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Biomedical subjects

A E Lambert

Publications and source records attributed to A E Lambert.

At least 19 recordsLinked to original sources
PubMed1996

[Reccurent abortions: unpublished syndrome suggesting the explanation of fetal death].

A report is given of 8 cases of recurrent "idiopathic" abortions sharing in common the following features, unreported so far: (1) high uterine arterial impedance; (2) decrease in endometrial thickness, in spite of normal hormonal and endometrial cycle at biopsy; (3) a history of previous curettages. Such a syndrome could be consistent with the existence of a narrow peripheral symphysis of the uterine cavity, unaffecting its shape at hysterography.

Abortion, Habitual↗
PubMed1992

Long-term reduction of microalbuminuria after 3 years of angiotensin-converting enzyme inhibition by perindopril in hypertensive insulin-treated diabetic patients.

We studied the long-term effects of the angiotensin-converting enzyme (ACE) inhibitor perindopril, administered for 36 months on glycemic control, creatinine clearance, and albuminuria in hypertensive insulin-treated diabetics. After 1 month treatment with placebo, 39 patients entered the study and received 4-8 mg perindopril/day. Within the first 3 months, diastolic blood pressure was normalized in 80% of the patients. From these, 23 were followed during a total of 3 years on perindopril therapy, and divided in three groups according to their initial urinary albumin excretion rate (AER): 11 had normal AER (less than 15 mg/24 hours), eight had microalbuminuria (AER 15-150 mg/24 hour), and four had AER greater than 150 mg/24 hours and had overt proteinuria. Long-term (3 years) diastolic blood pressure normalization (less than or equal to 90 mm Hg) was achieved throughout the study. Concomitant with blood pressure reduction, a long-term decrease in AER was observed in normo- and microalbuminuric patients. Macroproteinuria was unaffected by perindopril. Glycemic control and creatinine clearance remained stable during the whole study period. No major side effects were observed. We conclude that perindopril safely produces a long-term normalization of elevated blood pressure in hypertensive insulin-treated diabetics without affecting glycemic control. Blood pressure normalization is associated with long-term AER reduction in normo- and microalbuminuric patients.

Albuminuria↗
PubMed1991

Spontaneous pituitary apoplexy with transient panhypopituitarism and diabetes insipidus.

A 40-year-old patient presented with intractable headache, panhypopituitarism and diabetes insipidus 5 months after a severe shock syndrome. The magnetic resonance imaging of the brain confirmed a hemorragic necrosis of the pituitary gland. On follow-up, the patient recovered a normal pituitary function, except for the persistence of a partial ACTH deficiency. The pituitary image also normalized. Pituitary apoplexy is a rare disease of severe prognosis due to its neurological and endocrine consequences. It can now be more easily recognized by the new imaging techniques.

Adult↗
PubMed1990

Perindopril safety and tolerance in at-risk patients.

The angiotensin-converting enzyme (ACE) inhibitors are effective in the treatment of hypertension and congestive heart failure. They improve the quality of life when compared with other conventional antihypertensive drugs. Perindopril, a new ACE inhibitor, is well tolerated and associated with fewer side effects than other types of antihypertensive agents. Moreover, it does not induce adverse metabolic changes such as hyperglycaemia and/or alterations in the blood lipid profile that could negate the benefits of lowering blood pressure. In hypertensive diabetic patients, perindopril decreases microalbuminuria without affecting the quality of glycaemic control and thereby may delay the progression of nephropathy. Therefore, perindopril appears to be an alternative first-line antihypertensive agent which may be useful in hypertensive diabetics.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1990

[Diabetes, malnutrition and growth retardation].

We investigated the cellular mechanisms responsible for growth hormone (GH) resistance in diabetes and malnutrition in the rat. In insulin-dependent diabetes, a post-receptor defect participates in GH resistance. During fasting, there is a loss of liver GH binding sites. Dietary protein restriction causes a post-receptor defect. This defect can be attributed to the combined effects of decreased liver IGF-I mRNA content and impaired message translation.

Animals↗
PubMed1990

[Long-term decrease of microalbuminuria after one year of treatment with perindopril in hypertensive diabetic patients].

We studied the effects of perindopril, an angiotensin converting enzyme (ACE) inhibitor administered during 12 months, on creatinine clearance, albuminuria and glycaemic control in diabetic subjects with mild to moderate hypertension. After 1 month placebo, 40 insulin-treated patients were divided into 3 groups based upon their urinary albumin excretion rate. Group 1 had a normoalbuminuria (less than 15 mg/24 h), group II had a microalbuminuria (15-150 mg/24 h) and group III had a macroproteinuria (greater than 150 mg/24 h and Albustix +). They were given perindopril 4 to 8 mg orally once daily, and received a stable diet. Diastolic blood pressure was normalized within the first 3 months in 80% of the patients. From these, 28 (14.7 and 7 from groups I, II and III respectively) were followed during a total active treatment period of 12 months. They were matched for age, duration of diabetes and hypertension, systolic and diastolic blood pressures, daily insulin dose, postprandial plasma C-peptide and quality of glycaemic control. Mean supine diastolic blood pressure was decreased by 15 and 18% at 1 and 12 months respectively. Heart rate was not significantly modified. At 3 months, plasma ACE activity was nearly totally inhibited while plasma renin activity was markedly increased. In patients of group II, microalbuminuria was reduced from 66 +/- 13 (mean +/- SEM after placebo) to 39 +/- 6 mg/24 h after 1 month perindopril and this effect was maintained at 12 months. In group I, albuminuria remained within the normal range. In group III, macroproteinuria was not consistently modified by perindopril. Creatinine clearance did not change and glycaemic control remained stable throughout the study in the 3 groups. No major side effects were observed. We conclude that perindopril normalizes blood pressure in a large majority of hypertensive diabetic patients without affecting the quality of diabetes control. It also induces a marked and sustained reduction of microalbuminuria in patients at risk of developing diabetic nephropathy.

Adult↗
PubMed1989

Treatment of hypertension in diabetic patients.

Hypertension, common in diabetic patients, worsens not only the risk of cardiovascular complications, but also that of microangiopathic complications (nephropathy, retinopathy) of diabetes mellitus. It is thus important to ensure the perfect control of even mild hypertension in diabetic patients. However, treatment sometimes becomes difficult given that certain categories of antihypertensive drugs interfere with blood glucose control and/or lipid metabolism, interfere with the symptomatology of hypoglycemia, or promote orthostatic hypotension, a complication of autonomic neuropathy. A study was undertaken to determine the effects of rilmenidine, administered for 16 weeks, in 29 diabetic patients treated with insulin and experiencing mild-to-moderate hypertension (supine diastolic blood pressure, 96.7 +/- 0.5 mmHg). Administered as single-drug therapy, rilmenidine rapidly normalized blood pressure (systolic blood pressure, less than 160 mmHg; diastolic blood pressure, no more than 90 mmHg--supine) in 17 patients; this persisted throughout the trial period. Addition of a diuretic after 12 weeks in the remaining 12 patients led to normalization of blood pressure in nine additional patients. Blood glucose control (evaluated at home by weekly blood glucose measurements and by glycosylated hemoglobin levels) was unaffected by treatment. Plasma levels of cholesterol (total, high-density lipoprotein and low-density lipoprotein), triglycerides and proteinuria (or microalbuminuria) showed no change during the course of the trial. In conclusion, rilmenidine offers an effective and safe treatment for mild-to-moderate hypertension in diabetic patients treated with insulin and does not interfere with their blood glucose control.

Antihypertensive Agents↗
PubMed1989

The insulin pen.

Explore the source record for details and available documents.

Blood Glucose↗
PubMed1989

Effect of computer-assisted insulin delivery on glycemic control of type I diabetic patients: a preliminary experience.

The aim of the study was to evaluate the effect of a computer-assisted insulin delivery on the glycemic control of type I unstable diabetic patients. 6 subjects, who already received 2-4 daily insulin injections, were treated with a pocket-size microprocessor device for periods lasting 2-14 months. The total daily insulin doses remained unchanged during the experimental period. However, the percentage of regular insulin decreased significantly from 63 +/- 3% to 47 +/- 7% (p less than 0.05). HbA1 levels decreased from 10.1 +/- 0.6% to 9.4 +/- 0.4% after 2 months computer (p less than 0.05). However, in the 2 patients who used the device for 11-14 months, the overall glycemic control was comparable during the basal and experimental periods. Hypoglycemic episodes were not increased.

Adult↗
PubMed1989

Renal function, glycaemic control and perindopril in diabetic patients.

We studied the effect of perindopril, administered during 9 months on the renal function, albuminuria and glycaemic control of diabetic subjects with a mild to moderate hypertension. After 1 month placebo, 40 insulin-treated patients were divided in 3 groups based upon the level of albuminuria. Group I had a normoalbuminuria (less than 15 mg/24 hrs). group II had a pathological microalbuminuria (15-150 mg/24 hrs) and group III had a macroproteinuria (greater than 150 mg/24 hrs). They were given perindopril (4 or 8 mg) once daily. Diastolic blood pressure was normalized within the first 3 months in 80 p. 100 of the patients. From these, 29 (13, 9 and 7 from groups I, II and III, respectively) were followed during a total treatment period of 9 months. They were matched for age, durations of diabetes and hypertension, daily insulin dose, systolic and diastolic blood pressures and quality of glycaemic control. Diastolic blood pressure was decreased by 14 and 17 p. 100 at 1 and 9 months, respectively. Heart rate was not significantly modified. At 3 months, the activity of angiotensin-converting enzyme was markedly inhibited while plasma renin activity was increased. In patients of group II, microalbuminuria was reduced from 59 +/- 13 to 32 +/- 6 mg/24 hrs after 1 month and this effect was maintained at 9 months. Despite similar decreases in blood pressure, no significant change of the albuminuria excretion rate was observed in patients of group I or III, respectively. Creatinine clearance remained stable and glycaemic control did not change throughout the study in the 3 groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Albuminuria↗
PubMed1989

Renal function, glycemic control and perindopril in diabetic patients.

We studied the effect of perindopril, administered for a period of 9 months, on renal function, albuminuria and glycemic control of diabetic subjects with mild-to-moderate hypertension. After 1 month of placebo, 40 insulin-treated patients were divided into 3 groups based on the level of albuminuria. Group I had normal albuminuria (less than 15 mg/24 hr), group II had pathological microalbuminuria (15-150 mg/24 hr) and group III had macroproteinuria (greater than 150 mg/24 hr). They were given perindopril (4 or 8 mg) once daily. Diastolic blood pressure was normalized within the first 3 months in 80% of the patients. Twenty-nine of these patients (13, 9 and 7 from groups I, II and III, respectively) were followed for a total treatment period of 9 months. They were matched for age, duration of diabetes and hypertension, daily insulin dose, systolic and diastolic blood pressures and quality of glycemic control. Diastolic blood pressure was decreased by 14 and 17% at 1 and 9 months, respectively. Heart rate was not significantly modified. At 3 months, the angiotensin converting enzyme activity was markedly inhibited, while plasma renin activity was increased. In patients in group II, microalbuminuria was reduced from 59 +/- 13 to 32 +/- 6 mg/24 hr after 1 month and this effect was maintained at 9 months. Despite similar decreases in blood pressure, no significant change in the albumin excretion rate was observed in patients in groups I and III. Creatinine clearance remained stable and glycemic control did not change throughout the study in the 3 groups. We conclude that perindopril normalizes blood pressure in a large majority of hypertensive diabetic patients without affecting the quality of diabetes control. It also induces a marked and sustained reduction in microalbuminuria in patients at risk of developing diabetic nephropathy.

Albuminuria↗
PubMed1988

Treatment of systemic hypertension in insulin-treated diabetes mellitus with rilmenidine.

The effects of a new alpha 2 agonist (S 3341 or rilmenidine) on blood pressure (BP), glycemic control, lipid metabolism and renal function were investigated during a 16-week open study in 29 insulin-treated diabetic patients with mild to moderate hypertension. There were 17 men and 12 women aged 50.9 +/- 2.2 years (mean +/- standard error of the mean). Duration of diabetes and insulin therapy was 218 +/- 24 and 143 +/- 30 months. After 2 weeks of placebo, systolic and diastolic BP was 165 +/- 3 and 97 +/- 0.5 mm Hg, respectively (supine). Rilmenidine (S 3341) given alone at daily doses of 1 or 2 mg according to the clinical response led to a prompt and sustained decrease of systolic and diastolic BP (159 +/- 4 and 88 +/- 1 mm Hg after 2 weeks; 149 +/- 3 and 85 +/- 1 mm Hg after 12 weeks; p less than 0.01). Seventeen patients (59%) had normal BP (systolic BP less than 160; diastolic BP less than 90 mm Hg, supine) after 12 weeks of S 3341. Diuretics were associated with S 3341 for the nonresponders at week 12; this led to normalization of BP in 90% of the patients at the end of the study. Glycemic control was assessed by home glucose monitoring (5 determinations/1 day per week), 24-hour glucosuria and postprandial plasma glucose at the outpatient clinic (n = 7) as well as by the measurement of the glycosylated hemoglobin. None of these parameters was significantly affected by S 3341.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Agonists↗
PubMed1987

Serum fructosamine level as a marker of glycemic control in diabetic patients with and without a residual C-peptide secretion.

Serum fructosamine was determined in 115 diabetic patients with a C-Peptide secretion (0.84 +/- 0.06 pmol/ml, mean +/- SEM) (Group A) and in 30 type I C-peptide negative totally insulin-dependent subjects (less than 0.05 pmol/ml) (Group B). A significant correlation between fructosamine and HbA1 values (r = 0.70, p less than 0.001) was evidenced in Group A. In contrast, such a correlation was not found in Group B (r = 0.33, p greater than 0.05). Fructosamine levels were also in good agreement with the physician's ratings of the degree of glycemic control in Group A, but not in Group B. It is concluded that the fructosamine measurement represents a complement rather than an alternative to HbA1, in particular in unstable diabetic patients.

Blood Glucose↗