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)

Besides smoking cessation, antiobstructive therapy, and the treatment of intercurrent infections, long-term oxygen therapy has had the most impressive impact on survival in patients with chronic obstructive pulmonary disease (COPD). COPD leads to a functional and anatomical obstruction of the pulmonary vascular bed, with the development of pulmonary arterial hypertension and cor pulmonale. In these patients, survival benefit from long-term oxygen therapy (LTOT) stems mainly from improved hemodynamics. However, this improvement is limited: hypoxemic COPD patients treated by LTOT have the same life expectancy as nonhypoxemic COPD patients. Practical aspects concerning the prescription and application of LTOT are discussed, with special emphasis on ambulatory oxygen and oxygen-saving techniques.
 ...
PMID:Long-term oxygen therapy for cor pulmonale in patients with chronic obstructive pulmonary disease. 192 80

Perfusion scintigraphy of the lungs with 99mTc-labeled microspheres was used for a study of changes of regional perfusion of lesser circulation in patients with chronic bronchitis of a varying degree of disturbed pulmonary hemodynamics. Even before a stable rise of pulmonary vascular resistance and development of pulmonary arterial hypertension, chronic bronchitis was characterized by redistribution of the blood flow from the lower parts of the lungs to the upper ones, which progressed with disturbance of pulmonary arterial circulation and the development of chronic cor pulmonale. This redistribution could be determined by an earlier and more important rise of the vascular tone and resistance to the blood flow in the lower parts of the lungs. The use of scintigraphic indices of the upper and lower parts (U/L) perfusion ratio led to adequate assessment of a degree of redistribution of the pulmonary blood flow in patients with chronic bronchitis.
 ...
PMID:[Regional lung perfusion in patients with chronic nonspecific lung diseases based on scintigraphic study data]. 203 15

Although several previous studies have been done on the nature and prevalence of cardiovascular disease in Papua New Guinea no study has looked exclusively at a highlander population. This article reviews 154 cardiac patients who first presented to the Mt Hagen adult outpatient department over a period of one year. The study excluded non-highlanders, patients under 12 years of age, and patients with heart disease secondary to anaemia or diseases of the blood vessels. Heart disease was found to constitute a significant proportion of outpatient visits and admissions. Cor pulmonale secondary to chronic lung disease was the commonest condition seen, occurring in higher frequency than reported elsewhere, and accounting for the majority of cases of congestive heart failure. Valvular heart disease was also common, often presenting in a precocious and severe form. Congenital bicuspid aortic values were important in the generation of aortic valve disease in this population. Arrhythmias and conduction disturbances were also common. Diseases of the myocardium and pericardium occurred infrequently and were of the same nature as those reported in other studies in Papua New Guinea. Hypertension was probably underreported in this study, with renal disease being a contributing factor in the cases seen. Ischaemic heart disease represented a small number of the total cases, but was probably underreported.
 ...
PMID:Adult heart disease in Mt Hagen: a study of 154 patients. 208 Jun 72

Hypoxic pulmonary vasoconstriction is considered to be the primary cause of pulmonary hypertension and cor pulmonale in adult patients with cystic fibrosis (CF). The acute effect on pulmonary haemodynamics of a single sublingual dose of nifedipine 20 mg has been studied in 9 adult patients with CF. Nifedipine significantly attenuated the rise in mean pulmonary artery pressure and pulmonary vascular resistance induced by inhalation of a 13% oxygen gas mix. It also slightly reduced baseline pulmonary artery pressure and pulmonary vascular resistance and lowered pulmonary artery hypertension in the patients. Oxygen delivery was unchanged. Nifedipine is potentially useful for the treatment of hypoxic pulmonary hypertension in patients with CF.
 ...
PMID:Acute effects on pulmonary haemodynamics of nifedipine in adult patients with cystic fibrosis. 209 44

In patients with chronic obstructive pulmonary diseases and cor pulmonale, long-term treatment with oxygen leads to a reduction in pulmonary arterial pressure. The aim of this study was investigate the question as to the extent to which pulmonary arterial pressure reduction in response to acute administration of oxygen differed from the long-term effect of oxygen treatment, and whether it was possible to determine prognostic factors that would identify the patients who would obtain particular benefit from long-term oxygen therapy. Twenty patients suffering from severe obstruction, global respiratory failure and precapillary hypertension, were treated with oxygen for a period of 20 +/- 6 months. At the beginning of the treatment, the acute oxygen-induced reversibility of pulmonary hypertension with an FIO2 of 80% was established. After an average of 20 months, catheter examination was repeated. A comparison was made between reversibility with acute oxygen and the long-term effects of oxygen. Long-term treatment with oxygen led to a reduction in pulmonary arterial pressure (18%), which was comparable to the reversibility established for acute oxygen inspiration (20%). While, over the long-term, a reduction in pulmonary arterial pressure was caused solely by a drop in pulmonary vessel resistance, acute application of oxygen resulted in an approximately equal decrease in pulmonary vessel resistance and cardiac output. The more pronounced the pulmonary hypertension prior to treatment the greater the pressure reduction achieved with long-term oxygen treatment. Patients with a particularly marked acute oxygen reversibility also had greater long-term benefit, in the sense that, in these cases, the decrease in pulmonary arterial pressure was more substantial than in patients with smaller acute reversibility.
 ...
PMID:[Acute and long-term effects of chronic obstructive lung diseases]. 211 22

Negative U wave is usually observed in ischemic heart disease, left ventricular hypertrophy and in chronic cor pulmonale, sometimes in association with electrolytic imbalance or toxic effects of drugs. We assessed by ECG and echocardiography 559 patients with longstanding arterial hypertension. Negative U wave was significantly more frequent in patients with increased left ventricular mass and/or with congestive heart failure, particularly in the middle-age hypertension group. Negative U wave appears to be an ECG sign closely associated with the anatomical evolution toward hypertensive heart disease with hypertrophy and/or congestive heart failure.
 ...
PMID:[Arterial hypertension: clinical significance of U wave inversion in electrocardiogram]. 214 93

Acute course and long-term regimens of depin-E administration were evaluated clinically and pharmacologically in 50 patients with chronic obstructive bronchitis (COB) and chronic cor pulmonale (CCP). The drug has three mechanisms of action: arteriolovenodilating, bronchodilating, direct pulmonary vascular. Therapeutic effect was achieved in 80% and 60% of COB and CCP patients, respectively. No response was demonstrated for patients with severe cardiac failure. Depin-E can be recommended for prophylaxis and treatment of CCP, to arrest hypertension crises in lesser circulation, to improve pulmonary circulation, central hemodynamics, exercise tolerance.
 ...
PMID:[Effectiveness of depin-E in patients with chronic bronchitis]. 221 46

The diagnosis of obstructive sleep apnea is frequently made by taking a meticulous history coupled with a high index of suspicion. Snoring and hypersomnolence are clinical features common to individuals with sleep apnea. Since snoring is said to be a "disease of listeners," it is not uncommon that bed partners reported an increased incidence of depression and marital displeasure. It is for this reason that the spouse or bed partner should be interviewed, since the patient may not be aware of any sleeping problems. Physicians should also be alert to complaints of excessive daytime somnolence, because studies have shown that patients with obstructive sleep apnea are at increased risk for automobile crashes. It has been estimated that approx 58,000 motor vehicle accidents involving people with sleep apnea will occur in the US each yr. By proper diagnosis and treatment, the physician is in a unique position to prevent at least some of the automobile accidents that result from falling asleep while driving. Polysomnography is the only definitive way to obtain a diagnosis of sleep apnea. This allows the physician not only to diagnosis the disorder, but also helps in the evaluation of the severity of the syndrome and selection of therapy. An ENT evaluation is also important in ruling out anatomic disorders that can cause upper airway obstruction. Certain factors, such as alcohol and sedative ingestion, may aggravate the condition in a person predisposed to sleep apnea, and subtle changes, such as unexplained hypertension, polycythemia, and cor pulmonale, should lead one to investigate the possibility of sleep apnea as the etiology.
 ...
PMID:Diagnosis of obstructive sleep apnea. 229 95

The perioperative anaesthetic management of an adult patient with central alveolar hypoventilation syndrome (CAHS), Ondine's Curse, is described for anterior resection of a carcinoma of the bowel. This rare syndrome results in alveolar hypoventilation, hypercarbia, hypoxaemia with secondary polycythaemia, pulmonary artery hypertension, and cor pulmonale. Epidural morphine was used for postoperative analgesia in an attempt to improve postoperative respiratory function. However, postoperative mechanical ventilation was required until recovery of the respiratory drive, which was ablated by anaesthetic drugs, epidural morphine and high inspired oxygen concentrations. The pathophysiology and treatment of this syndrome are reviewed.
 ...
PMID:Anaesthesia for a patient with central alveolar hypoventilation syndrome (Ondine's Curse). 229 95

The increasing interest in geriatric medicine demands an understanding of aging in human tissues. The changes in the human heart are an important aspect of this understanding because cardiovascular diseases are a leading medical problem in the elderly. The published data about age-related changes in the human myocardium remain incomplete and occasionally are controversial. An ongoing study of the hearts of people aged 80 years and older is being conducted at our institution. Various aspects of morphologic changes in these hearts were studied. In this report, we discuss the presence and extent of myocardial fibrosis, namely, the interstitial type. Two types of fibrosis are recognized: (1) scarring, the fibrotic replacement of lost myocardium, usually of vascular origin; and (2) interstitial, in which a delicate fibrotic net encircles single myocardial fibers. The morphologic findings were correlated with the following clinical findings: hypertension, congestive heart failure, emphysema, cor pulmonale, and coronary artery disease. The results support the hypothesis that interstitial fibrosis develops independently of the above-mentioned clinical conditions and may be considered as a true aging process.
 ...
PMID:Myocardial fibrosis in the elderly. 239 10


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