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)

Sixteen previously treated (with only one prior regimen) patients with histologically proven metastatic or locally recurrent colorectal carcinoma were treated with recombinant tumor necrosis factor (rTNF) administered by 30-minute i.v. infusions twice daily for 5 consecutive days every other week for 8 weeks. Patients received 100 micrograms/m2 twice daily on day 1 of cycle 1 with escalation to 150 micrograms/m2 twice daily thereafter. Patients were concomitantly treated with indomethacin 25 mg every 6 hours and acetaminophen 650 mg every 4 hours to obviate fever and chills. Toxicities included: nausea/vomiting (69%), headache (25%), chills (69%), pain at tumor sites (63%), hypotension (31%), and hypertension (38%). Hematologic toxicity included leukopenia less than 2000 cells/mm3 (38%) and thrombocytopenia less than 100,000 cells/mm3 (13%). Liver function abnormalities occurred independently of the site or extent of metastatic disease and inconsistently in each treatment cycle. Four patients developed bilirubinemia greater than 2.5 x baseline values (range, 2.5 to 10.3 U/L); five patients had greater than 2.5 x elevations in alkaline phosphatase (range, 624 to 1663 U/L). Two patients developed retinal vein thrombosis in the absence of hemostatic abnormalities. In both instances, this complication occurred several weeks after completion of therapy. No objective responses were noted in 14 evaluable patients (95% confidence interval: 0 to 0.23). Three patients had stable disease for a median duration of 4.5 months. In conclusion, i.v. rTNF at this dose and schedule has no demonstrable antitumor efficacy. Twice-daily i.v. administration of this agent is associated with more hepatotoxicity than previously reported in trials using subcutaneous or once daily i.v. administration. Retinal vein thrombosis may be a late complication of i.v. rTNF at this dose and schedule.
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PMID:A phase II trial of recombinant tumor necrosis factor in patients with advanced colorectal carcinoma. 238 95

Liposome-encapsulated hemoglobin (LEH) is an experimental oxygen-carrying blood substitute. Previous studies in our laboratory with hydrogenated soy lecithin-based LEH indicated that while this solution maintained some physicochemical and oxygen-carrying properties of red blood cells, it evoked several transient (30-120 min) untoward biological responses, such as hypertension, tachycardia, thrombocytopenia, hemoconcentration, and elevation of plasma thromboxane B2 (TXB2). Such biochemical, hematological, and hemodynamic derangements are also produced by platelet-activating factor (PAF). The purpose of this study was to test the biological responses to administration of a newly produced synthetic distearoyl phosphatidylcholine-based LEH (s-DSPC-LEH) in the normal conscious rat (n = 6-11) and to examine the role of PAF in these processes. Systemic (IV) administration of S-DSPC-LEH caused transient hypotension (-23 +/- 8 mmHg, P less than 0.05), bradycardia (-24 +/- 11 bpm, P less than 0.05) followed by tachycardia (+62 +/- 21 bpm, P less than 0.05), decreased cardiac index (217 +/- 21 ml/min/kg, P less than 0.01), increased peripheral resistance (0.570 +/- 0.003 mmHg/ml/min/kg, P less than 0.01), transient leukocytosis (+6,870 +/- 1,801/microliters, P less than 0.05), hemoconcentration (+5.2 +/- 0.4%, P less than 0.01), thrombocytopenia (-160 +/- 18 X 10(3)/microliters, P less than 0.01), and increase in plasma TXB2 (45.0 +/- 1.9 pg/100 microliters, P less than 0.01). Separate infusion of the liposome vehicle or free hemoglobin, the two components of s-DSPC-LEH, did not evoke any consistent responses. Administration of the PAF antagonist BN 50739 (10 mg/kg, i.p.) 30 min prior to LEH prevented the hemodynamic changes and hemoconcentration induced by s-DSPC-LEH. These data suggest that hemoglobin/phospholipid interactions might account for the transient side effects of s-DSPC-LEH, possibly through interactions with blood elements and the resultant production of PAF and TXA2. Furthermore, PAF antagonists incorporated into or co-administered with LEH might enhance its biological applications.
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PMID:Biological responses to liposome-encapsulated hemoglobin (LEH) are improved by a PAF antagonist. 239 68

Serotonin metabolism was investigated in 15 patients (8 women, 7 men) with decreased renal function (clearance of endogenous creatinine = 0.07-0.74 ml/s) and compared to the values obtained in healthy controls. In spite of thrombocytopenia, the patients' platelet serotonin concentrations (1.99-47.6 nmol/10(9) platelets) as well as the plasma serotonin levels (190-2,176 nmol/l) were significantly higher than in controls (1.36-7.87 nmol/10(9) platelets, p less than 0.05; 0-500 nmol/l, p less than 0.001). The low urinary serotonin output (0-414 to 167-1,187 nmol/24 h in controls, p less than 0.001) probably reflects its decreased synthesis in the residual renal parenchyma. 5-Hydroxyindolacetic acid was excreted in normal amounts. The impairment in serotonin metabolism is closely correlated with the decrease in renal function. The data document accumulation of serotonin in the circulation. This impairment could contribute to platelet hyperaggregation and/or consumptive hypocoagulation, maintenance of hypertension, and acceleration of atherosclerosis.
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PMID:Serotonin metabolism in patients with decreased renal function. 247 19

A total of 22 patients with different solid tumours refractory to previous chemotherapy were treated between May 1985 and December 1986 (osteosarcoma, 7; Wilms' tumour, 6; rhabdomyosarcoma, 2; Ewing's sarcoma, 2; non-Hodgkin's lymphoma, 2; retinoblastoma, 1; cavum lymphoepithelioma, 1; dyktioma, 1). Patients were aged between 3 and 20 years (mean, 10.6 years). There was a 3.4:1 male-to-female ratio. The treatment consisted of ifosfamide given i.v. as a single agent at a dose of 3,000 mg/m2 over 1 h on days 1 and 2. Mesna was given as a uroprotector at 600 mg/m2 every 4 h, up to a total of 13 doses. The courses were repeated every 3 weeks. Every patient except those with osteosarcoma had previously received cyclophosphamide. There were 3 (13.6%) complete responses (CRs) in 2 osteosarcomas and 1 abdominal non-Hodgkin's lymphoma, lasting 12, 8 and 2 months, respectively; 4 (18.2%) partial responses (PRs) in 2 Wilms' tumours, 1 Ewing's sarcoma and 1 abdominal non-Hodgkin's lymphoma; 4 absences of remission (ARs); and 11 (50%) cases of progressive disease (PD). In all, 81 courses were given, and the toxicities found were leukopenia (less than 2,000 leukocytes) in 15 courses, thrombocytopenia in 3, microhaematuria in 7, neurotoxicity in 8, fever in 8 and hypertension in 2. The overall response rate (31.8%) was encouraging and the toxicity, acceptable and reversible. These results demonstrate that ifosfamide should be considered for introduction into phase III protocols for the treatment of solid malignancies in children.
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PMID:Phase II study of ifosfamide as a single drug for relapsed paediatric patients. 250 55

This study examines the incidence and significance of novel plasma derived platelet aggregating activity (PAA) in 190 consecutive patients admitted to the medical wards of a general hospital. Seventy five patients (39%) demonstrated this activity. The incidence was highest in patients with a history of thrombosis (52%) or in those with a heightened thrombotic tendency, for example, patients with diabetes or hypertension. In contrast, platelet aggregating activity was observed in six out of 62 patients (approximately 10%) in whom a current or past medical history of thrombosis could not be elicited and in only two out of 72 healthy volunteers examined (3%). A high frequency of PAA was also noted in a small group of patients with idiopathic thrombocytopenia and patients who had previously received platelet transfusions. In these patients, this activity presumably reflects the presence of antiplatelet antibodies. A good correlation between the presence of plasma derived platelet aggregating activity and the phenomenon of spontaneous platelet aggregation was observed. The platelet aggregating activity was not heparin dependent, but was completely abolished by EDTA (5 mM) and benzamidine (8 mM), or by pretreating the platelets with aspirin. A synergistic response was observed with subaggregatory concentrations of thrombin and adrenalin. Our results suggest that the presence of this platelet aggregating activity may provide a marker for vascular thrombosis. Furthermore we postulate that this plasma derived activity may be partly responsible for platelet hyperactivity previously observed in patients with thromboembolic disorders.
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PMID:Platelet aggregating activity in the plasma of patients with established thrombosis. 250 37

The presence of a lupus anticoagulant (LA) is paradoxically associated with a high incidence of arterial and venous thrombosis. In a patient with a lupus-like systemic disease, having received phenindione for 11 years, LA was discovered in association with recurrent deep venous thrombosis, a right atrial thrombus, coronary occlusion, arterial hypertension, thrombopenia, and anticardiolipin antibodies without anti-DNA antibodies. Renal cortical ischemia was detected by a tomographic scan. Renal biopsy showed glomerular ischemia and diffuse interstitial fibrosis. After a one-year anticoagulant and steroid therapy, LA has disappeared despite a high level of anticardiolipin antibodies, and renal function remains normal.
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PMID:[Renal cortex ischemia, right atrial thrombosis and coronary occlusion in anti-phospholipid antibody syndrome]. 251 17

A case of 30 year-old female with HELLP syndrome, who had undergone emergency caesarean section under general anesthesia, was reported. HELLP syndrome is characterized by hemolysis, liver dysfunction and thrombocytopenia, besides symptoms of severe toxemia of pregnancy. After an awake orotracheal intubation, anesthesia was maintained with nitrous oxide, oxygen and muscle relaxant. Blood pressure was controlled with intravenous administration of nitroglycerin. Though the eclampsia was recognized several times during and after the operation, the patient and her baby had no complication nor sequela on their discharge. The key in the anesthetic management of caesarean section in a patient with HELLP syndrome is to control hypertension and eclampsia, to consider the presence of liver and kidney dysfunctions, and to improve anemia and bleeding tendency.
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PMID:[Anesthesia for a patient with HELLP syndrome]. 261 90

The clinical presentation and prognostic determinants in a group of 20 patients who presented a hemolytic-uremic syndrome for a period of 14 years are reviewed. Patients younger than 10 years old and those with and hemolytic-uremic syndrome due to a systemic disease, renal transplant or accelerated arterial hypertension were excluded from the study. The clinical picture consisted mainly of renal, hematological, hemorrhagic, neurologic cardiovascular, gastrointestinal and hepatic manifestations. It was note worthy the high incidence of malignant hypertension which frequently developed after admission. Thrombocytopenia and hemolysis were frequently not severe and of limited duration. Severe neurologic manifestations was the key determinant of immediate vital prognosis, while severe arterial hypertension was the most reliable marker of irreversible renal failure. In general, the clinical picture was very severe, with and elevated early mortality rate (5 patients) and a high rate of irreversible loss of renal function (five patients needed dialysis, and 4 remained with residual renal failure).
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PMID:[Clinical presentation and prognostic factors in primary hemolytic-uremic syndrome in adults]. 262 47

Twenty cases of systemic lupus erythematosus (SLE) in prepubertal children (less than 14 years of age) were seen over a period of 14 years. The male:female ratio was 1:2.3, and the mean age at onset was 9.37 years. Fever with joint involvement was the commonest presenting manifestation (60%), followed by nephrotic syndrome (25%). Notable clinical features included a high incidence of renal involvement (75%), significant hypertension (45%) and reversibility of acute renal failure (2 cases). The other organs and systems involved included: mucocutaneous manifestations (60%), cardiovascular system (30%), respiratory system (25%), neuropsychiatric manifestations (45%), and anemia (75%). Raynaud's phenomenon and thrombocytopenia were rare while leucopenia was not seen in a single patient. Immunological abnormalities noted were 100% positivity for antinuclear antibodies, and 87.5 and 75% positivity for antibodies to double-stranded and single-stranded DNA, respectively. Hypocomplementemia was seen in 75% of patients tested.
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PMID:Systemic lupus erythematosus in Indian children. 263 4

A case of anti-phospholipids auto-antibodies syndrome is reported; it was an unusual expression of Systemic Lupus Erythematosus (SLE). The patient is a 38 years old woman, with a history of recurrent peripheral thrombosis, pulmonary and cerebral embolism, thrombocytopenia, abortions; moreover she suffered from arterial hypertension, and headache. Features of onset, with several episodes of relevant clinical severity and the long period without clinical and laboratory hallmarks of SLE suggest a serious caution in the diagnosis of "pure" anti-phospholipids auto-antibodies syndrome.
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PMID:[Antiphospholipid antibody syndrome: description of a case]. 264 52


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