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

Seventeen patients stung by Tityus serrulatus scorpion were classified as mild (pain at the site of the sting, n = 6), moderate (local pain and one of the following manifestations: vomiting, psychomotor agitation, prostration, sweating, tachypnea, tachycardia and mild arterial hypertension, n = 10) and severe cases (equal moderate cases plus cardiac failure, pulmonary edema and shock, n = 1). Venous blood was sampled for biochemical and hematological analysis and for IL-1alpha, IL-6, IL-10, TNF-alpha, IFN-gamma and GM-CSF ELISAs at the time of hospital admission, 6 h (moderate and severe cases), and 12, 18, 36 and 72 h (severe case) later. Ten age-matched healthy volunteers were used as control. Increased serum levels of IL-1alpha was noticed in all patients, high levels of IL-6, IFN-gamma and GM-CSF were observed only in a patient with severe envenomation. Our data suggest that a systemic inflammatory response-like syndrome is triggered during severe envenomation caused by T. serrulatus sting and that release of cytokines may be involved in this response.
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PMID:Serum levels of cytokines in patients envenomed by Tityus serrulatus scorpion sting. 1040 Feb 99

A 25-yr-old man, subsequently shown to be malignant hyperthermia (MH) susceptible by in vitro contracture testing, developed MH during anaesthesia for tonsillectomy. Prompt treatment, including dantrolene, led to rapid resolution of the metabolic crisis. Eighteen hours later the patient's trachea was extubated in the ICU, when he had been stable and apyrexial overnight. Twenty minutes after extubation, an episode of shivering was followed by the onset of tachycardia, hypertension, tachypnoea and a rapid increase in temperature. Recurrence of MH was suspected and the patient was given another dose of dantrolene with good clinical effect. Shivering in this patient may have been an indicator or a causative factor of recurrence of MH.
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PMID:Suspected recurrence of malignant hyperthermia after post-extubation shivering in the intensive care unit, 18 h after tonsillectomy. 1056 97

We report an unusual case of thrombocytopenia associated with neuroleptic malignant syndrome (NMS). A 31-year-old Black male with a history of hypertension, partial seizures, and schizophrenia developed acute rigidity closely followed by severe hyperpyrexia (temperature 102 degree F), tachypnea, and tachycardia. His home medications at the time of presentation included propanolol 10 mg tid, haloperidol 10 mg bid, sodium valproate 500 mg bid, benztropine 1 mg bid, and haloperidol decanoate 100 mg i.m. every 3 weeks, from another psychiatric facility. Despite vigorous therapy for the hyperthermia, he rapidly developed significant hypoxia requiring mechanical ventilation. A diagnosis of neuroleptic malignant syndrome was made and the patient continued to receive aggressive supportive care. On hospital day 2 his platelet count dropped to 47,000/microl and bottomed out at 36,000/microl by day 3 with other blood cell counts remaining within normal limits. Over the next few days he showed rapid clinical improvement with normalization of his blood chemistries and he was discharged home after 5 days of hospitalization in good condition.
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PMID:Neuroleptic malignant syndrome and severe thrombocytopenia: case report and literature review. 1079 26

Psychological disorders of infertile patients are traditionally thought to be chronic, to advance gradually, and to be long-term problems. We describe a patient in whom an acute psychiatric episode developed immediately after transvaginal ultrasound-guided oocyte retrieval. A 34 year old women without history of psychiatric disturbance or adverse reaction to drugs suffered an acute psychiatric episode immediately after oocyte retrieval. She exhibited tachycardia, tachypnoea, transient hypertension and limb rigidity, as well as alterations to stupor and posture. Her vital signs stabilized and she opened her eyes 6 h later, but she persistently raised her head to the left and stared blankly without response to external stimuli. Nine hours later, she was able to look around but remained unresponsive to stimuli. Aphasia was noted in the next morning and a wishful thinking of having delivered a baby was noted in the afternoon. Memory loss was noted on the third day. The patient was diagnosed as having dissociative amnesia and was discharged after three courses of supportive psychotherapy. Assisted reproductive technology-related acute psychiatric episodes, which may initially mimic brainstem stroke, are rare; however, attention should be paid to high-risk patients, and they should be offered elective psychological counselling.
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PMID:An acute psychiatric episode following transvaginal oocyte retrieval. 1192 17

Following acute multiple trauma, hypothalamic stimulation of the sympathetic nervous system and adrenal glands causes an increase in circulating corticoids and catecholamines, or a stress response. In individuals with severe traumatic brain injury or a Glasgow Coma Scale score of 3-8, this response can be exaggerated and episodic. A term commonly used by nurses caring for these individuals to describe this phenomenon is storming. Symptoms can include alterations in level of consciousness, increased posturing, dystonia, hypertension, hyperthermia, tachycardia, tachypnea, diaphoresis, and agitation. These individuals generally are at a low level of neurological activity with minimal alertness, minimal awareness, and reflexive motor response to stimulation, and the storming can take a seemingly peaceful individual into a state of chaos. Diagnosis is commonly made solely on clinical assessment, and treatment is aimed at controlling the duration and severity of the symptoms and preventing additional brain injury. Storming can pose a challenge for the nurse, from providing daily care for the individual in the height of the storming episode and treating the symptoms, to educating the family. Careful assessment of the individual leads the nurse to the diagnosis and places the nurse in the role of moderator of the storming episode, including providing treatment and evaluating outcomes.
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PMID:Riding out the storm: sympathetic storming after traumatic brain injury. 1499 1

A complication of severe brain injury is a syndrome of intermittent agitation, diaphoresis, hyperthermia, hypertension, tachycardia, tachypnea, and extensor posturing. To capture the main features of this syndrome, derived through literature review and our own case series, we propose the term paroxysmal autonomic instability with dystonia. We reviewed reports of autonomic dysregulation after brain injury and extracted essential features. From the clinical features, consistent themes emerge regarding signs and symptoms, differential diagnosis, and pharmacological therapies. We used these findings to make recommendations regarding diagnosis and treatment. Paroxysmal autonomic instability with dystonia appears to be a distinctive syndrome after brain injury that can mimic other life-threatening conditions. Early recognition may lead to fewer diagnostic tests and a rational approach to management. Prospective trials of specific drugs are needed to determine optimal efficacy.
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PMID:Paroxysmal autonomic instability with dystonia after brain injury. 1547 25

A child of 14 months accidentally swallowed a portion of an Ecstasy pill. Forty minutes after ingestion, he started a generalized convulsion. He also presented hyperthermia (38 degrees C), hypertension, tachycardia (130 bpm), ventricular extrasystoles, tachypnea (50 rpm), and mydriasis. At the hospital 5 hours later, the urine levels of amphetamine/metamphetamine were >16 mg/L. He was treated with general support measures and benzodiazepines intravenously and admitted to the pediatric intensive care unit. During the first 12 hours, he continued with hypertension, tachycardia, and long periods of trigeminy, without hemodynamic repercussion. He was discharged fully recovered. Gas chromatography/mass spectrometry analysis (8 hours after ingestion) showed a serum level of 3,4 methylenedioximethylamphetamine (MDMA) of 0.591 mg/L. The 3 cases described in the literature have shown a good evolution of Ecstasy poisoning in toddlers and infants, despite an initial critical situation. Regarding adults, the toddler intoxication seems to present symptoms sooner (20 to 30 minutes), having as an initial manifestation convulsions. However, great care must be taken on accidental ingestion of these attractive design pills.
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PMID:Accidental ecstasy poisoning in a toddler. 1529 51

To determine clinical and epidemiological features of scorpion stings in two departments of Colombia, a descriptive study was performed in the hospitals of 10 towns from Antioquia (2 256 071 inhabitants) and five from Tolima (630 424 inhabitants). One hundred and twenty-nine cases were admitted during one year, 51 in Antioquia, 78 in Tolima and 41 were children less than 15 years old. Most stings (70.5%) occurred inside the house; 27.9% were on the hands and 26.4% on the feet. The scorpion species involved were Tityus pachyurus (51), Centruroides gracilis (31), T. fuehrmanni (29), T. asthenes (7) and Chactas spp. (1). In 10 cases the scorpion involved was not identified. Systemic envenoming signs (e.g. vomiting, tachypnea) were significantly more frequent in children than in adults (P < 0.05). Four children had hypertension, but none developed pulmonary oedema. One 3-year-old girl, stung by T. asthenes, had acute oedematous pancreatitis. Ninety-eight patients had mild envenoming. Moderate (27 patients) and severe (four patients) envenoming was significantly more frequent in children than in adults (P = 0.003; relative risk = 2.97). A pepsin-digested anti-Centruroides spp. antivenom was administered to 19 of 31 patients presenting systemic envenoming signs. No adverse reactions to antivenom were observed.
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PMID:Scorpion envenoming in two regions of Colombia: clinical, epidemiological and therapeutic aspects. 1548 5

Acute inflammatory demyelinating polyneuropathy (AIDP) is an autoimmune process that is characterized by progressive weakness, mild sensory changes and autonomic dysfunction. It is a rare disorder, afflicting about 1 person in 100,000. Yet, since the decline in the number of polio cases, it represents the most common cause of acute neuromuscular paralysis. AIDP is thought to arise as a result of the production of antibody to bacterial Campylobacter jejuni, sugar-containing surface antigen(s) that, due to molecular mimicry, cross-react with the myelin sheath and the axons of nerve cells. Antibody and/or cell mediated immune reactions are believed to produce degeneration of the nerve or interruption of neurotransmission. Autonomic dysfunction include: transient hypertension or, less often, hypotension, sinus tachycardia, bradycardia, urinary retention who usually improves in parallel with motor and sensory function. Our purpose was to study the disturbances of autonomic function of the patients with acute idiopathic demyelinating polyneuropathy. We had studied 36 patients with AIDP admitted in I-st Clinic of Neurology, Iassy, between 1998 and 2002. Analyzing the evolution of these autonomic disturbances we observed the early onset together with motor symptoms, tachycardia and tachypnea was more persistent and a real vital risk factor.
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PMID:[Autonomic dysfunction in acute inflammatory demyelinating polyneuropathy]. 1568 75

This report describes a case of cardiac right auricle rupture (RAR) in a flock of 11,500 broilers that were 14 days old. The birds were housed at an altitude of 300 m, with an external temperature of -10 degrees C and an internal temperature of 15 degrees C. There was 3.6% mortality, due to sudden deaths, from 10 to 14 days of age. All necropsied birds had haemopericardium due to RAR at the point of the junction with the vena cava, and 85% of them had blood in the oral cavity and external acoustic meatus. The vena cava and its caudal branches, the intestinal vessels, and the sinus durae matris and sinus saggitalis were distended. Histological examination showed haemorrhages into the myocardium, degeneration of the cardiac muscle fibres, as well as oedema of the lungs and hypertrophy of the smooth muscle bundles of the parabronchial walls. Blood in the mouth of the broilers may have been due to haemoptysis, which in humans is caused mainly by mitral stenosis. In broilers, mitral stenosis and/or insufficiency, and left ventricular failure with consequent pulmonary hypertension (PH) were considered as possible triggers for right ventricular failure. The alarm reaction in hypoxaemia, due to secondary factors such as cold, caused tachycardia and tachypnoea, may have induced further elevation of PH, and acute myocardial infarction causing cardiac rupture and haemopericardium in this case. Hypertension and PH, due to possible mitral stenosis/insufficiency in association with acute myocardial ischaemia, were probably the determinant factors causing this acute episode. This opens the possibility that the RAR may be cardiogenic.
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PMID:Rupture of the right auricle in broiler chickens. 1623 69


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