Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound

---

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

In patients with chronic obstructive pulmonary diseases and cor pulmonale, long-term treatment with oxygen leads to a reduction in pulmonary arterial pressure. The aim of this study was investigate the question as to the extent to which pulmonary arterial pressure reduction in response to acute administration of oxygen differed from the long-term effect of oxygen treatment, and whether it was possible to determine prognostic factors that would identify the patients who would obtain particular benefit from long-term oxygen therapy. Twenty patients suffering from severe obstruction, global respiratory failure and precapillary hypertension, were treated with oxygen for a period of 20 +/- 6 months. At the beginning of the treatment, the acute oxygen-induced reversibility of pulmonary hypertension with an FIO2 of 80% was established. After an average of 20 months, catheter examination was repeated. A comparison was made between reversibility with acute oxygen and the long-term effects of oxygen. Long-term treatment with oxygen led to a reduction in pulmonary arterial pressure (18%), which was comparable to the reversibility established for acute oxygen inspiration (20%). While, over the long-term, a reduction in pulmonary arterial pressure was caused solely by a drop in pulmonary vessel resistance, acute application of oxygen resulted in an approximately equal decrease in pulmonary vessel resistance and cardiac output. The more pronounced the pulmonary hypertension prior to treatment the greater the pressure reduction achieved with long-term oxygen treatment. Patients with a particularly marked acute oxygen reversibility also had greater long-term benefit, in the sense that, in these cases, the decrease in pulmonary arterial pressure was more substantial than in patients with smaller acute reversibility.
...
PMID:[Acute and long-term effects of chronic obstructive lung diseases]. 211 22

In order to evaluate the hemodynamic effects of INPV, eight patients with COPD (FEV1/FVC, 54 +/- 6 percent; mean +/- SD), respiratory failure (PaO2, 52 +/- 6 mm Hg; PaCO2, 56 +/- 4 mm Hg), and clinical signs of inspiratory muscle fatigue underwent right cardiac catheterization while performing 20 minutes of INPV by a cuirass ventilator at a pressure (-20 to -40 cm H2O) able to reduce the diaphragmatic electromyographic activity. Patients showed a mild basal pulmonary artery hypertension. During INPV, no changes in the mean values of HR (from 79 +/- 20 to 80 +/- 18 beats per minute), systolic BP (141 +/- 19 to 139 +/- 16 mm Hg), CO (5.2 +/- 0.8 to 5.1 +/- 1.3 L/min), mean PAP (23.8 +/- 3.8 to 23.9 +/- 4.4 mm Hg), RAP (4.3 +/- 2.6 to 5.5 +/- 2.5 mm Hg), PWP (10.3 +/- 4.5 to 9.4 +/- 2.9 mm Hg), TPR (369 +/- 76 to 392 +/- 124 dynes.s.cm-5), and PVR (199 +/- 51 to 233 +/- 94 dynes.s.cm-5) were observed. Direct systemic BP monitoring could be performed in six patients. During INPV, three patients showed "pulsus paradoxus," as assessed by an inspiratory fall in systolic BP of 11, 13, and 20 mm Hg, respectively. We conclude that INPV by cuirass ventilator does not induce adverse hemodynamic effects in patients with COPD who have pulmonary artery hypertension.
...
PMID:Hemodynamic effects of negative-pressure ventilation in patients with COPD. 218 97

Multicystic dysplastic kidney is a common renal anomaly in the newborn. Long-term problems, such as pain, infection, hypertension and neoplasm, although infrequent, have been reported. Acute, life-threatening complications resulting from the size of the affected kidney are rare and emergency nephrectomy has been the only reported effective therapy. We present a case of ultrasound-guided percutaneous cyst decompression used as definitive treatment of respiratory failure associated with multicystic dysplastic kidney.
...
PMID:Percutaneous decompression: treatment for respiratory distress secondary to multicystic dysplastic kidney. 157 Oct 36

The echocardiographic and radionuclide angiographic abnormalities in children after scorpion envenomation with L. quinquestriatus, were evaluated. Five children were severely hypertensive, one of them in respiratory failure and another had pulmonary edema. The results revealed poor global contractility 12-15 hr after the sting in three patients. The radionuclide angiograms also revealed poor contractility with low ejection fraction. There was enzymatic evidence of myocardial damage. The changes observed in the echocardiograms and radionuclide angiograms were attributed to catecholamine induced myocardial ischemia. The abnormalities observed suggest that systolic dysfunction plays a role in the pathogenesis of heart failure in scorpion envenomation, in addition to a decrease of left ventricular compliance and increased impedance to left ventricular emptying. The beneficial effects of nifedipine in hypertension and other cardiovascular manifestations justify the routine use of afterload reduction in children with cardiovascular manifestations after scorpion envenomation.
...
PMID:Echocardiographic and radionuclide angiographic observations following scorpion envenomation by Leiurus quinquestriatus. 226 99

Seventy-seven very low birthweight (VLBW) infants (mean birthweight 891 +/- 209 g) with a diagnosis of bronchopulmonary dysplasia (BPD) were treated with a steroid (dexamethasone) in an attempt to wean them from mechanical ventilation. Seventeen of 77 (22%) treated infants died. Death from respiratory failure occurred in 13 infants; sepsis occurred in six infants (7.8%) and contributed to death in one. During steroid therapy systemic hypertension occurred in 18 surviving infants (30%), glucose intolerance occurred in 29 infants (38%), and marked irritability occurred in three infants (3.8%). Elevated blood pressure returned to normal and glucose intolerance resolved in all infants following discontinuation of therapy. Fifty infants were available for follow-up at a mean corrected age of 14.9 +/- 9.8 months. Twenty-two percent required rehospitalization in the first year of life for respiratory illnesses. Results of testing by Bayley Scales of Infant Development were normal in 60% of infants. Fifty percent were considered normal based on both developmental testing and physical examination. Twenty-eight percent had mild to moderate abnormalities, and 22% were severely handicapped. These follow-up results are statistically similar to those recorded in LBW infants with BPD not treated with steroids who were hospitalized during the same period. We conclude that the side effects of steroid therapy for BPD consist primarily of blood pressure elevation, glucose intolerance, and irritability. Causes of death are unchanged by steroids. The incidence of severe infection and the long-term neurologic outcome of high-risk infants with BPD are not appreciably compromised by this therapy. These data suggest that concern for steroid side effects should not prevent additional prospective investigation to determine the role of steroid therapy in the overall management of BPD.
...
PMID:Side effects and long-term follow-up of corticosteroid therapy in very low birthweight infants with bronchopulmonary dysplasia. 235 96

Systemic hypertension has been associated with extracorporeal membrane oxygenation (ECMO) applied in neonatal respiratory failure. To determine the incidence of ECMO-related hypertension, we reviewed blood pressure measurements from indwelling aortic catheters in 31 infants consecutively placed on ECMO. Systemic hypertension (systolic blood pressures greater than 100 mm Hg for 4 or more consecutive hours) developed in 18 of the 31. Causes investigated included the roles of renin secretion, sodium, and colloid loads. There was no evidence of increased plasma renin activities in hypertensive infants (H), when compared with their own pre-ECMO controls or with the nonhypertensive infants (NH). Sodium and colloid loads and their rates of delivery were not different between H and NH. No consistent duration of ECMO was clearly associated with development of hypertension (mean time on ECMO at onset of hypertension, 43.8 +/- 38.5 hours; range, 1 to 142 hours). Demographic information was not statistically significant. Contrary to previous reports, H did not seem predisposed to an increased incidence of intracranial hemorrhage. Development of hypertension during ECMO is not related to increased plasma renin activity, sodium or colloid loads, or their rates of infusion.
...
PMID:Incidence of hypertension in infants on extracorporeal membrane oxygenation. 240 8

The usefulness of doppler-echocardiography for the assessment of pulmonary arterial hypertension in patients with chronic respiratory failure was evaluated in 24 consecutive patients with chronic obstructive lung disease. Seventeen of these 24 patients (71 p. 100) who had tricuspid valve regurgitation analysable by the continuous wave doppler technique were selected as study group; they included 15 men and 2 women aged from 33 to 78 years (mean 63 years). The highest maximum velocity value (method A) or the maximum velocity value averaged on several cycles (method B) of the tricuspid regurgitation jet was used to calculate the right ventriculo-atrial pressure gradient, using Bernouilli's equation. Right atrial pressure was determined by three methods: haemodynamic measurement, clinical evaluation or attribution of an arbitrary 10 mmHg value. The pulsed doppler study of the pulmonary ejection flow included measurement of the acceleration time and calculation of the acceleration time/ejection time ratio. The usual echocardiographic parameters were measured. Catheterization was performed 2.5 days on average after the doppler study. Correlations between doppler examination and catheterization to evaluate the right ventricular systolic pressure were significant (p less than 0.001) and better with method B than with method A. Depending on the method employed to evaluate the right atrial pressure, the correlation coefficients obtained with method B were: 0.93 (haemodynamic measurement), 0.91 (clinical evaluation) and 0.88 (arbitrary value of 10 mmHg). The right ventricular systolic pressure evaluated by doppler ultrasound using method B and by clinical evaluation of the right atrial pressure was 47 +/- 12 mmHg (22 to 70 mmHg), as against 51 +/- 13 mmHg (28 to 74 mmHg) measured by catheterization.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:[Evaluation of pulmonary arterial hypertension by Doppler echocardiography in chronic respiratory insufficiency]. 251 Jun 78

Lung transplantation has been made possible by the advent of cyclosporin, and it can be divided into three categories: single lung, double lung and heart-lung transplantations. Heart-lung transplantation is the only one that can be performed in case of primary pulmonary arterial hypertension, but the respective indications of these three types of transplantation in patients with respiratory failure have not yet been clearly determined. Heart-lung transplantation is also the one that gives the best results in terms of survival and respiratory function. In the post-operative period, graft rejection and bacterial, viral, fungal or parasitic infections are responsible for a 35 per cent death rate. Later in life, transplant recipients are prone to respiratory impairment caused by obliterating bronchiolitis, itself due to insufficiently treated chronic rejection. The development of lung transplantation is considerably limited by the scarcity of donors with procurable lungs and by the frequency of heart procurement at the expense of the heart-lung block.
...
PMID:[Lung transplantation]. 213 26

The major complication of extracorporeal membrane oxygenation (ECMO) for the treatment of neonatal respiratory failure is bleeding related to heparinization. Systolic hypertension has emerged as another serious side effect in our experience. Thirty-eight of the first 41 newborns we treated with ECMO developed a systolic blood pressure greater than 90 mm Hg. The mean hypertension index (HI blood = hours greater than 90/hr on ECMO) was 0.17 +/- 0.16. Possible biochemical mediators were assayed in 17 patients. Plasma renin activity (PRA), aldosterone, epinephrine, norepinephrine, prostaglandin E2, thromboxane, and antidiuretic hormone were elevated. Angiotensin-converting enzyme (ACE) and prostacyclin were not elevated. Eighteen patients (44%) had intracranial hemorrhage (ICH), and 11 patients (27%) had clinically significant ICH. The HI was significantly (p less than 0.005) lower in those patients without ICH (0.11 +/- 0.01) than in those patients with ICH (0.25 +/- 0.04). PRA at hour 12, day 2, and day 3 was significantly higher (p less than 0.05) in patients experiencing ICH (62 +/- 42; 93 +/- 15; 73 +/- 30 ng/ml/hr) than in those without ICH (27 +/- 25; 14 +/- 8; 12 +/- 4 ng/ml/hr). An aggressive approach to medical management evolved that included hydralazine, nitroglycerine, and captopril, which protected against ICH. Two of 23 patients (9%) treated with the protocol sufferred clinically significant ICH, whereas nine of 18 patients (50%) treated before implementation of the protocol experienced ICH. The ACE inhibitor captopril was most effective in the control of hypertension. We conclude that systolic hypertension is common during neonatal ECMO, is associated with ICH, and is related to a high PRA. Aggressive management of hypertension during ECMO can reduce the incidence of ICH, and captopril is an important component of this aggressive medical management.
...
PMID:Hypertension during extracorporeal membrane oxygenation: cause, effect, and management. 282 41

Two siblings, a 14.5-year-old boy and his 11.5-year-old sister, with congenital nemaline myopathy presented with severe respiratory failure and, in the case of the older patient, with cor pulmonale and systemic hypertension. The children were treated initially by continuous mechanical ventilation, but after a few weeks they only required ventilation at night. At the start of treatment, both were found to have a decreased ventilatory response to CO2 which apparently improved during 4 to 5 years of follow-up treatment. It has not been possible to wean them from nocturnal mechanical ventilation, but during the daytime they attend school and function almost normally. It is postulated that respiratory failure in nemaline myopathy may not be related to the severity of the muscle weakness but may result from a disturbance of the feedback required for normal control of breathing.
...
PMID:Nemaline myopathy as a cause of sleep hypoventilation. 308 71


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

---