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

Cushing's syndrome with pregnancy is rare, and only about 60 cases have been reported. In the recent 4 years, 3 cases were diagnosed in Chang Gang Memorial Hospital. They presented with serious maternal complications early in the second month of pregnancy, including hypertension, proteinuria and lower leg edema. Unfortunately it was not diagnosed until the 20th week of pregnancy. They had the same hormone profile as other Cushing's syndrome patients who were not pregnant. Under the supportive treatment they had outcomes of two premature deliveries and one still birth. Just after delivery all patients received left adrenalectomy and pathology showed adenoma. All of them had good recovery courses. According to the literature, early treatment (surgical operation, medical treatment, or irradiation) could decrease maternal morbidity and fetal loss rate.
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PMID:[Cushing's syndrome with pregnancy. Report of three cases]. 129 59

1. A novel formulation of nicardipine (25% standard, 75% sustained release--SR) was evaluated in mild hypertension in a double-blind, randomized, placebo-controlled comparison with standard nicardipine (STD), using clinic measurements (Hawksley) augmented by home recorded blood pressures (Copal UA 251). 2. At 2 h after dosing (peak effect) both STD nicardipine (30 mg three times daily) and SR nicardipine (60 mg twice daily) for 28 days produced a highly significant reduction in sitting and standing blood pressure. The mean sitting blood pressure was reduced by 20/16 mm Hg (STD) and by 25/18 mm Hg (SR) compared with placebo. 3. Predose (8-11 h after last dose of STD, 12-15 h after last dose of SR) the reductions in sitting blood pressure relative to placebo were 11/6 mm Hg (STD) and 14/7 mm Hg (SR). 4. Home recordings confirmed the hypotensive effect of both formulations. Both exhibited a distinct 'peak dose' effect between 1-3 h after dosing. The effect of the SR formulation was sustained throughout the 12 h dosing interval. 5. Of the 60 patients entering the study, one died of unexplained staphylococcal septicaema, two were withdrawn for non drug-related reasons and 14 (32%) were withdrawn because of adverse effects on active therapy (headaches, facial flushing, leg oedema, chest pain, dizziness). 6. In the 43 patients who completed the study adverse symptoms were reported more frequently while they were on the two active formulations of nicardipine compared with placebo. Most of these reactions were again of vasodilator origin.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Nicardipine sustained release in hypertension. 195 36

Diuretic therapy was discontinued in 15 elderly patients. None of these patients had evidence of uncontrolled cardiac failure or hypertension, and they all had received diuretics long-term. Two patients required resumption of diuretics due to the development of cardiac failure or severe leg oedema. In the remaining 13 patients, mean leg volume increased by 8.2%. Discontinuation of diuretic therapy in elderly patients is associated with a small but significant worsening of lower limb oedema.
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PMID:Stasis oedema in the elderly: are diuretics necessary? 195 81

A 63-year-old white woman with a history of hypertension and chronic obstructive pulmonary disease presented to the emergency room with worsening shortness of breath, anorexia, coughing, increased thirst, and leg edema of two weeks' duration. Medications included lisinopril 10 mg/d, which had been started six weeks earlier, sustained-release theophylline 300 mg q12h, and an albuterol inhaler. The lisinopril was discontinued on admission. Serum sodium concentration was 109 mmol/L; the osmolality of the blood and of the urine were 253 mOsmol and 438 mOsmol, respectively, with a specific gravity of 1.025 and a urine sodium of 17 mmol/L. The hyponatremia initially was considered to be the syndrome of inappropriate antidiuretic hormone secretion in response to the patient's suspected pneumonia. Due to worsening blood pressure, lisinopril was restarted and the serum sodium concentration dropped from 134 to 126 mmol/L. Evaluation of the patient's hyponatremia included assessment of thyroid, adrenal, hepatic, and cardiac function that were within normal limits. The patient was discharged on the following medications: sustained-release theophylline 300 mg tid, prednisone 10 mg/d, albuterol inhaler 2 puffs q6h, and sustained-release verapamil 240 mg/d for blood pressure control. Her serum sodium concentration has remained between 135 and 140 mmol/L during hospitalizations for exacerbations of chronic obstructive pulmonary disease and for pneumonias 10 and 12 months after discharge.
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PMID:Severe hyponatremia: an association with lisinopril? 165 42

The serotonergic antagonist ketanserin (K) was compared to nifedipine (N) in a five-center international study on hypertensive patients over the age of 50 years. After a 4-week placebo run-in period, patients were randomly assigned to receive for 3 months either ketanserin (40 mg b.i.d. after 2 weeks of 20 mg b.i.d.) or nifedipine (20 mg N retard b.i.d.). After 1 month, monotherapy patients whose blood pressure was not sufficiently reduced received a diuretic in combination therapy. At the end of the active treatment period, patients who had remained on monotherapy received placebo until hypertension returned or for a maximum of 2 months. One hundred and seventeen patients were entered in the study, 58 on K and 59 on N. More patients switched to combination with a diuretic in the K group (14 patients) than in the N group (6 patients). The overall reduction in blood pressure was similar for K and N. Total response rate was high (96%) for the two drugs. Blood pressure was reduced both at peak and trough drug levels. No orthostatic reactions were observed, and no rebound hypertension occurred at discontinuation of therapy. Ketanserin monotherapy slightly decreased heart rate (-1 beats/min). whereas N produced a significant increase (+6 beats/min). Body weight significantly increased with K (+1.1 kg) and was unchanged with N. More patients complained of adverse reactions during N monotherapy (47%) than during K monotherapy (34%). Flushing and leg edema were more frequent with N.
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PMID:Ketanserin versus nifedipine in the treatment of essential hypertension in patients over 50 years old: an international multicenter study. 244 56

We studied the therapeutic action of CO2 Laser on leg ulcers due to chronic venous hypertension in 30 subjects. Our findings show good results in reducing pain and leg oedema and wound healing.
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PMID:[Defocused CO2 laser in the treatment of leg ulcers. Preliminary results]. 251 23

The use of nisoldipine (10-20 mg b.i.d.) was evaluated as a replacement therapy for long-acting nifedipine (40-120 mg/day) in 21 patients with severe hypertension, who were resistant to or intolerant of nifedipine. Except for one patient with specific contraindications, all participants received an individually determined constant dose of beta blocker throughout the 8-month study. Results indicated a significant decrease in blood pressure after four weeks of treatment with nisoldipine (173 +/- 5/98 +/- 4 to 156 +/- 3/91 +/- 2 mmHg, p less than 0.05) without an associated change in pulse rate in 19 patients; only 5 of the 21 patients showed no further benefit from nisoldipine. No significant biochemical changes were noted in any of the patients during the study. In three patients, leg edema that had developed as a consequence of previous nifedipine therapy resolved completely following nisoldipine administration. Two patients withdrew from the study before term because of headaches and palpitations. An additional two patients suffered headaches, but tolerated the drug and continued the study. One patient suffered from polyuria. Nisoldipine appears to be an effective substitute treatment for nifedipine in severely hypertensive patients sensitive or resistant to nifedipine.
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PMID:Nisoldipine: a replacement therapy for nifedipine in the treatment of severe hypertension. 338 70

A single-blind, placebo-controlled study was carried out to evaluate the suitability of slow-release nifedipine as antihypertensive monotherapy for the elderly. After a wash-out period, nifedipine slow-release tablets (20 mg twice daily) followed by matching placebo were administered, each for 4 weeks, to 23 patients over 60 years of age with essential mild to moderate hypertension. Nifedipine significantly reduced the systolic and diastolic blood pressure, and increased the pulse rate in both supine and upright positions. The pre-treatment supine systolic blood pressure proved the best single predictor of the blood pressure decreases in both positions. The decrease in mean arterial blood pressure correlated significantly with the nifedipine plasma concentration. Significant biochemical changes were observed with nifedipine, namely increased serum K+ level and decreased levels of serum Na+, cholesterol and triglycerides. Side-effects in general were mild and transient; nevertheless, 3 patients dropped out because of severe leg oedema.
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PMID:Nifedipine monotherapy in the hypertensive elderly: a placebo-controlled clinical trial. 355 59

Iliac vein compression syndrome is a clinical condition that occurs as a result of compression of the left iliac vein between the right iliac artery and the fifth lumbar vertebrae. Patients usually have marked edema of the left leg. We report a case of a 16-year-old man who sought medical attention with significant left lower leg edema and four previous episodes of left leg cellulitis. Evaluation demonstrated venous hypertension as a result of left iliac vein compression. The patient underwent surgical correction; his symptoms resolved. Details and management of the case are presented and discussed. A review of the current literature regarding this condition also is included.
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PMID:Iliac vein compression syndrome: case report and review of the literature. 935 79

The responses of various age-groups of psoriatic patients to a four-week period of climatotherapy at the Dead-Sea was compared in three separate studies. In the first study, plaque clearance following climatotherapy was evaluated in a group of 688 psoriatics, as a function of age, sex and duration of the disease. Neither the age of the patient when treated, nor the duration of the disease, appeared to influence the degree of plaque clearance. However, when the age at onset of the disease was evaluated as the comparative parameter-a decrease in the rate of response with increasing patients' age was recorded. In the second study, the type and incidence of side effects after climatotherapy was studied in 502 patients aged over 65, and in more than 4,500 younger psoriatics. There was no difference in the type and frequency of side effects between the two age-groups. The most frequent side effects were: slight sun burn (8.2%), sun allergy (5.0%), common cold (3.4%), leg oedema (2.0%), diarrhea (1.4%) and herpes simplex (0.8%). In all cases the side-effects disappeared within a few days. In the third study, the reduction in the diastolic and systolic blood pressures in a group of 1,142 hypertensive psoriatics was evaluated as a function of time. It was demonstrated that while there was no significant age-dependent difference in lowering their diastolic blood pressure throughout the study, differences in lowering systolic measurements between the younger (< 40 y) and older (> 65 y) hypertensive patients were highly significant. On the basis of these studies we conclude that psoriatics aged 65 and over benefit from climatotherapy at the Dead-Sea no less than younger patients, and that, irrespective of age, high blood pressure is not a contraindication for this treatment in psoriatic patients at the Dead-Sea.
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PMID:Climatotherapy of psoriasis and hypertension in elderly patients at the Dead-Sea. 898 62


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