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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The finding that urine cortisol excretion was increased in patients with hypokalaemic hypertension induced by licorice addiction led to this study on the effect of licorice in normal subjects. Thirteen normal volunteers ate either 100 or 200 g licorice for 1-4 weeks and assessment of pituitary-adrenal function was made before, during, and 1 week after cessation of licorice ingestion. Urine cortisol excretion more than doubled in 10 of 13 subjects (mean, 33.8 +/- 15.6 SD before and 83.3 +/- 56 SD micrograms/24 h at 1 week after commencing licorice) and excretion rates similar to those observed in Cushing's syndrome were seen in 7 subjects (range, 91-226, compared to normal range of 11-82 micrograms/24 h). Urine cortisol excretion remained significantly elevated (P less than 0.01) above control levels for at least 1 week after licorice was withdrawn. Despite these increases, urinary steroid metabolite (tetrahydrocortisol, tetrahydrocortisone, tetrahydro-11-deoxycortisol, 17-ketogenicsteroids, and 17-ketosteroids) excretion was not affected, plasma cortisol and ACTH values were unchanged, and normal 0800-1600-h diurnal variation of plasma cortisol was maintained. The direct intraadrenal infusion of the active mineralocorticoid component of licorice, glycyrrhetinic acid, in two sheep with autotransplanted adrenal glands failed to stimulate cortisol secretion acutely. It is concluded from these studies that the licorice-induced changes in cortisol excretion are not a result of adrenocoritcal stimulation but more likely represent a change in the renal handling of cortisol.
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PMID:Licorice raises urinary cortisol in man. 23 69

The analgesic syndrome, comprising renal disease, hypertension, peptic ulcer, anaemia and recurrent headache, accounts for wide-spread morbidity and mortality especially in Queensland and New South Wales. Epidemiological and clinical evidence gathered from many Western societies implicates unsupervised consumption of compound analgesic preparations, particularly those containing phenacetin, in the causation of the majority of cases. Laboratory experiments so far have failed to produce an entirely satisfactory model of clinical analgesic nephropathy. In small animals, papillary necrosis results from prolonged feeding with large doses of aspirin and a number of other anti-inflammatory agents more readily than when phenacetin, paracetamol or phenazone is given alone. The apparently conflicting deductive and experimental data may be reconciled if, as indicated by preliminary observations, salicylates enhance the toxicity of phenacetin derivatives. In planning a programme of prevention for the analgesic syndrome, the central aetiological role of non-narcotic drug dependency must be recognized. As the analgesics to which addiction commonly occurs are the compound powders and tablets, or those containing a stimulant, these preparations should be available only in circumstances where their use can be monitored. Suspected unsupervised and unwarranted consumption of analgesics should be checked by urinary testing for drug metabolites. Because the underlying problem of analgesic dependency is behavioural and environmental in origin rather than medical, the physician must combine forces with the social engineer to devise a definitive solution for this condition.
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PMID:Analgesic abuse and kidney disease. 107 83

Renal function was studied in 145 asymptomatic male heroin addicts admitted to a methadone detoxification program. The mean duration of addiction was ten years. Three patients had protein excretion greater than 150 mg/24 hr; in one of these, membranous glomerulonephritis was found. All except one had normal creatinine clearance. Hypertension was present in 2.7%. This study does not support the concept that heroin addiction is associated with a high prevalence of renal disease.
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PMID:Prevalence of renal disease in asymptomatic heroin addicts. 113 67

Conditions of work of seafarers depend on the influence of physical, chemical biological and psycho-social factors. In 1971-1973, the health of 3000 sefarers was examined; their main health problems were: neuroses (10.13%), arterial hypertension (4.63%), ulcer of stomach and duodenum (2.80%), renal calculi (2.80%), and the alcoholic addiction (1.73%). Those seamen worked on cargo ships which technically differed from ships which sail the seas in the nineties; they were slower, to load them and unload took much time, and they stayed in ports for long periods of time. Recent technical developments in shipbuilding, and the trend to build larger ships with more powerful engines and greater cruising speed, the mechanization and automation of ships operation, and computerization, caused the change in their crews structure and number. It also changes the psycho-social work environment. Using the same method, health examinations of 3,300 seafarers were conducted in 1983-1985. There was an increase in the prevalence of neuroses, arterial hypertension, ulcer of stomach and duodenum, and calculus of kidney. In 1990-1992, a group of 4,688 seafarers was examined. Their health problems were different, in comparison with the populations previously examined. For example, neuroses were recorded in 1.16% men, and ulcer of stomach and duodenum in 0.13% of men examined. The above differences in the health status of seafarers examined cannot be attributed only to the changes in their work conditions.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Observations on the conditions of work of Polish seafarers and their health. 134 92

The results of the treatment of 28 patients with mild to moderate hypertension using guanfacin (Estulic) monotherapy and of 24 patients receiving combined antihypertensive therapy containing Estulic are reported on. The blood pressure was lowered and stabilized during the first month of therapy. No addiction or loss in effectivity was seen. There were no changes in ECG or laboratory results during the mean follow up time of 11 months. Four patients discontinued the drug because of subjective side-effects. The single daily dose, the reliable effectivity, the safety of the drug makes it an important antihypertensive drug in general practice.
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PMID:Estulic--a well tolerated and effective antihypertensive drug in general practice. 146 81

This article reports the results of a critical analysis of English-language studies describing programs designed to improve physician prescribing behavior in primary care settings. Only 64% of studies met minimum research design standards, and are the basis for the results reported. The overall findings of the review confirm the conclusions of a previous evaluation of hospital-based studies. (1) The simple dissemination of printed educational materials had no detectable effect on prescribing practice when used alone in well-controlled studies. However, such educational materials do lay a necessary foundation for more personalized educational efforts. (2) Merely distributing computerized listings of patient-specific medication profiles, without specific recommendations for change, is ineffective in reducing overall drug costs or use of inappropriate drugs. Their lack of effect may be due to the large quantity and clinical irrelevance of such data. (3) Continuous computerized reminder systems have been shown to prevent omission of essential care, although such systems are effective only as long as reminders continue. This strategy has not been evaluated for its potential to reduce excessive or inappropriate drug prescribing. (4) Repeated feedback to physicians with specific suggestions for alternative agents has been shown to increase use of generic drugs in academic group practice settings. No adequate studies have tested whether this approach might reduce other types of misprescribing. Also in academic primary care settings, small group tutorials have been shown to improve use of antibiotics and hypertension treatment control. (5) A substantial literature in the U.S. and Canada supports the conclusion that brief, face-to-face educational outreach visits, conducted by either specially trained clinical pharmacists or physician "counsellors" and "opinion leaders", are effective in reducing prescribing of inefficient or contraindicated drugs in pediatric and adult primary care settings. These face-to-face approaches emphasize a tactful, supportive and facilitative role; in some cases, emphasis is put on helping physicians overcome barriers to appropriate prescribing (e.g. patient demand or addiction to minor tranquilizers). Most effective programs also utilize professionally credible sponsors and high-quality educational materials. In addition to improving quality, some programs have been found to produce savings in drug use which exceed the operational costs of the program.
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PMID:Quality assurance for drug prescribing. 210 70

In this paper we discuss recent experimental and clinical findings which lead us to propose that prolonged rhythmic exercise can activate central opioid systems by triggering increased discharge from mechanosensitive afferent nerve fibers (Group III or A-delta) arising from contracting skeletal muscle. We review evidence that supports the concept that many of the cardiovascular, analgesic, and behavioral effects of exercise are mediated by this mechanism and that the same or similar mechanisms are responsible for the central and peripheral effects of acupuncture. Based on this hypothesis, and supporting evidence from human and animal studies, we suggest a mechanism and a potential therapeutic role for exercise in the treatment of selected patients with disorders as diverse as hypertension, addiction, depression, and anorexia nervosa.
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PMID:Endorphins and exercise: physiological mechanisms and clinical implications. 220 77

The pharmacological properties of centrally acting alpha2-receptor agonists such as clonidine suggest a potentially important role as ideal adjuvants for anesthesia since they produce sedation, analgesia anxiolysis, xerostomia and cardiovascular stability without respiratory depression, development of tolerance or addiction liability. Further clinical experience with this exciting development will undoubtedly establish the ultimate role and optimal use of alpha2 -receptor agonists in anesthetic practice. Beta-blockage can result in significant bradycardia, atrial ventricular conduction problems, bronchospasm and left ventricular contractile dysfunction. Thus, the use of long-acting beta-blockers is of limited value in the perioperative period. Esmolol, because of its ultrashort action, cardioselective properties and titratability, has been shown to be safe and effective for the treatment of tachycardia and hypertension. Doses from 50 to 300 micrograms/kg/min for up to 7 hours in the perioperative period have been shown to cause no apparent cumulative effect. It has been used in the treatment of asthmatic patients with tachycardia and hypertension without significant increases in airway resistance. Studies using esmolol during general anesthesia have demonstrated no significant interaction with several anesthetic regimens.
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PMID:Clinical pharmacology of alpha2-agonist and beta-adrenergic blocker. 257 80

Identification of 5-HT receptor subtypes--5-HT1A, 5-HT1B, 5-HT1C, 5-HT1D, 5-HT2 (possibly A and B), 5-HT3 subtypes, and possibly 5-HT4--has encouraged the manufacture of 5-HT receptor inhibitors with greater subtype specificity. However, it appears that the receptors interact, and drugs initially thought to be specific may have multiple actions. For some conditions such as anxiety/depression, almost all receptors are implicated. Clinical studies provide clear evidence that manipulation of the 5-HT system has a role in treating depression, anxiety, obsessional illness, migraine, and eating disorders. Interactions between the various receptor subtypes make it difficult to identify specific clinical functions. The 5-HT1A receptors may be involved in aggression, anorexia, and hypotension. The 5-HT1B receptors may be involved in aggression, while the 5-HT1C receptors may play a role in central aversion systems and anxiety/depression. The role of the 5-HT1D receptors remains speculative; 5-HT2 receptors appear to be involved in depression, anxiety, appetite, sleep, vasoconstriction, and hypertension. Many drugs that are effective in treating migraine are potent 5-HT2 antagonists. 5-HT3 antagonists at high doses are effective in treating nausea and at low doses in treating anxiety. Treatment of aggression, suicidal behaviour, addiction behaviour, memory impairment, dementia, and schizophrenia with 5-HT inhibitors requires further testing.
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PMID:Is there a relationship between serotonin receptor subtypes and selectivity of response in specific psychiatric illnesses? 269 41

The problem of psychosomatic complaints in newly sober substance abusers is longstanding. While somatic symptoms are common in withdrawal generally, some patients experience symptoms which prevail to the point of distracting from the treatment of the addiction. This paper illustrates brief, collaborative interventions conducted in a treatment hospital for three such patients who had significant, persistent, and common psychosomatic difficulties: migraine, insomnia, and hypertension. The importance and utility of holistic, multimodal treatment of the patient is emphasized.
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PMID:Brief interventions for psychophysiological symptoms in hospitalized addicted patients. 274 9


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