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)

A 4-year-old girl had abdominal distention, muscular weakness, renal tubular dysfunction, and hypertension associated with hypokalemic metabolic alkalosis. There were no clinical symptoms of cortisol deficiency, but there was excessive deoxycorticosterone and cortisocsterone production. Basal plasma aldosterone levels were undetectable; however, adrenocorticotropic hormone (ACTH) stimulation brought plasma aldosterone levels up to normal. The urinary pregnanediol, tetrahydro-deoxycorticosterone (THDOC), and tetrahydrocorticosterone (THB) concentrations were elevated. Stimulation of ACTH failed to increase urinary 17-ketosteroid, 17-hydroxycorticosteroid, or plasma cortisol levels significantly, while urinary THDOC, THB, and plasma corticosterone concentrations were further elevated. The elevated plasma corticosteroid intermediates were suppressed by dexamethasone administration. When physiologic doses of dexamethasone were administered, the hypertension, electrolyte imbalance, and abnormal corticosteroid secretion were all corrected. The studies indicated a partial 17alpha-hydroxylase defect in this patient.
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PMID:Hypokalemic crisis simulating intestinal obstruction in a 4-year-old girl. A consequence of 17alpha-hydroxylase deficiency. 97 20

Because of the multiplicity of disease conditions and diminished tolerance for drugs in the aged, it is necessary to know concomitant pathologic conditions to determine which antihypertensive drug to use. In the Philadelphia Geriatric Center, there are about 1,000 residents, between 70 and 100 years of age. About 40% have hypertension; almost 50% have or once had depression; there are many cases of hiatal hernia and/or peptic ulcer; in one subdivision of residents, almost 40% have renal disease with BUN above 30 mg/100 ml. In antihypertensive treatment, some individuals respond fairly well to reassurance and weight reduction, when obese, even without drugs. All are given a low-salt diet. A diuretic is first used--thiazide in cases of good renal function, furosemide with impaired renal function. Liquid potassium supplements are given. If there is but little reduction in blood pressure in several weeks, methyldopa is added in ascending doses, in cases with or without renal impairment. In hypertension with impaired renal function, furosemide and/or methyldopa were especially valuable. Furosemide as an antihypertensive drug was also noted to delay the onset of congestive heart failure. Since reserpine can aggravate peptic ulcer and can precipitate or aggravate depression, it should seldom be used to treat hypertension in the aged. Guanethidine is rarely used, since it can cause cerebrovascular insufficiency and marked weakness. High blood pressure should be reduced slowly in the aged, to avoid untoward effects.
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PMID:An approach to the treatment of hypertension in the aged. 105 27

The efficacy of prazosin given either alone or in combination with polythiazide was assessed in a study of 50 outpatients with essential hypertension. Among the 29 who completed 42 months of therapy, blood pressure fell significantly in 76%. Of the 21 who dropped out of the study after 1 to 41 1/2 months, 43% showed improvement, 38% showed no change, and 19% showed worsening of hypertension. The most common side effects were lack of energy and weakness. Diabetics and alcoholics tolerated prazosin well. Of the 50 patients who started treatment with prazosin alone, only 23 required addition of polythiazide.
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PMID:A long-term clinical trial of prazosin. 110 91

The efficacy and safety of the antihypertensive drug, clonidine, were tested by open-label trial in 30 ambulatory, hypertensive patients who were concomitantly receiving the diuretic, chlorthalidone. This combined treatment followed several weeks of base line treatment with the diuretic alone. In both the recumbent and the upright position, clonidine potentiated the blood pressure-lowering effect of chlorthalidone to a noticeable degree; with combined treatment, the reductions in systolic and diastolic pressures were from 12.9% to 16.4% greater. Side-effects, consisting mostly of drowsiness and dryness of mouth, were mild and were observed mainly at the beginning of clonidine therapy. Orthostatic hypotension or weakness was experienced by 3 patients, but it subsided after dose adjustment in two of them. The drug combination was well suited for long-term management of patients with hypertension of all degrees of severity.
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PMID:Combined clonidine-chlorthalidone therapy in hypertension. Two years' experience in 30 patients. 116 25

Three different regimens of drug treatment for hypertension were compared with regard to the development of undesirable side-effects in a group of 53 patients attending a hypertension clinic. The combination of alpha-methyldopa and chlorthalidone produced the highest incidence of side-effects. Weakness and impotence were most frequently encountered. In contrast, the combination of chlorthalidone, hydralazine and propranolol, and chlorthalidone alone, produced fewer side-effects. It is recommended that alpha-methyldopa should not be a first choice in the treatment of hypertension.
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PMID:Some side-effects of alpha-methyldopa. 122 74

Since Fincher reported a case with arteriovenous fistula between the external carotid artery and dural sinus, many type of cases have been reported. On the other hand, so called the external carotid avernous fistula has been recognized less 20 cases in literature. We have observed three additional cases of dural arteriovenous shunts in the region of the cavernous sinus. Case 1. A 52 year old woman had suffered from left side sever headache. There was weakness of the left extraocular muscles and left ptosis. A bruit was heard over the left orbit. She was treated for hypertension since 38 year old. And she has no history of recent trauma. Selective internal and external carotid angiographies showed the bilateral external carotid cavernous sinus fistula. No operative treatment was performed in this case and the symptomes disappeared with decrease of blood pressure. Case 2. A 50 year old man came to this clinic with chief complaints of right ptosis, diplopia and headache. He was treated for diabetes mellitus and hypertension for six month...
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PMID:[Three cases of spontaneous bilateral external carotid-cavernous sinus fistula (dural arteriovenous shunts in the region of the cavernous sinus) (author's transl)]. 123 13

Spontaneous perforation of colon is a rare disease and physiopathologic basis are actually unknown. Surgical treatment is standardized and post-operative survival is over 60%, morbidity and mortality rate depends on peritoneal contamination. In 1984 J.A. Berry classified spontaneous perforations into "stercoral" and "idiopathic" perforations on the basis of etiopathogenetical causes of lesions. Anatomopathologically stercoral and idiopathic perforations present different characteristics. Macroscopically stercoral perforation origines from an ulcerative lesion often situated on the sigmoid colon or rectum. Microscopical characteristic is represented by a superficial ischemic necrosis of mucosa (caused by fecalomas) followed by an extension to sub-mucosa and muscular tissues of the colonic wall. On the contrary, "idiopathic perforation", frequently situated on the sigma, is a linear laceration of anti-mesenteric side of the colon without pathologic modifications of the colon. Physiopathologic basis of spontaneous perforations of the colon were also discussed. Stercoral perforation is often a consequence of chronic constipation. Instead, two hypoteses are advanced as regards idiopathic perforations. S.V. Kessing e coll. (1962) hypotized a parietal suffering caused by ischemia of anti-mesenteric side of the colon, depending on ipoperfusion of colonic tissues; they also hypotized a constitutional weakness of colonic wall as a cause of idiopathic perforation. Others hypotized an intraluminal hypertension caused by intestinal hernias (J.W. Eadie, 1955; K. Cronin, 1959), rectal prolapse or abnormal depth of Douglas cavity (D.C. Lyon, 1969). In these cases, lesion is caused by contraction of abdominal muscles during defecation, which presses colonic wall during distension.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Spontaneous perforations of the large intestine]. 129 Mar 69

Case 1, a 60-year-old man and case 2, a 70-year-old man had several year history of chronic renal failure with hypertension and hyperlipidemia due to diabetes mellitus. Treatment of hyperlipidemia was started by oral bezafibrate intake 1,200 mg per day in case 1 and 400 mg per day in case 2 respectively. Three to fourteen days later, both patients noticed symmetrical muscle pain and weakness. Then the symptoms worsened and they were hospitalized. At the time of admission, both patients revealed weakness in the proximal muscles of their upper and lower limbs and the serum creatine kinase and myoglobin levels were remarkably elevated. Myoglobinuria was also noted. Routine light microscopic examination of biopsied quadriceps femoris muscles of two patients showed scattered necrotic muscle fibers, some of which were under phagocytosis. The symptoms of the patients were immediately resolved after the drug was discontinued. Serum concentration of bezafibrate was remarkably elevated during treatment. Thus the diagnosis was established as having bezafibrate induced myopathy and, as far as we know, this is the first report of bezafibrate induced myopathy in Japan. On the basis of the above description, bezafibrate may induce muscle damage if dose is excess over the renal capacity. Extreme caution is warranted when the patient is placed on bezafibrate and has renal dysfunction. Strict dose adjustment is necessary in taking account of renal function to avoid muscle damage including rhabdomyolysis.
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PMID:[Bezafibrate myopathy in two patients with chronic renal failure]. 129 Nov 64

A 52-year-old woman was admitted to our hospital for further examination of central obesity, hypertension and hirsutism suggesting Cushing's syndrome. Hirsutism had been remarkable for two years, and muscle weakness of the lower extremities gradually developed during the past year. CT scan revealed a tumor in the left adrenal gland which was 1 cm in diameter, round, well-circumscribed, homogeneous and not enhanced. Endocrine data disclosed increased urinary 17-OHCS (11.5-16.4 mg/day) and elevated plasma ACTH (125 pg/ml) and cortisol (19 micrograms/dl) with a lack of diurnal rhythm. Administration of the single-dose dexamethasone (1mg) did not suppress plasma cortisol. However, consecutive administration of either 2mg or 8mg of dexamethasone for 2 days suppressed both plasma cortisol and urinary 17-OHCS. Administration of metyrapone raised both urinary 17-OHCS and plasma ACTH levels. Rapid ACTH test resulted in a hyperresponse of plasma cortisol. CRF injection raised plasma ACTH and cortisol. Bilateral adrenal glands were well demonstrated by 19-iodocholesterol (I-131) scintigraphy during the administration of dexamethasone. MRI with Gd-contrast revealed a microadenoma in the sella turcica. With the diagnosis of Cushing's disease, the microadenoma was removed by the transsphenoidal approach and adrenal function was normalized. However, the left adrenal tumor remained on CT scan but was not demonstrated by scintigraphy. These findings indicate that this is a very rare case of Cushing's disease which was associated with an unilateral non-functioning adrenal tumor.
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PMID:[A case of Cushing's disease associated with a non-functioning adrenal tumor]. 129 36

Loop diuretics (furosemide, bumetanide, muzolimine, piretamide, torasemide) are powerful drugs capable of increasing sodium excretion and urine output even when renal function is markedly impaired. In patients with chronic renal failure (CRF), loop diuretics may be given to control extracellular volume (ECV) expansion responsible for hypertension. But the use of loop diuretics in chronic uremia is mostly helpful when impaired renal function co-exists with nephrotic syndrome or chronic heart failure. Due to their powerful natriuretic activity, loop diuretics have been administered also to patients on maintenance dialysis to reduce the frequency of and/or to curtail dialysis time. In this condition, however, the increase of sodium and water excretion is very limited; whereas the use of diuretics in high dosage is not devoid of risky side effects such as neurologic lesions, cramps, deafness, weakness, muscle pain. In some patients with oliguric form of acute renal failure (ARF), loop diuretics increase sodium excretion and urine output. They do not affect the mortality rate for ARF but may facilitate the treatment of patients by reverting an oliguric form to a non-oliguric form of ARF.
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PMID:The place of loop diuretics in the treatment of acute and chronic renal failure. 129 11


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