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

The experience with 45 patients with lung abscess over a three-year period at the University College Hospital (UCH), Ibadan, is presented. This study confirms the rarity of this disease among Nigerian children and its prevalence in young adults in the third and fourth decades of life. The most common presenting symptoms were purulent cough, chest pain, fever, and life-threatening hemoptysis which was the sole indication for emergency operation in 14 out of 16 patients who were treated surgically. The predominance of these abscesses in the right lung, especially in the superior segment of the lower lobe, supports the fact that aspiration of infected material, following depressed level of consciousness, esophageal obstruction, foreign bodies, and oral sepsis form the major causative factors in patients with lung abscess. The frequent association of sickle cell disease, bronchiectasis, hypertension, and pulmonary aspergilloma contribute significantly to the morbidity and mortality attendant to this disease in our environment. Twenty-nine patients were treated medically with five deaths and 16 patients were treated surgically with six deaths. The high operative mortality (37.5 percent) in this series was due to the extreme emergency conditions under which these patients were operated.
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PMID:Lung abscess: a review of three-years' experience at the University College Hospital, Ibadan. 42 74

The mechanical and hemodynamic components of a cardiogenic hypertensive chemoreflex were studied in 50 dogs. Within 6 seconds after a single injection of serotonin (100 microgram/ml) into the left atrium, mean pressure (mm Hg) rose in the aorta from 103 to 197 and in the pulmonary artery from 21 to 34. Left ventricular dp/dt virtually doubled. There was an increase (75%) in peripheral vascular resistance that returned to control within 10 seconds. There was no significant change in pulmonary vascular resistance. Aortic and pulmonary arterial hypertension were associated with a profound depression (82%) in atrial force. Atropine transformed this negative inotropic effect on the atria into a positive inotropic action that averaged 65%. In contrast, ventricular force was always sharply increased, more in the right (95%) than in the left ventricle (50%). Bilateral stellectomy did not eliminate the reflex but it completely abolished the initial increase of cardiac contractility; a delayed increase in contractility persisted and was due exclusively to release of catecholamines from the adrenal glands. This cardiogenic hypertensive chemoreflex uses the vagus for its afferent neural traffic and both the sympathetic and the vagus nerves for its efferent route. The brief and intense systemic vasoconstriction concomitant with an increase in cardiac contractility might represent a kind of "aortic cough." Some possible clinical implications are discussed.
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PMID:Hemodynamic components of a cardiogenic hypertensive chemoreflex in dogs. 61 94

73 welders were examined, who weld in an assembly room of a machine factory, mainly by an electric arc. In anamneses 60% of persons under examination notified of coughing, expectorating, dyspnoea during work, and frequent acute rhinitis. Clinical symptoms of respiratory tract disease, resulting from welding, were found in 10% of welders. Simple bronchitis, resistant bronchitis with pulmonary emphysema, pleural adhesions were diagnosed. In one case fibronodular tuberculosis was found (1%). In 8% of workers, aged 40--50, a dynamic arterial hypertension and radiological symptoms of aortosclerosis were found. 5% welders had granulocytopenia. Disturbances of the examined systems occurred in factory welders with duration of employment above 10 years.
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PMID:[Health conditions of a group of factory arc welders]. 68 52

Eleven patients with hydatid disease of the liver with intrathoracic involvement have been treated at this hospital, and another patient was treated previously elsewhere. The clinical and roentgenologic symptoms depend greatly upon the evolutionary stage of the disease. General conditions are seriously affected in instances of ruptured and infected cysts. When the cysts open into the tracheobronchial tree as a result of coughing up pus in profuse quantities, the general condition may improve to a certain degree, but bronchopulmonary symptoms increase at that moment. An important spitting of bile must alert us to the existence of biliary hypertension. This condition must be treated first to avoid recurrence of the process. According to our experience, surgical treatment is based upon correct drainage of the cystic intrahepatic cavity under the diaphragm, separating the pleural cavity completely from the intrahepatic; excision of the transdiaphragmatic fistulous tract; conservative indications for pulmonary resection, and possible existence of biliary hypertension before and after operation.
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PMID:Hydatid disease of the liver with thoracic involvement. 95 73

A 29 year old man experienced exertional dyspnea and coughing 3 1/2 years after insertion of a Brauwald-Cutter aortic valve prosthesis. Clinical examination suggested pulmonary arterial hypertension, and cardiac catheterization revealed a saccular lesion apparently arising from the left ventricular outflow tract and producing compression of the right pulmonary artery. Origin from the left ventricular outflow tract just under the aortic ring was confirmed at operation. The lesion apparently arose from an anular excavation related to previous endocarditis with abscess formation. Reported cases of similar aneurysmal lesions are briefly reviewed, and other known causes of the pulmonary arterial compression syndrome are discussed.
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PMID:Pulmonary arterial compression syndrome caused by false aneurysm of left ventricular outflow tract. 99 31

Five children (four boys and one girl) with chronic renal failure (CRF) developed congestive heart failure 0.5 to 11 years after the onset of the disease. Their ages were from 4 to 13 years old. They noticed tachypnea, tachycardia, cough, chest anxiety, general fatigue and their chest X-rays showed cardiomegaly with cardio-thoracic ratio (CTR) of from 55 to 63% and pulmonary congestion. Their echocardiograms showed no cardiomuscular hypertrophy, but the dilatation of left ventricular diastolic diameter (LVDd), and the decreased ejection fraction (EF) were observed. They were treated with water restriction, antihypertensive agents, cardiotonics and dialysis. Their clinical symptoms improved promptly, but their cardiomegary and echocardiographic findings improved gradually. The causes of heart failure in these patients seemed to be due to uremia, fluid overload and hypertension. The echocardiographic examination was useful for the management of the children with CRF in heart failure.
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PMID:[Echocardiographic assessment of cardiac function in the children of chronic renal failure with cardiomegary]. 129 69

Angiotensin-converting enzyme (ACE) inhibitors are increasingly used to control hypertension although cough, sometimes severe enough to require discontinuance, is a well-described side effect of these drugs. Manufacturers' labeling indicates that this side effect occurs with a much lower frequency than is reported in the literature. This article describes the incidence of cough as a side effect of ACE inhibitors in a small inner-city practice and presents two reports of patients who required discontinuance of ACE inhibitors for this symptom. It is suggested that, consistent with the recent literature, the incidence of this symptom is more frequent than suggested by manufacturers' labeling, at least in this population.
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PMID:Cough requiring discontinuance of angiotensin-converting enzyme inhibitors in an urban inner-city population. 129 95

The aim of this 16-week trial was to determine the safety and efficacy of a step-care regimen of ramipril, an angiotensin converting enzyme inhibitor, from the minimal active dose (2.5 mg) in patients treated for mild to moderate hypertension. The trial was conducted by 102 general practitioners in 770 patients with mild to moderate hypertension. After a response rate to a 4-week placebo therapy of 9.1%, 57.0% of patients given active treatment with ramipril responded to daily doses of 2.5 mg. Ramipril 5 mg daily was effective in 55.6% of the remaining patients. There was no apparent statistically significant difference between the treatments with ramipril 10 mg or a combination of ramipril 5 mg + Lasix 20 mg daily (44.7% and 47.4% response respectively) in a 6-week double-blind arm of the study. In total, more than 90% of patients responded to treatment with ramipril by the end of the study. The incidence of adverse events was generally low, such as headache, cough, dizziness, asthenia, cramps and nausea. The incidence of cough appeared to be related both to the dosage of ramipril given and to outbreaks of influenza syndrome. Thirty-eight patients discontinued active treatment as a result of minor events such as cough, dizziness or diarrhoea, and one case each of myalgia and papular rash. There were no significant variations in laboratory parameters during the study, especially fasting blood glucose and apolipoprotein A1 and B. The results of this study provide evidence of the safety and efficacy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The French multicentre study of ramipril in ambulatory patients with mild-to-moderate hypertension. 130 60

The antihypertensive effects of lisinopril 10-20 mg once daily and felodipine (extended release formulation) 5-10 mg once daily were compared in a double-blind, parallel group study of eight weeks duration involving 219 patients with mild to moderate hypertension. On lisinopril treatment sitting blood pressure fell from 166.3/102.9 +/- 17.5/5.8 mmHg to 146.7/89.7 +/- 19.5/8.7 mmHg and on felodipine blood pressure fell from 166.7/103.3 +/- 18.3/5.4 mmHg to 153.6/92.3 +/- 15.9/7.9 mmHg. The decreases in sitting systolic and diastolic blood pressures were significantly greater on lisinopril than on felodipine treatment (p = 0.019 and p = 0.033). A subgroup analysis in elderly patients (age > or = 65 years) showed that lisinopril and felodipine were equally effective in reducing blood pressure. In young subjects (age < 65 years) felodipine treatment lowered systolic blood pressure less than did lisinopril treatment (p = 0.001). Lisinopril was better tolerated than felodipine. On lisinopril treatment, reports of headache and dizziness were reduced while that of cough increased. On felodipine treatment, dizziness was reduced but reports of flushing and oedema were increased. The results show a better antihypertensive effect and better tolerability for lisinopril compared with extended release felodipine.
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PMID:Efficacy and tolerability of lisinopril compared with extended release felodipine in patients with essential hypertension. Danish Cooperative Study Group. 133 Mar 86

In a Norwegian, double-blind, double-dummy multicenter study, 828 patients with mild to moderate hypertension were randomized to treatment by either lisinopril or nifedipine. One of the aims of the study was to specifically investigate the frequency of side effects. Spontaneously reported coughing reached 8.5% for lisinopril, as against 3.1% for nifedipine. In two patients coughing led to withdrawal from the study, and in another three it contributed partially to discontinuation of the treatment. A significant sex difference was found for spontaneously reported coughing among patients on lisinopril; 12.6% of the women and 4.4% of the men. A similar difference between the sexes was found for specific questioning about coughing. Use of a visual analogue scale by both patient and spouse revealed similar frequency of coughing as when reported spontaneously. The reason for sex being an important determinant for lisinopril-induced coughing remains obscure.
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PMID:[Cough during treatment with angiotensin-converting enzyme inhibitors is gender related]. 133 83


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