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N Genser

Publications and source records attributed to N Genser.

28 records · Page 2Linked to original sources
PubMed1991

[Values of atrial natriuretic peptide (ANP) and cyclic guanosine monophosphate (cGMP) in cardioversion].

We investigated atrial natriuretic peptide (ANP) and cyclic guanosine monophosphate (cGMP) in patients undergoing elective direct current cardioversion (CV group) due to atrial fibrillation (n = 9) or atrial flutter (n = 3). Anesthesia for cardioversion (CV) was induced with propofol 1.5 mg/kg. Conversion was achieved in all patients. Before CV all patients had elevated ANP and cGMP plasma levels. After CV the concentrations of ANP and cGMP decreased significantly within 15 and 30 minutes (p less than 0.01), respectively. Only one patient in the CV group showed increasing ANP and cGMP levels although his heart rate had decreased after CV and his blood pressure remained stable. High concentrations of ANP and cGMP might possibly be a compensatory mechanism of cardiac dysfunction. To study the influence the anesthetic agent on plasma levels of ANP and cGMP, we investigated six patients anesthetized with propofol for high-density radiation (HDR group). The data from this control group showed that propofol did not influence the plasma levels of ANP and cGMP. ANP correlated statistically significantly (p less than 0.05) with cGMP in both groups (r = 0.88 and 0.76 in the HDR and CV groups, respectively). In addition, we found a cGMP release of 149.6 +/- 17.6 per mol ANP in the HDR group, in the CV group the release was 109 +/- 54.2 cGMP per mol ANP. This phenomenon could be due to minor response of target cells to ANP stimulation (receptor down-regulation) in patients with heart disease. In conclusion, ANP and cGMP levels decreased after successful cardioversion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Propofol for direct current cardioversion in cardiac risk patients.

We investigated 69 patients (most belonging to NYHA classes II and III) undergoing elective direct current cardioversion of atrial fibrillation (46 patients) and atrial flutter (23 patients), respectively. Without premedication anaesthesia was induced with the new soya bean emulsion of propofol ('Diprivan') 1.2 mg.kg-1 over 45 s. Recovery time was measured from the start of the anaesthetic injection to the moment at which the patients regained consciousness. Completeness of recovery was assessed with two methods: opening eyes on command and time orientation. Good amnesia was observed in all patients. Conversion was achieved in all but seven patients (90%). After injection of propofol, the mean arterial pressure decreased slightly (2% below baseline). Induction of anaesthesia and successful DCC effected a statistically significant decrease in both the heart rate and the rate pressure product. Eleven patients required assisted ventilation for 2 min due to respiratory depression. Fifteen patients developed arrhythmias. Side-effects, such as myocloni, recall or vomiting, were not observed. In conclusion, propofol may well prove to be the anaesthetic of choice for DCC in cardiac patients because of good amnesia, low incidence of side-effects and short recovery time (mean 5.3 min).

Adult↗
PubMed1990

[Medical risk assessment in life insurance of applicants following coronary angioplasty].

The high incidence of instant results of PTCA in patients with coronary artery disease and the favourable prognosis of long-term follow-ups are beneficial for proposers being accepted for life insurance, even though they belonged to the group of high-risk-patients before. In assessing life insurance policies it is necessary to take the individual course of the CAD, the PTCA itself and the remaining left ventricular function into consideration. Risk factors and other cardiac or non-cardiac impairments must be regarded additionally.

Angioplasty, Balloon, Coronary↗
PubMed1990

[Preventive drug therapy following coronary bypass surgery or PTCA].

Antiplatelet therapy to prevent occlusion of coronary bypass grafts is widely used. Though the value of this therapy after bypass surgery is not yet settled, some favourable results have been achieved. Many physicians continue to use the Mayo Clinic recommendations (peri- and postoperative administration of aspirin and dipyridamole) while others used dipyridamole and aspirin after surgery, and others use aspirin alone. It is now well established that pretreatment with platelet inhibitors is effective in lowering the incidence of acute vessel closure after angioplasty: Numerous drugs, including warfarin, aspirin and dipyridamole, aspirin and heparin, nifedipine, diltiazem and the experimental antiplatelet agent ticlopidine have proved ineffective in reducing the rate of restenosis after coronary angioplasty. Only high dose administration of an omega-3 fatty acid dietary supplement for 1 week before angioplasty lowers patients' risk for restenosis, but this therapy does not appear effective if begun the night before the procedure or done with somewhat lower dose. Until additional results are available, clinicians must treat patients on extrapolation from the published trials. Low-dose aspirin should be used for several weeks after the procedure. Careful attention to risk factor modification, especially smoking, lipid profile and diabetes control, seems essential in any long-term plan of management in the patient with coronary disease.

Angioplasty, Balloon, Coronary↗
PubMedDate not supplied

Bone mineral densitometry in dialyzed patients: quantitative computed tomography versus dual photon absorptiometry.

Reduced bone mineral density (BMD) increases risk of fractures, thus making it necessary to monitor patients suffering from chronic renal failure and consecutive disturbance of bone metabolism. In order to evaluate the reliability of available methods, bone mineral density of the lumbar spine assessed with single energy computed tomography (QCT) was compared with bone mineral density of the lumbar spine, femoral neck, Ward's triangle and trochanteric region measured by dual energy photon absorptiometry (DPA) in 45 hemodialyzed patients with a mean hemodialysis duration of 35 +/- 26 months (SD). Depending on the measurement site and method 4-34% of dialyzed patients suffered from reduced BMD (z-score < -2). The highest correlation (r = 0.61, p < 0.01) was found between QCT of the spine, trabecular bone, and DPA of Ward's triangle. One year after baseline measurement bone mineral density was reassessed after randomization to either QCT or DPA in 14 and 18 patients, respectively. Whereas lumbar spine and femoral neck did not change, mean BMD showed a decrease at the measurement sites of Ward's triangle (DPA), trochanteric region (DPA) and trabecular bone of the spine (QCT), which, however, was statistically not significant. Cortical BMD of the spine assessed with QCT showed an increase. Although there is some reduction in bone density at most sites in hemodialyzed patients, no significant bone loss could be demonstrated over the course of 1 year.

Absorptiometry, Photon↗