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

Dr. Boyd C. Quint recently presented important data regarding the relationship of estrogen therapy to the risk of endometrial carcinoma, but the data seem to have been inappropriately analyzed. Dr. Quint studied 291 postmenopausal women who received primary treatment for endometrial carcinoma at the Swedish Hospital Medical Center in Seattle, Washington between 1960 and 1973. The 1st step in Quint's analysis was a determination of the ratio of new endometrial carcinoma cases to the total "major gynecologic operations" for the intervals 1960-1966 and 1966-1973. This ratio was observed to increase from about 2% for 1960-1966 to about 4% for 1966-1973, but this change -- while statistically significant - cannot be used to support the hypothesis that the absolute incidence of endometrial carcinoma increased from the 1st to the 2nd interval. The 2nd step in the analysis was a determination of the incidence of nulliparity, obesity and hypertension, and/or diabetes and prior estrogen therapy among the endometrial carcinoma patients 1st treated in each of the 2 intervals. The prevalence of the constitutional stigma commonly associated with endometrial carcinoma, obesity and hypertension and/or diabetes can be seen to be significantly lower among the 203 patients 1st treated between 1966 and 1973 than among the 88 patients 1st treated between 1960 and 1966. Conversely, the prevalence of prior estrogen therapy is seen to be much higher. Data indicating that approximately 50% of Seattle area women had used or were using estrogen therapy by 1973 to 1974 - median use of about 10 years - are in press. Quint's data do support the hypothesis that estrogen therapy may be an etiologic factor among the more recent cases of endometrial carcinoma.
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PMID:Estrogen therapy and endometrial carcinoma. 98 96

The search for the genetic configuration of essential hypertension and the link with intermediate phenotypes ranks high on the current research agenda. Juvenile borderline hypertension is supposed to contain essential clues to the identification of these phenotypes. According to a large number of investigations, this condition is characterized by a labile type of hypertension and an elevation of the cardiac index, plasma catecholamines and/or renin activity. The 'prehypertensive' offspring from hypertensive parents may be included in these observations. The psychometric profile of the hypertensive patient also enters the equation. It seems likely that external conditions affect the manifestation of borderline hypertension. In particular, the stigma of the term hypertension appears to be carried over into the clinical findings, presenting as components of the pathophysiological and psychological profile. This calls for a reinterpretation of the patterns observed in early human hypertension.
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PMID:A critical interpretation of juvenile borderline hypertension. 181 43

Morbid obesity is a major health problem in this country and throughout the world. In addition to its social stigma (in the western world), obesity exacerbates several disease states such as diabetes, hypertension, cardiac disease and restrictive lung disease. When effective medical treatment of obesity becomes available, it will depend in part upon understanding the physiologic factors that control satiety. This review summarizes the information available on brain and gut control mechanisms of satiety. Brain nuclei located in the lateral hypothalamus, ventromedial hypothalamus, and other paraventricular areas are the sites of action for potent neuropeptides, such as cholecystokinin (CCK) and neuropeptide Y, that appear to regulate feeding. Exogenous CCK has been used clinically to decrease meal size in obese patients. The sites of the satiety cascade that are most often manipulated are the gastric and intestinal phases. Physiologic gastric distension is a potent inhibitor of feeding, whereas the intermeal interval may be regulated by intestinal signals released by food in the gut. Jejunal-ileal bypass has fallen from favor and has been replaced by gastric restrictive procedures that create a small proximal gastric pouch that empties into the small bowel (gastric bypass) or the distal stomach (gastroplasty). These operations rely partially on their ability to produce gastric distension in the proximal gastric pouch at an early stage during a meal. Thus, failure results if the pouch compensates by distending or if the stoma widens with subsequent loss of slow emptying. Improved medical and surgical treatment will be designed to intervene at specific sites of the satiety cascade as knowledge of the physiologic control mechanisms of satiety increases.
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PMID:Physiologic approaches to the control of obesity. 229 39

During the past 10 years, extensive studies have shown that schizophrenia is a true biological illness. Like diabetes and hypertension, it cannot be cured as yet, but it often can be controlled by medication. Schizophrenia, therefore, is not a hopeless condition, and many sufferers who receive proper treatment can lead productive lives. The stigma attached to schizophrenia will disappear, and the resistance to the proper use of drugs will also cease when a change comes about in the way schizophrenia is perceived in the United States. Meanwhile, the unique tragedy of schizophrenia lies in the fact that victims often cannot recognize their illness, refuse treatment, and throw away their lives. The question becomes: Is court-mandated treatment indicated when persons are severely disabled, lack the capacity to make informed decisions, and will suffer mental and physical deterioration if treatment is not given?
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PMID:Schizophrenia, civil liberties, and the law. 338 14

The composition of the clientele from an ophthalmological practitioner's office is described with special reference to the occurrence of glaucoma and disc haemorrhages (h in singular; hh in plural). This study could not be planned as an epidemiological survey and gives no clue to sensitivity or specificity of hh in glaucoma. During a period of about 10 years ending with 1986 there were 731 patients with h and/or glaucoma. When detected, 185 patients had h but no glaucoma, 33 had both h and glaucoma and 513 had glaucoma but no h. During the follow-up period hh were detected in 83 cases of glaucoma, and glaucoma developed in 27 cases with hh. The detection rate of hh among glaucoma was low but steady, indicating that hh may occur at any stage of the glaucoma process. This study shows no predilection for hh in cases with general hypertension or diabetes, nor is the frequency of hh among pseudoexfoliation cases significantly lower than among cases without this stigma.
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PMID:Disc haemorrhages and glaucoma in a general ophthalmic practice. 338 91

Depression is a highly treatable disease that is more prevalent among primary care patients than hypertension. Primary care physicians must become accustomed to screening for and treating depression just as they screen for and treat hypertension. A psychiatrist should be consulted for severe cases of depression. The introduction of the serotonin selective reuptake inhibitors (SSRIs), antidepressants that are far less toxic and have a milder side effect profile than the tricyclic antidepressants (TCAs), has made it possible for depression to be treated more successfully in the primary care setting. Unlike the TCAs, the SSRIs have not been lethal in overdose. Early diagnosis and early treatment can reduce the morbidity and mortality associated with depression and can also reduce the costs associated with misdiagnosis. This article reviews the difficulties inherent in diagnosing depression in this health care setting, including somatization and the coexistence of other medical disorders. Suggestions are offered for effective screening and diagnosis, and a practical approach is given for explaining the diagnosis, which may help moderate patient denial or fear of stigma. Current pharmacotherapeutic options for treating mild-to-moderate depression are also summarized.
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PMID:Recognition and treatment of depression in a primary care setting. 781 55

With the aim to analyze the association of Type I Neurofibromatosis with secondary arterial hypertension, a retrospective study has been performed on 36 patients, diagnosed of pheochromocytoma (n = 12) and/or renal artery stenosis (n = 25), finding in 6 of them diagnostic criteria of Type I neurofibromatosis, of these 4 showed pheochromocytoma, 1 renal artery stenosis and 1 pheochromocytoma plus renal artery stenosis. CAT and angiography were the best diagnostic imaging methods to confirm clinic and biological suspicion of adrenal tumor of renal artery stenosis. It is recommended the systematized study of patients with NF-1 together with their relatives who phenotypically show some illness stigma, or with arterial hypertension resistant to conventional treatment.
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PMID:[Secondary arterial hypertension in type I neurofibromatosis (NF-1). Findings in 6 patients]. 848 62

The worldwide epidemic of obesity has made the development of effective treatment ever more urgent. Appropriate use of medication for the treatment of obesity may benefit patients at risk for developing diabetes, hypertension, coronary artery disease, osteoarthritis or gall bladder disease. In addition, with the appearance of very safe medications, short-term treatment for the relief of the stigma associated with obesity may also be valuable. The currently available medications for obesity work either by reducing fat digestion or by acting on receptor systems in the brain. Both have potential side-effects, but may be useful alone or in combination. The expansion of knowledge about the control of obesity offers the hope that many new agents will become available over the next decade.
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PMID:Uses and misuses of the new pharmacotherapy of obesity. 1021 9

Legal experts say that although three recent U.S. Supreme Court cases on mitigating measures may change the way the American with Disabilities Act (ADA) is applied, they should not affect HIV employment discrimination claims. The court held in June that corrective lenses and medications must be considered when determining whether a plaintiff is disabled with regard to the ADA. Two cases involved vision impairments and one involved high blood pressure. The employers in each case argued that the impairment was not a disability and therefore not subject to ADA protection. Employers welcomed the rulings, and disability-rights groups expressed alarm. Plaintiff's attorneys who specialize in AIDS law said the rulings probably will not affect their clients because living with HIV carries a stigma and HIV infection limits many life activities.
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PMID:'Mitigating measures' cases won't affect HIV plaintiffs. 1136 7

The development of external erection devices has evolved as the social stigma surrounding the treatment of erectile dysfunction has gradually disappeared during the late twentieth century. Although the success of surgical and medical therapy for erectile dysfunction has been documented, especially since the introduction of sildenafil citrate, patient demand for an effective, noninvasive, drug-free management of erectile dysfunction has remained. As the population continues to age, acquiring the comorbidities commonly associated with erectile dysfunction, such as hypertension, diabetes mellitus, and atherosclerotic vascular disease, the demand for such treatment should persist. This article examines the development, mechanism of action, efficacy, and patient satisfaction with regard to vacuum constriction and external erection devices.
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PMID:Vacuum constriction and external erection devices in erectile dysfunction. 1140 85


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