Biomedical subjects

S Felix

Publications and source records attributed to S Felix.

9 recordsLinked to original sources

PubMed2005

[Pulmonary hypertension in hereditary haemorrhagic teleangiectasia (Rendu-Osler-Weber disease). Progression over 10 years].

HISTORY: 10 years ago a now 49-year-old woman with Render-Osler-Weber disease showed unspecific symptoms of nausea, and general unwellness. Pulmonary manifestation of the disease was accompanied by pulmonary hypertension. INVESTIGATION: Teleangiectasia of the tongue and pharynx as well as of the mucosa of mouth and nose were observed. Fixed-splitting of the second heart sound with accentuated pulmonary component and a 2/6 systolic murmur over the tricuspid valve were heard. In addition, a murmur was heard dorsal over the right lung's lower lobe. Apart from minor oedema of both ankles, the physical status was not remarkable. Echocardiography showed dilatation of the right ventricle and a minor regurgitation of the tricuspid valve. The computed tomography showed dilatation of the pulmonary arteries as well as an arteriovenous malformation in the right lower lobe. Right-heart catheterisation revealed elevated pulmonary pressure. THERAPY AND FOLLOW-UP: Initial treatment with a calcium channel blocker proved insufficient and was changed to inhalative, and later to oral prostanoids. Under this treatment the cardiopulmonary state was stabilised, but episodes of epistaxis were increased. Two years after readjustment of the medication to a dual endothelin receptor antagonist, the cardiopulmonary state remains stable without significant haemorrhagic complications. CONCLUSION: Prostanoid treatment in patients with Render-Osler-Weber disease and additional pulmonary hypertension can lead to an increased risk of haemorrhagic complications. Treatment with newer medications, such as endothelin receptor antagonists, seems indicated as successfully illustrated in our case.

Anticoagulants↗

PubMed2004

Acute vanishing bile duct syndrome after ibuprofen therapy in a child.

We report the case of a 10 year-old girl who had Stevens-Johnson syndrome and cholestasis after ibuprofen therapy. Liver histology was compatible with vanishing bile duct syndrome. She received ursodeoxycholic acid, and liver tests normalized within 7 months. This report confirms that ibuprofen may induce acute vanishing bile duct syndrome.

Acute Disease↗

PubMed1994

E-selectin polymorphism and atherosclerosis: an association study.

Adhesion molecules like the members of the selectin family participate in the interaction between leukocytes and the endothelium. They are also involved in the pathogenesis of atherosclerotic processes. To contribute to the analysis of the genetic background of atherosclerosis we searched for DNA polymorphisms in the genes encoding adhesion molecules especially E-selectin which seems to be expressed only in activated endothelium. An adenine to cytosine substitution for cDNA position 561 resulting in an amino acid exchange from serine to arginine (position 128) was detected in the epidermal growth factor like domain. A significantly higher mutation frequency (P = 0.02) was observed in 97 patients aged 50 years or less with angiographically proven severe atherosclerosis (allele frequency of arginine 0.155) compared with an unselected population (allele frequency of arginine 0.088) as well as in 40 patients aged 40 years or less (allele frequency of arginine 0.21, P = 0.0025). These data suggest that the 128-serine/arginine polymorphism is associated with a higher risk for early severe atherosclerosis.

Adult↗

PubMed1994

[Therapy of cardiogenic shock].

Cardiogenic shock is a syndrome of different etiologies resulting in the inability of the heart to provide adequate O2 delivery to peripheral organs and tissues with or without signs of severe pulmonary congestion or pulmonary edema. Clarification of the underlying etiologies is essential for prognosis and therapy. Depending on the various etiologies, the therapeutic procedure may be totally different. Furthermore, it is decisive to differentiate between an acute shock (e.g., acute myocardial infarction) and the development of a cardiogenic shock state on the basis of preexisting chronic congestive heart failure (e.g., congestive cardiomyopathy). Whenever possible the underlying disease should be treated causally (e.g., PTCA or thrombolytic therapy in AM, lysis in acute pulmonary embolism) in addition to symptomatic pharmacologic treatment with vasodilators and/or inodilators. In myogenic cardiogenic shock, the treatment with inotropic drugs (with and without vasodilatory potency) and, if necessary, in combination with additional vasodilators may be life-saving. At present, there is no alternative to catecholamines in the acute state with apparent hemodynamic instability. Catecholamines still represent the initial first line treatment. A Swan-Ganz catheter is mandatory in such situations. In view of the rapid beta 1-receptor down-regulation induced by endogenous catecholamines, long-term administration of exogenous catecholamines (adrenalin, dopamine, dobutamine), seems essentially problematic, since these compounds intensify and accelerate this process.(ABSTRACT TRUNCATED AT 250 WORDS)

Angioplasty, Balloon, Coronary↗

PubMed1990

Cardiovascular effects of forskolin (HL 362) in patients with idiopathic congestive cardiomyopathy--a comparative study with dobutamine and sodium nitroprusside.

Forskolin, a diterpene derivative of the Indian plant Coleus forskhohlii, proved to be a marked positive inotropic and vasodilatory compound in animal experiments with a mechanism of action distinct from catecholamines, cardiac glycosides, and phosphodiesterase-inhibiting compounds. The cardiovascular effects of forskolin seem to be mediated by a direct stimulatory action at the catalytic unit of sarcolemmal adenylate cyclase. The aim of the present study was to clarify the cardiovascular profile of this compound in 12 patients with stage III (NYHA) congestive cardiomyopathy. The effects of forskolin were investigated by invasive techniques using the thermodilution catheter method and compared to the beta 1-receptor agonist dobutamine and the vasodilator sodium nitroprusside in an intraindividual comparison. Forskolin dose-dependently reduced cardiac pre- and afterload values, and led to a reduction in systolic, diastolic, and mean pulmonary artery pressure as well as pulmonary wedge pressure by greater than 50% concomitant with an increase in cardiac output. There was a slight increase in heart rate. Cardiac stroke volume and stroke volume index was increased by approximately 70%. The cardiovascular effects of dobutamine and nitroprusside were less pronounced; however, it seemed that a similar hemodynamic profile could be achieved by the combination of both dobutamine and sodium nitroprusside. In view of the rapid development of tolerance toward beta 1-receptor stimulation, forskolin, with its receptor-independent mechanism of action, may be advantageous for the treatment of severe heart failure, especially in patients with catecholamine-insensitive heart failure.

Adult↗

PubMed1989

Antihypertensive effects of tertatolol. A comparative study versus atenolol.

The purpose of this study was to compare the antihypertensive efficacy and tolerance of tertatolol and atenolol. Sixty-one ambulatory patients with uncomplicated mild to moderate hypertension (diastolic blood pressure (DBP) between 95 and 120 mm Hg) received, following a randomized allocation, either 5 mg tertatolol (T) (n = 30) or 100 mg atenolol (A) (n = 31) in single daily dose. After a one-month single-blind placebo run-in period, the two drugs were administered double-blind over a 3 month period. Blood pressure (BP) and heart rate were measured before, and after the first and third months. Electrocardiographic and biological data were collected respectively before and at the third month. At each consultation, patients were asked to report any side effects. Atenolol and tertatolol were similar in controlling BP: the decrease in supine systolic blood pressure (SBP) reached 24.2 mm Hg (P less than .001) in group T and 21.7 mm Hg in group A (P less than .001), and the decrease in DBP reached 16.6 mm Hg in group T (P less than .001) and 16.8 mm Hg in group A (P less than .001). Supine heart rate (HR) fell by 15.5 beats/min and 14.8 beats/min in the T and A groups, respectively (P less than .001). At the end of the trial, blood pressure control (DBP less than or equal to 90 mm Hg) was obtained in 80% and 70% of the patients in the T and A groups, respectively. The clinical tolerance of both drugs was satisfactory with 8 slight and transient complaints in T group, and 14 complaints with one treatment-related withdrawal at the second month in A group. Electrocardiographic and biochemical variations were not significantly different in the two groups. We conclude that the antihypertensive efficacy of 5 mg tertatolol is comparable to that of 100 mg atenolol, with a similar clinical and biochemical tolerance.

Adrenergic beta-Antagonists↗

PubMedDate not supplied

Ring chromosome 22: a case report.

A three year old girl with ring chromosome 22 is described. The clinical findings include epicanthus, flat nasal bridge, hypertelorism, long eye-lashes, lymphoedema, hypoplastic toe nails, hydrocephalus and muscular hypotonia. Speech and language development is delayed. At three years the child begins to walk.

Abnormalities, Multiple↗

PubMedDate not supplied

[Apparent central facial paralysis in Lyme borreliosis].

In childhood Lyme-Borreliosis often presents as facial palsy. This progredient infectious disease is to be treated by intravenous penicillin therapy in order to avoid future complications. In three out of four own observations facial palsy raised suspicion towards central origin. By performance of the orbicularis oculi reflex in all four cases peripheral damage of the facial nerve could be demonstrated. This simple electromyographic method seems to be a valuable tool in the differentiation of central and peripheral facial nerve palsy in childhood, preserving the affected children from painful electrodiagnostic procedure or useless search for supranuclear lesions.

Blinking↗

PubMedDate not supplied

Encapsulation of triphenyltin hydroxide.

Triphenyltin hydroxide was encapsulated to prolong its fungicidal activity and to decrease its phytotoxicity in peanut fields. The envelopes found to be adequate for this purpose were polyureas and ethyl cellulose, as was demonstrated by biological tests.

Cellulose↗