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

Long-acting oral contraceptives (OCs) for women were available for clinical experimentation in 1969. Through the country, 29 provinces, cities, and autonomous regions participated in this expirement. Based upon the cases between 1969 and 1976 findings from this expirement can be summarized as follows: 1) the 3 types of long-acting OCs have proved to be very effective, and the rate of breast cancer and cervical cancer is lower than the normal rate. The childbearing ability can be restored rapidly after discontinued use of the contraceptives. The impact on menses and metaboliism is not very serious. The health of the users and the newborn babies has not been found to be endangered. Statistics show that long-acting OCs are comparatively more secure measures for birth control; 2) some users have experienced dizziness, nausea, and excessive leukorrhea, and discontdiscontinued because of discomfort and inconvenience. This situation has some impact on the popular use of long-acting OCs. Research and studies are underway on a reduced dosage and reduction of side effects; 3) women who suffer from hepatitis, nephritis, a history of liver and kidney problems, breast tumors, cervical cancer, diabetes, active low blood sugar, or a history of having over-sized babies, or an overweight problem should not use OCs. Women who suffer from high blood pressure can only use OCs with a doctor's advice and caution.
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PMID:[Clinical observations on long-acting oral contraceptives--a report of 43,373 (author's transl)]. 26 34

An increasing incidence of endometrial cancer caused by a higher life expectancy and a number of other facters (i.e. obesity, diabetes, hypertension, lower pregnancy rate) as well as the unfavorable location for early detection when compared with cervical cancer has initiated this review in order to single out women with increased risk. Clinical characteristics of patients with endometrial cancer represented by age, menstrual disorders, reduced fertility, obesity, diabetes, hypertension, hirsutism, hyperplasia of the ovarian stroma or hilus cells in connection with an increased oestrogen effect in the vaginal smear and proliferative changes of the endometrium can be explained by extraglandular respectively peripheral aromatization of androgens to oestrogens, particular by the conversion of androstenedione to oestrone. This is supported by an increased plasma oestrone/oestradiol-ratio and increased conversion rate with age and overweight. In vivo- and in vitro-investigations have demonstrated the participation of adipose tissue in peripheral oestrogene production. The compiled data point towards the importance of the extraglandular oestrone production for the etiology of endometrial cancer by effecting the endometrium over a long period of time. The counter action of the normally cyclic changes of oestradiol and progesterone is lacking. Therefore, a dysoestrogenic effect of oestrone upon the endometrium can be fully effective, depending on the hormone receptor content of the respective endometrium. Based upon these data including recent publications, pre- and postmenopausal oestrogen therapy has to be critically reevaluated.
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PMID:[Endometrial cancer and extraglandular oestrogen biosynthesis (author's transl)]. 32 98

The organizational, educational, and policy implications of screening high-risk populations are considered for five selected conditions: (a) the role of pregnancy-risk indices for the identification of high-risk women as it relates to the efficient use of perinatal and neonatal intensive care centers; (b) screening school-age children for conductive hearing loss, with emphasis on the role of complete otologic examination, threshold testing, and tympanometry in children with a history of recent or recurrent middle ear disease; (c) the efficacy of Pap smears in reducing mortality from cervical cancer; (d) the current status of clinical examination and mammography for detecting breast cancer; and (e) the problems inherent in diagnosing and treating hypertension. Because of the increasing costs of new technology that have not yet been adequately tested, health professionals bear an increasing obligation to require scientific evidence of the efficacy of the screening procedures before instituting large-scale programs.
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PMID:Screening high-risk populations: a challenge to primary medical care. 100 64

A major challenge in the United States is to narrow the gap in the excess morbidity and mortality rates of minority populations. This article presents a synthesis of the 15-year results of a collaborative program between the Johns Hopkins Medical Institutions and an African-American community with the highest rates of premature disease and death in Maryland. The program began with an efficacious disease prevention clinical trial with patients and ended with effective population approaches. We transferred key components to community ownership and formally trained community health workers who provided health promotion counseling, monitoring, linkage, and referral services. Results indicated significant decreases in morbidity and mortality as a result of improved control of hypertension. This program has begun to decrease the health status gap in an African-American population and has demonstrated long-term sustainability. Current joint activities are directed at several major causes of excess morbidity and mortality, including smoking, obesity, hyperlipidemia, and hypertension, and at plans for programs to control diabetes, substance abuse, and breast and cervical cancer.
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PMID:Narrowing the gap in health status of minority populations: a community-academic medical center partnership. 141 34

The records of 123 patients with Stage I cervical cancer who underwent radical hysterectomy with pelvic lymphadenectomy and para-aortic node sampling from 1981 to 1988 were reviewed to assess the risks of surgery associated with increasing weight and age. Fifty-four patients were obese (20% or more over ideal body weight) and fourteen were elderly (age 65 or older). Previous abdominal/pelvic surgery and operative time were significantly increased in the obese patients (P less than 0.05). Increased weight was associated with increased blood loss (P = 0.06). Medical illnesses, transfusion rates, postoperative stay, intraoperative and postoperative complications (including wound infection and separation), long-term complications, and 5-year survival rates were not significantly different in obese and nonobese women. Diabetes mellitus, hypertension, any medical illness, intraoperative complications (29% vs 3%), and postoperative ileus were significantly higher (P less than 0.05) in elderly patients. However, operative time, blood loss, transfusion rates, postoperative stay, postoperative complications (exclusive of ileus), long-term complications (13-21%), and 5-year survival rates (77-99%) were not significantly different when analyzed by age. We found no significant increase in morbidity of radical hysterectomy for Stage I cervical cancer in the obese patient and minimally increased morbidity in the elderly patient with no increase in long-term complications or decrease in survival. Obesity should not represent a contraindication to radical surgery in appropriately selected patients with cervical cancer.
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PMID:Radical hysterectomy for cervical cancer: morbidity and survival in relation to weight and age. 161 10

Predisposing factors to cervical cancer development are age, smoking, socioeconomical status, parity, and number of sex partners. Long-term oral contraceptive (OC) use and less than 50 mg estrogen dose have been weakly linked to increased cancer risk. Regular examination and switching to other contraception in case of cervical intraepithelial neoplasia is recommended. Estrogen in sequential pills (Ovacon) increases the risks of uterine cancer by affecting the mucosa. Predisposing factors are: absence of pregnancy (nulliparity), postmenopause, hypertension, and diabetes. Parity reduces the risk. The risk is reduced in combined pills and after use of 1 year. Protection is offered by the progesterone component for 10-20 years after cessation of use. Ovarian cancer is prevented by parity and OC use even 10 years later. High estrogen levels inducing frequent ovulation damage the ovaries. Promoting factors are: old age, avoidance of breast feeding, and overweight. Breast cancer promoters are 1st pregnancy in older age, early menarche, and no pregnancy at all. OC use under age 25 and before 1st pregnancy are significant risk factors. High progesterone levels are associated with increased mitotic activity in the breast. Rare benign fibrocysts can develop into breast cancer. OC use is connected to hepatoma development mainly estrogen-induced. Liver cancer was found twice as high in OC users. Hepatoma often ruptures causing hemorrhage. 8% of liver tumors are malignant with a survival rate of 50% of patients to 4.8 years. The possible association of OCs to skin melanoma and hypophysial tumors could not be confirmed. OCs regulate menstruation, reduce bleeding, protect against uterine and ovarian cancer, but cervical and breast cancers have been influenced by them.
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PMID:[The contraceptive pill and cancer]. 207 68

Progestins counteract the positive effect of the estrogen component in oral contraceptives (OCs) on cholesterol levels thus increasing the risk of atherosclerosis. Low androgenic potency progestins do not have a negative effect, however. Other research indicates that the lower the estrogen dose in OCs the lower the risk of deep vein and superficial thrombosis. OC users, especially low dose OC users, with no other risk factors (e.g. smoking and hypertension) are not at increased risk of cardiovascular disease. Some research demonstrates elevated risk of stroke in OC users, however. Elevated cholesterol, obesity, diabetes and other factors further increases the risk of stroke. Combined OCs protect against endometrial and ovarian cancer and this effect increases with use and continues after use. Moreover OC users are not at increased risk of pituitary adenoma. Results of some studies shows an increased risk of cervical cancer, but other only demonstrates a slight increase. So far research does not indicate the following to increase breast cancer risk among OC users: early age at 1st OC use, formulation, family history, and history of benign breast disease. There is an increased risk for liver tumors in OC users, nevertheless it is rare. OCs do not raise the risk of diabetes or gallbladder disease. High dose formulations increases the risk of high blood pressure, but not so with low dose formulations. OC use does not impair, fertility, but delayed conception often occurs. Most research demonstrates no increase in pelvic inflammatory disease in OC users. OCs do not cause congenital malformations. Combined OC use is contraindicated for breast feeding mothers, but progestin only OCs can be used with no advance effects. Results of 1 study demonstrates an increase in HIV infection in OC users, but another study has opposite results. The article concludes with recommended clinical management practices.
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PMID:Reassessment of the metabolic effects of oral contraceptives. 185 68

Endometrial carcinoma found in patients younger than 50 years of age were analyzed clinicopathologically in comparison with those of other age groups. The results were 1) Out of 150 patients with endometrial carcinoma, 44 (29.3%) were diagnosed in those younger than 50 years of age and 17(11.3%) were under the age of 40. The average age of endometrial cancer was 53.6 years and that of atypical endometrial hyperplasia was 49.2. 2) The majority of these patients (93.4%) had ever complained of vaginal bleeding, whereas those younger than 40 years of age had in 82.4%. 3) History of irregular menstrual cycle was only observed in 25.6% of the patients with the age 50 or older, whereas it was complained of in 61.5% of those among forties and in 56.3% of those younger than 40. 4) Nulliparity was found in 19.8% among 50 and older, whereas 70.4% and 64.7% were seen respectively in those among forties and younger than 40. 5) Hypertension was found more frequently in older patients, but diabetes mellitus and obesity did not correlate with age. 6) Seventy cases (46.7%) has history of receiving screening for cervical cancer without detecting endometrial cancer. 7) Well differentiated adenocarcinoma (G1) and adenoacanthoma was observed frequently in younger age group. Endometrial hyperplasia was often combined with cancer in young women. Having the data above mentioned, importance of screening for endometrial cancer in younger women is discussed.
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PMID:[Clinicopathological analysis of endometrial carcinoma in young women]. 261 74

In recent years the incidence in endometrial cancer is rising. The relation of cervical to endometrial cancer has shifted to almost 1:1. The peak of age distribution is between 50 and 60 years of age. Accompanying diseases are obesity, diabetes and hypertension. The endometrial cancer has its precancerous stages. The pertinent estrogenic stimulus is probably significant for the development of precancerous lesions: adenomatous hyperplasia of the endometrium without atypias is known as an optional, that with atypia as an obligatory precancerous lesion. The range of morphologic variation extends from mature endometrial adenocarcinoma with favorable prognosis to immature neoplasias with unfavorable outcome. Besides various other parameters of neoplastic disease the depths of infiltration into the myometrium is known to be significant. The leading sign of endometrial cancer is uterine bleeding. The histological diagnosis is established by the examination of the tissue produced by curettage from the cervical canal and from the uterine cavity. A true early diagnosis--in comparison to the early detection of cervical cancer--does still not exist for endometrial cancer. Exfoliative cytology from the uterine cavity or ultrasonography does still not allow the final and definite diagnosis. Among the therapeutic alternatives abdominal hysterectomy in combination with bilateral adnexectomy plays the most important role. Depending from more specific morphologic criteria of a given case additional pelvic and paraaortic lymphnode-dissection is advised. Surgical therapy in general accounts for a 10 to 20 percent better survival. In patients who cannot surgically be treated because of the local extension of the tumor or due to a general high risk situation the primary therapy is pelvic irradiation both by packing and percutaneously. Disseminated neoplasms, adenocarcinomas in particular, respond well to large dosages of progestins, whereas combinations of cytostatics have failed to show favorable results, perhaps with the exception of those containing adriamycin. All endometrial cancer patients need special posttreatment care, because early recurrences still have a certain chance of survival when recognized and appropriately treated.
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PMID:[Precancerous conditions and cancer of the endometrium]. 269 33

Utah has lower incidence and mortality for many smoking-related forms of cancer and heart disease. It is an important epidemiologic question to assess whether the population attributable risk associated with cigarette smoking in this low-risk population is biased from under-reporting because of societal pressures not to smoke. To answer this question, we compared reported cigarette use to serum cotinine values in three different epidemiologic study designs. Included in these analyses were data from men interviewed for a cross-sectional study of dietary intake and hormones, women interviewed as a part of a case-control study of cervical cancer, and men interviewed in conjunction with a cardiovascular disease and hypertension family follow-up study. Cross-sectional study participants reported accurate cigarette usage 93.8% of the time; case-control participants accurately reported cigarette use 98.5% of the time; participants interviewed in the family cohort study correctly reported usage 82.8% of the time. Most inaccurate reporting of smoking was by exsmokers being followed for a disease known to be linked to smoking. The low attributable risk of smoking related to diseases in Utah is not from underreporting of cigarette smoking, and makes Utah an ideal population to examine other risk factors for diseases where smoking increases risk.
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PMID:Validity of cigarette smoking habits in three epidemiologic studies in Utah. 278 67


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