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Biomedical subjects

R O Gans

Publications and source records attributed to R O Gans.

At least 109 records · Page 6Linked to original sources
PubMed1991

Insulin and blood pressure regulation.

Epidemiological evidence suggests that there is a close association between obesity, non-insulin-dependent diabetes (NIDDM) and hypertension. Obesity and NIDDM are the classical insulin-resistant states. Even in the absence of these conditions, essential hypertension is associated with insulin resistance. In view of the acute effects of insulin on renal sodium reabsorption, the sympathetic nervous system, the renin-angiotensin-aldosterone system, the transmembranous cation transport, the cardiovascular reactivity, the atrial natriuretic peptide and the kallikrein-kinin system, hyperinsulinaemia may contribute to the development of hypertension in these diseases. Preliminary evidence suggests that sensitivity to these possible blood-pressure-elevating action(s) of insulin is still present despite the resistance to the glucose-lowering action of the hormone. However, extrapolation of the epidemiological data and results of acute experiments indicate that the impact on blood pressure is rather small. The pathophysiological mechanisms of hypertension in the above-mentioned conditions are also not always consistent with insulin action(s). Moreover, some data suggest that insulin resistance, and not hyperinsulinaemia per se, underlies the blood pressure elevation, while the possibility cannot be excluded that both hypertension and insulin resistance are co-inherited, but unrelated, abnormalities.

Animals↗
PubMed1990

Fish oil: a panacea?

Since the first report by Bang and Dyerberg regarding the apparent beneficial effects of a fish oil-enriched diet on the incidence of atherosclerotic heart disease in Greenland eskimos, a considerable number of studies have been performed regarding the effects of omega-3 polyunsaturated fatty acids on the prevention and treatment of a variety of disease states not necessarily related to atherosclerosis. Studies have been performed on healthy volunteers and in patients with hyperlipidaemia, atherosclerotic vascular disease, diabetes, asthma, psoriasis and chronic renal insufficiency, amongst others. Positive effects on platelet activity, lipid profile, blood rheology and blood pressure--all factors which are presumably of importance in the pathogenesis of atherosclerotic disease have been noted in these studies, albeit with a wide range of variability. Some negative effects also appear to exist. However, some general conclusions can be made regarding the effects of a fish oil-enriched diet.

Arteriosclerosis↗
PubMed1990

Fish oil supplementation in patients with stable claudication.

Increased blood viscosity occurs in patients with claudication. This increase in viscosity, which is mainly due to elevated fibrinogen levels and a decreased red cell deformability, adversely influences blood flow. In addition to a positive effect on blood pressure, blood lipids, and platelet responsiveness, fish oil may improve blood flow due to a favorable influence on hemorrheology. In a prospective, randomized, double-blind study, we evaluated the effect of six capsules of fish oil (1.8 g eicosapentaenoic acid and 1.2 g docosahexaenoic acid) versus six capsules of corn oil (3 g linoleic acid), administered for 4 months, on walking distances, pressure indices during rest and after exercise, blood pressure, red cell deformability, fibrinogen, and lipid levels in 32 patients with stable claudication. No significant changes in walking distances and pressure indices during rest and after exercise occurred, despite a significant increase in red cell deformability in the fish oil group. Fibrinogen levels did not change in either group. In the fish oil group, a favorable change in blood lipids was noted; high-density cholesterol increased and triglycerides decreased. Mean arterial blood pressure declined to a similar extent in both groups. Thus, short-term supplementation with fish oil does not lead to clinically significant improvement of symptoms in patients with stable claudication. This suggests that red cell deformability is of minor importance in the arterial blood flow in the legs of these patients.

Adolescent↗
PubMed1990

Diabetic nephropathy in insulin-dependent diabetes mellitus: pathogenesis and treatment strategies.

Diabetic nephropathy is an important problem in insulin-dependent diabetic patients. Directly or indirectly it is a major cause of death amongst them and accounts for a great number of patients requiring renal replacement therapy today. The last decade has seen a considerable growth in the insight into the pathophysiological mechanisms underlying the development of diabetic renal disease. In this article, the current knowledge concerning the pathogenesis of diabetic nephropathy and the implications of this understanding for therapeutic approaches will be discussed.

Blood Pressure↗
PubMed1989

Effects of chronic and acute protein administration on renal function in patients with chronic renal insufficiency.

In 6 volunteers with normal renal function, we investigated the effects of various kinds of protein (soy, lactoprotein and beef) and various amounts of an intravenously administered amino acid solution on glomerular filtration (GFR) and effective renal plasma flow (ERPF). As for the protein-induced changes in renal function, rises in GFR and ERPF were lowest with soy protein, and highest with beef (baseline GFR, 110 +/- 5; soy, 122 +/- 5; beef, 131 +/- 5 ml/min/1.73 m2; mean +/- SEM). High doses of intravenous amino acids induced a rise in GFR comparable to that after beef (132 +/- 5 ml/min/1.73 m2). In a combined test a liquid mixed meal together with intravenously administered amino acids induced a comparable increase of the GFR (baseline 114 +/- 5 versus 129 +/- 5 ml/min/1.73 m2). When investigating 9 patients with chronic renal insufficiency after 4 weeks of low protein intake (LP) and after 4 weeks of high protein intake (HP), GFR and ERPF rose significantly under baseline conditions (GFR-LP41 +/- 9 versus GFR-HP 45 +/- 9 ml/min/1.73 m2, p less than 0.02; ERPF-LP 169 +/- 39 versus ERPF-HP 180 +/- 40 ml/min/1.73 m2, p less than 0.02; paired Wilcoxon). At the end of both dietary periods a comparable rise in renal function could be induced through acute stimulation (GFR-LP 20 +/- 5, GFR-HP 16 +/- 4; ERPF-LP 23 +/- 7, ERPF-HP 22 +/- 3%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Fatal rhinocerebral mucormycosis and diabetic ketoacidosis.

The typical features of a fulminating rhinocerebral infection by the fungus Rhizopus in a patient with diabetic ketoacidosis are described. The clinical presentation was characterized by an infection of the face, followed by rapid bilateral visual loss and massive cerebral infarction due to extensive vascular involvement. Early diagnosis is a prerequisite for successful treatment, which consists of control of the underlying disease, surgical debridement and systemic antifungal therapy.

Diabetic Ketoacidosis↗
PubMed1988

Transfusion-related acute lung injury.

Noncardiogenic pulmonary edema after transfusion therapy is an infrequent but hazardous complication. The occurrence of this entity is linked to the presence of circulating leukoagglutinins. The clinical features are described on the basis of four cases. The hemodynamic changes, underlying mechanisms and therapeutic strategies are discussed.

Acute Disease↗
PubMed1987

Influence of salt on glycaemic response to carbohydrate loading.

The effect of dietary salt on glycaemic responses to different test meals was investigated. Eight healthy male volunteers ate four test meals on consecutive mornings and in random order; the meals were 50 g carbohydrate taken as a 20% glucose solution or as boiled macaroni with and without supplementation with 6 g salt. In contrast with other reports, no significant differences in peak plasma glucose concentrations or areas under the plasma glucose curves could be established. These findings do not support a beneficial effect of salt restriction on glycaemic control in diabetes.

Absorption↗