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Biomedical subjects

M C Houston

Publications and source records attributed to M C Houston.

45 records · Page 3Linked to original sources

Abrupt discontinuation of antihypertensive therapy.

The abrupt cessation of antihypertensive medication is usually without immediate consequence but may be associated with symptoms and signs of enhanced sympathetic activity, severe hypertension, morbid ischemic cardiovascular events, or death. This syndrome is more common after discontinuation of high doses of centrally acting antiadrenergic and beta-adrenergic blocking drugs or combination antihypertensive therapy, but it also occurs with numerous antihypertensive agents. Predisposing factors include ischemic heart disease, severe hypertension, renovascular or high renin hypertension, and high doses of multiple antihypertensive drugs. Gradual tapering of antihypertensive medications over seven to ten days will prevent symptoms and marked elevation of blood pressure. Should a discontinuation syndrome develop, re-administration of the drug previously discontinued is the most appropriate treatment.

Adrenergic beta-Antagonists↗

Pleural effusion: diagnostic value of measurements of PO2, PCO2, and pH.

A review of the literature suggests that the measurement of the partial pressure of oxygen (PO2) and carbon dioxide (PCO2) and pH may provide additional diagnostic, therapeutic, and prognostic information in the management of pleural effusions. Parapneumonic effusions with a pH less than 7.2 indicate an impending empyema requiring tube thoracostomy in more than 98% of cases. A distinction between a tuberculous pleural effusion and a malignant pleural effusion of recent onset (less than two months) can frequently be made by measuring the pleural fluid pH. In 100% of reported cases, tuberculous pleural effusions have a pleural fluid pH less than 7.4, whereas over 60% of recent malignant effusions have a pleural fluid pH greater than 7.4. Generally, measurements of PO2 and PCO2 have little discriminatory value in determining cause or proper management of pleural effusions. It is recommended that proper anaerobic collection of pleural fluid for pH measurements be obtained routinely in all pleural effusions of unknown cause.

Acidosis, Respiratory↗

Pericardial effusion associated with minoxidil therapy.

Pericardial effusions are occasionally observed in patients treated with the new oral vasodilator, minoxidil. Almost all of these cases are related to severe renal or congestive heart failure, but very rarely can be observed in patients without an identifiable cause. Such a case is reported herein, in which extensive investigation failed to reveal the cause. On further observation, the effusion subsided despite continuation of minoxidil therapy. Review of the literature suggests that pericardial effusion is uncommonly observed in patients treated with minoxidil unless accompanied by renal or cardiac failure, and that discontinuation of minoxidil therapy is not always indicated.

Furosemide↗

Mycotic aneurysms of the hepatic artery. Treatment with arterial embolization.

In a 29 year old white man with acute Staphylococcus aureus endocarditis of the aortic valve two mycotic aneurysms of the hepatic artery developed during antibiotic treatment. One aneurysm was treated with surgical ligation and the other with Gelfoam embolization. Successful obliteration of the embolized aneurysm was demonstrated by hepatic arteriography two months later. The pathogenesis, clinical manifestations and management of hepatic mycotic aneurysms is discussed with emphasis on arterial embolization.

Adult↗