Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Tuberous sclerosis (TS) represents a relatively frequent inherited disorder of the skin and neurological tissues. Defects of other organs may also be present, but subjects differ significantly in their individual involvement. Usually, white leaf - shaped macules, even though most subtle, are the first precocious sign of the disease in young patients. Other signs tend to appear when the patient grows older. Visceral disorders include renal angiomyolipomata; clinical behavior of these solid tumors is almost always benign. Sometimes the renal lesions present themselves as polycystic kidneys, and may be the earliest sign and the only manifestation of TS, such as the case here described. This unusual form of renal involvement may be a severe potential complication of TS for the possible blood hypertension, recurrent urinary sepsis and chronic renal failure. It is of the utmost importance to search for the classical stigmata of TS in any patient who has cystic renal enlargement as only apparent abnormality. Careful inquiry into the family history cannot be overemphasized. The authors believe that, failing availability of adequate therapy for TS, the role in genetic counseling is to provide as much informations as possible to enable the involved family to make an intelligent decision about future children.
 ...
PMID:[Clinical aspects (especially nephropathologic) and genetic counseling in tuberous sclerosis. Presentation of a case with polycystic kidney]. 367 Nov 35

A case of anaerobic sepsis associated with Fusobacterium mortiferum is reported. Blood cultures from a 60-year-old man with type II diabetes mellitus, hypertension, severe atherosclerotic cardiovascular disease, and renal insufficiency revealed on a gramstained smear highly pleomorphic gram-negative bacilli with bizarre forms and round bodies. Growth of the organism on nonselective anaerobic media and analysis of its pattern produced results characteristic of Fusobacterium mortiferum.
 ...
PMID:Anaerobic septicemia secondary to Fusobacterium mortiferum. 371 72

During 1978-1983, 57 maternal deaths (23 in blacks, 32 in coloureds and 2 in whites) occurred among 131,288 deliveries (36,564 in blacks, 89,335 in coloureds and 5389 in whites) in the Peninsula Maternal and Neonatal Service, Cape Town. Data for whites were not analysed further. Maternal mortality rates (MMRs) were higher in blacks than in coloureds. Age- and parity-specific MMRs showed that black teenagers and primiparas and coloureds aged 20-34 years and of parity 2-4 had the lowest rates. Advanced age and grand multiparity had a much greater adverse effect in coloureds than in blacks. Eighteen per cent of deaths in blacks and 9% of those in coloureds were in unbooked patients. The main causes of death (obstetric and non-obstetric) in blacks were sepsis, abruptio placentae, eclampsia and pneumonia. In coloureds they were eclampsia, other manifestations of proteinuric hypertension, cardiac disease, sepsis, haemorrhage (grouped) and diabetes. Of those who died, 43% of blacks and 38% of coloureds had had a caesarean section. The perinatal mortality rate was 417 for blacks and 469 for coloureds. A number of avoidable factors were identified. Most, if not all, deaths occurred because simple perinatal rules were broken.
 ...
PMID:Maternal mortality in Cape Town, 1978-1983. 371 61

Over a 6 years period, 51 autopsies have been performed in infants dead after severe sepsis. One third of them had renal damages, consisting mainly in haemorrhagic infiltration. Pathological and clinical data are not always well correlated, but some parameters may enhance a poorer renal prognosis, such as the duration of shock and anuria, or exchange transfusion. The clinical presentation of the infection and the encountered germs are the same in both groups, with or without renal damage. A better management of intensive haemodynamic cares in these neonates increases their survival rate and raises the problem of chronic renal failure or hypertension in this situation. It seems very useful to state precisely the surveillance and protection of the renal function in such patients.
 ...
PMID:[Anatomical study of the kidneys of newborn infants dying after a septic state]. 372 9

The differential leukocyte count was studied within the first 24 hours of life in 115 infants of diabetic mothers (IDMs) appropriate for gestational age (AGA), 16 IDMs large for gestational age (LGA), 104 infants of non-diabetic mothers (INM's) AGA, and 22 INMs-LGA. A significant "shift to the left" was found in IDM's-LGA only. The usual cause of "shift to the left" such as maternal hypertension or fever, respiratory distress syndrome, meconium aspiration, neonatal asphyxia, sepsis, convulsions, or hypoglycemia could not explain this finding. It is hypothesized that increased glucocorticoid secretion may possibly play a role.
 ...
PMID:Differential leukocyte count in infants of diabetic mothers. Increased band count associated with macrosomia. 373 70

In order to evaluate a new thoracic electrical bioimpedance (TEB) system for measurement of stroke volume based on the Sramek-Bernstein equation, 391 paired values of cardiac output were measured simultaneously with the standard thermodilution method. These values were obtained from 16 patients selected for having the most severe illness during a 6-month period; the intent was to evaluate the bioimpedance method in the worst possible situations. The correlation coefficient (r) was 0.83, slope was 0.87, intercept was 1.53, and the mean difference between the two methods was 16.2 +/- 11.8 (SD)% in the total series. In 285 paired samples where satisfactory conditions were met, r was 0.90, slope was 0.98, intercept was 0.34, and the mean difference was 11.8 +/- 8.9%. The data indicate satisfactory correlations between these two methods. When the TEB waveform is satisfactory, the agreement between TEB and thermodilution is as good as the agreement between serial thermodilution methods. Difficulties may arise with dysrhythmias, tachycardia (heart rate greater than 150 beat/min), metal in the chest or chest wall, sepsis, hypertension, and extremely oily skin. Mechanical ventilation did not appear to be a problem.
 ...
PMID:Comparison of measurements of cardiac output by bioimpedance and thermodilution in severely ill surgical patients. 376 4

A randomized trial was conducted of dexamethasone therapy in infants with bronchopulmonary dysplasia who were dependent on respirators and were not progressing clinically despite conventional treatment. Babies were admitted to the study if they had a roentgenogram and clinical diagnosis of bronchopulmonary dysplasia, were 2 to 6 weeks in age, weighed less than 1,500 g, had made no progress in weaning for the preceding five days, and were free of sepsis, patent ductus arteriosus, and congenital heart disease, and had had no intravenous fat for at least 24 hours. After parental consent was obtained, infants were randomly assigned to control or treatment groups. The study hypothesis was that with steroid treatment, babies could be weaned from the respirator within 72 hours and would show a significant improvement in lung compliance within that time. Sequential analysis exceeded criterion (P less than .05) when seven consecutive untied pairs showed weaning with dexamethasone and failure to wean in control infants. Pulmonary compliance improved by 64% in the treated group and 5% in the control group (P less than .01). No significant intergroup differences were noted in mortality, length of hospital stay, sepsis, hypertension, hyperglycemia, or electrolyte abnormalities. Study design permits the conclusion that dexamethasone can produce substantial short-term improvement in lung function, often permitting rapid weaning from the respirator, but long-term efficacy and safety must be demonstrated by further investigations.
 ...
PMID:Controlled trial of dexamethasone in respirator-dependent infants with bronchopulmonary dysplasia. 388 Aug 79

In anesthesized pigs, hemodynamic measurements and gated bloodpool scintigraphy were performed during and after infusion of live Escherichia coli (2 X 10(8)/kg). Ejection fractions (EF) as well as the relation between end-diastolic volumes (EDV) and stroke work (SW) were used to evaluate changes in left (LV) and right ventricular (RV) function. Porcine E. coli sepsis proved to be characterized by pulmonary vascular hypertension (PVH) and systemic arterial hypotension, accompanied by a reflex increase in heart rate. Systemic flow remained essentially unchanged. E. coli infusion resulted in pronounced and opposite changes in LV and RV preload. RVEDV increased initially and then returned to the value observed before E. coli infusion. LVEDV showed a continuous decrease during the observation of 3 hours. Alterations in LVSW and RVSW appeared to parallel the changes in LVEDV and RVEDV. No significant changes in LVEF and RVEF were found. It is concluded that porcine E. coli sepsis might be a suitable model for human sepsis complicated by PVH. In this animal model no clear signs of myocardial depression or evidence of right heart failure were observed.
 ...
PMID:Left and right ventricular function in porcine Escherichia coli sepsis. 388 76

Group B streptococcal sepsis in newborns produces pulmonary arterial hypertension and hypoxemia. The purpose of this study was to investigate the mechanisms by which hypoxemia occurs. Ten anesthetized, ventilated piglets were infused with 2 X 10(9) colony forming units/kg of Group B streptococci over a 30-min period. Pulmonary arterial pressure rose from 14 +/- 2.8 to 38 +/- 6.7 torr after 20 min of the bacterial infusion (p less than 0.01). During the same period, cardiac output fell from 295 to 184 ml/kg/min (p less than 0.02). Arterial PO2 declined from 97 +/- 7 to 56 +/- 11 torr (p less than 0.02) and mixed venous PO2 fell from 39.6 +/- 5 to 28 +/- 8 torr (p less than 0.05). The multiple inert gas elimination technique was used to detect increases in shunt and alterations in ventilation-perfusion matching. Intrapulmonary shunt did not increase during or after the infusion with group B streptococci. However, there was a significant increase (p less than 0.05) in the SD of pulmonary blood flow, an index of VA/Q mismatching, 20 min after initiation of the infusion of bacteria. All the above changes reverted toward baseline during the 2-h period following discontinuation of the infusion. We conclude that the hypoxemia occurring in the early phase of group B streptococcal sepsis does not develop solely because of increased shunt, but rather is produced by a decline in cardiac output in conjunction with mismatching of pulmonary perfusion to alveolar ventilation.
 ...
PMID:Mechanisms of pulmonary gas exchange abnormalities during experimental group B streptococcal infusion. 390 Sep 3

Reproductive care of women with spinal cord damage demands knowledge of such women's reproductive potential and the specific complications to which these women are prone during pregnancy and childbirth, especially autonomic hyperreflexia. Fertility in cord-damaged women of reproductive age is generally undiminished as are libido, ability to have intercourse, and ability to bear children. Frequent complications of cord-damaged pregnant women include urinary tract infection, anemia, pressure sores, sepsis, unattended birth, and autonomic hyperreflexia. Autonomic hyperreflexia or autonomic dysreflexia occurs during labor in up to two thirds of women with cord lesions above T-6. Autonomic hyperreflexia results from noxious stimuli including distention of the bladder, cervix, or rectum, which evokes mass triggering of sympathetic and parasympathetic afferents that are uninhibited by supraspinal centers below the cord lesion. Autonomic hyperreflexia manifests itself with sudden onset of marked hypertension and headache during uterine contractions, as well as bradycardia or tachycardia, various cardiac dysrhythmias, and marked diaphoresis with piloerection and flushing above the level of the cord lesion. We describe the second reported occurrence of intraventricular hemorrhage due to autonomic hyperreflexia during labor and detail recommendations for anticipating and mitigating this potentially lethal complication of parturition in cord-damaged women. Pregnancy and parturition are best carried out with informed cooperation of the patient and of obstetric, cord rehabilitation, anesthetic, and nursing personnel.
 ...
PMID:Autonomic hyperreflexia: a mortal danger for spinal cord-damaged women in labor. 397 Jan 1


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>