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

We performed a retrospective analysis of the results of 62 tibial and 54 femoral lengthenings in 88 consecutive patients. The patients mean age was 13.5 years and mean follow-up was four years. There was a significant difference between metaphyseal (27+/-1.2 days/cm) and diaphyseal (39.4+/-1.7 days/cm), tibial (34+/-1.7 days/cm) and femoral (31+/-1.4 days/cm) lengthening (P<0.05), but no significant difference among the lengthening indexes when treating one-, two-, or three-dimensional deformities, congenital (34+/-2.4 days/cm) and acquired (32+/-1.0 days/cm) limb length discrepancy (LLD) (P>0.05). The lengthening index was 33+/-1.1 days/cm, distraction regenerate length 6+/-0.4 cm, and lengthening percentage 21+/-2.1. The scatter plots of new regenerate length against time and the scatter plots of neurological complication, residual deformities, broken pins, joint contractures, and hypertension rate against lengthening percentage showed a positive linear relationship (r=0.8). We found the correlations between quantitative and qualitative parameters that should help to predict the treatment outcomes. Lengthening index depends on the amount of length gained. Higher length of new bone regenerate leads to a decrease in lengthening index. Expected gain in bone length can aid in estimating the duration of treatment. The lengthening percentage correlates very well with the complication rate and can be used to predict the complication rate.
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PMID:Axial deformity correction in children via distraction osteogenesis. 1654 15

Essential hypertension is characterised by reduced pain sensitivity. Hypertensive hypoalgesia has been attributed to elevated endogenous opioids and/or increased activation of descending pain modulation systems. A double-blind placebo-controlled design compared the effects of naltrexone and placebo on cold and ischemic pain in unmedicated newly-diagnosed patients with essential hypertension. Patients performed a cold pressor task while resting and while performing a distracting secondary task. They also performed a forearm ischemia task while resting. Although the cold pressor and ischemia tasks elicited significant increases in pain and blood pressure, pain ratings and pressor responses did not differ between naltrexone and placebo. Cold pain was reduced by distraction compared to rest. The finding that opioid blockade with naltrexone did not moderate the pain and pressor responses to cold and ischemia suggests that pain and associated blood pressure responses are not modulated by opioids in hypertension. The finding that the distracting secondary task successfully reduced pain ratings suggests normal supraspinal pain modulation in essential hypertension.
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PMID:Effects of opioid blockade with naltrexone and distraction on cold and ischemic pain in hypertension. 1720 92

For children with craniosynostosis presenting intracranial hypertension and facial hypoplasia, different techniques have been used. Commonly, an initial frontoorbital advancement to expand a tight cranium volume was followed by Le Fort III osteotomy to repair midface abnormalities several months later. The 2-stage surgeries were unified into a 1-step procedure to optimize treatment. We here report results of frontofacial monobloc advancement, applying gradual distraction by a rigid external distraction device. Three patients were treated with excellent functional and cosmetic outcome with high rate of patient satisfaction. There was no remarkable complication.
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PMID:Frontofacial monobloc advancement using gradual bone distraction method. 1892 39

We describe a boy with Apert syndrome, including cranial deformities and syndactyly (acrocephalosyndactyly), though intracranial hypertension, exophthalmos, and midfacial hypoplasia were mild. We treated him by mandibular distraction, in addition to fronto-orbital distraction, and Le Fort III midfacial distraction, with good results.
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PMID:Atypical Apert syndrome: sequential and segmental distraction osteogenesis of the skull, midface, and mandible. 1930 62

Syndromic craniosynostosis (SC) may cause intracranial hypertension, exorbitism, midfacial hypoplasia associated with airway obstruction, and class III malocclusion. Current treatment strategies for SC involve expansion of the cranial vault and orbits, and midfacial advancement to relieve symptoms and sequelae of obstructive sleep apnea. We present a case of a 12-week-old female patient with Saethre-Chotzen syndrome who presented with bicoronal craniosynostosis, severe turribrachycephaly, midface hypoplasia, and a history of obstructive sleep apnea (apnea-hypopnea index = 14). Posterior vault distraction and simultaneous transfacial pin placement under 3D CT surgical navigation was planned to concurrently relieve intracranial pressure and address airway obstruction by distraction of the midface without osteotomy. An uncomplicated surgery was completed in 290 minutes with an estimated blood loss of 340 mL. Midface distraction was initiated on postoperative day 1 at a rate of 1 mm per day for 21 days, which translated to 13 mm of midfacial advancement. Posterior vault distraction was initiated on postoperative day 5 at a rate of 1 mm per day for 25 days with a resultant 25 mm of posterior vault expansion. Transfacial pin and external distractors were removed after 6 weeks, and posterior vault distractors were removed after 8 weeks of consolidation. Craniometric comparison of 3D-CT scan demonstrated an increase in cranial vault volume of 47%, and the patient was able to be weaned from her home oxygen requirement. This is the first report of simultaneous posterior vault distraction with midfacial advancement across open facial sutures using surgical navigation as an initial stage in treating syndromic craniosynostosis.
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PMID:Posterior vault distraction with midface distraction without osteotomy as a first stage for syndromic craniosynostosis. 2385 85

In recent years, cranial distraction osteogenesis (DOG) for craniosynostosis has often been performed in Japan. Since 1998, DOG has been conducted in more than 80 patients with craniosynostosis in our institution. It is now important to define the appropriate indications for the application of DOG for craniosynostosis. From the point of view of our more than 10 years of experience with the application of cranial DOG, posterior enlargement is one of the most appropriate applications. Bilateral posterior expansion is conducted for hypertension because of bilateral lambdoidal synostosis, whereas unilateral posterior expansion is conducted for asymmetry because of unilateral posterior plagiocephaly. Posterior expansion by gradual distraction was conducted for 12 cases. Eight cases of syndromic craniosynostosis and 4 of simple unilateral lambdoid synostosis were included. Clinical and radiological improvement was observed in all cases. Postdistraction computed tomography demonstrated a decrease in digital printing within a few months in all cases. Distraction osteogenesis is a useful procedure for posterior enlargement by gradual expansion and guarantees postdistraction rigidity without collapse in a supine position in bilateral and unilateral lambdoid synostosis.
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PMID:Suitable indication for the application of distraction osteogenesis: occipital enlargement for lambdoid synostosis. 2403 20

The past two decades has seen a growing understanding that health care leads to harm in a large number of patients. With this insight has come an understanding that clinicians who care for patients who are harmed experience an understandable and predictable emotional response. After an adverse event, medical care givers may experience a wide range of symptoms including anger, guilt, shame, fear, loneliness, frustration and decreased job satisfaction. These may be accompanied by physical signs of fatigue, sleep disturbances, concentration difficulties, tachycardia and hypertension. These clinicians have been referred to as the "second victims." While many clinicians recover relatively quickly from an adverse event, for some this syndrome can last for weeks, months or indefinitely. Some have even contemplated or completed suicide. Being involved in an adverse event or error may also negatively impact the quality of care the clinician subsequently provides, either because of acute emotional distraction or chronic burnout. This can lead to additional errors and a vicious cycle of error, burnout and error. Health care systems have a moral responsibility to care for second victims. Care might be as simple as asking, "Are you OK?" and acknowledging the normal human emotional response to adverse events. Some centers have developed formal peer support programs in which clinicians are trained to act as peer supporter for emotional recovery after adverse events. Finally, more formal emotional support systems might be needed by some clinicians, including employee assistance programs, hospital clergy or psychological and psychiatric services.
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PMID:Care of the clinician after an adverse event. 2549 10

Eating is an essential activity to get energy and necessary nutrients for living. While chewing, the food is broken down by the teeth and dissolved by saliva. Taste, flavour and texture are perceived during chewing and will contribute to the appreciation of the food. The senses of taste and smell play an important role in selecting nutritive food instead of toxic substances. Also visual information of a food product is essential in the choice and the acceptance of food products, whereas auditory information obtained during the chewing of crispy products will provide information on whether a product is fresh or stale. Food perception does not just depend on one individual sense, but appears to be the result from multisensory integration of unimodal signals. Large differences in oral physiology parameters exist among individuals, which may lead to differences in food perception. Knowledge of the interplay between mastication and sensory experience for groups of individuals is important for the food industry to control quality and acceptability of their products. Environment factors during eating, like TV watching or electronic media use, may also play a role in food perception and the amount of food ingested. Distraction during eating a meal may lead to disregard about satiety and fullness feelings and thus to an increased risk of obesity. Genetic and social/cultural aspects seem to play an important role in taste sensitivity and food preference. Males generally show larger bite size, larger chewing power and a faster chewing rhythm than females. The size of swallowed particles seems to be larger for obese individuals, although there is no evidence until now of an 'obese chewing style'. Elderly people tend to have fewer teeth and consequently a less good masticatory performance, which may lead to lower intakes of raw food and dietary fibre. The influence of impaired mastication on food selection is still controversial, but it is likely that it may at least cause adaptation in food choice. Systemic conditions, such as high blood pressure, diabetes and cancer, with or without medicine use, tend to be associated with taste and chewing alterations. However, definite conclusions seem hard to reach, as research protocols vary largely.
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PMID:The influence of oral processing, food perception and social aspects on food consumption: a review. 2706 Oct 99

Executive function (EF) is increasingly recognized as being responsible for adverse developmental outcomes in preterm-born infants. Several perinatal factors may lead to poor EF development in infancy, and the deficits in EF can be identified in infants as young as eight months. A prospective cohort study was designed to study the EF in Chinese preterm infants and examine the relationship between EF in preterm infants and maternal factors during perinatal period. A total of 88 preterm infants and 88 full-term infants were followed from birth to eight months (corrected age). Cup Task and Planning Test was applied to assess the EF of infants, and the Bayley Scale of Infant Development (BSID-III) was used to evaluate cognitive (MDI) and motor abilities (PDI) of infants. In comparison with full-term infants, the preterm infants performed more poorly on all measures of EF including working memory, inhibition to prepotent responses, inhibition to distraction, and planning, and the differences remained after controlling the MDI and PDI. Anemia and selenium deficiency in mothers during pregnancy contributed to the differences in EF performance. However, maternal depression, hypertension, and diabetes during pregnancy were not related to the EF deficits in preterm infants. Future research should focus on the prevention of anemia and selenium deficiency during pregnancy and whether supplementing selenium in mothers during pregnancy can prevent further deterioration and the development of adverse outcomes of their offspring.
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PMID:Comparison in executive function in Chinese preterm and full-term infants at eight months. 2862 14

Crouzon syndrome (CS) is one of the craniosynostosis syndromes that leads to early fusion of cranial sutures and increased intracranial pressure. Intracranial hypertension is a serious complication that may lead to vision loss and cognitive impairment. Early detection and management are necessary to prevent complications. The authors present a patient with CS who underwent posterior cranial vault reconstruction with internal distraction after multiple episodes of headache and papilledema. The patient was unaware of any loss of color vision before the surgery; however, he noted an improvement in his color vision after the surgery. Color vision deficits may be an early sign of intracranial hypertension and finding these deficits using noninvasive testing methods may be an indication for early intervention.
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PMID:Improvement of Color Vision Following Posterior Cranial Vault Distraction for Crouzon Syndrome. 2948 54


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