. Postnatal growth was retarded and after further cyanotic attacks a cardiac catheter study was performed. This showed a hypoplastic aortic arch with an anomolous origin of the left subclavian artery and patent ductus arteriosus, findings similar to those previously reported in neonates following maternal use of troxidone.
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PMID:Troxidone (trimethadione) embryopathy: case report with reveiw of the literature. 55 Sep 45

Various aspects of OC (oral contraceptive) use are discussed. The combination and sequential preparations are the 2 most frequently used OCs. OCs regulate hormone secretion through a "feedback mechanism" which in turn regulates ovulation. The initial choice of the type of OC to be prescribed is made according to the length and volume of and the interval between menstrual bleedings. The risk of developing thromboembolic diseases is the most freqeunt serious side effect of OC use; this is, however, influenced by several predisposing and risk factors. Hypertension has also been observed in OC users, as well as irregularities in liver function (cholestasis), the endocrine system, and glucose tolerance. There is no evidence that OC use is related to a higher incidence of cancer. Studies show that OC use has no effect on later fertility, except perhaps in the case of the abortion rate.
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PMID:[Evaluation of modern contraception]. 75 9

Oral contraceptives have been implicated as a causative factor of venous thrombosis and thromboembolism. Compounds containing over 50 mcg of estrogen have developed this complication most frequently. Steroid hormones have a marked influence on liver function. Large doses have caused cholestasis and hepatocellular damage. Disturbances in carbohydrate metabolism have been recorded. Lipid metabolism have also been shown to be disturbed with increased serum levels of triglycerides and low density lipoproteins. A rise in the cholesterol serum level seems to be correlated with the progestogen content of the compound. The ''minipill'' with a small dose of progestogen alone had been effective by alteration of the cervical mucus. The ''one-a-month pill'' is a combination of a long-acting estrogen, quinestrol, and a chorter acting progestogen, qunigestanol acetate. It has not been as acceptable or as effective as combined compounds. The ''morning-after'' pill consists of large doses of stilbestrol. The method has been effective but when de-ethylstilbestrol has been given to a patient already pregnant to prevent an early spontaneous abortion, adenocarcinoma of the cervix or vagina has been reported. Hypertension has been more common with increased duration of pill use. High dosage of progestogens and increasing age of patients have increased the incidence of hypertension. Cerebrovascular disease had also been more frequent among pill users. An increased incidence of gallbladder disease and of gallstones has been shown in pill users. Urinary tract and vaginal infections were reported more often in pill users. Increased sexual activity may have been a factor in this relationship. Resumption of ovualation after discontinuation of oral contraceptives usually follows within 4-6 weeks. In about 1% of patients amenorrhea and anovulation result for 6 months or more. This is often accopanied by galactorrhea. There is evidence that mestranol is demethylated to ethinyl estradiol in the liver. Progesterone seems to interfere with conversion. Therefore ethinyl estradiol is preferred as a compound of the pill. Also the different progestogens used are metabolized in the liver to norethisterone before they exert their biological effects. Several drugs, as ampicillin and barbiturates, have been shown to interfere with the efficacy of oral contraceptives. It is concluded that the overall results have shown oral contraceptives to be an excellent form of contraception with minimal and acceptable side effects and the least metabolic disturbance.
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PMID:Current status of oral contraceptive. 82 61

Abnormal pregnancies (33 per cent) were studied in 417 consecutive, unmarried, primiparous women, age 12 to 18 years (black, 54 per cent; white, 46 per cent). Black patients had no increase in abnormal pregnancies but had more infants weighting less than 2,500 grams (p less than 0.01). Black patients with pre-eclampsia gained less weight than white patients (24 versus 34 pounds, p less than 0.05) and had smaller infants (2,834 versus 3,316 grams). In white patients, the mean age at menarche was earlier in women who lost their infants (11.0 versus 12.7 years; p less than 0.01). Smoking was more prevalent in normal pregnancies (47 per cent) than abnormal pregnancies (38 per cent). Spontaneous abortion and fetal loss occurred more often in smokers (p less than 0.01). White women smoked more than blacks (60 versus 37 per cent). In mothers of infants weighting less than 2,500 grams, there were fewer smokers. Unexpectedly, smokers had less hypertension and pre-eclampsia. Human chorionic somatomammotropin values correlated with infant size. Levels of less than 4 mug per milliliter after 30 weeks' gestation were identical in normal and abnormal pregnancies (4.4 per cent). They were associated with small infants but no fetal deaths and did not predict outcome of pregnancy.
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PMID:Abnormal adolescent primiparous pregnancy: association of race, human chorionic somatomammotropin production, and smoking. 96 62

The causes of mortality and frequency of diseases were tabulated in 304 autopsies performed at Hopital Mama Yemo, Kinshasa, between July 1973 and December 1974. 78 of these autopsies were performed on subjects who died at Hopital Mama Yemo, 36 encompassed subjects from other hospitals, and 190 were of medicolegal cases in which the cause of death was not apparent from external examination. Men comprised 63.5% of autopsied cases. The mean age was 30.19 +or- 1.31 for men and 19.84 +or- 1.76 for women. 16.8% of deaths were due to homicide, 6.3% to suicide, and 8.9% to accidents, yielding an overall prevalence for trauma of 32%. Cancer accounted for only 3% of deaths, and cardiovascular diseases 8.2%. Bacterial infections (predominantly streptococcal disease, lobar pneumonia, and pulmonary tuberculosis) represented the largest single cause of death (17.4%). Parasitic infections comprised a further 6.3% of mortality and viral infections 7.2%, giving infectious diseases a combined frequency of 30.9%. Metabolic diseases were responsible for an additional 11.8% of deaths. Obstetric causes were identified in 3.9% of fatalities, and 95% of these cases represented hemorrhagic and septic complications of illegal abortion. Neonatal deaths (4.3%) were largely due to pneumonitis from aspirated amniotic fluid. A final 5.9% of deaths were unexplained. Also analyzed were cases of sudden death occurring outside the hospitals. 31.3% of these deaths were attributed to cardiovascular diseases and 46.3% to infection (including 2.5% due to septic abortion). Finally, the frequency of major diseases in this series was tabulated. Malaria was most frequently found (41.8%), followed by intravascular erythrocytic sickling (18.3%) and hypertension (16%). 12% of females in this series (20% of those dying traumatically) showed evidence of pelvic inflammatory disease. This series is considered to overestimate the frequency of trauma because of the large number of medicolegal cases that fall in this category. This selection for trauma further led to an oversampling of adult men. Nonetheless, it represents the 1st and best qualitative estimate of disease mortality and prevalence in Zaire. The trends in mortality and morbidity identified through this study provide a basis for planning health care and health education.
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PMID:Autopsy analysis of disease frequency in Kinshasa, Republic of Zaire. 96 86

One hundred and ten women conceived 143 times following induction of ovulation by gonadotrophins. The abortion rate was 21 per cent. Some bleeding occurred in 38-7 per cent of pregnancies and 54 per cent of them ended in abortion. For the 112 pregnancies reaching 20 weeks, the multiple pregnancy rate was 26-8 per cent (21 twins, 5 triplets, 3 quadruplets and 1 sextuplet). Hypertension was present in 8-9 per cent of patients and in 3-3 per cent of those with multiple pregnancy. The length of gestation was related to the number of fetuses at birth and postmaturity did not occur. The Caesarean section rate was 32-1 per cent. The birth weight of the infants was normal and the male to female sex ratio was 0-64 for singleton births and 0-78 for twins. The fetal loss was 15-9 per cent (7-1 per cent for pregnancies of over 28 weeks). Growth and development of the children were apparently normal. The incidence of all congenital malformations was 7 per cent.
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PMID:The outcome of pregnancy after gonadotrophin therapy. 100 34

Sera from 2,008 pregnant women were examined for the presence of complement-fixing platelet antibodies (CFPAb) and lymphocytotoxic antibodies (LCTAb). Women with antibodies in their serum were compared with women without antibodies. No clinical significance of CFPAb or LCTAb was found as regards pre-eclampsia, arterial hypertension, albuminuria, oedema, glucosuria, premature delivery, spontaneous onset of labor and abortion.
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PMID:Complement-fixing and lymphocytotoxic antibodies in serum of pregnant women at delivery II. Clinical observations I. 107 43

This is a response to 2 previous articles in the Journal which confirmed the association between the risk of myocardial infarction and the taking of combined oral contraceptive pills. An alternative method of contraception should be recommended for women over age 34 years if they have predisposing risk factors, such as diabetes, obesity, hypertension, or Type 2 hyperlipidemia. The effect of the combined estrogen-progestogen pill may be synergistic. With other methods of contraception there may be a greater risk of pregnancy. However, after age 34 the fecundity is less. In case of failure, early abortion, if acceptable, should be offered. Sterilization might be best. Vasectomy for the husband offers a good alternative.
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PMID:Letter: Oral contraceptives in women over 34. 115 1


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