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

The primary goals in the management of hypertension, angina pectoris, and postinfarction cases are to prevent further damage to the cardiovascular system and to reduce the risk of subsequent myocardial infarction. Of all the drugs currently available, the beta-blockers seem the most likely to achieve this aim. The search for new beta-blockers centers around the need for agents that offer the advantages of beta 1-adrenoceptor antagonism without the unwanted beta 2 effects, which may be dangerous in asthmatic patients and may make bronchitis, diabetes, and arteriopathy worse or more difficult to control. One solution is to use a selective beta 1-adrenoceptor antagonist. Another is to develop a molecule that acts as an antagonist at beta 1-adrenoceptors and as an agonist at beta 2-adrenoceptors. celiprolol is such a "third-generation" beta-blocker in that it combines both attributes, and thereby offers a clinically relevant advance. It does not seem to disrupt glucose homeostasis or exacerbate peripheral vascular disease, the lipid profile appears to be positively altered, and the risk of bronchospasm is reduced. Celiprolol is therefore both clinically and biochemically well tolerated.
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PMID:Pharmacology of third-generation beta-blockers: greater benefits, fewer risks. 248 89

Chronic oral candidiasis is generally not considered a premalignant condition. We report on two patients with carcinoma in situ and carcinoma in the soft palate, probably preceded by long lasting chronic Candida infection. The first patient was a 56-year-old woman who suffered from disturbances in the calcium and potassium metabolism and high blood pressure due to a previous goiter operation during which the parathyroids had been removed. She also suffered from bronchitis and had been smoking 12 cigarettes a day for many decades. For several years she had had more or less constant symptoms from airway infections. Increasing symptoms from the throat had developed 2 years before referral and, in this period, she had been in constant antifungal therapy with no effect on the symptoms. Objectively, the entire soft palate, uvula and the palatoglossal arches were fiery red with whitish plaques which were not removable (Fig. 1). A biopsy revealed severe dysplasia and focal carcinoma in situ Subsequently, the lesion in the soft palate was partly removed by laser surgery followed by radiation therapy over a period of 2 month. One year later there was no signs of recurrence (Fig. 4). The second patient, a 53-year-old healthy woman, was referred because of difficulties in eating due to pain in the throat which had existed for 2 years. Without any effect on the symptoms, she had had antifungal therapy for 4 weeks. The patient had been smoking 15 cigarettes a day for many years. Objectively, an area with whitish plaques and nodules on an erythematous background was found (Fig. 5).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Carcinoma in situ and carcinoma in patients with chronic oral candidiasis]. 263 19

The relation between hypertension, cerebrovascular disease, and heart failure in the elderly is well established. The concept that this was entirely due to hardening of the arteries and, therefore, an essential feature of aging has been revised in the last 15 years to show that there are groups of elderly people in whom hypertension is not a problem, and in this group stroke disease and heart failure are relatively uncommon. The treatment of hypertension in the elderly attracts increasing attention. The successful lowering of blood pressure in the elderly has now been reported by many authors with a variety of therapeutic agents. The case for treatment has been demonstrated in those up to 80 years of age by the European Working Party in Hypertension in the Elderly, and relevant data on compliance are also available in the older age group in the Sub-Group Analysis of the Hypertension Detection and Follow-up Programme. A similar reduction of blood pressure, both systolic and diastolic, can be safely achieved with thiazides, beta-blockade, calcium channel blockade, angiotensin-converting enzyme inhibitors, and centrally acting drugs. The differentiation between these groups is largely a matter of the side effects that occur and any concurrent existing illness from which the patient suffers, e.g., diabetes, bronchitis, heart failure, and so on. From the information available to date, the problem of choice of the most suitable drug remains a clinical decision for the prescribing doctor.
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PMID:Hypertension in the elderly. 278 25

Drugs with pharmacological activity limited to the pulmonary circulation are not at present available. Serotonin antagonists, specific thromboxane A2 inhibitors and prostacyclin may offer new possibilities for the treatment of certain forms of pulmonary arterial hypertension (PAH), but their clinical efficacy remains to be evaluated. Vasodilators simultaneously influence the pulmonary and systemic vascular resistances, and their overall hemodynamic effects in patients with PAH are therefore unpredictable. Therapeutic trials with such drugs should be closely monitored to avoid serious adverse reactions. Oral administration of beta-adrenergic agents, such as salbutamol or terbutaline, is preferable to digoxin in the treatment of patients with right ventricular failure due to chronic obstructive bronchitis. Right ventricular failure following massive pulmonary embolism may be aggravated by reduced blood flow through the right coronary artery. Increase of aortic perfusion pressure (e.g. noradrenaline) should be considered as a therapeutic measure in patients with arterial hypotension.
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PMID:[Pharmacology of the pulmonary circulation]. 286 81

16 patients of the Medical ambulatory at the University of Basel born between 1940 and 1945 were explored with the State-Trait Anxiety Inventory (STAI) of Spielberger for the presence of anxiety. With this self-rating inventory state anxiety as well as general trait anxiety can be recognized. The examined group was not selected on specific diagnoses. Two patients with a heavy organic disease (Aids, Friedreich's ataxia) showed an increased state anxiety and an increased general trait anxiety. Six patients with hypertension showed decreased, average as well as increased values of state anxiety and general trait anxiety. In one patient with epilepsia decreased general trait anxiety and average state anxiety were manifest. A patient with a depressive neurosis and functional abdominal pain showed increased general trait anxiety and average state anxiety. Finally, in six patients with different diseases, such as patients with different diseases, such as bronchitis, diabetes, coronary and congestive heart disease, obesity and myalgias, no deviation of their state and general trait anxiety values was evident when compared with standard values. The results are discussed.
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PMID:[The assessment of anxiety in somatic patients--a pilot study]. 291 53

Comparison was made of the cost of medications between Shared Health Facilities (SHFs) or Medicaid Mills and a Neighborhood Health Center (NHC) for nine conditions in fields of adult medicine, pediatrics, and gynecology. A total of 10 cases from SHF reviews were matched by diagnosis, age, and length of time under care with those in the NHC. For otitis media and pharyngitis in children and questionable urinary tract infection and vaginitis in adult women, the average costs were significantly higher in the SHFs. Average costs for family planning services and vaginal bleeding were higher in the SHFs but not significantly so. Medication costs for children with asthma and adults with bronchitis and hypertension were approximately the same in both settings. The reasons for higher costs included greater use of more expensive antibiotics, concurrent use of decongestants and antihistamines for infectious conditions of childhood, and dispensing of medications on "shot-gun" basis without adequate diagnostic studies. The most striking difference was the additional average cost of $798 for hospitalization of the SHF patients with vaginal bleeding when D & C and surgery were performed. The NHC women had no hospitalizations as the recommended procedure of endocervical biopsy in the office was Center policy. Other quality inferences noted in the NHC, but not in SHFs, were routine performance of throat cultures for pharyngitis, wet smears for vaginitis, and deferral of treatment until cultures were received for urinary tract infection. The small number of cases for each condition and the large intersample variability were limiting factors in this study, but the findings do suggest that higher standards of care contribute to lower therapy costs.
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PMID:Medication costs in different provider settings. 298 Sep 8

Relatively few studies have addressed the issue of the Minnesota Multiphasic Personality Inventory (MMPI) alexithymia scale's construct validity. In this study, the validity of the scale is supported by the finding of a significantly lower percentage of alexithymic individuals in a large sample of psychiatric inpatients than in samples of patients with a variety of physical disorders (i.e., migraine headaches, asthma bronchitis/emphysema, and hypertension). Validity of the scale is further supported through a comparison of the alexithymic and nonalexithymic psychiatric inpatients on a series of Rorschach and MMPI variables. As predicted, alexithymics were less verbally productive, displayed less ability to fantasize, and demonstrated greater defensive pseudonormality. Results suggest the measure may be of value in studies of psychiatric patients as well as those with physical disorders.
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PMID:The construct validity of the MMPI alexithymia scale with psychiatric inpatients. 321 Jan 18

Overweight and obesity have been examined in 7735 middle-aged men in 24 British towns. Half the men exceeded the body mass index (BMI) range associated with minimum mortality (20-25 kg/m2). Social class differences in BMI were marked and obesity was more marked in manual workers. The association of reduced BMI with cigarette smoking and of increased BMI with stopping smoking was most clearly seen in manual workers. With increasing alcohol intake, BMI increased progressively, but the effect in the heaviest drinkers was probably diminished by concurrent heavy smoking. Mean BMI decreased with increasing levels of physical activity. There was considerable variation in the rate of obesity between the towns, from 11 to 28 per cent, determined to some extent by social class. Positive associations were observed between BMI and the presence of ischaemic heart disease, high blood pressure, gout, arthritis and gallbladder disease but not with diabetes mellitus. Peptic ulcer was inversely related to BMI and bronchitis showed a curvilinear relationship. For these men, overweight or obesity is virtually 'normal', and a considerable health education effort will be needed to produce a leaner, healthier society.
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PMID:Overweight and obesity in middle-aged British men. 338 26

Men who do not drink are frequently used as a baseline against which the effects of alcohol consumption are measured. The characteristics of such men have been examined in a large-scale prospective study of cardiovascular disease involving 7735 middle-aged men drawn from general practices in 24 British towns. Non-drinkers include lifelong teetotallers and ex-drinkers, both long-term and recent. Long-term ex-drinkers have many characteristics likely to increase their morbidity and mortality; recent ex-drinkers have similar characteristics but to a less marked degree. Ex-drinkers are older than the other groups and include an increased proportion of unmarried men and men in manual occupations. They have the same high percentage of current cigarette smokers as moderate/heavy drinkers and a prevalence of hypertension and obesity similar to moderate/heavy drinkers and higher than lifelong teetotallers or occasional/light drinkers. Ex-drinkers have the highest percentage of men with multiple doctor-diagnosed disorders. In particular, they have the highest prevalence rates of angina and possible myocardial infarction on standardized questionnaire, of myocardial infarction on electrocardiogram and of recall of a doctor-diagnosis of ischaemic heart disease. They also have high prevalence rates of recall of high blood pressure, peptic ulcer, diabetes, gall bladder disease and bronchitis. They have the highest rates for regular medical treatment and the highest proportion of men who consider their health to be poor. It is abundantly clear that the general category of non-drinkers, which includes a large proportion of ex-drinkers, should not be used as a baseline against which to measure the effects of alcohol consumption. Overall, it would appear that the occasional/light drinking category (less than 15 drinks/week) provides a large and satisfactory baseline group for comparative purposes in the study of cardiovascular and other organic disorders.
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PMID:Men who do not drink: a report from the British Regional Heart Study. 340 25

An epidemic of nephritis occurred among soldiers in World War I, predominantly those in the trenches. Characterized by the sudden onset of albuminuria, hypertension, edema, and dyspnea, atypical features such as bronchitis, an evanescent course, low early mortality, and frequent relapses distinguished it from poststreptococcal glomerulonephritis. Pathologic features included glomerular ischemia, capillary thrombi, endocapillary proliferation, and frequently epithelial crescents, suggesting an underlying vasculitis. The cause was not established, but a postinfectious, possibly postviral, etiology seems most plausible. Trench nephritis was the major nephrologic problem of World War I, accounting for 5% of medical admissions and more than 10% of military hospital bed occupancy at that time.
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PMID:Trench nephritis: a retrospective perception. 351 20


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