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Biomedical subjects

M Lucsko

Publications and source records attributed to M Lucsko.

At least 37 records · Page 2Linked to original sources
PubMed1982

Hemodynamic effects of hemodialysis and hemofiltration.

The hemodynamic effects (n = 8) of hemodialysis (HD) and hemofiltration (HF) were compared in the same group of dialyzed patients. The two procedures induced the same decrease in body weight, total blood volume, and blood pressure; however, hemodynamic alterations were different. Cardiac index and stroke index decreased markedly with HD and did not change significantly with HF, and peripheral resistance remained stable after HD and decreased significantly after HF. These results suggest that the maintenance of a high cardiac output may account for the lack of acute hypotensive episodes reported during HF. The reduction of blood pressure after HF is related to the decrease in total peripheral resistance. Thus, the arterial vasodilator effect induced by HF might explain the improvement of severe hypertension on long-term treatment with HF, as reported previously.

Adult↗
PubMed1982

[Acute effects of metoprolol on blood pressure and heart rate. Value of the nitroglycerin test].

The acute effects of Metoprolol on blood pressure and heart rate were studied with reference to the plasma level of the betablocker in 10 patients (6 male and 4 female) with permanent moderate uncomplicated hypertension. Each patient was given a single oral dose of 200 mg Metoprolol: blood samples were taken over a 12 hour period at given times for Metoprolol estimation. The blood pressure was measured with a mercury manometer; heart rate was measured lying and during a stress test (glyceryl trinitrate). The antihypertensive effect of Metoprolol was significant from the 4th hour; at the 8th hour the systolic pressure was reduced by 15% and the diastolic pressure by 17% (p less than 0.001). The blood pressure then rose progressively. The heart rate in the recumbent position fell 10 to 15% during the study. The heart rate during the trinitrin test varied linearly with time (r = 0.991, p less than 0.001). The variation in systolic and diastolic blood pressure did not correlate with the plasma Metoprolol level (r = 0.03, and 0.19); no correlation was found between the fall in lying heart rate and the plasma betablocker level. On the other hand, the trinitrin heart rate (at the end of the test) correlated negatively with the logarithm of the plasma Metoprolol (n = 56, r = 0.688, p less than 0.001). These results confirm that the antihypertensive effect of Metoprolol is not directly related to the plasma level of the betablocker. On the other hand, the betablocker effect assessed by the trinitrin test, correlated with the plasma Metoprolol level. This relationship is similar to those previously observed with other betablockers; atenolol and oxprenolol.

Adrenergic beta-Antagonists↗
PubMed1982

[Acute hemodynamic effects of prostacyclin in severe or malignant hypertension].

The antihypertensive effect of Prostacyclin (PGI2) was investigated in 7 patients with severe or malignant hypertension. Cardiac output (dilution method), arterial blood pressure and total blood volume (TBV, radio-albumin dilution method) were measured before and during a PGI2 infusion, the effective dose ranging from 10 to 20 ng/kg/min. Cardiac index(CI) rose from 2.8 to 3.9 1/min/m2 and heart rate (HR) from 75 to 94 beats/min (p less than 0.01) Mean blood pressure decreased from 154 to 120 mmHg (p less than 0.001) and total peripheral resistances from 4650 to 2540 dynes.s.cm-5 (p less than 0.001). The ratio: central blood volume/total blood volume increased from 0.21 to 0.26 (p less than 0.001). The results confirm that PGI2 produces a potent vasodilatation of the systemic compartment with a marked decrease in blood pressure; however the antihypertensive effect is blunted by the increase in CI mainly related to the increase in HR; significant central translocation of blood suggests that PGI2 does not produce dilatation of the capacitance vessels. Sympathetic nervous system is highly stimulated by PGI2 very likely through the baroreceptor system.

Antihypertensive Agents↗
PubMed1982

[The role of the venous reservoir in maintaining arterial pressure during hemodialysis. Effect of dihydroergotamine].

Hemodialysis has been reported to produce a decrease in cardiac output partially related to a peripheral relocation of blood volume. In order to further evaluate this hypothesis, the hemodynamic effects of dihydroergotamine (DHE), a veino-constrictor drug, were investigated in 5 patients undergoing hemodialysis. Body weight, total blood volume, arterial blood pressure, cardiac output and heart rate were obtained before (period A) and immediately after hemodialysis: before (period B) and after an acute infusion of DHE (period C); studies were performed in supine then in tilted position. During period B, cardiac index decreased by 27% (p less than 0.05) and stroke index by 35% (p less than 0.02). Acute infusion of DHE produced a significant increase in cardiac index (+ 18%, p less than 0.05), stroke index (+ 28%, p less than 0.05) and blood pressure (+ 20%, p less than 0.05). These results indicate that the hemodynamic alterations induced by hemodialysis may be partially reversed by contraction of the capacitance system following DHE infusion.

Adult↗
PubMed1981

[Long term treatment of resistant hypertension with captopril (author's transl)].

The orally active angiotensin converting enzyme inhibitor SQ 14225 (captopril) was administered to 14 hypertensive patients resistant to conventional therapy. A marked antihypertensive effect was observed; all the patients were responders and blood pressure decreased by more than 20% in 13 out of them. Subjective tolerance was very good. Untoward effects of an immuno-allergic type have been noticed in 30% of these cases but disappeared in all instances when daily doses of the drug had been reduced, allowing maintenance of the treatment. Plasma renin activity increased during captopril administration but no relationship appeared between pretreatment plasma renin activity and the extent of blood pressure response to the drug. The use of captopril must be considered in severe and resistant hypertension but careful monitoring of this treatment is needed.

Adult↗
PubMed1981

[Clinical pharmacology of prazosin in arterial hypertension with chronic renal insufficiency].

The pharmacokinetics of prazosin were studied in 10 patients (7 male and 3 female, Group I) with permanent hypertension and chronic renal failure (serum creatinine 40,5 +/- 5,9 mg/l) and in 10 normal subjects (10 male, Group II). Each patient received a single oral dose of 2 mg of prazosin; serum levels were studied at regular intervals over a ten hour period by spectrofluorometry Clinostatic blood pressure was measured with a mercury manometer in the patients in Group I. The rate of absorption of prazosin was identical in the two groups (t max: I,3 +/- 0,2 h and I,6 +/- 0,4 h). Maximal serum concentrations were significantly higher in Group I (33,5 +/- 3,7 microgram/1 compared to 22,0 +/- 2.5 microgram/l, p less than 0,02) as was the surface under the serum concentration curve plotted against time (206,I +/- 31.I microgram.h.l-1 compared to 99,9 +/- 12,3 microgram.h.l-1, p less than 0,01). Prazosin induced a significant fall in systolic and diastolic blood pressure (-19% and -23% respectively, p less than 0.001) in Group I, 90 minutes after administration, associated with a moderate rise in heart rate (+16%, p less than 0.01). The variation of blood pressure induced by prazosin correlated closely with its serum concentration (p less than 0.001). These results suggest that the bioavailability of prazosin is significantly higher in chronic renal failure and that a reduction of the daily dose should be envisaged in these patients on long-term therapy.

Adult↗
PubMed1980

[Granulomatous nephropathy of tuberculous origin revealed by prolonged fever (author's transl)].

In a 66-year-old female patient with a past history of tuberculosis, prolonged fever at 38 degrees C accompanied by a strong increase in ESR ultimately led to the diagnosis of renal cyst. Biopsies of renal tissue and of lymph nodes taken during surgery showed renal granulomatosis without caseum. Despite negative bacterial findings and anergy to tuberculin, an anti-tuberculous treatment was administered and the patient recovered.

Aged↗
PubMed1979

[Renovascular hypertension and beta blockers. Theoretical and practical implications].

Beta blockade was instituted in 10 patients with renovascular hypertension due to renal artery stenosis or thrombosis. The treatment was very effective in unilateral stenosis with a normal contralateral kidney (2 kidney Goldblatt) and in fibromuscular dystrophy of the renal artery. On the other hand many failures were observed in hypertension with a single kidney (1 kidney Goldblatt) and in renovascular hypertension with complex lesions or associated renal failure. Although a clear relationship was often observed between the increased plasma renin activity and the antihypertensive effect of beta blockade, this association was sometimes completely erroneous. Beta blockade, which is easy to perform, should be tried out systematically in renovascular hypertension, but, when no result is observed, this therapeutic test should not exclude surgical management thereafter.

Adrenergic beta-Antagonists↗
PubMed1978

[Spectrofluorimetric estimation in biological fluids of a new beta-blockader: atenolol. Application to its pharmacokinetic study (author's transl)].

The authors describe a simple method of fluorimetric estimation of atenolol, applicable to blood and urine, sufficiently sensitive to permit a pharmacokinetic study. After administration of a dose of 200 mg by the oral route to hypertensive subjects, one may observe a maximal plasma concentration 3 hours after the dose average value 3.91 +/- 0.71 mumol/l (1.04 +/- 0.19 mg/l). The apparent half life of elimination of phase beta is 14.1 +/- 4.9 h, values comparable with those calculated from urinary data 14.6 +/- 2.0 h. The renal clearance was 140 +/- 32 ml/min; 54 +/- 14% of the administered dose are excreted in the urine. After administration by the venous route, urinary excretion represents 96% of the dose administered.

Adult↗
PubMed1976

[Use of computers in real time. Clinical supervision of hypertension. Application to research (author's transl)].

High blood pressure has been selected as the subject of a first attempt at constituting an automated online medical records system at the Centre Médico-Chirurgical FOCH. This system is to be used routinely by physicians and nurses for daily care of patients and in statistical analysis of registered data for research purposes. Its operational phase is now beginning : registration of patients, edition of collected data, plannings of activity and abstracts are made routinely. Use of the system for clinical research purposes of an epidemiologic nature and its adaptation to more sophisticated tasks is planned in the near and more distant future.

Humans↗