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)

A four-year old boy was admitted to the hospital due to acute thrombocytopenic purpura. Three days later he developed edema, hematuria and hypertension. The diagnosis of acute poststreptococcal glomerulonephritis was based upon the evidence of previous sore throat, hypocomplementemia and increased antistreptolysin O titer. Renal biopsy was contraindicated due to throbocytopenia. An extensive work-up was done to exclude mebranoproliferative glomerulonephritis and systemic diseases such as hemolytic uremic syndrome or systemic lupus erythematosus. The clinical outcome of the nephritis and thrombocytopenia was excellent in respect to both conditions. To the best of our knowledge concurrent occurrence of acute thrombocytopenic purpura and poststreptococcal glomerulonephritis is very rare; there are only four similar cases reported in the literature. A careful work-up and follow-up are mandatory to exclude systemic disease.
 ...
PMID:Thrombocytopenia during the course of acute poststreptococcal glomerulonephritis. 1292 3

Autosomal-dominant polycystic kidney disease (ADPKD) is a systemic disease with multiple extrarenal manifestations. It accounts for 7% to 11% of patients receiving dialysis or renal transplantation (RT) for end-stage renal disease (ESRD) in Europe. We analyzed retrospectively the causes of death, the prevalence of cardiovascular risk factors (CVRF) and the patient and graft survivals in 62 consecutive ADPKD patients who received 63 cadaveric grafts (29 men and 34 women), of the 600 RTs performed between 1980-2001. The diagnosis of ADPKD was established by family history and ultrasound techniques. At present, 50 patients (79.4%) have functioning grafts, with a mean follow-up of 84.7 months (range, 12-255), and 13 patients have lost their grafts. The main cause of failure was patient death with a functioning graft (9 cases). Malignancies occurred in 5 patients, including 2 lymphomas, 1 renal carcinoma, 1 pancreas sarcoma, and 1 lung cancer associated with infection. Three patients died of cardiocerebrovascular events, and 1 patient of pneumonia. One patient lost the graft after decreasing the immunosuppression for an obstructing colon cancer. Three additional patients now on dialysis lost their grafts due to chronic rejection in 2 cases and primary nonfunction in 1 case. The prevalence of cardiovascular risk factors among the 50 patients with functional grafts were: hypertension, 70%; hypercholesterolemia, 62%; hyperhomocysteinemia, 30%; hyperfibrinogenemia, 68%; increased lipoprotein (a), 18%; microalbuminuria, 22%; hyperuricemia, 48%; hyperparathyroidism, 24%; overweight status, 24%; and nonlethal myocardial infarction, 10%. We conclude that ADPKD patients have good graft and patient survivals, and that the presence of malignancy is the main cause of death and graft failure at our center.
 ...
PMID:Autosomal-dominant polycystic kidney disease: high prevalence of graft loss for death-related malignancies and cardiovascular risk factors. 1296 69

Hypertrophic cardiomyopathy is a relatively common genetic disorder with heterogeneity in mutations, forms of presentation, prognosis and treatment strategies. Hypertrophic cardiomyopathy is recognized as the most common cause of sudden cardiac death that occurs in young people, including athletes. The clinical diagnosis is complemented with the ecocardiographic study, in which an abnormal myocardial hypertrophy of the septum can be observed in the absence of a cardiac or systemic disease (arterial systemic hypertension, aortic stenosis). The annual sudden mortality rate is 1% and, in selected populations, it ranges between 3 and 6%. The therapeutic strategies depend on the different subsets of patients according to the morbidity and mortality, sudden cardiac death, obstructive symptoms, heart failure or atrial fibrillation and stroke. High risk patients for sudden death may effectively be treated with the automatic implantable cardioverter-defibrillator.
 ...
PMID:[Hypertrophic cardiomyopathy. Arrhythmia in hypertrophic cardiomyopathy]. 1296 40

Retinal vein occlusion (RVO) is a relatively common disease, often associated with the presence of diseases related to internal medicine. It is well known that RVO is associated with common systemic vascular disorders such as hypertension, arteriosclerosis and diabetes. Several studies using hospital-based controls have shown an increased risk of RVO in patients with arteriopathy, or high levels of plasma glucose and arterial blood pressure. Patients are categorized into six types of RVO based on the site of occlusion and on the type of consequent vascular damage. Central retinal vein occlusion (CRVO) is the most frequently-occurring and clinically relevant type of RVO. In addition to the well-known classical risk factors, new haemostasis-related ones have been investigated in patients affected by CRVO. While data concerning a number of parameters remain contradictory, high levels of type 1 plasminogen activator inhibitor (PAI-1) and hyperhomocysteinemia appear to play a significant role in the pathogenesis of this disease. Although based on a limited number of studies, this new knowledge could eventually provide important indications regarding prognosis and therapeutic strategies. There is no established treatment for CRVO. Treatment consists primarily of managing any identified underlying systemic disease. The increasing role of hypercoagulability in patients with CRVO supports the use of antithrombotic drugs in the treatment of this disease. Vitamin treatment to correct hyperhomocysteinemia should also be taken into consideration. However, the approach to CRVO treatment with antithrombotic drugs is not evidence-based yet. There is urgent need of intervention trials to evaluate the role of these drugs in CRVO patients.
 ...
PMID:Retinal vein thrombosis: risk factors, pathogenesis and therapeutic approach. 1367 63

In patients presenting with intracranial hypertension without hydrocephalus, mass lesions, and with normal cerebrospinal fluid (CSF) composition (pseudotumor cerebri syndrome), the diagnosis of intracranial sinus venous thrombosis (ISVT) has crucial etiological, therapeutic and prognostic implications. Utilizing two well-defined groups of pseudotumor cerebri patients, one with magnetic resonance imaging (MRI) or angiography confirmed ISVT (17 patients) and the other in whom ISVT has been excluded (idiopathic intracranial hypertension [IIH], 27 patients), we investigated the characteristics that might be helpful in distinguishing them. No clinical or auxiliary findings differed between the ISVT and IIH groups except for female gender and lower CSF protein level, which were significantly associated with the latter. While the syndrome pseudotumor cerebri could be due to multiple causes including ISVT, the term IIH should be restricted for patients with isolated intracranial hypertension attributable to no other neurological or systemic disease. Since CT frequently misses ISVT, patients with pseudotumor cerebri syndrome should undergo MRI and MR venography before being labeled as IIH. We conclude that Modified Dandy's Diagnostic Criteria of pseudotumor cerebri, formulated prior to MRI era, can no longer be applied for the diagnosis of IIH.
 ...
PMID:Differential diagnosis of patients with intracranial sinus venous thrombosis related isolated intracranial hypertension from those with idiopathic intracranial hypertension. 1456 21

Erectile dysfunction (ED) can be an early and first sign of an underlying systemic disease. A screening program is offered by the Israeli Defense Force for career servicemen at the staff periodic examination center (SPEC), the aim of which was early detection of morbidity. We introduced the Sexual Human Inventory for Males (SHIM) questionnaire, in order to detect examinees with ED, and offer them suitable treatment options. The purpose of this study is to introduce the concept of an ED questionnaire as part of a screening program, and to describe the first months of its implementation. A computerized questionnaire is used to collect the medical history. The SHIM questionnaire was incorporated into the medical questionnaire. Relevant data including compliance to reply, SHIM scores, age and accompanying diseases of patients were collected from the computerized database of SPEC. A total of 2182 patients reported to SPEC from 1/5/01 to 1/11/01, 1980 of whom were males. Of the males, 881 (44.5%) chose to fill the SHIM questionnaire (mean age 34.5 +/- 6.7 y), and 244 of them (27.7%) had a score of 21 or less (20.7% had 17-21, 5.7% 11-16, 1.4% 0-10). The prevalence of ED and its severity increases with age. An inverted linear correlation was found between age and SHIM score (r = -0.22, P<0.0001). Prevalence of hypertension and diabetes mellitus is higher in patients with SHIM score < or =16 compared to those with a score > or =22. Only 15% of men with ED refer themselves for medical help. The concept of adding an ED questionnaire to a screening program may encourage more men to seek treatment, not only for their ED, but also for the underlying disease. The platform of a periodic examination offers maximum privacy to the examinees, resulting in better cooperation.
 ...
PMID:Screening for erectile dysfunction as part of periodic examination programs--concept and implementation. 1496 Oct 50

We assessed whether large-scale expression profiling of leukocytes of patients with essential hypertension reflects characteristics of systemic disease and whether such changes are responsive to antihypertensive therapy. Total RNA from leukocytes were obtained from untreated (n=6) and treated (n=6) hypertensive patients without apparent end-organ damage and from normotensive controls (n=9). RNA was reverse-transcribed and labeled and gene expression analyzed using a 19-K oligonucleotide microarray using dye swaps. Samples of untreated and of treated patients were pooled for each sex and compared with age- and sex-matched controls. In untreated patients, 680 genes were differentially regulated (314 up and 366 down). In the treated patients, these changes were virtually absent (4 genes up, 3 genes down). A myriad of changes was observed in pathways involved in inflammation. Inflammation-dampening interleukin receptors were decreased in expression. Intriguingly, inhibitors of cytokine signaling (the PIAS family of proteins) were differentially expressed. The expression of several genes that are involved in regulation of blood pressure were also differentially expressed: angiotensin II type 1 receptor, ANP-A receptor, endothelin-2, and 3 of the serotonin receptors were increased, whereas endothelin-converting enzyme-1 was decreased. Strikingly, virtually no changes in gene expression could be detected in hypertensive patients who had become normotensive with treatment. This observation substantiates the long-standing idea that hypertension is associated with a complex systemic response involving inflammation-related genes. Furthermore, leukocytes display differential gene expression that is of importance in blood pressure control. Importantly, treatment of blood pressure to normal values can virtually correct such disturbances.
Hypertension 2004 May
PMID:Broadly altered gene expression in blood leukocytes in essential hypertension is absent during treatment. 1500 37

The vascular placental pathology (VPP) is associated with many etiologies. Some are the consequence of a maternal genetic or acquired predisposition. Others are associated with a chronic maternal disease (hypertension, lupus, obesity, diabetes, ...). Finally, some others are associated with placental implantation leading to fetal ischemia (multiple pregnancy, chorioangioma, primiparity, feto-placental hydrops) or to environmental (altitude) or nutritional factors (famine and specific alimentary depressions). We classify these factors into three categories according to the risk level (moderate, significant and elevated). While any of these factors can increase the risk of VPP, no one is sufficiently sensitive or specific in predict inevitable onset of VPP. In most cases VPP results from a combination of two (or more) risk factors. The risk factors of VPP classified as moderate include age (> or = 35 years), increased blood pressure during the second trimester of pregnancy, a new paternity, dietetic factors or environmental factors, smoking and controlled diabetes (class B, C), or inactive systemic diseases. Risk is significantly elevated among obese (BMI > or = 25), primiparous women, women with a past familial history (first degree) of preeclampsia or eclampsia, cocaine use or association of tobacco and caffeine use, increased placental mass (associated with twin pregnancy, fetal hydrops or molar pregnancy), uncontrolled diabetes, lupus, active scleroderma. Risk is considered to be high among patients with chronic hypertension, women with a past history of preeclampsia, diabetes (class D, F, R), patients with active systemic disease or with antiphospholipid antibodies or women with lupus or renal lesions and/or proteinuria as well as chronic kidney disease resulting in proteinuria, hypertension and renal insufficiency. Finally, the risk of VPP is considered to be increased in the presence of acquired thrombophilia. It remains moderate in the presence of isolated genetic thrombophilia, except in forms presenting with multiple genetic mutations or associated with an hyperhomocysteinemia. A "high-risk group" is defined among women with past history of deep venous thromboembolic events outside pregnancy, or with a past history of placental vascular pathology (intra-uterine death, placental abruptio, severe and precocious placental, intra-uterine growth retardation, early and repetitive fetal loss) and who, in addition, present with acquired thrombophilia (antiphospholipid antibodies, thrombocytemia), unique homozygous genetic thrombophilia, amultiple genetic thrombophilia or unique heterozygous genetic thrombophilia associated with hyperhomocysteinemia. Prophylactic treatment of acquired thrombophilia and of the multiple genetic forms or associated with hypercysteinemia is a logical rationale, particularly among women with a past history of placental vascular pathology, or with a past history of venous thromboembolic events. On the contrary, prophylaxis using low-molecular-weight heparin in the event of asymptomatic genetic thrombophilic mutations and for women without a past history of deep venous thromboembolism or vascular placental pathology remains controversial.
 ...
PMID:[Vascular placental pathology in high-risk groups: definition and synopsis]. 1502 87

Although patients with systemic lupus erythematosus (SLE), especially those with antiphospholipid antibodies, have a high incidence of arterial and venous thrombotic manifestations, renal infarction has been rarely reported in these patients and is probably underestimated. A 9-year-old boy with renal infarction, diagnosed by computed tomography and scintigraphy, is described. Initially he complained of severe flank pain; he had no urinary abnormalities and his blood pressure was normal. No evidence of systemic disease was found. He responded well to antibiotic treatment without the need for immunosuppressive therapy. In subsequent years he presented a spectrum of clinical symptoms, including fever, malaise, arterial hypertension headache, and mononeuritis multiplex, accompanied by an increased erythrocyte sedimentation rate and transitory proteinuria. This suggested vasculitis involving peripheral vessels as well as the central nervous system. Treatment with oral prednisone and azathioprine led to remission. Four years after the renal infarction, the child presented with recurrence of systemic disease. The diagnosis of SLE was established, with positive antiphospholipid antibodies. The sudden appearance of severe unexplained flank pain should alert the clinician to a possible underlying renal vessel thrombosis. Renal venous thrombosis is probably much more common; however, renal arterial thrombosis and infarction in association with SLE with positive antiphospholipid antibodies should be added to the differential diagnosis.
 ...
PMID:Renal infarction in a child with systemic lupus erythematosus. 1506 40

Serious systemic disorders such as hypertension, cerebrovascular or heart disease, diabetes and psychiatric problems are common in elderly patients, and lead to the prescription of different drugs. This may in turn influence oral health, and the dentist should be familiarized with these situations when providing dental treatment in elderly patients. A retrospective study was made of 196 patients over age 65 years to evaluate the type of ambulatory surgery performed under locoregional anesthesia, taking into account the presence of background systemic pathology, multiple drug therapy, oral and dental health, the cause of consultation and the type of anesthesia used, relating these parameters to the development of intra- or postoperative systemic and/or local complications. Some systemic disease was documented in 88% of the patents-- hypertension being the most frequent disorder (in 45% of subjects with systemic disease). On the other hand, 78% of the patients used some medication, and 77% presented for hard-tissue treatment (tooth extractions, bone remodeling, etc.); 61% of all treatments comprised the removal of root fragments (54% of all hard-tissue interventions), symptomatic third molars (15%) or other dental inclusions. Only mild or moderate complications were recorded (13%) -- either local (n = 25) or systemic (n = 1). No significant relation was observed between the development of intra- or postoperative complications and the type of treatment provided or the medication used by these patients. Only diabetes was associated with a significant increase in intra- and postoperative local complications (p<0.003).
 ...
PMID:Complications of ambulatory oral surgery in patients over 65 years of age. 1512 28


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