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

There is a definite need for replacement estrogen therapy in menopausal women exhibiting vasomotor symptoms or osteoporosis, particularly if the woman has had bilateral oophorectomy. There is a less clearly defined need in women complaining of emotional symptoms. Atrophic vaginitis and trigonitis is usually best treated with topical application of estrogen, which does not have systemic side effects if used weekly; more frequent use can lead to vascular absorption. Some of the problems associated with estrogen replacement are dose-related and can be eliminated by using smaller dosages. Uterine bleeding can usually be controlled by administering cyclically with progesterine. Hypertension, thrombosis, and adenocarcinoma are problems associated with administration of exogenous estrogens; use should be undertaken with great care in women exhibiting these conditions and patients should be followed closely to make sure such conditions are not developing. Other conditions which may worsen with estrogen therapy are diabetes mellitus, seizure disorders, migraine, multiple sclerosis, collagen diseases, cholelithiasis, and hyperlipidemia. None except hyperlipidemia is an absolute contraindication but risk/benefit ratios must be considered carefully in these cases.
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PMID:Estrogens for the menopause. Maximizing benefits, minimizing risks. 19 9

Metabolic effects of long-term (at least 5 years) estrogen replacement therapy were studied. 301 patients were treated with replacement estrogen and 309 patients were untreated. Incidence figures for various metabolic diseases present at entry, and both during and after estrogen therapy were compared by statistical adjustments for certain group differences (Mantel-Haenszel statistics) and by statistical analysis. Long-term administration of estrogen to these women with hypoestrogenism was associated with significantly lower rates of development of cardiovascular disease (p .001), hypertension (p .001), osteoporosis (p .001), and fractures (p .01). The detrimental effects included a higher rate of abnormal uterine bleeding (47% of 207 women with uteri in situ) and an increase in the likelihood of developing adenocarcinoma of the endometrium. Cyclic adminsitration of estrogen did not seem to protect from the risk of endometrial carcinoma, however the addition of progesterone to sequential estrogen treatment did. It is believed that long-term estrogen therapy is of benefit for the woman deprived of estrogen function, particularly if this loss occurs at a relatively young age.
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PMID:Effects of long-term estrogen replacement therapy. I. Metabolic effects. 44 93

The jet-wash technique is an efficient method for diagnosing the endometrium carcinoma. Among 750 women we detected 50 endometrium carcinomata all of which were diagnosed by the jet-wash method. Wrongly positive findings do not exist in our series of examinations. Of the pre-stages of the endometrium carcinoma, such as adenomatous hyperplasia and adenocarcinoma in situ, however, only scarcely 50 per cent of all cases were diagnosed. The jet-wash method is also suited for outpatient clinics. Thus, patients with risk-factors for the endometrium carcinoma might be controlled annually once in outpatient clinics in addition to the usual cancer prophylactic examinations. Above all, we consider 1. patients suffering from bleeding anomalies as from the 40th year of age, 2. patients free from any symptoms, but suffering from obesity, hypertension and diabetes mellitus, 3. patients with an increased narcosis risk, 4. patients of the perimeno-pause prior to an estrogen treatment and 5. cancer post-care patients suffering from a primarily radiated endometrium carcinoma. The direct smears and the cytocentrifuge preparations can be diagnosed right on the day of examination. The thrombin cell block technique requires more work for a cytological laboratory. For a histological laboratory it might not mean any additional essential burden.
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PMID:[The diagnostic reliability of the jet-wash technique with regard to the diagnostic of endometrium carcinoma (author's transl)]. 57 Aug 31

Malignant disease of the female reproductive organs accounts for over 11,000 deaths annually in the United States in patients over 65 years of age. Hormonal treatment is being used in some cases in conjunction with more conventional methods of treatment. Synthetic progesterone is used in the palliation of patients with advanced adenocarcinoma of the endometrium. A significant increase in the incidence of ovarian cortical stromal hyperplasia, obesity, diabetes and hypertension is found in these patients. For treatment of carcinoma of the ovary, a massive dose of an experimental progesterone agent, dimethylprogesterone (NSC-123018) is being tested in a group study. The treatment is used only for patients for whom conventional therapy has been unsuccessful. Although a few patients have shown remission, it is too early for conclusive results. Patients with advanced breast cancer and estradiol receptors in their tissue may show a favorable clinical response to hormonal therapy in 40-60% of cases. Patients lacking estrogen receptors have only a minimal chance of responding to hormonal therapy.
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PMID:Geriatric malignancies and their hormonal aspects. 83 Feb 45

In a retrospective study characteristics of 729 climacteric and postmenopausal women with hyperplasia and adenocarcinoma of the endometrium are compared with those of 82 women with atrophic endometrium and 96 women with carcinoma of the cervix. In a prospective study 225 women with glandular-cystic, adenomatous and atypical hyperplasia of the endometrium have been checked by a control-curettage within a period of two months until four years following the first diagnosis. Low parity, disturbances of menstruation with anovulatoric bleedings during fertility period, adipositas, hypertension and diabetes mellitus in climacteric and postmenopausal women indicate a high risk of carcinoma of the endometrium. Hyperplasias of the endometrium in climacteric women cannot be considered as precursors of corpus carcinoma. They are the result of a temporary hormonal dysfunction. Prophylactic hysterectomy, however, should be performed, if adenomatous or atypical hyperplasia appears in older postmenopausal women with the indicators of high risk of endometriumcarcinoma as mentioned above.
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PMID:[Epidemiology of endometrial hyperplasia and adenocarcinoma]. 97 98

Diabetes and obesity were noted in 21.3% and 42.3% respectively of 94 patients with adenocarcinoma corporis uteri. Hypertension and ovarian or mammary neoplasia were also common. Obese and diabetic subjects proved more sensitive to treatment with high doses of medroxyprogesterone acetate. Screening for precancerous states or carcinoma of the endometrium in obese and diabetic women is suggested.
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PMID:[Diabetes, obesity and adenocarcinoma of corpus uteri]. 99 85

To determine the association between the incidence of endometrial cancer and the use of estrogen in menopausal and post-menopausal women, we retrospectively compared 317 patients with adenocarcinoma of the endometrium with an equal number of matched controls having other gynecologic neoplasms; 152 patients used estrogen, as compared to 54 of 317 controls. Thus, the risk of endometrial cancer was 4.5 times greater among women exposed to estrogen therapy. When estrogen use was adjusted for concomitant variables such as obesity, hypertension, diabetes, parity, referral pattern, age at diagnosis, year of diagnosis and other gynecologic neoplasms, the magnitude of the increased relative risk was associated with several of these variables, and was highest in patients without obesity and hypertension. Exogenous estrogen therapy is associated with an increased risk of endometrial carcinoma, but this increased relative risk is less apparent in patients with physiologic characteristics previously associated with an increased risk.
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PMID:Association of exogenous estrogen and endometrial carcinoma. 118 89

A 20-year-old man was admitted to Kyushu University Hospital with complaints of severe headache and episodic hypertension (200/100 mmHg). Ultrasonograms and computed tomographs revealed tumors in the left adrenal region and in the right lower lobe of the thyroid gland. Total thyroidectomy and left adrenalectomy were performed. The excised thyroid tumor and adrenal tumor were pathologically diagnosed as papillary adenocarcinoma and pheochromocytoma, respectively. A chromosome analysis revealed no karyotypic abnormality. Whereas the world literature records such occurrences in women, this is the first report of a simultaneous occurrence of pheochromocytoma and papillary adenocarcinoma of the thyroid in a young man.
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PMID:Concurrent adrenal pheochromocytoma and papillary adenocarcinoma of the thyroid in a 20-year-old man. 135 93

Parathyroid carcinoma is a rare tumor responsible for 0.5-5% of primary hyperparathyroidism. It is usually small (not more than 27 g) and the precise diagnosis of malignancy is made when local or distant metastases are found. We describe a case of a 37 yr old male presenting with a substernal goiter and no specific symptoms except hypertension. This mass had cysts and calcifications and it was in the anterior upper mediastinum. The patient had severe hypercalcemia (Ca greater than 14 mg/dl), high PTH levels and mild renal failure. Bone scanning showed signs of hyperparathyroidism. The patient was subjected to total thyroidectomy and removal of the mass en block. The tumor was circumscribed lobulated and mostly cystic. It weighed 1,200 g (380 g after evacuation of cysts) and measured 12 x 9 x 4.5 cm. Histologic examination showed a highly differentiated adenocarcinoma of parathyroid with metastasis in a regional lymph node. Almost 4 years later the patient is alive and well without hypercalcemia and without evidence of distant metastases.
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PMID:Large parathyroid functioning carcinoma (1,200 g) presenting as a substernal goiter. 156 Jan 89

In this retrospective study, 81 patients operated by craniotomy for a brain metastasis are reviewed. Mean age is 56.3 years and most of the patients are male (71.6%). Clinically, 79% of the patients present a focal semiology, most frequently with neuropsychologic disturbances (43%); epilepsy is found in 31% of the cases. Symptoms related to intracranial hypertension (vomiting and headache) are present in 43% of the patients. On C.T.-scan, there is a solitary metastasis in 89% and the most common intracranial location is the frontal lobe (33.3%). The most frequent primary neoplasms are: bronchial adenocarcinoma in 19%, squamous carcinoma of the lung in 11%, melanoma in 12% and unknown origin in 18%. The surgical removal (as judged by the surgeon) is total in 70%, subtotal in 19% and partial in 11%. Standard operative mortality (30 days after craniotomy) is 7.4%. The postoperative course (till the patients leave our department) is excellent in 58% (complete neurologic recovery), steady in 20% (stability of symptoms and neurologic examination) and bad in 22%, with worsening of the neurological deficits. Most of the patients (84% of the patients who survive more than 30 days after the craniotomy) had postoperative whole brain radiotherapy with a hypofractionned schedule (total doses of 15 to 40 Gy with fractions of 200 to 650 cGy). Ten patients had surgery alone. Mean survival is 10.2 months with a follow-up of 12 months to 10 years. Ten patients survived over 18 months and one is still alive almost 4 years after his craniotomy. In this study, the survival is not modified by the primary lesion's histology.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Cerebral metastases. A study of a surgical series of 81 cases]. 160 35


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