Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033687 (proteinuria)
 24,015 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of amphetamine abuse in late pregnancy is reported. The presenting features of convulsions, confusion, agitation with hypertension and proteinuria led to a diagnosis of eclampsia for which a caesarean section was performed. Investigations and differential diagnosis of convulsions in late pregnancy are reviewed. A general urinary drug screen gives results after 24 hr whereas, if amphetamine abuse is suspected, this can be confirmed within three hr if a specific test for urinary amphetamines is performed. The sympathomimetic effects of a single dose of amphetamine are contrasted with the depression of the sympathetic nervous system which occurs after long-term use. Implications for anaesthesia are discussed.
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PMID:Amphetamine ingestion presenting as eclampsia. 229 97

There are a number of factors that affect ureteral dilatation in patients with posterior urethral valves. These include large urinary outputs, a noncompliant bladder, and distal ureteric fibrosis. Dilatation alone does not imply obstruction, and careful studies should be obtained to document obstruction prior to considering any surgery. Our prejudice leads us to avoid ureteric reconstruction in the period immediately after valve ablation. Our findings suggest that these patients have hypertonic bladders immediately after valve ablation period, so it could be hazardous to reimplant the ureter in such a bladder and thereby expose these kidneys to unnecessary high pressures. Each patient with persistent dilatation should be treated on an individual basis. Some will require no treatment, some reimplantation with or without tailoring, and some an augmentation cystoplasty. More conservative approaches include double and triple voiding regimens, intermittent catheterization, anticholinergics, alpha sympathomimetic blockers, and regimens to decrease urinary output. These same regimens also seem to have a role in improving the level of continence, as does the onset of adolescence. Fortunately, the majority of patients with posterior urethral valves can be treated with valve ablation alone. Unfortunately, a number of patients who have creatinines of less than 1.0 mg per dl following treatment in the first year of life will go onto renal failure years later. Rapid progression to renal failure usually does not ensue until the teenage period, when proteinuria and hypertension seem to be the hallmarks. The progressive renal failure that develops in these patients may be related to the hyperfiltration syndrome that Brenner and Levine reported in patients with a decreased number of nephrons. A role for decreased intake of protein may have some influence in preserving the function of patients with a reduced number of nephrons and hopefully will affect the ultimate prognosis. The author anxiously awaits the formation and results of studies that will employ such a dietary regimen for patients with a history of severe valves in the hope of preserving renal function. However, such reports are not likely to be forthcoming during this decade.
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PMID:Current issues regarding posterior urethral valves. 388 21

Prazosin (Minipress; Pfizer), the first purely alpha-blocking antihypertensive agent, was used to treat 22 pregnant patients with moderately severe hypertension (diastolic blood pressure persistently above 95 mmHg at gestational ages ranging from 18 to 33 weeks). Prazosin was used because it is a postsynaptic alpha-blocking agent producing no direct tachycardia or renin stimulation and because its action in producing visceral vasodilation might improve uteroplacental perfusion. Oxprenolol (Trasicor; Ciba), a beta-blocking agent with intrinsic sympathomimetic activity, was added to the prazosin regimen in 12 cases. In this group pregnancy was prolonged for an average of 32 days and 10 infants survived the neonatal period. Fetal loss, mainly due to abortion, was high in the patients who had significant proteinuria, and it was not possible to prolong the pregnancy in these cases. There were no significant maternal, fetal or neonatal side-effects attributable to this combined alpha- and beta-blocking therapy, which may have both theoretical and practical advantages over other current therapies.
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PMID:Prazosin and oxprenolol therapy in pregnancy hypertension. 687 69

We present the case of a 20-year-old student with an undiagnosed pregnancy who had taken ecstasy and LSD (lysergic acid diethylamide). Twenty-four hours later she delivered a stillborn term infant, and subsequently developed eclampsia with seizures, hypertension and proteinuria. Illicit drug use is relatively common in women of child-bearing age in Australia, and is a risk factor for adverse obstetric outcomes. Ecstasy (MDMA [3,4-methylenedioxymethamphetamine]) is a sympathomimetic amine, similar to amphetamine in its cardiovascular effects. LSD is a hallucinogen with complex pharmacology and has potential for significant compromise of placental blood flow. We propose that the combined vasoconstrictive effects of MDMA and LSD caused placental ischaemia, contributing to the fetal death and precipitating a cascade of endothelial dysfunction which resulted in an eclamptic syndrome.
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PMID:Illicit drug use in late pregnancy associated with stillbirth and eclampsia. 2757 73