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

An analysis was undertaken, for the first time, of the total picture of the medical disorders of adults on a small Caribbean island. At present non-infectious diseases, especially diabetes and hypertension, are of major improtance. Parasitic infestation of the gut occurred in 50-60% of the hospital population. The pattern of diseases indicates that the island is in a transitional stage of its medical development, and that resources need not be directed to the curative as well as to public health programmes. The impact of peculiarities of local geography and customs are discussed as contributing to some of the more unusual diseases of the Caribbean.
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PMID:Medical disorders in a small Caribbean island. An analysis of the disease of adults in Dominica in 1972 and 1973. 126 3

The most suitable antibiotics for chemoprophylaxis in neurosurgery and risk factors for postoperative neurosurgical infection were investigated by retrospective analysis of 807 neurosurgical procedures in 566 patients between 1980 and 1989. Prophylactic antibiotics were administered intravenously for 6 or 7 postoperative days in all instances. The 807 operations were classified according to the antibiotics used into: 1) penicillin, 2) cephem-I, 3) cephem-II, 4) cephem-III, and 5) others. Postoperative neurosurgical infections occurred in 27 of 807 operations (3.3%), or 27 of 566 patients (4.8%). Hypertension and surgery performed in summer carried a significantly higher risk of infection. Diabetes mellitus, steroid administration, prolonged surgery, re-exploration, and surgery for hemorrhagic cerebrovascular diseases were associated with increased risk, but were not statistically significant. Infection rates by type of chemoprophylaxis were: 3.6% in the penicillin group, 3.7% in the cephem-I group, 1.7% in the cephem-II group, 5.7% in the cephem-III group, and 2.8% in the others group. This result indicates that the best choice for prophylactic antibiotic therapy may be a second-generation cephem.
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PMID:Postoperative neurosurgical infection and antibiotic prophylaxis. 137 63

The neutropenia often seen in infants of hypertensive mothers (IHMs) at < 12 hours of age has been associated with nosocomial infection in the first 18 days of life. To assess maternal hypertension as an independent factor for nosocomial infection, we compared 101 low birth weight (< or = 2.00 kg) IHMs to a concurrent birth weight-matched group of infants of normotensive mothers (INMs). Infants without differential leukocyte counts at < 12 hours of age were excluded, leaving 93 IHMs and 98 INMs. The incidence of neutropenia at < 12 hours among IHMs was not significantly different from that among INMs (42/92 (45%) vs 37/98 (38%)). Nosocomial infection was more frequent in neutropenic IHMs than in neutropenic INMs (12/42 vs 2/37; p = 0.007). Infection in IHMs included omphalitis (2 infants), pneumonia (4), and sepsis with or without meningitis (6); INMs had cellulitis (1) and sepsis (1). The underlying mechanism(s) for this predisposition remains to be elucidated, although limited data suggest that neutropenia may be more severe and prolonged among IHMs.
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PMID:Increased nosocomial infection in neutropenic low birth weight (2000 grams or less) infants of hypertensive mothers. 144 66

Two hundred thirty-one cases of neurocysticercosis are reviewed. Diagnosis was established by cerebral computed tomography during a seven-year period (1983-1989). One hundred and fourty-four (62%) presented with symptom-related disease (symptomatic neurocysticercosis and in 87 the diagnosis was incidental (asymptomatic neurocysticercosis). In symptomatic neurocysticercosis the parasitosis was considered inactive in 115 cases and active in 29. Seizures occurred in 135 patients (96% of the symptomatic neurocysticercosis). In the active form we also found: meningitis (n = 15), intracranial hypertension (n = 12), hydrocephalus (n = 10) and arteritis (n = 2). Treatment included praziquantel (n = 21), albendazole (n = 4), dexamethasone (n = 18) and surgery (n = 10).
Infection
PMID:Neurocysticercosis--a review of 231 cases. 158 85

Long-term experiments with the total artificial heart (TAH) are a source of valuable knowledge for later clinical application. Our observations result from 66 long-term experiments on calves and one goat ranging from 30 to 314 days, which have shown the main possible complications in the early period (one month) and later in the experiment. Problems until the second month of pumping concern the clinical pendant of the TAH as a bridge for transplantation, i.e. surgical problems, blood coagulation disorders, infection etc. Later problems are high venous pressure or arterial hypertension, infection with septic thromboembolization, mineralization of the driving diaphragm, etc., and are more closely comparable to the conditions of permanent clinical use of the TAH. Faultless surgery, device function and the regimen of pumping are essential factors in every long-term experiment, just as in clinical application. Infection is a threat throughout any experiment, as in clinical cases. The TNS-BRNO-VII/clin/80 TAH has been implanted in six patients.
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PMID:The applicability of experimental experience with the total artificial heart to its clinical use. 160 17

Rapid socioeconomic development has led to great changes in health and disease patterns in Bahrain. Specifically, chronic diseases are replacing infectious diseases as the leading causes of morbidity and mortality. Diabetes mellitus is 1 chronic disease which causes considerable problems in Bahrain. It has a higher death rate than that of hypertension, but a lower death rate than that of cardiovascular diseases. Type 2 (noninsulin-dependent) diabetes is the most prevalent form of diabetes in Bahrain. Changes in dietary habits and lifestyle occur with rapid development in Bahrain, often resulting in obesity and decreased physical activity, particularly in women. Obesity and lack of physical exercise are risk factors of Type 2 diabetes. A community- based nutrition survey among 18-to-48 year-old mothers in Bahrain reports that 8.5% suffer from diabetes. The prevalence of diabetes among elderly Bahrainis is 13.4% (15% in females and 10.2% in males). Physicians in Bahrain tend not to list diabetes mellitus as the main cause of death; thus there is underreporting of diabetes-related mortality. Nevertheless, diabetes is responsible for 3.4% of all deaths in Bahrain. Yet, Bahrain does not have programs to detect or control diabetes. Health workers in health centers can and do provide advice on health care and dietary management, but they are not properly trained. Physicians manage diabetes through dietary restrictions, tablets, or insulin injections. Mass media promote prevention of diabetes. Their effectiveness is low, however, because educational programs are poorly designed and unattractive. The government should accord diabetes prevention and control high priority. It should support and implement training of physicians in diabetes management, public education, epidemiological surveys, and nutritional assessment of local foods.
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PMID:Diabetes mellitus in Bahrain: an overview. 164 9

Between March 1982 and March 1991, 225 heart transplantations (HTx) have been performed in 220 patients suffering end stage cardiac disease. Thirteen percent were females and 87% were males. Age range was from 5 to 68 years. The underlying cardiac disease was ischemic cardiopathy in 51.5%, congestive dilated cardiomyopathy in 42%, valvular cardiomyopathy in 3.5%, toxic myocarditis (post-adriamycin) in 1.5% and chronic rejection in 2.5% (retransplantation). Selection of the recipients was done following the currently well established criteria also taking into account the absolute major contraindications for HTx. Due to the still increasing demand of donor organs, currently donor age has been extended up to 50 years for male and 55 years for female donors. One quarter of the grafts were harvested on site in our institution, two other quarters were harvested somewhere else in Belgium and the last quarter provided by other countries cooperating with Eurotransplant. All patients have undergone orthotopic cardiac transplantation using the standard Lower and Shumway technique. Immunosuppression protocols have changed four times throughout the years. Nevertheless all were based on the use of Ciclosporine variously combined with other current immunosuppressive drugs. Rejection monitoring relied on routine endocardiac biopsy and was diagnosed according to the Billingham criteria. The in-hospital mortality is currently 11%. Infection, early right heart graft failure and acute rejection were the leading causes of death. The major causes of early morbidity were several curable infections, reversible rejection episodes, transient acute renal failure and controllable arterial hypertension. Among the survivors followed for at least one month up to nine years, half of late mortality was caused by chronic rejection followed by infection, sudden death, metabolic disorders, stroke and malignancy. Late morbidity involves cases of mild coronary graft diseases, biological renal insufficiency, some degree of arterial hypertension, dislipidemia. Current actuarial survival rate is 87% at one year, 76% at 5 years up to 9 years. Our experience confirms that HTx represents today and effective therapy for selected patients suffering end stage cardiac disease.
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PMID:A survey of nine years heart transplantation at Erasme Hospital, University of Brussels. 178 50

A 22-year old unmarried healthy woman was admitted to the Swedish department with low fever, tiredness, SR 75 mm, positive uricult, but no urinary tract symptoms. Urinary tract infection was suspected and treatment was started with norfloxacin. Nevertheless, the urine culture proved to be negative. A few weeks later she had increasing trouble with stiff knee and shoulder joints and the left foot became swollen. The subfebrile status continued, and tonsillitis was suspected and diagnosed. V-penicillin and cefaklor treatment was applied. She was transferred to the infectious diseases ware, where fever was confirmed with leukocytosis (19 x 1 billion/1), C-reactive protein at 66 (normal value 10) mcg/ml, pronounced blood pressure increase (160/130 mm Hg), anemic signs, and pathological liver status with increased transaminases (ASAT 6.3-10.4 and ALAT 8.,8-16 ukat/1). ALP increased slightly to 6 ukat/1. The symptoms of weight loss indisposition, and muscles and joints aches, especially in foot ache continued. Collagen disease was suspected, and she was transferred to the internal medicine department. She regularly had tachycardia and high blood pressure. She had to use crutches for mobility because of the pain. S-albumin was 32 (normal 36- 50) g/l and S-hepatoglobin was 2.7 (normal value .4-1.8) g.l. Various others tests were normal. Ulnaris neuropathy was suspected on the left hand. Intensive blood pressure reducing combination treatment was started with 200 mg x 1 of metoprolol, 10 mg x 2 nifedipin, and 20 mg x 1 enalapril. The Desolett oral contraceptive (containing 30 mcg of ethinyl estradiol and 150 mcg of desogestrel) she had been taking for a few months were discontinued. Quick improvement of clinical and laboratory parameters followed. SR and leukocytosis became normal. The values of ALP, ASAT, and ALAT became normal some days later. She was discharged shortly thereafter, and blood pressure medication was gradually discontinued. In the 1940s there were reports about the hepatotoxic effects of synthetic estrogens followed by carbohydrate, lipid, and protein metabolism alterations. Jaundice has also been reported, and the Swedes have an ethnic susceptibility to it. The global incidence rate is 1/10.000 vs. 1/100 and 1/4000 in Sweden induced by high-dose OCs containing more than 50 mcg ethinyl estradiol, but with low-dose OCs this rate is much lower. Both estrogens and gestagens can increase blood pressure. A 1969 study reported that 22 young women developed arthritis, arthralgia, and myalgia after taking pills for 3- 12 months. Rheumatic symptoms were also recorded with pill use. Thus, it is very likely that OCs were responsible for the patient's symptoms, especially since her status rapidly improved after discontinuing them.
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PMID:[Were the severe adverse effects on several organs and the marked blood pressure increase caused by oral contraceptives?]. 182 62

Mortality statistics of Peninsular Malaysia for the period 1950-1989 have been studied in relation to cardiovascular diseases, with particular emphasis on coronary heart disease as an important cause of death. It was observed that among six major disease groups reviewed, cardiovascular diseases which occupied third place as a cause of death in 1950 emerged as the number one killer during the 1970s and has remained so since (with exception in 1980). In contrast, infectious diseases which ranked first in 1950 dropped to fourth position in 1980. Between 1960 and 1980, mortality due to cardiovascular diseases was higher in males than in females. This tendency became less apparent during 1985-1989. With reference to race, the incidence of cardiovascular deaths was highest in Indians followed by Chinese and Malays. Among the specific cardiovascular diseases, coronary heart and cerebrovascular diseases accounted for the main causes of mortality. Mortality due to coronary heart disease has increased by more than three fold over the last 40 years and is still rising. However, mortality incidence due to rheumatic heart disease and hypertension decreased during the same period. In 1965, mortality due to coronary heart disease was highest in the 55-59 age group. In recent years (1985 to 1989), it shifted to the older age group (i.e. 65-69). There was a tendency for higher mortality due to coronary heart disease in males compared to females. Indians had a higher mortality due to coronary heart disease than Chinese and Malays.
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PMID:Cardiovascular mortality in Peninsular Malaysia: 1950-1989. 756 97

With increasing urbanization, hypertension and its complications are becoming major health problems in many tropical countries. In particular, hypertension is a major cause of illness in black Africans. There is good evidence that an increasing dietary salt intake is partly responsible for this rising incidence of hypertension and possibly restriction of salt may help in prevention. The public health requirements for the prevention, detection and management of hypertension are likely to consume scarce resources in countries where life expectancy is gradually rising due to improved control of communicable disease and malnutrition. Failure to address the problem of hypertension could have serious effects on morbidity and mortality of economically active individuals in developing countries.
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PMID:Some recent advances in non-communicable diseases in the Tropics. 1. Hypertension: an emerging problem in tropical countries. 194 31


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