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)

Twenty psychotic patients with psychogenic polydipsia had hyponatremia (98 to 124 mEq/L) lasting up to 28 months, with headache, hypertension, dementia, seizures, lethargy, and coma. Two deaths also may be attributed to this syndrome. Patients drank 7 to 43 L of water daily. Urine was dilute during this water load (37 to 95 mOsm/kg), and free water clearance ranged from 12 to 36 L/day, while plasma osmolality was 236 to 244 mOsm/kg. During fluid deprivation in seven such patients, urinary osmolality exceeded plasma osmolality when plasma concentration had risen to between 242 and 272 mOsm/kg, thus suggesting a "reset osmostat" or antidiuretic hormone response to nonosmotic stimuli. This tended to sustain hyponatremia. Polydipsia should be recognized as a cause of hyponatremia, perhaps with reset osmostat. This ultimately may cause dementia or death, possibly secondary to recurrent cerebral edema. This sequence of events is potentially preventable or correctable.
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PMID:Hyponatremia in psychogenic polydipsia. 745 96

A 21-year-old female patient with psychotic symptoms developed hyperthermia, muscular rigidity and hypertension after administration of haloperidol. A muscle biopsy showed some atrophic and necrotic fibers, and a great number of fibers with central cores in the oxidative enzyme preparations. A related syndrome, Malignant Hyperthermia (MH), is sometimes associated with central core disease. The present case shows an association of a hyperthermic syndrome related to haloperidol with central core disease.
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PMID:Hyperthermic reaction to haloperidol with rigidity, associated to central core disease. 785 68

Complex interactions occur between psychological and biological factors in health and disease. Stressful life events have been shown to be important in the initiation and exacerbation of both infectious and non-infectious diseases while personality factors may act to increase or reduce vulnerability to physical disorders. Some of the psychosocial complications of physical disorders include marital and financial difficulties, personality changes, affective disturbances, memory impairment and intellectual deterioration. Psychotic reactions may occur in some cases. These complications could worsen the overall outcome and increase family stress and burden. Psychosocial intervention techniques may be required in the management of psychosocial consequences of physical disorders and for some physical illnesses uncomplicated by psychological disorders (e.g. application of biofeedback and relaxation training in the management of hypertension). It is thus important to pay more attention to the behavioural, psychological and social aspects of medical care, particularly in developing countries where available resources are limited.
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PMID:The role of psychosocial factors in the causation, course and outcome of physical disorders: a review. 805 68

Nine cases of human infection with Strongyloides stercoralis are reported among patients admitted to the Seoul Paik and Sang-Kye Paik Hospitals, Inje University, from April 1990 to January 1992. The patients, 7 males and 2 females aged between 50 and 70, either had the history of long term use of steroids for management of arthritis, or were complicated with other chronic diseases such as hypertension, liver diseases, psychotic disorders, and gastrointestinal problems. All of the nine patients revealed rhabditoid larvae of S. stercoralis in fecal examination. A 57-year-old woman who complained of arthritis and abdominal discomfort, was treated with albendazole and mebendazole, and on the 4th and 5th treatment day 220 parasitic adult females were collected from the diarrheal stool. The patient had a long history of administration of steroids for treatment of arthritis, and seems to have suffered from hyperinfection syndrome due to autoinfection with S. stercoralis. This is the 3rd report on the recovery of parasitic adult females of S. stercoralis in Korea.
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PMID:[Nine cases of strongyloidiasis in Korea]. 816 8

A case of hereditary coproporphyria was reported, he was a 21-year-old farmer, presenting with abdominal pain and fever. His manifestations were composed of all classical symptoms of acute hepatic porphyrias i.e. convulsions, psychosis, hypertension and respiratory failure as well as dark red urine with positive Watson-Schwartz test. Because of lack of cutaneous photosensitivity and strikingly increased urinary coproporphyrin, diagnosis of hereditary coproporphyria was most likely. Precipitating factor could not be identified. He responded well to glucose and other symptomatic treatment during the first admission but not in the second. He died from respiratory failure.
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PMID:Hereditary coproporphyria: a case report. 822 95

In modern anaesthesia various antagonists are used. They provide efficient tools to facilitate better control of pharmacological effects and side effects of drugs routinely used in anaesthesia. Naloxone is a competitive antagonist of opioids without any intrinsic activity. It counteracts respiratory depression, pruritus, sedation and analgesia caused by opioids. It is fast-acting with a duration of action of 45 to 90 min. Several investigators have reported severe side effects of naloxone including hypertension, tachyarrhythmias, left heart failure and cardiac arrest, and hence the use of naloxone must be carefully considered in every single patient. Flumazenil is a competitive antagonist of benzodiazepines. It is a remarkably safe drug and very effective to terminate all benzodiazepine effects in anaesthesia and intensive-care patients. Serious complications caused by flumazenil have been reported in patients receiving benzodiazepines in the treatment of seizure disorders and in patients with mixed intoxications. Neostigmine is one of several antagonists of neuromuscular blocking agents. Its side effects include bradycardia, increased bronchial secretions and increased peristalsis. Indication depends on the results of neuromuscular monitoring. Physostigmine is an unspecific antagonist of the central anticholinergic syndrome, an acute psychosis that may be caused by numerous drugs used in anaesthesia. Generally, antagonists should be carefully titrated. In emergency medicine the use of these antagonists is not recommended; the primary goal is to restore vital functions.
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PMID:[Antagonists in anesthesia]. 854 33

Traditional centrally acting antihypertensives have been associated with a high incidence of adverse effects and are no longer recommended as first-line therapy. The newer imidazoline receptor agonists must overcome this reputation if they are to gain recognition as potential first-line agents for hypertension. Methyldopa, a centrally acting alpha(2)-agonist, is characterized by a number of serious adverse reactions that limit its use. Although unpredictable idiosyncratic or hypersensitivity reactions are uncommon, these include hepatitis, myocarditis, and hemolytic anaemia. Less serious problems such as abnormal liver function tests, positive Coombs test, drug-induced fever, and pancreatitis also occur. Central side effects include drowsiness, fatigue, lethargy, sedation, depression, psychotic reactions, nasal stuffiness, impotence, and exacerbation of Parkinsonism. In hypertensive men, methyldopa is less well tolerated than either captopril or propranolol, and up to 20% of patients discontinue therapy because of adverse effects. Clonidine acts primarily as an alpha(2)-agonist but also acts as an agonist at imidazoline receptors in the rostroventrolateral medulla. It is equipotent to most other antihypertensives but is considerably less well-tolerated in comparative trials. The principal adverse effects of clonidine are drowsiness, sedation, lethargy and dry mouth. Reserpine acts primarily by depleting central catecholamine neurotransmitter stores. It was very extensively used in early hypertension trials, but its central side effects of sedation, nasal stuffiness, and severe depression are now considered so undesirable that the drug is seldom prescribed. The imidazoline (I1) agonists moxonidine and rilmenidine act selectively and have very little central alpha(2)-agonist activity. In comparative studies against placebo and other reference antihypertensives, the only adverse effect consistently associated with these drugs was dry mouth (approximate placebo-corrected incidence 10%). Sedation was not pronounced. Withdrawal syndromes are complex pathophysiologic processes and occur with a variety of antihypertensive drugs. Cessation of therapy with clonidine and, to a lesser extent, methyldopa may result in a severe withdrawal syndrome characterized by restlessness, sweating, anxiety, tremor, palpitations, and headache. There may be a rapid rise in blood pressure, often with a true "rebound" to higher than pretreatment levels. Plasma and urinary catecholamine levels are increased, and fatalities have been reported. It is important to stress that such a syndrome has not been recorded, in animal or human studies, with either moxonidine or rilmenidine.
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PMID:Aspects of tolerability of centrally acting antihypertensive drugs. 887 99

Many side effects of steroid treatment have been reported. Even experienced neurologists may not know all important side effects to the nervous system. Autonomic nervous system dysfunction, psychosis and myopathy are more frequently encountered than dependency, reversible dementia, brain atrophy and benign intracranial hypertension. This review describes symptomatology, pathogenesis and treatment of these steroid-induced side effects.
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PMID:[Neurologic side-effects of pharmacologic corticoid therapy]. 908 99

Behavioral and cognitive-behavioral strategies and a broad range of group, family, couples, and milieu treatment approaches have been developed for the psychotherapy of aggressive and violent patients. These methods have been carried out in diverse settings ranging from hospitals and prisons to individual outpatient practices and have been applied across diverse populations including adults with mental retardation, dementia, and brain injury; children with attention deficit and conduct disorders and autism; recurrent violent offenders with antisocial personality disorder; and individuals with chronic psychotic disorders, mood disorders, or medical illnesses such as hypertension. Bridging these different strategies are the underlying principles of psychotherapy with aggressive and violent patients. These include ensuring the safety of clinician, patient, and potential victims as the foremost concern; developing a finely detailed assessment of aggressive and violent acts and of the antecedents, assumptions, and consequences that are attached to them; formulating well-defined goals and striving for clear communication to achieve consistency in the pursuit of these goals between therapist and patient, and among therapist and other clinicians, staff, and relevant family members or agencies; specifying ahead of time well-considered outcome measures to be used to gauge the effectiveness of treatment; and maintaining a healthy vigilance for countertransferential and similar reactions and a willingness to use consultation as an integral part of treatment.
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PMID:Psychotherapeutic approaches to aggressive and violent patients. 919 24

Charts of 180 patients (147 women, 33 men) with systemic lupus erythematosus (SLE) complicated by renal involvement were retrospectively analyzed from a series of 436 patients. Mean age at renal disease onset was 27 years. Thirty-six percent of the patients had renal involvement after diagnosis of lupus, for 30.7% of that group it was more than 5 years later. Renal involvement occurred more frequently in young male patients of non-French non-white origin. Patients with renal involvement suffered more commonly from malar rash, psychosis, myocarditis, pericarditis, lymphadenopathy, and hypertension. Anemia, low serum complement, and raised anti-dsDNA antibodies were more frequent. According to the 1982 World Health Organization classification, histologic examination of initial renal biopsy specimen in 158 patients showed normal kidney in 1.5% of cases, mesangial in 22%, focal proliferative in 22%, diffuse proliferative in 27%, membranous in 20%, chronic sclerosing glomerulonephritis in 1%, and other forms of nephritis in 6.5%. Distribution of initial glomerulonephritis patterns was similar whether renal involvement occurred before or after the diagnosis of lupus. Transformation from 1 histologic pattern to another was observed in more than half of the analyzable patients (those who underwent at least 2 renal biopsies). Nephritis evolved toward end-stage renal disease in 14 patients despite the combined use of steroids and cyclophosphamide in 12. Initial elevated serum creatinine levels, initial hypertension, non-French non-white origin, and proliferative lesions on the initial renal biopsy were indicators of poor renal outcome. Twenty-four patients died after a mean follow-up of 109 months from SLE diagnosis. Among our 436 patients, the 10-year survival rate was not significantly affected by the presence or absence of renal involvement at diagnosis (89% and 92%, respectively).
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PMID:Renal involvement in systemic lupus erythematosus. A study of 180 patients from a single center. 1035 47


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