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 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Individuals who experience repeated stressful events are at risk for developing physical and psychological illnesses. African Americans are an ethnic group that is exposed to a range of stressors over time, including racism which leads to discrimination. African Americans also suffer disproportionately from hypertension, cardiac disease, obesity, and drug and alcohol abuse--all illnesses that have been linked to stress. This paper describes a model to guide nursing practice, research, and education about the influence of racism on the cognitive appraisal, stress, and coping of African Americans. Lazarus and Folkman's (1984) phenomenological approach to cognitive appraisal, stress, and coping is the theoretical framework on which the model is based.
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PMID:Stress and coping: the influence of racism on the cognitive appraisal processing of African Americans. 824 90

This paper is about the effort to measure the assistance load at the first level of attention given by arterial hypertension and care risk factors. It is been worked as a demonstration project to initiate activities within the setting of a Health Center. The risk factors are explored from the proportions of patients with the problems of obesity, smoking, hyperlipidemia, diabetes mellitus and alcoholism. The information was obtained from 395 consecutive cases out of 1100 persons who came to the center in a month period. They were 325 women (82.2%) and 70 men (17.2%) with a range of 18 to 85 years, average 40 +/- 17 and a median of 36. Obesity was encountered in 35.7% in men and 48.8% in women. Diabetes was found in 9.1% both sexes. Hypercholesterolemia > 200 mg/dl in 30.4% and > 240 mg/dl in 19.6%. Alcohol abuse was encountered in 14%, 9.2% in women and 37.7% in men. Smoking was present in 22.3% of them, 16.3% in women and 50% in men. High blood pressure > 140/90 mm Hg or hypertension history was present in 21% of the cases. Controlled cases were 6.6%. In the whole group 34% showed at least one risk factor, 57% showed two factors and 66% showed three factors. Therefore, the best estimate of assistance load, on the fight of risk factors associated to hypertension should not consider less than 70% among the regular subjects coming to this health center.
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PMID:[Arterial hypertension and other coronary risk factors in primary care]. 829 29

Two patients with severe liver disease complicated with ascites were recently treated at our institution. Both rapidly developed renal failure. In one patient, liver disease was the result of alcohol abuse, and in the other, was due to malnutrition associated with obesity and acute weight loss. The only reasonable therapeutic approach for these patients was believed to be a course of peritoneal dialysis, along with other supportive measures. In both cases, the management was successful. Furthermore, it was possible to discontinue dialysis at the time of discharge. We conclude that peritoneal dialysis can be a life-saving procedure in patients with severe liver disease and ascites complicated by renal failure.
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PMID:Peritoneal dialysis therapy for patients with liver and renal failure with ascites. 842 Feb 47

"Non response" to treatment of hypertension may have different reasons: it may be "physician-related" ("white coat hypertension"), of "patient related" (poor adherence to prescribed medication, alcohol abuse, obesity) and it may really be a "resistant hypertension". In such cases one should search for a primary disease. If no such disease is found one should--according to the time-factor--wait for several weeks before increasing the dose; later on one should switch to another drug with a different mechanism of action and, if necessary, use a rational combination.
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PMID:[Refractory hypertension--principles of combination therapy]. 857 49

Secondary hyperlipoproteinemias are found in connection with other primary organic diseases. Typical examples are those seen with diabetes mellitus, liver and kidney diseases. In addition there are changes induced by hormonal dysfunctions such as hypothyroidism, by the use of oral contraceptives or in postmenopausal women. During pregnancy there is a physiological transient increase in lipoproteins. In addition to primary organic diseases there are a number of exogenous factors such as obesity, malnutrition and alcohol abuse causing hyperlipidemia. The relation between hypertension and hyperlipidemia described as familial dyslipidemic hypertension is less well known. Obesity, hypertension, dyslipidemia, hyperuricemia and impaired glucose tolerance are the basic conditions of the metabolic syndrome. Familial combined hyperlipidemia is a genetically determined, dyslipidemic syndrome with a high prevalence among patients with coronary artery disease and stroke. As there are some links between familial combined hyperlipidemia and secondary hyperlipoproteinemias, this disease entity is discussed together in this paper. Familial combined hyperlipidemia is metabolically, genetically and by this on a molecular level closely linked to familial dyslipidemic hypertension as well as the metabolic syndrome. The exact mechanism of this disease is currently unknown.
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PMID:[Secondary disorders of lipid metabolism, metabolic syndrome and familial combined hyperlipidemia]. 865 Sep 33

The aim of this cross-sectional study was to evaluate the prevalence of gallstones in patients with chronic active liver disease in relation to age, sex, family history of gallstones, number of pregnancies, obesity, diabetes mellitus, aetiology of liver disease and presence or not of cirrhosis. We studied 508 patients (411 with liver cirrhosis and 97 with chronic active hepatitis) by ultrasonography. Overall prevalence of gallstones and previous cholecystectomy was 22.6% and 8.5%, respectively. A higher prevalence of gallstones was found in the subjects studied, matched for sex and age, than in the general Italian population. Univariate analysis of data showed that the prevalence of gallstones is higher in females and increases with age in both sexes and with the progression of liver disease to cirrhosis. No significant association was found between gallstones and lithogenic familiarity, obesity, diabetes mellitus, number of pregnancies and alcohol abuse. In multiple logistic regression analysis of data, female sex, increasing age and cirrhosis in the whole series, age in males and cirrhosis in females proved to be the only independent variables associated with gallstones.
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PMID:Cholelithiasis in patients with chronic active liver disease: evaluation of risk factors. 877 68

An epidemiological survey demonstrated that biliary disease detection in aborigines of the Far North is more frequent in subjects with nontraditional way of life. Chief biliary disease factors different in importance for Evens and Evenks are as follows: prior viral hepatitis, obesity, alcohol abuse. Incidence rate for different biliary diseases is not uniform in Far North native population. This may be explained by specificity of biliary functions.
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PMID:[The effect of socioeconomic status on the prevalence of biliary tract diseases in the Evens and Evenki]. 913 9

In common with other halogenated volatile anaesthetics, sevoflurane causes a dose-related cardiovascular depression and therefore the affection of blood flow of different organ systems is suggested. So far known, sevoflurane is not different compared to isoflurane in affecting liver and splanchnic blood flow. Concluded from former published studies there was no case of hepatic toxicity of sevoflurane been published so that this substance can be used in patients with reduced hepatic function. The primary organic metabolite of sevoflurane is hexafluorisopropanol (HFIP), which is readily and rapidly conjugated with glucuronic acid. No reactive intermediates are formed and HFIP appears to be an unlikely compound to form liver protein adducts. For this reasons sevoflurane "hepatitis" is not expected. Like most other inhalation agents sevoflurane increase the neuromuscular blockade after treatment with muscle relaxants in anaesthesia. The MAC values of Sevoflurane where reduced after the application of nitrous oxide, benzodiazepines and opiates. From human studies we know that chronic drug therapy with isoniazid induces the metabolism of sevoflurane, enflurane and isoflurane, markedly increasing peak plasma fluoride concentrations. However, barbiturates as well as phenytoin do not influence the metabolism of sevoflurane because these agents do not induce the major hepatic defluorinating enzyme cytochrome P450 2E1. Obesity, untreated diabetes mellitus and alcohol abuse increase the hepatic content and activity of cytochrome P450 2E1 and therefore enhanced anaesthetic defluorination is to be suspected. Until now, there are no studies about sevoflurane anaesthesia in patients after liver transplantation but the extremely low hepatotoxic potential as compared to isoflurane provides no argument to avoid this substance for anesthesia in liver transplanted patients.
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PMID:[Perfusion and metabolism of liver and splanchnic nerve area under sevoflurane anesthesia]. 989 76

Many different aetiological agents stimulate alanine aminotransferase (ALT) production. Viral markers and other aetiologies were investigated in 2166 individuals, randomly selected from 10,000 consecutive blood donors. Elevation of ALT was found in 10.8% of subjects. Grouping donors according to ALT level and correlating with, respectively, hepatitis B core antibody (HBcAb), cytomegalovirus antibody alone, or associated with HBcAb, showed similar findings (high ALT 11.1%, normal 11.6%; high 85.4%, normal 81.4%; high 10.2%, normal 11.0%, respectively). Hepatitis C virus (HCV) antibody was found to be significantly associated with elevated ALT levels (high 1.7%, normal 0.26%). Other causes of ALT elevation were alcohol abuse (17%), obesity (25%) and dyslipidaemia (38%), but in 11% there was no obvious aetiology. Although HCV is a rare cause of elevated ALT in blood donors, it seems to be the only virus, among those tested, to account for liver damage. This may be due to the non-protective role of HCV antibody, the low specificity of ALT, or the pathogenic role of uninvestigated viruses.
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PMID:Elevated alanine aminotransferase in blood donors: role of different factors and multiple viral infections. 1050 3

Non pharmacological treatments are useful in cerebral vascular diseases. An adequate diet, physical exercise and avoidance of modificable risk factors associated with lifestyle (smoking, obesity and alcohol abuse) are recommended as primary prevention against these diseases. In the early treatment, on initiation of the neurologic focalization, hyperthermia and hyperglycemia should be avoided and adequate nutrition must be achieved. The cephalic position of the patient should be adequate and physiotherapy should be initiated early. Urinary dysfunction, fecal incontinence and cutaneous complications should be prevented and appropriately controlled.
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PMID:[Non pharmacological treatments in cerebral vascular diseases]. 1061 32


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