Plethora of ACE inhibitors?
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Angiotensin-Converting Enzyme Inhibitors↗
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Results for “PLETHORA”
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A plethora of accents.
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Ambulatory Surgical Procedures↗
[Medical demography in Lebanon. Plethora, feminization, youthfulness].
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Adult↗
Prognostic value of echocardiography in hospitalized patients with pericardial effusion.
It is often difficult to predict outcome in hospitalized patients with pericardial effusion. To address this issue, the prognostic value of echocardiography was studied in 187 hospitalized patients diagnosed with pericardial effusions over a 1-year period. The index echocardiogram showed that 11 effusions were large (6%), 39 were moderate (21%), and 137 were small (73%). Right ventricular collapse was present in 7% of cases (13 of 178), right atrial collapse in 12% (21 of 168), and inferior vena cava (IVC) plethora with blunted response to respiration in 35% (46 of 132). During the course of hospitalization, 9 patients (5%) had cardiac tamponade and 16 (9%) had cardiac tamponade, pericardiocentesis and/or surgical drainage (combined end point). By univariate analysis, each echocardiographic sign was associated with both cardiac tamponade and the combined end point (p less than or equal to 0.01 for comparisons with size and right-sided chamber collapse; p less than or equal to 0.07 for comparisons with IVC plethora). When the data were analyzed with logistic regression modeling, effusion size was the most powerful predictor of outcome (cardiac tamponade: odds ratio 51, 95% confidence interval 3.5-729, p = 0.004; combined end point: odds ratio 78, 95% confidence interval 14-421, p = 0.0001), and neither right-sided chamber collapse nor IVC plethora with blunted response to respiration retained significant associations. It is concluded that echocardiographically determined effusion size is a powerful predictor of outcome in hospitalized patients with pericardial effusion, and that right-sided chamber collapse and IVC plethora with blunted response to respiration add little if any additional prognostic information.
Cardiac Tamponade↗
Ultrasonic research of abdominal organs in conditions of long-term antiorthostatic hypokinesia.
Change in functional activity of digestive system in space flight usually is associated with phenomenon of hypokinesia which takes place in microgravity. However, it is marked that the reorganization of a gastrointestinal tract in space flight occurs on a background of the phenomenon of venous plethora in abdominal cavity, which can also result in changes of functional activity in organs of digestive system. Insignificant amount of studies of venous plethora in abdominal cavity carried out in conditions of space flight does not allow to create a complete picture of this phenomenon. Hemodynamical changes comparable to microgravity are well-simulated in conditions of a long-term antiorthostatic hypokinesia (AH)--bed-rest in a head-down tilt. The present research was performed with the aim to study venous plethora in abdominal cavity in conditions of long-term AH.
Abdomen↗
[Vessels of the microcirculatory bed of the heart in myocardial infarction].
Vessels of the microcirculatory bed of the heart in myocardial infarction were studied on the basis of the material of 21 section observations using histological, histochemical methods and the technique of impregnation of films of the epicardium developed by V. V. Kupriyanov. In the ischemic stage in the zone of ischemia and in perifocal areas there were noted signs of increased vascular permeability and impairment of hemodynamics: plethora of the venous department of the microcirculatory system, stasis of the blood in capillaries, spasm and paresis of vessels of the microcirculation. In the necrotic stage in the zone of necrosis there were observed destruction of vessels of the microcirculatory bed; in the peri-infarction zone--drastic plethora of veins, venules and capillaries, higher vascular permeability, leucostasis, leucopedesis, perivascular cellular infiltrates, destruction of vessels of the microcirculatory bed, dilatation of lymphatic vessels; in the intact zone--venous plethora and elevated permeability. In cases of shocks and collapses in vessels of the microcirculatory bed of the heart beyond the zone of necrosis aggregations of erythrocytes were found. In the reparative stage newly formed vessels in the granulation tissue were observed; In the post-infarction scars sinusoid vascular cavities and arteries of the closing type were noted.
Aged↗
The origin of metallothionein in red blood cells.
The origin of metallothionein (MT) in red blood cells (RBCs) from a mouse given cadmium was studied in connection with RBC kinetics. Plasma Cd concentration rapidly decreased 3 hr following 109CdCl2 (2 mg/kg, sc) administration, whereas RBC Cd increased from 2 to 4 days, followed by a gradual decrease. RBC Cd was found to be distributed more in the high-molecular-weight fraction than in the MT fraction 12 hr after administration. But, thereafter, Cd increased rapidly in the MT fraction to show changes with time similar to Cd level in RBCs. Hepatic damage induced in a mouse given 21 injections of Cd, with resultant marked elevation of plasma MT concentrations, did not cause any change in RBC Cd concentration. MT was hardly transferred to RBC when a mouse RBC suspension was incubated with mouse hepatic MT. To examine the relationship of Cd-MT and erythropoietic function, mice in the normal group, the phenylhydrazine-induced anemia group (PH), the transfusion-induced plethora group (TR), and the erythropoietin administered plethora group (TR + EP) were given 109CdCl2. Three days after administration, Cd concentration in its RBCs and its MT fraction remarkably increased in the PH group, and was greatly decreased in the TR group. A significant increase was noted in the TR + EP group as compared with the TR group. These results indicate that MT in the RBCs is formed in erythroblasts.
Anemia, Hemolytic↗
A literature review of low back disorder surveillance measures and risk factors.
OBJECTIVE: The goal of this literature review was to gain insight into low back disorder risk factors via a critical examination of the surveillance measures and analysis techniques employed in existing literature. DESIGN: Fifty-seven original articles were evaluated and categorized as a function of their surveillance measures. BACKGROUND: There have been a plethora of articles concerning the causes of low back disorder, yet no specific risk factors are consistently associated with the development of these disorders. It was hypothesized that different low back surveillance measures and variations in risk factor (dependent variable) measurements have led to the inconsistencies in the literature. METHODS: Five low back disorder surveillance measures and five risk factor categories were defined for this review. Each article was classified on several criteria including: surveillance measures, risk factors, statistical methods, population and type of study. Summary statistics were calculated for the percentage of positive findings as a function of surveillance measure and risk factor category. RESULTS: The most consistently defined surveillance measure was incidence of low back disorder, with 82% of those investigating it as claims from medical records or Occupational Safety and Health Administration records. The combination of surveillance measures and risk factor influenced the outcome of investigations. Ninety-one percent of the direct or video methods of measuring exposure risk factor influenced outcome. Psychosocial measures had positive findings in 70% of the studies examining lost time. Finally, statistical methodology was critical in the outcome of these investigations. CONCLUSIONS: The surveillance measure of incidence had more positive findings, with exposure risk factors and the surveillance measures indicating more advanced stages of low back disorder such as lost time had more positive findings with psychosocial risk factors. Thus, as low back disorders progress to disability, the psychosocial risk factors play a more prominent role. RELEVANCE: In order to prevent low back disorders we must first understand the plethora of epidemiological literature. This literature review provides new insight on the critical issues that have contributed to the results of previous research.
Journal Article↗
Leukemia: beneficial actions of retinoids and rexinoids.
Acute promyelocytic leukemia (APL), a subtype of acute myeloid leukemia, is the prototype of a cancer that can be cured by differentiation therapy using combined retinoic acid (RA) and chemotherapy. Acute promyelocytic leukemia is caused by chromosomal translocations, which in the large majority of cases generate the prototypic promyelocytic leukemia-retinoic-acid receptor alpha (PML-RARalpha) an oncogenic fusion protein formed from the retinoic-acid receptor alpha and the so-called PML protein. The fusion protein leads to the deregulation of wild type PML and RARalpha function, thus inducing the differentiation block and an altered survival capacity of promyelocytes of affected patients. A plethora of studies have revealed molecular details that account for the oncogenic properties of acute promyelocytic leukemia fusion proteins and the events that contribute to the therapy-induced differentiation and apoptosis of patients' blasts. Illustrating the beneficial mechanisms of action of retinoids for acute promyelocytic leukemia patients this review goes on to discuss a plethora of recently recognized molecular paradigms by which retinoids and rexinoids, alone or in combination with other compounds, regulate growth, differentiation and apoptosis also in non-acute promyelocytic leukemia cells, highlighting their potential as drugs for cancer therapy and prevention.
Apoptosis↗
[Cushing's syndrome caused by paraneoplastic ACTH secretion 11 years after occurence of a medullary thyroid carcinoma].
HISTORY AND ADMISSION FINDINGS: A 47-year-old man, with known and treated hypertension for 2 years, was admitted because of recent marked weight gain. Eleven years before a medullary thyroid carcinoma had necessitated removal of his thyroid and parathyroids. He was not receiving levothyroxine, calcium and vitamin D. Physical examination revealed florid Cushing's syndrome with a "buffalo hump", plethora, truncal obesity and red striae. Both his mother and a maternal male cousin were reported to have had a medullary thyroid carcinoma. INVESTIGATIONS: Plasma ACTH was 80 pg/ml (normal 10-70 pg/ml), urinary cortisol 764 microgram/24 h (normal 20-100 microgram/24 h). ACTH rose to 93.1 pg/ml after dexamethasone, with little suppression of serum cortisol (reduced from 34.4 to 22.1 microgram/dl; normal 7-25 microgram/dl. Magnetic resonance imaging did not detected an abnormal hypophysis. Petrosal sinus catheterization revealed hypophyseal suppression of ACTH, without evidence of focal peripheral ACTH production. Calcitonin was 24 000 pg/ml (normal < 8.8 pg/ml). Computed tomography showed multiple round lesions in the liver (histology: metastasis of a C-cell carcinoma). Genetic test showed a multiple endocrine neoplasm type IIa. DIAGNOSIS, TREATMENT AND COURSE: The findings indicated Cushing's syndrome, most likely due to paraneoplastic ACTH secretion from a metastasis of the C-cell carcinoma. In the absence of a site of paraneoplastic ACTH secretion, bilateral adrenalectomy was performed. The plethora and striae regressed postoperatively and it was possible to reduce markedly the antihypertensive medication. CONCLUSION: An ectopic site of ACTH should be included in the differential diagnosis of Cushing's syndrome. This is the first reported case of a medullary thyroid carcinoma and ectopic ACTH production in which the paraneoplastic ACTH secretion had been delayed for 11 years.
Adrenalectomy↗
[Results of studies of carbohydrate metabolism and ultrasonography of the pancreas in man after continuous anti-orthostatic hypokinesia].
Data on the hypokinesia-induced transformation of the glycemic profile and ultrasonic changes in the pancreas structure are presented. The AOH study gave further evidence of transforming glycemic curves. Moreover, increased sizes of tail and head of the pancreas and a decrease in its echogeneity were observed in all test-subjects. Structural changes in the pancreas were confirmed by biochemical investigations which revealed increased levels of blood enzymes and activation of insulin secretion. Increases in the liver size, thickness of the wall of the stomach, diameter of the splenic vein were indicative of progressing venous plethora in the portal vein system. It was shown that venous plethora are the main cause for changes in the upper GI, and in the pancreas state in particular, which can be qualified as dysfunctional. These structural changes in the pancreas could suppress its functional activity manifested by increases in blood enzymes and hormones and transformation of the glycemic profile during the glucose load.
Adult↗
[Chronic progressive polycythemia and thrombocytosis].
The 73-year-old female patient presented with chronic progressive erythrocytosis diagnosed 5 years ago which now is accompanied by thrombocytosis. She complains about generalised itching, pain in distal limbs and shows marked plethora. Having excluded major causes of secondary erythrocytosis the diagnosis was polycythaemia vera with a typical constellation of symptoms, findings and course of disease. Under treatment with 5-Hydroxyurea and repeated phlebotomy thrombocyte count and haematocrit normalised and the patient recovered her usual vitality. Limb pain, itching and plethora disappeared.
Aged↗
Noninvasive/invasive correlates of exaggerated ventricular interdependence in cardiac tamponade.
Ventricular interdependence is that property of the normal heart such that distension of one ventricle alters the distensibility and filling pressure of the other. This phenomenon coupled with reciprocal changes in right and left heart venous return during normal quiet respiration results in minor decreases in left ventricular stroke volume, systolic blood pressure, pulse pressure, total electromechanical systole (Q-A2), left ventricular ejection time and mitral e-wave velocity during inspiration and minor increases in these parameters during expiration. Opposite changes in these parameters occur in the right heart with increases occurring during inspiration and decreases during expiration. Exaggerated ventricular interdependence occurs in cardiac tamponade when the pericardial constraint limits the total contents in the pericardial sac. This, together with the decreased effective left ventricular filling pressure which occurs during inspiration, is responsible for the exaggerated decrease in stroke volume, blood pressure, pulse pressure, left ventricular ejection time and mitral e-wave velocity in this condition. These observations, together with the echocardiographic findings of right atrial collapse, right ventricular collapse, and inferior vena cava plethora constitute the noninvasive diagnosis of pericardial tamponade. The utility of these noninvasive tests in detecting both the presence and degree of increased pericardial pressure was evaluated in 33 invasively studied patients with pericardial effusion. In Group 1 (n = 13) intrapericardial pressure was elevated but less than both right atrial pressure and pulmonary wedge pressure, in Group 2 (n = 10) intrapericardial pressure equaled right atrial pressure but was less than pulmonary wedge pressure, and in Group 3 (n = 10) intrapericardial pressure equaled right atrial pressure and pulmonary wedge pressure. From these data it is concluded that right atrial and right ventricular collapse are highly sensitive techniques for predicting increased intrapericardial pressure in all three groups, but fail to predict the level of intrapericardial pressure and the severity of hemodynamic compromise. However, the absence of inferior vena cava plethora helped separate Group 1 patients from Groups 2 and 3 patients, thereby aiding in distinguishing a group of patients with severe hemodynamic derangement requiring urgent intervention. Exaggerated reciprocal changes in mitral and tricuspid e-wave velocity is a very sensitive finding for increased intrapericardial pressure. However, its presence correlates poorly with the severity of tamponade. Acute pericardial tamponade is a clinical diagnosis determined by the integration of the history, physical exam and appropriate noninvasive physiologic and imaging techniques.
Adult↗
Brain vessels in the rats exposed to primary and repeated tail-suspension. Minimization of structural changes after repeated exposure.
The aim of study was histological examination of brain vessels in the rats exposed to repeated tail-suspension (TS). The rats were subjected to 30-day TS, then readapted to horizontal position for 30 days and again exposed to 14-day TS simultaneously with the rats which were underwent to 14-day TS for the first time. 30-day TS induced in brain vessels the adaptive changes hindering the excessive blood inflow to brain--spasm and hypertrophy of muscle-elastic valves in extra- and intracerebral arteries and also the destructive changes--loss of vascular tone in extra- and intracerebral arteries, plethora in extra- and intracerebral veins, intracerebral venules and capillaries, conglutination of erythrocytes in capillaries, plasmatization of veins and capillaries and edema of brain tissue pointing out in total the increase in blood inflow to the brain and difficulty of blood outflow. After 30-day readaptation of TS-rats to horizontal position only adaptive changes in extracerebral arteries and intracerebral capillaries (cell proliferation) and edema of brain tissue were revealed. After repeated, 14-day TS in spite of new redistribution of blood to the head, in contrast to the vessel alterations after primary 14-day TS, the adaptive and destructive changes in brain vessels were lack, excluding only moderate plethora of intracerebral veins, cell proliferation in capillaries and weak signs of edema.
Adaptation, Physiological↗
[Vascularization of the testes of the white rat in the high altitude conditions of the Pamir and Antarctica].
By means of histometric and morphometric methods vascularization of the white rat testes has been studied at adaptation to living conditions in the Alpian Pamir (at the altitude of 4,000 m) and in the Antarctic Continent (at the altitude of 3,488 m). The leading factor in development of the parenchymatous rearrangements of the testes are certain disturbances of the microcirculatory link in the intraorganic bed. Different degree in manifestation of the morphological signs of the circulatory disturbances are revealed: plethora, interstitial tissue edema, degenerative changes in the spermatogenic epithelium cells and hence decreasing activity of spermatogenesis. The disturbances noted are essentially various in different stages of adaptation to the altitude. In contrast to the Pamir series of the experiment, in the group of the animals adapting to the living conditions of "Vostok" station, dilatation of the capillary lumens and signs of moderate plethora accompanying them remain up to the end of the observations.
Acclimatization↗
[Adrenergic innervation of the myocardium in rats with toxic exposures].
Chronic intraperitoneal injection of cadmium and copper salts produces cardiotoxic effects of various degree. The degree of the muscular tissue lesion in the ventricles and atria is inverse to the number of luminescent nervous terminals. Changes in the adrenergic fibers are accompanied with certain metabolic shifts in the muscular tissue of the heart; this is evident from decreasing succinate dehydrogenase activity in cardiomyocytes and accumulation of lipids. Certain disorders are also revealed in cardiomyocytes, in vessels and in interstitial connective tissue demonstrated as: plethora, phenomena of stasis in the capillary bed, moderate perivascular edema, myocardial dystrophy. The foci of lesions are found more often in the left ventricle in myocardial tissue and under epicardium, sometimes near plethoric vessels and less often in the right ventricle and in the atria. The dependence between location of the myocardial lesions and vascular disorders is not always noted. This is observed more often under effect of cadmium sulfate and, evidently, is dependent not only on hypoxia, connected with congestive plethora, but with neurohumoral influences, too.
Adrenergic Fibers↗
Separation and concentration of murine hematopoietic stem cells (CFUS) using a combination of density gradient sedimentation and counterflow centrifugal elutriation.
To obtain concentrated suspensions of pluripotent hematopoietic stem cells *CFUS) from murine bone marrow, density gradient centrifugal sedimentation (DGCS) was combined with counterflow centrifugal elutriation (CE). This combination provided a 7.6 fold enrichment of the CFUS concentration. For DGCS, Percoll a suspension of silica particles coated with polyvinylpyrrolidone was used. For fractionation by the CE an elutriator rotor (JE-6, Beckman) was used for further concentration of the cells harvested from the DGCS. Bone marrow erythropoiesis was suppressed by transfusion plethora initiated 5-6 days before the bone marrow was harvested. These two physical separation procedures combined with transfusion plethora to suppress erythropoiesis are effective in producing an enriched fraction of CFUS without change in distribution of the histologic type of colonies.
Animals↗
Role of the hypophysis in erythropoietin production during hypoxia.
Hypophysectomized or sham-operated male rats were exposed to hypoxia (0.42--0.40 or 0.37--0.35 atm for 6, 12, or 24 hr) applied 2 wk to 7 mo after surgery. Erythropoietin (Ep) levels in rat serum were evaluated on the basis of the exhypoxic polycythemic mouse assay. Ep activity evoked by hypoxia was significantly lower in hypophysectomized rats than in sham-operated controls. Progressive increase of the EP response to hypoxia correlated with extension of the time interval between hypophysectomy and hypoxia from 2 wk to 2--4 mo apparently mediated by the simultaneous inverse decline of red cell mass (RCM) values, i.e., of the "relative plethora" induced by a low O2 demand associated with relatively high RCM values. However, after 3--7 mo hypoxic Ep activity was still lower than in sham-operated controls. In these ablated animals the relative plethora became negligible or absent; accordingly, the Ep response apparently had reached plateau levels. These studies indicate that hypophysis (hypophyseal and target hormones, with the exception of estrogens) modulates Ep production under hypoxic conditions, possibly via a permissive enhancement of renal Ep activity.
Animals↗