Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Renal and ureteral calculi are treated primarily using extracorporeal lithotripsy, with percutaneous nephrostolithotomy retaining an important role for the treatment of large stones and complex situations. Aspects of pretherapy evaluation are reviewed. The vast majority of calculi 5 mm or less in diameter in the mid and lower ureter will pass spontaneously; in patients with acute ureteral obstruction, lower-osmolar nonionic contrast for urography caused as much discomfort as conventional high-osmolar contrast. Treatment planning for extracorporeal lithotripsy has changed in that internal stenting is no longer routinely recommended. Milk-of-calcium and calyceal diverticular stones respond poorly to extracorporeal lithotripsy. The access route used for percutaneous stone removal varies among investigators. Some advocate an intercostal approach for up to one third of patients; substantial complications occur with placement of a track above the 11th rib. Sepsis develops after percutaneous nephrostomy in up to 21% of patients, but the risk of sepsis can be decreased significantly by the administration of antibiotics during and after the procedure. Complications of extracorporeal lithotripsy include renal hematoma (especially if the patient is hypertensive or is taking aspirin), regional organ injury, and bacteremia. Although originally feared to occur frequently, hypertension occurring after or caused by extracorporeal lithotripsy was not confirmed to be a major problem. The incidence in a 2-year postlithotripsy follow-up was no greater than that for control subjects.
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PMID:Radiology and treatment of urinary tract stone disease. 155 85

Sixteen patients with relapsed non-Hodgkin's lymphoma underwent autologous bone marrow transplantation and infusion of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF). Treatment consisted of involved-field radiotherapy, cyclophosphamide 60 mg/kg/d intravenously (IV) for 2 days, and fractionated total body irradiation (1,200 cGy). Autologous bone marrow was thawed and infused IV, followed 3 hours later by the first infusion of IV rhGM-CSF 11 micrograms/kg/d over 4 hours. Infusions of rhGM-CSF were continued daily until either both neutrophil count exceeded 1,500/microL and platelet count exceeded 50,000/microL, or until 30 days after marrow re-infusion. Toxicities encountered were mild and included fever, chills, hypertension, alopecia, rash, diarrhea, stomatitis, myalgias, and synovial (knee) effusions. Neutrophil recovery greater than 500/microL occurred a median of 14 days (range, 9 to 30 days) after marrow infusion, significantly earlier than in a comparable group of historic controls who recovered counts at a median time of 20 days (range, 12 to 51 days) (P = .00002). Median time to self-sustaining platelet counts greater than 20,000/microL was 23.5 days (range, 12 to 100 days), comparable with the historic group (P = .38). One bacteremia (central venous catheter exit site infection with Staphylococcus epidermidis) and one local infection (Giardia lamblia in stool) occurred. Patients received a median of 11.4 (range, 4.4 to 20.2) x 10(4) colony-forming unit granulocyte-macrophage (CFU-GM) progenitors per kg. Stem cell progenitors CFU-GM, CFU-granulocyte, erythroid, monocyte, megakaryocyte (CFU-GEMM), and burst-forming unit-erythroid (BFU-E) were detected in the bone marrow as early as 7 days after marrow re-infusion, and increased in proportion to peripheral blood counts, but by 30 to 60 days still remained much lower than before transplant. Neutrophils transiently decreased in 13 of 16 patients (median decrease, 42%) within 24 to 72 hours of discontinuing rhGM-CSF infusions. These data suggest that rhGM-CSF therapy enhances neutrophil recovery by forcing stem cells to produce mature elements at an enhanced rate but may not affect marrow stem cell and early progenitor population sizes.
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PMID:Recombinant granulocyte-macrophage colony-stimulating factor after autologous bone marrow transplantation for relapsed non-Hodgkin's lymphoma: blood and bone marrow progenitor growth studies. A phase II Eastern Cooperative Oncology Group Trial. 185 94

Altered vascular reactivity to numerous vasoactive substances in hypertension formed the basis for studying the in vivo microcirculation of skeletal muscle tissue during high cardiac output bacteremia and low cardiac output sepsis. Large and small arteriole and venule diameters of the cremaster muscle were measured via videomicroscopy in normotensive and 1K-1C-renovascular hypertensive rats before and after the infusion of live Escherichia coli bacteria. During hyperdynamic bacteremia and during hypodynamic sepsis, large arterioles constricted and small arterioles dilated in normotensive animals. During hyperdynamic bacteremia, this differential arteriolar response was blunted in hypertension. In hypodynamic sepsis, large arterioles did constrict in the hypertensive animals, but small arteriolar dilation was still blunted. Sodium-nitroprusside, a postreceptor acting agent applied locally, maximally dilated small arterioles to the same level in all groups to indicate that the ability of vascular smooth muscle to relax is intact in hypertension. We conclude that the failure of the small arterioles to dilate during sepsis in hypertension is not due to a loss of vascular smooth muscle function, but that hypertension may functionally alter arteriolar reactivity at the receptor and/or endothelial level to interfere with E. coli-mediated responses in the skeletal muscle microvasculature.
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PMID:Hypertension alters microvascular responses in skeletal muscle to hyperdynamic bacteremia and hypodynamic Escherichia coli sepsis. 264 61

Twenty-six episodes of Pseudomonas aeruginosa bacteremia treated with intravenous ceftazidime, 4-6 g/day were evaluated. Treatment was begun within the first 24 hours after the isolation of the microorganism and was maintained for 10-12 days. In two patients with neutropenia amikacin was added during the initial 48-72 hours until the susceptibility to ceftazidime was known. All isolates were sensitive to ceftazidime. The most common underlying diseases were neoplasia (12), diabetes with stroke (4), neurosurgical and vascular procedures (4), rheumatoid arthritis (2), burns (2), cor pulmonale (1), and hypertension (1). The origins of bacteremia were urinary (12), pulmonary (9), and unknown (5). The infection was hospital-acquired in 77% and community-acquired in 23%. A critical clinical status and the presence of complications were significantly (p less than 0.01) associated with an increased mortality rate. Clinical outcome was good in 18/26 (70%), with a 30% mortality rate. The microbiological evolution showed 14 eradications, 6 persistences, 3 relapses and 3 colonizations. Resistance did not develop during therapy. Ceftazidime may be a good alternative therapy for these severe infections, although wider comparative studies are required for a better evaluation.
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PMID:[Evaluation of ceftazidime monotherapy in Pseudomonas aeruginosa bacteremias. Prospective study]. 268 60

We report 3 cases of Clostridium perfringens bacteremia with uterine gas gangrene. Clinical presentation included severe infectious syndrome, hemoglobinemia and hemoglobinuria, jaundice, uterine tenderness and hypertension. All 3 cases were first seen with installed renal failure. Diagnosis and modalities of therapy were reviewed. Clostridium perfringens bacteremia with uterine gas gangrene still occur in developing countries.
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PMID:[Clostridium perfringens septicemia]. 290 May 47

The effects of selectively inhibiting synthesis of thromboxane A2 (TXA2) with dazoxiben and of all cyclooxygenase products with indomethacin were studied in goats after infusion of 5 X 10(8) live Escherichia coli bacteria/kg. Pulmonary and systemic pressures, cardiac output, and double indicator dilution extravascular lung water (EVLW) were measured at 15-min intervals. EVLW was determined gravimetrically at 6 hr to confirm the final double indicator dilution values. Plasma levels of TXA2 and prostacyclin (PGI2) were measured as their stable metabolites, TXB2 and 6-keto-PGF1 alpha, respectively. Dazoxiben blocked the increase in plasma TXB2, prevented pulmonary hypertension, and attenuated the increase in EVLW after E. coli. Mean gravimetric EVLW was 8.7 ml/kg in the dazoxiben-treated group compared to 11.3 ml/kg in the untreated control group. Indomethacin blocked the increased plasma TXB2 and 6-keto-PGF1 alpha, attenuated pulmonary hypertension, and prevented almost all increases in EVLW. Mean gravimetric EVLW was 8.2 ml/kg after indomethacin. We conclude that in acute bacteremia, the early pulmonary hypertension is mediated largely by TXA2 (however, a second phase of hypertension results from non-cyclooxygenase products), either production of cyclooxygenase products (perhaps PGI2) inhibits part of the action of pulmonary vasoconstrictors, or indomethacin stimulates the production of other vasoconstrictors (such as lipoxygenase products), and indomethacin prevents the accumulation of EVLW by blocking formation of cyclooxygenase products or by other nonspecific actions.
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PMID:Indomethacin, dazoxiben and extravascular lung water after Escherichia coli infusion. 309 72

A 56-year-old man with adult polycystic disease of the kidneys complicated by renal failure, hypertension, and bacteremia underwent bilateral nephrectomy because the enlarged kidneys compromised his gastrointestinal function and respiratory capacity. A scan using 99mTc-methylene diphosphonate demonstrated nonfunctioning kidneys, bilaterally. An unusual radioactivity pattern in the bowel in 67Ga scintigraphy was due to extreme renal enlargement and should be kept in mind to avoid misinterpretation.
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PMID:Adult polycystic disease of kidneys: a potential cause of false-positive 67Ga images. 658 62

Pulmonary effects, lung clearance, and tissue retention of blood-borne Pseudomonas aeruginosa were compared in dogs (n = 5) and pigs (n = 5) during continuous 6-hour intravenous infusion of 1.2(10(9)) bacteria/min/20 kg. Control pigs received an equal volume of sterile saline. In contrast to controls, experimental pigs developed pulmonary artery (PA) hypertension (mean, 30 +/- SE 3; baseline, 17 mm Hg) and pulmonary failure manifested by hypoxemia (mean PaO2, 49 +/- 4; baseline, 78 +/- 2 mm Hg; p less than 0.001), increased intrapulmonary shunting (40 to 50%), noncardiogenic pulmonary edema, and congestive atelectasis, a pattern of pulmonary failure very similar to sepsis-induced ARDS in humans. In dogs, PA pressures wee unchanged from baseline, no edema was detected, and comparable hyperventilation was associated with an increase in PaO2 from 77 +/- 4 (baseline) to 87 +/- 2 mm Hg (p less than 0.001). Tissue retention of viable blood-borne organisms in pigs was greatest in the lungs. In dogs, lung retention was minimal and greatest tissue retention occurred in the liver and spleen. We conclude that both lung clearance of blood-borne organisms and bacteremia-induced pulmonary failure are quite host dependent.
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PMID:Bacteremia: host-specific lung clearance and pulmonary failure. 678 63

Pre-operative and operative complications in 2266 patients having undergone transurethral resection of prostate (TURP) for the past 20 years at Kitasato University Hospital were analyzed. They consisted of 2008 benign prostatic hyperplasia and 258 prostate cancer patients. Seven hundred and fifty four patients showed some of physical disorders prior to TUR:hypertension in 147 cases, diabetes mallitus in 87, ischemic heart disease in 46, chronic obstructive lung disease in 41 and others. Operative and postoperative complications of TURP were seen in 308 cases (13.6%). Perforation of the prostatic capsule was seen in 100 cases (4.4%) and bladder perforation into intraperitoneal cavity in 6 cases (0.3%). Transurethral fulgulation for postoperative hemorrhage was conducted on 79 cases (3.5%). Hyponatremia lower than 130 mEq/L was noted in 14 cases (0.6%). Severe urinary tract infection leading to bacteremia was observed in 9 cases (0.4%). Postoperative epididymitis was evident in 20 cases (0.8%). There was postoperative urinary incontinence in 19 cases, 3 of which was treated with Teflon-paste injection successfully. One patient had to undergo AMS-800 artificial sphincter implantation. The number of postoperative urethral stricture patients requiring urethral dilatation or internal urethrotomy was 12 (0.5%) and postoperative bladder neck contracture was seen in 20 cases (0.9%). One patient (0.04%) who developed DIC after profuse postoperative hemorrhage died on the 37th postoperative day. The efficiency of TURP depends not so much on the skill of cutting as on the speed and accuracy of orientation and haemostasis. The quick recognition of anatomical landmarks will assure effective and safe resection.
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PMID:[Pre-operative, operative and postoperative complications in 2266 cases of transurethral resection of the prostate]. 768 90

Renovascular hypertension profoundly alters skeletal muscle arteriolar responses to sepsis, yet systemic hemodynamics to sepsis are not affected by hypertension. In this study, we hypothesized that microvascular responses of skeletal muscle and systemic hemodynamics are changed during high- and low-cardiac-output Escherichia coli bacteremia in normotensive Wistar-Kyoto (WKY) and spontaneously hypertensive rats (SHR). During high-cardiac-output bacteremia, blood pressure and heart rate increased in WKY, but blood pressure decreased in SHR. During low-cardiac-output bacteremia, blood pressure initially decreased in WKY, while in SHR, pressure dropped significantly and remained severely depressed. Heart rate increased by 50% in SHR, but only by 10-15% in WKY during low-cardiac-output bacteremia. Large A1 and A2 arterioles constricted in both WKY and SHR during both phases of bacteremia. Small A3 and A4 arterioles dilated in WKY during bacteremia, but this small arteriole dilation was blunted in SHR. However, nitroprusside, an endothelium-derived relaxing factor (EDRF)-independently acting vasodilator, caused maximal dilation of these small arterioles of SHR. We conclude that there are profound changes and differences in systemic hemodynamics during bacteremia between the normotensive and the genetically hypertensive groups, whereas despite a possibly decreased endothelium-dependent vasodilator responsiveness in small arterioles of SHR during bacteremia, overall blood flow changes in skeletal muscle were similar among the two groups.
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PMID:Systemic hemodynamic and microvascular responses in spontaneously hypertensive rats during Escherichia coli bacteremia. 834 79


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