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)

Take special care when recommending a product to people with a pre-existing medical condition (e.g., high blood pressure, stomach problems, asthma). It is safer to advise them to consult their pharmacist or doctor if there is a possibility of adverse drug interaction. Be aware of the possibility of overdosage (e.g., some patients take a large number of remedies simultaneously and may unwittingly be taking too much paracetamol, aspirin or ibuprofen). Green or yellow sputum suggests the patient has a bacterial infection in addition to a cold, and consulting a doctor is advisable. Enquire whether a cough is productive ("loose" or "chesty") or non-productive "dry, "tricky" or "irritating") so that you can advise on appropriate product. Productive coughs are helped by expectorants. Dry coughs are helped by suppressants. Cough preparations often contain antihistamine which may cause drowsiness, so be aware of this when advising a patient. For young children a paediatric formulation is advisable. Many of the main brands of cough and cold medicines have infant or junior varieties. Vapour products, often using substances like menthol placed on a tissue near the child but out of reach, can be very effective for blocked noses. Sugar-free preparations should be used for children (and adults) where possible, to avoid the risk of tooth decay. If patients suffer from repeated colds and coughs, and complain of feeling "run down", questioning may reveal that they have a poor diet. In that case, recommending a vitamin supplement or tonic and advice on a healthier diet may be appropriate. A persistent cough should receive medical attention.
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PMID:Coughs and colds: advising on what to take. 934 70

The study examined the 10-year outcome in a cohort of 227 unselected, consecutive patients (age 58+/-10 years) undergoing coronary balloon angioplasty between 1984 and 1986 and followed in a single cardiac center (Lady Davis Carmel Medical Center registry). In particular, we sought to identify the relative importance of the systemic risk factors diabetes and hypertension and the extent of coronary disease as opposed to procedure-related technical variables, the immediate success of the procedure, or completeness of revascularization. By life-table analysis (99% follow-up), 94% of the patients were alive at 5 years, and 77% at 10 years after angioplasty. Ten-year survival was reduced in patients with diabetes mellitus (59% vs 83%, p = 0.0008), in patients with previous myocardial infarction (68% vs 85%, p = 0.01), in patients with ejection fraction <50% (55% vs 82%, p = 0.005), and in patients with 3-vessel disease (58% vs 84% and 86% for 1- and 2-vessel disease, respectively, p = 0.04). Diabetes mellitus was the major independent predictor of poor survival (adjusted odds ratio 3.1, 95% confidence interval 1.55 to 6.19, p = 0.001). Survival at 10 years was identical in 199 patients in whom angioplasty was complete and in 25 in whom the balloon catheter did not cross the lesion, although bypass surgery was more frequent in the latter group (45% vs 21%, p = 0.001). Incomplete revascularization did not predict poor survival (72% vs 79% with complete angioplasty, p = NS). Event-free survival at 10 years for the whole group was 29%, and 49% of patients survived with no event other than a single repeat angioplasty procedure. Multivessel disease, hypertension, and diabetes mellitus were independent predictors of decreased event-free survival, but incomplete revascularization was not. Thus, long-term outcome after coronary balloon angioplasty was related to diabetes mellitus, systemic hypertension, and extent of coronary disease, but not to the immediate success of the procedure or completeness of revascularization.
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PMID:Importance of diabetes mellitus and systemic hypertension rather than completeness of revascularization in determining long-term outcome after coronary balloon angioplasty (the LDCMC registry). Lady Davis Carmel Medical Center. 973 77

The association between coagulation abnormalities and pregnancy outcome was investigated in a case-control study conducted at Lady Hardings Medical College and Associated Hospitals in New Delhi, India, in 1991-92. Enrolled were 30 neonates born to mothers with pregnancy-induced hypertension (PIH) and 30 infants of normotensive mothers. Compared with control infants, infants of mothers with PIH had significantly elevated levels of prothrombin time (PT), partial thromboplastin time with kaolin (PTTK), thrombin time (TT), and fibrinogen and fibrinogen degradation products (FDP) and significantly reduced platelet counts and fibrinogen. PTTK and TT were significantly higher in neonates born to mothers with hypertension of more than 1 month's duration, but the difference in PT, fibrinogen, and platelet count was not significant. Also observed was a significant correlation between decreasing gestational age and derangement in all coagulation parameters and between decreasing birth weight and an increase in FDP level. The incidence of disseminated intravascular coagulation was higher in preterm than term neonates. 43.3% of neonates required admission to the neonatal intensive care unit and the perinatal mortality rate was 3.3%.
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PMID:Correlation of coagulation abnormalities with clinical outcome in neonates of mothers with pregnancy induced hypertension. 983 64

Quality and number of subjects in blinded controlled clinical trials about the nutrition and dietary supplements discussed here is variable. Glucosamine sulfate and chondroitin sulfate have sufficient controlled trials to warrant their use in osteoarthritis, having less side effects than currently used nonsteroidal anti-inflammatory drugs, and are the only treatment shown to prevent progression of the disease. Dietary supplements of ephedrine plus caffeine for weight loss (weight loss being the current first line recommendation of physicians for osteoporosis) show some promise, but are not sufficient in number of study subjects. Phenylpropanolamine is proven successful in weight loss. Both ephedrine and phenylpropanolamine have resulted in deaths and hence are worrisome [table: see text] as an over-the-counter dietary supplement. Other commonly used weight loss supplements like Cola acuminata, dwarf elder, Yohimbine, and Garcinia camborgia are either lacking controlled clinical trials, or in the case of the last two supplements, have clinical trials showing lack of effectiveness (although Garcinia has been successful in trials as part of a mixture with other substances, it is unclear if it was a necessary part of the mixture). Safety of these weight loss supplements is unknown. Chromium as a body building supplement for athletes appears to have no efficacy. Creatine may help more in weight lifting than sprinting, but insufficient study subjects and safety information make more studies necessary. Carbohydrate loading is used commonly before endurance competitions, but may be underused as it may be beneficial for other sport performances. Supplements for muscle injury or cramps have had too few studies to determine efficacy. Although proper rehydration with fluids and electrolytes is necessary, a paucity of actual studies to maximize prophylactic treatment for exercise induced cramping still exists. Nutritional supplements for cardiovascular disorders are generally geared to prevention. The United States Department of Agriculture has good recommendations to prevent atherosclerosis; a stricter version by Ornish was shown to reverse coronary heart disease, and the low meat, high fruit, and vegetable DASH diet has been found to decrease hypertension. The epidemiologic studies of hyperhomocysteinemia are impressive enough to give folic acid (or vitamin B6 or B12) supplements to those with elevated homocysteine levels and test patients who have a history of atherosclerotic disease, but no controlled clinical trials have been completed. Soluble fiber has several positive studies in reduction of cholesterol levels and generally is accepted. The data on vitamin E are the most confusing. This vitamin was not helpful in cerebrovascular prevention in China and not helpful at relatively small doses (50 mg) in the United States or Finland against major coronary events. Levels of 400 mg appeared to decrease cardiovascular disease in the United States in studies based on reports by patients and in one large clinical trial. Vitamin E also was successful in prevention of restenosis after PTCA in one clinical trial. Both of these clinical trials need to be repeated in other developed country populations. Some nutritional and dietary supplements are justifiably useful at this point in time. Several meet the criteria of a late Phase 3 FDA clinical trial (where it would be released for public use), but many dietary supplements have insufficient numbers of studies. Some deaths also have occurred with some supplements. If these supplements were required to undergo clinical trials necessary for a new drug by the FDA, they would not be released yet to the public. Several nontoxic supplements appear promising, though need further study. Because they have essentially no toxicity (such as folic acid with B12, soluble fiber, and vitamin E) and may have efficacy, some of these supplementations may be useful now, without randomized clinical trials.
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PMID:Nutrition and dietary supplements. 1051 85

Glomerular hypertension and hyperglycemia are major determinants of diabetic nephropathy. We sought to identify the mechanisms whereby stretch-induced activation of mesangial cell extracellular signal-regulated kinase 1 and 2 (ERK1/ERK2) is enhanced in high glucose (HG). Mesangial cells cultured on fibronectin Flex I plates in normal glucose (NG; 5.6 mM) or HG (30 mM), were stretched by 15% elongation at 60 cycles/min for up to 60 min. In HG, a 5-min stretch increased ERK1/ERK2 phosphorylation by 6.4 +/- 0.4/4.3 +/- 0.3-fold (P < 0.05 vs. NG stretch). In contrast, p38 phosphorylation was increased identically by stretch in NG and HG. Unlike many effects of HG, augmentation of ERK activity by HG was not dependent on protein kinase C (PKC) as indicated by downregulation of PKC with 24-h phorbol ester or inhibition with bisindolylmaleimide IV. In both NG and HG, pretreatment with arginine-glycine-aspartic acid peptide (0.5 mg/ml) to inhibit integrin binding or with cytochalasin D (100 ng/ml) to disassemble filamentous (F) actin, significantly reduced phosphorylation of ERK1/ERK2 and p38. To determine whether the rate of mitogen-activated protein kinase dephosphorylation is affected by HG, cellular kinase activity was inhibited by depleting ATP. Post-ATP depletion, phosphorylation of ERK1/ERK2 was reduced to 36 +/- 9/51 +/- 14% vs. 9 +/- 5/7 +/- 6% in NG (P < 0.05, n = 5). Thus stretch-induced ERK1/ERK2 and p38 activation in both NG and HG is beta(1)-integrin and F-actin dependent. Stretch-induced ERK1/ERK2 is enhanced in high glucose by diminished dephosphorylation, suggesting reduced phosphatase activity in the diabetic milieu. Enhanced mesangial cell ERK1/ERK2 signaling in response to the combined effects of mechanical stretch and HG may contribute to the pathogenesis of diabetic nephropathy.
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PMID:Stretch-induced mesangial cell ERK1/ERK2 activation is enhanced in high glucose by decreased dephosphorylation. 1099 19

The tight junction of pancreatic exocrine cells is thought to regulate paracellular permeability, and is a possible reflux route of pancreatic juice into the blood flow. Morphological changes in the tight junction of canine pancreatic acinar cells following intraductal hypertension and secretin stimulation were morphometrically analyzed to obtain evidence of the control of the paracellular reflux. Pancreatic tissues obtained from 25 dogs after intraductal hypertension, 3 dogs after secretin stimulation, and 5 control dogs were studied. Intraductal pressure was either 20 cmH2O, 30 cmH2O, or 40 cmH2O. Freeze fracture replicas of these pancreatic tissues were observed by electron microscopy. Tight junctions were classified into six morphometric types. Reticular type, parallel type, and mixed type comprised the common types predominantly found in all groups, and three special types were found, infrequently, only after intraductal hypertension. The percentages of the common types were significantly different between the groups. The areas of the tight junctions, and other morphometric parameters, were significantly less after 20 cmH2O intraductal hypertension and secretin stimulation than in the controls. However, these findings after 30 cmH2O or 40 cmH2O intraductal hypertension did not differ from those in the controls. The areas of the three special types of tight junctions were larger than those of the common types. These results suggest that the tight junction of pancreatic exocrine cells is a morphologically dynamic structure that is altered by the extent of intraductal hypertension, and support the hypothesis that paracellular permeability is the mechanism of the reflux of pancreatic juice.
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PMID:The tight junction of pancreatic exocrine cells is a morphometrically dynamic structure altered by intraductal hypertension. 1106 20

Intercellular tight junctions play a role in the reflux of the exocrine pancreatic juice. Tight junctions of the main pancreatic duct were electron-microscopically compared between dogs with intraductal hypertension and controls, using a freeze-fracture technique and morphometrical analysis. Intraductal hypertension was created in seven dogs. Intraductal pressure was 20 cm H(2)O in two dogs, 30 cm H(2)O in two dogs, and 40 cm H(2)O in three dogs. Two dogs were killed as a control without any procedures. Freeze-fracture replicas were observed with an electron microscope. Tight junctions found in the replicas were morphometrically analyzed regarding the complexity, depth of strands, number of strands, and number of anastomoses. Parallel type and reticular type were recognized as two types of tight-junction complexity. The number of strands, the maximum and minimum depths, and the number of anastomoses were significantly higher in the reticular type than in the parallel type. The parallel type was predominant in the intraductal hypertension group and controls, and the parallel type was increased in the dogs with 20 cm H(2)O intraductal pressure. Morphometrical comparison between the intraductal hypertension groups and controls showed that the number of strands, the number of anastomoses, and the minimum and maximum depths of strands were significantly decreased only in the dogs with 20 cm H(2)O intraductal pressure. Intraductal hypertension may affect paracellular permeability through alterations in the number of strands and complexity in tight junctions of the main pancreatic duct epithelial cells.
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PMID:The tight junction of main pancreatic duct epithelial cells is a morphometrically dynamic structure altered by intraductal hypertension. 1235 35

Leaf protein containing approximately 50% rubisco (ribulose bisphosphate carboxylase/oxygenase) was obtained from fresh spinach leaf with the use of a simple extraction method. Pepsin and pepsin-pancreatin digests of spinach leaf protein have potent angiotensin-I converting enzyme inhibitory properties with IC(50) values of 56 and 120 microg/mL, respectively. Both digests of leaf protein have antihypertensive effects after oral administration to spontaneously hypertensive rats (SHR) with minimum effective doses of 0.25 and 0.5 g/kg, respectively. The maximum antihypertensive effect for the pepsin digest was observed 4 h after oral administration, while for the pepsin-pancreatin digest, the maximum effect was observed 2 h after oral administration. Undigested spinach leaf protein did not exert any significant antihypertensive effect after oral administration to SHR at doses of 0.5 and 1 g/kg. Obtained results show that the pepsin digest of leaf protein may be useful in treatment of hypertension.
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PMID:Antihypertensive properties of spinach leaf protein digests. 1508 Jun 24

Mainstream preventive interventions often fail to reach poor populations with a high risk of cardiovascular diseases (CVDs) in Pakistan. A community-based CVD primary prevention project aimed at developing approaches to reduce risk factors in such populations was established by Heartfile in collaboration with the National Rural Support Program in the district of Lodhran. The project implemented a range of activities integrated with existing social and health service mechanisms during a three year intervention period 2000/01-03/04. These were targeted in 4 key settings: community health education, mass media interventions, training of health professionals and health education through Lady Health Workers. The project received support from the Department for International Development, U.K. At the community level, a pre-test-post-test quasi-experimental design was used for examining project outcomes related to the community component of the intervention. Pre and post-intervention (training) evaluations were conducted involving all health care providers in randomly selected workshops in order to determine baseline levels of knowledge and the impact of training on knowledge level. In order to assess practices of physician and non-physician health care providers patient interviews, with control comparisons were conducted at each health care facility. Significant positive changes were observed in knowledge levels at a community level in the district of intervention compared with baseline knowledge levels particularly in relation to a heart healthy diet, beneficial level of physical activity, the causes of high blood pressure and heart attack and the effects of high blood pressure and active and passive smoking on health. Significant changes in behaviors at a practice level were not shown in the district of intervention. However the project played a critical role in spurring national action for the prevention and control of non-communicable diseases and introducing sustainable public health interventions for poor communities in Pakistan.
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PMID:The Heartfile Lodhran CVD prevention project--end of project evaluation. 1752 20

Various regions of interest (ROI) are used to semiquantify lung-to-heart (LHR) and liver-to-heart uptake ratios (LH) in myocardial perfusion imaging (MPI) with technetium-99m analogues. However, in bibliography, these ratios are correlated to a moderate number of clinicolaboratory indices for coronary artery disease (CAD). The aim of this study was: a) to find the best ROI positioning among one hepatic and multiple pulmonary ROI used to semiquantify technetium-99m tetrofosmin, single photon emission tomography myocardial perfusion scan (99mTc-TF SPET), LHR and LH ratios, b) to compare the diagnostic potential of the better selected ROI in correlation with: SPET scores, rest left verticular ejection fraction, five risk factors (RF) of CAD, (smoking, diabetes mellitus, hypertension, hyperlipemia and abnormal exercise-ECG) and coronary angiography (CAR), regarding the latter as the "gold standard" for the severity of CAD and c) to study the multivariate correlations among all the aforementioned diagnostic parameters, so that to rank them according their ability to screen and stratify the existence and the severity of CAD. We have studied 73 patients (54 men and 19 women, mean aged 58.5+/-10.3 and 59.8+/-8.7 years respectively), who underwent stress-rest 99mTc-TF SPET scan. All patients were classified according the following criteria: (a) CAR criteria: Group I: 34 patients with low likelihood of CAD, Group II: 19 patients with moderate CAD, Group III: 7 patients with severe CAD, Group IV: 13 patients with myocardial infarction. (b) RF criteria: Group A: 24 patients with 0-1 RF and Group B: 49 patients with >or=2 RF. (c) LVEF criteria: Group 0: 25 patients with LVEF>50, Group 1: 31 patients with LVEF=40-50, and Group 2: 4 patients with LVEF<40. (d) Regarding the existence (yes/no) of each RF (10 more subgroups). All patients underwent anterior planar imaging before the SPET scan acquisition. ROIs were placed on the following regions: Over the whole myocardium, peripherally, around the upper part of the previous ROI, on the lower right lung field, encompassing the whole right lung, on the middle mediastinum and around the upper part of the liver. Our results by multivariate regression analysis, showed that in 99mTc-TF SPET scan a modified technique of a peripheral ROI, drawn around the upper part of the heart, should be proposed as the optimal method for the calculation of LHR. This index, with normal cutoff <or= 0.48 had only a moderate clinical value in discriminating healthy people from patients with CAD (sensitivity=49%, specificity=65%, PPV=61%, NPV=52%, accuracy=56%) and insignificant incremental value over SPET scores (sensitivity of the SPET scores alone for the detection of the healthy people=78% and for CAD=91%, while combined with the LHR, these values turned to 74% and 94% respectively, (x2=0.12-0.19). The optimal diagnostic performance of LHR was however seen in the stratification of the severity of the disease in patients with a history of known CAD (sensitivity=86%, specificity=79%, PPV=60%, NPV=94%, accuracy=81%). Based on CAR, the diagnostic potential of all methods, ranks in the following decreasing order: SPET scores, rest LVEF and LHR and the existence of >or=2 RF. Due to the large variability of the hepatic uptake among the various groups, the diagnostic potential of LH ratio was not important.
Hell J Nucl Med
PMID:[Semiquantification of pulmonary and hepatic uptake of technetium-99m-tetrofosmin in myocardial perfusion imaging using multiple regions of interest. Multifactorial correlation]. 1768 94


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