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)

This report describes how a rare condition in pregnancy can present with features resembling more common diagnoses in the unwell obstetric patient. Our patient presented in late pregnancy initially with clinical features similar to mild preeclampsia, with proteinuric hypertension, epigastric pain and mildly deranged liver function tests. She went on to develop signs of acute abdomen associated with a persistent tachycardia and hypotension; there was evidence of fetal compromise. Following resuscitation, emergency caesarean section was performed and evolved into a laparotomy. The diagnosis was not clear clinically at this stage, but a retrospective amylase sample suggested acute pancreatitis. There was no clinical evidence of biliary perforation, but ongoing clinical suspicion prompted a CT of the abdomen. This proved unhelpful and our diagnostic dilemma was only resolved by endoscopic retrograde cholangiopancreatography, which demonstrated a biliary leak. A stent was placed with subsequent improvement in the patient's condition. With anaesthetists increasingly involved in the multi-disciplinary management of acutely sick obstetric patients, our case highlights the need for every practitioner involved in such cases to assess each individual fully, and be constantly aware that the diagnosis might not be obvious.
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PMID:Spontaneous common bile duct rupture in pregnancy. 1579 53

Few data exist about the incidence of drug-induced pancreatitis in the general population. Drugs are related to the etiology of pancreatitis in about 1.4-2% of cases. Although statins are generally well tolerated, acute pancreatitis has been reported in a few cases treated with atorvastatin, fluvastatin and simvastatin. A 86-year-old man with long-standing history of hypertension and hyperlipidemia, who was treated with lisinopril 10 mg and atorvastatin 20 mg once daily presented with acute pancreatitis. Other causes of the disease were ruled out. After cessation of the drugs, his physical condition improved and the amylase level decreased. To our knowledge, pancreatitis induced by a combination of atorvastatin together with lisinopril has never been reported in the literature.
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PMID:Acute pancreatitis associated with combined lisinopril and atorvastatin therapy. 1592 Mar 30

Long-term type 2 diabetes can lead to numerous biological complications, such as hypertension and cardio-vascular disease. Key enzymes involved in the enzymatic breakdown of complex carbohydrates,pancreatic alpha-amylase and intestinal alpha-glucosidase, have been targeted as potential avenues for modulation of type 2 diabetes-associated post-prandial hyperglycemia through mild inhibition of their enzymatic activities so as to decrease meal-derived glucose absorption. Further, inhibition of hypertension-linked angiotensin I-converting enzyme (ACE) was targeted as a potential approach for modulation of diabetes-linked hypertension. Water-soluble extracts of soybean optimized for phenolic content via sprouting or bioprocessing by dietary fungus (Rhizopus oligosporus, Lentinus edodes) were investigated for inhibitory activity against porcine pancreatic alpha-amylase (PPA), yeast alpha-glucosidase, and rabbit lung ACE in vitro. PPA was allowed to react with each phenolic-optimized extract and the derivatized enzyme-phytochemical mixtures obtained were characterized for residual amylase activity. Alpha-glucosidase and ACE activities were determined in the presence of each phenolic-optimized extract. All of the soybean extracts possessed marked anti-amylase activity, with extracts of R. oligosporus-bioprocessed soybean having the strongest inhibitory activity, but only slight anti-glucosidase activity. The anti-amylase activity of each extract seemed associated with extract antioxidant activity. Anti-enzyme activity was slightly associated with total soluble phenolic content per se, but seemed more associated to the length of sprouting or bioprocessing of the soybean substrate. Short-term sprouting or bioprocessing seemed to improve anti-amylase activity, while long-term sprouting or bioprocessing seemed to aid anti-glucosidase activity. While ACE activity was strongly inhibited by all of the soybean extracts (44-97%), only sprouting was found to increase this inhibition and bioprocessing of soybean with L. edodes decreased inhibitory activity of soybean extract. The results suggest that sprouting and dietary fungal bioprocessing of soybean improve the anti-diabetic potential of soybean extracts, potentially through modulation of the phenolic profile of the extract, and further suggest that enzyme inhibitory activity may be linked to phenolic antioxidant mobilization during spouting and/ or bioprocessing. The significance of food-grade, plant-based enzyme inhibitors for modulation of carbohydrate breakdown and control of glycemic index of foods in the context of preventing hyperglycemia and diabetes mellitus complications such as hypertension in the long-term is hypothesized and discussed.
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PMID:Anti-diabetic and anti-hypertensive potential of sprouted and solid-state bioprocessed soybean. 1592 31

Water soluble cranberry-based phytochemical combinations with oregano, rosemary, and Rhodiola rosea were evaluated for total phenolic content, related antioxidant activity and inhibition of diabetes management-related alpha -glucosidase, pancreatic alpha-amylase inhibition, and hypertension-related ACE-I inhibitory activities. Water extracts of oregano had 114.9 mg/g DW of phenolics which was highest among all the extracts tested, whereas the 75% cranberry with 25% oregano combinations had the highest phenolics (38.9 mg/g DW) among all the combinations tested. The water extracts of oregano had the highest DPPH radical inhibition activity (73.6 %), whereas among combinations the 75% cranberry and 25% oregano had the highest DPPH radical inhibition activity (50.8 %). These results indicated a correlation between total phenolic content and antioxidant activity. The water extracts of pure Rhodiola rosea had the highest alpha -glucosidase inhibition, whereas the 75% cranberry and 25% Rhodiola rosea combination had the highest inhibition among the combinations. In the case of alpha -amylase inhibition the water extracts of Rhodiola rosea had the highest inhibition, whereas the 75% cranberry with 25% Rhodiola rosea combination had the highest inhibition among the combinations. All the water extracts tested indicated that they had anti-ACE-I inhibitory activity. More specifically, among the water extracts 100% cranberry had the highest ACE-I inhibitory activity and among the combination the 75% cranberry with 25% rosemary had the highest ACE-I inhibitory activity. The analysis of alpha -glucosidase,alpha -amylase, and ACE-I inhibitory activities suggested that inhibition depend on the phenolic profile of each unique extract and by bringing together synergistic combinations to cranberry, health beneficial functionality was enhanced. This enhanced functionality in terms of high alpha -glucosidase and alpha -amylase inhibitory activities indicate the potential for diabetes management, and high ACE-I inhibitory activity indicates the potential for hypertension management.
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PMID:Potential of cranberry-based herbal synergies for diabetes and hypertension management. 1683 38

This study was designed to examine whether continuous pancreatic ductal hypertension (PDH) plays an important role in the onset and development of chronic pancreatitis (CP). Pancreatic, biliary, and duodenal cannulas were implanted in male Wistar rats. PDH was induced by vertically raising the free end of the pancreatic duct cannula to exert a hydrostatic pressure and maintained for 2 wk. PDH was gradually increased, but when the pancreatic juice (PJ) flow was interrupted, PDH was decreased to restore PJ flow. The induction of PDH resulted in a marked reduction of amylase activity in PJ and an increase in serum amylase activity. At 2 wk after persistent PDH, pancreatic exocrine function was markedly decreased in response to a bolus injection of secretin (100 pmol/kg) compared with the control group. Histological examination revealed interlobular as well as intralobular fibrosis in the form of nodular pancreatitis at 2 wk after the induction of PDH. Immunohistochemistry revealed the expression of fibronectin and collagen types I and III. Quantitative real-time RT-PCR showed an increase in transforming growth factor-beta(1) mRNA expression in the pancreas during PDH. The present results suggest that PDH plays an important role in the onset and development of CP. Furthermore, our animal model seems useful for investigating the mechanisms of CP in rats.
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PMID:A new model of chronic pancreatitis in rats. 1695 55

Idiopathic perforation of the gallbladder (IPGB) is a rare event, and the underlying mechanisms are unknown. We investigated the clinicopathological characteristics of this disorder. We reported a case of IPGB, and reviewed 30 other cases reported up to the end of 2005 in a Medline and Japan Centra Revuo Medicina search of the medical literature. We analyzed the clinical findings, laboratory data, and histopathological features. The mean age of the patients was 70.2 +/- 12.8 years, and there were 19 men and 12 women. Underlying diseases such as hypertension, cerebral infarction or hemorrhage, renal failure, respiratory failure, and malignancy were reported in 35.5% of the patients. Perforation was found more often in the fundus (53.3%) than in the body (43.3%) or neck (3.3%) of the gallbladder. Thrombus was found in the intramural vessels of the gallbladder wall in 13 patients (50%), whereas 13 (50%) were free of thrombus. Serum amylase was significantly higher in the intramural vessels in the thrombus-negative group than in the thrombus-positive group. The overall operative mortality was 3.3%. Univariate and multivariate analyses indicated that a delay of more than 24 h from the manifestation of symptoms to operation and a perforation size greater than 2 cm required significantly longer hospitalization. Thrombosis in the intramural vessels seems to be related to the events leading to IPGB; however, it is difficult to consider it the only cause. Early operation and the size of the perforation are important determinants of the outcome of treatment for IPGB.
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PMID:Clinicopathological analysis of idiopathic perforation of the gallbladder. 1764 3

Levels of obesity-linked non-insulin-dependent diabetes mellitus (NIDDM) and hypertension are highest among indigenous communities in North America. This is linked to changes in dietary pattern towards high calorie foods such as sugar, refined grain flour, and sweetened beverages. Therefore, a return to traditional dietary patterns may help to reduce these disease problems because of better balance of calories and beneficial nutrients. Further protective non-nutrient phenolic phytochemicals against NIDDM and hypertension are potentially high in these foods but less understood. In this study antidiabetic- and antihypertension-relevant potentials of phenolic phytochemicals were confirmed in select important traditional plant foods of indigenous communities such as pumpkin, beans, and maize using in vitro enzyme assays for -glucosidase, alpha-amylase, and angiotensin I-converting enzyme (ACE) inhibitory activities. In vitro inhibitory activities of these enzymes provide a strong biochemical rationale for further in vivo studies and dietary management strategy for NIDDM through the control of glucose absorption and reduction of associated hypertension. These enzyme inhibitory activities were further compared to total soluble phenolic content and antioxidant activity of the above-targeted plant foods. Pumpkin showed the best overall potential. Among the varieties of pumpkin extracts P5 (round orange) and P6 (spotted orange green) had high content of total phenolics and moderate antioxidant activity coupled to moderate to high alpha-glucosidase and ACE inhibitory activities. Therefore this phenolic antioxidant-enriched dietary strategy using specific traditional plant food combinations can generate a whole food profile that has the potential to reduce hyperglycemia-induced pathogenesis and also associated complications linked to cellular oxidation stress and hypertension.
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PMID:Health benefits of traditional corn, beans, and pumpkin: in vitro studies for hyperglycemia and hypertension management. 1765 Oct 62

We describe the clinical, imaging and cytopathological features of solid pseudopapillary tumor of the pancreas (SPTP) diagnosed by endoscopic ultrasound-guided (EUS-guided) fine-needle aspiration (FNA). A 17-year-old woman was admitted to our hospital with complaints of an unexplained episodic abdominal pain for 2 mo and a short history of hypertension in the endocrinology clinic. Clinical laboratory examinations revealed polycystic ovary syndrome, splenomegaly and low serum amylase and carcinoembryonic antigen (CEA) levels. Computed tomography (CT) analysis revealed a mass of the pancreatic tail with solid and cystic consistency. EUS confirmed the mass, both in body and tail of the pancreas, with distinct borders, which caused dilation of the peripheral part of the pancreatic duct (major diameter 3.7 mm). The patient underwent EUS-FNA. EUS-FNA cytology specimens consisted of single cells and aggregates of uniform malignant cells, forming microadenoid structures, branching, papillary clusters with delicate fibrovascular cores and nuclear overlapping. Naked capillaries were also seen. The nuclei of malignant cells were round or oval, eccentric with fine granular chromatin, small nucleoli and nuclear grooves in some of them. The malignant cells were periodic acid Schiff (PAS)-Alcian blue (+) and immunocytochemically they were vimentin (+), CA 19.9 (+), synaptophysin (+), chromogranin (-), neuro-specific enolase (-), a1-antitrypsin and a1-antichymotrypsin focal positive. Cytologic findings were strongly suggestive of SPTP. Biopsy confirmed the above cytologic diagnosis. EUS-guided FNA diagnosis of SPTP is accurate. EUS findings, cytomorphologic features and immunostains of cell block help distinguish SPTP from pancreatic endocrine tumors, acinar cell carcinoma and papillary mucinous carcinoma.
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PMID:Endoscopic ultrasound-guided fine-needle aspiration cytology diagnosis of solid pseudopapillary tumor of the pancreas: a case report and literature review. 1787 86

Acute intermittent porphyria (AIP) is an inherited metabolic disease that can affect the autonomic, peripheral and central nervous systems. Pancreatic diseases assocated with AIP is rarely reported. We report here a 60-year-old non-alcoholic male who had typical manifestations of AIP, including abdominal pain, constipation, tachycardia, hypertension, mental disturbances, psychiatric manifestations, seizures, peripheral neuropathy, and excessive excretion of porphyrin precursors in urine. Increases of serum amylase and lipase, as well as mild pancreatic edema on ultrasonography, were noted during the acute attack of AIP, suggesting concomitant acute pancreatitis. In this patient, brain magnetic resonance imaging revealed reversible multifocal cerebral lesions resembling a posterior reversible encephalopathy syndrome (PRES) during the acute attack of AIP. Because the clinical manifestations of acute pancreatitis could be present with an acute attack of AIP, early confirmation of diagnosis is mandatory to effectively manage the attack and avoid inappropriate treatment.
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PMID:Acute intermittent porphyria presenting as acute pancreatitis and posterior reversible encephalopathy syndrome. 1897 24

72 patients with chronic pancreatitis were investigated. The levels of nitrogen oxide in the blood and urine were examined in the patients with chronic pancreatitis depend on the disease's stage and its complications. The nitrogen oxide metabolites were determined to all patients (by method of V. A. Metelskaya, 2005) The trustworthy differences of NO levels were revealed depend on the chronic pancreatitis complications presence. The patients with the pancreatic hypertension due to pancreatic calcinosis, that was accompanied persistent painful syndrome and relativelly high blood amylase level (amylase increase 3-4 times in comparison with its normal level) were demonstrated the high NO levels. The tendency to the lowering of level NO and painful syndrome with blood amylase activity reduce were revealed in the patients with surgical treatment of the complicated chronic pancreatitis. The lowering of the painful syndrome and the blood amylase activity follow to normalisaton of pancreatic juice outflow and reduce of the inflammation in parenchyma pancreas. So, the revealed connection increase of NO level and pancreatic inflammation may be the additional criterions for the surgical treatment of such patients.
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PMID:[Change of nitric oxide metabolites in patients with chronic pancreatitis]. 1933 42


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