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

Venous ulceration is the result of progressive chronic venous insufficiency, the pathophysiology of which is complex and incompletely understood. Ambulatory venous hypertension in this disease has been well-documented; however, relatively little attention has been directed toward other parameters of venous function. This study evaluates a spectrum of hemodynamic variables and the degree to which they are altered in patients with venous ulceration, and correlates ambulatory venous pressure (AVP) with the noninvasive estimate of this parameter. Air-plethysmography was used to evaluate 36 ulcerated extremities from 30 patients with chronic venous disease and 80 asymptomatic extremities from 54 patients. This technique measures the functional venous volume (VV), assesses valvular function [Venous Filling Index (VFI)], evaluates the efficiency of the calf muscle-pump [Ejection Fraction (EF)], and provides an estimation of ambulatory venous pressure [Residual Volume Fraction (RVF)]. In addition, AVP's were recorded in 13 asymptomatic extremities from 10 patients and 16 ulcerated extremities from 14 patients with chronic venous disease. Significant differences existed between the two groups for all of the hemodynamic parameters. Ulcerated extremities had greater venous volumes, displayed marked deterioration in valvular competence and calf muscle-pump function, and showed significant ambulatory venous hypertension compared to the asymptomatic group. Additionally, the relationship between RVF and AVP appeared linear, with a correlation coefficient of 0.87. Air-plethysmography currently provides the most complete evaluation of venous hemodynamics and should improve our understanding of the pathophysiology of chronic-venous disease.
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PMID:The hemodynamics of venous ulceration. 154 69

This discussion reviews drugs that affect the eye, including antihyperglycemic agents; corticosteroids; antirheumatic drugs (quinolines, indomethacin, and allopurinol); psychiatric drugs (phenothiazine, thioridazine, and chlorpromazine); drugs used in cardiology (practolol, amiodarone, and digitalis gylcosides); drugs implicated in optic neuritis and atrophy, drugs with an anticholinergic action; oral contraceptives (OCs); and topical drugs and systemic effects. Refractive changes, either myopic or hypermetropic, can occur as a result of hyperglycemia, and variation in vision is sometimes a presenting symptom in diabetes mellitus. If it causes a change in the refraction, treatment of hyperglycemia almost always produces a temporary hypermetropia. A return to the original refractive state often takes weeks, sometimes months. There is some evidence that patients adequately treated with insulin improve more rapidly than those taking oral medication. Such patients always should be referred for opthalmological evaluation as other factors might be responsible, but it might not be possible to order the appropriate spectacle correction for some time. The most important ocular side effect of the systemic adiministration of corticosteroids is the formation of a posterior subcapsular cataract. Glaucoma also can result from corticosteroids, most often when they are applied topically. Corticosteroids have been implicated in the production of benign intracranial hypertension, which is paradoxical because they also are used in its treatment. The most important side effect of drugs such as chloroquine and hydroxychloroquine is an almost always irreversible maculopathy with resultant loss of central vision. Corneal and retinal changes similar to those caused by the quinolines have been reported with indomethacin, but there is some question about a cause and effect relationship. The National Registry of Drug Induced Ocular Side Effects in the US published 30 case histories of cataract suspected to be induced by allopurinol; numerous additional cases have been reported to the registry since. Phenothiazine, with an estimated 3% incidence of side effects, appears to be safer than other antipsychotic drugs, but the rate of ocular effects increases with the duration of therapy. Thioridazine and chlorpromazine are known to cause lens deposits and pigmentary retinopathy. There is a significantly high prevalence of thrombophlebitis and pseudotumor cerebri among women who use OCs and thrombotic retinal vascular disease, such as retinal vein occulsion, might be linked with them. It also is probable that, because of altered hydration of the cornea, there is a decreased tolerance to contact lenses.
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PMID:Drugs affecting the eye. 286 12

Use of converting-enzyme inhibitors in patients with hypertension and bilateral renal artery stenosis or renal artery stenosis in a single kidney may be complicated by acute renal failure (ARF). The aim of this work was to find a simple test to predict this accident. PAH clearance (CPAH), Inuline clearance (CIn) and Glomerular Filtration Fraction (GFF) were measured before and three hours after a single oral dose of Captopril (50 mg) in 7 hypertensive patients (sodium intake = 6 g/24 h). All these patients presented significant stenosis (greater than 60%) of the artery of a transplanted kidney (5), of a single kidney (1) or a bilateral renal artery stenosis (1). During the following three days, 50 mg captopril was given twice a day. ARF with creatinine serum level higher than 300 mumoles/l was seen in 4 patients (Group II); in 3 patients (Group I) creatinine serum level didn't change. Values measured before the single dose of captopril and variations after three hours are reported in the table: (Table: see text). Before captopril, in Group II CPAH and CIn are lower and GFF is higher, but these is not significant difference between the two groups. After Captopril CIn and GFF are significantly decreased in Group II (29.1 and 36.6% vs 7.8 and 10%). These results allow two conclusions: 1) Basal values of Glomerular Filtration Rate plasma flow and filtration fraction are not predictive parameters for acute renal failure after captopril therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Predictability of post-captopril acute renal failure in hypertension with renal artery stenosis of a single kidney or bilateral stenosis]. 309 6

We isolated renin granules from cadaver kidneys using discontinuous sucrose density gradient centrifugation, and investigated the storage form of the renin from these granules. Approximately 23% of the total renin activity in the original homogenate was obtained from the surface phase between 1.6 and 1.7 M sucrose (Fraction 6). Granule renin extracted from the granules in Fraction 6 was separated into active and inactive renin using pepstatin affinity chromatography. Only the active renin had an affinity for pepstatin. The inactive renin, albeit activated by trypsin, was little activated by acidification. The proportion of inactive renin was about 25% of the total granule renin (active renin + inactive renin). Trypsin concentrations over 10 micrograms/ml resulted in a decrease in the renin activity of the trypsin-activated renin, but the enzymatic activity of active renin was decreased by trypsin. With gel filtration, the inactive renin revealed a single peak, and the molecular weight (MW) was 48,000. The active renin had a MW of 44,000. The inactive renin could be activated by trypsin without an apparent change in molecular weight.
Hypertension
PMID:The storage form of human renal renin. 704 Feb 25

This study investigates whether plasma extracts previously demonstrated to have natriuretic and antinatriferic activity have effects on vascular reactivity of rat cremaster arterioles. Plasma from hydropenic and saline-loaded dogs was subjected to Diafiltration, and eluted on a strong cation exchange column (SCX). The effects of intraarterial injections of various column fractions on constrictor responses to repeated injections of 33.3 ng of norepinephrine (NE) were used to indicate changes in vascular responsiveness in third order cremaster arterioles. SCX fraction I (void volume) from saline-loaded dogs (FI-S) caused an increase in constrictor response to NE of 101%. Increased vascular responsiveness peaked at 40 minutes and remained significantly elevated (p less than 0.05) for 130 minutes. Fraction I from plasma of hydropenic dogs (FI-H) and fraction III from plasma of saline-loaded dogs (FIII-S) did not increase vascular responsiveness to NE. FI-S shifted the dose response curves for NE, arginine vasopressin, and angiotensin II parallel and to the left relative to control by a factor of 3.05-, 2.95-, and 5.63-fold, respectively, at the 50% constrictor dose. Systemic injections of FI-S, but not FI-H, caused a 10 mm Hg rise in blood pressure at 50 minutes, and blood pressure was significantly elevated for 30 to 90 minutes after injection (p less than 0.01). These data demonstrate a vascular-sensitizing factor in FI-S. The factor appears in the same chromatographic fraction previously demonstrated to contain natriuretic, antinatriferic, and digoxin-like activity. The correlation of these activities with salt loading suggests they are due to the same substance, which may be the putative natriuretic hormone.
Hypertension
PMID:Evidence for a vascular sensitizing factor in plasma of saline-loaded dogs. 720 78

Previous work has shown that parathyroidectomy lessens hypertension if performed on young SHR (5-6 weeks of age). In this work, ionic changes (Na+, K+, Ca2+, Mg2+) were studied in heart and aorta during a chronic experimentation. In the heart, atria and ventricle, Ca2+ content was significantly diminished, 15 days after parathyroidectomy. Nevertheless after 8 months, this difference did not remain. A correlation between Ca2+ content and heart rate (lessened immediately after parathyroidectomy) is suggested. In the aorta, parathyroidectomy did not change Na+, K+, Ca2+ and Mg2+ content after 15 days. At the opposite Mg2+ content was significantly lessened after 8 months (-33 p. 100, p less than 0,001). Calcium content in the Lanthanum Resistant Fraction was also depressed significantly at this time. Variations in heart and aorta ionic contents are discussed in relation with hypertensive development.
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PMID:[Parathyroidectomy and calcium exchange in cardiovascular tissue in the SHR rat]. 732 10

The increase in the incidence of Craneoencephalic Trauma takes us to the search of new techniques such as the calculus of the Fraction of Oxygen Brain Extraction, determined by the channelling of the jugular bulb and later extraction of cerebral venous gasometries simultaneously to peripheric arterial gasometries. The aim of our work is to let Nursing know its handling as well as the diagnostic and therapeutical advantages and their associated complications. We conclude that this technique shows important advantages in the handling of endocraneal hypertension without being a work overload for Nursing. We suggest a performing guide to avoid the most common complications during its maintainance.
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PMID:[Analysis and handling of the jugular catheter in the determination of cerebral anoxia]. 749 80

Clinical data, MR-scans, time-dose fractionation schemes and neuropathologic findings of two cases of delayed radiation myelopathy (DRM), are presented. Both patients, a 72-year-old diabetic woman with cervical lymphnode metastasis from a squamous cell carcinoma and a 46-year-old woman with tonsillar carcinoma, developed paraparesis followed by quadriplegia, at 7 and at 10 months following radiation. The spinal cord received 46 and 49 Gy. (Fraction dose 2.25 Gy and 2.0 Gy, 4 times/week). Serial MR-scans showed spinal cord enlargement and focally increased signal intensity (T1-gd). The second patient survived and stabilized following therapy with coumarins. The first patient died 13 months after radiotherapy. At autopsy necrosis, local calcium deposits, lipid macrophages and swollen astrocytes were observed in the white matter. There was slight hyalinosis of the intramedullary vessel walls. We conclude that serial MRI may be helpful to distinguish DRM from other causes of spinal cord injury. DRM may occur at a total dose less than 50 Gy. Additional risk factors (diabetes, hypertension), and fraction doses above 2 Gy contribute to the development of DRM.
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PMID:Delayed radiation myelopathy: serial MR-imaging and pathology. 883 1

The paper presents the results obtained upon examination of inpatients with various types of biliary dyskinesia. The examination included: fraction chromatic duodenal intubation, stepwise manometry, cholecystography, ultrasound investigation of the liver, gall bladder, biochemical tests of the bile. Fraction duodenal intubation discovered gall bladder dysfunction. The manometry was necessary for diagnosis of duodenal hypertension. X-ray revealed primary defects in gall bladder motility. It is concluded that the diagnosis of functional disorders implies combined clinical and instrumental modalities.
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PMID:[The role of different investigations in diagnosis of functional disorders of the biliary system]. 912 Oct 86

In eight young healthy subjects on a 240 mM Na diet mean arterial pressure (MAP), renal hemodynamics and renal handling of Na and exogenous Li were measured at baseline and during acute nitric oxide (NO) inhibition with 90-minute infusion of 3.0 microg/kg x min(-1) of N(G)-L-arginine methyl ester (L-NAME). The same experiment was repeated with infusion of 50 microg/kg x min(-1) of DA2 receptor blocker L-Sulpiride (L-SULP) alone and, finally, with simultaneous infusion of both L-NAME and L-SULP. L-SULP alone did not elicit any effect. L-NAME alone produced no changes in MAP from 0 to 45 minutes (P1) and a 6.6% increase at 45 to 90 minutes (P2) of infusion. Effective renal plasma flow (ERPF, PAH clearance) and glomerular filtration rate (GFR, inulin clearance) declined by 10.2% and 7.6%, respectively, in P1 and by 15.3% and 11.5% in P2. Filtration Fraction (FF) rose by 4.2% in P2. Calculated renal vascular resistance (RVR) increased by 13.0% to 25.6%. Fractional excretion of Na (FENa) and Li (FELi) fell by 20.0% and by 16.0%, respectively, in P1 and by 40.0% and 25.1% in P2. All these variations, except for MAP and GFR, were significantly greater during coinfusion of L-NAME and L-SULP. ERPF declined by 17.8% to 33.7%, FENa by 26.7% to 53.3%, FELi by 13.8% to 34.8%, while RVR rose by 22.5% to 59.1% and FF by 10.1% to 29.3%. The present data confirm that NO blockade with low-dose systemic infusion of L-NAME produces renal vasoconstriction, reduced GFR with slight increase in FF, and enhanced tubular Li, and Na reabsorption. Since increase in RVR and FF and decrease in FENa and FELi are markedly potentiated by the simultaneous infusion of DA2 blocker L-SULP, which exerts no effects by itself, we suggest that DA interactions between DA system at the level of DA2 receptors and basal NO production play a physiological role in the regulation of renal function in humans.
Hypertension 1998 Jan
PMID:Dopamine-2 receptor blockade potentiates the renal effects of nitric oxide inhibition in humans. 945 16


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