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Biomedical subjects

P Pretschner

Publications and source records attributed to P Pretschner.

7 recordsLinked to original sources
PubMed1981

Thromboembolism after hip surgery.

Since 1973 a prospective trial of antithrombotic agents for the prophylaxis of deep venous thrombosis and pulmonary embolism was undertaken in 386 high risk patients. Five drugs were employed: 1. A combination of aspirin and dipyridamol (95 patients); 2. Dextran 60 (43 patients); 3. Dihydroergotamine (61 patients); 4. Low dose heparin (63 patients); 5. A combination of dihydroergotamine and low dose heparin (twice daily in 61 patients and three times daily in 63 patients). The patients were investigated by I125 fibrinogen uptake test, phlebography, lung scan and careful clinical evaluation before and after operation. In cases of established thrombosis simultaneous anticoagulation with heparin and coumadin was started. In the first group, 32 (34%) thromboses and three pulmonary emboli were detected of which one patient died. In the dextran group, 24 patients (54%) developed thrombosis and there were no fatal pulmonary emboli. In the low dose heparin group we detected 29 (46%) thromboses and three pulmonary emboli. Only the combination of low dose heparin and dihydroergotamine significantly reduced the incidence of thromboembolic complications-15 (25%) thromboses and no pulmonary emboli. The application of this combination three times a day showed no further improvement but more haemorrhagic complications appeared. Since 1975 no fatal pulmonary emboli have occurred in 720 patients undergoing total hip replacement.

Aspirin↗
PubMed1981

[201-thallium stress scintigram in patients with coronary artery disease after administration of the cardioselective betablocker atenolol (author's transl)].

UNLABELLED: Changes of regional myocardial perfusion before and after administration of Atenolol (AT) (5 mg i.v.) were investigated by 201-Tl stress-imaging in 14 patients (PAT) with greater than or equal to 70% coronary obstructions. Scintigrams were performed in 4 projections (AP, 30 degree LAO, 60 degrees LAO, left lateral); scintigraphic defects (SD) in one of the 6 LV segments (anterior, apical, inferior, septal, lateral, posterior) had to be identified in at least 2 projections and to show a decrease of activity greater than or equal to 25%. All PAT had at least one reversible SD. RESULTS: After AT, stress, induced SDs were unchanged in 11 of the 14 PAT at identical work loads (131 Watt). The total number of reversible defects was 33 before and 28 after AT (n.s.). However, not only the 3 PAT with improved stress scintigrams, but also 6 of the 11 PAT with unchanged abnormal stress scintigrams were clinically improved (ECG normalized, no angina). Thus in almost half of the patients (6/14), the stress ECG was normalized without normalization of perfusion pattern of thallium scintigrams. We conclude that in these patients subendocardial perfusion was enough improved to meet the reduced metabolic needs, but not enough to normalize stress images.

Adult↗
PubMed1980

[The effect of combined alpha and beta blockade with labetalol on the haemodynamics of stress reaction in hypertensives (author's transl)].

The haemodynamic reaction to an acute emotional stress was tested in nine patients with essential and eleven with renal hypertension after an intravenous bolus of labetalol (0.6--1.6 mg/kg body-weight). Labetalol reduced the arteriolar tone at rest. The emotional blood pressure rise was maintained, but started from a lower level due to labetalol and under stress only rose to the pre-labetalol level. The diastolic pressure rose significantly less compared with control values, while systolic and mean blood pressure responses were not uniform. The usual emotional rise in heart rate and cardiac output was clearly diminished by labetalol. Total peripheral vascular resistance, which had been significantly reduced by labetalol, remained unchanged under acute emotional stress. In contrast to untreated hypertensives, venous distensibility and regional blood volume in the lower arm rose significantly on stress while on labetalol medication. Lower arm vascular resistance, which had also been reduced by labetalol, remained uninfluenced by stress: as a result, emotional hyperaemia was much less.

Adult↗
PubMed1979

[Isosorbide-dinitrate in myocardial perfusion (author's transl)].

UNLABELLED: The effect of isosorbide dinitrate (ISDN) (10 mg sublingually) on myocardial perfusion during ischemic conditions was analyzed in 14 patients with angiographically severe coronary artery disease and typical angina pectoris, using the 201-Thallium-myocardial scintigraphy. All patients underwent two identical scintigrams with the same work load during bicycle ergometry; a control scintigram leading to angina and ST-depressions of greater than 0.1 mV was followed 4--6 weeks later by a scintigram after ISDN; all drugs -- except sublingual nitroglycerin -- were withheld for an entire week. -- RESULTS: 25 of 39 new or enlarged, exercise-induced defects (64%) were normalyzed after ISDN; 14 new or enlarged defects remained unchanged (p less than 0.0005). In the 11 patients, in whom ISDN led to complete abolishment of angina, 23 of 30 new defects (76%) were normalized against none in the 3 patients with persistent angina and ST-depressions. Quantitation of perfusion was attempted by calculating the average impulse rate (counts/min/matrix point): in those patients reacting favorably to ISDN average impulse rate decreased significantly especially in the normal area (p less than 0.001), resulting in a more homogeneous distribution of Thallium activity, indicating a marked reduction in local oxygen consumption.

Adult↗
PubMed1979

Effect of an alpha- and beta-adrenoceptor-blocking agent (labetalol) on haemodynamics in hypertension.

1 The effect of an intravenous bolus of labetalol (0.6--1.6 mg/kg body weight) on central and peripheral haemodynamics was studied in nine subjects with essential hypertension and in eleven subjects with chronic renal disease and hypertension. 2 The BP reduction amounting to 20/13 mmHg was entirely due to the lowering of the total peripheral vascular resistance. This also included the vascular resistance in the muscles. 3 This peripheral vasodilatation was not counteracted by a reflex increase of the cardiac output. 4 The reflex tachycardia and overshoot of BP in Valsalva's manoeuvre were largely abolished. 5 Central and peripheral venous BPs, vascular volume of the forearm and venous distensibility did not show any significant change after treatment with labetalol. 6 In spite of the lowering of the vascular resistance of the forearm by labetalol, forearm blood flow was not significantly affected due to the parallel decrease in the perfusion pressure. 7 Plasma renin activity fell after labetalol in all instances.

Adult↗