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Biomedical subjects

A Marquez-Julio

Publications and source records attributed to A Marquez-Julio.

18 recordsLinked to original sources
PubMed1994

Perceived interpersonal attitudes and psychiatric complaints in patients with essential hypertension.

The association between perceived interpersonal attitudes and psychiatric complaints in a group of hypertensives (N = 37) was evaluated. The Influential Relationships Questionnaire (IRQ), which measures perceived care, overprotection, and criticism, was administered to all patients. Hypertensives with psychiatric complaints (n = 14) were not different in terms of age, gender, obesity, smoking, alcohol intake, occupational stress, drug treatment, and baseline systolic and diastolic blood pressures compared to hypertensives without psychiatric complaints. They were, however, different in perceiving their social environment. Hypertensives with psychiatric complaints perceived their social environment as less caring, more overprotective, and more critical. Finally, patients without psychiatric complaints showed better outcome in terms of baseline vs. follow-up measures of systolic and diastolic blood pressures than did patients without psychiatric complaints.

Adolescent↗
PubMed1991

Bulbo-pontine paralysis with deafness: the Vialetto-Van Laere syndrome.

A Caucasian girl developed slowly progressive sensory neural deafness and bulbar and spinal muscle weakness typical of the Vialetto-Van Laere syndrome. As the condition progressed the major disabilities became dysphagia, respiratory muscle weakness and postural hypotension. Treatment with gastrostomy feedings, oxygen and fludrocortisone acetate produced worthwhile functional improvement.

Adolescent↗
PubMed1989

Intravenous labetalol versus sodium nitroprusside for treatment of hypertension postcoronary bypass surgery.

Hypertension is common following coronary artery bypass surgery. The safety of labetalol, a recently released combined alpha-1 and beta-adrenergic blocking agent for treatment of hypertension in this clinical situation is controversial. The authors compared the hemodynamic effects of labetalol with those of sodium nitroprusside (SNP) in 91 patients with good left ventricular function and equally severe coronary artery disease and in whom coronary artery bypass surgery had been just completed. They were anesthetized using fentanyl, diazepam, and enflurane. If hypertension developed postoperatively, patients were randomized to receive labetalol, 2 mg/min to a maximum of 300 mg (20 patients) or sodium nitroprusside in 0.5 micrograms.kg-1.min-1 increments by infusion (20 patients) to return blood pressure to normal. Compared with control values, labetalol brought about significant (P less than 0.05) reductions in heart rate, and cardiac index. No change was noted in stroke volume or systemic vascular resistance, but slight increases were found in central venous pressure and pulmonary capillary wedge pressure. Sodium nitroprusside treatment caused significant increases in heart rate and cardiac index while reducing diastolic blood pressure, central venous pressure, and pulmonary capillary wedge pressure. Stroke volume remained unchanged. Following the study period, blood pressure was controlled in all patients with SNP. Total doses of SNP in the 16 h following the study period were significantly less in the labetalol group (46.6 +/- 11.7 mg) versus (116.1 +/- 10.3 mg) in the SNP group (P less than 0.05). In this clinical circumstance, labetalol can be safe and effective for controlling hypertension, but its mechanism of achieving this effect varies from that for sodium nitroprusside.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Cardiovascular effects of indapamide in hypertensive patients with or without renal failure. A dose-response curve.

Fifteen patients with mild-to-moderate hypertension (10 with normal and five with decreased renal function) were studied after treatment with placebo and low (1 mg), intermediate (2.5 mg), and high (5.0 mg per day) doses of indapamide, each for four weeks. Six patients--five with normal renal function--were classified as nonresponders (decrease in diastolic blood pressure less than 5 mm Hg). The remaining nine patients had dose-related decreases in blood pressure. Patients with or without renal failure showed similar decreases in blood pressure. Blood pressure reduction was associated with a significant decrease in cardiac index in the responders at the highest dose, related to a decrease in left ventricular end-diastolic dimension and stroke volume, whereas heart rate did not increase. This apparent decrease in venous return was associated with a significant decrease in body weight but not plasma volume in the responders. Indapamide did not change plasma norepinephrine levels, but decreased pressor responsiveness to exogenous norepinephrine. Responders had lower initial plasma renin activity and a smaller absolute increase in plasma renin activity while receiving indapamide, whereas angiotensin II pressor responsiveness was decreased more. The results presented indicate that the blood pressure lowering effect of indapamide in the present patient population is observed with or without renal failure and is associated with a decrease in pressor reactivity. In nonresponders, compensatory mechanisms (e.g., renin) may negate the antihypertensive effect of indapamide.

Cardiovascular System↗
PubMed1987

Increased platelet Na+-H+ exchange rates in essential hypertension: application of a novel test.

Enhanced sodium-proton exchange may play a role in the pathogenesis of hypertension. Na+-H+ exchange was measured indirectly in platelets as the rate of amiloride-sensitive and sodium-dependent volume gain of cells suspended in sodium-propionate; the cytoplasmic acidification induced by the permeant propionic acid activated the exchanger and the volume changes coupled to Na+ uptake were measured by cell sizing with a Coulter counter and 'Channelyzer'. The test was rapid, simple, and reproducible. 20 normotensives; 8 normotensives with a family history of hypertension; 15 patients with essential hypertension receiving medication; and 7 hypertensives who had not received any antihypertensive drugs were studied. The exchange rate constants of these groups were (mean [SE] in s-1 X 10(-3)) 13.1 (0.6); 15.5 (0.7); 18.4 (0.9); and 25.6 (2.8), respectively. The differences between hypertensives and normotensives were significant. Measurement of sodium-proton exchange in platelets may help to clarify the pathogenesis of hypertension.

Blood Platelets↗
PubMed1987

Vasodilators and regression of left ventricular hypertrophy. Hydralazine versus prazosin in hypertensive humans.

Long-term treatment of hypertensive rats with arterial vasodilators may further increase left ventricular hypertrophy. Since left ventricular hypertrophy may be an important determinant of outcome in hypertension, the long-term effects of arterial vasodilation with hydralazine on left ventricular mass and function were compared with those of an alternative third-line drug, the alpha1 blocker prazosin, in patients still hypertensive despite combined diuretic and beta blocker therapy. A single-blind, randomized, two-group parallel design was employed. Both treatments induced a sustained antihypertensive effect, with hydralazine showing more effect on supine blood pressure, and prazosin having more effect on standing pressure. Heart rate, cardiac output, and volume status showed only minor changes. Plasma norepinephrine showed a sustained increase when measured in both the supine and standing positions, but the increases were similar for the two treatments. Supine and standing plasma renin activity increased only during long-term treatment with hydralazine. Prazosin induced a progressive decrease in left ventricular mass over time (-34 +/- 15 g/m2 at 12 months), but hydralazine did not (-9 +/- 10 g/m2 after 12 months). Stepwise regression indicated that a decrease in systolic blood pressure was associated with a decrease in left ventricular mass with both treatments, but an increase in plasma norepinephrine was associated with an increase in left ventricular mass only with hydralazine, suggesting that increased sympathetic activity may affect left ventricular mass via cardiac alpha1 receptors. Thus, if regression of left ventricular hypertrophy is a worthwhile therapeutic goal, hydralazine and analogous arterial vasodilators are not drugs of choice.

Adult↗
PubMed1986

Pheochromocytoma of the heart.

A patient with a pheochromocytoma involving the posterior wall of the left ventricle and the coronary sinus is reported. Complete surgical removal of the tumor was possible, although it caused a perioperative myocardial infarction. The literature regarding cardiac pheochromocytoma is reviewed.

Adult↗
PubMed1984

A study of efficacy, tolerance and compliance of once-daily versus twice-daily metoprolol (Betaloc) in hypertension. Betaloc Compliance Canadian Cooperative Study Group.

The effects of metoprolol (Betaloc tablets) in a group of 193 hypertensives were compared with the effects of a slow-release formulation (Betaloc Durules) in a further group of 196 patients. Patients were selected at random for treatment. There were no differences between the groups in terms of age, weight, sex, blood pressure, concurrent illness or concomitant therapy. Blood pressure control and apparent adverse effects were similar for both groups; the overall withdrawal rate from each group was similar. Compliance, assessed by tablet counts, was significantly improved in the group receiving once-daily therapy. Simplification of the dosage regimen to once-daily therapy appears to improve the patient's willingness to comply with the physician's instructions.

Clinical Trials as Topic↗
PubMed1983

Diuretic and cardiovascular effects of indapamide in hypertensive subjects: a dose-response curve.

In a single-blind, placebo-controlled study, the effects were evaluated of increasing doses of indapamide (1.0, 2.5 and 5.0 mg/day, each dose for 4 weeks) on volume and haemodynamic status of 10 hypertensive subjects. Body weight showed a decrease of 0.5 kg at the 1 mg dose, of 1.0 kg at the 2.5 mg dose and no further decrease at 5 mg. Plasma volume did not change. Mean arterial pressure decrease in 8 subjects by about 20 mmHg; 2 patients were classified as 'non-responders'. The decrease in blood pressure was accompanied by a reduction in total peripheral resistance and no change in cardiac output. LV end-diastolic volume decreased by about 20 ml. These results suggest that indapamide not only has a diuretic effect, but also acts as a veno-arterial vasodilator.

Adult↗
PubMed1977

Purpura associated with hypergammaglobulinemia, renal tubular acidosis and osteomalacia.

Two patients with hyperglobulinemia associated with purpura were studied. One had features of Sjögren's syndrome, while the other appeared to have a primary condition -- "chronic benign purpura". Both patients also had renal tubular acidosis, osteomalacia and renal calculi, with disturbed calcium metabolism and acid-base balance. Autoantibodies were detected in the serum of both patients, and mononuclear cell infiltrates were noted in skin and kidney biopsies from both.

Acid-Base Equilibrium↗
PubMed1977

Minoxidil in refractory hypertension: benefits, risks.

The blood pressure of 18 patients with refractory hypertension was controlled by treatment with Minoxidil in combination with Propranolol and diuretics. Ten of these patients were studied prospectively and were found not to have deterioration of carbohydrate tolerance while on Minoxidil therapy. Pericardial effusions occurred in 40% of the patients, including 2 with normal renal function. This untoward effect of prolonged use Minoxidil warrants further study.

Adult↗
PubMed1972

Idiopathic orthostatic hypotension treated with levodopa and MAO inhibitor: a preliminary report.

The clinical and pathophysiological features of a case of idiopathic orthostatic hypotension (Shy-Drager syndrome) are presented. Recent reports on the pathological findings in this condition indicate that there may be a defect in catecholamine synthesis in the pigmented brain stem nuclei and sympathetic ganglia similar to that in idiopathic parkinsonism. On this basis a new form of therapy using levodopa combined with MAO inhibition is derived. The results of a trial of this therapy, which produced improvements in both the hypotension and in the extrapyramidal features of the disease, are reported.

Basal Ganglia Diseases↗
PubMedDate not supplied

Once-daily dosing of acebutolol in hypertension.

Twenty-six patients with essential hypertension were admitted to a protocol comparing the efficacy of the once-a-day administration of acebutolol with twice-a-day administration. A placebo was substituted initially for their beta-blocker therapy. Other therapy was continued in 14 (11, diuretics alone; two, diuretics plus hydralazine or alpha-methyldopa; one, alpha-methyldopa alone). After 4 weeks, lying blood pressures were 160 +/- 16 (SD) mm Hg systolic, and 101 +/- 7 mm Hg diastolic. Incremental twice-a-day doses of acebutolol resulted in normotension (lying systolic, 131 +/- 12 mm Hg; diastolic, 84 +/- 5 mm Hg) in all 26 patients (eight on 400 mg, four on 600 mg, seven on 800 mg, one on 1,000 mg, and six on 1,200 mg/day). The same twice-a-day acebutolol dose was continued for two visits, 4 weeks apart, recording pressures at 8 a.m., 12 noon, 4 p.m., and 8 p.m.; followed by two visits, 4 weeks apart, while taking the total daily dose after the 8 a.m. recording. Blood pressures during once-a-day dosing were not different from those during twice-a-day dosing at any time. Highest pressures were at 8 a.m. and lowest were at 12 noon or 4 p.m. Variations during the day in both systolic and diastolic pressures were greater during once-a-day dosing. Plasma acebutolol and metabolite concentrations were proportional to the administered dose. Eighteen patients continued acebutolol for 1 year without adverse effects other than an asymptomatic positive antinuclear antibody test in six. Once-a-day dosing was as effective as twice-a-day dosing in this group of hypertensive patients.

Acebutolol↗