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)

The problem of the toxic effects of ergotism is raised by two cases of acute lower limb ischaemia observed in young patients. Although commonly encountered up to the 20th century, the problem is now reappearing sporadically from iatrogenic causes. The clinical features and treatment of ergotism are discussed. Prophylaxis is based on two main principles: the respect of contraindications, the most important being hypertension, coronary insufficiency, arteriopathies, acrocyanosis and thrombophlebitis, and less importantly, the association of tetracycline type antimicrobials, triacetyloleandomycin and phenothiazine; on the other hand, attention must also be paid to the instructions on its use, particularly with respect to the maximum dosage, 4 mg/day per os, 10 mg/week per os. The treatment should be given intermittently and not continuously. Full knowledge of the composition of composite drugs is required as many drugs are commercialised with their ergotamine content masked. This justifies, if there is still need, constant pharmacovigilance.
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PMID:[Systemic arterial spasms. Ergotamine tartrate]. 10 87

Cutis marmorata telangiectatica congenita was observed in two adult sisters. The condition appeared at birth and did not change much with age. In one sister the condition was accompanied by hypertension, acrocyanosis and ulceration of the big toe. On the basis of a comparison of the symptoms in patients and their relatives, the authors assume that Van Lohuizen syndrome is a dominantly inherited genetic disorder with low penetrance and great intrafamilial variability.
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PMID:Cutis mamorata telangiectatica congenita in two sisters. 50 99

We describe a patient who presented frostbite in extremities in addition to characteristic symptoms, such as severe hypertension, sweating attacks, palpitations and headache. The patient was eventually diagnosed as having single extra-adrenal pheochromocytoma. The frostbite in extremities rapidly resolved after the removal of the tumor as well as other characteristic clinical symptoms. It is speculated that this frostbite might have been induced by severe continuous constriction of peripheral artery and loss of heat by frequent sweating attacks. Regarding cutaneous symptoms in this disease, pallor, acrocyanosis and cold extremities are commonly found. However, it seems that typical frostbite associated with pheochromocytoma has not been reported so far.
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PMID:[A case of extra-adrenal pheochromocytoma with frostbite in extremities]. 148 15

Arterial hypertension is sustained by either of two long-term mechanisms of arteriolar vasoconstriction or by an inappropriate reaction between them. One mechanism is renin-mediated, the other is related to antecedent renal sodium retention. The plasma renin value directly reflects the presence and degree of renin-mediated vasoconstriction, and, inversely, defines the predominance of sodium-related vasoconstriction. A hypotensive response, or lack of it, to angiotensin-converting enzyme inhibitor is similarly informative. Because the normal kidney exposed to high arterial pressure and normal salt intake will reduce its renin secretion to near zero, any renin secretion in a hypertensive setting can be considered abnormal. Typically, high-renin hypertensive patients are more vasoconstricted than low-renin patients with similar blood pressures. The intense vasoconstriction leads to relative hypovolemia, hemoconcentration, hyperviscosity, postural hypotension, and in severe forms even to acrocyanosis, all of which are dramatically reversed with anti-renin therapy. Conversely, low-renin equally hypertensive patients have relatively more sodium volume and are less vasoconstricted; they are generally responsive to natriuretic drugs (e.g., diuretics or calcium antagonists) and appear relatively protected from vascular sequelae such as stroke and heart attack. These observations provide a new means for evaluating prognosis and a basis for mechanistically differentiating and treating hypertensive patients, allowing increasingly simpler and more-specific long-term therapies.
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PMID:Abnormal sodium metabolism and plasma renin activity (renal renin secretion) and the vasoconstriction volume hypothesis: implications for pathogenesis and treatment of hypertension and its vascular consequences (heart attack, stroke). 191 96

The aim of this study was to measure the cutaneous pulpar temperature of the fingers and assess its evolution after one minute of controlateral hand immersion in a water bath at 4 degrees C and during 10 minutes after cooling. This test was carried out in 347 subjects (120 M, 227 F) divided in 5 groups: 117 healthy volunteers (49 M, 68 F) without any vascular diseases, 46 patients (5 M, 41 F) with acrocyanosis, 87 patients (19 M, 68 F) with Raynaud's phenomenon, 31 patients (24 M, 7 F) with peripheral arterial occlusive disease and 66 patients (23 M, 43 F) with other vascular diseases (high blood pressure and coronary disease). The mean initial temperature (TO) analysis in each group, showed that 2 groups, acrocyanosis and especially Raynaud's group, had a finger temperature significantly lower than the control group (27.4 +/- 4.8 degrees C 25.3 +/- 4.9 degrees C versus 30.5 +/- 4.9, p < 0.02). The cooling test showed 3 different cutaneous temperature reactions: subjects without any modification during and after immersion, subjects with a temperature decreasing after immersion and a normal rewarming after 10 minutes and subjects with a decreasing without any total recovery after 10 minutes. In the subjects with cold hands (initial temperature < 30 degrees C), this cooling test can isolate all patients with a temperature decreasing without any rewarming after 10 minutes with a specificity at 100% (no normal subject with cold hands were abnormal to this test).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Cutaneous pulpar temperature and cold test. Predictive specificity and sensitivity in pharmaco-clinical studies]. 774 57

The new aspects of the use of the central adrenopositive agent clopheline as a component of combined endotracheal anesthesia were studied. In distinction to the recommendation of some authors, clopheline was used in the preanesthesia period in an average dose of 2.5-3.0 mcg/kg (in debilitated patients in a dose of 1.8-2.2 mcg/kg). The authors examined 86 patients 60 to 85 years of age during planned and emergency operations on the biliary tract. All of them suffered from arterial hypertension: 70% had three and more concomitant diseases; 20% of patients were related to IB category of anesthesiological risk, 65% to IIB category, and 15% to IIIB category. The condition of peripheral and central hemodynamics, the stress index, and the excretion of the free forms of catecholamines (CA), their precursors, and metabolites were studied. During anesthesia with the use of clopheline by the suggested method, moderate activation of the sympathoadrenal system within the stress-norm occurs. During anesthesia as well as in the postanesthesia period the mechanisms of autoregulation, which contribute to rapid return of the activity of the sympathoadrenal system to the initial level and the control of the relationship of the synthesis and inactivation of CA, their precursors, and metabolites, are maintained. The method made it possible to reduce the doses of barbiturates to 2-3 mg/kg, and the doses of fentanyl by 3-4 times as compared with those in neuroleptanesthesia, which, in turn, facilitated rapid regaining of consciousness, adequate spontaneous breathing, a good cough reflex, and sufficient physical activity immediately after the operation. There were no complaints of pain hyperdynamic circulatory shift, trembling of muscles, suppressed respiration, and acrocyanosis.
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PMID:[Experience with the use of clopheline in geriatric anesthesiology]. 815 44

We investigated 2 patients with Sneddon's syndrome, elevated anticardiolipin antibodies and systemic complications, which included stroke, habitual abortions, cardiac valvular lesions, acrocyanosis, hypertension and renal insufficiency. Treatment with a combination of immunosuppressive agents and warfarin or aspirin prevented further complications and improved renal function. It is important for those in different specialties to be aware of this potentially treatable disorder.
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PMID:Sneddon's syndrome with anticardiolipin antibodies--complications and treatment. 831 Mar 61

The term vasoneuroses comprises functional disorders of peripheral vessels, in particular arterioles, manifested by vasospasms on the periphery of the upper and lower extremities, more rarely the nose and ears. The main representant of these diseases is a disorder manifested by episodic attacks of ischaemia of the fingers, in particular of the upper extremities--Raynaud's phenomenon (RP) which has two forms: primary RP (Raynaud's disease) where no other basic disease is diagnoses during a two-year period. secondary RP (Raynaud's phenomenon) as an associated symptom of other, in particular systemic diseases. The etiology and pathology of Raynaud's phenomenon has not been elucidated satisfactorily so far. With regard to the variety and scope of detected functional and morphological abnormalities RP is rather multifactorial, caused by an unbalanced action of local and systemic factors affecting the sensitivity of the vascular wall to spastic stimuli. Treatment therefore remains symptomatic. It is restricted to administration of vasodilatating agents, in more severe cases sympathectomy is considered; it is important to rule out another basic disease. Vasoneuroses include also acrocyanosis, livedo reticularis and erythromelalgia. In the case of erythromelalgia it is important to rule out secondary causes (hypertension and polycythemia vera), otherwise it is not necessary to use pharmacological means to influence these diseases because of their relatively harmless course.
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PMID:[Vasoneuroses]. 1104 64

Extra-adrenal pheochromocytomas (EAPs) are rare catecholamine-secreting tumours. The patient commonly present with headache, palpitation, anxiety, diaphoresis, raised blood pressure and heart rate which can be sustained or episodic and less commonly Raynaud's phenomenon. We present a case of an adult woman who presented with unilateral upper limb acrocyanosis and hypertension which was secondary to EAP and resolved completely after surgical removal of the tumour.
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PMID:Acrocyanosis in a young adult: a rare presentation of extra-adrenal pheochromocytoma. 2487 81

In the contemporary era of medical diagnosis via sophisticated radiographic imaging and/or comprehensive serological testing, a focused physical examination remains paramount in recognizing the cutaneous manifestations of chronic vascular disease. Recognition of the unique cutaneous signs of lymphatic and venous hypertension assists in the diagnosis as well as the staging and classification of both lymphedema and chronic venous insufficiency. Awareness of explicit dermatologic vasomotor manifestations aids not only in the identification of acrocyanosis, Raynaud phenomenon, pernio, and erythromelalgia but also mitigates confusion related to their clinical overlap. Although the clinical signs of peripheral artery disease are not necessarily specific or sensitive, a knowledge of suggestive dermatologic findings is helpful in recognition of severe limb ischemia. A brief review of the epidemiology, etiology, pathogenesis, and therapy of cutaneous related chronic vascular disease follows including an emphasis on characteristic clinical features supported by illustrative photographs.
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PMID:Cutaneous Manifestations of Chronic Vascular Disease. 2953 83


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