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Biomedical subjects

D de la Hamette

Publications and source records attributed to D de la Hamette.

10 recordsLinked to original sources
PubMed1994

Intensive vascular training in stage IIb of peripheral arterial occlusive disease. The additive effects of intravenous prostaglandin E1 or intravenous pentoxifylline during training.

In a randomized open study, the combination of either prostaglandin E1 (PGE1) or pentoxifylline with controlled vascular training was compared with vascular training alone in patients with peripheral arterial occlusive disease in stage IIb. Forty-four patients were randomly assigned to treatment either of intensive vascular training alone (n = 15) or in combination with either i.v. pentoxifylline (200 mg over 2 hours BID, n = 15) or PGE1 (40 micrograms over 2 hours BID, n = 14). The basic therapy was a well-defined routine for vascular training, which was identical for all groups. The duration of therapy was 4 weeks. In all three test groups, there was a significant increase in the walking distance. There was a 119% increase in symptom-free walking distance in the exercise-only group. In comparison with exercise alone, the additional administration of pentoxifylline produced no greater effect; the increase was 105%. In contrast, administration of PGE1 combined with exercise achieved a remarkable improvement of 604%. Between-group comparison revealed the significant superiority of treatment with PGE1 (P < .05). During the 1-year follow-up, there was a reduction in the walking performance in all groups, albeit of variable extent. In the exercise-only and the pentoxifylline groups, the maintained increase in walking distance was only 30% compared with baseline values before the beginning of therapy. In the PGE1 group, on the other hand, the maintained improvement was 149%. Nine of 14 patients were still in stage IIa of peripheral arterial occlusive disease 1 year after PGE1 therapy.

Alprostadil↗
PubMed1994

[Noninvasive studies of macro- and microcirculation in follow-up of femoropopliteal bypass operation in IIb peripheral arterial occlusive disease].

In 42 patients with POAD in stage IIb the blood-flow in the common femoral artery and in the superficial femoral artery was measured before, 10 days after, 3 and 12 months after femoro-popliteal bypass surgery. Blood-flow was detected noninvasively using a multichannel ultrasound computer system (MAVISR). Simultaneously Doppler pressure, skin temperature and tcPO2-values were measured. Thereafter the patients had to undergo treadmill tests (painfree and maximal walking distance). Compared to healthy volunteers preoperative blood-flow was significantly (p < 0.001) reduced in the common femoral artery and in the superficial femoral artery. Postoperatively the blood-flow increased significantly (p < 0.001) in patients with an open bypass. This increase could still be demonstrated up to one year after bypass surgery. Surprisingly, a significant (p < 0.01) postoperative rise in blood-flow was also observed in the non-operated leg. Doppler pressure, tcPO2-values (calf) in the operated leg and walking distance increased significantly (p < 0.001). The MAVISR as a noninvasive procedure allows to check the further development of the bypass-function independently of subjective influences, because quantitative changes in blood-flow are documented.

Adult↗
PubMed1991

[Controlled vascular training in IIb peripheral arterial occlusive disease: additive effect of intravenous PGE1 versus intravenous pentoxifylline during training].

An intensive 4-week vascular training (patients with PAOD IIb) leads to an effective amelioration of painfree walking distance (+120%). Additive i.v. Pentoxifylline was not more effective (+105%) whereas PGE1 showed a remarkable increase (+605%). After one year the results in all groups diminished: training group: +30%, Pentoxifylline group: +30%, PGE1 group: +149%.

Alprostadil↗
PubMed1990

Coincidence of risk factors and early carotid lesions, detected with modern ultrasound techniques.

Using a multichannel pulsed Doppler ultrasound device, studies of flow kinetics and vessel wall motility at the beginning of the internal carotid artery (ICA) were carried out. Regarding the results of special computer analysis in 120 subjects with healthy vessels, a dilation of the proximal ICA and a decrease in mean flow velocity which was related to the age of the individual could be assessed. Depending on age and risk factors, wall dyskinetics and turbulences in the dorso-lateral part of the vessel could be detected and confirmed by the flow imaging method. In a second study of 100 subjects (between 15 and 50 years of age) without risk factors, an age-dependent dilatation of ICA could be diagnosed by high resolution Duplex system. In the same study an increased incidence of wall thickening and plaques formation in the dilated area of the ICA was observed. The study of 234 patients with different risk factors showed that hypertonics developed an extended dilatation of the ICA and that wall thickening and plaque formation occurred significantly more often than in other risk groups.

Adult↗
PubMed1989

Therapeutic efficacy of intravenously applied prostaglandin E1.

The pharmacological effects of intravenous PGE1 on the macro- and microcirculation were investigated in two independent studies. In the first study 10 healthy subjects were given one i.v. infusion of 2 and 3 ampoules of Prostavasin (40/60 mcg PGE1) respectively, each over 1 hour with at least 1 day wash-out phase. Before as well as 20', 30', 40', 60' and 90 min after the infusion had started measurements of the blood flow in the A. femoralis communis were performed by the means of a Doppler ultrasound technique combined with a computer program (Mavis). Furthermore, tcPO2, heart rate and blood pressure as well as possible adverse reactions were registered. In the second study 10 patients with PAOD stage IIb (mean age: 49.5 years) received one i.v. infusion of 1, 2 and 3 ampoules of Prostavasin (20, 40, 60 mcg PGE1) respectively, in 250 ml saline over 1 hour with at least 1 day wash-out phase. Before as well as 20', 40', 60', 120' and 180 min after the infusion had started, the arterial blood flow was recorded with the method described above. TcPO2, plasma viscosity, erythrocyte aggregation, blood pressures and heart rate just as possible side effects were also registered. All PGE1 regimens induced a significant dose-dependent increase in the femoral blood flow with a maximum of 68% after 40 mcg of PGE1 and 79% after 60 mcg of PGE1 in healthy subjects and a maximum of 60% after 20 mcg of PGE1, 128% after 40 mcg of PGE1 and 161% after 60 mcg of PGE1 in the patients with pAOD (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

[Use of streptokinase and urokinase in deep venous thrombosis and pulmonary embolism: indications and clinical experience].

The efficacy of fibrinolysis in DVT is dependent upon the age and organization of the thrombus as well as its localization. In consequence, selective evaluation prior to determining the indication for thrombolytic therapy is just as important for therapeutic success as choosing the appropriate fibrinolytic agent. To improve the results of fibrinolysis a team of angiologists, hemostaseologists, radiologists and surgeons are cooperating in a special "thromboembolic care unit". Phlebographic criteria were defined which allow differentiation of fibrinolytic indications depending upon the site of the thrombus. Selection of the fibrinolytic agent and careful monitoring of the thrombolysis should ensure a maximum therapeutic effect with a minimum of bleeding complications. The duration of thrombolysis was established through phlebographic verification and functional tests with venous occlusion plethysmography. The cause and results of 108 cases of thrombolysis shall be presented.

Humans↗