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

The hypertensive disorders of pregnancy are a frequent cause of neonatal morbidity and mortality. 259 newborns of hypertensive women were study to establish the relationship between some maternal findings and the subsequent neonatal complications. The severity, early onset of hypertension, proteinuria and the gestation of 32 week or less, are related with special risk of small-for-date, anoxia, seizures and neutropenia. Preeclampsia was related with foetus more compromised. Also hyperuricemia, thrombocytopenia and cesarean section were light predictors of neonatal trouble. These findings can orientate the neonatologist to select the newborns prone to complications, watching them closely to start the treatment, if necessary, as soon as possible.
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PMID:[Prediction of complications in children of hypertensive mothers]. 176 48

Preeclampsia is a syndrome of unknown etiology characterized by the sequential development of facial and hand edema, hypertension, and proteinuria after the 20th week of gestation. Patients with preeclampsia may progress to a seizure-like state: The patient is then said to have eclampsia. The major goal of prenatal care is detecting the early onset of preeclampsia and to activate aggressive therapy to prevent severe complications either for the mother or the fetus. There currently are no specific forms of therapy to prevent the disease.
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PMID:New concepts in the understanding of hypertensive diseases during pregnancy. An overview. 176 77

Regimens using cyclosporin (CSP) and either methylprednisolone (MP) or methotrexate (MTX) have been useful in the prophylaxis of acute graft-versus-host disease (GVHD) after allogeneic bone marrow transplantation (BMT). However, CSP produces a number of side effects, including neurologic toxicity. A retrospective review of recipients of 239 BMTs given CSP-based prophylactic regimens revealed that 10 patients (4.2%, 95% confidence interval 0% to 10.4%) experienced a syndrome characterized by hypertension, severe visual disturbances, seizures and occipital lobe density changes on brain computed tomography (nine patients) or nuclear magnetic resonance imaging (one patient). Neurologic findings were reversible in all cases, usually after temporary discontinuation of CSP. Univariate analysis identified the following risk factors for neurotoxicity: use of unrelated or HLA-mismatched related donors, administration of etoposide (VP-16) or total body irradiation as part of conditioning, use of corticosteroids for prophylaxis or treatment of acute GVHD, or development of either acute GVHD or clinically significant microangiopathic hemolytic anemia (MAHA) post-BMT. In multivariate analysis, the most important predictors were the use of VP-16 (p = 0.008), the use of a continuous infusion CSP plus MP prophylactic regimen for GVHD (p = 0.003) and the development of MAHA after BMT (p less than 0.001). The strong association with MAHA suggests that endothelial damage is related to the development of this complication.
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PMID:Neurologic complications in allogeneic bone marrow transplant patients receiving cyclosporin. 176 75

Bilateral carotid artery ligation (BCL) was performed with one week interval between the each operation in male spontaneously hypertensive rats (SHR) and Wistar-Kyoto rats (WKY) aged 4 months. BP rose immediately after unilateral carotid artery ligation (UCL) and BCL in both WKY and SHR due to carotid sinus reflex. Once returning to preoperative levels after both UCL and BCL, BP of SHR and WKY increased again gradually one and 4 months after BCL and thereafter, respectively. BP was significantly higher than that in the controls of each strain, and the BP increment was significantly greater in SHR than in WKY. A significant regional cerebral blood flow (rCBF) increase on the contralateral side of carotid ligation was observed in SHR in contrast to a little change in that of WKY and a reduction of rCBF after BCL was significantly greater in SHR than in WKY. Behavioral activities in SHR were also reduced after BCL. Cerebral edema with nerve cells damage was recognized in SHR. In contrast, little change was found in WKY. On the other hand, upper cervical sympathectomy attenuated convulsive seizures after BCL more markedly in SHR, which survived longer than non-denervated SHR. These results suggest that chronic mild cerebral ischemia caused by BCL with one week interval accelerates the development of severe hypertension in SHR and developed mild hypertension in WKY. Sympathetic innervation might play much more important role in collateral circulation through the vertebrobasilar system in SHR.
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PMID:Effects of long-term cerebral ischemia caused by bilateral carotid artery ligation on the acceleration or the development of hypertension in spontaneously hypertensive rats (SHR) or Wistar-Kyoto rats (WKY). 177 95

35 cases of pregnancy-induced-hypertension (PIH) and 125 controls taken on nonconsecutive days from 792 deliveries during the period June-August 1988 at the University Teaching Hospital, Lusaka, Zambia, were analyzed for mean arterial pressure (MAP), and contributing factors. Data were taken from delivery logs and patients' antenatal cards. The cases were women diagnosed with PIH or a history of seizures. Controls were the 5 preceding deliveries with adequate data. Results for MAP were presented as a matrix showing good outcome controls, poor outcome controls, and cases, by MAP at antenatal visits 1-4, with numbers of women in groupings by MAP ranges. There were more high MAP values for cases than for controls. Over 25% of both groups were women aged 17-19. 64.7% of cases were primigravida, compared to 43% of controls. Data on weight gain were not consistently available, but a higher proportion of cases gained 20 pounds than controls. Most women gained 0 or 1-10 pounds. 44% of cases and 41% of controls had hemoglobin 10 mg/dl. There were 4 positive VDRLs among 34 women tested. 4% of the control infants were stillborn; 7% died in hospital. Among the cases there were 1 fetal death, 2 stillborns, 4 hospital deaths, 20% pregnancy loss overall. Apgar scores were lower among cases, with 25% 4-6, compared to 3.3% of controls. These results did not indicate that MAP would be useful in comparison with blood pressure and other risk factors in monitoring pregnant women for PIH.
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PMID:Parameters of normotensive women and women with pregnancy induced hypertension (PIH) in Lusaka. 179 36

This multicentre study in 142 transfusion-dependent patients with chronic renal failure maintained by haemodialysis was performed to establish the appropriate dose regimen of rHuEpo and define its long-term safety profile. Only one of 132 patients eligible for efficacy analysis did not achieve the haemoglobin target of greater than or equal to 10 g/dl; this particular patient had folate deficiency and overt hyperparathyroidism. Regular blood transfusions were no longer necessary in any patients, however five patients needed blood transfusions only once, not due to rHuEpo failure: two for iron deficiency and three for intercurrent disease. In parallel with the haemoglobin increase a statistically significant improvement in quality of life scores was observed. The weekly dose required to maintain median haemoglobin between 10 and 10.5 g/dl for 1 year (n = 79) was 200-225 U/kg, applied as two or three i.v. injections. Mean serum ferritin decreased from 1900 to 1300 ng/ml and transferrin saturation from 60% to 30%; this feature was associated with statistically significant decrease of pre-study elevated liver enzymes. The treatment had no untoward effect on the outcome of renal transplantation (n = 24). Of the 56 patients who experienced hypertensive episodes during rHuEpo therapy, 47 had a history of hypertension and nine had not. The patient incidence during the first 3 months was 28.9% and fell markedly to 4% after 1 year. Only two hypertensive episodes could not be controlled and the patients dropped out. Seizures occurred in 11 patients, most of them during early treatment; annualised incidence during the first 3 months was 7.78 per year vs 2.07 per year for seizures beyond 3 months treatment. Clinical presentation, patients' history, haemoglobin pattern, BP recordings, brain scan, and EEG indicated that the pathophysiology is multifactorial, with emphasis on rate of haemoglobin increase. Therefore a smooth haemoglobin increase rate, induced by a conservative starting dose regimen (50 U/kg thrice weekly) is recommended, to allow the circulation to adapt to changes in haematocrit/viscosity and O2 delivery. The majority of the observed adverse reactions were related to rHuEpo's therapeutic effect, i.e. increase the haematocrit. The side-effects are therefore largely predictable and can be successfully managed.
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PMID:Treatment of transfusion-dependent anaemia of chronic renal failure with recombinant human erythropoietin. A European multicentre study in 142 patients to define dose regimen and safety profile. 179 95

From 1954 to 1971, 69 operations in patients with crs, resulting in relieving the intracranial hypertension symptoms, were performed. The patients were aged 1-34 years. In 1989, i.e. 20-29 years after the operation (mean 22.8 years), 14 patients were submitted again for a neurological, neuropsychological, EEG and brain CT check-up. The patients were divided into 3 groups: I gr. (3 patients)--with negligible disorders of attention and memory, without neurological changes in the EEG and CT--in a good social and occupational status. II gr. (4 patients)--with slight headaches, with discrete neurological and neuropsychological symptoms, slight generalized changes with the moderate burst activity in EEG, signs of hydrocephalus in CT scan. III. gr (7 patients)--with seizures, deficit symptoms, some with symptoms of mental impairment, generalized epileptic changes in EEG, signs of cortical and subcortical atrophy in CT scan. In this group some patients did not work and had no families. We have found that the frequency of epileptic seizures in the crs patients is higher, and their social and occupational status is worse.
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PMID:[Fate of patients after surgical treatment of premature closure of cranial sutures]. 180 24

This paper describes the clinical features of two patients with chronic renal failure and uremic anaemia treated with recombinant human erythropoietin (9000 I.U. subcutaneously subdivided in 3 times weekly at the end of haemodialysis treatment) who developed seizures and status epilepticus. This treatment has unequivocal benefits but in some patients has been accompanied by elevated blood pressure leading to hypertensive encephalopathy with seizures. In fact, the correction of the anaemia results in a rise in packed cell volume with a consequent increase in blood viscosity, predisposing to increased vascular resistance and the development of hypertension.
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PMID:[Status epilepticus in chronically dialyzed patients treated with erythropoietin]. 181 73

One to two per cent of children and up to 11% of adolescent have arterial hypertension. In most cases children and adolescent are not recognized to be hypertensive because physicians do not routinely measure blood pressure. Often the diagnosis is recognized only when the pediatric patients develop a complication: seizure, stroke, heart failure or paraplegia. Renovascular hypertension in children and adolescents is more common than all of the other causes combined, except for coarctation of the aorta. The diagnosis is not so easy and includes the usual history, physical examination (signs and symptoms of coarctation of the isthmic or abdominal aorta or of an abdominal mass or of one of the adrenal causes of hypertension), laboratory studies, abdominal ultrasound study and chest x-ray. Sometime a CAT can be usefull. The next steps are the early and rapid-sequence IVP, renal angiography and peripheral and renal renin activity. The management of renovascular hypertension in children and adolescent includes a conservative approach (percutaneous transluminal renal angioplasty or renal embolization), rarely used in pediatric age, and the surgical treatment. This latter includes all the surgical procedures of renal revascularization and, in unilateral renal parenchymal diseases, the nephrectomy or a partial nephrectomy. The postoperative results are very good in a high percentage of cases. In bilateral cases, the revascularization surgical procedures improve or normalize also the impaired renal function.
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PMID:[Renovascular hypertension in childhood]. 182 81

Two children, 1 with idiopathic nephrotic syndrome and 1 with endo-extracapillary glomerulonephritis, presented an episode of seizures and transient blindness at different times after i.v. pulse methylprednisolone (IVPMP) treatment. Neurological manifestations in patient 1 could be due to hypertension secondary to IVPMP, while the pathogenesis of such manifestations remained difficult to clarify in patient 2. The severity of uremia in patient 2 could be one of the conditions that, in association with the abrupt changes obtained with IVPMP, predispose to neurological manifestations. Careful clinical and biochemical monitoring seems necessary in children with primary glomerulonephritis, other than those transplanted, after IVPMP, and factors predisposing to neurologic sequelae should be further defined.
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PMID:Seizures and transient blindness following intravenous pulse methylprednisolone in children with primary glomerulonephritis. 186 81


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