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

Bilateral electrolyte lesions of the Anterior Hypothalamus (AH) were placed in rats to determine the extent to which this area participates in the regulation of Arterial Blood Pressure (ABP). Experiments were performed in two groups of rats; in one ABP was measured continuously for 44 hr subsequent to the lesion, and in a second group ABP was measured 24 hr after the placement of the lesion. The destruction of this area results in a rapid development of arterial hypertension, hypermotility and hyperexcitability. 24 hr later these effects are attenuated. We conclude that arterial hypertension is probably due to a disinhibition of sympathetic activity through central interruption of baroreceptors reflexes.
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PMID:Participation of the anterior hypothalamus in the regulation of arterial blood pressure. 26 60

A system for discriminating between adrenal adenoma and hyperplasia based on the levels of aldosterone production, plasma renin concentration, severity of electrolyte disturbances, plasma aldosterone patterns during recumbency and after assuming erect posture, and 131I-19-iodocholesterol scan has been developed. Indicated for operation are patients with adenomas whose elevated blood pressure cannot be continuously controlled with usual doses of medication and patients with documented deterioration of target organ function. Adrenalectomy has been performed 83 times in 81 patients with a diagnosis of primary hyperaldosteronism. Results of excision of adrenal adenomas have been excellent with significant lowering of blood pressure in all cases and cure of hypertension in over 60%. Results of total or subtotal adrenalectomy for hyperplasia have been poor with almost all patients still requiring medication for hypertension. Adenomas have always been unilateral, and usually can be localized so that unilateral exploration is curative. Therefore, we have tried to distinguish preoperatively between adenoma and hyperplasia. Anterior transperitoneal adrenalectomy has been effective with few complications, and no postoperative hypercortisolism after unilateral adrenalectomy for adenoma. The unilateral extraperitoneal approach gives shorter morbidity and potentially fewer serious complications.
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PMID:Selection of patients and operative approach in primary aldosteronism. 118 May 75

Management of epistaxis is directly related to the site of the bleeding. Anterior nosebleeds are the least dangerous and the most common, especially among children. Sinus disease, colds, allergies, abrupt temperature changes and dry heat produce fragile and hyperemic nasal mucosa that bleeds easily with nose blowing or mild abrasion. Anterior epistaxis can be reached easily and stopped by pinching the nostrils, applying silver nitrate cautery or lightly packing the anterior nose. Posterior epistaxis may be severe and may be more difficult to locate and control. Occurring more often in the elderly, posterior nosebleeds are frequently associated with hypertension, atherosclerosis and conditions that decrease platelets and clotting function. Visualization of the bleeding site is enhanced by proper positioning of the patient, use of topical vasoconstricting anesthesia and suctioning. Anterior and posterior nasal packing, hospitalization, antibiotics and close follow-up may be required to control posterior nosebleeds.
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PMID:Management of anterior and posterior epistaxis. 204 44

The aim of the study was to investigate the relationship of arterial hypertension coexisting with myocardial hypertrophy to the infarct size evaluated by serial CK-MB measurements. The group of 98 patients (72 males and 26 females) with the first Q-wave infarction was selected from 137 patients admitted to I Clinic of Cardiology of Poznan Medical School with acute myocardial infarction (AMIO). Age of the patients ranged from 35 to 82, mean 60 years. Time from the onset of symptoms to admission to the hospital varied from 1 to 8 hours, mean 4. Enzymatic tests were performed on admission, every 4 hours during the first 24 hours, every 6 hours during the second and the third day and every 8 hours during the 4th and the 5th day. Anterior infarction was diagnosed in 46 patients and inferior infarction in 52 patients. The type of CK-MB curve, maximal CK-MB activity and the mass of necrotic tissue was evaluated for every patient using Sobel formula modified by Norris. Total mass of the left ventricle was calculated from echocardiographic measurements (2-D and M-mode) and the ratio of LV mass per square meter of the body surface was was calculated according to Horton's formula. The subgroup of 44 patients (25 males and 19 females) with the history of hypertension was selected. Ophthalmic examination revealed angiopathic changes of I and II grade K-W. This group, as compared to remaining patients with AMI was characterised by higher left-ventricular mass (198.0 +/- 28.6 vs 151.0 +/- 16.9 respectively).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Myocardial infarction in patients with arterial hypertension. Changes in the creatine kinase MB isoenzyme activity in relation to myocardial hypertrophy]. 214 63

Epistaxis is a common emergency usually caused by local trauma to the nasal mucosa. Occasionally, it may result from systemic diseases such as atherosclerosis, hypertension, or coagulopathy. Anterior nosebleed often can be controlled with topical vasoconstriction and cautery. Intranasal packing may be necessary to tamponade bleeding vessels. Occlusion of the sinus ostia by anterior nasal packing may necessitate prophylactic use of antibiotics to prevent sinusitis. Posterior nosebleed requires nasopharyngeal packing. Patients must be closely monitored and given supplemental high-humidity oxygen. Persistent or recurrent nosebleed or failure of posterior nasopharyngeal packing to control bleeding indicates the need for otolaryngologic consultation and perhaps surgical intervention.
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PMID:How to stop a nosebleed. 233 22

Preoperative laser Doppler velocimetry (LDV) measurements of calf and brachial skin perfusion were performed in 29 patients prior to undergoing below-knee amputation; dual calf measurements on the anterior and posterior skin flaps were routinely obtained. Patients' ages ranged from 24 to 83 years; 16 had diabetes, 13 were smokers, 6 had hypertension, and 2 had known coronary artery disease. Anterior and posterior calf LDV values greater than or equal to 20 mV were associated with successful below-knee amputation wound healing in 25 of 26 patients; all 3 patients with either anterior or posterior calf LDV values less than 20 mV had below-knee amputations that failed to heal. Calculation of calf-brachial LDV indexes did not increase predictive accuracy compared to calf LDV measurements alone, although patients with wounds that failed to heal tended to have lower calf-brachial indexes. Preoperative noninvasive LDV may be used to aid in predicting the likelihood of successful healing after below-knee amputation.
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PMID:Prediction of below-knee amputation wound healing using noninvasive laser Doppler velocimetry. 266 88

Epimyocardial excitation is delayed in areas overlying infarcted myocardium. On the assumption that a delayed R peak in V6 could indicate anterior myocardial infarction (AMI) in the absence of diagnostic Q waves, the findings of angiocardiography (n = 148) and thallium scanning (n = 46) of 194 patients with suspected coronary heart disease (CHD) were compared with regard to two criteria: A (R peak in V6 precedes S peak in V2, or both peaks occur simultaneously, n = 158) and B (R peak in V6 is later than S peak in V2 [R peak delay in V6], n = 36). Of 92 patients with unconfirmed CHD, 4 fit criterion B, and 3 of these had hypertensive heart disease. In 102 patients with confirmed CHD, B was present in 15 of 79 evaluated with angiocardiography and in 17 of 23 patients who had nuclear scanning. Anterior akinesis or dyskinesis was more prevalent in group B (13 cases, 86%) than in group A (17 cases, 26.6%; p = 0.000), as were irreversible anterior thallium defects, with 16 cases in group B (94.1% and 3 cases in group A (50%) (p = 0.016). Two of the three false positives had anterior hypokinesis and one had hypertensive cardiovascular disease. B was less sensitive (59.2%) but demonstrated a specificity of 95.2% and a positive predictive value of 80.6% for the detection of AMI. If used in conjunction with C (poor or reverse R wave progression from V1 to V4, notching at the R upstroke or rsR' in V4, V5, or V6), sensitivity was decreased (38.6%) but false positives were eliminated (specificity and positive predictive value reached 100%). Thus, in the setting of CHD, B can be recommended as a marker of non-Q wave AMI, and its diagnostic reliability is maintained, even in systemic arterial hypertension, if C is taken into consideration.
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PMID:R peak delay in V6. Diagnostic implications in coronary heart disease. 279 37

This is a study of the relationship between the site of infarction and both risk factors and in-hospital outcome in 745 consecutive patients admitted with a first myocardial infarction. Patients with anterior infarctions were significantly more likely never to have smoked than patients with inferior infarctions. They had a higher prevalence of hypertension and a higher mean cholesterol level. In-hospital prognosis was worse in anterior infarctions, with significantly higher rates of death and complications. Atrioventricular blocks were more common in inferior infarctions. Non-Q-wave infarctions had a lower incidence of complications than Q-wave infarctions. There was no difference in risk factor levels between Q-wave and non-Q-wave infarctions. Anterior and inferior infarctions were of similar size. Non-Q-wave infarctions were significantly smaller. A logistic regression showed a negative relationship between in-hospital mortality and smoking, and a positive one with peak cardiac enzyme levels. Any effect of site of infarction on mortality was eliminated when corrected for these factors. Our data indicate that the adverse prognosis associated with anterior myocardial infarction is related to differences in aetiology rather than to infarction size.
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PMID:Aetiological and prognostic correlates of site of myocardial infarction. 316 42

In situ saphenous vein bypass presents unique problems in wound management. A retrospective analysis of wound complications occurring after in situ bypass was undertaken in 93 patients who had 98 operations. For purposes of statistical analysis, only the first procedure was considered in patients having bilateral bypass. Fifty-nine percent of patients were male; the average age was 69 years. Medical risk factors surveyed included diabetes (64%), hypertension (52%), and smoking (53%). Ninety-one percent of the procedures were done for limb salvage; the mean ankle-brachial index was 0.43. Sixty percent of bypasses were infrapopliteal, and the mean duration of surgery was 4.6 hours. Continuous incision was used to expose the vein in 59% of cases. Skin closure was effected with staples in 44% and with sutures or both in the remainder. The mean postoperative hospital stay was 27 days. Wound problems developed in 31 cases, 11 of which were major. The thigh was the most common location. There was a significant association between continuous incision and anterior tibial bypass and wound complications. Anterior tibial bypass and staple closure were found to be independent predictors of wound problems with the use of stepwise logistic regression. Postoperative hospital stay was significantly prolonged; two bypasses failed and three lower extremities were amputated because of incisional complications. A discussion of the technical aspects of wound management is presented.
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PMID:Wound complications after in situ bypass. 337 22

The mode of right ventricular hypertrophy was assessed by two-dimensional echocardiography (2DE) for 24 patients with hypertrophic cardiomyopathy (HCM), and the results were compared with those of 51 patients with hypertension (HT). The patients with HT were categorized in four groups depending on the thickness of the interventricular septum (IVST) and left ventricular posterior wall (PWT): HT-ASH with both left ventricular hypertrophy (LVH) (IVST greater than or equal to 13 mm) and asymmetric septal hypertrophy (ASH) (IVST/PWT greater than or equal to 1.3), severe HT with LVH and without ASH, and mild HT without LVH and ASH. Anterior wall thickness (AWT), posterior wall thickness (PWT), and diaphragmatic wall thickness (DWT) of the right ventricle were obtained from 2DE in the parasternal long-axis view, the short-axis view and subxiphoid view, respectively. These were recorded on video tape, and the measurements were made on the stop frames. Right ventricular hypertrophy (RVH) was estimated by the maximal right ventricular wall thickness (max RVWT), and the ratio of the maximal and minimal thickness (max RVWT/min RVWT) was calculated to evaluate asymmetrical hypertrophy (AH) of the right ventricle (RV). The incidence of RVH (Max RVWT greater than or equal to 5 mm) and asymmetrical hypertrophy (AH) (max RVWT/min RVWT greater than or equal to 1.3) of the RV in HCM, HT-ASH and mild HT were 67% and 41%, 57% and 45%, and 15% and 11%, respectively. The incidence of RVH with AH was more frequent in patients with HCM as well as HT with ASH than in patients with HT without ASH.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Regional right ventricular hypertrophy in hypertrophic cardiomyopathy and hypertension]. 409 19


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