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)

The term "obstructive colitis" is defined by the presence of ulcero-inflammatory lesions in a colonic area proximal to a potentially obstructive lesion. Seven cases retrospectively identified during a 5-year period are here reported. They illustrate the clinico-pathological spectrum of this entity. Most patients were women, with a mean age of 66 years and with history of chronic underlying disease (diabetes mellitus and arterial hypertension). Abdominal distension and pain, as well as acute constipation were the main clinical symptoms. An adenocarcinoma predominantly located at the rectosigmoidal region accounted for the obstructive nature in 100% of cases. Macroscopically the colitis area was moderately dilated and there were single or confluent ulcers in the luminal surface. Characteristically, there was always a transitional preserved area between the obstruction and the colitis area. Microscopically, the mucosa was totally replaced by a granulation tissue with a relevant inflammatory infiltrate involving up to the muscularis propria. The cytometric study revealed and increase in the cell cycle (S-phase) and proliferation index, at the level of the obstructive lesion, with marked aneuploidy in cases with advanced neoplastic invasion. The role of mural hypoperfusion with localized ischemia in the pathogenesis is discussed. The similarities with other colonic inflammatory diseases are emphasized.
 ...
PMID:[Obstructive colitis: analysis of 7 patients]. 958 36

End-stage renal disease (ESRD) is the stage of renal failure at which an individual requires dialysis therapy or a renal transplant to survive. The prevalence of ESRD is disproportionately higher among patients aged > 65 years, and the average age of new ESRD patients is continually rising in the US Medicare population. Medication management in this population is challenging because of the combination of multiple comorbid disease states, a plethora of medications and the added dimension of dialysis therapy, as well as pharmacokinetic and pharmacodynamic changes attributable to the aging process. Cardiovascular disorders such as hypertension, coronary artery disease, congestive heart failure and arrhythmias are common in elderly patients with ESRD, and account for most of the deaths in this population. Constipation is common in patients aged > 65 years, and its incidence is even higher among those receiving dialysis. Pain management is of particular concern because elderly dialysis patients are frequently prescribed inappropriate pain relief regimens. Many healthcare practitioners do not realise that patients with uraemia are at a higher risk of bleeding caused by nonsteroidal anti-inflammatory drugs than are patients with normal renal function. In addition, most practitioners do not appreciate that virtually all opioids (narcotics) and their active metabolites accumulate in patients with renal failure, leading to an increased risk of narcosis. Infectious complications are frequent in the ESRD population, with dialysis access infections and pneumonia being the 2 most common infections seen in hospitalized patients receiving dialysis treatment. The establishment of vaccination programmes for the prevention of hepatitis B, influenza and pneumococcal infections is important because of the increased risk of these disease in this population. Unfortunately, these high-risk patients display, in general, a decreased immunogenic response to vaccinations. This article addresses some of the practical issues that surround the medication management or prevention of these particular diseases in elderly patients undergoing haemodialysis. Specifically, we discuss the pharmacokinetic and pharmacodynamic changes that occur with specific medications in such patients. Drug dialysability is also discussed.
 ...
PMID:Drug therapy in haemodialysis patients. Special considerations in the elderly. 963 93

Three hepatic porphyrias--acute intermittent porphyria, hereditary coproporphyria and variegate porphyria--are characterized by episodic acute attacks that consist of various neuro-psychiatric symptoms and signs, such as abdominal pain, vomiting, constipation, hypertension and tachycardia associated with increased excretion of porphyrins and porphyrin precursors. Peripheral neuropathy is manifested as pain in the extremities, and it may progress to a severe motor neuropathy. Measurement of porphobilinogen in the urine gives a prompt diagnosis during acute attacks. Attacks are often induced by precipitating factors such as drugs, alcohol, infection, fasting or changes in sex-hormone balance, and they should be eliminated when a patient is treated during an attack. Heme, the end biosynthetic product, is the most effective therapy for restoration of porphyrin biosynthesis to normal, and it is usually infused at 3 mg/kg daily for 4 days. Adequate calories are necessary and parenteral nutrition with carbohydrates may be necessary. Attacks may also require therapy for hypertension, pain and epileptic seizures. Strict avoidance of all precipitating factors may not be necessary in the asymptomatic phase.
 ...
PMID:Management of the acute porphyrias. 963 23

Selegiline (deprenyl), a selective, irreversible inhibitor of monoamine oxidase type B (MAO-B) is widely used in the treatment of Parkinson's disease. As the first MAO-B inhibitor approved for the treatment of Parkinson's disease, concerns were raised about the safety of the drug based on the adverse effect profiles of older, nonselective MAO inhibitors. Unlike the nonselective MAO inhibitors, selegiline does not significantly potentiate tyramine-induced hypertension (the 'cheese effect') at the dosages (5 to 10 mg daily) used for the treatment of Parkinson's disease. Selegiline has been well tolerated when given alone. The most frequent adverse events seen during monotherapy have been insomnia, nausea, benign cardiac arrhythmias, dizziness and headache. When combined with levodopa, selegiline can potentiate the typical adverse effects of levodopa, if the dose of levodopa is not reduced sufficiently. Thus, the most common adverse effects associated with this combination are nausea, dizziness, fatigue, constipation and insomnia. At the later stages of Parkinson's disease when fluctuations in disability occur, peak dose dyskinesias, psychiatric complications like hallucinations and insomnia, and orthostatic hypotension are further potentiated by selegiline. Mortality was recently reported to be increased when selegiline and levodopa were given together in comparison with treatment with levodopa alone, but a large meta-analysis of 5 long term studies and 4 separate studies did not support this conclusion. Selegiline seems to be generally well tolerated in combination with other drugs. However, when pethidine (meperidine) has been given to patients who are receiving selegiline therapy, severe adverse effects have been reported. Thus, the concomitant use of these drugs is not recommended. A low tyramine diet is recommended if selegiline is used together with nonselective MAO inhibitors or the selective, reversible MAO-A inhibitor, moclobemide. Several adverse effects have been reported when fluoxetine and selegiline have been used together. A recent survey revealed that the incidence of a true serotonin syndrome is, however, very low with this combination. Concomitant use of selegiline and other selective serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors (SSRIs) like citalopram, which have generally less interactions than fluoxetine, seems to be well tolerated. Nevertheless, caution is advised when combining a SSRI or a tricyclic antidepressant and selegiline.
 ...
PMID:Safety of selegiline (deprenyl) in the treatment of Parkinson's disease. 967 55

We encountered a patient with enterohemorrhagic Escherichia coli (EHEC) O157:H7 infection and secondary hemolytic uremic syndrome (HUS). The patient was a 79-year-old woman with hypertension, constipation, and asymptomatic cholelithiasis. She complained of nausea and abdominal pain, and had bloody stool EHEC O157 was detected by fecal culture. The bloody stool resolved after treatment with antibiotics, but the patient was hospitalized on July 23, 1996 because of abdominal distention. HUS was diagnosed because of proteinuria, hematuria, thrombocytopenia, hemolytic anemia, fragmentation of red blood cells, and increased serum LDH. Treatment was focused on plasma exchange, administration of antibiotics, large doses of gamma-globulin, haptoglobin replacement, and anticoagulation. Within about 2 weeks, the level of hemoglobin, the number of platelets, and the serum LDH had normalized, and the patient recovered from HUS. The decreased intestinal movement continued. On August 23, acute cholecystitis was diagnosed, and percutaneous transhepatic gall bladder drainage was done. Another exacerbation was noted on October 13, and cholecystectomy was done on November 12, when the patient's status had improved after instillation of antibiotics. Macroscopically, the gallbladder wall was thickened. Histopathological examination showed diffuse infiltration of lymphocytes into the mucosa, chronic cholecystitis was diagnosed. Because the postoperative course was satisfactory, the patient was discharged from the hospital on December 15. Acute exacerbation of chronic cholecystitis might have been caused by decreased cholic excretion after the marked decrease in intestinal movement due to O157 infection and secondary HUS. Because elderly people frequently have anamnesis of the digestive system, considerably attention should be paid to the management of anamnesis, as well as O157 infection and secondary HUS.
 ...
PMID:[Enterohemorrhagic Escherichia coli O157 infection in an elderly patient with secondary hemolytic uremic syndrome who developed recurrent acute exacerbation of chronic cholecystitis]. 977 57

Perindopril 4 mg once daily was given to 40 hypertensives for 4 weeks. The results showed that systolic and diastolic blood presure were decreased by 3.2 kPa (22.2 +/- 2.21-19.0 +/- 1.92 kPa) and 1.87 kPa (13.4 +/- 1.21-11.5 +/- 1.27 kPa), respectively. The total effective rate was 80%. Serum Angiotensin-I-converting enzyme activity in 30 patients was significantly decreased from 58.5 +/- 29.5 U to 18.2 +/- 16.2 U (P < 0.01). The urine level of N-acetyl-beta-D-glucosaminidase (NAG) in 27 patients significantly decreased from a prior level of 13.66 +/- 7.81 U.gCr-1 to 10.12 +/- 5.57 U.gCr-1 (P < 0.01). The side effects of perindopril were cough (7.5%), constipation (10%), dizziness (7.5%), flatulence (7.5%) and diarrhea (5%). We conclude that perindopril is a potent antihypertensive drug with significant prevention on hypertension-induced early renal damage.
 ...
PMID:[Effects of perindopril on hypertension, serum angiotensin-I-converting enzyme activity and urine level of N-acetyl-beta-D-glucosaminidase]. 986 22

A multicentre, randomised, double-blind, parallel group comparison of nifedipine GITS 20 mg (Adalat LA) once daily and bendrofluazide 2.5 mg once daily in patients with mild-to-moderate hypertension was conducted. Two hundred patients with a diastolic blood pressure (BP) in the range 95 to 109 mm Hg were randomised to active treatment for 6 weeks. For the per-protocol efficacy population, both treatments resulted in clinically significant mean reductions of trough diastolic BP (nifedipine GITS -8.9 mm Hg, bendrofluazide -7.9 mm Hg) and systolic BP (nifedipine GITS -10.4 mm Hg, bendrofluazide -10.5 mm Hg). The study demonstrated that nifedipine GITS was 'at least equivalent' to bendrofluazide in the reduction of trough diastolic BP (one-sided upper 95% confidence limit, 0.5 mm Hg), where inequivalence had been pre-defined as a difference in mean diastolic BP of > or =5 mm Hg. Both drugs were well tolerated, the overall incidence of adverse events in the nifedipine GITS treatment group being 34.0% (34/100) and in the bendrofluazide treatment group being 29.0% (29/100). The commonest events (incidence > or =5%) were headache, constipation, 'flu syndrome and vasodilatation with nifedipine GITS and headache and nausea with bendrofluazide. An increased incidence of elevations of plasma urea and glucose was observed in patients treated with bendrofluazide (9.6% and 30.4% respectively) compared to those treated with nifedipine GITS (3.1% and 18.8% respectively). Nifedipine GITS 20 mg once daily is 'at least equivalent' to bendrofluazide 2.5 mg once daily in reduction of blood pressure in patients with mild-to-moderate hypertension.
 ...
PMID:A randomised double-blind study comparing nifedipine GITS 20 mg and bendrofluazide 2.5 mg administered once daily in mild-to-moderate hypertension. 992 55

The psychopharmacology of depression is a field that has evolved rapidly in just under 5 decades. Early antidepressant medications--tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs)--were discovered through astute clinical observations. These first-generation medications were effective because they enhanced serotonergic or noradrenergic mechanisms or both. Unfortunately, the TCAs also blocked histaminic, cholinergic, and alpha1-adrenergic receptor sites, and this action brought about unwanted side effects such as weight gain, dry mouth, constipation, drowsiness, and dizziness. MAOIs can interact with tyramine to cause potentially lethal hypertension and present potentially dangerous interactions with a number of medications and over-the-counter drugs. The newest generation of antidepressants, including the single-receptor selective serotonin reuptake inhibitors (SSRIs) and multiple-receptor antidepressants venlafaxine, mirtazapine, bupropion, trazodone, and nefazodone, target one or more specific brain receptor sites without, in most cases, activating unwanted sites such as histamine and acetylcholine. This paper discusses the new antidepressants, particularly with regard to mechanism of action, and looks at future developments in the treatment of depression.
 ...
PMID:Mechanism of action of antidepressant medications. 1008 78

Polya partial gastrectomy was performed for peptic ulcer in a previously healthy woman aged 28 years. She complained afterwards of a variety of non-specific symptoms including weakness, tiredness, debility, slowness of walking, poor appetite and constipation. Within ten years her back became bent. She was treated for intercurrent hypertension and epilepsy. Bone fractures on low-impact trauma occurred in her fifties. At 57 years, she was unable to care for herself and had to be admitted to a nursing home. She could still walk slowly with the aid of a stick. For three months at the age of 65 years, she was unable to rise from her chair. Investigations disclosed severe post-gastrectomy bone disease. At no time had she complained of bone pains.
 ...
PMID:Post-gastrectomy bone disease undiagnosed for forty years. 1049 25

A 45-year-old Mexican woman with a history of noninsulin dependent diabetes mellitus (NIDDM), hypertension, and coronary artery disease presented to the hospital after 2 months of intractable nausea, vomiting and diarrhea-all made worse by eating and drinking. She reported fever, chills, anorexia and a documented 50-pound weight loss during this period. She denied the signs and symptoms of melena, hematochezia, steatorrhea or constipation. She also reported left leg pain and decreased sensation and strength of her left leg compared to the right leg. She had been hospitalized 2 weeks prior to admission with the same symptoms and a diagnosis of viral gastroenteritis. She was also treated for H. pylori, but subsequent biopsy results were negative by Steiner stain.
 ...
PMID:Intractable nausea, vomiting and diarrhea in a Mexican woman with No recent travel history. 1068 42


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