Biomedical subjects

D Andronescu

Publications and source records attributed to D Andronescu.

At least 19 recordsLinked to original sources

PubMed2005

Portal hypertensive gastropathy.

Portal hypertensive gastropathy (PHG) is the term used to describe the endoscopic appearance of gastric mucosa seen in patients with cirrhotic or non-cirrhotic portal hypertension with a characteristic mosaic-like pattern with or without red spots. The prevalence of PHG varies from 50% to 98%, this variation of the prevalence being perhaps related to patient selection, inter- and intra-observer variation and absence of uniform criteria and classification. About 8% of the upper digestive hemorrhages in the cirrhotic patients are secondary to PHG. There is no general consensus on the endoscopic classification of PHG (the most New Italian Endoscopy Club). The exact pathogenesis of PHG is not completely understood, but the portal hypertension is the main factor involved in its development and not the severity of the hepatic disease. Gastric Antral Vascular Ectasia (GAVE) is a term used for the typical endoscopic findings of red stripes, separated by normal mucosa, most frequently seen in the gastric antrum or proximal stomach. Current therapy of PHG includes beta blockers, somatostatin and derivates, endoscopic and surgical methods including hepatic transplantation.

Gastric Antral Vascular Ectasia↗

PubMed2004

The role of octreotide on renal function in patients with advanced cirrhosis.

UNLABELLED: Advanced cirrhosis is characterized by arterial vasodilatation and the reduced arterial response to vasoconstrictors. Both of these are related to an increase of endothelial (prostacyclin and nitric oxide) and nonendothelial vasodilatators (glucagon) level. Experimental study had shown that the responsiveness to vasoconstrictors of the mesentery artery may be normalized by the inhibition of glucagon or nitric oxide. The aim of our study was to assess the effects on renal hemodynamics by the administration of octreotide, the synthetic somatostatin analog, an inhibitor of the release of endogenous vasodilatators. METHODS: We studied forty-six patients admitted at the University Hospital in Bucharest for advanced cirrhosis between 2000-2002. The patients aged (35-62) were divided in two groups: Group I--23 patients received intravenous octreotide by infusion of 50 microg/hour for three days; Group II--23 patients received placebo. Exclusion criteria were: A recent gastrointestinal bleeding; Hepatic encephalopathy; Serum creatinine > 1.5 mg/dl; Ultrasonographic evidence of renal disease or urinary tract obstruction. STUDY PROTOCOL: Discontinuation of pharmacological treatment with beta-blockers, nitrates and angiotensin converting enzyme inhibitors 7 days before the study; Sodium restricted diet (35 mEq/day) 2 weeks before and during the study. All the patients underwent on day 0 and 3 the following; Routine laboratory tests, Creatinine clearance for glomerular filtration rate (GRF); Urinary sodium excretion (24 hours), Water diuresis, Lithium clearance, Plasma renin activity, Plasma aldosterone concentration, Medium blood pressure, Cardiac output (by ecocardiography). CONCLUSIONS: Octreotide in a short infusion treatment induces an inhibitory effect on renin aldosterone secretion which may be responsible for the benefical effects on sodium excretion. The significant increase of MAP may be the result of an inhibition of vasodilatatory substances or an increased arterial responsiveness to vasoconstrictors. The significant effect on renal function in patients with advanced cirrhosis can be a promising therapeutic perspective in the treatment of hepatorenal syndrome.

Adult↗

PubMed2003

The effects of carvedilol a nonselective beta-blocker on portal hemodynamics in cirrhosis.

UNLABELLED: Portal hypertension is the result of increased hepatic resistance and portal influx. AIM: To assess the effects of Carvedilol, a 3rd-generation nonselective beta blocker with alpha1-adrenergic activity on portal and systemic homodynamic in patients with cirrhosis and portal hypertension. METHODS: Fifty patients with cirrhosis and portal hypertension were divided into two groups and statistically compared as follows: group I - 25 patients received Carvedilol, 12.5 mg/day and group II - 25 patients received placebo for six days. All the patients had hemodynamic, endocrine and renal measurements before and after administration of Carvedilol or placebo. They underwent creatinine clearance, lithium clearance, plasma renin activity, concentration of plasma aldosteron and urinary sodium excretion. Hemodynamic effects were assessed by portal flow volume and velocity, cardiac output and medium blood pressure. RESULTS: Carvedilol significantly increased the portal blood flow and velocity (p<0.05). Carvedilol reduced the medium blood pressure (p<0.001) with statistically insignificant alterations in creatinine clearance and 24-hours urinary sodium excretion. Carvedilol also reduced the concentration of plasma aldosteron (p < 0.002). CONCLUSIONS: Carvedilol can be used as an alternative drug for the prophylactic treatment of portal hypertension with careful monitoring of blood pressure regarding its hypotensive effects.

Adrenergic beta-Antagonists↗

PubMed1974