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 67-year-old woman presented to a community emergency department in Orange County, CA, after she was stung by a scorpion identified as Centruroides limbatus from Central America. She developed local pain and systemic symptoms, including parasthesias, flushing, hypertension, and wheezing. Envenomation by this genus of scorpion has not previously been reported in Orange County. Scorpions have been reported to be accidentally transported to areas where they are not indigenous, and patients may present anywhere with envenomation by dangerous scorpion species. Physicians should recognize general identifying characteristics of dangerous scorpions and serious signs of envenomation. Almost all dangerous genera of scorpions (including Centruroides sp.) are in the family Buthidae, which can be identified by a triangular sternal plate. Severe systemic signs of envenomation by Centruroides sp. may include respiratory difficulty, somatic neuromuscular dysfunction, and cranial nerve dysfunction. Patients stung by dangerous scorpions may require airway support, extended observation, antivenin, and avoidance of respiratory depressive medications.
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PMID:Envenomation by the scorpion (Centruroides limbatus) outside its natural range and recognition of medically important scorpions. 1056 Mar 10

A 58-year-old man experienced an asthma exacerbation after administration of nicotine nasal spray for smoking cessation. His medical history was significant for asthma, chronic obstructive pulmonary disease, hypertension, and tobacco use when he was prescribed nicotine nasal spray for smoking cessation in an outpatient setting. Within the first 3 days of administering the spray, he developed wheezing, coughing, and significant shortness of breath, which required hospitalization. The patient was hospitalized for 48 hours and discharged with a diagnosis of asthma exacerbation probably related to administration of nicotine nasal spray. Prudent administration of nicotine nasal spray is recommended in patients with underlying respiratory disease. Patients should be counseled on the potential adverse effects of treatment and proper administration techniques in order to minimize these effects.
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PMID:Asthma exacerbation after administration of nicotine nasal spray for smoking cessation. 1206 70

There have been few reports on aneurysms of the anomalous branch of the aortic arch. We present a rare case in which correct placement of the movable blocker of a Univent tube was difficult due to an aberrant right subclavian artery aneurysm. A 72-year-old man with a history of hypertension had manifested coughing and wheezing for four months prior to admission to our hospital. A chest computed tomogram revealed that his aortic arch had four branches and that the right subclavian artery did not originate from the first branch, but was the fourth branch. The angiogram disclosed that an aneurysm had developed in the anomalous artery close to the aorta, and behind the other three branches, trachea, and esophagus. The aneurysm not only had pushed the trachea out of place but was also pressing against it. After anesthetic induction, his trachea was intubated using an endotracheal tube with a movable blocker, the Univent tube, for single-lung ventilation. The blocker could not be advanced into the left main bronchus due to the tracheal deviation caused by the aneurysm. Several methods of blocker placement, including those recommended in the manual attached to the product, were attempted without success. Finally, the trachea was intubated again using a Univent tube with the blocker tip bent manually, which permitted entrance of the blocker into the bronchus. Blocker placement should be modified to suit patients with a problem in the trachea or bronchi.
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PMID:Difficult placement of Univent tube blocker due to aberrant right subclavian artery aneurysm. 1247 66

The carcinoid syndrome, associated with carcinoid tumors of the midgut, consists of symptoms such as diarrhea, flushing, wheezing and cardiovascular symptoms. This review focuses on these symptoms and discusses therapeutic options. The symptoms are caused by the secretion of biogenic amines, polypeptides and other factors of which serotonin is the most prominent. However, diarrhea is also due to factors such as malabsorption. Besides antitumor therapy, more specific interventions such as serotonin receptor blockers can be useful. The carcinoid heart disease involves the tricuspid and pulmonary valve. In the pathogenesis, serotonin plays a central role. The therapeutic approach is mostly symptomatic. Other cardiovascular complications include bowel ischemia and hypertension. Pellagra and psychiatric symptoms are due to a depletion of tryptophan, which is consumed by the carcinoid tumor for serotonin synthesis. Finally, follow-up and clinical practice of patients with carcinoid tumors are discussed.
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PMID:Complications of midgut carcinoid tumors and carcinoid syndrome. 1547 13

Once the diagnosis of pulmonary arterial hypertension is established, wheezing and chronic cough are rarely described during the course of the disease. The present study reports on two nonsmoking patients with severe pulmonary arterial hypertension, confirmed by right-heart catheterisation, who developed chronic cough, wheezing and irreversible obstructive lung disease masquerading as adult-onset severe refractory asthma. In both cases, extrinsic proximal airway obstruction by dilated pulmonary arteries was demonstrated by fibreoptic bronchoscopy and computed tomography of the chest. The present observations add dilatation of the central pulmonary arteries with compression of the mainstem bronchi to the list of masqueraders of asthma in patients with pulmonary arterial hypertension.
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PMID:Pulmonary arterial hypertension masquerading as severe refractory asthma. 1866 91

A 45-year-old man presented with a six-month history of progressive dyspnea with productive cough and wheezing. The patient was a heavy smoker and had a history of tongue cancer, hypertension, and asthma. Chest X-ray and computed tomography showed a mass lesion in the left hilar region and total collapse of the upper left lobe of the lung. Bronchoscopy revealed a whitish solid tumor obstructing the left upper lobe bronchus. Positron emission tomography showed increased tracer uptake in the lesion. A thoracoscopic lobectomy of the left upper lobe of the lung was performed. The final pathologic diagnosis was inflammatory myofibroblastic tumor.
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PMID:Inflammatory myofibroblastic tumor of the lung--a case report. 2064 17

The origins of asthma might be traced back to events occurring during fetal life. Reduced lung development has been shown to be a risk factor both for viral induced wheeze and allergic asthma. The evidence for a causal relationship between exposure to environmental tobacco smoke, chemical domestic products for cleaning, outdoor pollutants, and reduction in lung function is quite strong. Reduced maternal intake of vitamin E, vitamin D, and zinc, or increased use of paracetamol during pregnancy is associated with increased wheezing outcomes in children. The odds ratio for asthma onset is also increased in infants born from mothers with oligohydramnios, chorioamnionitis, hypertension, preeclampsia, diabetes and exposed to stressful events. The risk of developing allergic asthma is increased if the child is exposed in the first months of life to synthetic bedding and is enhanced by allergen exposure and an inadequate barrier function of the skin. In conclusion, several lines of evidence support the concept of fetal programming and very early life events in the development of the different phenotypes of asthma. Since some environmental triggers can be easily avoided and some protective factors can be easily implemented all efforts should be made to prevent intrauterine insults and early sensitization.
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PMID:Fetal and early postnatal life roots of asthma. 2092 57

To investigate late toxic effects of sulfur mustard (SM) on the upper and lower respiratory tracts of Iranian veterans, 43 male veterans with more than 25% disability due to SM poisoning in 20-25 years after exposure, were studied. Direct laryngoscopy, pulmonary function tests, arterial blood gasses and pH, computed tomography of sinuses and lungs were investigated. The patients were aged 50.6 (8.9 SD) years with body mass index (BMI) of 26.6 (4.0) and disability of 53.2 (17.0%). The common findings of the upper respiratory tract were dysphonia (79.1%), post-nasal discharge (PND; 41.9%), lower larynx position (30.2%), limitation of vocal cords (25.6%) and mucosal inflammation of larynx (14.8%). The common lower respiratory diseases were diagnosed as chronic obstructive respiratory disease (84%), bronchiectasis (44.1%) and lung fibrosis (7.7%). Severity of disability was negatively correlated with BMI (p = 0.032), spirometric parameters (p < 0.001) and oxygen saturation (p < 0.001), but positively correlated with low-density lipoproteins (LDL <0.010), blood pressure (p = 0.008), diabetes mellitus (p < 0.001), wheezing (p = 0.0043) and bronchiectasis (p < 0.001). Delayed toxic effects of SM in upper and lower respiratory tracts were mostly inflammatory and infectious complications, SM-induced disabilities were significantly correlated with risk factors such as diabetes mellitus, hypertension, LDL and lower-respiratory complications.
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PMID:Delayed toxic effects of sulfur mustard on respiratory tract of Iranian veterans. 2107 49

Propafenone is a membrane-stabilizing agent belonging to a subgroup of the Vaughan Williams class I antidysrhythmic agents, structurally resembling propranolol and characterized by weaker beta-blocking activity. Despite respiratory complications having been reported as examples of side effects, very few reports have been published in the literature.We describe the case of an elderly woman with a history of hypertension and allergy to Parietaria, grass, olive, mites, and with periodic asthmatic manifestations, for whom the administration of oral propafenone for recurrent supraventricular dysrhythmia was associated with the sudden onset of severe bronchostenosis.A 78-year-old woman was frequently admitted to the Emergency Department for a recurrent supraventricular tachycardia, which was treated initially with veramapil and thereafter with ivabradin. During her last visit to the cardiologist, she was prescribed propafenone (150 mg, 3 times a day) in place of ivabradin. After the administration of the second dose on the first day of the therapy, the patient began to complain of the onset of progressively severe dyspnea at rest. In the Emergency Department, respiratory auscultation showed diffuse rhonchi, wheezing, and rales; and arterial pressure was 200/100 mm Hg. Hemogasanalysis revealed hypoxemia, respiratory acidosis with 83% of O2-saturation. Emergency treatment with O2 therapy, methylprednisolone intravenous, furosemide, and then salbutamol was also started; the electrocardiogram only showed sinusal tachycardia. Results of laboratory examinations, including a white cell count and cardiac enzymes, were within the normal range. The patient achieved good respiratory function, after a period of 3 days.This report describes that even a relatively small dose of oral propafenone after commencing treatment can have a severe effect in exacerbating the obstruction of the airways in a susceptible subject. The likely mechanisms are an allergic reaction or a direct bronchospastic effect. Considering the recognized asthmogenicity of propafenone due to beta-blocker activity, we suggest that the cardiologist always refer to the patient's medical history before prescribing this drug, which is capable of producing notable side effects in predisposed individuals, beginning the eventual administration in the hospital setting. The use of bronchial provocation test allows the selection of inclined patients, thus reducing the risk of bronchospasm.
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PMID:Severe Brochostenosis by Oral Propafenone Immediately After Commencing Treatment. 2124 22

Black widow spider envenomation is commonly reported to poison centers. Black widow spider envenomation produces a clinical syndrome, known as latrodectism, characterized by headache, nausea, vomiting, several muscle cramping and pain, joint stiffness, hypertension, and regional diaphoresis. Black widow spider antivenom (Merck & Co, Inc, West Point, PA USA) is an effective and relatively safe treatment option. There is 1 clear case of anaphylaxis secondary to black widow spider antivenom reported in the medical literature. Here, we report a case of anaphylaxis to antivenom. A 12-year-old boy presented to the emergency department (ED) with diffuse, severe pain 2 1/2 hours after being bitten by a black widow spider on the right lower extremity. In the ED, the patient failed analgesic therapy with fentanyl and was given black widow spider antivenom. Within 45 minutes, he exhibited signs and symptoms consistent with anaphylaxis, including wheezing, chest tightness, pruritus, and urticarial rash. The patient was given standard therapy for anaphylaxis, and all of his signs and symptoms (including the pain secondary to the black widow envenomation) resolved over 6 hours of observation. Leading experts agree that the use of antivenom is indicated in cases of severe envenomation not responsive to standard therapy. Despite concern that the antivenom is an equine-derived whole IgG and can precipitate early hypersensitivity reactions, there is only 1 other reported case of anaphylaxis to the antivenom in the medical literature.
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PMID:Anaphylaxis to black widow spider antivenom. 2164 Nov 65


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