[Utilization of the halothane test in the detection of the malignant hypertension syndrome [MHS] in pigs]

By the halothane test we determined the development of the syndrome of malignant hyperthermia in pigs of the Belgian Landrace breed with body weight of 20 kg. We found that from 27 animals that were subjected to the test 12 positively reacted to Narcotan - Spofa anaesthesis. Pigs with the syndrome of malignant hyperthermia had considerably higher rectal temperature after anaesthesis, lower PH of venose blood, higher concentration of lactic acid and glucosis in the blood plasma. Halothane-negative animals did not produce and conspicuous changes of these indices. Most differences were statisticaly highly significant.

Malignant hypertension

Malignant or accelerated hypertension is a life-threatening disease whose complications may be prevented by rapid reduction of the blood pressure. Diazoxide is presently regarded as the preferred therapeutic agent, but drugs such as trimethaphan, sodium nitroprusside, phenoxybenzamine and hydralazine may be useful in particular situations. Treatment is best carried out in an intensive care unit, where appropriate monitoring and study of the patient can be done. Since the introduction of antihypertensive agents the life expectancy of these patients, even those with renal insufficiency, has increased.

Spontaneous remission of accelerated (malignant) hypertension in renal infarction

Malignant hypertension occurred in a young man who also was found to have a left renal infarct and higher renal vein renin levels on the left side. His hypertension was controlled with drugs and subsequently treatment with these medications was gradually discontinued over a period of nine months. He remained normotensive when no longer receiving medication, and another intravenous pyelogram demonstrated a persistent cortical defect in the left kidney.

Renovascular hypertension as a cause of cerebrovascular accident in childhood: a case report

Report on a 10 year-old boy with acute hemiplegia after an ischemic cerebrovascular accident, provoked by an unilateral renovascular disease with malignant hypertension, for which nephrectomy was carried out. The few publications pertinent to cerebrovascular complications in children with hypertension and the value of comprehensive diagnostic operations, are the basic motives for this report.

Management of hypertensive crisis in children

The availability and rapidity of onset of pharmacologic agents for the treatment of hypertensive crisis allow the pediatrician to treat nearly every case effectively. Diazoxide seems to be the agent of choice as a first drug for the patient with encephalopathy. Failure of the blood pressure to respond to this agent should lead to consideration of the use of sodium nitroprusside. The possibility of the presence of a cathecholamine-secreting tumor should also be considered in these rare patients. In less severe cases, reserpine and hydralazine--alone or in combination--offer sufficiently rapid and prolonged action to prevent the development of encephalopathy in patients with acute elevations of blood pressure.

[Malignant hypertension. Report of a case]

A case of malignant arterial hypertension, treated with sodium nitroferrecianuro, beta blockers, vasodialators, and hemodialysis with hyposodic baths is presented. It shows the favorable response to this type of treatment, in the cardiac sphere as well as the alteration in the eye grounds. The etiopathogenisis and treatment of malignant arterial hypertension, and indications for the nephrectomy and renal transplant are discussed.

Angiotensin II. Vascular reactivity and humoral effects

The vasopressor response to angiotensin II was found useful in the differential diagnosis of arterial hypertension and for a better understanding of its pathogenesis. Sodium supply was proved to influence significantly the pressor response to angiotensin II and not that to noradrenaline thus implying the presence of arterial receptors which bind angiotensin specifically. Angiotensin caused an increase of the urinary excretion of electrolytes in hypertensive patients and a decreased electrolyte excretion in normotensives. In most hypertensive patients angiotensin was found to decrease the plasma angiotensinogen and to activate the bradykinin-bradykininogen and fibrinolytic systems. In the presence of urinary infection angiotensin increased the platelet adhesiveness and the thrombelastographic changes proved that in this condition angiotensin increases the tendency to thrombosis.

[The correlation of clinical-electrocardiographic criteria with pathologic-anatomical findings in myocardial infarct]

Electrocardiographic signs of myocardial infarction obtained in 591 patients by the corrected orthogonal lead system according to Frank were compared with corresponding results of autopsy-proven material and corrected. By the corrected orthogonal lead system myocardial infarction could be recognized in 89% of the autopsy-proven cases. Moreover, electrocardiographic alterations which suggest accompanying mono- or biventricular hypertrophy were demonstrated.

[Primary aldosteronism and arterial hypertension]

The experience of surgical management of 16 patients with primary aldosteronism is summarized. The aspects of its diagnosis are analysed, and its possible atypical course indicated. The authors used pneumoretroperitoneography for determining the localization of the aldosteromas. The localization of an aldosteroma having been established, the best approach is the modified Smithweak's one, for the revision of both adrenal glands a median or transversal laparotomy is employed. All the 16 patients survived the operations favourably.

The clinical significance of systolic murmurs in the elderly

A group of 278 patients, over the age of 60 years, and representative of geriatric and general medical admissions to the District General Hospital in Banbury, Oxforshire, was studied to correlate the prevalence of systolic murmurs to age, sex, cardiac failure, ischaemic heart disease, dysrrhythmias, hypertension, peripherial vascular disease and anaemia. The object was to establish the clinical significance of these murmurs and test a postulate that they could not be dismissed as benign. Seventy-five per cent of the murmurs were judged to be aortic and 12 per cent mitral in origin. The prevalence of systolic murmurs increased with age from 32 per cent at 60-64 years to 57 per cent over 85 years, and was greater in females (44 per cent) than in males (34 per cent). The presence of systolic murmurs was related to the presence of cardiac failure, ischaemic heart disease, dysrrhythmias, hypertension, peripheral vascular disease and anemia. Only 8 per cent of patients with systolic murmurs had none of the above-mentioned six cardiovascular abnormalities compared with 36 per cent of patients without such a murmur, while multiple cardiovascular abnormalities were also commoner in the former group. The mortality rate in hospital was similar for patients with or without a systolic murmur.

Essential malignant hypertension with renal failure and persistent Australia-antigenaemia

Images

Hematuria, headache and blurred vision

Images