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

Clinical studies have long suggested the presence of a specific cardiomyopathy in sickle cell anemia secondary to intracoronary thrombosis and subsequent infarction. Fifty-two autopsy patients were studied (48 with SS hemoglobin, 4 with S-C or S-Thal hemoglobin) to ascertain the range of cardiac pathologic abnormalities associated with this disease. The average age was 17 years (range 1 month to 48 years). Renal failure and infection were the most common causes of death; the former was a more common cause in adults than in children. Right and left ventricular hypertrophy and dilatation were the most common abnormal pathologic findings. No evidence of recent or remote myocardial infarction, coronary thrombosis or arteritis was noted in any patient. Eight patients who were studied with postmortem coronary arteriograms exhibited markedly increased coronary arterial caliber with no evidence of atherosclerosis. Seventeen of the 52 patients studied had clinical evidence of congestive heart failure before death. Of these 17 patients, 7 had moderate to severe left ventricular hypertrophy associated with chronic renal failure and hypertension, 2 had right ventricular hypertrophy with organized pulmonary thrombosis, 2 had rheumatic mitral valve disease and 2 died during the second trimester of pregnancy. Two of the 17 patients thought to have pulmonary edema before death in fact had aspiration pneumonia and hemorrhagic pneumonitis, respectively. The data suggest that cardiac dysfunction in sickle cell anemia can usually be explained by the adverse effect of coexisting disease on the diminished cardiac reserve of chronic anemia. The data do not support the concept of a specific "sickle cell cardiomyopathy".
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PMID:Clinicopathologic analysis of cardiac dysfunction in 52 patients with sickle cell anemia. 15 Jul 86

The prevalence and causes of anemia have been studied in 104 patients over 60 years of age admitted to a general medical ward in Jerusalem. In males and females, mean hemoglobin levels were about 1 g less than in the corresponding groups of healthy younger controls. A primary nutritional anemia could not be implicated in any of the 15 patients with hemoglobins below 11 g/dl. The most important causes of anemia were chronic renal failure, metastatic carcinoma, gastrointestinal bleeding, and infection. Conversely, in diseases with no adverse effect on erythropoiesis such as chronic ischemic heart disease, hypertension and diabetes, hemoglobin levels were equal to those of the younger controls. These findings indicate that although diminished serum iron and RBC folate levels may occasionally be found in elderly subjects, nutritional deficiency is seldom responsible for anemia in this age group in Israel- and anemia when present is often the manifestation of a chronic underlying disease.
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PMID:Prevalence and causes of anemia in elderly hospitalized patients. 31 45

Terminal renal failure secondary to the hemolytic uremic syndrome (HUS) developed 18 months after initial transplantation and 4 1/2 months after the child received his second cadaveric renal allograft. Recurrence of the syndrome was evidenced by gross hematuria and hypertension after a 'flu-like' illness, sudden decrease in platelet count and hemoglobin, and erythrocyte fragmentation. Renal biopsy findings were compatible with HUS. Evidence is presented that the HUS was a recurrence of the original disease.
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PMID:Recurrence of the hemolytic uremic syndrome in a 3 1/2-year-old child, 4 months after second renal transplantation. 35 9

Hypertensive and hypotensive strains of turkeys were observed for the possibility of a synergistic response between hypertension and temperature stress. The birds in four experiments were placed in chambers with temperature settings of 15.6, 26.7, and 37.8 C (humidity approximately 60%) and an ambient control. The temperature effect was measured by comparing the responses in body weight-gain, systolic blood pressure, and hematocrit and hemoglobin values. In each experiment both hypertensive and hypotensive strains in the 37.8 C chamber had a significantly lower (P less than or equal to .05) weight gain than those in the other chambers. The 26.7 C chamber had the next lowest weight gain. Considerably more variability in weight gain was observed in the hypertensive strain. Systolic blood pressure data were similar for all experiments. The lowest average blood pressures were recorded in the 37.8 C chamber. The high and low blood pressure strains showed overall average decreases in blood pressure of 28% and 14%, respectively. There was no consistent response in hematocrit and hemoglobin values due to temperature stress. Overall average hematocrit values were 39.1 and 38.0% for the hypertensive and hypotensive strains, respectively, while average hemoglobin values were 11.8 and 12.2 g/dl. The hypertensive strain showed more variation in weight gain, a greater percentage drop in blood pressure, and a 19% mortality rate in the high temperature chambers. These factors indicate that hypertension is an added factor in the overall stress of these birds.
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PMID:The effect of controlled temperature variations on growth rate and blood pressure, hematocrit, and hemoglobin values in the turkey. 51 57

A series of 106 cases of polycystic kidneys in adults is presented. The main clinical, exploratory and therapeutic data are analyzed. The average age of the patients at the time of the first clinical manifestation was 35 years; average age at the time of diagnosis was 43 years. The most common forms of presentation included renal colics, blood hypertension, noncolic lumbar pain, macroscopic hematuria, and polydipsia-polyuria. The most frequent symptoms were: abdominal pain of any type (73 patients), polydipsia-polyuria (66 patients), blood hypertension (61 patients), macroscopic hematuria (47 cases), episodes of urinary infection (41 cases), and passing of calculi (22 cases). Seventy-eight subjects had arterial high blood pressure; it was easily controlled in all except 14 cases. Proteinuria was slight in all except two cases. Values for hematocrit and hemoglobin remained high in relation to the degree of renal insufficiency. The mean value of hematocrit in patients with creatinine clearance below 10 ml/min was 30 percent. Renal function decreased gradually, from normal to a clearance of less than 10 ml/min over a period of 12 years on the average. Diagnosis was based mainly on abdominal physical examination and intravenous urography; 89 patients had palpable abdominal masses. Urography revealed typical images of polycystic kidney in every case. The following associated conditions were also discovered: liver cysts (17 cases among 57 liver scanning; bilateral ovarian cysts in one case; Cacci-Ricci's disease in one case; and cerebral arterial aneurysms in another patient. Treatment was conservative with the aim to control arterial blood pressure and urinary infection. Twenty-nine patients required saline replacement; peritoneal dialysis was practiced in two cases and permanent hemodialysis was prescribed for 15 individuals.
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PMID:[Polycystic kidneys in adults. A clinical study of 106 cases (author's transl)]. 52 27

Setting out from the components of respiratory function, i.e., ventilation, distribution, diffusion, circulation, respiratory mechanics, and regulation of breathing, the pathogenic mechanisms leading to respiratory failure are discussed. In every case, the vital capacity is decreased by 4 factors, namely loss of ventilated lung parenchyma, diminished compliance of lungs, thorax or both, airway obstruction, and insufficient respiratory airflow. With few exceptions, these alterations can be attributed to the two general groups of obstructive and restrictive disturbances of ventilation. Essential for the understanding of airway obstruction from the viewpoint of mechanical ventilation is the dependence of the airway caliber on lung volume, thoracic pressure, and bronchial gas flow. The functional differentiation of restrictive disorders between forms with lung retraction(fibrosis, scarring) and with lung fettering (pleural thickening) is important for adequate correction of complications during the intensive care phase. Respiratory failure is the consequence of these alterations which usually impede pulmonary gas exchange. Hypoxemia results in most situations through disturbance of ventilation/perfusion ratio, especially increase of anatomical or functional pulmonary right-to-left shunting. Disturbance of diffusion or alveolar hypoventilation are far less frequently leading mechanisms for hypoxemia. The differential diagnosis of these hypoxemic mechanisms is generally by arterial blood gas analysis under resting conditions breathing air and 100% oxygen, and during exercise. Respiratory failure often leads to hypertension in the lesser circulation. Pulmonary arterial hypertension must be subdivided into the active, the passive and the hyperdynamic forms, of which only the active component is important for the evaluation of pulmonary insufficiency since only this kind of elevated pressure in the pulmonary circulation is connected with increased vascular resistance due to thoracopulmonary disease. By restoration of normoxic conditions, the functional variant of active pulmonary hypertension can be efficiently improved by correction of respiratory disease or directly by treatment with oxygen and by mechanical ventilation. Finally, disturbances of gas transport in the blood may have an essential bearing on respiratory failure, but are often overlooked in diagnostic and therapeutic considerations. Shifting of the oxygen-dissociation curve to the left may, by increased oxygen affinity of hemoglobin, create a lack of oxygen in the peripheral tissue, while right wardshifting impedes oxygenation of hemoglobin in the lung. Thus, the correction of acidosis and elevated body temperature may become an important factor in the treatment of respiratory failure.
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PMID:[Basis of respiratory insufficiency]. 52 97

Intact anesthetized dogs were exposed for 75 min to either 5.75, 9.0, or 12.0% oxygen in nitrogen. Although pulmonary artery pressures were significantly elevated in all hypoxic exposures, systemic hypertension occurred only at the onset of severe hypoxia(5.75% O2). Coronary blood flow increased from an average of 130 during normoxia to a peak of 400 ml/100 g per min during inhalation of 5.75% O2, and coronary sinus oxygen tensions of 8 Torr and oxygen contents of 1.1 ml/100 ml were sustained for 75 min without biochemical, functional, or electrophysiological evidence of myocardial ischemia. Cardiac index (CI) increased significantly only during severe hypoxia (5.75% O2) with the greatest elevation after 30 min. Subsequently, CI decreased concomitantly with a 27% elevation in arterial hemoglobin concentration and oxygen-carrying capacity. It is concluded that the hypoxic threshold for significant elevations of cardiac output is between 6.0 and 9.0% O2.
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PMID:Effects of acute prolonged hypoxia on cardiovascular dynamics in dogs. 59 70

The causes of disqualification in a volunteer blood donor population for a period of two years were analyzed. Of 138,436 prospective volunteer blood donors, 24,327 (17.6%) donors were disqualified. Phlebotomy was unsuccesful in 721 (0.5%) donors and blood was drawn from 113,388 (81.9%) eligible donors. The majority of rejections were due to medical history findings (61.0% of all rejections). The ten leading causes of disqualification were: low hemoglobin/hematocrit, medication, allergies, signs and symptoms, high blood pressure, illness in last month, hepatitis and hepatitis exposure, malaria and travel overseas, atypical antibodies, and high serum bilirubin. Hepatitis B surface antigen was detected in 82 donors out of 114.746 donors tested (0.07%).
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PMID:Causes of disqualification in a volunteer blood donor population. 59 14

The possible risk factors were evaluated in 249 patients with cerebral infarction and in the control group consisting of 190 subjects of the same age and sex distribution. The following factors were significantly associated with brain infarction: elevated blood pressure, cardiac abnormalities, elevated blood glucose content, abnormal glucose tolerance, elevated blood cholesterol and beta-lipoproteid content and hemoglobin level. It was concluded that at present the key to stroke prevention is the early detection and control of hypertension and cardiac activity impairment.
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PMID:[Cerebral infarct risk factors]. 62 40

The data of 140 patients with polycythemia vera during the period 1955--1975 were analyzed with regard to clinical signs and prognosis. The average age was 53,4 years. The sex ratio was 1.9:1 in favor of men. The most frequent symptoms were headache and vertigo. In more than half of the cases hepatosplenomegaly and hypertension were found. Besides typical changes in the blood count with elevated erythrocytes, hemoglobin, hematocrit, leukocytes and thrombocytes, increased levels of alkaline leukocyte phosphatase and uric acid were found. As to therapy, after 32P-medication the survival was two years longer than after phlebotomy. In 9 patients osteomyelofibrosis developed, and in 7 cases chronic myeloic leukemia. The mean age of death was 61 years.
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PMID:[Polycythemia vera, clinical aspects and disease course]. 64 97


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