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Hypertension

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1
5

The pressures of pregnancy

In most developed countries except, notably, the United States, women are delaying parenthood for longer and longer. In England and Wales the latest data show that the mean age of a mother giving birth was at an all time high of 29.8 years in 2012 and that women aged 40 or over had the fastest rising fertility rate. Against this backdrop Kate Bramham and colleagues have explored a surprisingly under-researched area: the risks of pregnancy for women with chronic hypertension (doi:10.1136/bmj.g2301).  
bmj.com
over 5 years ago
Www.bmj
1
29

Chronic hypertension and pregnancy outcomes: systematic review and meta-analysis

Objective To provide an accurate assessment of complications of pregnancy in women with chronic hypertension, including comparison with population pregnancy data (US) to inform pre-pregnancy and antenatal management strategies.  
bmj.com
over 5 years ago
Www.bmj
1
23

Chronic hypertension during pregnancy

Hypertensive disorders of pregnancy are among the leading causes of fetal and maternal morbidity and mortality. Worldwide, 50 000 to 60 000 women die from pre-eclampsia each year, corresponding to 12% of all maternal deaths.1 2  
bmj.com
over 5 years ago
Www.bmj
1
52

A man with a mass in the thigh

A 54 year old man presented to his general practitioner because of a fullness in his left lateral thigh that he first noticed while playing golf, although it was not related to an identifiable injury. He had a history of hypertension and fibromyalgia and was taking atenolol, ramipril, pregabalin, and tramadol but was otherwise well. The GP thought that the swelling was caused by a muscular injury, but the patient re-presented four months later because the mass had grown from a small bump to a swelling of 8 cm in diameter. It was also beginning to cause some knee stiffness but no pain. On examination he had a large firm swelling in his lateral thigh. On this occasion his GP referred him on a two week wait to the regional plastic surgery department. An ultrasound scan showed a 6 × 8 cm intramuscular mass with cystic changes and patchy neovascularity, but no inguinal or pelvic lymphadenopathy. Ultrasonography was followed by magnetic resonance imaging, with and without gadolinium contrast (fig 1⇓).  
bmj.com
over 5 years ago
Www.bmj
1
21

Chronic hypertension during pregnancy | The BMJ

Hypertensive disorders of pregnancy are among the leading causes of fetal and maternal morbidity and mortality. Worldwide, 50 000 to 60 000 women die from pre-eclampsia each year, corresponding to 12% of all maternal deaths. - currently located behind a paywall. Your institution may have access through Athens/Elservier or similar.  
bmj.com
over 5 years ago
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1
29

A complicated case of diarrhoea

An 82 year old man presented with a six day history of watery diarrhoea, vomiting, abdominal cramps, and confusion. He had a history of hypertension, gout, and prostate cancer, which was well controlled on hormonal therapy. He was independent and lived alone. He had not travelled or used antibiotics within the past two months.  
bmj.com
over 5 years ago
Www.bmj
1
20

Chronic hypertension during pregnancy

Hypertensive disorders of pregnancy are among the leading causes of fetal and maternal morbidity and mortality. Worldwide, 50 000 to 60 000 women die from pre-eclampsia each year, corresponding to 12% of all maternal deaths.1 2  
bmj.com
over 5 years ago
Www.bmj
1
43

A man with a mass in the thigh

A 54 year old man presented to his general practitioner because of a fullness in his left lateral thigh that he first noticed while playing golf, although it was not related to an identifiable injury. He had a history of hypertension and fibromyalgia and was taking atenolol, ramipril, pregabalin, and tramadol but was otherwise well. The GP thought that the swelling was caused by a muscular injury, but the patient re-presented four months later because the mass had grown from a small bump to a swelling of 8 cm in diameter. It was also beginning to cause some knee stiffness but no pain. On examination he had a large firm swelling in his lateral thigh. On this occasion his GP referred him on a two week wait to the regional plastic surgery department. An ultrasound scan showed a 6 × 8 cm intramuscular mass with cystic changes and patchy neovascularity, but no inguinal or pelvic lymphadenopathy. Ultrasonography was followed by magnetic resonance imaging, with and without gadolinium contrast (fig 1⇓).  
bmj.com
over 5 years ago
Www.bmj
1
5

An unusual case of quadriparesis

A 48 year old man presented with a four day history of lethargy, dizziness, and an unsteady gait with recurrent falls, on a background of chronic alcohol misuse. The patient was taking desmopressin for nocturnal enuresis and bendroflumethiazide for hypertension, which were both stopped on admission.  
www.bmj.com
over 5 years ago
Www.bmj
1
48

A man with a mass in the thigh

A 54 year old man presented to his general practitioner because of a fullness in his left lateral thigh that he first noticed while playing golf, although it was not related to an identifiable injury. He had a history of hypertension and fibromyalgia and was taking atenolol, ramipril, pregabalin, and tramadol but was otherwise well. The GP thought that the swelling was caused by a muscular injury, but the patient re-presented four months later because the mass had grown from a small bump to a swelling of 8 cm in diameter. It was also beginning to cause some knee stiffness but no pain. On examination he had a large firm swelling in his lateral thigh. On this occasion his GP referred him on a two week wait to the regional plastic surgery department. An ultrasound scan showed a 6 × 8 cm intramuscular mass with cystic changes and patchy neovascularity, but no inguinal or pelvic lymphadenopathy. Ultrasonography was followed by magnetic resonance imaging, with and without gadolinium contrast (fig 1⇓).  
bmj.com
over 5 years ago
Preview
1
25

A complicated case of diarrhoea

An 82 year old man presented with a six day history of watery diarrhoea, vomiting, abdominal cramps, and confusion. He had a history of hypertension, gout, and prostate cancer, which was well controlled on hormonal therapy. He was independent and lived alone. He had not travelled or used antibiotics within the past two months.  
www.bmj.com
over 5 years ago
Www.bmj
2
56

A man with a mass in the thigh

A 54 year old man presented to his general practitioner because of a fullness in his left lateral thigh that he first noticed while playing golf, although it was not related to an identifiable injury. He had a history of hypertension and fibromyalgia and was taking atenolol, ramipril, pregabalin, and tramadol but was otherwise well. The GP thought that the swelling was caused by a muscular injury, but the patient re-presented four months later because the mass had grown from a small bump to a swelling of 8 cm in diameter. It was also beginning to cause some knee stiffness but no pain. On examination he had a large firm swelling in his lateral thigh. On this occasion his GP referred him on a two week wait to the regional plastic surgery department. An ultrasound scan showed a 6 × 8 cm intramuscular mass with cystic changes and patchy neovascularity, but no inguinal or pelvic lymphadenopathy. Ultrasonography was followed by magnetic resonance imaging, with and without gadolinium contrast (fig 1⇓).  
bmj.com
over 5 years ago
Preview
1
2

The pressures of pregnancy

In most developed countries except, notably, the United States, women are delaying parenthood for longer and longer. In England and Wales the latest data show that the mean age of a mother giving birth was at an all time high of 29.8 years in 2012 and that women aged 40 or over had the fastest rising fertility rate. Against this backdrop Kate Bramham and colleagues have explored a surprisingly under-researched area: the risks of pregnancy for women with chronic hypertension (doi:10.1136/bmj.g2301).  
bmj.com
over 5 years ago
Www.bmj
1
19

Chronic hypertension during pregnancy

Hypertensive disorders of pregnancy are among the leading causes of fetal and maternal morbidity and mortality. Worldwide, 50 000 to 60 000 women die from pre-eclampsia each year, corresponding to 12% of all maternal deaths.1 2  
www.bmj.com
over 5 years ago
Www.bmj
1
37

A man with a mass in the thigh

A 54 year old man presented to his general practitioner because of a fullness in his left lateral thigh that he first noticed while playing golf, although it was not related to an identifiable injury. He had a history of hypertension and fibromyalgia and was taking atenolol, ramipril, pregabalin, and tramadol but was otherwise well. The GP thought that the swelling was caused by a muscular injury, but the patient re-presented four months later because the mass had grown from a small bump to a swelling of 8 cm in diameter. It was also beginning to cause some knee stiffness but no pain. On examination he had a large firm swelling in his lateral thigh. On this occasion his GP referred him on a two week wait to the regional plastic surgery department. An ultrasound scan showed a 6 × 8 cm intramuscular mass with cystic changes and patchy neovascularity, but no inguinal or pelvic lymphadenopathy. Ultrasonography was followed by magnetic resonance imaging, with and without gadolinium contrast (fig 1⇓).  
bmj.com
over 5 years ago
Www.bmj
1
2

The pressures of pregnancy

In most developed countries except, notably, the United States, women are delaying parenthood for longer and longer. In England and Wales the latest data show that the mean age of a mother giving birth was at an all time high of 29.8 years in 2012 and that women aged 40 or over had the fastest rising fertility rate. Against this backdrop Kate Bramham and colleagues have explored a surprisingly under-researched area: the risks of pregnancy for women with chronic hypertension (doi:10.1136/bmj.g2301).  
bmj.com
over 5 years ago
Www.bmj
1
41

A man with a mass in the thigh

A 54 year old man presented to his general practitioner because of a fullness in his left lateral thigh that he first noticed while playing golf, although it was not related to an identifiable injury. He had a history of hypertension and fibromyalgia and was taking atenolol, ramipril, pregabalin, and tramadol but was otherwise well. The GP thought that the swelling was caused by a muscular injury, but the patient re-presented four months later because the mass had grown from a small bump to a swelling of 8 cm in diameter. It was also beginning to cause some knee stiffness but no pain. On examination he had a large firm swelling in his lateral thigh. On this occasion his GP referred him on a two week wait to the regional plastic surgery department. An ultrasound scan showed a 6 × 8 cm intramuscular mass with cystic changes and patchy neovascularity, but no inguinal or pelvic lymphadenopathy. Ultrasonography was followed by magnetic resonance imaging, with and without gadolinium contrast (fig 1⇓).  
bmj.com
over 5 years ago
Preview
1
42

CHA2DS2-VASc

CHADSVASc score for assessing the risk of stroke in AF Congestive heart failure (1 point) Hypertension (1 point) Age >75 years (2 point) Diabetes Mellitus (1 point) Prior Stroke or TIA (2 points) Vascular disease (e.g. PVD, MI) (1 point) Age 64-75 years (1 point) Sex (female) (1 point) Anticoagulation based on the CHADS2 score:  
almostadoctor.com - free medical student revision notes
over 5 years ago
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1
28

A 68 year old woman with deteriorating hearing

A 68 year old woman presented to the ear, nose, and throat (ENT) clinic with gradually worsening bilateral hearing loss over at least the past five years. This was associated with some non-intrusive tinnitus but no other otological symptoms, history of vertigo, or associated systemic problems. She found that she was increasing the TV volume to a level that her family found uncomfortable, and she had started to avoid social situations because she struggled to hear conversation among the background noise. Her medical history was unremarkable except for well controlled hypertension, for which she was taking amlodipine. She also had no history of excessive noise exposure, no previous otological problems, and no family history of note.  
bmj.com
over 5 years ago
Preview
1
27

A 68 year old woman with deteriorating hearing

A 68 year old woman presented to the ear, nose, and throat (ENT) clinic with gradually worsening bilateral hearing loss over at least the past five years. This was associated with some non-intrusive tinnitus but no other otological symptoms, history of vertigo, or associated systemic problems. She found that she was increasing the TV volume to a level that her family found uncomfortable, and she had started to avoid social situations because she struggled to hear conversation among the background noise. Her medical history was unremarkable except for well controlled hypertension, for which she was taking amlodipine. She also had no history of excessive noise exposure, no previous otological problems, and no family history of note.  
bmj.com
over 5 years ago