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

Intraocular pressure (IOP) was measured before and 6, 24, 48 and 72 h after extracapsular cataract extraction with implantation of a posterior chambers lens in 3 groups of patients. Group I (30 patients): Sodium hyaluronate (Healon) was used during anterior capsulotomy and lens implantation and was aspirated at the end of surgery. Group II (22 patients): Healon as in group I + 500 mg acetazolamide at the end of surgery. Group III (17 patients): BSS and/or air was used instead of Healon during surgery. In all groups statistically significant rises in IOP after 6 h were followed by significant falls in the remaining post-operative period. The rise and subsequent fall in IOP was significantly greater in group I than in group III. Acetazolamide in group II did not prevent excessive rises in IOP. Aspiration probably shortens the period of Healon-induced hypertension. We recommend a meticulous aspiration of Healon at the end of surgery.
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PMID:Intraocular pressure in the first days after implantation of posterior chamber lenses with the use of sodium hyaluronate (Healon). 352 3

A series of 49 cases with cerebral venous thrombosis (CVT) and a series of 17 cases with benign intracranial hypertension (BIH) without CVT, both observed between 1973 and 1983, have been compared. Papilledema has been found in 100% of BIH and 28.5% of CVT, visual acuity loss in 52% of BIH and 6% of CVT, obnubilation in 0% of BIH and 65% of CVT. Cerebrospinal fluid, EEG, cerebral angiography and Scanner were normal in all cases of BIH, while in CVT the same investigations were abnormal in respectively 90%, 100%, 100% and 54% of cases. Prognosis was excellent in BIH with only one residual mild loss of visual acuity. Recurrences occurred in 18% of BIH. Among CVT 18% died, 23% developed neurological sequelae, 59% totally recovered. There was no recurrence. On the basis of this comparative study we emphasize the following points: 6% of CVT only follow a course of BIH from end to end, according to Johnston and Paterson's diagnostic criteria of BIH. These cases concern only thrombosis of lateral sinuses. Other cases of CVT rather deal with patients admitted in neurosurgical units on emergency. Diagnosis of CVT is a difficult one and prognosis is still serious in spite of the use of Heparin. 85% of BIH are irrelevant to CVT. BIH is a "quiet" intracranial hypertension without trouble of vigilance. Prognosis is really good if diagnosis is early made, in spite of possible multiple recurrences. Treatment consists of CSF subtraction, preferably through external lumbar drainage, and Acetazolamide prescription. Head injuries and hormonal imbalance in women are two common etiologies of BIH and CVT.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Benign intracranial hypertension (17 cases) and cerebral venous thromboses (49 cases). Comparative study]. 408 5

Authors checked values of the blood pressure as well as in 23 hypertensive diabetic patients during the antihypertensive therapy with hydrochlorothiazide (Spofa) and acetazolamide (Diluran Spofa) and compared it with values gained before the therapy was started. After a preceeding period patients received both remedies over a period of 9 weeks each, the sequence of the remedies being effected in two groups of twelve and eleven patients each. There were not found any differences in the glycaemia values during the follow up study. Blood pressure has been lowered after both diuretics but has even more diminished after the hydrochlorothiazide. We conclude that the use of small doses of thiazides in the treatment of high blood pressure can also recommended for diabetics, if by correct checking of the potassium values possible negative metabolic consequences can be avoided from the first.
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PMID:[Effect of different saluretics on carbohydrate metabolism and blood pressure behavior in diabetics]. 638 79

The effect of unilateral, electrical stimulation of the cervical sympathetic chain in rabbits anesthetized with pentobarbital sodium and vasodilated by hypercapnia, acetazolamide, papaverine or PGI2 was investigated to determine to what extent the sympathetic nerves to the brain and the eye cause vasoconstriction and prevent overperfusion in previously vasodilated animals. Evans blue was given as a tracer for protein leakage. Blood flow determinations were made with the labelled microsphere method during normotension and acute arterial hypertension. Hypertension was induced by ligation of the thoracic aorta and in some animals metaraminol or angiotensin was also used. Acetazolamide caused a two to threefold increase in cerebral blood flow (CBF) and hypercapnia resulted in a fivefold increase. CBF was not markedly affected by papaverine or PGI2. In the choroid plexus, the ciliary body and choroid, papaverine and hypercapnia caused significant blood flow increases on the control side. Sympathetic stimulation induced a 12% blood flow reduction in the brain in normotensive, hypercapnic animals. Marked effects of sympathetic stimulation at normotension were obtained under all conditions in the eye. In the hypertensive state the CBF reduction during sympathetic stimulation was moderate, but highly significant in hypercapnic or papaverine-treated animals as well as in controls. Leakage of Evans blue was more frequently seen on the nonstimulated side of the brain. In the eye there was leakage only on the control side except in PGI2-treated animals where 2 rabbits had bilateral leakage. The effect of sympathetic stimulation on the blood flow in the cerebrum and cerebellum in vasodilated animals seems to be small or absent if the blood pressure is normal. In the eye pronounced vasoconstriction occurs under these conditions. In acute arterial hypertension sympathetic stimulation protects both the cerebral and ocular barriers even under conditions of marked vasodilation.
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PMID:Effects of sympathetic stimulation on cerebral and ocular blood flow. Modification by hypertension, hypercapnia, acetazolamide, PGI2 and papaverine. 675 90

The role of CO2 in hyperbaric oxygen toxicity was investigated by administering acetazolamide (Diamox), Tris buffer [tris(hydroxymethyl)aminomethane], and sodium bicarbonate by i.p. injection, and by exposure of other groups of animals to an atmosphere of 5% CO2 and 95% O2. All animals were placed in a pressure chamber and maintained at 50 psig in 100% O2 until death. The Tris buffer and the sodium bicarbonate buffer significantly extended time to onset of convulsions and to time of death. Acetazolamide and also 5% CO2 shortened time to onset of convulsions and significantly shortened survival time. These results suggest that increased tissue levels of CO2 play an important role in hyperbaric oxygen toxicity. The cause of death in our animals exposed to hyperbaric oxygen was pulmonary edema secondary to a systemic hypertension.
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PMID:Acetazolamide and CO2 in hyperbaric oxygen toxicity. 680 59

Fifty-eight patients with intraocular hypertension or primary open angle glaucoma participated in a double masked randomized study. Timolol in concentrations 0.25% and 0.5% was compared with 1, 2, or 4% pilocarpine Acetazolamide (250 mg x 3) was added if intraocular pressure (IOP) was uncontrolled with the highest concentrations tested. No statistical difference was found in hypotensive effect between pilocarpine and timolol neither on ocular hypertensions nor glaucomas. The additive hypotensive effect of acetazolamide was the same for both substances. Once a day by administration of timolol was sufficient in 17 of 20 cases controlled merely by topical administration.
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PMID:Timolol versus pilocarpine separately or combined with acetazolamide-effects on intraocular pressure. 701 Aug 86

A girl with HIV infection acquired at birth by blood transfusion, was admitted at the age of 10 years for diplopia, vomiting, headache and papilledema. CT scan was negative. A lumbar puncture revealed clear CSF, protein 0.40 g/l, glucose 2 mmol/l, 5 mononuclear cells/mm3. The Indian ink preparation and the latex agglutination antigen test were positive for Cryptococcus n. Treatment with amphotericin B and flucytosine was started. After 10 days, since the in vitro susceptibility testing of the isolates showed resistence to both drugs, fluconazolo (400 mg/day) was started. Acetazolamide, furosemide and spironolactone were then added to the antifungal therapy for the persistence of severe intracranial hypertension. Diuretics were maintained for 10 weeks. The patient returned to school two and half months after the admission to the hospital. After 19 months, she is doing well and she is on maintenance of fluconazole (200 mg/day). We hypothesized that the increased intracranial pressure would be due to an impaired CSF reabsorption probably as a consequence of a direct cryptococcal infiltration of the villi.
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PMID:Intracranial hypertension and cryptococcal meningitis in a girl with AIDS. 887 56

Hydrochlorothiazide has been shown to exert direct vasodilator effects by activation of calcium-activated potassium (KCa) channels in human and guinea pig isolated resistance arteries. Since hydrochlorothiazide binds to and inhibits the enzyme carbonic anhydrase and because KCa channel activation is pH sensitive, we investigated the role of intracellular and extracellular carbonic anhydrase in the vascular effects of thiazide diuretics. Small arteries were isolated from guinea pig mesentery and studied by use of a microvascular myograph technique. In some experiments, tone and intracellular pH (pHi) were measured simultaneously with 2', 7'-bis(2-carboxyethyl)-5(6)'-carboxyfluorescein (BCECF-AM). Bendroflumethiazide, a thiazide diuretic with minimal inhibitory effects on carbonic anhydrase, had little effect on noradrenaline-induced tone (16+/-8% relaxation) compared with hydrochlorothiazide (74+/-12% relaxation). In contrast to hydrochlorothiazide, the action of bendroflumethiazide was unaffected by 100 nmol/L charybdotoxin, a selective blocker of KCa channels. All inhibitors of carbonic anhydrase relaxed noradrenaline-induced tone in a concentration-dependent manner, and this effect was blocked by charybdotoxin. Hydrochlorothiazide and the inhibitors of carbonic anhydrase failed to relax tone induced by a depolarizing potassium solution. Acetazolamide and hydrochlorothiazide increased pHi by 0.27+/-0.07 and 0.21+/-0.04, respectively, whereas bendroflumethiazide had a much smaller effect: 0.06+/-0.03. The rise in pHi induced by any agent was not inhibited by charybdotoxin. The vasorelaxant effect of hydrochlorothiazide is shared by other inhibitors of carbonic anhydrase. Inhibitors of carbonic anhydrase, but not bendroflumethiazide, cause intracellular alkalinization, which is associated with KCa channel opening. These data suggest that the vasodilator effect of thiazide diuretics results primarily from inhibition of vascular smooth muscle cell carbonic anhydrase, which results in a rise in pHI, leading to KCa channel activation and vasorelaxation.
Hypertension 1999 Apr
PMID:Inhibition of carbonic anhydrase accounts for the direct vascular effects of hydrochlorothiazide. 1020 45

Euphorbia hirta is locally used in Africa and Australia to treat numerous diseases, including hypertension and edema. The diuretic effect of the E. hirta leaf extracts were assessed in rats using acetazolamide and furosemide as standard diuretic drugs. The water and ethanol extracts (50 and 100 mg/kg) of the plant produced time-dependent increase in urine output. Electrolyte excretion was also significantly affected by the plant extracts. The water extract increased the urine excretion of Na+, K+ and HCO3-. In contrast, the ethanol extract increased the excretion of HCO3- decreased the loss of K+ and had little effect on renal removal of Na+. Acetazolamide, like the water extract, increased urine output and enhanced the excretion of Na+, K+ and HCO3-. The high-ceiling diuretic, furosemide, increased the renal excretion of Na+ and Cl-; but had no effect on K+ and HCO3- loss. This study suggests that the active component(s) in the water extract of E. hirta leaf had similar diuretic spectrum to that of acetazolamide. These results validate the traditional use of E. hirta as a diuretic agent by the Swahilis and Sukumas.
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PMID:Euphorbia hirta leaf extracts increase urine output and electrolytes in rats. 1035 Mar 69

Idiopathic intracranial hypertension (IIH) is a disorder of increased intracranial pressure of unknown cause. It is a disorder, predominantly of overweight women in the childbearing years. The major morbidity of the disease is visual loss. Damage to the visual system occurs at the optic nerve head. This damage is most likely due to axoplasm flow stasis and resultant intraneuronal ischemia. Management of IIH begins with educating the patient about the disease and its potential outcomes. I recommend modest dieting and following a low-salt regimen with caution against overuse of fluids. Acetazolamide and Lasix appear to be efficacious. Patients failing medical therapy have optic nerve sheath fenestration performed if visual loss is the main morbidity. Shunting procedures are considered if headache is the main symptom. Most patients respond well to therapy, but idiopathic intracranial hypertension may recur throughout life.
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PMID:Idiopathic intracranial hypertension: mechanisms of visual loss and disease management. 1087 79


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