PubMed Health⌕ Search

Biomedical subjects

L Bara

Publications and source records attributed to L Bara.

At least 55 records · Page 3Linked to original sources
PubMed1992

Tolerability of isradipine in the treatment of mild-to-moderate hypertension in general practice: a large-scale surveillance study.

The tolerability of isradipine was evaluated in an open trial of patients with mild-to-moderate essential hypertension as treated in general practice. The primary objective was to identify all adverse reactions, especially those that were newly occurring (greater than or equal to 6 reports), with a frequency greater than 1/1,000. Over 1,100 general practitioners and 5,526 patients participated in this trial. After a 2-week washout period, and a 3-week placebo run-in, patients with diastolic blood pressure (DBP) greater than or equal to 95 mm Hg were initially given isradipine at 1.25 mg twice daily. After 4 weeks, doses were doubled if DBP was greater than 90 mm Hg. If, after a further 4 weeks with doubled dosages, the DBP was still greater than 90 mm Hg, a second (nonspecified free-choice) antihypertensive agent was added to the treatment. Adverse events were recorded by open questioning. The incidence of adverse events was found to be similar to that with placebo; adverse events were generally mild or moderate in intensity and disappeared over time. No newly occurring adverse events were found. In conclusion, isradipine is safe and well tolerated at effective antihypertensive doses in patients with mild-to-moderate hypertension as treated in general practice.

Calcium Channel Blockers↗
PubMed1991

Anti Xa activity and prothrombinase inhibition in patients treated with two different doses of enoxaparin in gynecologic surgery.

A prospective open study was performed in a series of 547 patients undergoing gynecologic surgery. A dose of 20 mg of enoxaparin was administered to all patients 2 hours before surgery. Then patients at high risk of thrombosis (mostly oncologic surgery) received 40 mg of enoxaparin daily whereas those at moderate risk received 20 mg of enoxaparin daily. The principal aim of this prospective open study was to monitor amidolytic anti Xa activity and to study the inhibition of intrinsic prothrombinase using prothrombin consumption measurement as a simple and global test. A second aim was to investigate efficacy and tolerance of these regimens. Treatment tolerance was satisfactory with both regimens since the total incidence of bleeding was 1.8%. A single patient developed a clinically significant thrombosis during hospital stay. The results confirm and extend previous reports regarding a dose effect relationship between the dose of Enoxaparin and plasma Anti Xa activity 3 hours after s.c. injection. A significant relationship was found between Anti Xa activity and patients body weight. Interestingly a dose dependent inhibition of intrinsic prothrombinase was observed when using a one stage prothrombin consumption assay in whole blood. This test in whole blood can be considered as closer to physiological conditions than assays performed in citrated platelet rich or platelet poor plasma samples. The mechanism of intrinsic prothrombinase inhibition during prophylactic treatment with enoxaparin requires further investigation.

Adult↗
PubMed1991

Pharmacokinetics and biodistribution of technetium 99m labelled standard heparin and a low molecular weight heparin (enoxaparin) after intravenous injection in normal volunteers.

For a better understanding of low molecular weight heparin pharmacokinetics, 99m technetium labelled heparin and enoxaparin were injected intravenously to four normal volunteers, after approval by the Ethics Committee and preliminary animals studies. In vitro and in vivo, the labelled products proved to be stable and identical to the non-labelled drugs. Radioactivity curves in blood, organs and urines were similar for both products. Anti Xa plasma half-life was 3 times longer for enoxaparin than for heparin. Anti IIa plasma half-lives were similar. However, radioactivity persisted much longer than biological activities for both products. After chromatography, most of the radioactivity was bound to AT III, where an anti Xa activity peak was also detected. The anti Xa activity peak seen after adding AT III to plasma was much higher with heparin than with enoxaparin. In urine, biological activities, measured with AT III supplementation, were higher with enoxaparin than with heparin. These results suggest that phenomena other than biodistribution are responsible for the differences in pharmacokinetics observed between these two products. The two most likely explanations are differences in metabolism and/or a release of an endogenous factor.

Adult↗
PubMed1990

The inhibition of intrinsic prothrombinase and its generation by heparin and four derivatives in prothrombin poor plasma.

The effect of different heparins and a synthetic pentasaccharide on the inhibition of intrinsic prothrombinase and of its generation was studied by a new technique, using a defibrinated prothrombin poor human plasma, supplemented with phospholipids and calcium. Prothrombinase activity was evaluated on purified prothrombin with a chromogenic substrate. This technique is designed to bypass the interference of massive endogenous thrombin generation on the measurement of prothrombinase activity. We first validated the specificity of the technique by using specific Xa and IIa inhibitors. Then, the inhibition of prothrombinase generation and the inhibition of generated prothrombinase were both studied. The results showed that anti-Xa activity measured on exogenous bovine factor Xa added to plasma was not correlated with the inhibition of prothrombinase generation or prothrombinase activity. The concentrations required for unfractionated heparin (the 4th International Standard: 4th IS UH), 1st International Standard Low Molecular Weight Heparins (1st IS LMWH), enoxaparin, Fraxiparine, and pentasaccharide in order to inhibit preformed prothrombinase were significantly higher than those necessary to inhibit prothrombinase generation. These data suggest that anti-Xa activity of unfractionated heparin and its derivatives does not completely reflect the extent of the inhibition of intrinsic prothrombinase generation by UH, LMWH, and pentasaccharide. On the other hand, anti-IIa activity of heparins could be responsible for the inhibition of prothrombinase generation. The action of pentasaccharide devoid of anti-IIa activity on prothrombinase generation appears related to its indirect effect on the formation of initial thrombin traces. This new technique provides a tool to study the essential role played by thrombin during the early steps of coagulation.

Factor Xa Inhibitors↗
PubMed1990

In vitro effect on Heptest of low molecular weight heparin fractions and preparations with various anti-IIa and anti-Xa activities.

The Heptest heparin assay has recently been introduced, and evaluated for the laboratory monitoring of patients receiving low molecular weight heparins (LMWH). The aim of the present study was to elucidate the relative role on the Heptest assay of the anti-factors Xa and IIa activities present in the three types of compounds that possess: 1. exclusively anti-Xa activity (LF1: LMWH fractions with MW ranging from 1,200 to 4,200 D.); 2. both anti-Xa and anti-IIa activities (LF2 with MW from 4,800 to 12,000 D.); 3. exclusive anti-IIa activity (Hirudin and Dermatan Sulfate). All compounds studied demonstrated dose-dependent activities in both amidolytic and clotting assays. The LF2 in contrast to the LF1, additionally enhanced the clotting times of Heptest. This enhancement was shown to be due to the anti-Factor IIa activity of the agents. Heptest does not exclusively reflect Anti-Xa activity since it is influenced by agents containing exclusive anti-IIa activity like Hirudin and Dermatan Sulfate. At low concentrations of LF2, Heptest measures predominantly the anti-factor Xa activity while at higher concentrations it is influenced by the combined activity of anti-factor Xa and anti-factor IIa. However, Heptest sensitivity to anti-factor IIa is significantly lower than for anti-Xa activity.

Chondroitin↗
PubMed1990

Factor VII activation and menopausal status.

The incidence of coronary heart disease (CHD) is higher in postmenopausal or oophorectomised women than in premenopausal women of the same age. The difference cannot be explicable in terms of conventional CHD risk factors. Since factor VII may be relevant to the pathogenesis of CHD, we have investigated the menopause-related changes in factor VII activation in 228 healthy women aged 45-54 years. A standard factor VII clotting assay (FVIIc) and a factor VII antigen assay (FVIIag) were carried out on the same plasma samples. Both FVIIc and FVIIag levels were significantly higher in postmenopausal than in premenopausal women. Despite the strong correlation between the two assays (r = 0.80), the FVIIc/FVIIag ratio was positively and significantly associated with the menopause, suggesting that activated factor VII form might in part account for the high FVIIc levels in postmenopausal women. With respect to the type of menopause, the highest levels of both FVIIc and FVIIc/FVIIag ratio were found in women having undergone bilateral oophorectomy. These results suggest that raised factor VII coagulant activity may contribute to an increased risk of CHD in postmenopausal women.

Antigens↗
PubMed1990

Pharmacokinetics of low molecular weight heparins.

When measured in terms of biological activities (using only markers of molecules with affinity for antithrombin III), the pharmacokinetics of low molecular weight heparins are clearly different from those of unfractionated heparin after intravenous and subcutaneous injections. The plasmatic anti-Factor Xa activity half-life, whatever the injected dose of the different low molecular weight heparins, is about two to four times longer than for unfractionated heparin while anti-Factor IIa plasmatic half-life is only slightly longer for enoxaparin than for unfractionated heparin. Preferential endothelial cell binding of high molecular weight heparin chains that possess greater anti-Factor IIa activity may partly explain these differences. When measured in terms of radioactive markers of molecules with either high or low affinity for antithrombin III, in native form or degraded after endocytosis by endothelial cells, using 99 m technetium labelled heparins in human volunteers, the pharmacokinetics in blood, urine and organs are similar whatever the heparin used (enoxaparin or unfractionated heparin). The radioactive half-life was longer than that of the biological activity. These results suggest that enoxaparin binds less than unfractionated heparin to proteins other than antithrombin III and that enoxaparin is partly eliminated in urine as active metabolites.

Factor Xa Inhibitors↗
PubMed1990

Determinants of fat consumption in a general population.

In a random sample of the adult population (aged 25-64 years) from Ghent and Charleroi in Belgium, dietary fat consumption was estimated using both qualitative and quantitative dietary methods. A fat consumption score (FCS) was constructed from the qualitative method, and it correlated significantly with the dietary polyunsaturated/saturated fatty acids (P/S) ratio calculated from the quantitative method (r = -0.48; p less than 0.001). Differences in FCS were then studied using univariate and multivariate analyses. In both men and women, FCS was higher in Charleroi than in Ghent. In men, FCS was inversely related with educational level and with age. In women, significant correlations were observed with marital status. No differences were found in FCS by smoking behaviour. With the coronary risk factors, low-order relationships were found, but only in men. In the middle-aged group, significant correlations were found between FCS and the fatty acid composition of the serum cholesteryl esters, in particular with the linoleate/oleate ratio.

Adult↗
PubMed1989

[Determinants of fat consumption in a general population].

In a random sample of the adult population (aged 25-64 yr) from Ghent and Charleroi in Belgium, dietary fat consumption was estimated using both qualitative and quantitative dietary methods. A fat consumption score (FCS) was constructed from the qualitative method and correlated significantly with the dietary P/S ratio calculated from the quantitative method. Differences in FCS were then studied using univariate and multivariate analyses. In both men and women FCS was higher in Charleroi than in Ghent. In men FCS was inversely related with educational level and with age and positively related with BMI. In women no significant correlations were observed. In the middle-aged group (aged 45-64 yr) significant correlations were found between FCS and the fatty acid composition of the cholesterol-esters, in particular with the linoleate/oleate ratio.

Adult↗
PubMed1989

[Dermatan sulfate and the prevention of experimental venous thrombosis].

Although the specific anticoagulant activity of dermatan sulphate is seventy times less than that of standard heparin, its venous antithrombotic activity, tested on a great number of experimental models, appears at gravimetric doses which are only seven fold higher. This antithrombotic activity is not correlated with the factor Xa inhibition, but is associated with thrombin generation inhibition and potentiation of heparin cofactor II. Meanwhile, others factors, still non entirely identified, i.e. like the release of endogenous tissue plasminogen activators, must probably be involved in the antithrombotic activity of dermatan sulphate. In contrast to heparin, dermatan sulphate possesses hemorrhagic properties only at doses which are forty times higher than the antithrombotic dose. These hemorrhagic properties seem associated with an inhibition of collagen induced platelet aggregation. Finally, the pharmacokinetic profile of dermatan sulphate after intravenous injection in the rabbit, is different from that of standard heparin, and close to that of low molecular weight heparins.

Animals↗
PubMed1988

Aging and diabetes increase the aggregating potency of rat skin collagen towards normal platelets.

Acid-soluble collagen samples were prepared from individual skins of 24 month old rats (n = 8), 2 month old young controls (n = 8) and from 6 month old streptozotocin-diabetic rats (n = 5) and their age-matched controls (n = 10). Less collagen was obtained by acid extraction and salt precipitations from skins of diabetic and aged rats than from those of their respective controls. The collagen preparations from diabetic and aged rats showed an increased ratio of beta/alpha components. The rate of "in vitro" fibrillogenesis was less for collagen from diabetic rats than from controls. It was not modified for collagens from aged rats. The aggregating potency towards normal human platelets was markedly increased for collagens from aged and diabetic rats: reduced latency time (p less than 0.01) and increased velocity (p less than 0.01) were observed for collagens from aged rats when compared with young rats (16.5 micrograms/ml). Increased velocity (p less than 0.01) was also observed for collagens from diabetic rats (8.25, 11 and 16.5 micrograms/ml), without modification of latency time.

Aging↗
PubMed1988

The inhibition of the generation of thrombin and the antithrombotic effect of a pentasaccharide with sole anti-factor Xa activity.

A chemically synthesized heparin pentasaccharide (Institut Choay, Paris, France) has been shown to exhibit an antithrombotic action in a rabbit stasis induced thrombosis model, in an IV dose range of 25 to 200 micrograms/kg (0.5 to 3.5 micrograms/ml plasma circulating concentrations). Ex vivo plasma analysis from treated animals revealed expected anti-factor Xa activity but no direct inhibitory effect against thrombin. Global anticoagulant activities were not found by PT and APTT methods. Platelet activation remained unaffected at the antithrombotic dosages of pentasaccharide. To more specifically elucidate the anti-factor Xa mediated antithrombotic mechanism of action of this pentasaccharide, it was studied in several thrombin generation assays. Pentasaccharide added to human and rabbit plasmas in vitro from 0 to 5.0 micrograms/ml produced a concentration dependent effect up to a 35 to 50% inhibition of generated thrombin. In ex vivo studies similar concentration dependent inhibition of thrombin generation was observed. Analysis of plasma obtained from animals in which a complete antithrombotic effect was observed in vivo demonstrated an approximate 45 to 55% inhibition of thrombin generation. These results indicate that a relationship exists between the pentasaccharide induced inhibition of experimental venous stasis thrombosis and the inhibition of thrombin generation.

Animals↗
PubMed1988

The antithrombotic activity and pharmacokinetics of enoxaparine, a low molecular weight heparin, in humans given single subcutaneous doses of 20 to 80 mg.

The pharmacokinetics of enoxaparine, a low molecular weight heparin, was randomly studied in 12 healthy male volunteers. Doses of 20, 40, 60, and 80 mg were injected subcutaneously in randomized cross-over fashion. Anti-IIa and anti-Xa activities (using amidolytic methods), and calcium thrombin time, were measured over 36 hours. The maximum Amax of the anti-IIa and anti-Xa activities appeared 3 to 4 hours after administration. The terminal half-lives of anti-IIa and anti-Xa activities were approximately 2 and 4 hours, respectively, with no significant variation between the different doses. For the anti-Xa activity, there was a highly significant positive correlation between the dose injected and individual values of Amax (r = +0.915; P less than .001) and AUC (r = +0.913; P less than .001). Enoxaparine displays a relatively small apparent volume of distribution (about 7.0 L) and its total body clearance is about 1.25 L/hr. The mean residence time ranges from 4.6 to 7.6 hours. Thus, the pharmacokinetic profile of enoxaparine is characterized by a linear relationship between dose and absorption, a relatively low clearance and long elimination half-life, and a high anti-Xa/anti-IIa ratio.

Adult↗
PubMed1988

Relationship between sex hormones and haemostatic factors in healthy middle-aged men.

Associations of plasma testosterone and estradiol with some haemostatic factors (factor VII activity, fibrinogen, antithrombin III and alpha 2-antiplasmin) were cross-sectionally examined in 251 healthy, middle-aged men participating in the Paris Prospective Study II on risk factors for ischaemic heart disease. Testosterone levels were negatively correlated to factor VII activity and alpha 2-antiplasmin, the main inhibitor of fibrinolysis. No association was found either between testosterone levels and both fibrinogen and antithrombin III, or between estradiol levels and the set of haemostatic variables. The associations between testosterone and both factor VIIc and alpha 2-antiplasmin were independent of HDL-cholesterol, LDL-cholesterol, triglycerides, smoking, alcohol, body mass index and blood pressure. These results suggest that low circulating testosterone levels might be associated with a hypercoagulability state and therefore could contribute to an increased risk of IHD.

Antigens↗
PubMed1988

Age-related changes in factor VII activation in healthy women.

1. To investigate the age-related changes in factor VII activation in healthy women, a regular factor VII clotting assay (factor VIIc) was carried out simultaneously with a new enzyme immunoassay for the quantification of antigen factor VII (factor VIIag). 2. Both factor VIIc and factor VIIag levels were positively correlated with age (r = 0.79 and r = 0.62, respectively, n = 25, P less than 0.001). The rise with age in factor VIIc was steeper than in factor VIIag and the ratio of factor VIIc to factor VIIag (an indicator of the activity state of factor VII) increased with age (r = 0.42, P less than 0.05). 3. The results show that an increased conversion of native single-chain factor VII to the fully active double-chain form is associated with advancing age in women. 4. This finding is consistent with a possible role of activated factor VII in the pathogenesis of thrombo-occlusive vascular disease in women.

Adult↗