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

A case of toxemia misdiagnosed as idiopathic thrombocytopenic purpura is presented. An unusual temporal relationship between the fall in platelets and the appearance of hypertension was the cause of the confusion. A rise in platelets following glucocorticoid administration is discussed.
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PMID:Toxemia of pregnancy masquerading as idiopathic thrombocytopenic purpura. 668 29

Twelve cases of benign intracranial hypertension (BIH) are reported, there being a higher proportion of women patients and a greater frequency of those in the 3rd decade of life. Symptoms were principally headache (11 patients) and/or transient or permanent visual disorders (10 patients). Bilateral papillary edema was often associated with diminished visual acuity (5 cases) and/or amputation of the visual field (5 cases). Cerebral venous occlusion was detected in 3 patients and an infective focus in 7 cases. Three patients were receiving some treatment but none of the women was taking oral contraceptives. Two were pregnant. The CSF was abnormal in 5 of the 7 patients (mixed cell reaction and red blood cells: 1 case; pleiocytosis: 3 cases; raised protein levels: 1 case), and CT scans were normal except for reduced ventricular system size in 9 patients. Follow-up for a mean of 1 year showed total disappearance of symptoms and signs in 4 cases. Papillary edema had not totally regressed at the last ophthalmological examinations performed on 5 patients, and visual sequelae (visual acuity and/or visual field anomalies) were present in 5 cases. Two patients relapsed. The conventional acceptance of the benign nature of BIH must be tempered by the possible onset of possible serious visual disorders. Two factors appear to be determinant: the presence of severe visual disorders initially and/or the existence of arterial hypertension. Various physiopathogenic hypotheses have been evoked to explain BIH. The essential mechanism appears to be an anomaly of absorption of CSF, either from increased pressure in the dural venous sinuses or lesions of the arachnoid villi, but the role of cerebral edema and/or increased cerebral blood volume cannot be excluded. Incomplete understanding of physiopathogenic mechanisms account for the numerous treatments proposed and for some confusion in their indications.
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PMID:[Benign intracranial hypertension (pseudotumor cerebri). 12 cases]. 669 22

The morbidity and 30-day operative mortality were reviewed in the 43 patients 70 years of age or older who underwent pulmonary resection between June 1976 and May 1981. In addition to their surgical illness, many of these patients had pre-existing medical conditions including: coronary artery disease (8), hypertension (14), diabetes (4), and congestive heart failure (5). The mean preoperative 1 second forced expiratory volume (FEV1) was 1.7 liters and 17 patients had an FEV1 of less than 1.5 liters. The operative mortality was 2.3% (one patient), the average duration of postoperative hospital confinement was 9 days, and 39 of 42 (93%) of the patients were discharged within 2 weeks of their operation. There were 38 postoperative complications in 25 of the 42 survivors, most of which were minor and all of which were resolved. Problems included: air leak (13), atrial fibrillation or flutter (3), myocardial infarction (1), respiratory difficulties (9), hemorrhage (2), mental confusion (3), hyperpyrexia (3), difficult-to-manage diabetes (1), and social problems (3). Only two patients required prolonged mechanical ventilation. The low operative mortality, the short postoperative stay, and the minimal number of serious complications is contrasted with other published reports describing a high-operative mortality in elderly patients. The improvement may be related to recent advances in postoperative management and anesthetic techniques. These data suggest that advanced age is not a contraindication to curative pulmonary resection.
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PMID:A review of morbidity and mortality in elderly patients undergoing pulmonary resection. 671 15

Two weeks following a renal arteriogram a 56-year-old man with severe hypertension developed a staphylococcal septicaemia. After six weeks treatment with intravenous fusidic acid and cloxacillin he became icteric, confused and disorientated. The fusidic acid was stopped and the serum bilirubin fell to normal. His confusion persisted and serum cloxacillin levels were found to be grossly elevated. The patient's mental state returned to normal following withdrawal of cloxacillin. We attribute his jaundice to treatment with fusidic acid and his acute confusional state to cloxacillin neurotoxicity.
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PMID:Staphylococcal septicaemia complicated by probable cloxacillin neurotoxicity and by jaundice induced by fusidic acid. 686 1

Interest has intensified in the possible role of dietary sodium in the etiology of hypertension and its management. A summary is provided of the evidence relating salt intake to hypertension from three sources: epidemiology of hypertension among societies, observations that management of hypertension is easier at lower intakes of NaCl, and observations that relate blood pressure to urinary output of sodium. The doubts raised about such a relationship are also summarized. Part of the confusion surrounding the relationship between sodium intake (or output) and blood pressure between individuals results from the interplay of other determinents: genetics (family history), weight, body mass index and Na/K ratio. These are discussed and research issues are outlined. The public policy implications of the current information and means for lowering of dietary sodium intake are discussed.
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PMID:Salt sensitivity in experimental animals and man. 701 85

Complications from mydriatic and cycloplegic drugs are rare compared with their extensive use. Adverse effects are often related to dosage or other factors. The ocular complications include increased intraocular pressure, pigmentation of the conjunctiva and cornea, pigment in the anterior chamber, lacrimal duct blockage, macular edema, corneal endothelium damage, hyperemia, allergy, discomfort, and blurred vision. The systemic complications are those common to sympathomimetic and parasympatholytic drugs and include tachycardia, hypertension, headache, faintness. pallor, trembling, excessive sweating, palpitations, arrhythmias, confusion, hallucinations, drowsiness, ataxia, flushed skin, high fever, dysarthria, thirst, dry mouth, convulsions, disorientation, nervousness, coma, and death. An understanding of all possible side effects is of paramount importance to those using these drugs in the treatment of anticholinesterase poisoning. This review is intended as a ready reference to the adverse effects of mydriatic and cycloplegic drugs.
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PMID:Mydriatic and cycloplegic drugs: a review of ocular and systemic complications. 703 29

This is a case report of a malignant pheochromocytoma in a 10 years old boy with attacks of abdominal pains, diarrhea, visual difficulties and hypertension. No familial history was noted. At that time, a large functionally active and extraadrenal tumor was surgically removed just above the diaphragm. 3 years later, a retroperitoneal active recurrence required a 2nd operation. Then, a vertebral invading obliged to resect almost the whole T 12 and to stabilise the rachis with a double osteosynthesis, by a posterior and anterior approach. Although this may represent compression and invasion of the bone rather than a true metastasis, the authors think that the clinical course demonstrates malignancy. They emphasize the fact that the acceptance of strict criteria should help to overcome much of the confusion regarding the diagnosis of a malignant pheochromocytoma. It is generally accepted that such a diagnosis cannot be made in the absence of metastases, irrespective of the histologic picture. The technical problems of peri-neural surgery are also discussed.
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PMID:[Malignant pheochromocytoma. A case report in a 10-year-old boy with vertebral metastasis]. 707 19

Bilateral optic atrophy developed in a 15-year-old patient receiving concomitant neuraxis radiation therapy and weekly vincristine sulfate for medulloblastoma. Other neurologic manifestations that have been associated with vincristine therapy, including inappropriate secretion of antidiuretic hormone, hypertension, confusion, and a severe peripheral neuropathy, were also observed. Neither increased intracranial pressure nor active tumor was identified. Recovery of visual function followed discontinuation of vincristine. Other neurotoxicities also reversed with drug withdrawal. Visual loss occurring in a patient receiving vincristine should alert the physician to the possibility that the process is drug related. This complication may be more likely in patients receiving concomitant or previous cranial radiation therapy. Other central neurotoxicities of vincristine may also be accentuated by neuraxis radiation. It is recommended that vincristine be discontinued in this situation if an aggressive search for a structural anatomic lesion in the optic mechanism is unrevealing, as the prognosis for recovery of visual function appears excellent.
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PMID:Optic atrophy induced by vincristine. 709 98

Cardiomyopathy and hypertension are both common in Black patients, and confusion may arise between them. A series of 19 patients admitted to hospital in congestive cardiac failure had been diagnosed as cases of cardiomyopathy but were shown to have persistent hypertension. The differential diagnosis is discussed.
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PMID:Can hypertension masquerade as congestive cardiomyopathy? 745 18

A comparison of the major cerebral arteries between humans and rats shows many similarities, including anomalies in their general organization, the structure of these vessels at the light and electron microscope levels and their morphological changes associated with cerebral vascular diseases. The general organization of the major cerebral arteries shows the following main differences between humans and rats. In rats, the internal carotid arteries have become an integral part of the circle of Willis. In the anterior cerebral arteries, a common variation in humans is the underdevelopment of one of the two arteries, whereas in rats, buttonhole-like structures are common in one or both arteries. The anterior communicating artery present in humans is absent in rats. The olfactory artery is prominent in rats, but absent in humans. The posterior communicating artery in humans is the most variable component of the circle of Willis, being asymmetric in its origin, diameters and branches. Similarly, the posterior cerebral arteries in rats often exhibit asymmetrical origin from the basilar artery. There was some confusion in the literature regarding the name of the posterior cerebral arteries in rats, but this was caused mainly by misquotations and incorrect interpretations of the papers. In humans, most aneurysms occur in the anterior half of the circle of Willis, and the incidence is higher in females than males; the middle cerebral artery is most often the one to become occluded, and the vertebral arteries are common sites for thrombosis. The various channels that constitute collateral circulation in humans provide a margin of safety, so that in case of cerebral occlusion due to thrombosis, atherosclerosis, or vasospasm related to hemorrhage, blood supply to the affected area can be maintained through these collaterals. Collateral circulation is also present in rats. However, in rats, information on the presence of various types of aneurysms, their location and frequency in normal and experimental models of hypertension and stroke is still lacking. Cerebral arteries from humans and rats are characterized by the absence of external elastic lamina, as compared with systemic arteries. A type of multipolar cell resembling the interstitial cell of Cajal is present in the cerebral arteries of humans. Its function is unknown. Earlier reports of cerebral valves have been shown to represent intimal cushions near the branching points of the cerebral arteries. Intravascular bridges present in human cerebral arteries, have not been reported in rats. Finally, the presence of vascular remodeling, as found in the cerebral arterioles of hypertensive rats, remains to be established in the cerebral arterioles of human hypertensives.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Morphology of cerebral arteries. 763 Sep 27


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