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

We report the unusual case of a patient with chronic carriage of Salmonella typhi who presented with partially calcified splenic abscess linked to colic fistula and ascitis. The colic fistula could be secondary to ischemic necrosis by left colon compression due to spleen large abscess. Fistula was evidenced by abdominal computed tomography scan and confirmed by barium enema. The possible etiologies of ascitis are either tuberculosis or ascitic peritonitis secondary to the fistulisation; nevertheless, the role of segmentary portal located hypertension cannot be completely excluded. The splenic abscess was probably due to Salmonella typhi which was only isolated from stool specimens. The calcified splenic abscess was the evidence that the infection had occurred first. In addition, the isolation of Salmonella typhi in stool cultures six months after the subject had returned from the Comores proved the chronic carriage. Treatment by splenectomy and left colectomy was successful in this patient.
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PMID:[Calcified splenic abscess, colonic fistula and ascites in a chronic carrier of Salmonella typhi]. 1005 88

Tribulus terrestris L. is an annual plant which has been commonly used in folk medicine as diuretic and against colic pains, hypertension and hypercholesterolemia in Turkey. This study investigated the effects of liophilized saponin mixture of this plant on several smooth muscle preparations in vitro. The liophilized material was obtained from dried and powdered T. terrestris L. by specific extraction method for saponins. Median lethal dose (LD50) of saponin mixture on Swiss albino mice was calculated according to Litchfield-Wilcoxon method via i.p. route. LD50 and its 95% confidence limits were 813 and 739-894 mg.kg-1 respectively. Saponin mixture has caused a significant decrease on peristaltic movements of isolated sheep ureter and rabbit jejunum preparations in a dose-dependent manner (p < 0.05). However it has been observed no effect on isolated rabbit aorta and its contractile response to KCl or noradrenaline (p > 0.05). According to these results it has been suggested that T. terrestris L. or its saponin mixture may be useful on some smooth muscle spasms or colic pains.
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PMID:Effect of Tribulus terrestris L. saponin mixture on some smooth muscle preparations: a preliminary study. 1007 81

This article evaluates the results of single vessel bypass surgery for symptomatic chronic mesenteric ischaemia (CMI) in 6 patients undergoing a total of 8 superior mesenteric artery (SMA) bypass operations, all with good post-operative symptom relief. Post-prandial pain and weight loss was present in 5 out of 6 patients. Epigastric bruit was present in only two patients and 4 out of 6 patients had diarrhoea. The patients had varying degrees of peripheral vascular disease, ischaemic heart disease and hypertension. All patients had occlusion of the SMA on angiography and bypassing the occluded segment resulted in disappearance of the symptoms and weight gain. The vascular graft was sutured end to side to the front of the infra-renal aorta and end to side to the SMA, distal to the origin of the middle colic artery. Two patients had recurrence of symptoms due to graft occlusion at 3 and 4 years, respectively; they were successfully treated with repeat SMA bypass. There were no major complications or deaths related to the procedure in this study; one patient developed an incisional hernia requiring elective repair. Thus, early restoration of SMA circulation by bypass grafting in patients with CMI is sufficient to alleviate symptoms and prevent intestinal infarction with its high mortality rate.
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PMID:Superior mesenteric artery bypass for chronic mesenteric ischaemia: a DGH experience. 1107 74

The present paper represents an overview of the imaging methods which could integrate the first ultrasonographic approach to nephrologic diagnosis. It summarizes the clinical indications and the appropriate imaging protocols including conventional radiology, CT, MR and Nuclear Medicine in five different clinical scenarios: reno-vascular hypertension, hematuria, acute pyelonephritis, acute and chronic renal failure, and acute urinary colic.
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PMID:[Nephrologic diagnosis besides ultrasonography: which other imaging methods? Guideline on the use of radiologic methods]. 1250 36

Our objective is to present a case of symptomatic lead toxicity (plumbism) with abdominal colic and hemolytic anemia following a gunshot wound. It is a retrospective case report and the setting is in a teaching hospital in south central Los Angeles. The case report is that of a patient who presented with abdominal pain, generalized weakness, and hypertension following multiple gunshot wounds, 15 years previously. Other causes of abdominal pain and weakness--such as diabetes mellitus, alcohol abuse, pancreatitis, and substance abuse--were ruled out. Interventions included treatment with the newer oral chelating agent, Succimer (2, 3-dimercaptosuccinic acid), and subsequent surgery. The main outcome was the initial reduction in blood lead levels with improvement of symptoms. Because of a recurrent rise in the blood lead levels, the patient was again treated with Succimer and underwent surgery to remove two bullet fragments from the face. We conclude that lead toxicity should be ruled out in patients presenting with abdominal cramps and a history of a gunshot wound. Prompt therapy--including environmental intervention and chelation therapy--is mandatory, and surgical intervention may be necessary.
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PMID:Gunshot-induced plumbism in an adult male. 1462 Jul 13

We report the case of a 35-year-old man with no cardiovascular morbidity, presenting with acute flank pain, microscopic haematuria and normal blood pressure. Initially diagnosed as a ureteral colic, the patient was recovered 6 weeks later with severe hypertensive crisis. Further investigations revealed a massive renal infarction secondary to medial fibromuscular dysplasia (FMD). Several aspects of this presentation are intriguing. Renal infarcts are usually seen in older patients having cardiac problems and/or major atheromatous plaques. In addition, FMD is mainly observed in young females and rarely progresses to renal artery occlusion. Furthermore, in this case, FMD remained silent until the acute renal infarction occurred, despite a significant kidney size reduction at the time of diagnosis. Finally, the observation of a delayed hypertensive response to a major renovascular insult provides incentives to discuss possible pathophysiological mechanisms involved in renovascular hypertension.
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PMID:A young man with a renal colic. 1464 2

We present the unique case of a previously healthy, 2-year-old boy with resistant hypercalcemia and hypertension resulting from an unintentional overdose with an imported vitamin D supplement. The patient presented initially to the emergency department with colic and constipation and was discharged after a benign physical examination. The symptoms persisted and, on the second visit, the patient was found to have a serum calcium level of 14.4 mg/dL. Despite therapy with intravenously administered 5% dextrose solution at one-half normal strength, furosemide, calcitonin, and hydrocortisone, the calcium concentration increased to 15.0 mg/dL on the second hospital day and did not decrease until the fourth hospital day, when it fell to 13.9 mg/dL. The vitamin D concentration peaked at 470 ng/mL on hospital day 3. With additional questioning, the mother revealed that she had been giving her son a daily dose of 1 ampule of Raquiferol, an imported vitamin D supplement, instead of the recommended 2 drops per day. Each ampule contained 600,000 IU of vitamin D; therefore, the boy received a total of 2,400,000 IU over 4 days. The patient's hypercalcemia persisted for 14 days and was complicated by persistent hypertension. No renal, cardiac, or neurologic complications were noted. At discharge, the vitamin D concentration was still elevated at 389 ng/mL and the total calcium level had decreased to 11 mg/dL. The boy made a complete clinical recovery. This case highlights the need for caution when using imported and/or unregulated medicines, as well as the dangers of parental dosing errors.
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PMID:Acute vitamin D intoxication in a child. 1614 Jun 92

Onion (Allium cepa L.) and garlic (Allium sativum L.), among the oldest cultivated plants, are used both as a food and for medicinal applications. In fact, these common food plants are a rich source of several phytonutrients recognized as important elements of the Mediterranean diet, but are also used in the treatment and prevention of a number of diseases, including cancer, coronary heart disease, obesity, hypercholesterolemia, diabetes type 2, hypertension, cataract and disturbances of the gastrointestinal tract (e.g. colic pain, flatulent colic and dyspepsia). These activities are related to the thiosulfinates, volatile sulfur compounds, which are also responsible for the pungent of these vegetables. Besides these low-molecular weight compounds, onion and garlic are characterized by more polar compounds of phenolic and steroidal origin, often glycosilated, showing interesting pharmacological properties. These latter compounds, compared to the more studied thiosulfinates, present the advantages to be not pungent and more stable to cooking. Recently, there has been an increasing scientific attention on such compounds. In this paper, the literature about the major volatile and non-volatile phytoconstituents of onion and garlic has been reviewed. Particular attention was given to the different methodology developed to perform chemical analysis, including separation and structural elucidation.
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PMID:The analysis of onion and garlic. 1638 13

Pediatric renovascular hypertension (RVH) associated with neurofibromatosis 1 (NF1) is a rare entity that is often resistant to endovascular treatment. A 12-year-old girl with NF1 and hypertension presented with severe stenosis of the right main renal artery and its posterior segment, the latter of which thrombosed spontaneously, and total occlusion of the celiac artery with rare branching of the accessory middle colic artery. She underwent successful reconstruction of the anterior segment of the right renal artery, and has been free of medication for ten years. A review of the recent literature suggests that renal artery bypass remains the best treatment in pediatric RVH with NF1.
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PMID:Surgical treatment of a patient with progressive thrombosis of the renal artery associated with neurofibromatosis. 2008 91

Fibromuscular dysplasia (FMD) is an uncommon disorder, accounting for less than 10% of cases of renal artery stenosis, and typically presenting with hypertension in young women. This article reports the case of a previously healthy 37-year-old man presenting with acute-onset, severe, bilateral flank pain. Initially treated for ureteral colic and urinary tract infection, he was transferred to the nephrology clinic upon recognition of a rising serum creatinine. He was found to have FMD of bilateral renal arteries with a stenotic pattern on the right side and a dissecting aneurysm on the left side with resultant infarctions in both kidneys. On the basis of negative serological markers of vasculitis, a diagnosis of FMD complicated by bilateral renal infarctions was made. A stent was placed to the right stenotic renal artery, which resulted in sufficient lumen patency. No invasive procedure was performed on the other side owing to the complexity of the lesion. After 2.5 years of follow-up, the patient remained in good condition with normal renal function and adequate blood pressure control with dual antihypertensive therapy. Renal infarction complicating FMD of renal arteries is rare in the literature, with most of the cases having causative cardiovascular risk factors including coagulopathy, ischaemic heart disease, atrial fibrillation or structural cardiac abnormalities, none of which was present in this case. In conclusion, FMD may occur in atypical asymmetric presentations causing renal infarctions in both kidneys. Radiological interventions in such cases should focus on stabilizing renal lesions and renal function.
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PMID:Bilateral renal infarctions complicating fibromuscular dysplasia of renal arteries in a young male. 2162 38


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