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Biomedical subjects

B Fouquoire

Publications and source records attributed to B Fouquoire.

5 recordsLinked to original sources

[Is scheduled hospitalization over a specific period still justified in hypertension?].

To general practitioners' request, a 36-hour scheduled hospitalization over a determined period (SHDP) was set up to assess the effects and the etiology of the arterial hypertensions they had detected and to propose an appropriate treatment. From November 1988 to December 1990, 277 patients (156 male/121 female) with mean age of 44.7 +/- 14.5 were thus hospitalized over a determined period. All of them underwent 24-hour semi-ambulatory blood pressure monitoring (Bard Sentron) by using the oscillometric method, which permits to measure mean blood pressure (MBP) instead of calculating it. This 24-hour MBP was on average of 108.5 +/- 16.2 mmHg and not significantly different from daytime MBP (111 +/- 16.3 mmHg). Figures of MBP superior to 105 mmHg confirmed permanent HBP (High Blood Pressure). On the 277 patients, 46 (16%) had a normal MBP, 67 (24%) had a "borderline" MBP (between 96 and 105 mmHg). A severe HBP (MBP > 125 mmHg) found in 66 cases (23%) was confirmed by visceral impairment. Left ventricular hypertrophy (LVH) was detected in 12 cases (4.3%) on the chest radiograph, in 24 cases (8.6%) on the ECG and in 75 cases (27%) on the echocardiogram. The etiological assessment revealed 10 cases (3.61%) of secondary hypertension with 3 reno-vascular HBP and 2 Conn's adenomas. Eventually, therapeutic abstention was recommended in 57 patients (20.5%) though 20 of them had previously received antihypertensive therapy. All in all, SHDP permits a more accurate determination of the consequences and severity of HBP. The small number of secondary HBP reflects the proportion found in practice.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Measurement of blood pressure in obese patients: reliability and value of finger measurement (Finapres)].

Indirect measurement of the blood pressure in obese persons is still inaccurate, especially if the arm circumference deeply differs from one measure point to the other, so that the use of a wide bladder is inappropriate. Some alternative solutions have been described: oscillometric device on the arm or on the forearm, different shapes of the cuff-bladder, auscultation on the radial artery with the cuff on the forearm. We tested the capability of the Finapres device which measures the finger arterial blood pressure, beat to beat, using the volume clamp method of Penâz. In six obese patients (BMI > 30, arm circumference > 35 cm) treated for hypertension were undergoing functional respiratory tests. The finger pressure was measured simultaneously with intrabrachial on homolateral arm. Blood pressure was measured at rest and after a cold pressor test. [table: see text] The use of the Finapres seems to be possible. The correlation with the systolic is excellent, where as the correlation with the diastolic is weaker; which however is usual in any diastolic correlation between non invasive and invasive device. The CPT does not modify the correlations. Moreover the Finapres allows dynamic exploration which is of particular interest in obese persons because their blood pressure is particularly variable.

Blood Pressure↗

[Ambulatory blood pressure: methods, equipment, technical problems, validations].

The measurement of ambulatory blood pressure provides a discontinuous recording which reflects the pressure load over a 24 hour period. The latest recorders allow the patient a relative autonomy due to discontinuous but programmable recording and the miniaturisation of the recorder and relative silence during inflation of the cuff. The main disadvantage of the technique is the necessity of interruption of the patient's physical activity at the moment of recording indicated by an audible "beep". The concept of "active pressure load" is therefore illusory. The traditional controversy between supporters of the auscultatory versus those for the oscillometric method is far from being settled and these discussions do not resolve the problem. The use of finger plethysmographic techniques (Finapress-Ohmeda) is an interesting approach but limited for the time being by the necessity of confinement to a laboratory and recordings of short durations requiring strict conditions of ambient temperature. Future developments using ultrasonic techniques may provide a solution to these problems.

Ambulatory Care↗

[Compression of the right pulmonary artery by chronic aortic dissection].

The authors report the case of a 56-year old woman who had presented with clinical symptoms resembling those of pulmonary embolism and due to chronic dissection of the first aortic segment compressing the right branch of the pulmonary artery. Eighteen months after the acute episode, the diagnosis was suspected at echocardiography, but the other paraclinical examinations performed (scintigraphy of the lung, angiography, computerized tomography) failed to display the aortic dissection, although they enabled the diagnosis to be approached and the physiopathology to be determined. At surgery, a type II dissection was discovered, the compression was relieved and the pulmonary artery was recanalized. The post-operative period was uneventful, with return to normal of the scintigraphic and CT images. This case is exceptional in that it is extremely rare (this is the 6 th case reported) and the lesion was well tolerated, probably due to the presence of a systemic-pulmonary circulation.

Aortic Dissection↗

[Calcium intestinal absorption in normotensive and essential hypertensive subjects before and after nicardipine].

The part played by calcium in genesis of essential hypertension may be suspected. Yet, the whole of epidemiological research as well in the animal as in man is still not very convincing. The objective of such a research has been to appreciate the calcium intestinal absorption before and after nicardipine treatment in 11 subjects (5 M/6 F) aged between 32 and 82. The group is made up of 7 hypertensive patients (2 M/5 F) and 4 normotensive ones (3 M/1 F). Subjects showing bone disease, kidney insufficiency and stone in kidneys or under such a treatment as to interfere with calcium metabolism had been excluded. Dosage of calcium and phosphate, Na, K, aldosterone, in blood and urine and PTH and PRA in blood had been effectuated. Estimation of true calcium absorption has been made by double isotope deconvolution method. Blood pressure has been measured by semi-ambulatory monitoring method. Similar evaluation has been made after four weeks treatment (60 mg of nicardipine a day). Without any treatment, normotensive subjects have a lower intestinal absorption coefficient than the hypertensive ones, which is normal (non significative statistical results: NS). Under nicardipine, hypertensive patients seem to get lower intestinal absorption (NS); other clinical, biological parameters show no change, except a rise of apoprotein A after nicardipine treatment (P less than or equal to 0.05). So, the intestinal absorption of calcium would become higher in hypertensive subjects and diminished by calcium antagonist treatment.

Aged↗