Biomedical subjects

I Esch

Publications and source records attributed to I Esch.

17 recordsLinked to original sources

PubMed1999

A randomized trial comparing the impact of a nonionic (Iomeprol) versus an ionic (Ioxaglate) low osmolar contrast medium on abrupt vessel closure and ischemic complications after coronary angioplasty.

OBJECTIVES: To assess the effect of nonionic versus ionic contrast media on abrupt vessel closure and major ischemic complications after coronary angioplasty. BACKGROUND: There is a continuous debate about the "thrombogenic potential" of nonionic contrast media. The results of both in vitro and in vivo investigations are incongruent. METHODS: We prospectively evaluated the outcomes of 2,000 patients undergoing percutaneous transluminal coronary angioplasty (PTCA). According to a randomized, double-blind protocol, they received either iomeprol (nonionic; n = 1,001) or ioxaglate (ionic; n = 999). Intracoronary thrombus before PTCA was found more often in the iomeprol group (4.2% vs 2.7%, p = 0.04). No other significant differences between both groups were observed with regard to pre-PTCA clinical and angiographic characteristics. RESULTS: The frequency of reocclusions necessitating repeat angioplasty occurring either in laboratory (2.9% with iomeprol and 3.0% with ioxaglate) or out of laboratory (3.1% vs 4.1%) was not significantly different. The rate of major ischemic complications was also comparable after both contrast media (emergency bypass surgery: 0.8% vs 0.7%, myocardial infarction: 1.8 vs 2.0%, cardiac death during hospital stay: 0.2% vs 0.2%). In the iomeprol group, more patients had dissections post-PTCA (30.2% vs 25.0%, p = 0.01) and more patients received intracoronary stents (31.6% vs 25.7%, p = 0.004). Allergic reactions requiring treatment occurred only in the ioxaglate group (0.0% vs 0.9%, p = 0.002). CONCLUSIONS: The nonionic contrast medium was not associated with a higher rate of abrupt vessel closure requiring repeat angioplasty, or major ischemic events. These data suggest that nonionic contrast media do not increase the risk of thrombotic complications in patients undergoing coronary interventions.

Acute Disease↗

PubMed1976

[Plasma renin activity in essential hypertension: different short- und long-term effects of diuretics (author's transl)].

In an acute clinical trial 12 patients with essential hypertension on a standardized sodium and potassium dietary intake were given either amilorid (10 mg daily, orally) or potassium canrenoate (200 mg daily, i.v.) for two days. Either treatment caused a significant decrease in blood pressure and an increase in plasma renin activity (PRA). The aldosterone excretion rate was elevated only in the patients receiving amilorid. Furthermore potassium retention and sodium loss were more pronounced in the amilorid group. Long-term treatment (up to 14 weeks) with amilorid (10 mg daily), spironolactone (200 mg daily) or chlortalidone (50 mg daily) significantly lowered the blood pressure of patients with essential hypertension. Plasma potassium and PRA rose significantly in patients receiving either amilorid or spironolactone. However, after three weeks of therapy the mean PRA returned to the pretreatment level in patients on amilorid while it remained persistently elevated in the spironolactone group. On the other hand, chlortalidone caused potassium loss and persistent elevation of PRA. A possible relationship between the changes in plasma potassium levels and PRA in response to diuretics is discussed.

Adult↗

PubMed1976

[First experiences with BS 100-141, a new antihypertensive substance].

The administration of a new guanidine derivate, BS 100-141, to 20 patients resulted in a statistically highly significant reduction of blood pressure. A comparative clinical trial of BS 100-141 and alpha-methyl-DOPA showed BS 100-141 to be more efficient in lowering the arterial pressure than alpha-methyl-DOPA, especially when the drug was used in the second period of treatment. In the majority of the patients treated with BS 100-141 a slight increase in blood glucose concentration, not exceeding the upper limits of normal values, was found.

Adult↗

PubMed1975

[The question of indication for surgery in renovascular hypertension].

11 of 22 patients with angiographical identified unilateral stenosis of renal artery underwent a reconstruction of vessels. 11 patients were treated according to conservative methods. To achieve a prognosis, we compared pressure gradient and methods based on determination of plasma renin activity (PRA) including the difference of concentration of PRA in both renal veins as well the relationship between the concentration in the renal veins and peripheral blood and the suppression of the renin secretion in the undamaged kidney. In cases when all prognostic criteria were in positive accordance, operation was successful (7 cases). When there was no accordance, we noticed a correlation between pressure gradient and surgical success in 3 cases and predicaments based on PRA and success in 2 cases. Pressure gradient is pointed out as important parameter, 3 of non operated patients showed a progression of this disease.

Adult↗

PubMed1974