PubMed Health⌕ Search

Biomedical subjects

H Bründler

Publications and source records attributed to H Bründler.

6 recordsLinked to original sources
PubMed1987

Broxaterol (Z.1170), a new oral beta 2-agonist compared with salbutamol.

The bronchodilating activity and tolerability of a single 0.5-mg oral dose of broxaterol (Z.1170) were evaluated in 18 patients with reversible bronchial obstruction. Salbutamol 4.0 mg and placebo were used as controls. The study design was double-blind within patients. The forced expiratory volume in 1 s (FEV1), pulse rate, and blood pressure were measured immediately before and 0.5, 1, 2, 3, 4, 5, and 6 h after each treatment. At the same time clinical controls were made to detect the possible presence of side effects. Both broxaterol and salbutamol caused significant increases in FEV1 until the 5th hour as compared to baseline values and until the 2nd hour as compared to placebo. No significant difference was reported between the effects of broxaterol and those of salbutamol at all the times considered. The tolerability of broxaterol was good, as was that of salbutamol. The pulse rate and blood pressure did not show any significant clinical variations. The side effect reported most frequently was tremor.

Adrenergic beta-Agonists↗
PubMed1985

Right heart catheterization in the pre-operative evaluation of patients with lung cancer.

The right heart catheterization and lung function data of 637 consecutive patients with lung cancer evaluated preoperatively were analysed retrospectively, in order to review our past experience, and to examine, whether a subgroup of patients could be identified, in whom invasive haemodynamic measurements were dispensable due to a predictable normal result. 95 patients (14.9%) had precapillary pulmonary hypertension, 44 (6.9%) already at rest, 51 (8.0%) on exercise only. In contrast, 276 patients (43.3%) had pulmonary hypertension secondary to abnormal left ventricular function, 67 (10.6%) at rest, 209 (32.8%) on exercise only. In order to characterize a subgroup of patients, in whom precapillary pulmonary hypertension is very unlikely to be present, and in whom, therefore, right heart catheterization could be regarded as dispensable, a discriminant analysis was performed. By these means a discriminant function using FEV1, PaO2, DLCO - both on exercise - and RV/TLC as discriminant variables was obtained which can provide a qualitative prediction of precapillary pulmonary hypertension with a high sensitivity (at least 95%) and an acceptable specificity (approximately 50%). The usefulness of such a prediction was verified in a subsequent group of 71 patients. Precapillary pulmonary hypertension was correctly predicted in all cases; the specificity was 55%. It is concluded, that right heart catheterization has its value in the pre-operative evaluation of candidates for pulmonary resection due to a high prevalence of compromised haemodynamics, and that patients with a negligible risk of having precapillary pulmonary hypertension can be identified by means of non-invasive functional measurements.

Adult↗
PubMed1982

Prevalence and significance of reversible radionuclide ischemic perfusion defects in symptomatic aortic valve disease patients with or without concomitant coronary disease.

To determine the prevalence and significance of exercise-induced localized perfusion defects in symptomatic patients with aortic valve disease, thallium-201 rest and exercise studies were performed in a consecutive series of 29 such patients prior to left heart catheterization with coronary arteriography. Eight patients had repeat studies after aortic valve replacement. Twelve of 17 patients with predominant aortic regurgitation (AR) had distinct LV apical defects during exercise despite normal coronary arteries, while 10 of 12 patients with aortic valve disease and associated coronary artery disease (CAD) had localized perfusion defects in LV areas other than the apex. In patients with AR, reversible apical perfusion defects can occur without CAD; these apical defects are probably a reflection of severe LV volume overload in AR. LV perfusion defects in areas other than the apex are specific for CAD in aortic valve disease, and concomitant CAD may not provoke regional LV perfusion deficits in aortic stenosis patients with severe LV hypertrophy.

Adult↗
PubMed1980

[Myocardial perfusion scintigraphy and radionuclide angiography for the evaluation of outpatients with suspected coronary disease].

Combined ECG/myocardial perfusion szintigraphy (MPS) exercise tests were performed in 82 out-patients with suspected CAD who eventually underwent left heart catheterization. The sensitivity of MPS as compared to ECG was higher in patients with angina (86% vs. 67%) as well as in patients with atypical symptoms (63% vs. 25%). Here MPS was also more specific than ECG (86% vs. 68%). Combination of both tests improved sensitivity even more. The comparison of radionuclide and contrast ventriculography in 20 patients studied at rest revealed an excellent correlation (r = 0.90). Changes in radionuclide ejection fraction during exercise in 60 subjects showed significant differences between normals (increase of greater than 10% above resting level) and patients with CAD (decrease in patients with angina, no significant change without angina). Methods and indications are briefly discussed in the light of this experience.

Coronary Disease↗
PubMed1978

[Hyponatremia and hypoglycemia after treatment with chlorpropamide. Case histories with review of the literature on 18 cases of chlorpropamide induced hyponatremia].

A case of chlorpropamide-induced, symptomatic hyponatremia in a diabetic patient is reported. The hyponatremia was associated with loss of appetite, nausea, and vomiting. These symptoms caused reduced food intake which provoked severe hypoglycemia with disturbed consciousness. The hyponatremia developed when the chlorpropamide doses were increased from 400 to 600 mg/day. Withdrawal of chlorpropamide was followed by remission of hyponatremia. Chlorpropamide-induced hyponatremia is a rare complication and is due to an antidiuretic effect of chlorpropamide caused by increased secretion of adiuretin and potentiation of the effect of chlorpropamide caused by increased secretion of adiuretin and potentiation of the effect of adiuretin in the tubuli of the kidney. This case report and the analysis of 18 published cases in the literature show the following characteristics for chlorpropamide-induced hyponatremia: (1) Hyponatremia is a rare complication in the treatment of diabetics with chlorpropamide. The patients typically are female and over sixty. The dosage of chlorpropamide usually was 500 mg daily or even more. (2) Hyponatremia is often unrecognized for a long time because the symptoms are not specific. The characteristic symptoms include loss of appetite, nausea, vomiting, abdominal pain, confusional state and, rarely, convulsions and coma. Recovery occurs spontaneously after withdrawal of the drug. (3) The incidence of this type of hyponatremia is increased in cases of preexisting tendency to water retention such as heart failure and renal failure, and in cases of diuretic therapy. In the light of these findings, the authors believe that chlorpropamide is no longer a drug of choice in the treatment of diabetic women, especially in cases of preexisting tendency to water retention and in diuretic therapy. In such cases, a sulfonylurea without antidiuretic effect is to be preferred.

Adult↗