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

A group of 102 patients (66 males, age 62 +/- 11 years) surviving an acute myocardial infarction was followed for 6 to 48 months. Survival was analyzed by the method of Kaplan Meier and Cox analysis was used to identify prognostic factors. Thirteen patients died during follow up: 3 had sudden death, 3 a stroke, 3 died from heart failure, 3 had reinfarction and cardiogenic shock and 1 died from cholangitis. Most deaths occurred in the first few months of follow up. Survival was 92% at 6 months, 90% at 1 year, 88% at 2 years and 86% at 3 years after infarction. Single variable analysis disclosed a 2 to 3 fold late mortality risk associated to the presence of age over 60 years, old myocardial infarction, hypertension, diabetes mellitus and ventricular tachycardia or fibrillation during the acute phase. Greater than 3 fold risk was seen for patients developing heart failure or shock during myocardial infarction. Heart failure was the only statistically significant risk factor identified by multivariate analysis.
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PMID:[Prognosis after myocardial infarction]. 213 24

Case report of a 39-year-old woman treated by Danazol for a paroxystic nocturnal hemoglobinuria who developed benign intracranial hypertension and sclerosing cholangitis. Bilateral papilloedema cleared 4 weeks after Danazol was stopped. Twelve similar cases have already been reported in the literature. Danazol should be added to the list of drugs potentially inducing pseudo-tumor cerebri.
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PMID:[Pseudotumor cerebri induced by danazol]. 213 30

Hereditary hemorrhagic telangiectasia is a rare, hereditary fibrovascular dysplasia. We report a case associated with hepatolithiasis. Hepatolithiasis, relatively common in East Asia, is rare in the West. The association of the two conditions has not been previously reported. In this case, vascular malformations in the liver gave rise to arteriovenous and arterioportal fistulas, causing arteriovenous shunting and protal hypertension, respectively. Abnormal blood flow is the proposed mechanism for the hepatic fibrosis and nodular regeneration. Hepatic fibrosis, by causing stenosis of large intrahepatic bile ducts, bile stasis, and secondary infection, is the hypothesized mechanism for calculus formation. Hepatolithiasis ultimately caused death from acute bacterial cholangitis and septicemia.
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PMID:Hepatolithiasis in hereditary hemorrhagic telangiectasia. 232 2

On the basis of examination and treatment of 364 elderly and senile patients with obstructive jaundice and cholangitis, the authors conclude that the frequency of these complications is high and that cholangitis takes an atypical course in patients over 60 years of age. They determine the significance of the respiratory insufficiency syndrome in manifestation of the severity of the disease. In view of the high risk of surgery at the peak of jaundice and cholangitis, the authors suggest the wide use of endoscopic papillosphincterotomy according to indications for correcting biliary hypertension. It proved to be one of the most effective methods in the treatment of jaundice and cholangitis, contributed to reduction of the number of surgical operations on cavities and to a 4.4-fold decrease of postoperative death rates among this contingent of patients.
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PMID:[Treatment of nontumorous obstructive jaundice and cholangitis in middle-aged and elderly patients]. 262 3

Experience in the treatment of 238 patients for nontumorous lesions of the biliary tract by choledochotomy is generalized. Choledochotomy was performed in obstructive jaundice during the operation, in cholangiolithiasis, suppurative cholangitis, strictures of the terminal part of the choledochus, and indurative pancreatitis which were attended by biliary hypertension. Diagnostic choledochotomy was undertaken only in 5.8% of patients. Twenty-two (9.2%) patients died after choledochotomy. The method of completing choledochotomy was chosen individually according to the character of the pathological changes in the bile ducts and the acuteness of the inflammatory process. Choledochotomy was completed by external drainage of the common bile duct in 116 patients, by complete suturing of the choledochus in 19, by creation of bile-draining anastomoses in 89, and by papillosphincterotomy in 14 patients. Terminal and lateral choledochoduodenoanastomosis was formed in 25 patients, with good immediate results. Mortality was highest after papillosphincterotomy and external drainage of the choledochus.
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PMID:[Indications for choledochotomy and methods for its performance]. 267 5

The clinical features and laboratory data of 93 children with polycystic kidney disease were analysed. Family studies showed that the disease was dominant (DPKD) in 17 and recessive (RPKD) in 32 of them. Of the remaining 44 sporadic patients, 1 was classified by histological and/or imaging findings as having DPKD, 41 as having RPKD and 2 could not be classified. The symptoms tended to be more severe in RPKD than in DPKD, but there was much overlap. Death in early life was common in RPKD (55/73) and more rare in DPKD (4/18). If a child with DPKD had disease manifest during the neonatal period, then siblings were usually affected in the neonatal period. Survival to adulthood was seen in both diseases. In the patients who survived the neonatal period, hypertension was more common in RPKD (11/18) than in DPKD (4/14). Symptoms of portal hypertension were present in 2 patients with RPKD and none with DPKD. None of the laboratory investigations discriminated between the two entities. Glomerular filtration rate was diminished more often in RPKD (9/11) than in DPKD (2/8). Some difference was seen in the maximal urine concentrating ability; it was always reduced, often markedly, in RPKD but usually either normal or only moderately disturbed in DPKD. Studies on hepatic function and hepato-cellular damage were usually normal, but bacterial cholangitis was noted in some children with RPKD. The differential diagnosis between DPKD and RPKD needs to be based on the family history, family studies, radiological and/or histological features.
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PMID:Dominant and recessive polycystic kidney disease in children: evaluation of clinical features and laboratory data. 315 29

A 15-yr-old girl presented with complaints of right upper quadrant pain and jaundice. Elevation of serum alkaline phosphatase, signs of protal hypertension, and computed tomographic scan findings suggested a diagnosis of primary sclerosing cholangitis. However, cultures of the bile and of the common bile duct specimen obtained during a surgical procedure grew Cryptococcus neoformans. Treatment with amphotericin B was begun. An episode of upper gastrointestinal bleeding, however, led to the hepatorenal syndrome, and the patient died before antifungal therapy was completed. At autopsy, active sclerosing cholangitis associated with cryptococci involved the common bile duct. We suggest that opportunistic infection of the biliary tree should be considered in pediatric patients with presumed primary sclerosing cholangitis.
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PMID:Cholangitis associated with Cryptococcus neoformans. 397 25

When larvae of C. sinensis reach the biliary system and mature, the flukes provoke pathological changes, both as a result of local trauma and of toxic irritation. The appearances vary with duration and severity of the infestation, but they are sufficiently distinctive and characteristic to allow a classification into four phases as follows; 1st phase, desquamation of epithelial cells, 2nd phase, hyperplasia and desquamation of epithelial cells, 3rd phase, hyperplasia and desquamation of epithelial cells, and adenomatous tissue formation, and 4th phase, marked proliferation of the periductal connective tissue with scattered abortive acini of epithelial cells and fibrosis of the wall of the bile duct. The onset of symptoms and signs is at times gradual, at times sudden. Chill and fever up to 40 degrees C occur during the acute stage, i.e. the period less than a month after parasite invasion. And a few weeks later, the chronic stage follows with the classical clinical features. In general, symptoms and signs can be classified as follows: mild, essentially symptomless, progressive, with irregular appetite, gastrointestinal disturbances, oedema, hepatomegaly, etc., and severe, with a syndrome associated with portal cirrhosis and hypertension. Pathogenic changes and complications are generally restricted to foci, but may eventually affect the whole liver. Calculi, acute suppurative cholangitis, recurrent pyogenic cholangitis, cholecystitis, hepatitis, and acute pancreatitis are important complications. Carcinoma of the liver is often found in association with clonorchiasis, too.
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PMID:Clonorchis sinensis: pathogenesis and clinical features of infection. 639 2

From 1971 to 1980, 7015 operations of the bile duct were performed at the IIIrd Surgical Clinic (University of Brno) and the District Hospital Brno: 25 cases for acute septic cholangitis, 725 cases for acute or recurrent cholecystopancreatitis and 30 cases for acute obstruction of Vater's papilla with concomitant biliary hypertension of the biliary tree and shock symptoms. This "papillary shock" was complicated by infection and needed urgent surgical intervention.
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PMID:[Operations in acute blockade of the common bile duct and the papilla]. 663 11

Results of the observation of 160 operated patients with acalculous cholecystitis complicated by biliary hypertension resulting from choledocholithiasis, stenosis of the great duodenal papilla, indurative and acute pancreatitis or purulent cholangitis in 52,5% are described. The authors believe that the surgical intervention should include, in addition to cholecystectomy, choledochotomy followed by correction of the alterations revealed.
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PMID:[Complicated noncalculous cholecystitis]. 746 53


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