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Biomedical subjects

P Bielmann

Publications and source records attributed to P Bielmann.

At least 19 recordsLinked to original sources
PubMed1999

Metabolic and antihypertensive effects of nebivolol and atenolol in normometabolic patients with mild-to-moderate hypertension.

This was a double-blind, randomized, two-center, active-controlled, prospective, parallel study designed to evaluate the effects of nebivolol at daily doses of 5 mg on lipid and carbohydrate metabolism and on blood pressure in comparison with atenolol at daily doses of 50 mg. Normometabolic subjects with mild-to-moderate essential hypertension were recruited for this study, which included a 4-week, single-blind placebo washout phase and a 12-week double-blind treatment phase. After 12 weeks of treatment, both drugs demonstrated a significant decrease from baseline in high-density lipoprotein (HDL) apolipoprotein A-I (HDL-apoA-I) (nebivolol, P <.02; atenolol, P <.05). A significant reduction in HDL cholesterol (HDL-C) from baseline was also observed with nebivolol (P <.05). There were no significant differences between the drugs for these parameters, and the ratio low-density lipoprotein cholesterol (LDL-C)-to-HDL-C did not change significantly after 12 weeks of active treatment with nebivolol or atenolol. There were no significant changes in total cholesterol, HDL (2) -C, HDL (3) -C, LDL-C, very-low-density lipoprotein cholesterol (VLDL-C), total triglycerides, HDL-triglycerides (TG), LDL-TG, VLDL-TG, total apoB, LDL-B, VLDL-B (including the ratio LDL-C-to-LDL-apoB), or Lp(a) during treatment with both drugs. No significant differences in plasma apoA-I and apoC-III as well as in apoA-I-, C-III-containing lipoprotein particles (including the apoC-III ratio) were observed between the drugs, neither before nor after each active treatment. There were no significant differences between the drugs or within each treatment group in plasma glucose, insulin, or C-peptide concentrations after a 2-hour oral glucose tolerance test. Mean clinic trough sitting systolic blood pressure (SBP)/diastolic blood pressure (DBP) significantly decreased from 150/98 mm Hg at baseline to 141/90 mm Hg at termination for nebivolol and from 160/99 mm Hg at baseline to 145/88 mm Hg at termination for atenolol. No significant between-treatment differences were observed for the mean clinic trough sitting SBP/DBP. Both drugs significantly increased the atrial natriuretic factor (ANF) N-terminal plasma levels, whereas no changes were observed in ANF C-terminal plasma concentrations. A significant decrease (P <. 05) in the plasma adrenocorticotropic hormone levels was observed after administration of both drugs. A significant decrease (P <.05) in plasma cortisol levels was observed only after atenolol treatment. The incidence of adverse events reported during nebivolol treatment was comparable to that observed during atenolol treatment. Heart rate was significantly reduced by both drugs. There were no significant changes in hematology, biochemistry, or urinalysis studies. Neither nebivolol nor atenolol adversely affected lipid or carbohydrate metabolism in normometabolic hypertensive patients. Both treatments demonstrated adequate and similar antihypertensive effects and were well tolerated.

Adrenocorticotropic Hormone↗
PubMed1991

Effects of chlorthalidone and metoprolol alone or in combination (logroton) on blood pressure, lipids, lipoproteins and circulating plasma ANF levels in essential hypertension.

The effects of chlorthalidone (mean dose 25 mg/day), metoprolol (mean dose 200 mg/day) or their combination (logroton) on blood pressure, lipids, lipoproteins and circulating atrial natriuretic factor (ANF) were evaluated in a controlled trial of 42-week duration in 33 hypertensive patients. There was a significant reduction in mean arterial pressure after chlorthalidone and metoprolol treatments. This effect was more pronounced with the chlorthalidone/metoprolol combination (logroton). There were no significant changes in mean ANF levels after any drug regimen, although a tendency to increase was observed after six weeks of treatment with metoprolol. Both chlorthalidone and metoprolol as monotherapy increased the total triglycerides. This effect was less pronounced with logroton. During metoprolol treatment, HDL cholesterol decreased significantly, whereas VLDL-C increased. When combined drug therapy was administered, the unfavorable effects on HDL-C were partially blunted and VLDL-C returned to baseline. LDL-cholesterol did not change significantly during any drug regimen nor did the ratio of LDL-C/HDL-C. Logroton significantly increased the VLDL apo B levels in patients who had received chlorthalidone as monotherapy but had no effect in patients already treated with metoprolol. Neither treatment had a significant influence on the ratio of LDL-C/B. There were no serious adverse events reported throughout the study. It is concluded that logroton may be an effective combination therapy that produces less adverse effects on lipid and lipoprotein metabolism than chlorthalidone or metoprolol monotherapies.

Atrial Natriuretic Factor↗
PubMed1990

Effects of ketanserin on lipids, lipoproteins, and plasma atrial natriuretic factor in patients with essential hypertension.

The effects of ketanserin, 40 mg/day (KE40) and 80 mg/day (KE80) on mean arterial pressure, lipids, lipoproteins, and circulating atrial natriuretic factor (ANF) were investigated in a 24-week controlled study in 29 patients suffering from mild to moderate hypertension. A significant decrease in mean arterial pressure (MAP) was observed after 18 weeks of therapy, accompanied by a 64% (P less than .05) and 80% (P less than .02) increase in circulating ANF levels with KE40 and KE80, respectively. There were no significant changes in mean total cholesterol, triglycerides, or cholesterol of the high density lipoproteins (HDL), low density lipoproteins (LDL), and very low density lipoproteins (VLDL) fractions. There was a significant increase in the mean apo B levels and consequently a slight but statistically significant decrease in the ratio of LDL C/B. It is concluded that both doses of KE are effective for monotherapy of mild to moderate essential hypertension. The drug sharply increases circulating ANF levels without significantly altering the plasma lipids. In contrast, by increasing the apolipoprotein B content of the LDL fraction, the beneficial cardiovascular effect of a lowered blood pressure may be partly blunted.

Atrial Natriuretic Factor↗
PubMed1990

Hyperprolactinemia and temporal lobe epilepsy in a woman: concomitant and persistent prolactin suppression and temporal lobe epilepsy relief.

It has been reported that hyperprolactinemia may be associated with increased temporal lobe activity. Coexisting hyperprolactinemia (97.5 +/- 3.2 ng/ml) related to a pituitary tumefaction (8 mm) and Temporal Lobe Epilepsy (TLE), were observed in a 37-year-old woman. Carbamazepin (CBZ) therapy induced a marked improvement in TLE symptoms and EEG recordings, but did not influence hyperprolactinemia and related symptoms. Long-lasting (27 months) normoprolactinemia (19.4 +/- 0.6 ng/ml) and TLE relief were achieved on a dopamine (DA) agonist medication, e.g. pergolide mesylate, 25-50 micrograms/day given over 8 months, and persisted as long as 27 months after drug withdrawal. Posttreatment CT scans showed progressive shrinkage of the pituitary tumor (2 mm) associated with an empty-sella. It is proposed that, whenever TLE and hyperprolactinemia coexist, therapy with a DA agonist such as pergolide mesylate, resulting in normoprolactinemia, may be beneficial in TLE control.

Adult↗
PubMed1988

Effects of fenfluramine in hypertriglyceridemic obese subjects.

Forty-four hyperlipidemic obese subjects, selected because of their refractoriness towards diet-therapy, participated voluntarily in a 12-week double-blind study comparing the effects of a long-acting fenfluramine (Ponderal Pacaps) to those of a placebo. In spite of no dietetic intervention, a significant 3-kg weight loss (P less than 0.001) was observed in the fenfluramine-treated group, accompanied by a significant improvement of most atherogenic parameters of plasma lipoproteins. Fenfluramine-induced weight loss produced decrease in total cholesterol (P less than 0.05), total triglycerides (P less than 0.05), LDL cholesterol (P less than 0.05), total apoprotein B (P less than 0.005) and LDL apoprotein B (P less than 0.001). An apoprotein B LDL depletion seemed to occur, as suggested by the reduction of LDL cholesterol/apoprotein B ratio (P less than 0.001). Total plasma apoprotein A did not change but the total apoprotein B/total apoprotein A ratio decreased significantly (P less than 0.005). Moreover, fenfluramine increased both HDL phospholipid (P less than 0.005) and HDL cholesterol (P less than 0.05) resulting in a fall of the atherogenic LDL-cholesterol/HDL cholesterol ratio (P less than 0.001) as well as an elevation of the anti-atherogenic HDL cholesterol/LDL + VLDL cholesterol ratio (P less than 0.001). The placebo group demonstrated some improvement in lipid blood parameters without weight loss, indicating a possible qualitative amelioration of nutritional habits. Thus, fenfluramine reduces the risk for cardiovascular disease in hyperlipidemic obese individuals not responding to behavioral intervention.

Adult↗
PubMed1982

Beta blockers and their effects on lipoproteins, phospholipids, apoproteins A and B, in whole plasma and the different fractions.

Plasma levels of cholesterol (C), triglycerides (TG), phospholipids (PL) (in total plasma, very low density [VLDL], low density (LDL), and high density [HDL] lipoproteins) and of two apolipoproteins (apo-B and apo-A) were studied in 13 hyperlipidemic patients suffering from hypertension and/or stable angina and treated by metoprolol or propranolol. Propranolol reduced the low density and high density lipoprotein phospholipids by 26% and 11%, respectively, and increased the very low density phospholipids by 24%. Metoprolol had only a transient effect on high density lipoprotein phospholipids. VLDL apolipoprotein-B was markedly increased by propranolol (67%), whereas apolipoprotein-A was slightly (8%) increased during metoprolol treatment. The reduced low density lipoprotein phospholipids and the increased high density lipoprotein apo-A correlated with the plasma concentration of propranolol and metoprolol, respectively. These results suggest that the comparative effects of beta-adrenoreceptor blocking agents on lipoprotein metabolism should be considered in their long-term use in patients with risk factors for hypertension and myocardial infarction.

Adrenergic beta-Antagonists↗
PubMed1980

Effect of acute and chronic administration of calcitonin on serum glucose in patients with Paget's disease of bone.

The effects of an acute injection of synthetic salmon calcitonin (sCT) and human CT (hCT) and of long term (4-month) administration of sCT on serum glucose levels were investigated in eight patients with Paget's disease of bone. The results obtained demonstrate a small but statistically significant rise in serum glucose after a single sc injection of synthetic hCT. However, the serum glucose level was not increased after 4 months of daily administration of synthetic sCT to our pagetic patients. Our results also substantiate the clinical observation that long term administration of CT does not cause clinical diabetes or significantly change fasting blood glucose concentration. Our results are also consistent with the view that the effect of CT administration on glucose metabolism is related to the secondary hypocalcemia.

Aged↗
PubMed1980

An etiologic survey of clinical factors in cervical intraepithelial neoplasia: a transverse retrospective study.

In this retrospective survey 235 patients were studied: 123 patients with cervical intraepithelial neoplasia (CIN) and 112 controls. Fourteen epidemiologic variables were reviewed. The stepwise logistic multiple regression analysis demonstrated that age at first sexual contact was the variable most related to CIN appearance, followed by the occupation of the husband. School attendance and socioeconomic indices of the patients' fathers, husbands or partners were lower in the CIN group, as shown in the descriptive analysis. Age at first pregnancy was also found to be lower among CIN patients. Promiscuity and contraception did not seem to play a significant role in the incidence of neoplastic disease. A carcinogenic model is proposed.

Adult↗
PubMed1979

Effect of acute administration of salmon and human calcitonin on blood urate and renal excretion of uric acid in patients with Paget's disease of bone.

The sc injection of salmon calcitonin (CT) (100 MRC U) or human CT (50 MRC U) to Pagetic patients reduces the plasma urate concentration and increases the renal excretion of uric acid. This effect is independent of the natriuretic, phosphaturic, or glycosuric actions of CT and is not due to the transient increment of the glomerular filtration rate noted after CT administration. Our results suggest that the hypouricemia observed during CT treatment is related, at least in part to a direct action on the renal handling of uric acid.

Aged↗
PubMed1979

Effects of metoprolol and propranolol on lipid metabolism.

Treatment of five hypertriglyceridemic and one normolipemic patients with propranolol, a non-selective beta-blocking agent, and metoprolol, which is generally considered to be a cardioselective beta-adrenoceptor antagonist, was observed to produce a further elevation in their triglyceride levels. The subjects were followed for 20 weeks, during which they received propranolol for eight weeks, a placebo for four weeks and metoprolol for eight weeks in a crossover design. The analysis suggested that the increase in triglyceride levels was less pronounced with the more cardioselective agent. Moreover, alpha-cholesterol decreased significantly after propranolol but remained constant while on metoprolol. Both drugs decreased beta-cholesterol whereas chylo- and pre- beta-cholesterol increased, particularly with propranolol. Considering the contradictory evidence regarding the clinical importance of chronic elevation of plasma triglyceride and decreased alpha- und beta-cholesterol concentrations, it is suggested that a cardioselective drug would be presently preferable in hyperlipidemic subjects.

Cholesterol↗
PubMed1978

Comparison of serum phenytoin levels in epileptic patients who swallowed their phenytoin tablets with or without previous chewing.

This cross-over study was conducted to compare serum phenytoin levels after chronic ingestion of phenytoin tablets with or without previous chewing. The phenytoin therapy was administered as 50 mg chewable Infatabs tablets in a single morning dose of 200 mg. There was no significant difference between the two modes of ingestion as regards serum phenytoin levels measured at various times after ingestion of the phenytoin tablets. Moreover, the area under the curve did not differ significantly during the 24 h interval. Minor changes between two Dilantin formulations, however, could influence drug availability.

Epilepsy↗
PubMed1978

Clonazepam: its efficacy in association with phenytoin and phenobarbital in mental patients with generalized major motor seizures.

In a 36-week controlled study, the efficacy of clonazepam administered with phenytoin and phenobarbital was evaluated in twenty-four epileptic mental patients suffering from major motor seizures. The patients were distributed in two strata according to the presence or the absence of chlorpromazine. As compared with placebo treatment in the chlorpromazine-free patients, a significant reduction in the frequency of the tonic-clonic seizures was observed during the 24-week clonazepam treatment. This effect could not be observed in the patients requiring the antipsychotic drug. The EEG performed before and at the end of the experimental period did not show any significant change. The most common adverse reactions to clonazepam were drowsiness and ataxia; they diminished with continued treatment.

Benzodiazepinones↗
PubMed1977

Hypolipidemic effect of tibric acid. A comparison with clofibrate and placebo in type IV hyperlipoproteinemia.

The effects of tibric acid, clofibrate, and placebo were compared in type IV hyperlipidemic patients for a 6-month period. The patients were divided into two pathological level groups according to their baseline triglyceride levels. Compared to the placebo, both tibric acid and clofibrate reduced the mean serum triglyceride concentration in the high pathological level group; however, clofibrate was also effective in the low pathological level group. The effects on total cholesterol were less pronounced with the two drugs. No effect was observed on esterified cholesterol, phospholipids, free fatty acids, and fasting blood sugar. After a 6-week follow-up period under placebo, no rebound of the triglyceride and cholesterol levels could be observed after discontinuation of the two active drugs. The other biochemical changes observed after each active treatment are discussed in relation to the different degree of activity of each active drug and to the different baseline levels of triglycerides.

Adult↗