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

Five hundred women 20 to 29 years of age were evaluated 48 hr after delivery to detect the presence of chronic diseases. An overall prevalence of 14.4% was found. Circulatory, osteo muscular, connective tissue and endocrine, metabolic and immune related disorders constituted the main groups of diseases detected. Leading diagnosis were hypertension, scoliosis, gallstones and goiter. No differences were found in type of delivery when comparing healthy and chronic disease affected women. Chronic disease in younger females should be further studied in order to avoid complications, sequelae and to improve reproductive conditions in this population.
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PMID:[Prevalence of chronic diseases in young postpartum women]. 134 May 63

A 23-year-old woman with Marfan's syndrome was scheduled for Cesarean section at 31 week gestation because of progressive aortic dissection. Since she had undergone two surgical corrections for scoliosis (Harrington rod instrumentation) 5 and 12 years ago, we selected general anesthesia. She had been taking diltiazem and propranolol for hypertension and tachycardia. Anesthesia was induced with thiopental 75 mg iv followed by O2-N2O-enflurane (4%) by face mask. Following iv administration of vecuronium 4 mg and tracheal injection of 4% lidocaine 120 mg, the trachea was intubated without a significant hemodynamic change. Anesthesia was maintained with O2-N2O-enflurane (0.5-1.5%) before delivery. Following delivery, enflurane was discontinued and small doses of fentanyl iv (total 0.2 mg) were given with iv infusion of nitroglycerin (0.2-0.5 micrograms.kg-1.min-1) during surgery. Bleeding after delivery was controllable by iv infusion of oxytocin. The Apgar score was good (9 at 1 min and 10 at 5 min respectively). Post-operative course was uneventful. Therapeutic abortion or Cesarean section should be performed as soon as possible in a patient with dissecting aortic aneurysm because of increasing risk of aneurysm rupture during pregnancy. During the surgery, minimal hemodynamic changes are required to prevent the rupture.
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PMID:[General anesthesia for cesarean section in a patient with Marfan's syndrome associated with dissecting aortic aneurysm]. 205 91

Acrorenal syndrome is characterized by central longitudinal axis defects of the limbs, ie, split hand and/or foot. Associated renal lesions described so far comprise agenesis, bilateral hypoplasia (originally diagnosed as oligomeganephronia), and duplication abnormalities. The case of a 29-year-old patient with split hand resulting from bilateral aplasia of the third phalanges associated with dysplasia of the third and fourth metacarpals is reported. In addition, the following lesions were noted: hypoplasia of the middle phalanx of the fifth toe, arched palate, pectus excavatum, hypoplastic mammilae, scoliosis, and congenital hip dislocation. The patient presented with hypertension, modest reduction of glomerular filtration, proteinuria, microhematuria, cylindruria, and moderate harmonic hypoplasia of the right kidney on angiography. Glomeruli had no immune deposits on immunohistology. Light microscopy showed widening of the mesangial axis, focal segmental glomerular sclerosis, and renal interstitial fibrosis with occasional foam cells. This case shows that the spectrum of renal abnormalities in the acrorenal syndrome is wider than previously noted.
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PMID:Acrorenal syndrome in an adult--presentation with proteinuria, hypertension, and glomerular lesions. 277 25

A 77-year-old woman was admitted with obstructive jaundice. US and CT demonstrated a solid mass 2.5cm in diameter in the hepatic hilum. Cholangiography revealed not only severe stenosis of the hilar hepatic duct but also involvement of the right-posterior-inferior-ventral branch and right caudal branch. Angiography showed almost normal appearance except cystic artery. Duodenal invasion was also detected by per oral duodenography. These findings forced to plan extended right hepatic lobectomy with caudate lobectomy and pancreatoduodenectomy for radicality. In spite of the aged and her complications such as DM, hypertension, scoliosis and bradyacusia, liver function was good and she was mentally very active for life. Therefore, planned operation was performed and the suitability of this operation was proved by histological examination. She underwent resection of the abdominal wall for recurrence 8 months after and now alive without the disease 27 months after the first operation. It is stressed that the most suitable operation should be selected conceiving the mode and severity of cancer extension which is revealed by precise preoperative examinations and extended operation may be indicated in even the elderly if various conditions are good.
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PMID:[A case of advanced gallbladder carcinoma of a 77-year-old female successfully resected with extended right hepatic lobectomy with caudate lobectomy and pancreatoduodenectomy]. 318 98

Twenty-six out of a total of 49 patients who were treated for Wilms' tumor at the Mallinckrodt Institute of Radiology between January 1960 and December 1975 have survived at least five years. The median follow-up time is 153 months (12 years, 9 months). One girl, who received pelvic irradiation, has not reached puberty at age 14, but the other 25 patients are currently in good health and have no major complaints or functional impairments at present. Twenty-one patients have, however, developed some complication at some time since treatment. Serious side-effects requiring hospitalization included one case of pericarditis and one of esophageal varices secondary to portal hypertension. Both these patients, however, had advanced tumors requiring aggressive treatment and their complications should be seen in perspective. There has also been one case of temporary low grade renal failure and one of transient hypertension. More common complications were 14 instances of scoliosis (only three have had any symptoms, however), five of osseous hypoplasia, three of soft tissue hypoplasia, three of liver damage and three of lung damage. There was one case of osteochondroma within a radiotherapy field. The factors pertaining to these complications and the anticancer therapy which preceded them are discussed in detail. We conclude that, whereas structural changes following modern radiotherapy for Wilms' tumor are very common, severe dysfunctions are infrequent. Even more extended periods of observation will be required before the total number of abnormalities is ascertained. However, the striking observation from this study is the lack of late functional effects.
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PMID:Late effects of treatment for Wilms' tumor. 630 94

Adolescents receive care from different specialists whose training may affect the quality of care. To measure possible effects, all 80 level 1 and 3 pediatric and medical residents at one institution completed a questionnaire that asked if they planned to care for adolescents and determined their attitudes and skills for 30 relevant tasks. The mean age chosen for transfer of care from a pediatrician to an internist was 18.7 years by the pediatric residents and 16.6 years by the medical residents (P = .00001). Skill in obtaining histories; staging puberty; screening for scoliosis; performing pelvic examinations; diagnosing delayed puberty, psychiatric disorders, or learning disabilities; immunizing; and treating knee and hip pain more often were thought to be important by pediatric residents (88% to 100%) than by medical residents (40% to 75%) (P less than .02). More than 70% of PL-3 but fewer than 50% of ML-3 residents rated themselves skilled for these tasks (P less than .05). Fewer than 60% of each resident group rated themselves skilled in contraception. Both groups rated themselves underskilled in adolescent history-taking; counseling; evaluation of psychopathology; and treatment of dysmenorrhea and hypertension. In both groups, the decision to care for an adolescent was negatively influenced by the presence of a psychosocial disorder. In conclusion, both pediatric and medical residents plan to care for adolescents, and both recognize deficiencies in their training. Pediatric residents, however, are more confident of their skills in adolescent care than are medical residents.
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PMID:Adolescent medicine: attitudes and skills of pediatric and medical residents. 646 19

The Edinburgh Register of the Newborn 1964-1968 and the Edinburgh Scoliosis Clinic 1964-1971 have been used to establish the population frequency in the city of the idiopathic forms of talipes equinovarus and calcaneovalgus, metatarsus varus, congenital dislocation of the hip, and infantile scoliosis. A survey of 165 patients now aged 7 to 11 years showed an aetiological relationship, but with differing environmental factors. These factors were established by comparison with the Edinburgh Register control group of 692 normal infants born over the same period, giving a unique opportunity to obtain more accurate antenatal data than has previously been possible. The principal associations were: talipes equinovarus with antepartum haemorrhage and maternal hypertension; metatarsus varus with twin pregnancies; congenital dislocation of the hip with first born children, older than average fathers, breech presentation, a significant lack of menstrual problems in the mother, and maternal upper respiratory infection during pregnancy; infantile idiopathic scoliosis with breech presentation, prematurity, and the onset of the curve in the winter months. No significant association with raised intrauterine pressure (hydramnios or oligohydramnios) was found among these simple idiopathic deformities. It is concluded that the multifactorial genetic background in likely to be similar in all, but that the additional environmental element is variable.
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PMID:Aetiology and interrelationship of some common skeletal deformities. (Talipes equinovarus and calcaneovalgus, metatarsus varus, congenital dislocation of the hip, and infantile idiopathic scoliosis). 714 83

A series of eight 60-second dialogues was cooperatively produced by the Tacoma-Pierce County Health Department's Adolescent Clinic and KTAC Radio, Tacoma, Washington. The format was one in which the radio announcer made a statement concerning adolescent health, followed by an adolescent's asking a specific health question, a response being made by a health professional, and the announcer's concluding by giving a local resource and phone number. Included in this series were questions about weight reduction, scoliosis, headaches, hypertension, sexually transmitted diseases, temper and anger, stress, and fatigue. The dialogues were aired ten times a day at times appropriate for the adolescent listener. In addition to acquainting the adolescent with clinic and community services, this series gave answers to many developmental questions that may influence the adolescent's behavior and self-concept.
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PMID:The media as an approach to adolescent health education. 733 26

A retrospective analysis of the medical records of 234 children with renal tumors managed over a 25-year period at the Children's Memorial Medical Center was undertaken to evaluate long-term morbidity and mortality. There was a significant increase in survival over the years of the study. The 5-year survival for patients treated during the period 1985 to 1989 was 94% versus 68% for the period 1965 to 1969. Thirty-three children have died, 15 with known disease progression. Long-term morbidity included scoliosis (39), cardiorespiratory insufficiency (13), hypertension (7), renal insufficiency (7), small bowel obstruction (10), chest wall deformity (3), amenorrhea (1), leg length discrepancy (1), and 1 patient with an esophageal stricture. One patient with cardiomyopathy secondary to adriamycin has recently undergone cardiac transplantation. Five patients with renal insufficiency have required dialysis. Of these five, one patient has had two renal transplants. The presence of distant metastases and positive hilar or regional lymph nodes were the only findings at operation that were associated with an increased mortality (P = .005). There was a significantly increased mortality in those children operated on by general surgeons or urologists at other hospitals (11/43) versus those operated upon at our hospital (22/191) (P = .033). There was no statistical difference in the staging or histology among these children. We feel that the careful and systematic approach of a radical nephrectomy assures accurate staging of the tumor removing gross and microscopic disease in the abdomen.
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PMID:A 25-year experience with renal tumors of childhood. 826

The first palliative operations of congenital heart disease in the 1940s and 1950s, and then open heart surgery in the 1960s, have resulted in survival of patients whose follow-up is now over 30 years. Problems of patients with congenital heart disease are cardiac (pulmonary hypertension, systemic hypertension, dysrhythmias, endocarditis, cerebral insults, etc.), and noncardiac (scoliosis, intrathoracic adhesions, cosmetic problems, pregnancy, physical activity, employment, etc.). A pediatric cardiologist usually follows up such patients until adolescence, however, after that time they remain without physician's care who followed them in their childhood, being transferred for further controls and follow-up to internists-cardiologists. Many difficulties arise since internists-cardiologists are not properly trained in this particular sense, and pediatricians are not trained to follow-up adult patients. The care for a patient should be coordinated. To care for an adolescent, who was the child with congenital heart disease, pediatrician and cardiologist have to work at the same medical centre. The follow-up should continue as a team work, in which, besides pediatrician and cardiologists, cardiosurgeon, psychologist, psychiatrist, obstetrician, specialist for physical medicine and social worker should be included. A correction of educational plan is mandatory.
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PMID:[Problems in adolescents and adults with congenital heart defects]. 853 60


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