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Biomedical subjects

M Solèr

Publications and source records attributed to M Solèr.

82 records · Page 5Linked to original sources
PubMed1989

[Late reaction in asthma].

In addition to an immediate bronchoconstrictive reaction, about half of patients with allergen-induced bronchial asthma have a second, delayed and more prolonged obstructive response after inhalation of allergen. This late response is more difficult to treat than the immediate bronchoconstriction and is associated with inflammatory changes in the bronchial walls, an increase in bronchial responsiveness and increased severity of asthmatic symptoms for days or weeks. Therefore, mechanisms leading to late responses may play a central role in the pathophysiology of asthma. Pathogenetic mechanisms, pathology and pharmacology of the late response are discussed.

Asthma↗
PubMed1989

A PAF antagonist blocks antigen-induced airway hyperresponsiveness and inflammation in sheep.

We studied the effects of WEB-2086, a specific antagonist of platelet-activating factor (PAF), on the development of antigen-induced airway hyperresponsiveness and inflammation in sheep (n = 8). For these studies, airway responsiveness was determined from slopes of carbachol dose-response curves (DRC) performed at base line (prechallenge) and 2 h after Ascaris suum antigen challenges in the following three protocols: 1) antigen challenge alone (control trial), 2) WEB-2086 (1 mg/kg iv) given 30 min before antigen challenge (WEB pretreatment), and 3) WEB-2086 given 2 h after antigen challenge, immediately before the postchallenge DRC (WEB posttreatment). Airway inflammation was assessed by bronchoalveolar lavage (BAL) before antigen challenge and after the postchallenge DRC for each trial. A. suum challenge resulted in acute increases in specific lung resistance that were not different among the three trials. Antigen challenge (control trial) caused a 93% increase (P less than 0.05) in the slope of the carbachol DRC when compared with the prechallenge value. WEB pretreatment (1 mg/kg) reduced (P less than 0.05) this antigen-induced hyperresponsiveness, whereas pretreatment with a 3-mg/kg dose completely prevented it. WEB posttreatment was ineffective in blocking this hyperresponsiveness. BAL neutrophils increased after antigen challenge in the control trial and when WEB-2086 was given after antigen challenge (P less than 0.05). Pretreatment with WEB-2086 (1 or 3 mg/kg) prevented this neutrophilia. This study provides indirect evidence for antigen-induced PAF release in vivo and for a role of endogenous PAF in the modulation of airway responsiveness and airway inflammation after antigen-induced bronchoconstriction in sheep.

Airway Resistance↗
PubMed1987

Antihypertensive efficacy of ketanserin alone or in combination with a beta-blocker or a diuretic: the Swiss Ketanserin Study.

In the Swiss Ketanserin Study the antihypertensive efficacy and tolerability of ketanserin (given in 20 or 40 mg doses twice daily) was investigated, after a placebo run-in phase, as monotherapy (n = 68) as well as in combination with either atenolol (100 mg/day) (n = 30) or the potassium-sparing diuretic hydrochlorothiazide (50 mg/day) and amiloride (5 mg/day) (n = 26) in 124 patients with essential hypertension, aged 41 to 82 years. With the addition of ketanserin, diastolic blood pressure fell by 8 +/- 8, 8 +/- 8, and 7 +/- 9 (+/- SD) mm Hg, respectively (p less than 0.05 for all) in the three treatment groups; heart rate remained unchanged or fell slightly. Ketanserin had no effect on body weight, or biochemical variables, including total serum cholesterol and triglycerides, with the exception of a minor increase in apolipoprotein B. Using a patient self-assessment questionnaire (30 items), the addition of ketanserin was associated with a reduction of most of the symptoms encountered in the placebo phase, including sleep disturbances, general feeling of weakness, headaches, nervousness, and fatigue, but there was a tendency toward increases in stuffy nose and dry mouth. In patients older than 60 years, the antihypertensive efficacy of ketanserin was greater, with 59% achieving a diastolic pressure less than or equal to 95 mm Hg versus 45% in the younger patients. This age trend also emerged when ketanserin was combined with either atenolol or the diuretic.

Adrenergic beta-Antagonists↗
PubMed1986

[Physical performance with rate-responsive pacemakers].

The effects of the new rate-responsive pacemaker Medtronic Activitrax on maximal exercise heart rate and physical work capacity were studied acutely and after two weeks in 10 patients. Compared to the VVI-mode, heart rate increased in activity mode during exercise from 102.1 +/- 29.0 to 115.8 +/- 13.5/min (p less than 0.05). Similarly, physical work capacity increased from 343 +/- 260 to 528 +/- 354 watts X min (p less than 0.02). This effect persisted over 2 weeks. Thus, using rate-responsive pacing a significant improvement in working capacity could be shown in patients with inadequate exercise heart rate.

Aged↗
PubMed1986

Prognostic significance of right ventricular ejection fraction for persistent complex ventricular arrhythmias and/or sudden cardiac death after first myocardial infarction: relation to infarct location, size and left ventricular function.

To assess the prognostic significance of right ventricular dysfunction after a first myocardial infarction for complex ventricular arrhythmias and or sudden cardiac death in relation to infarct location, size and left ventricular function, a series of 127 consecutive patients was prospectively studied and followed up for one year. Prior to hospital discharge, a 24-hour electrocardiographic recording and radionuclide angiocardiography were performed. Right ventricular ejection fraction was related to inferior infarct location and size (r = 0.45, P less than 0.01): similarly left ventricular ejection fraction was related to anterior infarct location and size (r = 0.76, P less than 0.001). The incidence of severe ventricular arrhythmias was significantly higher in patients with isolated right or left ventricular dysfunction compared to patients with normal function; it was highest in patients with severe depression of both ventricles. Patients with complex ventricular arrhythmia and/or sudden cardiac death had significantly reduced left and right ventricular ejection fractions. Detailed analysis in patients with left ventricular ejection fraction greater than 0.40 vs. less than or equal to 0.40 showed that presence of complex ventricular ectopic activity and/or sudden cardiac death after myocardial infarction was related not only to left, but also independently to right ventricular dysfunction. These results imply a significant prognostic contribution of right ventricular dysfunction to the occurrence of severe ventricular arrhythmias and/or sudden cardiac death after myocardial infarction independent of and additive to left ventricular dysfunction.

Adult↗
PubMed1984

[Incidence and extent of right ventricular functional disorders following the 1st myocardial infarction].

A series of 63 patients were studied by gated radionuclide angiocardiography 51/2 weeks after their first acute myocardial infarction. Left (LVEF) and right (RVEF) ventricular ejection fraction were assessed in three groups of patients: 12 patients with transmural anterior infarctions, 35 patients with transmural inferior infarctions and 16 patients with non-transmural infarctions. LVEF was depressed only in the group of patients with anterior infarctions (34.4 +/- 16.3%) but remained within normal limits in the other two groups. RVEF was reduced in 64% of patients with inferior infarctions; the mean value in this group was 36.3 +/- 10.2% (normal range 48 +/- 8%, p less than 0.02). In the other two groups RVEF was only rarely reduced and the mean values were within normal limits. Regional wall motion abnormalities ( WMA ) were found in 47% of all patients, those localised in the left ventricle matching ECG localisation of necrosis in 86% of cases. Only patients with infarctions of the inferior left ventricular wall were found to have WMA in the right ventricle. Functional signs of ischemia (decrease of RVEF or LVEF during physical exercise) were found in 34% of patients with transmural infarctions and 57% of patients with non-transmural infarctions. Radionuclide angiocardiography showed itself a valuable method for assessing persistent dysfunction after acute myocardial infarction not only of the left but also of the right ventricle, a phenomenon not easily detected clinically.

Female↗
PubMed1983

[Asymptomatic ischemia following myocardial infarct].

To assess the incidence of silent ischemia after myocardial infarction, a prospective series of 100 consecutive patients was studied 5 weeks after the acute event. Objective evaluation of myocardial ischemia included a 9-lead ECG, thallium-201 scintigraphy and radionuclide ventriculography, each at rest and during symptom-limited bicycle ergometry. Diagnostic criteria were ECG: greater than or equal to 1 mm horizontal or downsloping ST depression or greater than or equal to 1 mm ST elevation; thallium scintigraphy: a clearly reversible perfusion defect at rest, detectable only after exercise; radionuclide ventriculography: an exercise-induced decrease in global LVEF greater than or equal to 5% and/or in anyone regional EF greater than or equal to 14%. Presence of ischemia was assumed if at least 2 of 3 objective ischemic signs were found. This was the case in 28 of 100 patients. During exercise, 15 of 100 patients complained of chest pain, but only 8 (54%) had objective evidence of ischemia. Thus, silent ischemia was demonstrated in 20 of 100 patients. The sensitivity of both nuclear cardiology procedures was markedly superior to that of the ECG in diagnosing post-myocardial ischemia.

Coronary Disease↗