Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pheochromocytomas cause the most dramatic life-threatening crises in all of endocrinology. Pheochromocytoma is an explosive clinical syndrome that may be characterized by either severe hypertension associated with cerebral, cardiac, and renal complications or hypotension, or even shock and sudden death. Other emergencies include lactic acidosis, hypoglycemia, hypercalcemic crisis, severe hypokalemic alkalosis, and acute bowel obstruction due to bowel ischemia, necessitating prompt surgical intervention. Better understanding of the mechanisms of catecholamine action and the pathophysiology of pheochromocytoma and the availability of various treatment modalities have made successful management more promising than ever before.
 ...
PMID:Pheochromocytoma. 832 90

Markedly premature infants may present with intestinal obstruction and perforation secondary to inspissated meconium in the absence of cystic fibrosis. Between 1990 and 1994, 13 patients were treated for intestinal obstruction secondary to inspissated meconium. The average birth weight was 760 g. Prenatal and postnatal risk factors were identified, and included intrauterine growth retardation, maternal hypertension, prolonged administration of tocolytics, patent ductus arteriosus, hyaline membrane disease, and intraventricular hemorrhage. Stooling was absent or infrequent during the first 2 weeks of life. Surgical presentation consisted of distension and/or perforation between days 2 and 17 of life. Twelve patients required operative intervention. Findings invariably included one or more obstructing meconium plugs with proximal distension and frequent necrosis of the dilated segments. Surgical options consisted of resection or enterotomy, accompanied by primary closure or by distal irrigation and exteriorization. Irrigation led to iatrogenic bowel injury in two patients. One patient was managed successfully with oral and rectal gastrograffin and oral acetylcysteine. Ten patients were discharged, all of whom had normal stooling patterns and tested negatively for cystic fibrosis. Three patients died, two from the primary disease. The markedly premature infant is at risk for obstruction and eventual perforation secondary to meconium plugs, presumably formed in conjunction with intestinal dysmotility. Prompt diagnosis and timely intervention require a high index of suspicion, attention to stooling patterns and abdominal examinations, and screening radiographs when indicated.
 ...
PMID:Meconium obstruction in markedly premature infant. 863 62

We analysed the results of oocyte donation to women of advanced reproductive age (> or = 45 years old) and followed their pregnancies through to delivery in order to assess obstetrical outcomes. Patients (n = 162) aged 45-59 years (mean +/- SD; 47.3 +/- 3.4 years) underwent 218 consecutive attempts to achieve pregnancy. Oocytes (16.2 +/- 7.2 per retrieval) were provided by donors < or = 35 years old. Cleaving embryos (8.2 +/- 4.8 zygotes/couple) were transferred transcervically (4.5 +/- 1.1 per embryo transfer) to recipients prescribed oral micronized oestradiol and intramuscular progesterone. Following oocyte aspiration there were six instances of non-fertilization (2.8%) and 212 embryo transfers. A total of 103 pregnancies was established for an overall pregnancy rate (PR) of 48.6%, which included 17 preclinical pregnancies, 12 spontaneous abortions, and 74 delivered pregnancies (clinical PR 40.6%; delivered PR 34.9%). Multiple gestations were frequent (n = 29; 39.2% of pregnancies) and included 20 twins, seven triplets, and two quadruplets. Two of the triplet and both of the quadruplet pregnancies underwent selective reduction to twins. Antenatal complications occurred in 28 women (37.8% of deliveries) and included preterm labour (n = 9), gestational hypertension (n = 8), gestational diabetes (n = 6), carpel tunnel syndrome (n = 2), pre-eclampsia (n = 2), HELLP syndrome (n = 2), and fetal growth retardation (n = 2). 48 (64.8%) deliveries were by Caesarean section. The gestational age at delivery for singletons was 38.3 +/- 1.3 weeks (range 35-41 weeks), with birth weight 3218 +/- 513 g (range 1870-4775 g); twins 35.9 +/- 2.0 weeks (range 32-39 weeks), birth weight 2558 +/- 497 g (range 1700-3450 g); and triplets 33.5 +/- 0.7 weeks (range 32-34 weeks), birth weight 1775 +/- 190 g (range 1550-2100 g). Neonatal complications (4.6% of babies born) included growth retardation (n = 2), trisomy 21 (n = 1), ventricular septal defect (n = 1), and small bowel obstruction (n = 1). There were no maternal or neonatal deaths. We conclude that oocyte donation to women of advanced reproductive age is highly successful in establishing pregnancy. However, despite careful antenatal screening, obstetrical complications are common, often secondary to multiple gestation.
 ...
PMID:Oocyte donation to women of advanced reproductive age: pregnancy results and obstetrical outcomes in patients 45 years and older. 898 Nov 51

Hemolytic uremic syndrome spontaneously arises in a few patients with advanced cancer, but it is more commonly related to the use of certain chemotherapeutic agents. Mitomycin-C is, etiologically, the most common causative agent inducing hemolytic uremic syndrome, in a dose dependent manner. We report this syndrome, attributable to mitomycin-C at a cumulative dose of 40 mg/m2, in a gastric cancer patient. A 42-year-old female with stage III gastric cancer underwent radical gastrectomy and was given mitomycin-C at 10 mg/m2 intravenously every four weeks as adjuvant therapy. Hemolytic uremic syndrome was diagnosed three months after the last dose of mitomycin-C administration. The most prominent symptoms included pallor, hypertension and anasarca, with laboratory evidence of microangiopathic hemolytic anemia, azotemia and hyperkalemia. Her disease was progressive, but fortunately stabilized after staphylococcus column A dialysis. Her disease remained in remission for 24 months from the time of diagnosis, and then relapsed in the form of peritoneal carcinomatosis with partial intestinal obstruction.
 ...
PMID:Mitomycin-C induced hemolytic uremic syndrome: a case report and literature review. 915 2

A 5-year-old boy presented with episodic, postprandial abdominal pain and hypertension. A few days after the onset of symptoms, the pain became more severe, and progressed into a picture of acute abdomen and intestinal obstruction. Urgent laparotomy findings showed the presence of small bowel gangrene. Pathology findings of the superior mesenteric artery (SMA), which was found to be occluded, showed intimal fibroplasia. The patient died 7 weeks after the onset of symptoms.
 ...
PMID:Abdominal angina and intestinal gangrene--a catastrophic presentation of arterial fibromuscular dysplasia: case report and review of the literature. 931 69

Appropriate management of renal trauma is controversial. Successful outcome and long term complication rates are not well defined. In an effort to evaluate management options, outcomes, and complications of renal injuries, we conducted a retrospective review of all trauma patients admitted to the trauma service from January 7, 1989 through August 31, 1995. Inpatient and outpatient charts were reviewed for type and mechanism of injury, radiologic studies utilized, method of treatment, and short and long term complications. Fifty-five patients were identified with renal injuries. Most injuries were parenchymal injuries due to blunt trauma. Only nine patients with renal artery injuries and four patients with collecting system injuries were identified. CT scan was the most commonly used study to identify renal injuries. All nine renal artery injuries were due to blunt trauma and were initially diagnosed by CT scan. Six were confirmed with arteriogram, and two with renal scans. Of the seven patients seen in follow-up (average 153 days), there were three complications: one patient with small bowel obstruction and two patients with hypertension. Among the 47 patients with parenchymal injuries, including 4 patients with collecting system injuries, there were 2 with complications: an intraoperative ureteral transection and a urinoma. Both complications were treated successfully with a ureteral stent. Five deaths occurred in the entire group; none were related to renal injury. Thirteen patients underwent laparotomy for associated injuries only. Eight patients underwent surgical treatment for their renal injury, including five nephrectomies. The nephrectomy rate among those patients who underwent laparotomy as part of their initial management was 20 per cent, versus 3 per cent for those patients initially managed nonoperatively. Thus, most renal injuries can be managed nonoperatively with a low incidence of complications. The incidence of long-term complications after renal artery injuries and the appropriate management of these patients deserves further study.
 ...
PMID:Management of renal trauma at a rural, level I trauma center. 952 Aug 11

Y-27632, a highly selective inhibitor of p160ROCK, desensitizes the smooth muscle to Ca2+ and inhibits smooth muscle contraction. While this drug has the potential to become a novel drug for hypertension, it might also affect other smooth muscle, including that of gastrointestinal tract. We studied the effects of Y-27632 on gastric contractions in conscious rats. Strain gauge force transducers were sutured onto the serosal side of the gastric antrum and contractions were recorded before and after the intravenous injection of Y-27632. Doses of 1.0 mg/kg to 10 mg/kg significantly decreased contraction amplitude and the motility index in a dose dependent manner. With 10 mg/kg, the mean amplitude was decreased by up to 69 +/- 14% and the motility index by up to 81 +/- 7%. The change occurred immediately after drug infusion and lasted for 3.5h. Contraction frequency showed only a slight decrease. No signs of bowel obstruction were observed. These results indicate that Rho-mediated Ca sensitization has a role in the physiologic contractions of gastric smooth muscle in rats. Y-27632 is useful to investigate the physiology of gastrointestinal motility.
 ...
PMID:Y-27632 inhibits gastric motility in conscious rats. 1066 15

We evaluated the role of endothelin-B- (ET(B)) receptor-mediated action in the development and maintenance of deoxycorticosterone acetate (DOCA)-salt-induced hypertension, cardiovascular hypertrophy and renal damage, using the spotting lethal (sl) rat which carries a naturally occurring deletion in the ET(B)-receptor gene. Homozygous (sl/sl) rats exhibit abnormal development of the neural crest-derived epidermal melanocytes and the enteric nervous system (ENS), and do not live beyond 1 month because of intestinal aganglionosis and resulting intestinal obstruction. Therefore, the dopamine-beta-hydroxylase (D betaH) promoter was used to direct ET(B) transgene expression in sl/sl rats to support normal ENS development. D betaH-ET(B) sl/sl rats live into adulthood and are healthy, expressing ET(B)-receptor in adrenals and other adrenergic neurons. When homozygous (sl/sl) and wild-type (WT) (+/+) rats, all of which were transgenic, were treated with DOCA and salt for 4 weeks, the homozygous rats exhibited significantly earlier and higher increases in systolic blood pressure than WT rats. The daily oral administration of ABT-627, a selective ET(A)-receptor antagonist, almost completely suppressed the DOCA-salt-induced hypertension in both groups. Renal dysfunction and histological damage induced by DOCA-salt treatment were more severe in homozygous than in WT rats. Increased and marked vascular hypertrophy of the aorta was also observed in homozygous rats, compared with WT rats. Renal and vascular injuries induced by DOCA and salt were significantly improved by ABT-627 administration. We propose that ET(B)-receptor-mediated actions are protective factors in the pathogenesis of DOCA-salt-induced hypertension. ET(A)-mediated actions are at least partly responsible for the increased susceptibility to DOCA-salt-induced hypertension and related tissue injuries in ET(B)-receptor-deficient rats.
 ...
PMID:Increased susceptibility to deoxycorticosterone acetate-salt-induced hypertension in endothelin-B-receptor-deficient rats. 1107 44

Chilaiditi syndrome is interposition of the intestine between liver and diaphragm. It is often asymptomatic but there were cases presented as acute pain in the abdomen, needing corrective surgical procedure; or as mistaken renal colic, or as suspected subphrenic abscess, or as pneumoperitonium. The interposition of proximal transverse colon was found to be more common than the small intestine. Chilaiditi syndrome was associated with colonic volvulus. The colonic interposition then progressed from mild abdominal discomfort to intermittent bowel obstruction. Some patients needed surgical operation like hepatic extraperitonealization, after replacement of the dislocated gastroenteric tract, bringing the superior surface of the liver again into direct contact with the related diaphragmatic dome. A rare case of Chilaiditi syndrome incidentally associated with hypertension and ischaemic heart disease, in a male aged 50 years is reported.
 ...
PMID:Chilaiditi syndrome with hypertension. 1136 Dec 85

Laparoscopy and palpation offer only a rough estimate of the extent of endometriosis. Consequently, endometriosis involving the bowels and urinary tract is under-diagnosed. Bowel obstruction and retroperitoneal endometriosis with obstruction of the ureter are uncommon conditions, but awareness of them is important. Ureteric obstruction develops slowly from periureteral fibrosis and often results in an asymptomatic hydronephrosis, loss of renal function and hypertension. Although renography is the first line of choice in investigation of the upper urinary tract in cases of suspected ureteric obstruction, ultrasound of the kidneys may be useful in the hands of the experienced gynecologist as a screening tool at consultation. The rationale for this recommendation is that ureteric obstruction and hydronephrosis often occur simultaneously. We present a case with bowel obstruction mimicking sigmoid carcinoma, ureteric obstruction and hypertension, caused by endometriosis, where the diagnostic difficulties are illustrated. Collaboration between gynecologist and urologist is essential in selected cases of endometriosis.
 ...
PMID:[A case report. Endometriosis caused colonic ileus, ureteral obstruction and hypertension]. 1140 1


<< Previous 1 2 3 4 5 Next >>