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)

A case of mixed IgM-IgG cryoglobulinemia and polyarteritis nodosa is described. The patient exhibited non-deforming arthritis, Raynaud's phenomena, cutaneous vasculitis, and a sensory neuropathy.. The terminal phase of the illness was characterized by hypertension and retroperitoneal hemorrhage, with widespread large vessel arteritis. The isolated cryoprecipitate contained IgM, IgG, and C3 and possessed rheumatoid factor activity. Mild reduction in serum complement (CH50 and C3) was noted on one occasion. The evidence that these cryoprecipitable proteins may be acting as immune complexes and contributing to the arterial lesions is reviewed.
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PMID:Mixed IgM-IgG cryoglobulinemia terminating in polyarteritis nodosa. 23 31

During a 5-year period from 1979 to 1983 all patients in Denmark with metastatic non-seminomatous and extragonadal germ cell cancer were treated with 6 cycles of cisplatin, vinblastine, and bleomycin (PVB). Thirty-nine patients referred to the Finsen Institute accepted a follow-up examination of side-effects 3.5-9 years after chemotherapy. Renal toxicity consisted of an irreversible decrease in glomerular filtration rate (GFR) in 47% of the patients, while the decrease in GFR was fully reversible in 23%. Significant pulmonary toxicity was observed in smokers and consisted of an irreversible decrease in carbon monoxide diffusion capacity to median 72% of the predicted value. Neurotoxicity was the most pronounced long-term side-effect. Nearly all patients had a peripheral sensory neuropathy probably caused by axonal degeneration. A central conduction defect was observed in 88% of the patients by measuring auditory brain-stem potentials. Irreversible high-frequency hearing loss was induced in 39% of the patients. Parasympathetic nerve dysfunction was found in 36% of the examined patients, including 2 patients with impotence. Half of the patients revealed Raynaud's phenomenon (RP), and the mechanism underlying this side-effect was found to be hyperreactivity of the central sympathetic nervous system. Vascular toxicity was found only in terminal arterioles and was not responsible for RP. PVB treatment caused low sperm counts and a subclinical Leydig cell dysfunction in the majority of patients. Azoospermia was observed in 27% of the patients. Six patients had hypertension and this was not related to renal impairment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Late-effects after treatment for germ-cell cancer with cisplatin, vinblastine, and bleomycin. 138 50

The authors describe a family (mother, son and two daughters) with mitochondrial myopathy. The mother was asymptomatic. Two daughters had lactic acidosis and myoclonic epilepsy, mild dementia, ataxia, weakness and sensory neuropathy. The son suffered one acute hemiplegic episode due to an ischemic infarct in the right temporal region. All the patients studied had hypertension. EEG disclosed photomyoclonic response in the proband patient. Muscle biopsy disclosed ragged-red fibers and abnormal mitochondria by electron microscopy. Biochemical analysis showed a defect of cytochrome C oxidase in mitochondria isolated from skeletal muscle. Several clinical and genetic aspects of the mitochondrial encephalomyopathies are discussed.
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PMID:Mitochondrial myopathy and myoclonic epilepsy. 216 73

Seventy-four patients previously treated in our department for germ cell tumour of the testis underwent a series of tests to determine the frequency of long-term therapeutic complications. All had received cisplatin-based chemotherapy as part of their treatment. There was a significant deterioration in renal function throughout the group. Eighteen (24%) had supine blood pressure greater than systolic 140 mmHg or diastolic 90 mmHg after treatment but hypertension did not correlate with renal impairment. Raynaud's phenomenon was common after chemotherapy (26/74) as was persistent sensory neuropathy (23/74). Although 34% had testosterone levels below the normal range, only six patients had a low free testosterone index with one testis still in situ; 18 patients have fathered children after chemotherapy. Approximately half of the patients completed a psychosexual questionnaire and some 30% of them admitted to sexual problems which they attributed to their treatment. Long-term sequelae of cisplatin-based chemotherapy for testicular malignancy are frequent and persistent, and follow-up of these patients should include prospective measurement of changes in blood pressure.
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PMID:Long-term sequelae of treatment for testicular germ cell tumours. 217 22

The purpose of this study was to determine the occurrence and severity of diabetic retinopathy and to clarify its association with the duration of diabetes and several other factors in an outpatient diabetic population. The material consisted of 328 diabetics, mainly (77%) C-peptide negative, type 1 diabetics. The mean age of the patients was 45 years, and the mean duration of diabetes was 15 years. Retinal changes were assessed by ophthalmoscopy and widefield fundus photography. All retinopathy was confirmed in 59% and proliferative retinopathy (PR) in 20% of the patients. The frequency of diabetic retinopathy was 15% in patients with diabetes for less than five years but 100% in those with diabetes for 30 or more years. In type 1 diabetics PR was seen only after 10 or more years' duration but, after 20 years' duration it was seen in half of the patients with type 1 and in one-third of the patients with type 2 diabetes. The patients with diabetic nephropathy often had PR. In type 1 diabetics with onset of the disease less than 30 years peripheral sensory neuropathy, coronary disease, hypertension and leg-vessel disease were also often associated with PR. Because one reason for visual handicapping in diabetes is the delay of the diagnosing of vision-threatening lesions screening for treatable retinopathy should be intensive after 10 years' duration and in poorly-controlled diabetics even earlier.
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PMID:Predicting diabetic retinopathy. 283 48

A 32-year-old female was admitted complaining of pain over the whole body and dysesthesia in all extremities. On admission, physical examination revealed hypertension, tachycardia, abdominal distension and urinary retention. Neurological examination revealed sensory impairment over the whole body and mild muscular weakness with absent deep tendon reflexes. Abdominal roentgenogram showed gaseous distension of the bowels. CT scans showed low density areas on the bilateral parieto-occipital lobes. CAG showed diffuse narrowing of the cerebral arteries. Laboratory examinations showed an albumino-cytologic dissociation (cells; 21/3mm, prot.; 78 mg/dl) of the cerebrospinal fluid and increased levels of norepinephrine (214 micrograms/day) and epinephrine (16.1 micrograms/day) in the urine. Motor nerve conduction velocities of the median nerves was 42.8 m/sec in the right and 50.0 m/sec in the left. The autonomic function tests revealed hyper-responsiveness to 10 mg of phentolamine and low baroreflex sensitivity. Within 2 months, most symptoms improved. Repeated CT scans showed no abnormality, while CAG showed only mild arterial narrowing. This case was diagnosed as having acute autonomic and sensory neuropathy which was a subtype of acute polyradiculoneuritis. Occult encephalitis or autonomic dysfunction was considered to contribute to the peculiar findings on CT and CAG.
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PMID:[A case of polyradiculoneuropathy associated with diffuse arterial narrowing]. 376 86

This report summarizes the major design features, methods, and baseline characteristics of patients enrolled in a Veterans Administration Cooperative Study. In eleven V.A. centers, 231 male diabetic patients who had either a recent amputation for gangrene (N = 207) or active gangrene (N = 24) were randomly assigned to a group which received aspirin (325 mg t.i.d.) plus dipyridamole (75 mg t.i.d.) (N = 110) or two placeboes t.i.d. (N = 121). Major end point were vascular death and amputation of the opposite extremity for gangrene. Forty-one percent of the 563 patients screened were enrolled during a 39 month period. Enrollment errors were found in 8.7%. Historically, the two groups were well matched regarding the following variables: age, duration of diabetes, insulin therapy, previous oral agent therapy, hypertension, myocardial infarction, congestive heart failure, renal disease, sensory neuropathy, and smoking. The drug therapy group had an increased frequency of a history of cerebrovascular disease (19% vs 7%, p = 0.01). The groups were well matched regarding amputation site, obesity, extent of lower extremity vascular disease, retinopathy, and neuropathy upon examination. Their baseline fasting values of glucose, cholesterol, triglycerides, and creatinine were also comparable. We conclude that this study should provide definitive data on the efficacy of these antiplatelet agents in preventing further vascular disease in this patient group. It should also provide new prospective data on the natural history of vascular disease, and the association of vascular risk factors with subsequent vascular events in this patient population.
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PMID:V.A. Cooperative Study on antiplatelet agents in diabetic patients after amputation for gangrene: III. Definitions and review of design and baseline characteristics. 390 83

A Specialist Clinic was commenced in August 1983, from the Medical School at Universiti Sains Malaysia, Penang, Malaysia to assess: 1) the present control and 2) the incidence of complications in a diabetic population already receiving primary health care at Penang General Hospital. The ethnic groups among the diabetics were Chinese (39%), Malays (26%) and Indian (35%). There was a greater percentage of Indians than would be expected from the ethnic distribution of the population of Penang. The results of the first 100 (43 males and 57 females) non-insulin dependent diabetic patients are reviewed. The mean age was 54 years, 41% had relatives with diabetes, and all were taking oral agents. The diet comprehension and compliance were poor. 65% of the group, 54% of males and 75% of females were obese. The mean blood glucose was 11 m.mols/l (fasting) and 12.8 m.mols/1 (2 hours post prandial). The complications seen in the 100 diabetics were: albuminurea 41, skin infection 37, cataracts 35, hypertension 32, peripheral sensory neuropathy 32, retinopathy 22, ischaemic heart disease 19, autonomic neuropathy 10, impaired renal function 4 (urea or creatinine elevated), foot ulcer 2 and gangrene 1. Urinalysis for glucose at the Clinic showed very little correlation with blood glucose at the same time. Nine out of 43 males admitted to impotence on questioning. Comparisons of findings in Penang were made with recent studies in Singapore and Hong Kong.
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PMID:Findings among 100 type 2 diabetics in a clinic in Penang, Malaysia, 1983-84. 403 86

This report describes the experimental design, methods, and baseline characteristics of patients enrolled in a Veterans Administration Cooperative Study on the effect of aspirin (325 mg t.i.d.) and dipyridamole (75 mg t.i.d.) (110 patients), or placebo (121 patients) on major vascular outcome variables in noninsulin-dependent diabetic patients with either a recent amputation for gangrene (n = 207) or active gangrene (n = 24). It also describes the baseline characteristics of the patients. A total of 231 patients of 563 screened (41%) were enrolled at 11 participating V.A. Medical Centers during a 39 month period. The median age at entry was 60 years, the median duration of diabetes was 10 years, and weight was 110% of desirable. All patients were men. Sixty-eight percent were treated with insulin and 32% with diet alone. Only 42% were smokers at entry, 40% had retinopathy, 61% sensory neuropathy, 42% hypertension, and 29% had a history of myocardial infarction, angina, and/or congestive heart failure. Thirteen percent had a history of cerebrovascular disease. Despite randomization, the treatment group had an increased frequency of a history of cerebrovascular disease (p = 0.01), diagnosed as stroke (p = 0.03), a finding suggesting that the treatment group was at a slightly increased risk for vascular disease upon enrollment in the study. Other baseline variables did not differ significantly between the two groups. This study should provide definitive data on the efficacy of these doses of antiplatelet agents in preventing further vascular disease in diabetic men with gangrene or recent amputation for gangrene, using death due to vascular disease and subsequent amputation of the opposite extremity for gangrene as major outcome variables. It should also give useful information on the effect of antiplatelet therapy on vascular outcome variables such as same side amputations, myocardial infarction, stroke, transient ischemic attack, retinopathy, and renal failure. Finally, the study should provide useful data on the natural history and significance of risk factors in this patient population.
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PMID:V.A. Cooperative Study on antiplatelet agents in diabetic patients after amputation for gangrene: I. Design, methods, and baseline characteristics. 637 22

This study evaluates the wall thickness of common carotid arteries and the atherosclerotic involvement of the carotid bifurcations in patients with noninsulin-dependent diabetes mellitus (NIDDM), with and without microvascular complications. Seventy subjects affected by NIDDM, and 17 healthy controls were evaluated by means of high-resolution echo-Doppler scan. Twenty-six diabetics (Group A) and complications (overnight proteinuria > 500 mg, background retinopathy, sensory neuropathy), while 44 (Group B) had no complications. The two groups were comparable for age, sex, plasma lipid profile, and smoking habit. Arterial hypertension was present in 15 of 26 (58%) complicated patients (Group A) and in 18 of 44 (41%) uncomplicated patients (Group B). None of the patients had a history of cerebrovascular disease. The authors found that the wall thickness of the common carotid artery was greater and atherosclerotic lesions of the carotid bifurcation were more frequent in diabetic patients with microvascular complications than in uncomplicated diabetics (who had a similar distribution of other risk factors for atherosclerosis) and in nondiabetic controls. These data on the one hand confirm the role of diabetes as an independent risk factor for carotid atherosclerosis and, on the other hand, indicate a correlation between microvascular lesions and early atherosclerosis in diabetes.
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PMID:Wall thickening of common carotid arteries in patients affected by noninsulin-dependent diabetes mellitus: relationship to microvascular complications. 766 82


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