Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 49-year-old man with liver cirrhosis and hypertension was found to have hyperkalemia out of a degree of renal insufficiency and metabolic acidosis with low to normal anion gap, aggravated by volume contraction with diarrhea and medications (captopril, spironolactone and atenolol) interfering with potassium homeostasis. Plasma renin activity and serum aldosterone levels of this patient on a regular diet after discontinuation of medications were very low compared to those of five other cirrhotic patients with normokalemia as controls. Also, the renin-aldosterone stimulation testing on this patient performed by sodium restricted diet and furosemide, upright position and by angiotensin converting enzyme inhibition (captopril, 50 mg) showed the blunted renin and aldosterone responses to each of these stimuli, almost no changes from baseline renin and aldosterone levels, it was concluded that the underlying defect responsible for hyperkalemia in this case was hyporeninemic hypoaldosteronism and this was aggravated by other factors or drugs affecting potassium homeostasis.
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PMID:Hyperkalemia due to hyporeninemic hypoaldosteronism with liver cirrhosis and hypertension. 817 35

We prospectively determined the prevalence of morbidity from the various forms of diabetic neuropathy over one year in a population of 800 patients with diabetes mellitus (336 type 1, 464 type 2 DM). Symptoms documented were: pain/paraesthesia in the feet, loss of feeling and the restless legs syndrome. We also documented the prevalence of: neuropathic ulcers, amyotrophy, foot drop, and oculomotor palsy. Autonomic symptoms documented were: impotence, postural hypotension and diarrhoea. The only symptoms reported by 100 non-diabetic control subjects were: loss of feeling in 2% and restless legs syndrome in 7%. In the diabetics; pain/paraesthesia was present in 13%, feeling loss in 7% and neuropathic ulcers in 2%. The prevalence of Diabetic amyotrophy (proximal femoral neuropathy) was 0.8%, oculomotor palsy 0.1% and peroneal nerve palsy 0.1%. Erectile impotence was present in 20%, symptomatic postural hypotension in 1% and diabetic diarrhoea in 1%. Overall; 22.9% of the population was afflicted by one or more problems resulting from neuropathy. Neuropathy was associated with older age (p < 0.001), and serious retinopathy (p < 0.001) in both groups of diabetics and with duration of diabetes, proteinuria (p < 0.02), hypertension (p < 0.01) and ischaemic heart disease (p < 0.02) in type 1 diabetics.
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PMID:Prevalence and forms of neuropathic morbidity in 800 diabetics. 820 Jul 77

The relationship of the duration of anuria to the recovery in glomerular filtration rate (GFR) was studied in 71 children with diarrhea-associated hemolytic uremic syndrome. A significant relationship was found, and regression analysis revealed that y = 114.61 - 5.68 x, where y is predicted GFR (ml/min/1.73 m2) and x is the square root of the duration of anuria in days. The presence of hypertension or proteinuria on follow-up was significantly related to the duration of anuria (p = 0.005 and p = 0.002, respectively).
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PMID:Relationship of the recovery in the glomerular filtration rate to the duration of anuria in diarrhea-associated hemolytic uremic syndrome. 821 30

Although hemolytic-uremic syndrome (HUS) is a clinico-pathological entity, renal biopsies are usually not indicated for diagnosis, and therefore, studies concerning the histological aspects of the syndrome are few. This study mainly describes the morphological characteristics of 15 tissue-diagnosed sporadic cases of HUS. The ages of the patients ranged between 10 mos. to 15 yrs., with five being under two. The male/female ratio was 2:3. The prodromal phase was present in 10 patients (67%) with gastrointestinal symptoms in four patients (27%) with neurological symptoms, and in three patients (20%) with upper respiratory infections. Five patients had HUS associated with diarrhea (D+) (three infants and two children), while the remaining ten patients (two infants and eight children) had no diarrhea (D-). E. coli was identified in the stool of four of the D+ cases, one of which was also associated with Shigella. The shortest clinical course was 14 days and the longest 55 days in 13 patients. The disease recurred after three months in one patient, and on three occasions in 15 months after onset of HUS in the other. Fourteen patients died and one biopsy-diagnosed case recovered after the acute phase. All patients had anemia (Hb 3.4-10 g/dl) and acute renal failure. Seven cases demonstrated Burr cells, eight cases had thrombocytopenia and six cases oliguria/anuria. Microscopic hematuria was detected in four cases and gross hematuria in two cases. All patients revealed proteinuria and azotemia (40-200 mg/dl). Five/five (100%) cases had decreased creatinine clearance, 12/14 (86%) cases had increased uric acid levels, 9/14 (64%) cases had an electrolyte imbalance. Light microscopy revealed microangiopathic type involvement of the glomeruli in all cases. According to additional findings, the cases were classed into three histological groups: type 1 showing cortical necrosis (3 cases), type 2 predominant glomerular and arteriolar involvement (11 cases) and type 3 predominant arterial involvement (1 case). All cases were considered primary HUS except for one which was associated with membranous glomerulonephritis. (D+) HUS cases were predominantly of the microangiopathic type, similar to the (D-) group; the latter being contrary to the literature. Hypertension was present in 67% of cases and there was no correlation found between the clinical duration of HUS and the histological type. All five patients studied immunohistologically revealed a nonspecific type fibrinogen deposition. Extra-renal microangiopathy was demonstrated in the adrenals, stomach, pancreas, liver and skin in two necropsies studied.
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PMID:Hemolytic-uremic syndrome (HUS): a clinicopathological study of 15 cases. 823 14

A health survey on 22 health topics was conducted among 300 patients, 77 doctors in primary health care centers in hospitals, and 31 journalists in Riyadh, Saudi Arabia, during September 1990. The self-administered questionnaire had been pretested among 30 doctors and 100 patients. Male and female patients were equally balanced by gender and about 50% were students. Most doctors and journalists were male. Priority for health topics to be covered in the media was given more by doctors than journalists or patients. Group A topics were smoking, exercise, venereal disease and AIDS, hypertension and diabetes, heart and circulatory disease, contamination and environmental cleanliness, nutrition, first aid, compliance with traffic regulations, endemic diseases in Saudi Arabia, breast feeding, treatment of childhood diarrhea, and rational use of home drugs. Group B topics (acne and cancer) were considered more important by journalists, followed by patients; doctors considered group B topics least important. Group C topics (modern diagnostic techniques, new drugs, and new means of treatment) were given more importance by patients, followed by journalists. Menstrual problems were scored lowest by journalists and highest by doctors. The findings were considered tentative, pending a more representative sample. This sample of respondents was well-educated. Patients gave less priority to smoking (44%) than cancer (66%) and acne and hair loss (71.3%). Physicians gave greater emphasis to smoking (98.7%) than acne and hair loss (58.4%) and cancer (53.2%). 28.6% of doctors and 66.3% of patients gave emphasis to modern diagnostic techniques; new drugs followed a similar pattern with 69.0% of patients and 16.9% of doctors favoring this topic. New means of treatment were accorded similar priorities by doctors and patients. Quality of health services was given a priority of 72.7% among doctors, 65.3% among patients, and 58.9% among journalists.
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PMID:The selection of appropriate health education topics for publication in the press. 827 46

A 60-year-old lady with type II diabetes, arterial hypertension and 'melancholia' was treated with Lithium, a neuroleptic (Leponex) and an ACE inhibitor (Reniten). She was referred to our hospital because of abdominal pain, subfebrile temperatures, diarrhea and hematochezia. The radiological and sonographic examinations showed a thickened wall of the left hemicolon. Colonoscopy revealed a sharply delineated segment with pronounced inflammation in the descending colon and the proximal sigmoid colon, suggestive for an ischemic colitis. Histology of the inflamed colon was compatible with this diagnosis. Under suspended enteral feeding and antibiotic therapy the symptoms disappeared within two weeks, and a control colonoscopy six weeks later was completely normal. 1 1/2 years later the patient suffered from a second episode of ischemic colitis exactly a the same site. Again, complete cure was achieved by conservative treatment.
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PMID:[Abdominal pain, fresh blood in the anus]. 827 9

70% of the 2.2 million population of Mongolia are younger than 35 years old. More than 75% of the population live in urban areas, but many adopt the traditional nomadic lifestyle for at least a few weeks each year. 95% of the population is literate. Winters produce extremely cold temperatures and shortages. Mongolia has a well structured and staffed health care system. 3.9 physicians serve 1000 people. Women comprise more than 80% of physicians. Leading causes of mortality and morbidity are acute respiratory infections (ARIs) in the winter and diarrhea in the summer, particularly among children. Hypertension and ischemic heart disease are common. Mongolians are the greatest consumers of red meat in Asia and perhaps the world. The health system is in the process of switching from a centralized system of specialist clinics to a family doctor system. Family doctors usually are general physicians, pediatricians, and gynecologists who have undergone family doctor training. They have not received adequate training in treating ARIs, however. Family doctor clinics have 3-6 physicians, each physician with his/her own nurse. Each physician cares for 200-350 families (350-600 children younger than 16). Family doctors must visit each newborn every 2 weeks for the first 3 months and then once a month until age 1. They must also visit each elderly and homebound chronically ill patient at least once a month. Their nurses either come with them or visit patients alone to administer injections, change dressings, take infants' measurements, and encourage persons to come for vaccinations. The small district and county hospitals face shortages of drugs, raw materials, and functional equipment. The few national hospitals provide tertiary care. Treatment without medicine and traditional treatments of herbal remedies and Buddhist rituals and prayers are resurging in popularity. Harmful practices include swaddling babies, which contributes to rickets and pneumonia, and giving ill children their mother's early morning urine. Immunization coverage is high. Supplementary ration cards provide milk, flour, meat, rice, and sugar to pregnant women and mothers of children under 1 year old. Milk centers in major towns provide milk to children with a doctor's prescription. Even though malnutrition is rare, vitamin deficiencies are common.
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PMID:Mongolia: a health system in transition. 829 57

Weight loss reduces many of the health hazards associated with obesity including insulin resistance, diabetes mellitus, hypertension, dyslipidemia, sleep apnea, hypoxemia and hypercarbia, and osteoarthritis. Potential adverse effects of weight loss include a greater risk for gallstone formation and cholecystitis, excessive loss of lean body mass, water and electrolyte problems, mild liver dysfunction, and elevated uric acid levels. Less consequential problems such as diarrhea, constipation, hair loss, and cold intolerance may also occur. The short-term adverse effects are not severe enough to contraindicate weight loss, nor do they outweigh its short-term benefits.
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PMID:Short-term medical benefits and adverse effects of weight loss. 836 5

We describe the clinical and laboratory features of 20 children who were seen during the past 20 years with idiopathic nondiarrhea-associated hemolytic-uremic syndrome. There was no seasonal variation in time of onset; a genetic pre-disposition seemed likely in two of the cases. The prodromal illness was nonspecific and by definition did not include diarrhea. Hypertension was a major problem in the majority of the patients. Five died, three during the initial illness; four are in end-stage renal failure, and all but two of the survivors have residual nephropathy. Eleven patients had a "relapsing" course; up to eight additional documented episodes of hemolytic-uremic syndrome occurred in individual patients. Of the nine children treated before 1980, three died shortly after onset, two never recovered function after the initial illness, one had a relapsing course and died later, and one had residual nephropathy. Plasma exchange was introduced for the management of non-diarrhea-associated hemolytic-uremic syndrome in 1980; since then, all of the 11 patients have recovered function after the initial episode, but 10 of them had relapses. It appears that with the introduction of plasma exchange there has been an improved outcome in the initial phase, but the survivors tend to have relapses. Atypical (non-diarrhea-associated) hemolytic-uremic syndrome is a heterogeneous yet distinct subgroup of hemolytic-uremic syndrome that differs from diarrhea-associated hemolytic-uremic syndrome on epidemiologic, clinical, laboratory, histologic, and prognostic grounds.
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PMID:Atypical (non-diarrhea-associated) hemolytic-uremic syndrome in childhood. 846 96

Effects of angiotensin II (AT-II)-induced hypertension on the distribution of macromolecules to Walker carcinoma and to bone marrow of SMANCS [poly(styrene-co-maleic-acid)-neocarzinostatin conjugate] were investigated in rats. AT-II-induced hypertension from about 100 to 150 mmHg significantly increased the accumulation of the macromolecular drug SMANCS and 51Cr-labelled bovine serum albumin ([51Cr]BSA), representatives of macromolecular drugs, in tumour tissue. At 1 h after i.v. administration, intratumour concentrations of [51Cr]BSA and SMANCS were elevated by 1.2-1.8-fold. The higher drug accumulation in the tumour that was produced by the artificial hypertension was retained even 6 h after administration. This observation indicates an additive effect to that under normotensive conditions where intratumour macromolecular drug concentrations increase steadily during this period. Furthermore, distributions of these drugs in the bone marrow and the small intestine decreased during artificial hypertension to 60-80% of those in the normotensive state. Therefore, the drug concentration ratios of tumour/bone marrow and tumour/small intestine were increased by 1.8-2.4-fold. A decreased distribution of SMANCS to normal tissues under hypertensive conditions was also confirmed by the significant reduction of its toxicity e.g. leukopenia, diarrhoea, and body weight loss, even at a lethal dose. On the contrary, [3H]methylglucose showed no remarkable difference in tumour or bone marrow accumulation under this hypertensive condition. These results show the advantages of macromolecules over small molecules for AT-II-induced hypertension chemotherapy.
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PMID:Augmentation of tumour delivery of macromolecular drugs with reduced bone marrow delivery by elevating blood pressure. 849 31


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