Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cerebral symptoms were registered in a multicenter study including 64 patients with severe hypertension, diastolic blood pressure (DBP) greater than or equal to 135 mmHg, and more or less pronounced hypertensive encephalopathy. The symptoms were: headache (70%), dizziness (35%), consciousness disturbances (28%), nausea (27%), paresis (23%), blurred vision (22%), paraesthesia (21%) and vomiting (14%). None had convulsions or coma. Initial treatment was furosemide i.v., and if DBP was greater than or equal to 125 mmHg after one hour, patients were randomized to treatment with either i.v. diazoxide (bolus injections of 75-150 mg) or i.m. dihydralazine (bolus injections of 6-12.5 mg). A gradual fall in blood pressure (BP) was obtained in all three groups. Along with BP reduction a substantial regression of neurological symptoms was registered. After 5 hours only minor cerebral symptoms were present without significant difference between diazoxide and dihydralazine. None developed cerebral complications. The study failed to show a significant correlation between BP reduction and regression of neurological symptoms graded semiquantitatively. Reduction of BP by titration using small repeated bolus injections is recommended, but oral treatment should be considered in the patients who are able to ingest peroral medication in spite of neurological symptoms.
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PMID:Reversibility of cerebral symptoms in severe hypertension in relation to acute antihypertensive therapy. Danish Multicenter Study. 353 94

A case of intravenous labetalol in the treatment of a resistant hypertensive emergency is reported. Although there have been several reports of the use of oral labetalol in resistant hypertension, no intravenous administration in hypertensive emergency resistant to other drugs has been reported to date. A 36-year-old black female with BP of 270/160 mm Hg with complaints greater than one month's duration of dizziness, severe headaches, blurred vision, shortness of breath, vomiting, palpitations, flushing, agitation, diarrhea, weakness, and weight loss, was treated successfully with intravenous labetalol after she failed to respond to other established parenteral antihypertensive drugs. The patient received labetalol 20 mg iv bolus, and then 20 mg every ten minutes until a cumulative dose of 200 mg was attained. Labetalol produced a prompt but smooth reduction in BP without any reflex tachycardia or other adverse effects. Intravenous labetalol may be safe and effective for the management of rapid BP control in hypertensive emergencies resistant to other parenteral antihypertensive agents.
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PMID:Intravenous labetalol in the management of resistant hypertensive emergency. 360 97

A 34-year-old woman was admitted for the chief complaints of headache and blurred vision. She had bilateral papilledema and slight increase in CSF pressure (175mmH2O) with normal visual acuity and field. Neurological and hormonal examination were normal except for over response of PRL and TSH to TRH test. The sella was enlarged and MRI and metrizamide CT demonstrated intrasellar CSF filling with remodeling of the pituitary gland. The patient was diagnosed as primary empty sella syndrome associated with benign intracranial hypertension. The complaints did not subside for six months. The patient was treated via the transsphenoidal approach. The dura mater of the floor of the sella was elevated by extradural balloon expansion filled with silicone, and subsequently the empty sella was obliterated. Her headache disappeared and amblyopic attack also improved. Obliteration of the empty sella with an extradural silicone balloon via the transsphenoidal approach seemed to have been effective for headache and visual complaints of primary empty sella syndrome which did not respond to medical therapy.
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PMID:[Primary empty sella syndrome treated by transsphenoidal extradural balloon expansion--a case report]. 362 70

A controlled study was conducted in hypertensive patients to investigate whether captopril can be substituted for the various other antihypertensive drugs (not including diuretics) to reduce side effects and improve the quality of life. Captopril in a twice daily dose of 25-50 mg, was substituted and titrated in 54 patients. Fifty-two patients, matched by age and sex, comprised the control group, and were treated with a variety of agents. During a follow-up of 9 months, 44 of the patients receiving captopril (81%) achieved the goal of supine blood pressure less than 90 mmHg. Captopril was discontinued in two patients due to side effects. Mild proteinuria was observed in two patients. A significant reduction in scores or rates of side effects (numbness, blurred vision, insomnia, vivid dreams, cold extremities, sleepiness, sexual dysfunction and fatigue) and improvement in quality of life (general feeling, mood and concentration) was observed in the study group compared with the control group. Captopril alone in a twice daily dose of 25-50 mg, or in co-treatment with thiazide, provided sustained blood pressure control with minimal side effects and improvement in quality of life compared with the treatment of hypertension with beta-blockers, vasodilators or methyldopa.
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PMID:Captopril as a replacement for multiple therapy in hypertension: a controlled study. 391 Jul 75

A self-administered symptom questionnaire was completed by 477 patients in a hypertension clinic. The complaints of the patients were analysed according to the type of therapy being given and the dose of drug taken. Methyldopa therapy was associated with sleepiness, weakness of the limbs, sleeping longer at night, and rising more frequently at night to pass urine. Diarrhoea, impotence, failure of ejaculation, blurred vision, depression, and the symptoms of postural hypotension were not related to methyldopa therapy. Bethanidine administration was related to postural hypotension, impotence, and failure of ejaculation but not to weakness of the limbs, blurred vision, depression, or diarrhoea. Patients receiving guanethidine complained of postural hypotension, failure of ejaculation, and had their bowels open more frequently. Similarly, patients receiving propranolol had an increased frequency of defaecation but also tended to complain of weakness of the limbs.Considering each drug individually, 5% of patients failed to take the prescribed dose of diuretic whereas
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PMID:Side effects of hypotensive agents evaluated by a self-administered questionnaire. 472 58

A case is presented of a 32-year old gravida 3, para 1, ab 1, presented at 26 weeks with chief complaints of periorbital edema, headaches, and blurred vision for about 1 week. 2 weeks prior to admission she had experienced shortness of breath and decreased fetal movement. Admission was at 28 weeks with uncontrolled hypertension, blood pressure 190/120, pulse 100/min. Temperature was 98.8 degrees. Attempted induction of labor with oxytocin was unsuccessful. A hydralazine infusion decreased the blood pressure to 180/100 and a 20 mg prostaglandin (PG) E2 suppository was inserted. A few hours later the blood pressure had dropped to 100/60 and the hydrazaline infusion was discontinued. About 3 hours later a stillborn female infant was born; post delivery examination revealed a large gap in the wall of the uterus extending into the lateral vaginal fornix. A total abdominal hysterectomy and right salpingo-oophorectomy was then performed and recovery was uneventful. PGE2 reliably initiates labor even in the presence of an "uninducible cervix" and is prone to increase intrauterine pressure to a level beyond that of normal labor with a lag in cervical changes. The 2 most common traumata reported following PG administration for therapeutic abortion are either cervico-vaginal fistulas or lateral tears. In this case since there was no indication of any congenital weakness of the uterine wall, it is reasonable to assume that the mechanism leading to the rupture was intense and prolonged uterine contractions combined with a rigid cervix.
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PMID:Uterine rupture associated with the use of vaginal prostaglandin E2 suppositories. 658 51

Complications from mydriatic and cycloplegic drugs are rare compared with their extensive use. Adverse effects are often related to dosage or other factors. The ocular complications include increased intraocular pressure, pigmentation of the conjunctiva and cornea, pigment in the anterior chamber, lacrimal duct blockage, macular edema, corneal endothelium damage, hyperemia, allergy, discomfort, and blurred vision. The systemic complications are those common to sympathomimetic and parasympatholytic drugs and include tachycardia, hypertension, headache, faintness. pallor, trembling, excessive sweating, palpitations, arrhythmias, confusion, hallucinations, drowsiness, ataxia, flushed skin, high fever, dysarthria, thirst, dry mouth, convulsions, disorientation, nervousness, coma, and death. An understanding of all possible side effects is of paramount importance to those using these drugs in the treatment of anticholinesterase poisoning. This review is intended as a ready reference to the adverse effects of mydriatic and cycloplegic drugs.
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PMID:Mydriatic and cycloplegic drugs: a review of ocular and systemic complications. 703 29

A 13-year-old girl with a severe headache, blurred vision, altered mental status, seizures, high blood pressure, edema and hematuria is presented. With a previous history of upper respiratory tract infection, acute onset of edema, gross hematuria, high ASO and low C3 levels, she was diagnosed with acute poststreptococcal glomerulonephritis (APSGN) and hypertensive encephalopathy. Computed tomography (CT) revealed symmetric hypodense areas representing edema in the parieto-occipital regions. As noted in previous reports, these CT findings are of value in establishing the diagnosis of hypertensive encephalopathy. In this particular case the CT appearance and the subsequent clinical improvement without any neurological deficit supported the diagnosis of hypertensive encephalopathy due to APSGN. We emphasize that awareness of the CT findings of hypertensive encephalopathy may facilitate in making the correct diagnosis in symptomatic hypertensive patients, especially in cases with an unusual presentation or clinical course.
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PMID:Cranial computed tomographic findings in a patient with hypertensive encephalopathy in acute poststreptococcal glomerulonephritis. 782 39

To study acute organophosphorus (OP) poisoning cases, 190 OP-intoxicated cases admitted to Civil Hospital, Ahmedabad, were investigated in depth. The group consisted of subjects ranging from 11 to 60 years of age, with the maximum number of cases in the age group 21-30 years and a male-to-female ratio of 2.1:1. Most of the subjects (71.61%) were partially educated, 24.2% of the cases were illiterate, and only 4.2% of the cases were highly educated. Socioeconomically, 21.1% of the subjects were of low economic status, 52.6% were low middle class, 16.8% were upper middle class, and only 9.5% were upper class. With regard to marital status of the subjects, 98 cases were married and 92 were unmarried. About 67.4% of the cases had the intention of committing suicide, 16.8% of the cases were the result of occupational exposure, and 15.8% of the cases were from accidental poisoning. Social and domestic problems (37.5%), marital friction (15.6%), financial stress (15.6%), love affairs (14.1%), job problems (10.9%), chronic illness (4.7%), and failure in examination (1.6%) were observed as the precipitating factors. Muscarinic manifestations such as vomiting (96.8%), nausea (82.1%), miosis (64.2%), excessive salivation (61.1%), and blurred vision (54.7%) and CNS manifestations such as giddiness (93.7%), headache (84.2%), disturbances of consciousness (44.2%), and typical pungent odor from mouth and clothes (77.9%) were the main presenting symptoms. Cardiac manifestations such as sinus tachycardia (25.3%), sinus bradycardia (6.3%), and depression of ST segments with T-wave inversion (6.3%) were observed electrocardiographically, with hypertension (10.5%) and muscular twitching in some (2.1%) cases. Biochemical changes such as albuminuria (12.6%) and azotemia (18.9%) with inhibition of acetylcholinesterase enzyme activity in blood were recorded in 78.9% of the cases. About 89.5% of the cases recovered completely, 4.2% of the cases absconded after partial recovery, and 6.3% of the cases died. The mortality rate (6.3%) depended on various factors such as the organophosphorus compound consumed, the amount ingested, the time interval for hospitalization, and the general health of the patient. Chances of recovery were higher when the patient was hospitalized at the earliest indication.
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PMID:A clinical, biochemical, neurobehavioral, and sociopsychological study of 190 patients admitted to hospital as a result of acute organophosphorus poisoning. 832 67

Charts from 1,074 consecutive emergency department patients who underwent cranial computed tomography (CT) were reviewed for predictors of a CT abnormality. Twenty-six clinical variables and the results of neurologic examination were compared with cranial CT findings. Patients with focal neurologic deficit, unresponsiveness, and hypertension had an increased risk of a CT abnormality. Blurred vision, trauma, loss of consciousness, headache, and dizziness were each associated with a lower risk of a CT abnormality. Multivariate analysis showed that only focal neurologic deficit and unresponsiveness effectively helped predict a CT abnormality. In patients with negative neurologic findings, only intoxication and amnesia were associated with greater than 10% positive scans and an increased risk for a CT abnormality. The data indicate that positive neurologic findings coupled with intoxication and amnesia would have helped detect 90.7% of the positive scans and provide an effective initial approximation strategy for selecting patients to undergo CT. Although 15 patients with positive scans (1.4%) would have been missed, this strategy would have yielded a negative predictive value of 97.3% and eliminated 53.9% of the CT scans obtained.
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PMID:Unenhanced emergency cranial CT: optimizing patient selection with univariate and multivariate analyses. 843 Jan 85


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