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)

Retrospective clinical studies of 211 thyreotoxic patients having received 131I-therapy were performed and processed by computer. The patients' mean age was 58 years, the male-female ratio 7.1 to 1. The incidence of symptoms and associated diseases was in agreement with data in the literature. Of the clinical symptoms, weight loss, weakness, fatigability, a fine tremor, decompensation and nervousness, called attention to the condition. Of the ECG changes, an absolute arrhythmia of atrial fibrillation and extrasystole may be indicative of hyperthyroidism. Clinically, there is an essential difference between juvenile and old-age thyrotoxicosis. Differences could also be noted between patients with toxic adenoma and those with non-toxic one. Toxic adenoma patients were more advanced in age and the female-male ratio was higher than in non-toxic cases. Absolute arrhythmia of atrial fibrillation, extrasystole, repolarization disorders, diabetes, hypertension and arteriocardiosclerosis occurred more often, while ophthalmopathy and immune disease were less frequent. The clinical picture may raise the suspicion of old-age thyrotoxicosis. Following laboratory diagnosis, treatment should be administered without delay.
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PMID:Experience with 131I-therapy. Hyperthyroidism in old age. 367 Oct 18

Function of the hepatobiliary system was studied in 33 patients with thyroid diseases (11 with diffuse euthyroid goiter, 15 with diffuse toxic goiter, of them 7 with thyrotoxicosis of a mild degree and 8 with thyrotoxicosis of an average severity, and 7 patients with primary hypothyrosis) and in 14 healthy persons of the control group by a radionuclide method using a gamma-chamber and 99mTc-HIDA, a hepatotropic radiopharmaceutical. It was established that absorptive-excretory liver function and the concentration ability of the gall bladder decreased in noticeable thyrotoxicosis and moderate hypothyrosis. Hypermotor dyskinesia of the gall bladder and hypertension of the biliary tract sphincters were revealed in more than half of the patients. Similar changes though quantitatively less pronounced were noted in the patients with euthyroid goiter. Thyrotoxicosis of a mild degree was characterized by the affection of motor function of the gall bladder (hypermotor dyskinesia) and frequent hypertension of Oddi's sphincter. Possible mechanisms of the development of the above changes were discussed.
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PMID:[Functional state of the hepato-biliary system in patients with thyroid diseases studied with radiopharmaceuticals]. 382 18

The development of beta-adrenoreceptor-blocking drugs provided an important group of agents to treat the cardiovascular disorders hypertension, angina pectoris, and cardiac arrhythmias and to manage patients with thyrotoxicosis. For clinical purposes, these drugs can be divided into two groups, that is, those with intrinsic sympathomimetic activity (ISA) and those without (non-ISA). The non-ISA drugs include propranolol, which is noncardiac selective: labetalol, which is noncardiac selective with alpha blockade: and and metoprolol and atenolol, which are cardiac selective. The drugs with ISA include pindolol, oxprenolol, and alprenolol which are noncardiac selective, and practolol which is cardiac selective. These drugs resemble isoprenaline in chemical structure, but their interaction with the beta-adrenoreceptors causes no response or only a slight response if the drug has ISA. By occupying the receptors, they block excitation by noradrenaline released from the sympathetic nerves and by adrenaline from the adrenal medulla. Drugs with ISA appear to depress cardiac activity and to interfere with bronchodilator drive less than do non-ISA drugs. Beta-blocking drugs differ considerably in their bioavailability because of differences in the rate and extent of metabolism in the first past through the liver after absorption from the gut. The therapeutic dose range varies widely for those with low bioavailability but is more predictable for those with high bioavailability. The drugs also differ in plasma protein binding and in their receptor affinities. In addition to their usual adverse effects, which include exacerbation of cardiac failure, bronchospasm, sleep disturbances, and Raynaud's phenomenon, concern has arisen about possible ocular and mucocutaneous side effects with beta-blocking drugs. This is a recognized problem with practolol, and it is not certain whether it occurs with other beta-blocking drugs. A double-blind study reported here of 110 matched patients, 36 of whom were on pindolol for more than 2 years, did not reveal any evidence of oculomucocutaneous problems related to drug treatment.
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PMID:Clinical pharmacology of adrenergic-adrenoreceptor-blocking drugs. 612 97

At present more than 20 beta-adrenergic blocking drugs are commercially available in Western Europe, and six are available in the United States. The clinical indications for their usage include hypertension, arrhythmias, ischemic heart disease, thyrotoxicosis, migraine headaches, glaucoma, and anxiety states. We will review the mechanisms suggested for the antihypertensive action of beta-adrenergic blocking drugs as well as these agents' clinical pharmacologic aspects. In general, the pharmacodynamic effects of the beta blocking drugs are quite similar, yet the properties of biotransformation, including pharmacokinetics, tend to be distinguishing features.
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PMID:Mechanisms of action and the clinical pharmacology of beta-adrenergic blocking drugs. 614 90

Oxprenolol is a nonselective beta-adrenergic blocking agent that also possesses intrinsic sympathomimetic activity (ISA) and membrane stabilizing effects. Oxprenolol undergoes first pass metabolism with only 30% of an oral dose reaching the systemic circulation. The drug is approximately 80% protein bound and is eliminated primarily by glucuronidation in the liver. Less than 4% of oxprenolol is excreted unchanged in the urine. Oxprenolol may reduce the heart rate and prolong the effective and functional atrioventricular nodal refractory period. Oxprenolol has less negative inotropic and chronotropic effects than propranolol. Plasma renin activity is reduced; however, changes in plasma aldosterone level are not significant. Long term metabolic effects require further study. Oxprenolol appears to be comparable to other beta blockers in the treatment of hypertension and angina pectoris with no additional adverse reactions. If its partial agonist effect proves useful, it may have an advantage over other agents in treating patients with borderline cardiac reserve. Because of limited data, the use of oxprenolol for the treatment of arrhythmias, migraine, thyrotoxicosis, anxiety, and glaucoma cannot be recommended at this time.
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PMID:Oxprenolol hydrochloride: pharmacology, pharmacokinetics, adverse effects and clinical efficacy. 634 36

To assess the problem of continuing atenolol in a breast-feeding mother with hypertension associated with thyrotoxicosis, studies were performed to determine simultaneous plasma and breast milk concentrations of atenolol after a single dose of 50 mg and on continuous therapy of varying weekly dosages. Peak atenolol concentrations in breast milk were 3.6 times higher than simultaneous plasma atenolol concentrations after single-dose administration and 2.9 times higher after continuous-dose administration. A single plasma concentration obtained in the infant following a peak level feeding was less than 10 ng/ml. Although it would seem unlikely that the amount of atenolol excretion in breast milk should warrant interruption of breast-feeding because of maternal medication with ordinary doses, the infant should be evaluated for signs of beta-blockade.
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PMID:Atenolol in human plasma and breast milk. 670 Aug 80

Individual features of the endocrine system were studied in 26 healthy men, divided into 2 groups, according to the characteristics of EEG, electrocutaneous thresholds and the time response (TR) upon sound signals of 40 to 120 decibels. The subjects of the 1st group were characterized by the high energy of EEG delta- and theta-rhythms, low energy of alpha-rhythm, low thresholds and TR40 : TR120 ratio. The patients of the 2nd group had the opposite parameters. In both groups the blood plasma and urine catecholamine content, ACTH, TTH, 11-hydroxycorticosteroids, cortisol, aldosterone, thyroxine, triiodothyronine, testosterone and plasmatic insulin were determined by means of spectrofluorometry and radioimmunoassay. The elevation of the cortisol level after ACTH injection and of the TTH concentration following thyroliberin administration were investigated. Two polar variants of the endocrine system organization were revealed. The patients of the 1st group had an elevated activity of the sympathico-adrenal, hypophyseal-adrenal system and insular apparatus, comparatively lowered activity of the hypophyseal-thyroid system and gonads. The subjects of the 2nd group demonstrated an opposite character of the endocrine system. It is suggested that the individual peculiarities of the human endocrine system promote the development of obesity, Icenko-Cushing's disease, hypertension, thyrotoxicosis, acromegaly and bronchial asthma.
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PMID:[Individual characteristics of the organization of the human endocrine system]. 712 44

We analysed hospital use for 58 common clinical conditions in the medical specialties, using data from the two districts covered by the Oxford record linkage study 1968-1986. Episode rates, person rates, and ratios of multiple admissions per person were computed. In young adults, poisoning was the most common reason for admission. In older adults, the most common clinical conditions included atherosclerotic diseases and smoking-related lung diseases. Comparing the first and last time periods studied, admission rates increased by 10% or more in 37 of the 58 conditions, including 7 of the 10 conditions with the highest overall hospitalization rates. Conditions in which admissions increased by 10% or more included myocardial infarction, other ischaemic heart disease, chronic obstructive lung disease, asthma, pneumonia, diabetes, poisoning, dementia, prostate cancer and breast cancer among others. Workload declined by 10% or more in 13 conditions, including stroke, subarachnoid haemorrhage, hypertension, thyrotoxicosis, acquired hypothyroidism, and tuberculosis. Secular trends in hospital use are generally attributable either to changes in disease frequency in the population or to changes in clinic- or hospital-based technology and practice.
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PMID:In-patient workload in medical specialties: 2. Profiles of individual diagnoses from linked statistics. 758 80

Atrial fibrillation (AF) predisposes to stroke, particularly in patients with rheumatic heart disease, congestive heart failure, arterial hypertension, diabetes mellitus or uncontrolled thyrotoxicosis. In those with rheumatic heart disease it is usual to give warfarin to reduce the incidence of stroke, although there has been no randomised controlled trial on which to base this approach. Whether patients with non-rheumatic AF should be anticoagulated was unclear when we tackled this subject five years ago. This article reviews the evidence from recent randomised controlled trials and considers whether anticoagulation with warfarin, or antiplatelet therapy with aspirin, should now be routine for patients with non-rheumatic AF.
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PMID:Warfarin or aspirin for non-rheumatic atrial fibrillation? 763 36

Two hundred and ninety one patients admitted with atrial fibrillation through the emergency room of a regional hospital in the year 1993 were reviewed to evaluate the presenting features and in-hospital treatment of patients with symptomatic atrial fibrillation. The incidence of atrial fibrillation increased with age (mean age was 73 +/- 12 years) and the ratio of female to male was 1.8:1. The commonest presenting features were palpitation (42.3%), dyspnoea (38.1%) and heart failure (16.4%). The most frequently associated cardiac conditions were hypertension (28.9%), atherosclerotic cardiovascular disease (24.7%) and rheumatic heart disease (17.5%). Pulmonary diseases (18.6%), diabetes mellitus (12.7%) and thyrotoxicosis (6.2%) were the principal associated non-cardiac conditions. Thromboembolic complications were found in 15 patients at presentation (5.2%). Cardiac enzyme assessment was investigated in two thirds of the patients (68.1%), while thyroid function test (59.5%) and echocardiography (29.6%) were less commonly investigated. Digoxin was still the most popular drug used for ventricular rate control, and cardioversion was performed in only 6.9% of patients. Antithrombotic therapy was used in 5.8% of patients only although it was clinically indicated in more than half of the patients (52%). Contraindications of anticoagulation were found in 23 patients (7.9%), including a history of gastrointestinal or cerebrovascular bleeding, active bleeding, chronic renal failure and poor drug compliance. The mean hospital stay was 5 +/- 4 days, compared to a mean stay of 2.7 days for other medical patients. Fourteen patients (4.8%) died during hospitalisation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Presentation and management of patients admitted with atrial fibrillation: a review of 291 cases in a regional hospital. 778 42


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