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

Anemia of malignancy is a complication of neoplastic disease which causes impairing symptoms and often requires blood transfusions. In this clinical trial, we have treated 13 patients suffering from chronic anemia of malignancy and multiple myeloma with recombinant human erythropoietin (rHuEPO) three times a week. Eleven patients responded to the treatment by appropriate increases of their hemoglobin levels and the eventual correction of the anemic state, one non-responding patient had to terminate the treatment early because of transfusion requirements. Under rHuEPO therapy, the evaluated parameters of iron metabolism indicated the enhanced synthesis of hemoglobin. The symptoms of anemia subsided in the responding patients and most of them reported a hightened subjective sense of well-being. No adverse side effects, particularly no episodes of hypertension, were observed in any patient.
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PMID:[Erythropoietin treatment of tumor-associated anemia in patients with multiple myeloma]. 218 25

Treatment of anemia with human recombinant erythropoietin (EPO-R) and its effect on bone marrow was studied in 10 anemic patients on periodic hemodialysis (HD). Blood transfusion was not required once treatment started. Hemoglobin (Hb) levels normalized at six months in all patients (7.2 +/- 0.2 vs 12.4 +/- 3 g/dl, p less than 0.01). Serum ferritin levels decreased progressively as Hb increased (r = -0.5609), and six patients needed iron supplement since the third month. Bone marrow iron deposits decreased significantly (p less than 0.001), together with an increase of cellularity and improvement of erythrodysplasia. EPO-R was associated with worsening hypertension in previously hypertensive patients, although it could be controlled with more aggressive treatment. Thrombotic events either systemic or at the vascular access, were not observed. EPO-R corrects the anemia in uremic patients undergoing HD. Iron stores and blood pressure in hypertensive patients on treatment with EPO-R must be monitored regularly.
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PMID:[Treatment of anemia with recombinant human erythropoietin and the bone marrow response in uremic patients undergoing periodic hemodialysis]. 224 77

A case of a 29 year old man with typical picture of Cushing's syndrome is presented: pronounced hypodynamics, diabetes mellitus, hypertension, transitory psychic disorders, severe hypokalemia, metabolic alkalosis, hypercorticism, disturbed 24 h rhythm of cortisol secretion, high serum ACTH level. The treatment with steroidogenesis blockers (Metyrapone, o,p'DDD) led to a limited improvement. The well expressed organic changes in the cardiovascular and respiratory systems and pulmonary thromboembolism led to a fatal outcome. The post mortem examination revealed a pancreatic tumor 30/30 mm in size (histologically carcinoid) and enlarged hypophyseal gland with oxyphil cell hyperplasia. The electron microscopic examination found secretory granules in the pancreatic tumor cells. Concurrent ectopic secretion of ACTH by the oxyphil tumor cells is discussed.
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PMID:[Cushing's syndrome resulting from ectopic hormonal secretion]. 228 96

Like all drugs, combined oral contraceptives (COCs) have side effects that may be harmful or beneficial. During the last 20 years their adverse effects have been fully reported, but their benefits have been largely ignored. Most of the benefits of COCs result from the suppression of ovulation. This means that the advantages they confer are not dose-dependent, provided that ovarian activity is effectively suppressed. The most important health benefit of COCs worldwide is the effective prevention of pregnancy, which carries high risks in developing countries and has a mortality as high as 1 in 150 in Africa. The risk of ectopic pregnancy is reduced by 90% in COC-users compared with women using no contraception. The COC prevents the repeated proliferation of ovarian and endometrial tissue that takes place in the menstrual cycle, and it is therefore not surprising that it reduces the risk of ovarian and endometrial malignancy. What is surprising is that a relative risk of 0.6 for these cancers can be detected after only 12 months or less of COC use, and persists for at least 15 years after the COC is stopped. The COC reduces the incidence of benign breast disease, though not the types of disease linked with breast cancer. It considerably reduces the incidence of benign ovarian cysts, and this has been calculated to avoid 28 operations for functional ovarian cysts per 100,000 pill users every year. The risk of uterine fibroids is reduced by 17% with every five years of COC use. By thickening the cervical mucus, the COC reduces the risk of pelvic inflammatory disease by about 50%. By inhibiting growth and development of the endometrium it reduces the incidence of menorrhagia and consequently iron-deficiency anaemia, and it produces a 40% reduction in the frequency of dysmenorrhoea. Unlike the benefits of the COC, its risks appear to be to some extent dose-dependent. The first serious risk to be discovered was a three- to six-fold increase in venous thromboembolism, which is probably an oestrogen effect and disappears quickly when the COC is stopped. The COC doubles the risk of haemorrhagic stroke, this risk is related to smoking and hypertension, unlike the increased risk of thrombotic stroke. The risk of myocardial infarction is related to smoking and age, and COCs are contraindicated over the age of 35 in smokers though not necessarily in non-smokers. Much of this information, however, is based on studies involving older high-dose COCs. Risks may well be lower with modern COCs, but firm data are lacking.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Benefits and risks of oral contraceptives. 229 44

The relationship between haematologic parameters and pregnancy outcome was investigated in a prospective study, taking important covariates into consideration. A questionnaire asking information about smoking, alcohol consumption and iron intake was completed by a consecutive series of 796 ambulatory singleton pregnant women at 31-32 weeks of gestation. Subsequently, haematologic parameters were measured. After delivery, birth weight, gestation length and blood pressure values during pregnancy were abstracted from the obstetricians' records. Low birth weight (less than 2.500 g) and preterm birth (less than 37 weeks), were significantly more frequently seen in women with high haemoglobin (greater than or equal to 8.0 mmol/l) or high haematocrit (greater than 38%) values, with Mantel-Haenszel odds ratios varying from 2.4 to 4.2. Also a high erythrocyte count (greater than or equal to 4.5/pl) was correlated with low birth weight, while for mean corpuscular volume (MCV) no such relationships were found. Pregnancy induced hypertension was positively associated with haemoglobin, haematocrit and erythrocyte count, but could not fully explain the relationships between these parameters and adverse outcomes. Using multiple logistic regression with low birth weight and or preterm birth as the dependent variable, the effect of haematocrit still was demonstrable after controlling for smoking, hypertension, parity, alcohol consumption and iron intake. These results are in agreement with the hypothesis that a higher blood viscosity is a risk factor for suboptimal placenta-perfusion.
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PMID:Haematologic parameters and pregnancy outcome. A prospective cohort study in the third trimester. 232 86

Anemia is a common complication of multiple myeloma. It resolves early in the disease if chemotherapy induces a complete remission, but persists if the disease progresses, causing disabling symptoms and often requiring blood transfusions. We treated 13 patients with myeloma-associated anemia by administering recombinant human erythropoietin three times a week for six months. Eleven patients (85 percent) had steady increases in hemoglobin levels and eventual correction of the anemia. Their symptoms of anemia subsided, and they reported a heightened sense of well-being. No patient had any adverse side effects, particularly episodes of hypertension. Monitoring of the serum M component showed a predominantly stable tumor load without apparent interaction between the underlying disease and the response to erythropoietin therapy. The number of erythroid burst-forming units in the bone marrow and peripheral blood and the level of erythropoiesis in bone marrow smears increased significantly during therapy. Pretreatment serum levels of erythropoietin were higher in the patients who did not respond and in those who required more than two months of treatment before they responded. Serum iron, ferritin, and transferrin concentrations reflected responses to treatment. We conclude that recombinant human erythropoietin is a promising therapeutic tool for treating myeloma-associated anemia.
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PMID:Erythropoietin treatment of anemia associated with multiple myeloma. 198 68

Recombinant human erythropoietin (rHu-EPO) was given during 12 to 20 months in 15 long term haemodialysis anaemic (mean Hb: 6.6 +/- 1 g/dl) patients who required no blood transfusion. Patients over 65, or with severe arterial disease or with uncontrolled hypertension were not included in this trial. Correction of anaemia (mean Hb 12.1 +/- 0.6 g/dl) was achieved in all patients and maintained all along the study. An improved sense of wellbeing and increased exercise tolerance were reported by all patients. Appropriate maintenance dosage of rHu-EPO was 74 +/- 6 U/kg i.v. twice weekly. High dose oral and/or intravenous iron therapy was necessary in the absence of previous marked iron overload. One retinal venous thrombosis was the sole severe side-effect encountered. A slight but significant increase of blood pressure was observed with the need of intensifying previous anti-hypertensive therapy in one patient and of starting one in one another. Fine adjustment of the dry weight was necessary to maintain blood pressure in the normal range. Heparin requirements increased in the majority of patients because of hollow fibre clotting but there was no evidence of decreased efficacy of dialysis. In two patients clotting of arteriovenous fistula was not obviously related to the rHu-EPO treatment.
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PMID:[Treatment of anemia in chronic hemodialysis patients with recombinant human erythropoietin: long-term results in 15 patients]. 237 41

Cadmium is a highly toxic element that is cumulative and has a long biological half-life in mammals. The severe toxicity of cadmium in man has been known for more than 100 years. Despite the knowledge that cadmium is toxic, only 20 human cases of poisoning via ingestion were recorded prior to 1941, whereas in the ensuing five-year period more than 680 cases of cadmium poisonings from accidental oral ingestion of this metal were documented. Some of the recorded effects of exposure to cadmium in laboratory animals include renal tubular damage, placental and testicular necrosis, structural and functional liver damage, osteomalacia, testicular tumors, teratogenic malformations, anemia, hypertension, pulmonary edema, chronic pulmonary emphysema, and induced deficiencies of iron, copper, and zinc. Some of these effects have also been observed in human after accidental exposures to cadmium oxide fumes and are characteristic of the syndrome described in Japan as Itai Itai disease in which ingestion of cadmium is the inciting chemical.
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PMID:Cadmium inhalation and male reproductive toxicity. 240 89

A 62-year-old male, was admitted on Oct. 7, 1987 because of productive cough and dyspnea. He worked for an iron factory, where pneumoconiosis was regarded as an occupational disease, for 40 years. No abnormal finding had been noted on his mass screening chest roentgenograms. He was well until three years ago when hypertension and Parkinsonism were noted. Since then he was treated with beta blockers, L-DOPA, amantadine and bromocriptine. Two weeks before admission, he suddenly complained of dyspnea and productive cough. His chest roentgenograms showed diffuse reticulonodular infiltration in both lung fields. The partial pressure of oxygen of the arterial blood was 65.9 Torr. The first transbronchial lung biopsy obtained from right B8 on Sept. 29, 1987 (before the admission) revealed some epithelioid granulomas and the second biopsy obtained from right B10 on Oct. 14, 1987 demonstrated bronchiolar edema and infiltration of inflammatory cells. Fibrotic changes associated with carbon dust between airways and vessels were also noted. Lymphocyte stimulation index by bromocriptine was 362%, and that by amantadine, 139%, L-DOPA, 150%, respectively. After ceasing the administration of bromocriptine, productive cough, dyspnea and the reticulonodular shadows diminished gradually. These findings strongly suggest that the interstitial pulmonary lesions are bromocriptine-induced interstitial pneumonitis. His occupational exposure to inorganic dust may be a predisposing factor.
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PMID:[A case of bromocriptine-induced interstitial pneumonitis in an iron factory worker exposed to sand dust]. 261 76

The feasibility of parenteral iron administration for treatment of pregnancy anaemia, in field conditions was investigated. High reaction rates were observed (30-40%) with either intramuscular (im) or intravenous (iv) iron-dextran complex (test dose). Mothers with lower body weight had higher reaction rates with both im or iv iron-dextran complex. In pregnancy induced hypertension (PIH) the reaction rate was significantly lower. Our study indicates that under the existing situations of the health care system in India and the poor body weight and weight gain of Indian women during pregnancy, parenteral iron therapy for controlling anaemia may not be a feasible approach, at the field level.
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PMID:Feasibility of parenteral iron therapy as a field approach for management of pregnancy anaemia. 262 Sep 51


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