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)

There are 2 striking differences in the practice of medicine in the US and in the UK: 1) in the former, there is a great emphasis on private medicine, and 2) in the US there is a much higher incidence of litigation, whereas in the UK, family planning services are free, and litigation in this area is almost unknown. British medical opinion agrees with the US on the following oral contraceptive contraindications: 1) cancer of the breast, ovary, uterus, vagina, or cervix; 2) coronary thrombosis, pulmonary embolism, deep vein thrombosis, angina pectoris, or stroke; and 3) unusual or unexplained vaginal bleeding. Both countries agree that it is inadvisable to give the combined pill over the age of 45, and over the age of 35 in smokers. The UK agrees with 75% of the routines adopted by US doctors on a patient's 1st visit for oral contraceptives. However, a patient who becomes amenorrheic while taking the pill is not regarded as lightly in the UK as she would be in the US; she is closely monitored. If 1 of 4 risk factors (age 35 or over, hypertension, obesity, or smoking) is evident, a patient in the UK is closely supervised while taking the pill. If more than 2 risk factors are present, a UK doctor may advise against the pill. Since the 1960s the media have both praisd and condemned the pill. There is no doubt that, in the field of contraceptive advice, the US and the UK lead the way, and a closer liaison between the 2 medical professions is essential to reassure patients.
 ...
PMID:Contraceptive advice: how the English differ from the Americans. 309 Feb 54

Two young women (aged 32 and 25 years) with systemic lupus erythematosus and heart valve lesions in association with antiphospholipid antibodies are presented. In addition to the presence of the 'lupus anticoagulant' and false positive Venereal Disease Research Laboratory (VDRL) tests, both patients had high levels of IgG anticardiolipin antibodies. The first patient additionally had contraceptive induced chorea, chorea gravidarum, seven miscarriages, livedo reticularis, pulmonary embolism, and thrombocytopenia and developed culture negative endocarditis as well as hypertension. The second patient, who had presented with hypertension, developed aortic and mitral regurgitation, suspected myocarditis, manifested transient ischaemic attacks, and responded well to anticoagulation and steroid treatment.
 ...
PMID:Diagnostic and therapeutic problems in two patients with antiphospholipid antibodies, heart valve lesions, and transient ischaemic attacks. 314 42

The incidence of deep-vein thrombosis was studied in 146 consecutive Korean patients who had a cementless total hip replacement with a porous-coated anatomic prosthesis. All of the patients had discontinued taking aspirin, aspirin-containing compounds, or other antiplatelet medications fourteen days before admission to the hospital for the operation. Deep-vein thrombosis was diagnosed by roentgenographic venography, and pulmonary embolism, by perfusion lung-scanning. There was an unusually low incidence (10 per cent) of deep-vein thrombosis in this series. In contrast to other reports, we did not identify a relationship between deep-vein thrombosis and so-called risk factors such as advanced age, number of venous valves (more than five) in the lower extremity, abnormal coagulation-assay data, certain diseases, or preoperative limitation of mobility. In addition, hypertension, blood group, surgical approach, and choice of cemented or cementless total hip replacement did not seem to affect the incidence of deep-vein thrombosis. There was a low incidence of deep-vein thrombosis in patients in whom obesity, prolonged immobilization postoperatively, varicose veins, and hyperlipemia were not factors.
 ...
PMID:Low incidence of deep-vein thrombosis after cementless total hip replacement. 339 86

Intraluminal signal in the pulmonary arteries on spin-echo, ECG-gated MR images is limited to the diastolic phase of the cardiac cycle in normal subjects. Initial experience has indicated that signal persisting during systole may be characteristic of slow blood flow associated with pulmonary arterial hypertension (PAH) or of thrombotic material secondary to pulmonary embolism. This study analyzes our cumulative experience (31 patients) with multiphasic, double spin-echo MR for assessing PAH and/or suspected pulmonary embolism. In PAH, the abnormal systolic signal showed an intensity increase from first to second echo. This pattern was observed in 92% of PAH patients, including 100% of patients with pulmonary systolic pressures greater than or equal to 80 mm Hg and 60% of patients with pressures less than 80 mm Hg. At any focus in the pulmonary arteries, such signal disappeared at some phase of the cardiac cycle. In patients with pulmonary embolism, signal from thrombus was fixed throughout the cardiac cycle and showed little or no increase in relative intensity change from first- to second-echo image. Using this guideline, MR made six confirmed positive and four confirmed negative diagnoses of proximal pulmonary embolism, while it failed to identify thrombus in the one patient with a peripheral pulmonary embolism. Intraluminal signal in the pulmonary arteries caused by PAH or pulmonary embolism can be differentiated in most instances using multiphasic, double spin-echo, ECG-gated MR. However, at its current stage of development, the procedure does not appear to be useful for the evaluation of peripheral pulmonary embolism.
 ...
PMID:MR imaging of pulmonary arterial hypertension and pulmonary emboli. 349 75

The study comprises 74 patients alive 30 days after the start of treatment of pulmonary embolism with heparin (n = 32), streptokinase (n = 22) or embolectomy (n = 20). The cumulative 5-year survival was 100% in the embolectomy group, compared to 75 +/- 7% (SE) in the medically treated patients (p less than 0.05). Cancer caused 78% of the late deaths. At follow-up 0.5-8.7 years after treatment the treatment groups were indistinguishable as regards right-sided heart catheterization data, pulmonary artery rest-obstruction, right ventricular diameter and wall thickness, ventilatory function and ECG changes. The embolectomized patients were in a more favourable NYHA classification level than the medically treated. Chronic pulmonary artery hypertension was found in 75% of patients with greater than or equal to 3 anamnestic recurrent embolic episodes before diagnosis compared to 8% of patients with less than or equal to 2 recurrent episodes (p less than 0.001). Patients with irreversible cardiocirculatory shock before embolectomy all had abnormal pulmonary vascular resistance (greater than 1.5 mmHg/l/min), depressed ventilatory function and more than 25% reduced pulmonary perfusion at follow-up. The major prognostic factors thus were cancer, the number of recurrent episodes and the degree of cardiocirculatory affection in the acute event. Although the embolectomized patients were the most affected initially, they had a good prognosis. This led us to extend our indications for embolectomy to include all patients with central emboli, irrespective of the degree of cardiocirculatory impairment.
 ...
PMID:Pulmonary embolism: long-term follow-up after treatment with full-dose heparin, streptokinase or embolectomy. 356 86

Magnetic resonance imaging (MRI) is a completely noninvasive technique for the evaluation of the cardiovascular system. With a multi-section-technique and the spin echo pulse sequence the entire heart can be examined within 10 minutes. All cardiac MR studies were performed with electrocardiographic (ECG) gating to obtain adequate resolution of the cardiac structures. With this technique patients with congenital and acquired heart diseases, with thoracic aortic aneurysms, with mediastinal and pulmonary mass lesions, with central pulmonary embolism and with pulmonary arterial hypertension were studied. MRI offers an enormous potential for cardiovascular diagnosis, even beyond the demonstration of pathoanatomy, because of the capability for direct tissue characterization and blood flow measurements.
 ...
PMID:[Magnetic resonance tomography (MRT) in cardiovascular and lung diagnosis]. 357 30

Radionuclide imaging, quite apart from its role in the diagnosis of pulmonary embolism, offers information about the distribution of ventilatory and perfusion abnormalities within the lung. The extent of ventilatory abnormality seen can be related to the severity of airways obstruction as assessed spirometrically, whilst abnormalities in the matching of perfusion to ventilation can be related to the severity of hypoxaemia in patients with chronic airflow limitation. Clearance of mucus from the lungs of patients with chronic mucus hypersecretion may be assessed by following the clearance rate of insoluble radioaerosol particles; by such means the relative contributions of mucociliary transport and of cough to the overall clearance can be observed. Clearance is often severely impaired in patients with airways obstruction; the radioaerosol technique can be used to determine the effects of drug or physiotherapy treatment. Chronic airflow limitation leading to hypoxaemia can be associated with pulmonary artery hypertension and right ventricular hypertrophy--this may be investigated noninvasively by a radionuclide test of right ventricular ejection fraction.
 ...
PMID:Current status of nuclear medicine in chronic airflow limitation. 360 64

Records of 34 patients with established causes of pulmonary arterial hypertension were retrospectively reviewed. The ventilation-perfusion scans were blindly classified according to standardized criteria as normal or high, low, or intermediate probability of pulmonary embolism as the cause of pulmonary arterial hypertension. Twelve of 13 patients with primary pulmonary hypertension had normal or low-probability scans, but the perfusion pattern was not helpful in distinguishing between histologic subtypes. All eight patients with large-vessel thromboembolic hypertension had high-probability scans; however, three of 13 patients with nonembolic secondary pulmonary hypertension also had high-probability scans. While a normal or low-probability scan excluded proximal pulmonary emboli as a cause of pulmonary hypertension, a high-probability scan may be associated with a variety of other nonembolic causes of secondary pulmonary hypertension.
 ...
PMID:Pulmonary arterial hypertension: value of perfusion scintigraphy. 361 69

A total of 1605 patients with myocardial infarction had been admitted to the district hospital--Sliven for 24 years. The percentage of the deceased out of them is 26.5%. The patients with cardiogenic shock were 166 (10.3%) and 131 of them died (85%). The cardiogenic shock in myocardial infarction reduced its incidence within the 5 years, from 14/4% to 5.3%, and lethality was increased from 75.5 to 91.4%. The males represented 60%. To the age of 60 proved to be 30.1% of the patients. To the age of 45-3.6%; to from 46 to 60-26.5%; from 61 to 75-51.6% and over the age of 75-18%. Angina pectoris was present in 80% in the clinic of the patients with cardiogenic shock in myocardial infarction, with irradiating pain--41%, with asthmatic manifestations--49%, with abdominal manifestations--20% and cerebral manifestations--23%. According to localization the myocardial infarction was grouped as follows: 8.4%--anteroseptal; 17.4%--anterior, 9.6%--massive anterior, 1.8--anterior-apical, 6.4%--anterior lateral, 25.3%--posterior, 9%--posterior-lateral, 5.6%--anterior-posterior, 0.6%--focal and 1% subendocardial. Hypertension proved to be a favourable factor in the development of cardiogenic shock in myocardial infarction in 21.7% as well as diabetes in 15%, rhythm disorders--in 32.2%, pulmonary embolism in 7.9% and decompensation in 14.4%.
 ...
PMID:[Cardiogenic shock in myocardial infarct]. 371 75

The purpose of this paper is to evaluate the indications for surgical or thrombolytic treatment of massive pulmonary embolism. Analysis of the outcome of the disease depending on the indices of lung vascular damage volume and hemodynamics was performed. One hundred and thirty five patients with thromboembolism of truncus or main branches of the pulmonary artery were examined. Right cardiac catheterization, angiopulmonography and Tc-perfusion lung scanning were carried out. Predictive criteria of the lethal outcome (with 86% probability) were defined in patients without surgical treatment. These criteria included extensive volume of lung vascular damage (Miller angiographic index greater than or equal to 27, scannographic perfusion deficit greater than or equal to 60%) and significant hemodynamic disturbances (refractory systemic arterial hypotension or severe pulmonary arterial hypertension: right ventricular systolic pressure greater than or equal to 60 mmHg, right ventricular end-diastolic pressure greater than or equal to 15 mmHg, mean right ventricular pressure greater than or equal to 25 mmHg, and mean pulmonary arterial pressure greater than or equal to 35 mmHg). With these indices available these are indications for pulmonary artery embolectomy. With lower indices, but close to those estimated in the study, thrombolytic therapy is indicated.
 ...
PMID:Massive pulmonary embolism: embolectomy or thrombolysis? 383 Nov 30


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>