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Biomedical subjects

L Poirier

Publications and source records attributed to L Poirier.

At least 55 records · Page 3Linked to original sources
PubMed1993

Captopril or conventional therapy in hypertensive type II diabetics. Three-year analysis.

The effects of long-term treatment with captopril and conventional therapy on albuminuria and metabolic parameters were compared in 74 hypertensive type II diabetics with normal serum creatinine. Patients were treated double-blind with either captopril monotherapy or combined with hydrochlorothiazide or therapy with metoprolol, hydrochlorothiazide, or both for 36 months. The treatment was titrated to achieve goal diastolic blood pressure of < or = 85 mm Hg. The reductions in blood pressures during treatment were similar in patients with (n = 21) and without (n = 53) microalbuminuria treated with either captopril or conventional therapy. No significant changes in albuminuria occurred in normoalbuminuric patients with either therapy. Although albuminuria fell in nearly all patients with microalbuminuria treated with captopril, it rose in eight of 12 patients on conventional therapy, with macroalbuminuria developing in two of them. Renal function was preserved by both types of treatment in both patient groups. Long-term treatment with either conventional therapy or captopril did not alter metabolic variables. We conclude that captopril alone or in combination decreases albuminuria and prevents the development of macroalbuminuria in hypertensive type II diabetics with persistent microalbuminuria. The renoprotective effect of this agent, however, remains to be demonstrated with longer term data on renal function. Aggressive antihypertensive treatment with either captopril or conventional therapy appears to be effective in preventing the onset of microalbuminuria in most normoalbuminuric patients. In contrast, with previous short-term studies, the use of converting enzyme inhibitors or conventional therapy did not cause adverse metabolic effects.

Aged↗
PubMed1993

Comparison of amlodipine and captopril in hypertension based on 24-hour ambulatory monitoring.

The efficacy and toleration of once-daily amlodipine (5-10 mg o.d.) and captopril (25-50 mg b.i.d.) were compared in 45 patients with mild-to-moderate essential hypertension. Twenty-four-hour ambulatory blood pressure monitoring was performed at baseline and at the end of the 8-week study period. Clinic blood pressure, heart rate, and adverse events were assessed during a placebo run-in and after 2, 4, and 8 weeks of treatment. Both amlodipine and captopril significantly reduced clinic blood pressure without affecting heart rate. Between-treatment comparisons showed that amlodipine produced a significantly greater reduction in sitting diastolic blood pressure than captopril. Ambulatory blood pressure monitoring revealed a sustained reduction in both systolic and diastolic blood pressure throughout a full 24-h period in patients taking amlodipine. In contrast, however, the effects of captopril were no longer evident during the final 3 h of the dosing interval. Both drugs were generally well tolerated, and the incidence of adverse events was similar in each group. This study demonstrates that amlodipine is more effective as a once-daily antihypertensive agent than captopril administered twice daily.

Adult↗
PubMed1993

[The Schocket tube. A retrospective study of 36 cases].

Thirty-six eyes with refractory glaucoma were operated using a Schocket technique (anterior chamber shunt to an encircling band). The follow-up was more than one year in all cases with a two-year maximum follow up. The intraocular pressure was < or = 25 mmHg in 87.5% to 95% of cases, and < 21 mmHg in 75.8% to 81.5% of cases. The results were analysed for each etiology and compared with those of other series and those of other surgical techniques used in the treatment of this type of glaucoma. (Molteno drainage tube, cyclodiathermy, ultrasonic treatment and yag laser transcleral contact cyclophotocoagulation).

Adolescent↗
PubMed1993

[Characteristics and functions of friendship in adolescence].

This article reviews recent studies which have examined various aspects of friendship relations in adolescence. Friendship relations are of central importance in the social life of adolescents because they assume a crucial role in certain developmental functions: emancipation from parental guardianship, commencement of heterosexual relations and affirmation of one's identity. This article reports on various aspects of friendships in adolescence: number of friends, places of recruitment, frequency of meetings, and common themes of conversations. Friendship relations are relatively conflict free in adolescence. They can be characterised by three main elements: trust, communication and intimacy. Friendships evolve in adolescence from a common interest in activities to a sharing of opinions, emotions and feelings. At all ages, girls value the elements of friendship more than boys. In the last ten years research has demonstrated that there is a correlation between adolescent friendship, coping mechanisms, and the acquisition of social skills. The quality of friendship relations and particularly the ability to communicate personal worries predicts this correlation better than the number of friends. The research in the field of friends versus parent influence has abused the concept of peer pressure in committing delinquent crimes. Indeed there is a great deal of agreement between parents and friends in terms of moral values and academic and vocational aspirations. The influence of friends predominates only when there are severe conflicts between parents and their children.

Adaptation, Psychological↗
PubMed1993

[Values and complications of peripheral deepenings in radial keratotomies].

Single and double peripheral deepenings were used to increase the refractive effect of radial keratotomy (RK). The objective of this study was to statistically evaluate the effect and the complications of these surgical techniques. Simple and double peripheral deepenings were performed in 36 patients (52 eyes) and 14 patients (19 eyes) respectively. The functional results and the complications in these two groups were statistically compared with those of a control group which was comparable according to criteria of size, age, sex and preoperative myopia. The standard RK surgical technique was used in this control group. The difference of mean gain between the control group, and the single and double peripheral deepening groups, was 0.53 and 0.47 diopter, respectively. This difference was statistically significant. On the other hand there was no significant difference diopter gain between the single and the double peripheral deepening groups. There was a significant difference concerning spherical equivalent. The non corrected visual acuity was significantly higher in the peripheral deepenings groups, probably due to corneal topographic alterations generating multifocal corneas. The complication rate (micro-perforations, induced astigmatism, loss of best corrected visual acuity) was higher in the peripheral deepenings groups. The limited diopter gain (about 0.50 diopter) compared with the standard radial keratotomy surgical technique, the lack of decreased, reoperation rate and the increased rate complication justified peripheral deepenings surgery technique discussed by the authors.

Adult↗
PubMed1993

[Results of reoperation for under correction of radial keratotomies. Apropos of 25 cases].

Twenty-two under corrected patients (25 eyes) after radial keratotomy, were reoperated according to the Stan Franks surgical technique. The results and the possible factors of predictability of this method of reoperation were evaluated. The residual myopia was less than one diopter in 88% of cases (20% before reoperation). The non corrected visual acuity was superior or equal to 20/40 in 88% of cases (32% before reoperation). The mean dioptrie gain after reoperation was 1.30 diopters. Statistical analysis showed that the refractive gain significantly increased with: the initial residual myopia, the delay between the first radial keratotomy and the reoperation, the number of incisions concerned. Age, sex, corneal thickness, initial protocol and presumed cause of undercorrection were not correlated to the refractive gain. (concerning the mean dioptrie gain). The comparison between data derived from different studies, showed no significant differences between the techniques of reoperation. Induced astigmatism with loss of best corrected visual acuity in 12% of cases was the main complication. The causes of under correction after radial keratotomy, and the effectiveness of the Stan Franks method of reoperation are discussed. The authors emphasize the interindividual corneal reaction to radial keratotomy.

Adult↗
PubMed1992

Comparative effects of a new cardioselective beta-blocker nebivolol and nifedipine sustained-release on 24-hour ambulatory blood pressure and plasma lipoproteins.

This double-blind, parallel-group study compared the effects of nebivolol, a novel cardioselective beta-blocker, with those of nifedipine sustained-release on 24-hour ambulatory blood pressure and plasma lipoprotein levels. After a washout period of 8 weeks, 51 patients with mild to moderate essential hypertension were randomized to double-blind treatment with either nebivolol 5 mg once a day (n = 26) or nifedipine sustained-release 20 mg bid (n = 25) over a period of 12 weeks. Both treatments produced similar and significant (P = .0001) reduction in office blood pressure as well as in 24-hour, work, awake, and sleep ambulatory blood pressure. The clinical response (diastolic blood pressure less than 90 mmHg or decreased by greater than or equal to 10 mmHg) rate was 69% for nebivolol and 59% for nifedipine, respectively. Moreover, the nebivolol and nifedipine treatment-induced decreases in mean 24-hour ambulatory blood pressure were similar to the decreases in clinic blood pressure. Furthermore, the percentages of "blood pressure loads" (awake greater than 140/90 mmHg and asleep greater than 120/80 mmHg) were lowered significantly (P = .0001), from 60% to 29% with nebivolol and from 60% to 39% with nifedipine. Mean ambulatory heart rate was reduced (P = .0001) from 79 +/- 7 to 68 +/- 7 beats/minute during nebivolol therapy and from 80 +/- 9 to 79 +/- 7 (not significant) with nifedipine. Total plasma cholesterol and low-density lipoprotein levels decreased significantly (P less than .05) by 5 and 8%, respectively, after nebivolol treatment, and each decreased by 3% after nifedipine treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Ambulatory blood pressure monitoring for the assessment of nicardipine as a third drug in severe essential hypertension.

The antihypertensive efficacy of sustained-release nicardipine compared to placebo as third-line therapy has been assessed by ambulatory blood pressure monitoring in severely hypertensive patients with clinically unsatisfactory blood pressure control on 50 mg hydrochlorothiazide o.d. and 75 mg captopril b.d. Forty-two patients, 31 m and 11 f, with supine diastolic blood pressure 95-115 mm Hg after a 4 week run-in period on open hydrochlorothiazide and captopril, were randomly allocated to sustained-release nicardipine 45-60 mg/d or placebo. At a visit to the clinic blood pressure and heart rate were measured 12 h after the evening dose by a trained observer unaware of the treatment. Twenty-four hour ambulatory monitoring was performed at the end of baseline and after 8 weeks of blinded medication. There was no significant change in BD at the visit or on ambulatory monitoring in the placebo treated patients. In contrast, nicardipine produced a significant reduction in both blood pressures without affecting heart rate. Nicardipine also decreased the mean 24-h blood pressure by 14/10 mm Hg in patients whose clinical hypertension had been confirmed by ambulatory blood pressure monitoring but by only 3/2 mm Hg in ambulant patients who were normotensive on two-drug therapy. One patient experienced an episode of severe symptomatic hypotension while on nicardipine. Otherwise, the numbers and percentages of patients from each group reporting adverse experiences were similar. It is concluded that nicardipine appears to be an effective antihypertensive agent when used as third line therapy with diuretics and angiotensin converting enzyme inhibitors in patients with severe hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Epidemiologic and serologic definition of primary and secondary trichinosis in the Arctic.

A large outbreak of trichinosis acquired from walrus in Salluit in 1987 provided the immunologic and epidemiologic data from which two distinct clinical syndromes were identified. The first syndrome is the classic myopathic form with edema, fever, myalgia, and rash. The second is a persistent diarrheal illness with little edema or myalgia. The clinical presentations are paralleled by distinct differences in type and development of antibody response. The clinical and serologic profiles of the two syndromes support the hypothesis that the myopathic form represents a primary infection of Trichinella nativa, while the second represents a secondary infection in previously sensitized individuals.

Adolescent↗
PubMed1992

Prospective trial on captopril-related cough.

OBJECTIVE: Quantify and characterize cough as an adverse reaction secondary to captopril. DESIGN: Cohort analytic study: six-month prospective trial including two-week, placebo, run-in period; five-month, single-blind, active treatment; and two-week, dechallenge period. SETTING: Outpatient clinic. PATIENTS: 199 previously treated or newly diagnosed untreated patients with mild to moderate hypertension. INTERVENTIONS: Captopril 50 mg/d during five months. OUTCOME MEASURES: Self-questionnaires, interviews, dechallenge, and rechallenge periods. Naranjo's algorithm. RESULTS AND CONCLUSIONS: (1) Cumulative incidence of captopril-induced cough over a five-month period was 7.1 percent (95 percent C.I., 6.8-7.4 percent). Incidence of drug withdrawal secondary to severe cough was 1.0 percent; this figure is somewhat similar to first reports about the reaction. (2) Cough was a generally mild to moderate symptom, present day and night in 71.4 percent of patients and resistant to antitussive agents. Cough was not statistically related to sex, age, or smoking habit; however, the female gender and the development of a common cold may be predisposing factors.

Adolescent↗
PubMed1992

Comparison of the effects of amlodipine and captopril on clinic and ambulatory blood pressure.

Forty-one patients with mild to moderate essential hypertension (sitting diastolic blood pressure (DBP) 95-114 mmHg) were randomised in a double-blind fashion to treatment with either amlodipine 5-10 mg once daily (n = 21) or captopril 25-50 mg twice daily (n = 20) over a period of 8 weeks. Office BP, heart rate and side effects were assessed during the run-in period on placebo, and after 2, 4 and 8 weeks' treatment. Blood pressure and heart rate were measured at the same time at each visit, 12 hours after the last captopril dose and 24 hours after the last amlodipine dose. At the end of the 8 week study, the reduction in sitting DBP was significantly greater (P = 0.002) with amlodipine. Ambulatory BP recordings were performed over a 24-hour period, at baseline and at the end of the study. Both treatment regimes significantly reduced clinic BP without affecting heart rate. However, amlodipine reduced ambulatory systolic (SBP) and DBP almost every hour over the whole circadian cycle, whereas the antihypertensive effect of captopril was attenuated during the final 3 hours of each dosing interval. The incidence of headache and peripheral oedema was identical between the two regimens. Only one patient taking amlodipine withdrew due to ankle swelling. This study demonstrates that the once-daily administration of amlodipine has a more sustained antihypertensive effect than does captopril taken twice daily.

Adult↗
PubMed1992

[Multifocal and monofocal implant. Comparative functional results (contrast sensitivity and dynamic visual acuity)].

The functional results (contrast sensitivity and dynamic visual acuity) of 19 multifocal (3 M design) and 14 monofocal intraocular (IOL) were compared. Best corrected visual acuity was > or = 8/10 P 2. Major differences of functional performance in favour of monofocal IOL's were found under standard conditions of vision (low contrast and illumination levels). Dynamic visual acuity allowed accurate evaluation of the difference of performance between these two models of implant. The indications for multifocal IOLs were reconsidered in the light of these results.

Aged↗
PubMed1991

Comparative effects of 2.5 and 5 mg cilazapril versus placebo on daily blood pressure load.

The antihypertensive efficacy of 2.5 and 5 mg cilazapril and placebo in lowering 24-h ambulatory blood pressure (ABP) and BP load were compared in 42 patients with mild to moderate hypertension. After a 2-week placebo run-in period, patients were randomized double-blind to receive either 2.5 mg cilazapril (n = 14), 5 mg cilazapril (n = 14), or placebo (n = 14) for 4 weeks. There were no significant differences in 24-h and awake ABP or in office BP between 2.5 and 5 mg cilazapril. Moreover, the percentage of patients that had BP control (mean daytime ABP less than 90 mm Hg) was 14% in the placebo group, 64% and 71% with 2.5 and 5 mg cilazapril, respectively. Furthermore, the percentage of BP load was similar with both regimens (29 v 36%). These observations indicate that 2.5 and 5 mg cilazapril have equipotent antihypertensive efficacy.

Analysis of Variance↗
PubMed1991

Beneficial effects of the calcium antagonist isradipine on apolipoproteins in hypertensive patients.

The objective of the study was to assess the effects of the calcium antagonist isradipine on plasma lipids, lipoproteins, and apolipoproteins in patients with essential hypertension. After a four-week placebo wash-out period, 73 patients (41 men, 32 women) were studied in a double-blind, randomized, crossover study comparing sustained-release isradipine (isradipine SR) with the standard isradipine formulation. Nineteen patients received 5 mg/day and 54 patients 10 mg/day. Lipids were evaluated at the end of the placebo period and after 12 weeks of treatment with isradipine. In both treatment groups, lipid and lipoproteins were not modified. However, apolipoprotein A-I levels increased significantly (P less than .001) and the ratio of apolipoprotein B to apolipoprotein A-I concentration decreased significantly (P less than .01) irrespective of gender. These data show that the levels of plasma apolipoprotein A-I, a strong predictor of coronary heart disease, are favorably affected by isradipine of either formulation. The mechanisms of this effect remain to be elucidated.

Adult↗
PubMed1991

Antihypertensive effects of cilazapril, 2.5 and 5 mg, once daily versus placebo on ambulatory blood pressure following single- and repeat-dose administration.

Ambulatory blood pressure (ABP) monitoring was used to evaluate the 24-h antihypertensive efficacy of single- and repeat-dose administrations of the nonsulfhydryl-converting enzyme inhibitor cilazapril, 2.5 and 5 mg, versus placebo in patients with mild to moderate essential hypertension. After a 2-week placebo run-in period, patients were randomized to receive, in a double-blind procedure, either 2.5 mg cilazapril (n = 14), 5 mg cilazapril (n = 14), or placebo (n = 14) for 4 weeks. In calculating the systolic/diastolic blood pressure (BP) trough-to-peak (T/P) ratio after subtraction of the placebo effect, 5 mg cilazapril appeared to be more effective than 2.5 mg cilazapril following single- (59/54% vs. 21/48%) and repeat-dose administration (47/76% vs. 31/49%). There were significant differences in 24-h and awake ABP for both 2.5 and 5 mg cilazapril as compared to placebo after single- and repeat-dose administrations. However, there were no significant differences in 24-h and awake ABP reduction between 2.5 and 5 mg cilazapril after single- and repeat-dose administrations. Furthermore, the percentages of "BP load" were identical with both regimens after the first dose (46 vs. 43%) and at steady-state (37 vs. 29%). These data demonstrate that 2.5 and 5 mg doses of cilazapril have equivalent antihypertensive efficacy using ABP and that 24-h ABP monitoring should also be performed in dose-response studies.

Adult↗
PubMed1991

Once vs twice daily administration of a fixed combination of captopril plus hydrochlorothiazide in essential hypertension: a double-blind crossover study in known responders to a standard combination.

The purpose of this randomized, double-blind, crossover trial was to compare the hypotensive effects of a fixed combination of captopril (C) 50 mg and hydrochlorothiazide (HCTZ) 25 mg (C 50/HCTZ 25) once daily with those of a fixed combination of C 25 mg and HCTZ 12.5 mg (C 25/HCTZ 12.5) twice daily. We studied 199 patients (108 M, 91 F) with mild to moderate essential hypertension whose BP was already controlled by the co-administration of C 25 mg and HCTZ 12.5 mg twice daily. They were randomly assigned to either C 25/HCTZ 12.5 twice daily during the first 6 weeks and C 50/HCTZ 25 once daily during the second 6 weeks or C 50/HCTZ 25 once daily followed by C 25/HCTZ 12.5 twice daily. Both regimens showed comparable efficacy on office diastolic BP (91.6 vs 91.3 mm Hg). Systolic BP was slightly but significantly higher (P = 0.02) with the once daily formulation (141.2 vs 139.1 mm Hg). Fixed combinations once daily and twice daily resulted in identical working ambulatory BP (133.7 +/- 13/83.6 +/- 8 mm Hg vs 132.4 +/- 11/83.3 +/- 7 mm Hg) without affecting heart rate. Adverse events were reported by 16% of patients and cough was the most common occurring in 7%. In conclusion, these results indicate that the fixed combination of C 50/HCTZ 25 given once daily controls office and working BP as well as the fixed combination C 25/HCTZ 12.5 given twice daily in patients with mild to moderate hypertension.

Adult↗