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

Clinical and hemostasis evidence on fibrinolysis is presented for patients with hypertension running an uneventful course, in hypertensive crisis and acute disorder of cerebral circulation. Changes in fibrinolysis are shown for patients on conventional treatment and on adjuvant dipyridamole.
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PMID:[Fibrinolysis in patients with hypertension]. 208 28

Evidence suggests that unstable angina, non-Q-wave myocardial infarction and Q-wave myocardial infarcts represent a continuum, such that transient reduction in coronary blood flow associated with platelet aggregation and dynamic vasoconstriction at sites of coronary artery stenosis and endothelial injury lead to abrupt development of unstable angina. Factors potentially responsible for the conversion from chronic to acute coronary artery disease include endothelial injury at sites of stenosis. The endothelial injury may be the result of plaque fissuring or ulceration, hemodynamic factors (including systemic arterial hypertension or flow shear stress), infection, smoking, coronary arteriography or balloon angioplasty. Clinical and experimental animal studies suggest that interference with thromboxane and serotonin contributions to platelet aggregation and dynamic coronary artery constriction may prevent chronic coronary artery disease syndromes from converting to acute disease. To protect against this process may require both thromboxane and serotonin receptor antagonists or a combination of thromboxane synthesis inhibitor and receptor antagonist with a serotonin receptor antagonist. Further studies are needed to test this hypothesis.
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PMID:Potential usefulness of combined thromboxane A2 and serotonin receptor blockade for preventing the conversion from chronic to acute coronary artery disease syndromes. 214 68

Aortic dissection, the most common acute disease of the thoracic aorta, is associated with high mortality and morbidity. The authors reviewed their experience over the last 20 years with 258 patients who had aortic dissection (259 dissections). The diagnosis was made at autopsy in 69 (27%) patients (59 type A, 10 type B). Of the remainder, 97 patients had type A dissection (78 acute, 19 chronic) and 93 had type B dissection (56 acute, 37 chronic). The sudden onset of severe, unremitting chest pain associated with hyper- or hypotension or a history of hypertension are suggestive of acute aortic dissection. The diagnosis should be followed by prompt investigation and treatment. The 30-day survival rate for patients with type A dissection who underwent surgical treatment was 62%; survival rates for patients with type B dissection, acute and chronic, were 70% and 86% respectively with pharmacotherapy and 66% and 91% with surgery. The authors stress the importance of early, accurate diagnosis and immediate surgical treatment for all patients who have type A dissection and complicated or unresponsive (carefully monitored pharmacologic control of blood pressure) type B dissection.
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PMID:Aortic dissection: current expectations and treatment. Experience with 258 patients over 20 years. 225 24

The clinical presentation, initial laboratory and renal biopsy findings, and subsequent clinical course were studied and compared in 128 children with Henoch-Schoenlein (HS) nephritis and in 206 children with IgA nephropathy. The clinical and pathological findings of the two conditions were similar. After a mean follow-up period of 5 years, 72 patients (56%) with HS nephritis and 67 (32%) with IgA nephropathy showed no demonstrable abnormality, 29 (23%) with HS nephritis and 103 (50%) with IgA nephropathy had minor urinary abnormalities, 7 (5%) with HS nephritis and 26 (13%) with IgA nephropathy had heavy proteinuria and/or hypertension, and 20 (16%) with HS nephritis and 10 (5%) with IgA nephropathy had developed chronic renal failure. A worse outcome was significantly associated with the more severe clinical presentations and more severe glomerular changes by light microscopy in HS nephritis, whereas there was no relationship between the severity of clinical presentation and glomerular changes and prognosis in IgA nephropathy. These findings suggest that HS nephritis is an acute disease and prognosis is associated with the severity of glomerular changes at onset, while IgA nephropathy is a chronic, slowly progressive glomerular disease.
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PMID:Henoch-Schoenlein nephritis and IgA nephropathy in children: a comparison of clinical course. 359 38

Physical conditioning induces many favourable changes in the body, including an increase of maximum oxygen transport, a decrease of body fat, a strengthening of muscles, tendons and bones, an improvement of blood lipid profile, and a better balance between oxygen demand and supply in the myocardium. The preventive value of such changes is often seen in measures of perceived health or their practical consequences. Industrial fitness programmes apparently reduce the use of medical services (physician visits and hospital days), with gains of productivity, a lessening of absenteeism, and a lower employee turnover. Techniques such as the Canadian Health Hazard Appraisal questionnaire suggest a general reduction in 'risk-taking' behaviour among exercise-class participants, with a substantial reduction in their 'appraised' age. There is little evidence that regular moderate exercise can alter the response to acute disease, but both theoretical considerations and epidemiological data suggest the value of physical activity in preventing manifestations of ischaemic heart disease, obesity and maturity onset diabetes, cholecystitis, hypertension, certain neuroses, and age-related pathologies. A fit individual is also at a lesser risk of industrial injury, and is capable of living independently for a longer fraction of his or her old age. It is concluded that physical activity is one of the more useful tactics of preventive medicine; the current challenge to both research workers and policy makers is to carry this message beyond the white-collar executive to such target groups as blue-collar workers, ethnic minorities, housewives, the elderly and the handicapped.
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PMID:The value of physical fitness in preventive medicine. 384 82

We report two pediatric cases of rhabdomyolysis. This disease involves the destruction of skeletal muscle, which can present with myalgia and a brown-pigmented urine. The first patient presented with acute renal failure, hypertension, and hyponatremia. The second patient was pyrexic, hypernatremic, and hypokalemic, and later developed hypertension. Evidence of rhabdomyolysis in both patients included dark, o-tolidine-positive urine, granular casts in the urinary sediment, and grossly increased activities of creatine kinase (greater than 60 000 U/L) in serum. An uncommonly recognized entity in the pediatric age group, rhabdomyolysis often presents as an acute disease with severe onset but can be diagnosed with relatively simple laboratory tests.
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PMID:Rhabdomyolysis: two pediatric case reports. 396 73

Studies in patients with congenital adrenal hyperplasia due to 11-hydroxylase deficiency (11-OHD) suggest a common defect in the adrenal zona fasciculate and zona glomerulosa. The hypertension in untreated 11-OHD patients is considered to be secondary to the accumulation of deoxycorticosterone as a consequence of inadequate 11-beta-hydroxylation in the biosynthesis of aldosterone, and is alleviated by glucocorticoid suppression. To investigate whether deoxycorticosterone suppression in these patients resulted in loss of salt, 11 patients with 11-OHD aged 4-26 yr were studied. Patients were evaluated during dexamethasone suppression (0.6 mg/m for 2 weeks) while receiving a normal diet and a low salt diet (10 meq Na/24 h). There was no significant change in serum electrolytes, cortisol, 11-deoxycortisol, and DOC during these two dietary regimens. PRA in the recumbent and upright positions on both diets was significantly higher in the patients than in normal subjects. Plasma or urinary aldosterone levels were significantly lower in the 11-OHD patients than in the normal controls. Moderate salt loss occurred during the low salt diet. It is concluded that sodium retention is incomplete in glucocorticoid-treated 11-OHD patients. Partial sodium retention is maintained by increased PRA and a subnormal aldosterone response. 11-OHD patients should be carefully monitored during acute disease states and, when electrolyte imbalance is suspected, treatment with mineralocorticoid should be considered.
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PMID:Salt loss in hypertensive form of congenital adrenal hyperplasia (11-beta-hydroxylase deficiency). 660 65

Forty-one patients with systemic lupus erythematosus and glomerulonephritis were studied in a randomized drug trial. Thirteen patients received prednisone only (Group 1), 16 received oral cyclophosphamide and oral azathioprine (1 mg/kg body weight . d of each initially) (Group 2), and 12 were given boluses of intravenous cyclophosphamide (0.5 to 1.0 g/m2 body surface area every 3 months) (Group 3). The mean observation period was 42 months (range 1 to 6.5 years). Renal function deteriorated in four of 12 patients in Group 1 and three of 27 patients in Groups 2 and 3 (p = 0.114). By life-table analysis, 86% of the entire group survived 5 years after entry to the study. Marked hypertension, fluctuating changes in serum creatinine, erratic changes in levels of antibody to DNA, reduced C3 levels, increasing proteinuria or sustained hematuria, and flares of extrarenal disease activity occurred more commonly in Group 1. Infectious complications were not commoner in Groups 2 and 3. We conclude that any marginal benefits produced by the programs tested cannot be shown in this class of patients without markedly increasing the sample size. Our current studies involve more vigorous treatment of patients with more acute disease and less treatment during prolonged periods of relatively good health.
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PMID:Alternative modes of cyclophosphamide and azathioprine therapy in lupus nephritis. 704 43

The acute porphyric crisis is a characteristic clinical feature common to all hereditary hepatic porphyrias (acute intermittent porphyria [AIP], porphyria variegata and hereditary coproporphyria). The crisis is marked by an acute disorder of the central, peripheral and autonomic nervous system. Autonomic disorders may play a major part and may provoke severe cardiovascular symptoms. According to the literature our findings support data describing supraventricular tachycardia as the most important sign, followed by hypertension--or, rarely, hypotension--cardioarrhythmias and cardiomyopathy. While tachycardia, blood pressure disturbances and cardioarrhythmia indicate sympathetic overactivity, cardiomyopathic alterations suggest functional or structural coronary dysfunction. The existence of a specific "angiopathia porphyrica"--based on functional, angiospastic or secondary hypertensive disorders--has been discussed for a long time. Recent results concerning a 20-year follow-up study of AIP patients revealed chronic hypertension as being the most significant disorder and seem to support a hypertensive aetiology.
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PMID:[Cardiovascular disorders in acute intermittent porphyria (AIP) (author's transl)]. 730 4

Results of morbidity and medical care surveys of the Santiago's population are presented in this paper. A random sample of 1,000 dwellings with 4,700 people was selected and studied 3 times, in 1993 and 1994. All health events (acute and chronic morbidity, health examinations, dental care) and main features of medical care were registered in the interviews which covered a 2-week period each time. The population sample had similar characteristics than the results of the last Population and Dwellings Chilean Census. Health events were registered with high frequency: 56% of the families had one or more members with chronic disease; 51% with acute diseases; 46% with emotional troubles; 24% had dental care; 17% health examination and 6% different types of injuries. Frequency of medical care during the fortnight period was 5.6% out of total population of acute diseases; 1.0% of injuries; 4.9% for chronic diseases, 3.9% of health examinations and 5.6% of dental care. Frequency of diseases was significantly higher among women (50%) than in men (33%) and in poor people than in higher socioeconomic levels. Most of the acute disease were respiratory illnesses followed by communicable diseases, skin troubles and rheumatologic disorders. The most important detected chronic diseases were blood hypertension, diabetes mellitus, bronchial asthma and alcoholic addiction.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Characteristics and management of morbidity in Santiago 1993]. 765 19


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