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

Hypo- and hypertension, arrhythmias, bradycardia extending to cardiac arrest with circulatory failure, pneumothorax, allergic reactions with or without anaphylactic shock, production of methaemoglobin, vomiting, vertigo, disorientation, acoustic and visual disorders, tinnitus, slurred speech, muscle contractions, unconsciousness, and epileptic seizures are well-known complications associated with local anaesthetics. We have observed an additional central nervous system complication: a case of transient, total motor aphasia (Broca aphasia) in a 50-year-old patient after axillary blockade of the brachial plexus. Possible causes such as type and dosage of local anaesthetic or a transient ischaemic attack in the area of the prerolandic artery are discussed and related to the literature. Ultimately, however, it is still not apparent why this complication could appear although there was no overdosage intravascular injection, or abnormality of the pulse or blood pressure, and why its manifestation was limited to a motor aphasia.
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PMID:[Transient total motor aphasia. A complication of an axillary brachial plexus block]. 149 33

A retrospective study was made of 309 randomly selected potential service recruits seen over five years by different consultant physicians in an Army hospital. Only nine of 133 referred with a history of asthma were turned down because of an abnormality in their exercise lung function test. Only four of 92 referred for a systolic heart murmur were rejected. Only one was turned down because of a headache or migraine out of 30 referred with that diagnosis. None of nine with supposed high blood pressure nor of five with a past history of pneumothorax was rejected. Of seven referred because of epilepsy, all five with definite evidence of this were turned down. The predictability of the specialist decision in these conditions suggests that more than 80% of all potential recruits referred to hospital with medical problems (at least 800 people yearly in UK) do not need to attend.
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PMID:Potential recruits in medical outpatients--an audit. 226 35

A 67-year-old woman was admitted to our hospital with chest pain and dyspnea which occurred suddenly after vomiting. She was well until admission except for cholelithiasis and hypertension which had been pointed out 3 years earlier. Arterial blood gas analysis showed hypoxemia without hypercapnea. Chest X-ray examination on admission revealed intra-mediastinal air with a niveau behind the heart which compressed the vasculature of the left lower lobe and a small amount of air in the regions adjacent to the trachea, left main bronchus and aortic arch. The serial chest radiographs showed pneumomediastinum, subcutaneous emphysema, pneumothorax and pleural effusion in that order within 16 hours after the onset. The diagnosis of esophageal rupture was made by CT scan of the chest performed after oral administration of Gastrografin, which demonstrated extravasation of contrast medium into the mediastinum. Surgical treatment including eversion stripping and esophagogastrostomy was performed 23 hours after the onset. Pathological examination of the removed specimens revealed a rupture of the lower portion of the esophagus originated in the gastric ulcer of the cardia. In spite of intensive care, she died 45 days after surgery because of renal failure. It was considered that the most important point in the early diagnosis of esophageal rupture was to suspect this disease based on the gastric symptoms followed by the respiratory symptoms and to demonstrate pneumomediastinum in chest X-ray. Chest CT scan performed after the oral administration of contrast medium could be an useful and non-invasive diagnostic procedure.
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PMID:[A case of esophageal rupture confirmed by chest CT: characteristic changes in chest radiographs]. 261 3

To assess the previously reported association of intraventricular hemorrhage (IVH) with neutropenia, we prospectively followed during a 38-month study period infants with birth weight less than or equal to 1500 gm who survived greater than 72 hours and underwent serial cranial sonography and neutrophil counts for the first 14 days of life. Neutrophil counts were interpreted according to a widely employed reference range. Infants with conditions other than IVH reported to be associated with neutropenia (sepsis, maternal hypertension, 5-minute Apgar score less than or equal to 5) were excluded. Final study groups included 38 infants with IVH and 114 without IVH. No significant differences were found for birth weight, gestational age, respiratory distress syndrome, mechanical ventilation, prolonged rupture of membranes, patent ductus arteriosus, route of delivery, pneumothorax, or sex. The occurrence of neutropenia before 14 days of age was not significantly different between the groups (50% with IVH, 56% without IVH), nor were differences found at individual postnatal ages. Comparison of immature neutrophil count and immature/total neutrophil ratio also revealed no differences. The high incidence of neutropenia in our non-IVH group raises questions about application of these widely accepted reference ranges to very low birth weight infants.
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PMID:Neutropenia and intraventricular hemorrhage among very low birth weight (less than 1500 grams) premature infants. 265 58

Two hundred seventy-two intubated infants who weighed less than 1751 g were enrolled in a clinical trial of phenobarbital prophylaxis of postnatal germinal matrix hemorrhage. The incidence of germinal matrix hemorrhage was 3.1% (one of 32) among infants born to women with toxemia, and 23% (55 of 240) among those born to women without toxemia. The apparent protective effect of toxemia could not be explained by intrauterine growth retardation, mode of delivery, or maternal receipt of any medication. Infants born to toxemic women were less likely than their peers to develop pneumothorax, become acidotic, and to require extensive respiratory assistance. This apparently protective effect of maternal toxemia was not seen in infants born to nontoxemic, hypertensive women. Thus, maternal toxemia, but not hypertension, might reduce the risk of germinal matrix hemorrhage by reducing the occurrence and/or severity of pulmonary and related problems that place infants at high risk of germinal matrix hemorrhage.
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PMID:Maternal toxemia and neonatal germinal matrix hemorrhage in intubated infants less than 1751 g. 263 70

Under ultrasound guidance, we treated 25 cases of renal cyst with 99% ethanol instillation to prevent the recurrence of this disease from January 1985 to June 1987. Patients' age was from 17 to 85 years old with the average age of 63 years. Twelve cases were men, and 13 cases were women. Among the 25 cases, eleven were asymptomatic and 14 showed clinical features of lumbago, microhematuria, hypertension or proteinuria. The aspirated site was the right side in 9, left side in 14 and bilateral kidneys in 2 cases. Subsequently, cyst puncture was carried out 27 times. We encountered 12 complications following puncture. These complications were derived from the puncture itself or caused by the ethanol instillation. Flank pain caused by the injection of ethanol, nausea, causalgia or a feeling of drunkenness appeared immediately after the inoculation procedure. However, no serious complications such as pneumothorax, perirenal hematoma or infection were recognized. Some complications arose in 7 cases of 9 examples (77.8%) following more than 50 ml of ethanol injection, but the complications were observed in only 5 cases of 18 examples (22.8%) following less than 50 ml of administration. Based on these findings, ethanol injection in renal cysts appears to be useful for the treatment of this disease. In case of huge cysts when more than 50 ml of ethanol, is instilled the case should be followed up carefully after the instillation procedure.
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PMID:[Renal cyst puncture under ultrasound guidance: complications of ethanol injection]. 306 4

Pial-arachnoidal microvessels (40-210 micron) were studied by fluorescent microscopy in anaesthetized, immobilized and ventilated newborn piglets in the course of bilateral experimental pneumothorax (BEP; n = 10) using the open cranial window technique. Na+-fluorescein and fluorescein isothiocyanate (FITC)-dextran (mol.wt. 40,000 and 70,000 Da) administered i.v. served as blood-brain barrier (BBB) indicators. After gradual exhaustion of compensatory mechanisms a critical phase, characterized by severe acidosis, bradycardia, arterial hypotension following hypertension and arterial hypoxaemia ensued, with vasoconstriction following vasodilation. Moreover, progressive circulation disturbances, sludging and microthrombi formation occurred in small venules. Concomitantly, diffuse BBB opening for Na+-fluorescein ensued in all piglets with BEP as shown by extended fluorescence in the brain tissue around the small venules (less than 80 micron); never observed for FITC-dextran and in the control animals (n = 4) without BEP. In the acute phase of pneumothorax a selective opening of the BBB should be considered.
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PMID:Selective opening of the blood-brain barrier in newborn piglets with experimental pneumothorax. 321 68

Of 582 patients who underwent percutaneous nephrolithotomy, 4% had complications. The most common complications were fever (23%) and bleeding necessitating transfusion (12%). Extravasation was seen in 7% of patients and transient ureteral obstruction in 6%. Other complications included pneumothorax or hydrothorax, pneumonia/atelectasis, paralytic ileus, nephrostomy-tube dislodgment or urine drainage from the flank lasting more than 1 week, significant infection, urinoma formation, renal pelvic laceration, ureteral avulsion, ureteropelvic or ureteral stricture, bowel injury, or escape of stone fragments into the retroperitoneum. Seven patients (1%) required immediate surgery: four to repair renal pelvic lacerations, one to repair a ureteral avulsion, and two to control bleeding after nephrostomy-tube removal when embolization failed. Four patients required delayed surgery for ureteral or ureteropelvic junction strictures, which may have been caused by a tissue reaction to the stones rather than by the procedure itself. There were two deaths--one from respiratory failure in a patient with severe interstitial pulmonary fibrosis and chronic renal failure and the other from myocardial infarction in an obese diabetic patient with hypertension.
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PMID:Complications of percutaneous nephrolithotomy. 349 9

This retrospective study consisted of 500 consecutive renal transplantations performed between September 1977 and September 1981. Preoperatively, congestive heart failure was registered in 262 cases (53.0%) and blood pressure disease in 352 cases (71.3%). The total number of patients with ischaemic heart disease was 22 (4.5%). General anaesthesia was given in 493 and regional anaesthesia in seven cases. In general anaesthesias, tubocurarine was the main relaxant and halothane the main inhalation agent used. Major complications during anaesthesia were blood pressure changes with a higher incidence of hypotension (49.6%) than hypertension (26.8%). Severe cardiac arrhythmias were rare and no intraoperative deaths occurred. One patient was successfully resuscitated in the ICU postoperatively, this being possibly related to hypoventilation caused by prolonged muscular relaxation. Other rare complications included one pneumothorax, one haemo- and hydrothorax, and two large haematomas all caused by preoperative central venous cannulation. In 69 cases (14.0%) additional neostigmine doses and in 34 cases (6.9%) naloxone was given at the end of anaesthesia. Pneumonia during the first postoperative week was recorded in 11 cases (2.2%), and occurred only in patients who received general anaesthesia. One of the three patients who died during the first week developed pneumonia postoperatively.
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PMID:Anaesthesiological complications in renal transplantation: a retrospective study of 500 transplantations. 354 45

A review of 46 perinatal deaths was conducted using a 1982 to 1985 regional perinatal network database of 6701 delivered postdate (greater than or equal to 42 weeks gestation) infants. Perinatal mortality (6.9 per 1000 births) increased as gestational age advanced beyond 42 weeks, and was higher in young teenagers or mothers with some additional antenatal complications, such as hypertension. Meconium staining of the amniotic fluid, low Apgar scores, low birthweight, congenital malformations, and neonatal complications, including pneumothorax, meconium aspiration, and seizures, were associated with perinatal death.
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PMID:Postdate pregnancies: a review of 46 perinatal deaths. 365 Nov 86


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