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Biomedical subjects

E Selman

Publications and source records attributed to E Selman.

10 recordsLinked to original sources

A double-blind, placebo-controlled study of the effects of policosanol in patients with intermittent claudication.

This study was undertaken to evaluate the efficacy and tolerability of policosanol, a new cholesterol-lowering drug with concomitant antiplatelet effects, in patients with intermittent claudication. After a baseline period of 6 weeks, 62 patients were randomized to receive, under double-blind conditions, either placebo (31 patients) or policosanol (31), 10 mg twice daily. Walking distances in a treadmill (constant speed 3.2 km/hr, slope 10 degrees) were assessed before and after 6 months of treatment. Both groups were similar at randomization. Policosanol increased significantly (p < 0.01) the initial claudication distance from 132.5+/-13.5 m (baseline) to 205.7+/-36.3 m (after therapy) and the absolute claudication distance (p<0.0001) from 229.5+/-22.0 m to 365.4+/-46.9 m; meanwhile both variables remained unchanged in the placebo group (p<0.05). The reduction of lower limb symptoms showed a greater benefit in the policosanol group. There was no significant change in either group in the ankle/arm pressure ratio. The treatment was well tolerated. There were 10 discontinuations (seven placebo, three policosanol) from the study. Six withdrawals occurred because of adverse events (AE); all were in placebo patients. There were five serious vascular AEs in the placebo group but none in the policosanol group (p<0.05). Overall, 12/31 (38.7%) placebo patients and 3/31 (9.7%) policosanol patients experienced AEs after randomization, which showed a lesser incidence of AEs in the policosanol group (p<0.01). The present study demonstrates a beneficial effect of policosanol in patients with intermittent claudication.

Adult↗

Prenatal detection of congenital hypospadias in the Wolf-Hirschhorn (4p-) syndrome.

Hypospadias is one of the most prominent and characteristic midline defects in male infants with the Wolf-Hirschhorn (4p-) syndrome. In this report we present a case in which hypospadias was identified prenatally at 29 weeks' gestation in association with intrauterine growth retardation. Cytogenetic evaluation after birth confirmed a 46,XY,del(4)(p14) karyotype. The prenatal identification of hypospadias in fetuses with intrauterine growth retardation and normal amniotic fluid should suggest a diagnosis of Wolf-Hirschhorn syndrome.

Abnormalities, Multiple↗

[The atrioventricular canal and vascular ring. The surgical treatment of a rare anatomical association].

We report the clinical and surgical data of 11 patients with atrioventricular canal and vascular ring. Down syndrome was present in 8 cases (72.7%); 8 patients were female (72.7%). Seven patients underwent, at the same time, correction of vascular ring and banding of the pulmonary artery with 4 death. Two children underwent correction of vascular ring and subsequent correction of atrioventricular canal without mortality. Two patients underwent correction of atrioventricular canal and subsequent correction of the vascular ring with one death. The mortality of the 6 patients operated after the age of 6 months was in measure of 16.6%. This association of malformations may be due to anomalies of neural crest and, although rare, should be particularly kept in mind referring to female patients with Down syndrome.

Aorta, Thoracic↗

Postoperative evaluation after end-to-end subclavian-left coronary artery anastomosis in anomalous left coronary artery.

In most instances of anomalous left coronary artery originating from the pulmonary artery, surgical treatment is recommended. Because establishment of a direct systemic to coronary blood flow is expected to provide the best recovery of left ventricular function, various corrective procedures have been proposed. Subclavian-left coronary artery anastomosis appears to be a logical approach. Four patients operated on at Sainte-Justine Hospital, at an average age of 33 months (27 to 44), with an end-to-end subclavian-left coronary artery anastomosis were evaluated 6 to 46 months postoperatively. The anastomosis was patent in all cases. End-diastolic volume index (74.6 +/- 24.7 versus 122.7 +/- 15.3 ml/m2) and ejection fraction (0.58 +/- 0.07 versus 0.33 +/- 0.06) were improved significantly. Subclavian-left coronary artery anastomosis appears to meet the main criteria for an optimal physiologic correction of anomalous left coronary artery: restoration of a two-coronary artery system, improvement of left ventricular function, and likelihood of long-term patency.

Anastomosis, Surgical↗

[Long-term study of patients with active chronic hepatitis treated with leukocyte interferon].

Seven patients with active chronic hepatitis who received Interferon Alfa showed a marked humoral and histological improvement one year after the treatment was concluded, in 3 patients the hepatic histology was almost normal, 2 evolved to a persistent chronic hepatitis and only one showed deterioration. These results differed from those obtained immediately after the treatment (p 0.05). Interferon Alfa proves to be of the most usefulness in this disease, studies should be continued up to one year after the treatment has ended.

Follow-Up Studies↗