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Biomedical subjects

A Tugaye

Publications and source records attributed to A Tugaye.

11 recordsLinked to original sources

Renal revascularization in high-risk patients: the role of iliac renal bypass.

Between 1984 and 1989, 29 iliac renal artery bypasses were performed in 29 patients (mean age 67.8 years) with severe renovascular disease due to atheroma. The indication for renal artery reconstruction was hypertension in all patients, which was associated with kidney failure in 16 cases. In six cases, reconstruction was performed after failure or complications of percutaneous transluminal angioplasty. The bypass was constructed with polytetrafluoroethylene in 24 cases (83%) and vein graft in five cases (17%). There was no postoperative mortality. All bypasses were found to be patent on duplex scanning or digital subtraction arteriograms. One patient was lost to follow-up. Mean follow-up was 23.2 months. One patient died of acute kidney failure, probably related to occlusion of the bypass. Hypertension improved in 22 cases (79%), was cured in two cases (7%), and remained unchanged in four (14%). Renal function remained unchanged in six cases (40%) and improved in nine (60%). Iliac-to-renal artery bypass seems to be the surgical renal revascularization modality best adapted to high-risk patients or those who have severe atheroma. Additionally, this technique enables rapid treatment of failures or complications of percutaneous transluminal angioplasty of the renal artery.

Aged↗

[Treatment of arterial hypertension. Comparative effectiveness of the day care hospital and classical hospitalization].

Four years of activity in the one-day hospital (ODH) and the several-day hospital care (SHC) of the Hypertension Clinic at the Hôpital Saint-Joseph, Paris, were evaluated and compared. All data were recorded using the computerized Artemis system. Evaluation was performed by means of two prospective studies: a controlled trial of 121 patients randomized to either ODH or SHC, and a prospective follow-up study of 633 patients. Criteria for admission to the controlled study were: diastolic BP between 95 and 120 mmHg, age between 30 and 65 years, no anti-hypertensive treatment at first visit, no major cardiovascular or renal complication and no suspicion of secondary hypertension. Similar criteria applied to the uncontrolled study. The results, assessed after 2 years, were the same in both studies, with a drop-out rate of about 15%, a mean diastolic BP lower than 95 mmHg in 80% of the patients and a bodyweight reduction of about 1 kg in obese patients. The percentage of smokers who stopped cigarette smoking was higher in the SHC groups than in the ODH groups. It is concluded that the ODH system is effective in the initial management of hypertensive patients but that greater educational efforts are needed to effectively reduce cigarette smoking in OHD patients and bodyweight excess in both OHD and SHC patients.

Adult↗

Rapid identification of diabetic patients with essential hypertension sensitive to acebutolol.

The antihypertensive effect of 2,000 mg of acebutolol investigated with an acute 48 hr test in 60 diabetic and 60 non-diabetic in-patients with essential hypertension. In hypertensive diabetic patients, acebutolol was induced a significant fall in blood pressure similar to that observed in non-diabetics. The acute antihypertensive effect of acebutolol was not uniform in hypertensive subjects: a significant decrease of blood pressure was observed in 34 diabetics and 31 non-diabetic patients. Fifteen out of the 34 diabetic responders to the 48 hr test were treated by acebutolol alone for six months; a highly significant correlation between the acute and the chronic antihypertensive effect of the beta-blocker was observed. As long-term results paralleled those of the short-term experiment, acute acebutolol administration appears to be a rapid means to select hypertensive diabetics sensitive or resistant to betablockers. Plasma renin activity was not found to give, in hypertensive diabetics, a reliable predictive index of the response to acute administration of acebutolol.

Acebutolol↗