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

Right atrial hypertension has been considered to have a major physiologic influence on the formation of transudative pleural effusions. Since pleural fluid is thought to be cleared primarily by the parietal pleural lymphatic vessels that empty into the systemic veins, systemic venous hypertension secondary to right atrial hypertension should decrease the lymphatic drainage of the pleural space. We retrospectively studied nine patients and prospectively studied 18 patients with long-term right atrial or pulmonary arterial hypertension (or both). All patients had stable respiratory symptoms, and none had a significantly elevated pulmonary arterial wedge pressure. Our purpose was to determine the relationship of right atrial and pulmonary arterial hypertension to the development of transudative pleural effusions. Posteroanterior and bilateral decubitus chest roentgenograms and ultrasound were used to detect pleural effusions. Pleural effusions were not identified in any of the 27 patients, even in four patients with right atrial pressures greater than 20 mm Hg. We conclude that chronic elevation of right atrial pressure or pulmonary arterial pressure (or both) alone is not a cause of pleural effusion. In contrast, elevation of left atrial and pulmonary arterial wedge pressures is associated with the formation of transudative pleural effusions in man. Thus, if pleural effusions are detected in patients who have cor pulmonale, a search should be made for coexisting left heart failure or a primary cause of pleural inflammation, such as pulmonary emboli or infection.
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PMID:Lack of association of pleural effusion with chronic pulmonary arterial and right atrial hypertension. 367 41

These students, as representative of french population, were examined in 1983. Right humeral arterial blood pressure was measured three times on dorsal decubitus with a mercury manometer by a medical doctor. People with a systolic arterial pressure greater than or equal to 150 mmHg and/or diastolic arterial pressure greater than or equal to 90, were considered as hypertensive. These hypertensive people came then for a new complete examination, six months later. A witness group, drawn by lot, were examined in the same conditions. Systolic, diastolic and mild arterial blood pressures (in mmHg) were for: (table; see text) Prevalence of hypertension is 2.2 p. 100 (46) for girls and 11.9 p. 100 (184) for boys. The most important difference between high blood pressure people and normal blood pressure people lies in morphological characters. (Table: see text). Sport activities, coffee and diet concerning sodium are identical in the two groups. High blood pressure people smoke less than normal blood pressure people. Previous history of hypertension are more frequent in high blood pressure people than normal blood pressure people. Upright posture induce modification in pressure on high blood pressure people. Meanwhile, stress induced by mental arithmetic, does not bring more elevation pressure about high blood pressure people than normal blood pressure people. Six months later: 58 p. 100 of high blood pressure group have still a high blood pressure, 26 p. 100 have a borderline blood pressure (systolic greater than or equal to 140, diastolic greater than or equal to 85).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Epidemiology of arterial hypertension in students at the University of Nice]. 393 33

Reproductive care of women with spinal cord damage demands knowledge of such women's reproductive potential and the specific complications to which these women are prone during pregnancy and childbirth, especially autonomic hyperreflexia. Fertility in cord-damaged women of reproductive age is generally undiminished as are libido, ability to have intercourse, and ability to bear children. Frequent complications of cord-damaged pregnant women include urinary tract infection, anemia, pressure sores, sepsis, unattended birth, and autonomic hyperreflexia. Autonomic hyperreflexia or autonomic dysreflexia occurs during labor in up to two thirds of women with cord lesions above T-6. Autonomic hyperreflexia results from noxious stimuli including distention of the bladder, cervix, or rectum, which evokes mass triggering of sympathetic and parasympathetic afferents that are uninhibited by supraspinal centers below the cord lesion. Autonomic hyperreflexia manifests itself with sudden onset of marked hypertension and headache during uterine contractions, as well as bradycardia or tachycardia, various cardiac dysrhythmias, and marked diaphoresis with piloerection and flushing above the level of the cord lesion. We describe the second reported occurrence of intraventricular hemorrhage due to autonomic hyperreflexia during labor and detail recommendations for anticipating and mitigating this potentially lethal complication of parturition in cord-damaged women. Pregnancy and parturition are best carried out with informed cooperation of the patient and of obstetric, cord rehabilitation, anesthetic, and nursing personnel.
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PMID:Autonomic hyperreflexia: a mortal danger for spinal cord-damaged women in labor. 397 Jan 1

Autonomic dysreflexia, a syndrome sometimes occurring in spinal cord injured (SCI) individuals, may be life-threatening. It involves, in varying degrees, hypertension, diaphoresis, headache, bradycardia, anxiety, and flushing and is believed due to unrestricted sympathetic activity below the level of the lesion in individuals with injuries above T4-6. The most frequent causes of the syndrome are urinary infections, rectal impaction, bladder distention, and decubitus ulcers. To our knowledge, medication has seldom been described as causal agent. We report here on an autonomic dysreflexic syndrome following use of an isometheptene combination (Midrin), to treat migraine. The individual involved is a C4-quadriplegic man with a long history of migraines. He was given a standard initial adult dose of the medication. Over a one-hour period, he was initially relieved of the headache, but then noted a new more severe headache, diaphoresis, and flushing. His vital signs showed progressive BP elevation to 210/130 and a relative bradycardia. Treatment over the next three hours was limited to elevation of the head of the bed and observation, during which his vital signs returned to baseline and he became asymptomatic. This experience reinforces the belief that sympathomimetic drugs in general, and isometheptene in particular, should be used in caution in patients with high-level SCI.
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PMID:Autonomic dysreflexia due to medication: misadventure in the use of an isometheptene combination to treat migraine. 403 34

In the present study we report the renal pathological findings from autopsy material along with relevant clinical data on 21 spinal cord injury patients with end-stage renal disease (SCI-ESRD) treated with maintenance haemodialysis. These data are compared with the relevant clinical and post-mortem findings on 43 ambulatory dialysis patients who expired during the same time period. The SCI-ESRD patients exhibited markedly different clinical and renal histopathological data when compared to the ambulatory--ESRD group. Chronic pyelonephritis and amyloidosis dominated the findings and were the major causes of renal insufficiency. Acute pyelonephritis, papillary necrosis, calculous disease, pyonephrosis and perinephric abscess formation were also more frequently present in the SCI-ESRD patients. Hypertension and nephrosclerosis, which were common findings in the ambulatory--ESRD patients were comparatively rare in the SCI-ESRD patients. In addition, the incidence of acquired cystic disease (ACD) was considerably less in the SCI-ESRD group. Although the reasons for these findings are not entirely clear several possible explanations are given. Infection with gram negative sepsis was the predominant cause of death in the SCI-ESRD patients, while death secondary to cardiovascular disease predominated in the ambulatory-ESRD group. Furthermore, the urinary tract and infected decubitus ulcers were determined to be the major source for sepsis in the SCI patients. From these findings it would follow that more effective prevention and control of these infections would result in not only a lower incidence of renal failure but also a substantially reduced morbidity and mortality in chronic SCI.
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PMID:Renal pathology in end-stage renal disease associated with paraplegia. 671 46

A cross-sectional study on the correlates of elderly disability was conducted in Taiwan. A total of 400 subjects was randomly selected according to Barthel Index scores from among 2600 subjects, which was a sample of a previous community-based health survey of elderly aged 65 or over. After comprehensive interviews and examinations of the subjects, disability dimensions and its correlates were identified. Results showed elderly with lower Mini-Mental State Examination scores and chronic diseases (such as stroke, pressure sores, hypertension, fracture, etc.) were more physical-functionally and socially disabled. This suggests that prevention and treatment of chronic diseases should be pursued further and that further assessment of cognitive-mental status in the elderly is warranted. In addition, males were more disabled than females in a physical-functional aspect, which may be the consequence of the traditional Chinese cultural effect.
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PMID:Disability among the elderly of Taiwan. 757 14

The state of health of old patients with spinal cord injury (SCI) was investigated to clarify the disorders that they are presently suffering from. A questionnaire was sent by mail to 668 patients with SCI living in western Japan. Valid answers were returned from 448 (67%), and they were divided into a young group (160 patients aged 18-39 years), middle-aged group (193 patients aged 40-59 years), and elderly group (95 patients aged 60-73). About 30% in the young group answered that they were ill or worrying about their health. This percentage was about 60% in the middle-aged and elderly groups. According to disease types, none of the young group had urological diseases except urological impairment or cardiovascular diseases, but many of the elderly group had urological tract infection, kidney diseases, cardiovascular diseases, and digestive diseases. Decubitus ulcer was reported in all groups. Urological diseases and decubitus ulcer were considered to be characteristic ailments of individuals with SCI. The elderly group was also characterized by a high incidence of adult diseases such as hypertension and diabetes mellitus. Therefore, the types of diseases and their frequency are considered to be different in older patients with SCI compared with the aged population in general because of the characteristic conditions of SCI in addition to adult diseases.
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PMID:Characteristics of the health conditions of old patients with spinal cord injury. 773 May 99

The management of patients with acute ischaemic stroke includes treatment of stroke itself, the management of medical problems, and the early initiation of rehabilitation. Current research focuses more on specific stroke treatment, such as reperfusion or prevention of extension of ischaemic brain damage, than on the management of general conditions and the treatment of medical complications associated with acute stroke. At present, a better prognosis of stroke is more often the consequence of good general management than of a specific therapy. General management of stroke includes cardiac and pulmonary care, fluid and ion balance restoration, metabolic maintenance, blood pressure control and prevention of bed sores and phlebitis. Treatment of elevated intracranial pressure and temperature control must also be considered in some cases. Several points, however, remain controversial, such as the treatment of arterial hypertension and the management of cardiac arrhythmia.
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PMID:General management of patients with ischaemic stroke: clinical features and epidemiology. 774 14

The objective of this study was to describe the health problems of a group dementia patients on admission and during residence in a Dutch nursing home and to compare these with figures of patients of 75 years and over from general practice. In 890 nursing home patients suffering from dementia prevalence of health problems on admission and the incidence during the residence were classified by means of the ICHPPC-2-defined. The differences between men and women were studied as was the influence of the season on the incidence during the stay. Results were compared with figures of patients of seventy five year and over from the continuous morbidity registration (CMR) from 'Nijmegen'. The most frequently occurring health problems on admission were: varicose veins of legs, acquired deformation of the spine, presbyacusis, hypertension, arthrosis, COPD, cerebrovascular disorders, heart murmur, cataract and chronic ischemic heart disease. During the residence the following health problems were frequently diagnosed: urinary tract infection, side effect of medicine, constipation, pneumonia, pressure sore, feeding problem, contusion, heart failure, cold and conjunctivitis. There were clear differences between men and women. Especially the incidence of intercurrent diseases showed great differences from the patterns in general practice. Prevalence of health problems on admission to the nursing home home agreed mor with figures from general practice. Respiratory tract infections frequently occurred in winter and urinary tract infections, pressure sores and conjunctivitis seemed to occur more in the summer. Nursing home patients with dementia have a lot of chronic and intercurrent health problems. They differ clearly from patients in general practice.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Incidence and prevalence of health problems in a group of nursing home patients with dementia. A comparison with family practice]. 780 16

While studying the functional activity of poly- and mononuclear leucocytes in 75 patients with various clinical types of ischemic heart disease (angina of effort, angina decubitus, arrhythmias, cardiac insufficiency at the background of atherosclerotic cardiosclerosis and atherosclerotic hypertension), decline in the functional activity of the phagocytizing cells has been revealed, this being considered to be a pathogenetic prerequisite for atherosclerosis progression.
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PMID:[The functional activity of the poly- and mononuclear leukocytes in patients with different clinical forms of ischemic heart disease]. 783 69


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