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

Over a period of 10 years, 60,197 stress and nonstress tests were done in 25,313 patients. There were 229 (0.9%) positive tests. In 47.2% of patients who had positive tests, preeclampsia and hypertension were the indications for the test, followed by suspected intrauterine growth retardation (26.6%) (table I). The cesarean section incidence was 71%. The mean age of the patients was 32 years. Nine per cent of patients were 45 years or older, 7% between 40 and 44 years, 23% between 35 and 39 years, 30% between 30 and 34 years, 20% between 25 and 29 years, 7% between 20 and 24 years and 4% younger than 20 years. There were 13 intrauterine deaths of which 9 fetuses were regarded as too small to be delivered. Of the remaining 4 patients, intrauterine death occurred in 3 patients before cesarean section could be done and in the fourth a macerated twin was unexpectantly found when a cesarean section was done for fetal distress. Routine autopsies were not done on intrauterine deaths. The only external abnormality that could be found was an umbilical hernia. Apart from this abnormality there were 9 liveborn babies with congenital abnormalities. Four of these babies died neonatally, bringing the perinatal death rate up to 50%. Four babies (1.7%) had chromosomal abnormalities. These were trisomy-21 in two patients, a trisomy-18 and a true hermaphrodite. Ages of the patients with the trisomy-21 were 46 and 49 years. Other abnormalities were exomphalos, microcephalus with hypospadia, hydrocele, polysyndactyly and hypospadia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The prevalence of congenital abnormalities in patients with positive contraction stress tests. 343 Mar 26

Living related donor (LRD) nephrectomies are controversial due to the risks to the donor and improved cadaveric graft survival using cyclosporine A. Between December 22, 1970, and December 31, 1984, 1096 renal transplants were performed at a single institution, 314 (28.6%) from LRD. The average age was 34.3 years (range: 18-67); none had preoperative hypertension. All nephrectomies were performed transabdominally. Major perioperative complications occurred in 22 (7.0%). These include wound infections (3.5%), pancreatitis (1.0%), injuries to spleen (1.0%) or adrenal gland (0.3%) requiring removal, pneumonitis (0.6%), ulnar nerve palsy (0.6%), femoral artery thrombosis after arteriogram (0.3%), pulmonary embolus (0.3%), and upper pole infarct of contralateral kidney (0.3%). There are six known deaths in this series, none of which were related to the operation. Major late complications were seen in 50 (20.0%) of 250 patients followed for 6 to 175 months (mean 53.1 months). These included definite hypertension (5.6%), suture granuloma (4.4%), incisional hernia (3.6%), proteinuria (2.4%), bowel obstruction (2.0%), nephrolithiasis (1.2%), wound infection (0.4%), scrotal hydrocele (0.4%), and chronic pancreatitis (0.4%). While the risk of hypertension appears to increase as the interval from donation increases, no cases of renal failure after donation have been noted, and negligible proteinuria among those followed long-term has been seen in this series. It is felt that living related kidney donation is justified when the relative is sincerely motivated and well informed prior to donation.
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PMID:Living related kidney donors. A 14-year experience. 352 9

Physical examinations were performed and personal histories were obtained for 496 12-14-year-old inner city, middle school students participating in extracurricular activities. Health problems were identified in 47 (9.5%) students. The most common health problems were hypertension (5 students), cardiac arrhythmia (8), hernia (5), genital abnormality (6), and obesity (8). Of those students with a medical problem, 72% were male and 28% were female. A subset of 276 students, with a mean age of 13 years, was questioned about sexual activity. 21% of these students (36% of the males and 12% of the females) reported having experienced sexual intercourse. 47% of these students reported using condoms, 12% relied on oral contraception, and 32% used no method of birth control. Parents were cited as the source of knowledge about sex by 53%. 21% of the females sampled had not reached menarche. Self-injurious behavior such as cigarette smoking and alcohol use was reported by only 1% of students. Overall, these findings suggest that inner city, middle school students have general and reproductive health care needs that require early intervention so preventive practices can be established. The data further indicate a need for early sex education in the schools; only 9% of students stated they had received information on sex from a teacher or clergy.
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PMID:Health problems and sexual activity of selected inner city, middle school students. 364 Jan 25

The occurrence of diabetes, hypertension, and diaphragmatic hernia was investigated in an institutionalized population of long-term epileptics. Review of medical records determined the prevalence ratio of diabetes to be about 1.6% and the prevalence of hypertension to be about 2.3%. Both of these estimates are significantly lower than the rates in the general US population. The prevalence of diaphragmatic hernia among females (4.8%) was found to be significantly higher than the general population rate, but the corresponding ratio among males (3.6%) was not. Associations with major drugs used were subsequently investigated using a case-control methodology. Implications for etiologic research are discussed.
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PMID:Prevalence and correlates of diabetes, hypertension and diaphragmatic hernia among an epileptic population. 383 79

Urethral stricture in the tropics may be a serious public health problem; the majority of cases are caused by the gonococcus. The pathology is varied, and many advanced cases with complications are seen. Most strictures are seen in the posterior urethra, where fibrosis and narrowing may extend from a short length of under 5 mm to well over 10 cm. A wide variety of complications occurs. Diagnosis is easy when the patient presents in acute retention or with a history of difficult micturition, but more difficult when stricture is the underlying cause of perianal abscess, gangrene of the scrotum caused by extravasation, uremia or hypertension, hernia or rectal prolapse, urinary infection, or elephantiasis of scrotum with multiple fistulae. A careful history is helpful, paricularly if previous gonorrhea is involved. Physical examination varies according to mode of presentation and complications; a rectal examination and neurological examination should be included. Definitive investigation to prove the presence of a stricture includes urethrography and urethroscopy, if facilities are available. Indirect methods of diagnosis include tests for hemoglobin, blood urea, plain X-ray of the whole urinary tract, urinalysis, and others. It is preferable to leave instrumentation until last in diagnostic cases, to avoid infection, but a diagnostic bougie may be passed under strict aseptic conditions prior to treatment. The mainstay of treatment is regular bouginage for life, which is best done in a bougie clinic held at regular intervals. Equipment for bouginage, in order of desirability, includes soft plastic bougies, straight metal bougies, or curved metal bougies in larger sizes, a large stainless steel instrument tray, a basin for sterile water, and lubricant. Care should be taken during bouginage not to pass bougies into acutely inflamed strictures, and not to overstretch the urethra. Plastic bougies are preferable, until a stable situation has been reached. Surgery is indicated for a persistently impassable stricutre, for 1 requiring difficult bouginage at frequent intervals with many failures, for an established false passage, and for complications, especially bladder neck stenosis. Instructions for intravenous pyelograms and for urethrography from below and above, and diagrams of urethrograms indicating various pathological states and a diagnostic schema for urethral stricture are included.
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PMID:Urethral stricture. 469 33

Experimental comparison of the lungs of 7 sheep foetuses with surgically induced CDH and 7 controls permitted an assessment to be made of the changes that take place in lung growth, generally described as hypoplasia, through a study of their morphology and histology, and the lung: lamb weight ratio. Changes increased in gravity in function of the duration of hernia. They included: reduced alveolar expansion, fewer generations of bronchi and alveoli, and septal thickening. An increase in the smooth muscle component of 5th-6th generation arteries (i.e. resistance) may offer an explanation of the hypertension characteristic of CDH, and the non-reactivity of these vessels in response to vasodilators. It is also suggested that damage to the mesenchyma can be regarded as the sole cause of the changes in lung growth observed in CDH. Early treatment before these changes become irreversible is thus advisable.
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PMID:[Experimental intrauterine surgery. Morphological study of lung development in the sheep fetus with congenital diaphragmatic hernia]. 665 19

During a retrospective multicentric study of the encountered congenital pathology of the diaphragmatic domes, we focused our special attention on the prevalence of the congenital Bochdalek hernia. 140 charts were statistically analysed. The seriousness of the medical and surgical emergency situation enticed the authors to examine the most important prognostic clinical features. The interval between diagnosis and surgical therapy should be as short as possible. Respiratory acidosis and resuscitation were a common denomination in all infants who succumbed in the post-operative period. The early occurrence (less than 6 hrs) of respiratory distress disclosed the seriousness of the associated pulmonary hypoplasia. Surgical technical problems were rare. This in contrast to the struggle against pulmonary arterial and capillary hypertension. Pulmonary vasodilator drugs have not convinced those who initiated their use.
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PMID:[Bochdalek's congenital diaphragmatic hernia: a clinical review of 114 cases]. 671 Dec 39

A report is presented on gastric bypass (n = 27) and gastroplasty (n = 2) in patients with morbid obesity. One patient died postoperatively (mortality 3.4%). Mean weight prior to operation was 129 kg (96 to 205 kg), i.e. 117% (63 to 253%) in excess of the ideal weight. During a follow-up period of 6 to 46 months, the mean loss of weight amounted to 38 kg (3 to 77 kg). 86% of the patients judged their condition as being very good to good. Diseases related to obesity were reduced to a remarkable degree: hypertension from 43 to 5%, hypertriglyceridaemia from 50 to 5% and diabetes mellitus from 52 to 13%. Two patients had to be reoperated on due to a peptic jejunal ulcer, five because of an incisional hernia. No patient suffered from diarrhoea, calculi of the biliary or urinary tract or electrolyte disorders. On the basis of these results gastric bypass would appear to be indicated for the treatment of obesity not amenable to conventional therapy.
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PMID:[Indications and results of gastric bypass in the treatment of extreme obesity]. 674 Nov 46

This article describes a method for measuring the performance of clinicians treating patients with unilateral inguinal hernia or myocardial infarction. The scoring was based upon the percentage of occasions when appropriate education was given and acute conditions resolved in accordance with clinical expectations. The method was applied to patients of general surgical and general medical firms at two London teaching hospitals in 1972 and 1975. Scores for samples of each diagnosis correlated significantly with subjective evaluations of care by clinicians. Multiple regression was used to identify and weight the patient risk factors (physiological and demographic) significantly associated with lower scores in each disease. Score of patients with these risks were adjusted upward to compensate for the difficulty of achieving good clinical results when these risks were present. Comparison of firms was based upon adjusted scores. Being older and being single, widowed or divorced were significant in both diseases. High blood pressure and anemia were also significantly associated with lower scores for hernia patients, as were the number of cigarettes smoked for infarction patients. The range of scores was wide in surgical firms in both years. While relatively narrow in the medical firms, scores suggest that there is still scope for improvement in some firms. The authors discuss a plan for using these data to arrive at score standards for each disease which could be used to screen clinical care routinely.
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PMID:Measuring the quality of clinical performance with hernia and myocardial infarction patients, controlling for patient risks. 721 93

A patient with an unsuspected phaeochromocytoma presented with transient hypertension during anaesthesia for an elective hernia repair, and developed severe post-operative hypotension. The management of this acute crisis, appropriate preoperative preparation and the subsequent successful removal of the tumour is described. Awareness of this unusual presentation may help the attending physician to save such a patient.
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PMID:Unsuspected phaeochromocytoma presenting during surgery. 728 89


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