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

The case of a Cuban child with AIDS acquired by perinatal transmission is reported. Thirteen days after birth, the child had chronic diarrhoeas affecting its pondostatural development. It was hospitalized many times due to recurrent respiratory processes, in one of which Pneumocystis carinii was detected. Oral candidiasis, cryptosporidiosis and intestinal amebiasis in faeces were also diagnosed. It died with generalized tonic-clonic convulsions and bradypnea. At autopsy, the direct death cause was endocranial hypertension due to unspecific sub-acute viral meningitis.
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PMID:[Pediatric AIDS: a report of the first fatal Cuban pediatric case]. 134 87

The pattern of dying from immersion hyperthermia was documented in 8 dogs, 9 rhesus monkeys and 12 pigtail monkeys. Under light general anesthesia and spontaneous breathing, the animals were immersed into water of 45 degrees C, which was subsequently adjusted to control brain (parietal epidural) temperature at 42 +/- 0.5 degrees C. Transient initial hypertension, tachycardia, tachypnea and hypocarbia were followed by progressive hypotension with decreasing central venous pressure and pulmonary artery occlusion pressures (measured in three dogs only), bradycardia and bradypnea. Cardiac arrest occurred in the dogs after immersion of 288 +/- 66 min and more rapidly (P less than 0.02) in the rhesus monkeys (at 137 +/- 75 min) and pigtail monkeys (at 178 +/- 26 min). EEG silence occurred in the monkeys at MAP 40 mmHg and in the dogs at MAP 25 mmHg. Cardiac arrest occurred in form of sudden ventricular fibrillation (2/5 dogs, 2/9 rhesus monkeys, 3/12 pigtail monkeys), or later in electromechanical dissociation leading to electric asystole (3/5 dogs, 7/9 rhesus monkeys, 9/12 pigtail monkeys). The mean blood glucose levels decreased to less than 30 mg/dl (P less than 0.002), whereas hematocrit, serum osmolality, lactate and potassium levels increased. Necropsies revealed macroscopic petechial hemorrhages in all extracerebral organs, but not in the brain. There was no gross evidence of cerebral edema. Death seemed to be the result of primary cardiovascular failure leading to secondary (ischemic) cerebral failure (EEG silence) and apnea, which coincided with pulselessness.
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PMID:Hyperthermia-induced cardiac arrest in dogs and monkeys. 217 84

Effects of brevetoxin were evaluated in cats anesthetized with pentobarbital under conditions of controlled end-expiratory pCO2 and constant body temperature. Recordings were made of arterial blood pressure, heart rate, respiratory pattern, diaphragm EMG, evoked tibialis muscle twitch and evoked contraction of the nictitating membrane. Electrical stimulation was employed for periodic excitation of the medullary respiratory center, the phrenic nerve, the peroneal nerve and the cervical sympathetic nerve. Brevetoxin was prepared at a concentration of 1.0 mg/ml in an aqueous medium of 2.5% ethanol plus 2.5% Emulphor 620 (General Aniline and Film Corp., New York). Small i.v. bolus injections of the toxin (40 micrograms/kg) evoked, without tachyphylaxis, the Bezold-Jarisch reflex triad of bradycardia, hypotension and bradypnea. This effect was essentially abolished by vagotomy. Continued injections then resulted in pressor reactions and tachycardia, along with the development of respiratory dysrhythmia. Large doses of brevetoxin (160 micrograms/kg i.v.) caused somatomotor seizures accompanied by severe hypertension, that occurred even after decerebration and cervical spinal cord transection. Cranial intra-arterial and intra-cerebroventricular injections of brevetoxin produced hypertension and respiratory depression more effectively than did i.v. injections. Systemic cumulation of the toxin, with the respiration supported artificially, caused death from cardiovascular collapse, without significant blockade of neuromuscular and ganglionic transmission. It is concluded that brevetoxin exerts its major toxic effects on the circulation and respiration through reflex and central actions, largely sparing peripheral motor mechanisms.
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PMID:Neurological analysis of respiratory, cardiovascular and neuromuscular effects of brevetoxin in cats. 299 23

In 12 cases of closed head injury without fracture or hematoma, but with clinical signs of increased intracranial pressure (ICP) and brain stem compression and with computed tomographic (CT) scan evidence of cerebral edema and contusion, subgaleal shunts were inserted for immediate decompression of the ventricular system and continuous drainage of hemorrhagic cerebrospinal fluid (CSF). Three patients with fixed dilated pupils and no reflexes or spontaneous respiration on admission did not improve and expired within 72 h. Nine patients who manifested Cushing's triad (bradycardia, bradypnea, and hypertension) shortly after admission made significant recovery and underwent catheter removal 1 wk later; 8 were able to be discharged home after extended periods of physiotherapy. No complications, postoperative hemorrhage or infection, were recorded.
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PMID:Ventriculosubgaleal shunting for acute head trauma. 660 Sep 95

Slow breathing practiced routinely using an interactive device has demonstrated a sustained reduction in high blood pressure (BP). We reevaluated the BP response of hypertensives (n = 13) to this daily treatment for 8 weeks using 24-h ambulatory, home, and office BP measurements. A clinically significant BP reduction of similar magnitude was observed in all BP monitoring modalities during the daytime. Greater BP reductions were found for older patients and higher baseline BP. The results provide additional support for the efficacy of the device as an adjunctive lifestyle modification for treating hypertension.
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PMID:Device-guided breathing exercises reduce blood pressure: ambulatory and home measurements. 1120 85

Sympathetic hyperactivity and parasympathetic withdrawal may cause and sustain hypertension. This autonomic imbalance is in turn related to a reduced or reset arterial baroreflex sensitivity and chemoreflex-induced hyperventilation. Slow breathing at 6 breaths/min increases baroreflex sensitivity and reduces sympathetic activity and chemoreflex activation, suggesting a potentially beneficial effect in hypertension. We tested whether slow breathing was capable of modifying blood pressure in hypertensive and control subjects and improving baroreflex sensitivity. Continuous noninvasive blood pressure, RR interval, respiration, and end-tidal CO2 (CO2-et) were monitored in 20 subjects with essential hypertension (56.4+/-1.9 years) and in 26 controls (52.3+/-1.4 years) in sitting position during spontaneous breathing and controlled breathing at slower (6/min) and faster (15/min) breathing rate. Baroreflex sensitivity was measured by autoregressive spectral analysis and "alpha angle" method. Slow breathing decreased systolic and diastolic pressures in hypertensive subjects (from 149.7+/-3.7 to 141.1+/-4 mm Hg, P<0.05; and from 82.7+/-3 to 77.8+/-3.7 mm Hg, P<0.01, respectively). Controlled breathing (15/min) decreased systolic (to 142.8+/-3.9 mm Hg; P<0.05) but not diastolic blood pressure and decreased RR interval (P<0.05) without altering the baroreflex. Similar findings were seen in controls for RR interval. Slow breathing increased baroreflex sensitivity in hypertensives (from 5.8+/-0.7 to 10.3+/-2.0 ms/mm Hg; P<0.01) and controls (from 10.9+/-1.0 to 16.0+/-1.5 ms/mm Hg; P<0.001) without inducing hyperventilation. During spontaneous breathing, hypertensive subjects showed lower CO2 and faster breathing rate, suggesting hyperventilation and reduced baroreflex sensitivity (P<0.001 versus controls). Slow breathing reduces blood pressure and enhances baroreflex sensitivity in hypertensive patients. These effects appear potentially beneficial in the management of hypertension.
Hypertension 2005 Oct
PMID:Slow breathing improves arterial baroreflex sensitivity and decreases blood pressure in essential hypertension. 1612 18

Imidacloprid [1-(6-chloro-3-pyridylmethyl)-N-nitroimidazolidin-2-ylideneamine, CAS 138261-41-3] belongs to a relatively new class of insecticidal chemistry, the chloronicotinyl neonicotinoid compounds. Animal studies indicate relatively low toxicity to mammals. Despite wide usage in some countries, the understanding of human poisoning is quite limited. Here we report a fatal case of rapid ingestion of an insecticide formulation containing imidacloprid. Clinical manifestation included severe vomiting, hypertension, tachycardia, mydriasis with sluggish reaction to light, and loss of consciousness. In the course of toxicity, the patient manifested bradycardia, bradypnea, and cardiopulmonary arrest and death. Because moderate- to high-dose imidacloprid in animals causes central nervous system activation similar to nicotine, including tremors, impaired papillary function, and hypothermia, it is more likely that the formulation ingredients caused most of the clinical symptoms including central nervous system depression and gastrointestinal irritation.
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PMID:Fatal intoxication with imidacloprid insecticide. 1853 11

Prior studies have found that > 50% of prehospital intravenous catheters (i.v.s) were unutilized for treatment; however, few data are available regarding which patients benefit. The objective of this study was to examine the association between i.v. utilization in the field, paramedic primary impression, and patient presentation. Prehospital records for 34,585 patients were evaluated for i.v. placement and utilization in the field. Logistic regression was used to evaluate the association of primary impression, systolic blood pressure, heart rate, respiratory rate, Glasgow Coma Scale score, skin sign color, and capillary refill with placement and utilization. Intravenous catheters were placed in 60% of patients, but only 17% of the total was utilized. Examples of primary impressions with frequent initiation and low utilization (n = number in group, % of total with i.v. placed, % of total used): post-seizure (n = 989, 72%, 9%); weakness/dizzy/nausea (n = 3092, 69%, 20%), syncope/near-syncope (n = 2034, 81%, 26%), and abdominal pain (n = 1554, 70%, 14%). Fifty-eight percent with normal vital signs received an i.v. and 28-30% were utilized; hypotension: 80% received i.v. (odds ratio [OR] 1.211, p = 0.012), 70% utilized; hypertension: 61% received i.v. (OR 1.060, p = 0.027), 28% utilized; bradycardia: 82% received i.v. (OR 1.588, p < 0.0001), 51% utilized; tachycardia: 66% received i.v. (OR 1.152, p = 0.001), 33% utilized; bradypnea: 93% received i.v. (OR 1.638, p = 0.051), 86% utilized; tachypnea: 70% (OR 1.120, p = 0.024), 33% utilized. A Glasgow Coma Scale score < 15: 76% received i.v. (OR 1.672, p < 0.0001), 32% utilized. Abnormal skin color: 79% received i.v. (OR 1.691, p < 0.0001), 42% utilized. Certain primary impressions are associated with high i.v. initiation rates but infrequent utilization. High utilization rates were associated with hypotension, bradycardia, bradypnea, and abnormal skin signs. Study of high-frequency, low-utilization groups could reduce unnecessary i.v. placement.
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PMID:When are prehospital intravenous catheters used for treatment? 1857 88

Studies on various medical conditions have shown that poor health is associated with lower parasympathetic tone. People with epilepsy appear to have decreased parasympathetic tone, with a greater decrease in those with intractable seizures than in those with well-controlled epilepsy. Slow breathing exercises have been shown to increase parasympathetic tone in healthy volunteers. Slow breathing exercises have been shown to improve a number of medical conditions including asthma, hypertension, anxiety states, and posttraumatic stress disorder. We hypothesize that slow breathing exercises in people with epilepsy can lead to an increase in parasympathetic tone and an accompanying reduction in seizure frequency. The slow breathing exercises, probably through baroreceptors, chemoreceptors, and pulmonary stretch receptors, affect cortical activity and hence seizure thresholds. It is also possible that slow breathing exercises might reduce seizure frequency by reducing anxiety. The hypothesis can be tested by employing devices and protocols that have been used to reduce breathing rates and have been shown to improve health outcomes in other medical conditions.
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PMID:Can slow breathing exercises improve seizure control in people with refractory epilepsy? A hypothesis. 2063 Aug 7

The therapy of refractory hypertension is an increasing problem for health care systems and a frontend in research in both pharmacology and neuroelectronic engineering. Overriding the baroreceptive information of afferent nerve fibers, originating from pressure sensors in the aortic arch, can trigger the baroreflex, a systemic control system that lowers the blood pressure (BP) almost instantaneously. Using a multichannel cuff electrode, wrapped around a rat vagal nerve, we were able to regulate the BP using selective, tripolar stimulation. The tripolar stimulation was sufficiently selective to not trigger any unwanted side effects like bradycardia or bradypnea. The BP was reduced best with charge balanced stimulation amplitudes of 1 mA and pulse duration of 0.3 ms. The stimulation frequency had only a mild influence on the effectiveness of the stimulation and did work best at 40 Hz. We found that the BP took up to five times the stimulation period to recover to the value prior to stimulation.
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PMID:BaroLoop: using a multichannel cuff electrode and selective stimulation to reduce blood pressure. 2410 97


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