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Biomedical subjects

O Madonna

Publications and source records attributed to O Madonna.

10 recordsLinked to original sources

Lisinopril versus atenolol: decrease in systolic versus diastolic blood pressure with converting enzyme inhibition.

In a multicenter, parallel, double-blind study, lisinopril, a new converting enzyme inhibitor, was compared with atenolol in the treatment of mild to moderate essential hypertension. Four hundred ninety patients were randomized to once-a-day treatment with lisinopril 20 mg or atenolol 50 mg for 4 weeks, and the doses of lisinopril or atenolol were increased at 4-week intervals up to 80 mg or 200 mg, respectively, if sitting diastolic blood pressure (SDBP) was not well controlled. Lisinopril and atenolol reduced SDBP to a similar extent. All reductions from baseline in sitting diastolic and systolic blood pressure were significant (p less than 0.01). Lisinopril produced a significantly greater reduction (p less than 0.01) in sitting systolic blood pressure (SSBP) than atenolol. The predominant reduction in SSBP could not be explained on the basis of age, race, or severity of hypertension. It is suggested that the increase in arterial compliance reported for converting enzyme inhibitors could explain the predominant decrease in systolic blood pressure.

Adult

Effects of xamoterol on sodium excretion in volunteers.

Xamoterol has been shown to reduce the frequency of oedema and lung crepitations in heart failure. We examined its effects on blood pressure and renal function in healthy volunteers. Systolic blood pressure rose, sodium and chloride excretion increased and there was a strong correlation in individual subjects between rises in systolic blood pressure and in sodium excretion. Although no changes in glomerular filtration rates were seen, changes sufficient to explain the observed rise in sodium excretion are well within the experimental error of this study. Xamoterol may increase sodium excretion by an action on renal haemodynamics.

Adrenergic beta-Agonists

[Reference values of ambulatory arterial pressure in activity and during the night. Multicenter study of 394 normotensive subjects at rest].

The blood pressure pattern and variability were assessed in a population of 394 normotensive subjects (OMS) stratified by age (20 to 75 years) and sex. Ambulatory blood pressure measurements were performed with an automatic device (Spacelabs 5200) every 15 min. from 6 a.m. to 12 p.m., and every 30 min. from 0 a.m. to 6 a.m. The analysis was effected during normal daily activities (from 9 a.m. to 7 p.m.) and during night (from 11 p.m. to 7 a.m.). Blood pressure levels were higher in males than females. During daytime and nighttime, diastolic blood pressure rose with age until 59 years while SBP was not affected, except for the females older than 60 years. After this age, diastolic blood pressure decreased. No epidemiological study has provided a measure of the cardiovascular risk related to ambulatory blood pressure, so that we were unable to define true normal values. However, reference population values provided from two statistical methods: limit of the 95th upper confidence interval for the mean of limit of the 90th percentile value for the total data. These blood pressure distributions according to age and sex may allow a better approach to borderline hypertensive patients.

Adult

Myocardiotoxicity of 5 fluorouracil.

We report a case of specific myocardiotoxicity due to 5 F.U. not previously described in man. A 41-year-old man was admitted to the ICU for heart and renal failure, appearing 24 h after 5 days treatment with 5 F.U. and cis-platinum. Dopamine was necessary to maintain blood pressure. Two-D echocardiography and a right heart catheterisation confirmed the alteration of myocardial contractility. After 2 weeks a complete cardiac recovery occurred.

Adult

The prognosis of renal vein thrombosis: a re-evaluation of 27 cases.

Twenty-seven patients with renal vein thrombosis were retrospectively studied to evaluate their long-term prognosis and relevant prognostic factors. Twenty-four patients presented with a nephrotic syndrome, and 15 had renal impairment (8 acute; 7 moderate). Ten patients had a previous history of proteinuria, and 14 of nephrotic syndrome. Renal biopsy performed in 20 patients, of whom 19 were nephrotic, showed membranous glomerulonephritis in 14, focal segmental glomerulosclerosis in three, minimal change glomerulonephritis in two, and periarteritis nodosa in one. Renal vein thrombosis was angiographically proven in all patients and was bilateral in 18, localised to the left renal vein in seven, and to the right in two. Thrombosis of the inferior vena cava was associated in seven patients. Ten patients were treated by anticoagulants alone, nine by surgical thrombectomy, seven by thrombolysis, and two did not receive any specific treatment. One patient underwent successively thrombectomy and then thrombolysis. Eleven patients died within the first 6 months, mainly from haemorrhagic complications (n = 5) or severe sepsis (n = 2). Survivors were followed up from 6 months to 19 years. Nephrotic syndrome improved or even disappeared in 12 patients, and renal function did not worsen throughout the follow-up in any patients. The main prognostic factors were initial renal function and type of nephropathy: patients with membranous glomerulonephritis had a significantly better renal function and a lower mortality rate than patients with other nephropathies. Initial renal insufficiency was significantly associated with a poor prognosis. There was no advantage, in terms of survival, kidney function and nephrotic syndrome, of either thrombectomy or thrombolysis over anticoagulants alone, despite two complete venous recanalisations after thrombolysis. Accordingly, patients with renal vein thrombosis from membranous glomerulonephritis should be treated by anticoagulants alone, since the long-term prognosis of this disease seems unaffected by intercurrent renal vein thrombosis. With respects to the risk-to-benefit ratio, thrombectomy should be avoided and thrombolysis considered only in patients with initial acute renal failure from acute renal vein thrombosis.

Adult

Influence of treatment by betaxolol on the renal response to postural changes in moderate hypertension.

Assumption of upright posture is known to be associated with significant variations in renal function, which are thought to be mediated through the stimulation of the renin angiotensin system. The effect of an eight-week treatment with betaxolol, a selective beta-blocker, was studied in patients with moderate hypertension and normal renal function. Betaxolol induced the expected changes in systemic hemodynamics and reduced supine plasma renin activity and aldosteronemia. The glomerular filtration rate showed no variation but the tubular reabsorption of sodium increased. The renal adaptation to postural changes (decrease in glomerular filtration rate, increase in sodium reabsorption and in plasma renin activity) was unaffected by treatment. It is concluded that betaxolol does not impair the renal response to a physiological stimulus such as change in posture.

Adult

Autoradiographic localisation of VIP receptors in human lung.

Localisation and pharmacological properties of the VIP receptor in human lung sections are described. The receptor density determined by saturation analysis using 125I-VIP is approx. 100 fmol/mg protein, with a Kd of approx. 600 pM. Inhibition of 125I-VIP binding with VIP and related peptides gives a rank order of potency: VIP greater than peptide histidine methionine greater than secretin. Light microscope autoradiography reveals specific VIP binding sites, with a high density over the pulmonary artery smooth muscle and the alveolar walls and with a lower density over the bronchial epithelium.

Autoradiography

[Sports and blood pressure: association in a population of wage-earners].

In a cross-sectional epidemiological survey, we examined the association between the practice of sports and blood pressure (BP). The study included 3,388 male employees (representing 90.1% of the target population) who were questioned about their habitual sports activity, in terms of average duration per week and intensity. The proportion of subjects who stated to engage in sports activity decreased with age, from 50.9% in the age class 20-29 years to 16.4% in the age class 50-59 years. We found a negative relationship between both systolic and diastolic BP and the weekly duration of sports activity. However this association increased with age and reached the statistical significance only in the age classes 40-49 years and 50-59 years (p less than 0.01 and p less than 0.001, respectively). Similar results were obtained when intensity of sports was used instead of duration. In order to test the independence of the observed association, the duration of sports activity (hours/week) was included as an independent variable in a multiple linear regression analysis, along with the following potential confounders: age, Quetelet index, alcohol consumption, cigarette smoking, heart rate, and level of education. In this analysis the sports-BP relationship was considerably attenuated or entirely disappeared. It remained statistically significant only in the age class 50-59 (p less than 0.01 for systolic BP an p less than 0.05 for diastolic BP). Our results support those of others showing a modest beneficial effect of leisure time physical exercise on BP.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

[Cardiac abscess in infectious endocarditis. Apropos of 25 anatomo-clinical cases].

Although rarely suspected clinically, cardiac abscesses are a serious and not uncommon complication of infective endocarditis (IE). Twenty-five cardiac abscesses were found at autopsy in 125 cases of IE on native valves. The anatomoclinical features of these cases are described. Cardiac abscesses usually occur in patients with previous valvular heart disease (21/25) and more commonly in aortic valve endocarditis (15/25) especially when complicating calcific aortic stenosis (9/25). The predominant infecting organism was staphylococcus aureus (9 cases). An iatrogenic portal on entry was confirmed in 9/25 cases. Conduction defects (14/25) commonly led on to sudden death (9 cases) despite attempts at temporary pacing (14/25) commonly led on to sudden death (9 cases) despite attempts at temporary pacing (2 cases%. The clinical history was shorter than 2 months in 4/5 cases. The average age of the patients was 53.3 years. The commonest site of infection was the aortic valve (16/25), affecting the posterior cusp in all cases. It is difficult to summarise the localisation of the abscesses as collection of pus extended in all directions. Involvement of the valve rings (aortic 10 cases--mitral 5 cas), of the interventricular septum (15 cases), of the LV free wall (17 cases), was common, sometimes in association, and fistula formation between two different cavities was observed in 4 cases. The abscess may communicate with a cardiac chamber or remain enclosed in the parietal structures (17 cas) reaching an average size of 2 cm diameter. Histological examination distinguished collected forms with an identifiable pyogenic membrane from the extensive, gangrenous, necrotic form with detectable microbial colonies in 9 cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Abscess