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

The cardiovascular and metabolic responses to severe head injury were studied in the acute phase after severe head injury with the object of determining if a common response was present and, if so, its significance in the management of the patients' intracranial and systemic physiological states. The cardiovascular response to head injury was studied by measurement of cardiac output, pulmonary capillary wedge pressure, arterial blood pressure, arterial and mixed venous blood gases and arterial and mixed venous epinephrine and norepinephrine serially in 15 patients during the first three days after injury. A hyperdynamic state was found characterized by increased cardiac output and cardiac work, moderate hypertension, tachycardia, decreased or normal systemic and pulmonary vascular resistance, increased pulmonary shunting and increased oxygen delivery and utilisation. Arterial E and NE levels correlated well with the cardiac output, cardiac work, blood pressure, heart rate, oxygen delivery, and oxygen utilization but not with vascular resistance or pulmonary shunt. The magnitude of the hyperdynamic state did not correlate with intracranial pressure, Glasgow Coma Score, or findings on CT scan. The metabolic response to head injury was studied by measurement of resting metabolic expenditure (RME) in 14 comatose head-injured patients in the first nine days after injury. During this period patients were fed with a continuous parenteral infusion of a formula containing 2 Kcal/cc and 10 mg nitrogen/liter. Indirect calorimetry was carried out for 102 patient-days. The mean resting metabolic expenditure (RME) for nonsedated, nonparalyzed patients was 138 +/- 37% of that expected for a non-injured resting person of equivalent age, sex, and body surface area. Nitrogen excretion was measured for 109 patient-days. The mean excretion was 20.2 +/- 6.4 mg/day. The mean protein caloric contribution was 23.9 +/- 6.7% and was greater than 25% for six patients, compared to normal values of 10-15%. Despite hyperalimentation, positive nitrogen balance for any 3-day period was achieved in only seven patients, and required replacement of 161% to 240% of RME with the parenterally administered formula. Head-injured patients had a metabolic response similar to that reported for patients with burns of 20-40% of the body surface.
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PMID:Cardiovascular and metabolic responses to severe head injury. 281 17

A study was made of the main signs of food motivation in 132 patients with stages I-III essential hypertension on the basis of analysis of a special questionnaire: the patients were interviewed in hospital and after discharge (a total of 40-46 days) to reveal the effect of raised arterial pressure on food behavioral reactions. Clinical signs of a hypertensive crisis were noted in 87 patients, in 45 patients raised arterial pressure was not accompanied by a crisis. In 82% of the cases hypertensive reactions produced a marked effect on the manifestations of food motivation. Anorectic reactions prevailed in the first 3-6 days in 98 of 109 patients (80.7%). These reactions were pronounced and prolonged in the patients with normal body mass. During the second week hyperphagic reactions prevailed in 68% of the cases, their frequency, expression and period were greater in the patients with concomitant obesity. The revealed time course of food behavioral reactions reflected the phase of food motivation in patients with arterial hypertension: hypertensive anorexia followed by post-hypertensive hyperphagia for 2-3 weeks.
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PMID:[Clinical evaluation of changes in alimentary motivation and arterial pressure in patients with essential hypertension]. 382 98

Although hyperphagia and obesity in the Zucker rat strain have been reported to be associated with spontaneous focal glomerulosclerosis (FGS), little is known about the age of onset and the natural history of hypertension, albuminuria, renal function, and glomerular injury in this model. We systematically investigated renal structure and function in obese male Zucker rats. Lean male littermates were used as controls. Obese rats developed glomerular mesangial matrix expansion and albuminuria by 14 weeks of age. These changes occurred despite normal inulin clearance (2.2 +/- 0.6 ml/min obese vs. 2.0 +/- 0.4 ml/min lean, P greater than 0.1) and filtration fraction (0.32 +/- 0.08 obese vs. 0.34 +/- 0.06 lean, P greater than 0.1), suggesting that increased glomerular filtration and renal plasma flow were not a prerequisite for the development of FGS. By 28 weeks of age, FGS was evident in seven of eight obese rats, and at 68 weeks of age all obese rats had marked FGS. Mean systolic blood pressure was elevated by 11 to 25 mm Hg in obese rats at all ages. Although the pathogenesis of glomerular injury is unknown, our data demonstrate that microalbuminuria, mild hypertension, and mesangial matrix expansion precede the development of progressive FGS in obese Zucker rats.
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PMID:Effects of genetic obesity on renal structure and function in the Zucker rat. 405 70

Genetically obese and hypertensive rats (Obese/SHR) were subjected to sham or bilateral adrenalectomy at 4-5 weeks of age with the onset of hyperphagia. The sham-operated Obese/SHR ate voraciously and by 180 days of age males weighed 700 g and females 590 g. The adrenalectomized Obese/SHR ate much less and weighed 325 and 225 g. The systolic blood pressure of the intact Obese/SHR ranged from 160 to 170 mmHg, whereas the blood pressure of the adrenalectomized animals ranged from 108 to 110 mmHg. The thymi of the intact Obese/SHR were massive compared to those of the adrenalectomized rats. Adrenalectomy effectively reduced the hyperinsulinaemia, adiposity, hyperlipidaemia, hyperglycaemia, and elevated BUN levels of the obese rats. Several obese rats had old or new myocardial infarcts, fatty livers, giant-sized islets of Langerhans, nodular and hyperaemic adrenal glands, narrow zona glomerulosa devoid of lipid, vacuolated inner cortical zones, foci of intimal fibrinohyalin deposits in mesenteric arteries, early glomerulosclerosis, and large, rounded bladder calculi. The adrenalectomized Obese/SHR displayed none of these stigmata. It is suggested that the genetically programmed obesity and hypertension in these SHR are mediated by abnormal activity of the hypothalamic-pituitary-adrenal-gonadal axis, may be likened to Cushing's disease in the human, and is associated with accelerated ageing.
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PMID:Ameliorative effects of adrenalectomy on the hyperphagia, hyperlipidaemia, hyperglycaemia and hypertension of obese, spontaneously hypertensive rats (Obese/SHR). 701 60

The prevalence of diabetes mellitus in Kamchatka newcomers in 26.7/1000 of the subjects examined (21 among males and 30.7 in females). The urban population is more often subjected to the risk of diabetes mellitus development (30/1000), than that of the rural locality (15/1000). Among the groups of different ages it is maximum in males, aged 50 to 59 years (48.6/1000), and in females, aged 40 to 49 years (59/1000), and is minimum in boys and girls, aged 15 to 19 years (5 and 5.3/1000, respectively). The highest indices of the distributed tolerance to glucose were seen in males, aged 50 to 59, 60 years and older (86.9 and 73.1/1000) and females, aged 50 to 59 years (68.5/1000), remaining sufficiently high in subjects, aged 40 to 49,60 years and older (33.4 and 46.2/1000). High indices of the disease prevalence are observed among office workers (5.2/1000 in males and 49.3/1000 in females) and not engaged subjects (29/1000 among males and 36/1000 among females). Cases of diabetes mellitus risk were adaptation period, (247), heredity (207), biliary (150) and hepatitis (122) diseases, overeating (104), cardiovascular diseases (97) for males, aged 50 to 59 years (48.6), and females, aged 40 to 49 years (59), arterial hypertension (36). Diabetes mellitus risk factors, i.e. the birth of large foetuses, cardiovascular diseases, age, an increased, carbohydrate content in the diet were noted in the native population. A scientific system of prophylactic measures has been developed on the base of the results obtained.
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PMID:[Prevalence of diabetes mellitus in the population of Kamchatka Province and its risk factors]. 714 80

The physician, faced with the formidable statistic of one person in the five having hypertension, should be prepared to instruct patients about the role of dietary factors, such as salt, alcohol, and overeating, in the etiology, treatment, and prevention of high blood pressure and to provide counseling and help in making dietary changes. The physician can enlist the aid of a dietitian in all phases of the task.
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PMID:Dietary considerations in hypertension. 723 52

The Spanish brush goat (Capra hiricus) was studied as an animal model for the anephric state. This rugged animal has a hardy appetite and offers ready blood access for dialysis and sampling. BUN, plasma creatinine and potassium could be brought to normal values by daily hemodialysis. Continual weight loss, severe anemia and some tendency for the development of hypertension were observed despite dialysis. Maintenance of a healthy rumen proved a continual challenge but was possible by hyperalimentation and vigorous dialysis immediately postnephrectomy.
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PMID:Chronic hemodialysis in the anephric goat. 735 40

From January 1986 through December 1992, 9 cases of diverticular disease of the colon have been surgically operated in our department. In 56% of the cases, diverticula were located in the left side, in 33% in the right side, and in 11% in the both sides. 67% cases had a complication of hypertension, 33% cases had hypoproteinemia, and 78% cases had anemia. Moreover, 67% cases had hyperlipidemia. Only one case had a minor leakage in the anastomosis after colectomy, which was cured by intravenous hyperalimentation. These results suggest that such a complication should be taken into consideration in the surgical treatment of diverticular disease of the colon, although the disease is in itself a benign disease.
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PMID:[Operative cases of diverticular disease of the colon: in comparison with colo-rectal cancers]. 809 23

An unblinded, historical controlled study of 49 bone marrow transplant (BMT) patients was carried out in our institution to assess the effect of oral pentoxifylline (PTX) on BMT regimen related toxicity (RRT). Twenty-eight consecutively treated BMT patients (17 allogeneic, 11 autologous) were entered into the PTX treatment group and treated with oral PTX 400 mg at intervals of 4 h from day -10 until day +35 or discharge, whichever came sooner. These were compared with a control group of 21 BMT patients (14 allogeneic, 7 autologous). Patient groups were very similar with respect to age, sex, conditioning regimen, graft-versus-host disease (GVHD) prophylaxis and baseline liver and renal function. Compliance with the drug was 85%. Despite this, no significant difference in days of mucositis or hyperalimentation, incidence or severity of renal or hepatic dysfunction, hypertension, GVHD, weight gain > 5%, day 100 mortality or length of hospitalization was observed. Median follow-up is > 2 years in both groups and no difference in relapse or survival was observed. We were unable to confirm an effect of oral PTX on BMT related morbidity or mortality.
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PMID:Effect of pentoxifylline on regimen related toxicity in patients undergoing allogeneic or autologous bone marrow transplantation. 779 47

Placement of two symmetrical lesions in the ventromedial hypothalamus of the rat causes massive overeating and obesity. We have studied male (n=8) and female (n=5) Munich-Wistar rats 7 months after induction of obesity and compared them with age-matched controls. Body weight and kidney weight were greater in control males versus females (396 +/- 7 and 1.5 +/- 0.1 g versus 229 +/- 4 and 1.0 +/- 0.1 g, respectively; both P <.001). Both obese males and females were heavier than lean counterparts (592 +/- 30 and 361 +/- 19 g, both P <.001), whereas kidney weight was similar between obese and control rats of each sex (obese males, 1.5 +/- 0.1 g; obese females, 1.1 +/- 0.1 g). Blood pressure was higher in obese versus control males; there was no differences between other groups. Single-nephron glomerular filtration rate was similar in control females and males and obese females but depressed in obese males. Glomerular blood pressure was normal in all groups. Urinary protein excretion and the percentage of sclerosed glomeruli were similar in control females and males and obese females but elevated in obese males. Plasma triglyceride levels were elevated in obesity, particularly in males. We conclude that hypothalamic lesioning induces overeating and obesity and selectively in the male causes hypertension and glomerular damage as well as declines in renal function. This injury is not hemodynamically mediated (glomerular blood pressure is normal) but may be related to the elevation in plasma triglyceride levels, which has previously been causally linked to glomerular damage in genetically obese rats.
Hypertension 1996 Apr
PMID:Hypothalamic lesions induce obesity and sex-dependent glomerular damage and increases in blood pressure in rats. 861 70


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