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

This paper outlines the pattern of drug utilisation in the elderly inpatient population in the nursing homes, Bumhudzo and BS Leon Trust and the two central hospitals, Harare and Parirenyatwa, in urban Harare, during the period, February to September 1990. The total population of elderly patients in the four institutions was calculated at 324 (52 pc) 170 of which were males and 48 pc were females. Of these patients 273 (84 pc) were Black, 44 (14 pc) were White and seven (2 pc) were Asians. Drug use pattern was estimated using the defined daily dose (DDD) system. The pattern of drug use was matched with the disease pattern to detect any discrepancies in drug utilisation. Of the 324 patients interviewed 114 (35 pc) were not on medication. The total number of drug formulations taken by the studied population was 1,117 with a mean of 3.45 drugs per individual at any one moment. Polypharmacology seems rife. The study indicated irrational and over utilisation of centrally acting drugs and vitamins and minerals. The most utilised group of drugs are the cardiovasculars (22 pc of the total) The most common disease conditions encountered in the elderly were hypertension, 7 pc, congestive heart failure, 7 pc, epigastric pain, 6 pc, senile dementia, 5 pc and pneumonia, 5 pc. The responses on sources of drug information available for the elderly revealed that pharmacists are totally unknown to the elderly in this respect. Measures that could be taken to improve elderly drug use are suggested.
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PMID:Drug utilisation in the geriatric population in the nursing homes and central hospitals of urban Harare. 795 24

The acute chest syndrome is a clinical entity appearing in patients suffering from sickle cell anaemia. It presents with pleuritic pain, fever, leucocytosis and pulmonary infiltrates in the thoracic radiology. The etiological diagnosis is difficult, and it is necessary to distinguish between pneumonia and pulmonary infarction. This syndrome is quite frequent among the patients at risk, and can be lethal according to the severity and the etiology of the event. A case of acute chest syndrome due to a S. pneumoniae sepsis is presented. The interest of the case lies in the rareness of this disease in our population and the peculiar evolutive clinical features of this case, with the development of intracranial hypertension and death.
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PMID:[Acute thoracic syndrome]. 798 60

A 78-year-old man with a history of hypertension was admitted for a fall with back pain. The blood pressure was at 110/50 mmHg and the pulse at 115 b.min-1. A pulsatile abdominal mass was palpated. No signs of respiratory insufficiency or congestive heart failure were found. The diagnosis of abdominal aortic aneurysm was promptly confirmed by echography. Before laparotomy, a pulmonary artery catheter was inserted for haemodynamic monitoring which showed a high cardiac output, low systemic vascular resistances, increased pulmonary artery wedge pressure and a high SvO2 (93%). This was not consistent with a hypovolaemic shock but rather an aortocaval fistula. After incision and aortic clamping, surgical procedure consisted of transaortic closure of the fistula and restoration of arterial continuity with a prosthetic graft. Initial control of venous bleeding was obtained by passing a Foley's catheter distally and by clamping the vena cava. The postoperative course was initially satisfactory. The patient was extubated, but remained with a major renal insufficiency. After a stay of 15 days in the intensive care unit, he died from nosocomial pneumonia. Aortocaval fistulas are either traumatic or spontaneous. Spontaneous fistulas are more common, and in about 90% of the cases result from a rupture of an atherosclerotic aortic aneurysm. Clinical findings include signs of high cardiac output symptoms of venous hypertension and regional arterial insufficiency. Haemodynamic changes can be of value for the recognition of an aortocaval fistula. Most authors emphasize the importance of preoperative diagnosis, allowing the use of appropriate operative techniques and a prompt control of the fistula. This could decrease haemodynamic instability and transfusion requirements.
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PMID:[Hemodynamic diagnosis of aortocaval fistula complicating abdominal aortic aneurysm]. 799 47

The clinical course of 16 patients with polycythemia vera (PV), treated in the period 1982 to 1993, was shown. Splenomegaly occurred in three fourths of these patients (75%), and hypertension was a major symptom. Thrombosis such as myocardial infarction and cerebral infarction was noted. Eight patients was treated with myelosuppressive agents and the 8 other patients were treated with phlebotomy. A 70-year-old male who was treated with mitobronitol (DBM) developed acute myeloblastic leukemia (AML) 11 years later. He was treated with multi-combination chemotherapy (BHAC-DMP), and entered complete remission, followed by early relapse. He became refractory to chemotherapy and died of acute pneumonia 6 months later. Median survival of 16 cases of PV was more than 10 years, and long-term treatment and care are necessary.
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PMID:[A clinical study of sixteen polycythemia vera cases--acute myeloblastic leukemia in patients with polycythemia vera]. 799 24

Pulmonary edema is a frequent and common cause of death in patients in critical care settings. It is seen as a complication of myocardial infarcts, hypertension, pneumonia, smoke inhalation, and high-altitude pulmonary edema. Pulmonary edema occurs when there are alterations in Starling forces and capillary permeability, opposition to lymphatic flow in the lungs, decreased plasma oncotic pressure, central nervous system lesions, and following some types of strenuous exercise. Pulmonary edema presents initially with crackles, wheezing, and dry cough and progresses to tachypnea, dyspnea, orthopnea, pink frothy sputum, and cyanosis. Treatment involves supportive therapy, reduction in blood volume, and oxygen therapy.
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PMID:Pathophysiology of pulmonary edema. 800 Sep 33

Cough is known to be the major respiratory side effect of treatment with angiotensin converting enzyme inhibitors (ACEI). Recently, ACEI have been implicated in drug-induced lung disease. We report a new case of diffuse pneumonitis which occurred during treatment with ACEI. A 73-year-old man was admitted for cough, dyspnea at rest, fever and weight loss. The patient had been treated with the ACEI pirindopril during 6 months for systemic hypertension. Chest radiographs showed reticular infiltrates in the upper lung fields. A CT scan confirmed the infiltrates and showed pleural thickening and airspace opacities. White blood cell counts showed 15,700/mm3 leucocytes with 940 eosinophils/mm3. Transbronchial biopsy was consistent with infiltration of the lung with eosinophils. There was no evidence for another etiology. Once the drug was withdrawn, clinical and radiological abnormalities improved but steroids were required to control symptoms. This report suggests that pirindopril, as captopril, can induce the picture of drug-induced pulmonary disease.
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PMID:[Pneumopathy induced by pirindopril. A case report]. 804 99

In recent years health professionals have been concerned about the health of aborigines which has been neglected for a long time. Health disparities are known to exist among aborigines and non-aborigines in the United States or other countries. In Taiwan, there are nine main aboriginal tribes consisting of approximately 330,000 people. In general, their health status, evaluated by life expectancy, mortality rates and the prevalence and incidence of various diseases amongst them, is worse than amongst the rest of the Taiwanese (general) population. Current investigations indicate that life expectancy for aborigines is on average 10 years less than that of the general population; 12.5 years less for men, 6 years less for women; approaching a standardized mortality ratio of 2 fold, that is 2.1 fold in men, 1.7 fold in women. Accidental injures, suicide, tuberculosis, liver cirrhosis, alcoholism, pneumonia, bronchitis, parasite infections are the most important sources of diseases. Hypertension, heart disease, some selected sites of cancer, nutrition and lack of adaptation are gradually becoming important new sources of disorders. Although aboriginal health has improved over the decades, the author estimates that their overall health status is 25-30 years behind that of the general population or of off-shore islanders. The extent of their development varies with tribes. It is necessary to study the cause of why aborigines die so young. It may be due to insufficient medical care for heart disease whose prevalence is relatively low among aborigines but resultant mortality is nevertheless high. However, insufficient medical care cannot explain the high incidence of a number of cancers and resultant mortality. All factors relating to the environment, agents, hosts and diseases should be taken into consideration, such culture, transportation, life style, health behavior etc, and compared to those of non-aborigines. A series of studies are proposed to address the specific, multi-dimensional health demands of the aborigines. The author suggests the development of prevention and intervention strategies designed to overcome difficulties and barriers to eliminate these disparities among the people of Taiwan.
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PMID:[Issues on aboriginal health in Taiwan]. 808 70

An analysis has been made of causes of admission of black patients in 1991 to Murchison Hospital, Port Shepstone, Natal. Of 6675 total admissions, 6329 (95%) were classifiable. Of the latter, 1462 (23%) were aged 12 years and-younger, namely, 763 boys and 699 girls. Their chief causes of admission were pneumonia, gastroenteritis, trauma, acute glomerular nephritis, and malnutritional diseases. Of 4867 adults (73%), 1536 were males and 3331 females. Among men, chief causes were tuberculosis, congestive cardiac failure, hypertension and cerebral vascular accidents. Among women, apart from pregnancy, chief causes of admission were disorders of pregnancy, tuberculosis, congestive cardiac failure, pneumonia, diabetes, and hypertension. Of western diseases, 3.9% of adults were admitted for diabetes, and 2.8% for asthma. The general pattern of admissions is similar to that in other rural hospitals. The causes of admissions are discussed, regarding (1) public health improvements occurring, and (2) means of promoting further improvements by (a) community self-help, and (b) help from State health and other services.
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PMID:Causes of admissions of rural African patients to Murchison Hospital, Natal, South Africa. 816 43

This self-directed learning module highlights the preexisting comorbid conditions and the medical complications during and after rehabilitation of the patient with stroke. Part of the chapter on stroke rehabilitation in the Self-Directed Medical Knowledge Program for practitioners and trainees in physical medicine and rehabilitation, this article identifies several of the major associated medical problems, such as venous thromboembolism, pneumonia, seizure, and pressure sore; discusses methods of management for each of these problems; and reviews implications of associated conditions, such as heart disease, diabetes, and hypertension, and secondary complications for rehabilitation and outcome.
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PMID:Stroke rehabilitation. 2. Comorbidities and complications. 818 63

We report here an autopsy case of Binswanger's disease (BD) without hypertension and associated with cerebral infarction in the terminal stage. The female patient, who was 74 years old at the time of death, had initially demonstrated manic-depressive disorder-like mental disorder, followed by dementia and neurological deficits. A brain CT scan showed white matter low attenuation bilaterally and symmetrically. BD was clinically diagnosed despite the lack of hypertension. In the terminal stage, she suffered an infarction in the left anterior cerebral artery region, and died of pneumonia. Neuropathologically, we found the infarction of the left anterior cerebral artery region, demyelination, fibrillary gliosis, lacunae and arteriosclerosis of the small arteries and arterioles in the white matter.
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PMID:An autopsy case of Binswanger's disease without hypertension and associated with cerebral infarction in the terminal stage. 820 1


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