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Biomedical subjects

S M Lal

Publications and source records attributed to S M Lal.

35 records · Page 2Linked to original sources
PubMed1987

Renal protective effect of strict blood pressure control with enalapril therapy.

The effect of strict blood pressure control on progression of renal disease in patients with essential hypertension has not been well defined. We have followed prospectively for three years 23 patients with essential hypertension. Blood pressure was well controlled on either enalapril or enalapril-hydrochlorothiazide therapy. Yearly assessment of renal function revealed no change in glomerular filtration rate as assessed by creatinine or inulin clearance, and a sustained 17% increase in effective renal plasma flow. In patients with moderately impaired renal function (inulin clearance less than or equal to 1.33 mL/s [80 mL/min]), there was a first-year 50% increase in inulin clearance, and a 33% increase in inulin clearance at year three. In these patients, there was a 39% first-year increase in effective renal plasma flow, which was sustained at year three. Filtration fraction and urinary protein excretion were unchanged. These results suggest that long-term blood pressure control with the angiotensin-converting enzyme inhibitor enalapril or enalapril-hydrochlorothiazide is associated with preservation and/or improvement in renal function.

Blood Pressure↗
PubMed1987

Liposome encapsulated subunit (VP1) and virion vaccines against foot-and-mouth disease.

Subunit vaccine prepared from VP1 protein of foot-and-mouth disease virus (FMDV) types 0 and Asia 1 protected guinea pigs against FMD and also induced high levels of antibody. Liposomes have been used as a safe and potent immunological adjuvant for FMD vaccines. Vaccines prepared from inactivated virus types 0 and Asia 1 encapsulated in liposomes protected guinea pigs against challenge with homologous virus and showed good antibody response in pigs on a small scale field trial.

Adjuvants, Immunologic↗
PubMed1987

Total creatine kinase and isoenzyme fractions in chronic dialysis patients.

We measured total serum creatine kinase (CK) and serum creatine kinase MB fraction (CK-MB) in 53 patients on continuous ambulatory peritoneal dialysis (CAPD) and 52 patients on maintenance hemodialysis (HD), using Scalva UV methodology for CK and electrophoresis for CK-MB. Seven of the 53 CAPD patients (13%) had an elevated total CK, and only one of these 7 patients had an elevated CK-MB greater than 5%. In contrast 22 HD patients (42%) had increased total CK values, and 6 of these 22 HD patients (27%) showed elevated CK-MB isoenzyme greater than 5%. For each sex, blacks had higher mean CK values than whites. Twenty-one out of the 43 HD patients who received intramuscular injections had elevated total CK values and 6 of these 21 patients had elevated CK-MB isoenzyme independent of the timing of injection. The increased frequency of higher total CK values in HD patients appears to be related to race and androgen administration. The modest elevations in CK-MB fraction (5 to 8%) in these patients require careful interpretation.

Adult↗
PubMed1986

Benign intracranial hypertension: a complication of subclavian vein catheterization and arteriovenous fistula.

Thrombosis of the right innominate vein occurred in a patient on maintenance hemodialysis following repeated subclavian vein catheterization. The patient had a functional right brachial arteriovenous fistula for blood access that resulted in a massive retrograde blood flow into the cerebral venous system with the development of the benign intracranial hypertension. The symptoms and signs of intracranial hypertension abated following ligation of the arteriovenous fistula. This unusual association of benign intracranial hypertension with an arteriovenous fistula and innominate vein thrombosis has not been reported previously. Pertinent literature dealing with benign intracranial hypertension and complications of subclavian vein catheterization is reviewed.

Arteriovenous Fistula↗
PubMed1986

Comparative studies on growth of foot-and-mouth disease virus types 0 and Asia 1 in BHK-21 Razi cells.

Growth pattern of foot-and-mouth disease virus types 0 and Asia 1 in BHK-21 Razi cells was compared; while type 0 virus grew in high titre, Asia 1 virus was produced in low titre. Inhibition of host protein synthesis in type 0 virus-infected cells was more pronounced than in Asia 1 virus-infected cells. Foot-and-mouth disease virus type 0 infected cells showed higher lactic dehydrogenase activity when compared to Asia 1 virus. A significant decrease in virus yield was observed when Actinomycin D had been added at 50 micrograms/ml to infected cells.

Animals↗
PubMed1986

Enalaprilat: an intravenous substitute for oral enalapril therapy. Humoral and pharmacokinetic effects.

Thirteen subjects with essential hypertension controlled on oral enalapril (20 mg/day) therapy were entered into a protocol to assess serially 24-hour blood pressure, the renin-angiotensin-aldosterone system, angiotensin-converting enzyme activity, and plasma and urine enalaprilat drug levels, following both chronic oral administration of enalapril and its replacement with intravenous enalaprilat. Results indicate that systolic and diastolic blood pressures remain well controlled following cessation of oral enalapril and replacement with intravenous enalaprilat. Enalaprilat drug levels, following oral enalapril and intravenous enalaprilat, remained above the therapeutic levels required for angiotensin-converting enzyme inhibition. However, therapeutic enalaprilat levels can probably be achieved with one fourth of the total cumulative dose of enalapril, administered as enalaprilat at 6-hour intervals. Intravenous enalaprilat stimulated plasma renin activity and decreased immunoreactive plasma angiotensin II and plasma aldosterone concentrations. However, immunoreactive plasma angiotensin II concentrations were not suppressed below pretreatment values, suggesting that chronic enalapril/acute enalaprilat therapy controls blood pressure through a nonangiotensin-mediated antihypertension mechanism.

Administration, Oral↗
PubMed1983

Association between rising haemoglobin concentration and renal cyst formation in patients on long term regular haemodialysis treatment.

Seventeen of 20 (85%) patients on RDT for six to 13 years were found to have acquired renal cysts. There was a significant positive association between Hb and duration of RDT. The extent of cyst was positively and significantly correlated with the latest Hb and years on dialysis. There was also a significant positive correlation between size and years on dialysis only approached statistical significance. There was no correlation between kidney size and latest Hb. Complications in patients with acquired renal cysts appear to resemble those of familial polycystic disease with the added risk of neoplasia.

Adult↗
PubMed1975

A study of the ultrastructure of the buffalo pox virus.

Buffalo pox virus (strain BP 4) has been studied by electron microscopy of sections of infected chorioallantoic membrane cells. The ultrastructure of the virus has been described and compared with the ultrastructure of vaccinia virus. No differences between the two viruses were found. In relation to the ways of release two forms of mature virions have been described. These are probably analogous to the previously described C- and M-form of vaccinia.

Animals↗
PubMedDate not supplied

Hyperlipidemia in continuous ambulatory peritoneal dialysis patients.

Hyperlipidemia is frequently seen in continuous ambulatory peritoneal dialysis patients. The cause of abnormal lipid profile in these patients is multifactorial. In both short and long term studies, abnormal levels of total cholesterol, triglycerides, and, HDL cholesterol were observed. In short term studies, both lovastatin and gemfibrozil were shown to favorably alter the lipid profile.

Cholesterol↗
PubMedDate not supplied

Does cholestyramine interfere with cyclosporine absorption? A prospective study in renal transplant patients.

Increased cardiovascular deaths have been reported in long-term survivors after renal transplantation. In the primary and secondary coronary prevention trials, reduction of elevated cholesterol has been demonstrated to decrease the incidence of cardiovascular events. The authors previously reported that only 33% of renal transplant patients achieved the National Cholesterol Education Program Expert Panel target values of total and low density lipoprotein cholesterol with niacin > or = 2 g/day or lovastatin 40 mg/day. Indeed, combination therapy with the bile acid sequestrant, cholestyramine appears to be a logical choice. Hence, the pharmacokinetics of cyclosporine were studies before (baseline, on day 1) and after starting cholestyramine 4 g/day, given as a single dose at noon (study repeated on day 4) in six nondiabetic renal transplant patients. Included were 1 woman and 5 men; their mean age (+/- SEM) was 45 +/- 6 years, and they were all > 1 year post transplantation. These patients were receiving cyclosporine, azathioprine, and prednisone based maintenance immunosuppression. Compared to day 1 (baseline period), the peak (644 +/- 142 ng/ml versus 625 +/- 168 ng/ml; ns) and trough (196 +/- 17 ng/ml versus 214 +/- 32 ng/ml; ns) cyclosporine levels and the time to peak (2 hr versus 2 hr) were not significantly different on day 4 (post cholestyramine period) of the study. Furthermore, the area under the curve (3721 +/- 586 ng/hour/ml versus 4143 +/- 778 ng/hour/ml; ns) was not significantly different. Our data suggest that cholestyramine 4 g, given once a day at noon, did not interfere with the absorption of oral cyclosporine. Hence, combination therapy with cholestyramine appears to be a reasonable choice in renal transplant patients with resistant hypercholesterolemia.

Adult↗