PubMed Health⌕ Search

Biomedical subjects

J Ménard

Publications and source records attributed to J Ménard.

At least 217 records · Page 12Linked to original sources
PubMed1981

[Screening for phaeochromocytoma : in which hypertensive patients? A semiological study of 2585 patients, including 11 with phaeochromocytoma (author's transl)].

In an attempt to find out whether phaeochromocytoma could be screened by questioning, the authors have recorded in a population of 2585 hypertensive patients the symptoms known to be most frequently associated with the tumour, i.e. headaches, palpitations and sweating attacks. Since 72.4% of the entire population reported one or another of these complaints, no single symptom could be taken as suggestive of phaeochromocytoma. However, only 6.5% of the patients reported all three symptoms and could therefore be considered as forming a subgroup likely to have the tumour. Patients in this subgroup differed from the others in the predominance of females (p less than 0.01), the higher frequency of anxiety (p less than 0.01) and above all, the higher incidence of phaeochromocytoma (5.9% as against 0.04%; p less than 0.01). The symptomatic triad (headaches, palpitations, sweating attacks) has a specificity of 93.8%, a sensitivity of 90.9% and an exclusion value of 99.9% for the diagnosis of phaeochromocytoma. Its presence in hypertensive patients justifies systematic assays of blood or urinary catecholamines. In its absence, the probability of phaeochromocytoma is inferior to 1 in 1 000.

Adrenal Gland Neoplasms↗
PubMed1980

[Role of the renin-angiotensin system in arterial hypertension with aortic coarctation in young adults].

The renin-angiotensin system (RAS) was evaluated in 7 hypertensives with pure isthmic coarctation of the aorta. RAS was studied under basal conditions, standing, after saralasine (a specific angiotensin II antagonist) and after acebutolol (a cardioselective beta-blocker and an inhibitor of renin secretion). Plasma volume was measured by radio isotopic methods and cardiac catheterisation was performed to assess the pressure gradient across the coarctation. On a normal salt diet on orthostatism, plasma renin activity (PRA) was increased in 5 patients and normal in the other 2. After moderate salt depletion, saralasine injection caused a significant fall in diastolic blood pressure (89,2 +/- 4,4 to 77,3 +/- 6,6 mmHg; p < 0,02) with an associated rise in PRA (5,7 +/- 4,4 to 17,1 +/- 9,1; p < 0,01). There was no correlation between these two parameters or their variations. The test was negative in two patients. The antihypertensive effect of acebutolol was moderate due partly to the absence of salt depletion. Inhibition of renin secretion by acebutolol was significant (4,7 to 1,95 +/- 1,10 ng AI/ml/h; p < 0,02) but did not correlate with variations of arterial blood pressure. There was no correlation between the antihypertensive effect of saralasine and acebutolol (R = 0,51). Plasma volume (n = 5) was almost always increased (47,15 +/- 5,4 ml/kg). No correlations were observed between the different levels of PRA, plasma volume, and the systolic and/or diastolic gradient. In conclusion, this study underlines the limitations of isolated peripheral assessment of PRA and the acebutolol test. On the other hand, the effectiveness of saralasine, a specific RAS antagonist, and the demonstration of the effective participation of this system associated with the usual increase in plasma volume, seems to liken coarctation of the aorta to the single kidney Goldblatt experimental model.

Adolescent↗
PubMed1979

[Effects of minoxidil on blood pressure and plasma volume in refractory hypertension (author's transl)].

We substituted minoxidil for dihydralazine in the treatment of 10 patients with refractory hypertension. Supine diastolic blood pressure decreased from 114 +/- 15 mmHg ou dihydralazine to 90 +/- 10 mmHg after one week on minoxidil (mean +/- ISD, p less than 0.01), the concomitant therapy being unchanged (sodium depletion and betablockade in all patients, methyl dopa or clonidine in seven). Simultaneously themean plasma volume increased by 395 ml (p less than 0.02) with no correlation to the decrease in blood pressure, and with no change in plasma renin activity and plasma aldosterone. Further expansion of plasma volume was prevented by furosemide, individual dosage requirement ranging from 40 to 500 mg/day, irrespective of the renal function. fter three to six months of ambulatory treatment a satisfactory blood pressure control was maintained. Hirsuties appeared in all our patients, but no subjective side effects was reported.

Adolescent↗
PubMed1979

[Plasma renin and noradrenalin levels during hypotensive therapy using acebutolol (author's transl)].

The effects of acebutolol (800 mg per day for three days) on pulse rate, blood pressure, plasma noradrenaline and plasma renin activity were measured in nine patients with essential hypertension, at rest in a horizontal position, after five minutes standing upright and after walking for one hour. Acebutolol reduced pulse rate, blood pressure and plasma renin activity in all three positions. Treatment has no influence on plasma noradrenaline in a horizontal position, but significantly reduced its orthostatic stimulation. The inhibition of noradrenergic response to an orthosatic position is compatible with a central or presynaptic effect of acebutolol. This effect would not appear to be essential to its antihypertensive action since acebutolol reduced blood pressure but not plasma noradrenaline in a horizontal position. Blood pressure response to treatment was positively correlated to initial values of plasma renin activity measured after walking for one hour and plasma noradrenaline measured after five minutes in an orthostatic position. On the basis of this correlation, measurement of these two hormonal indices is of predictive value, within the limits of a short period of treatment with acebutolol and strictly defined hospital conditions.

Acebutolol↗
PubMed1979

Direct radioimmunoassay and immunocytochemical localization of renin in human kidneys.

1. Highly specific antibodies to human renin were prepared in rabbits and used for the preparation of a renin-free substrate, the direct radioimmunoassay of renin in plasma and kidneys, and the localization of renin with fluoresceinated antibodies. 2. In a patient with a partially infarcted kidney, plasma renin activity was increased, and could be activated by acid. The direct measurement of plasma renin by radioimmunoassay gave identical values before and after acidification. 3. In the ischaemic part of the kidney, renin content was high, both by the enzymatic and the direct method of measurement. It was low in the non-ischaemic part of the kidney. 4. All afferent and some interlobular arteries of the obsolescent glomeruli were stained with fluoresceinated anti-renin antibodies. In the non-ischaemic area, the juxtaglomerular appratus did not stain. 5. Renin can now be measured in human plasma and kidney as an entity, by a specific radioimmunoassay. A direct investigation of this intrarenal hormone is now possible at the renal tissue level.

Animals↗
PubMed1979

Noradrenaline producing phaeochromocytomas with absent pressor response to beta-blockade.

In 2 patients with phaeochromocytoma, effective beta-blockade was obtained with propranolol (40 mg twice a day for 3 days) or acebutolol (400 mg twice a day for 3 days) without any effect on the blood pressure. In both patients the excretion of noradrenaline predominated over that of adrenaline, a picture found in most cases of phaeochromocytoma. A hypertensive response to beta-blockade might be expected in patients with an adrenaline-secreting tumour. It cannot be a regular event or constitute a diagnostic test in patients with suspected phaeochromocytoma.

Acebutolol↗
PubMed1979

[Role of scintigraphy in the localization of pheochromocytoma].

Of the metabolic precursors of the catecholamines fixed by the adrenal medulla, 131I marked thyrosine was chosen as a radio-tracer. 6 positive results out of 11 pheochromocytomas confirmed at surgery were obtained in a series of 23 patients. This result is comparable with the results of arteriography but there are more false positives, reflecting the insecurity of this technique which is otherwise quite innocuous.

Adrenal Gland Neoplasms↗