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

A freeze-dried human diet, based on linoleic acid-enriched food stuffs derived from ruminants, was evaluated and compared with a similarly-prepared diet based on conventional ruminant-derived foodstuffs, using Porton rats in a whole-of-life study. A cereal-based stock diet was used for comparison. Serum biochemical and histopathological examinations were carried out at 0.25, 1.1 and 2.1 years of age and other rats were left until they died of natural causes. Although some diet-specific biochemical differences were noted, triglyceride and cholesterol levels showed changes which were more age-specific than diet-specific. Longevity did not seem to be influenced by quantity or quality of dietary fat. The most common cause of death was a bronchopneumonia at about 2 years of age. Dietary fat also did not affect incidence of tumors. The most common tumor was a pituitary adenoma which occurred most often in females. Only minor causes of death were specific to diet with waxy intra-cardial plaques occurring in less than 5% of rats fed both of the high-fat diets and severe systemic hypertension occurring in rats fed the low-fat stock diet at the same frequency. No deleterious changes were noted that were unique to the linoleic acid-enriched diet.
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PMID:Effects of life span feeding of ruminant-derived human diets to rats. 44 65

Twenty-six patients with the syndrome of inappropriate secretion of antidiuretic hormone were reviewed. The underlying diseases were bronchogenic carcinoma (12 cases); myxoedema (five cases); diseases of the nervous system (five cases); bronchopneumonia, carcinoma of the oesophagus, acute intermittent porphria and chlorpropamide therapy (each one case). Serum sodium levels ranged between 104 and 125 mEq per litre. Eighteen patients presented neurological manifestations, which in 14 were considered to be due to hyponatraemia. Neurological signs included disorders of consciousness (stage I and II coma), extrapyramidal signs, asterixis and epileptic seizures. An hyponatraemic coma was the first manifestation of the syndrome in five cases. In all cases where the EEG was recorded it showed non-specific signs of metabolic coma. The fundi never showed signs of intracranial hypertension. Blood urea and creatinine levels were invariably low in the euthyroid patients; these values were normal or elevated in patients with myxoedema and hyponatraemia. Hypokalaemia was frequent, and hypocalcaemia constant. In eleven cases an excess of water intake revealed the clinical syndrome: six patients were excessive beer drinkers and five had received extensive intravenous infusions. In one case the deleterious effect of diuretics was evident, and in another, the syndrome became evident during radiotherapy of an oesophageal tumour. Treatment of the syndrome was successful in all cases. A review of the literature concerning the various pathogenic mechanisms corresponding to the different underlying diseases is presented. The concept of aberrant hormonal production by a tumour is illustrated by an electron microscopic study.
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PMID:Clinical, biological and pathogenic features of the syndrome of inappropriate secretion of antidiuretic hormone. A review of 26 cases with marked hyponatraemia. 100 53

A retrospective analysis of the medical charts of 117 patients (50 men and 67 women) with multi-infarct dementia took place. All patients admitted to the psychogeriatric nursing home 'Joachim en Anna' in Nijmegen between 1980 and 1989 were studied. The aim of the study was to obtain epidemiological information and to investigate the prevalence of comorbid conditions, prognosis and mortality. The results were compared with patients with Alzheimer's disease. The patients remained in the institute for 1.4 years and the mean total duration of the disease was 5.3 years. About twenty-five percent died in the first three months of admission. Life expectation, counted from time of admission, was 6 years shorter in comparison with Dutch mortality tables. Morbidity frequently seen at admission included circulatory system diseases and cerebrovascular accidents. The risk factor hypertension was seen in a smaller percentage of patients than expected. During the stay the diseases most frequently diagnosed were respiratory and urinary tract infections, adverse effects of drugs, constipation and chronic ulcers of the skin. About twenty percent of the patients were struck by a (recurrent) cerebrovascular accident or a transient ischaemic attack. Most patients died of dehydration or bronchopneumonia. There was, apart from the diagnosis of multi-infarct dementia, no single patient aspect that could predict a poor prognosis. Nursing home patients with multi-infarct dementia are clearly different from patients with Alzheimer's disease. Time spent in the nursing home and duration of disease are shorter. They have more comorbid conditions, especially of a cardiovascular nature, and they have a poor life expectation.
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PMID:[Multi-infarct dementia in nursing home patients; more comorbidity and shorter life expectancy than in Alzheimer's disease]. 143 2

Records from 910 autopsies performed at a university hospital in Salvador, Bahia, Brazil were examined in order to assess the accuracy of clinical diagnoses of the patients' underlying causes of death. This study found inaccurate clinical diagnoses in 31% of the cases. The overall rate of diagnostic error appeared to remain fairly stable from 1970 to 1982, being highest for older patients. Thirty-six percent of the 263 cancer deaths were incorrectly diagnosed, and a number of pathologies considered relatively easy to diagnose were not always correctly identified--the underlying cause of death being incorrectly diagnosed in many of the fatalities caused by such ailments as arterial hypertension, chronic obstructive lung disease, pneumonia/bronchopneumonia, and schistosomiasis. Quite aside from their direct medical implications, diagnostic errors of the magnitude observed in this and other studies seriously jeopardize the quality of vital statistics and such statistics' usefulness for improving public health.
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PMID:[Clinical diagnosis versus autopsy]. 183 Oct 25

Three patients aged over 60 with endocapillary proliferative glomerulonephritis and nephrotic syndrome were reported. Immunofluorescence and electron microscopical findings were similar in all of them: granular deposits of IgG and C 3 along the capillary loops, electron dense deposits in the subendothelial area, and partial mesangial interposition. The levels of CH 50 were slightly suppressed in two of them, but neither preceding infection nor elevation in ASLO were noticed. None of then responded to steroid therapy. One patient fell in renal failure in spite of intensive steroid therapy, and died of bronchopneumonia. In another patient, proteinuria was remitted with systemic treatment against high blood pressure. The remaining patient took a favorable course during the admission without any special treatment, but proteinuria recurred after the discharge. These clinical manifestations and clinical courses were not compatible with the diagnoses of acute glomerulonephritis, mesangiocapillary glomerulonephritis, or vasculitis. We concluded that the endocapillary proliferative glomerulonephritis in adults over 60 years might be different form of glomerulonephritis from that of AGM, MPGN, and vasculitis, in which diffuse endocapillary proliferative changes in the glomeruli are seen in younger people.
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PMID:[Three elderly cases of endocapillary glomerulonephritis and nephrotic syndrome]. 273 23

Three different cases of cerebral embolism occurring in combination with hyperthyroidism are reported. Case 1; a healthy 37-year-old woman presented with sudden onset of left hemiparesis and left sided hypoesthesia of all modalities. Embolism in area of the right middle cerebral artery was confirmed by angiography and CT scan. Laboratory examination revealed hyperthyroidism and anemia. Antithyroid treatment brought about euthyroid function while slight hemiparesis remained present. Case 2; a 79-year-old woman who suffered from hypertension for one year had sudden onset of disorientation and left hemiparesis. Electrocardiogram showed atrial fibrillation. The CT scan indicated infarction in the right anterior and middle cerebral artery. The patient was diagnosed as having masked hyperthyroidism. Although antithyroid medication reduced it to euthyroid condition, the patient is now bedridden with hemiparesis. Case 3; a 45-year-old man who had partial thyroidectomy for Basedow's disease and had been treated with antithyroid and antiarrhythmic therapy for 10 years. Suddenly, he was in coma with dilated right pupil and left hemiplegia. Atrial fibrillation and hypothyroid function were observed. CT scan indicated hemorrhagic infarction in the territory of the middle cerebral artery with transtentorial herniation. He died on the 59th day of hospitalization following an episode of bronchopneumonia. On the basis of the cases presented here as well as on the basis of those described in the literature it appears that thyrotoxic patients with atrial fibrillation exhibit high incidence of cerebral embolism, and prophylactic anticoagulant therapy may be recommended.
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PMID:Cerebral embolism and hyperthyroidism. 277 Feb 20

A 60-year-old woman with a history of hypertension and chronic headache initially presented with irritative personality change and mild but steadily progressive dementia and oral tendency, left-sided hemiplegia, intense nuchal stiffness, and swallowing difficulty in the later stage. She died of bronchopneumonia at the age of 76. The brain showed marked loss of nerve cells with gliosis in the cerebral cortex and fibrillary gliosis in the white matter in addition to the typical pathological findings of progressive supranuclear palsy (PSP): extensive subcortical neurofibrillary tangles (NFTs) and loss of nerve cells with gliosis accentuated in the globus pallidus, Luys body and substantia nigra. In many case reports on PSP, the cerebral cortex is described as normal or within normal limits [Jellinger 1971, Steele et al. 1964], and to our knowledge, there is no reported case of severe cortical atrophy as seen in this case. The differential diagnosis of this case is also discussed.
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PMID:Severe cerebral atrophy in progressive supranuclear palsy: a case report. 277 86

A 51-year-old man with diabetes mellitus and mild hypertension developed acute interstitial nephritis 4 days after starting a course of co-trimoxazole for bronchopneumonia. Following initial symptoms of overt hypersensitivity, he developed azotemia and renal tubular dysfunction with malaise and anorexia requiring hospitalization. Renal pathology demonstrated an acute granulomatous interstitial nephritis superimposed on chronic diabetic renal disease.
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PMID:Acute granulomatous interstitial nephritis due to co-trimoxazole. 326 85

The determinate causes of death, physical findings, and major pathologic findings in the organ systems of 32 patients, aged 100 years or older who died between 1921 and 1983, on whom autopsies were performed, are described. Atherosclerosis, neoplasia, and bronchopneumonia were common, but diabetes mellitus, obesity, hypertension, and cerebrovascular accident were absent or rare. Deaths from infection were fewer in the era of antibiotic usage, while cardiovascular and neoplastic deaths became more frequent during that time. The pathologic findings in our series of centenarians indicate that few of these patients died from debilitating diseases and that mortality from infection has been modified by antibiotic usage.
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PMID:Geriatric autopsy pathology in centenarians. 382 43

A 52-year-old woman presented with increasing pain, weakness, and paraesthesiae of four months' duration in the lower limbs. She suffered from chronic obstructive airways disease and hypertension. Neurological examination revealed wasting of the quadriceps muscles, weakness of the lower limbs, and absent ankle jerks. The sensory examination was normal. Full blood count, ESR, biochemical, immunological, and viral studies, urinary heavy metal assays, and cerebrospinal fluid examination were normal. Nerve conduction studies were consistent with a sensorimotor neuropathy, and electromyographic sampling was consistent with acute denervation. A sural nerve biopsy showed axonal degeneration and segmental demyelination. One month after admission, she developed carbon dioxide retention. Her weakness spread to affect the upper limbs, and she could not be resuscitated after a cardiac arrest three months after admission. General autopsy examination revealed bronchopneumonia. Neuropathological examination showed a lymphocytic infiltrate in the nerve roots of the cauda equina, the lumbosacral plexus, and the sural and vagal nerves. Increased cellularity and collagen were evident in these nerves. A diagnosis of chronic inflammatory polyneuropathy was made. The neuropathology of this entity is discussed.
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PMID:Neuropathological findings in a case of chronic inflammatory polyneuropathy. 384 15


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