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Biomedical subjects

A Gerber

Publications and source records attributed to A Gerber.

At least 109 records · Page 6Linked to original sources
PubMed1986

[Prevention of hyaline membrane disease].

Prevention of respiratory distress syndrome (RDS) may be achieved with measures aimed at lung maturation and at prevention of perinatal asphyxia. Besides successful inhibition of premature labor, the following substances have clinical importance in lung maturation: glucocorticosteroids, thyroid hormones, aminophylline and ambroxol. The efficacy of prenatal steroids has been demonstrated in numerous studies. Most of the potential risks in this treatment have not shown any relevance in clinical trials. Prenatal steroids are so far the standard approach to lung maturation. Certain contraindications and limitations need to be taken into consideration. The results with thyroid hormones are still limited and also contradictory. When steroids are contraindicated, they may still be of possible value. Aminophylline was found to be just as efficacious as steroids, with fewer infectious complications. These studies are, however, limited in number. Ambroxol was found to improve lung maturation after the 32nd week of gestation in a few studies. It seems to have few side effects. Possibly, it will also prove to be effective in treating established RDS.

Ambroxol↗
PubMed1985

[Sick sinus syndrome--clinical presentation, diagnostic and therapeutic measures in an ambulatory patient sample].

Incidence, clinical picture, ECG features, as well as chosen diagnostic and therapeutic measures were investigated in patients attending the Basel University Medical Outpatients Department with the diagnosis of sick sinus syndrome. A retrospective study was conducted by selecting patients' charts with this diagnosis during the period 1979-1983. Forty-four patients (17 women, 27 men, mean age 64.5 +/- 14.5 years) were "discovered" and divided into three groups: Group 1: asymptomatic patients with pathological ECG (n = 7), Group 2: symptomatic patients with pathological ECG (n = 22), Group 3: main symptom syncope (n = 15). All patients had had an ECG and 15 a 24-hour-ECG. Carotid sinus massage was performed in three patients and sinus node recovery time was measured in another three. Seventeen patients remained without treatment, 13 received a permanent pacemaker, 9 of whom had additional medication, while 12 were anticoagulated. Three patients who were not anticoagulated suffered a stroke. More invasive electrophysiological investigations should be undertaken only with caution. In group 1, further diagnostic or therapeutic consequences need to be drawn. In the symptomatic patients from group 2, 24-hour-ECG is indicated when there is a history of palpitations, dizziness or severe heart failure. The immediate implantation of a pacemaker is justifiable in group 3 patients. Drugs with antiarrhythmic activity should be avoided in these patients before pacemaker implantation.

Aged↗
PubMed1984

Studies on acute glucose-induced aldosterone suppression: role of renin-angiotensin system.

Glucose loading is known to cause acute suppression of plasma aldosterone and stimulation of plasma renin activity. The relative contribution of variations in circulating angiotensin II to the regulation of aldosterone secretion following glucose loading was assessed in ten normal subjects. The effects of a standard oral glucose loading test (100 g) on plasma concentrations of glucose, insulin, potassium, aldosterone, renin activity and cortisol were studied (a) under basal conditions, and (b) after inhibition of angiotensin II with the converting enzyme inhibitor captopril (50 mg t.i.d. during 3 days). Under basal conditions the acute increase in plasma glucose and insulin after glucose loading was accompanied by a significant decrease (P less than 0.01) in plasma cortisol and aldosterone and by a significant increase in plasma renin activity (P less than 0.01); plasma potassium was decreased slightly but not significantly. Following captopril treatment preloading plasma renin activity was increased significantly, most probably reflecting an effective reduction of angiotensin II. Glucose loading caused a similar suppression of plasma aldosterone, as observed under basal conditions. This observation suggests that renin activation does not substantially contribute to the acute regulation of plasma aldosterone after an oral glucose load.

Adult↗
PubMed1984

Increased serum high-density lipoprotein cholesterol in hypertensive men treated with the potent vasodilator carprazidil.

The effects of the potent arteriolar vasodilator carprazidil on serum lipoproteins and various clinical, biochemical and endocrine parameters were assessed in 15 men with mild to moderate essential hypertension. Following a carprazidil monotherapy (average dose 50 to 60 mg/d) of 8 weeks (N = 15) or 16 weeks (N = 12) duration, blood pressure was decreased significantly (P less than 0.01), while serum high-density lipoprotein cholesterol (+ 26% and + 24%, respectively; P less than 0.01) and the alpha-lipoprotein fraction (+ 26% and + 41%) were increased. Low- and very low-density lipoprotein cholesterol, triglycerides, as well as mean body weight, blood and plasma volume, heart rate, and plasma renin, aldosterone, norepinephrine, and epinephrine were not consistently altered. These results indicate that treatment of hypertensive men with carprazidil in modest dosage may have a favorable influence both on blood pressure and serum lipoproteins.

Adult↗
PubMed1984

The improved quality of life with the Kock continent ileostomy.

The conventional Brooke ileostomy is performed far more frequently than the Kock continent ileostomy. To determine the relative satisfaction with these operations, patients whose Brooke ileostomy had been converted to a Kock pouch were questioned about changes in their life-styles. Data were obtained from 80 patients who had worn an external appliance from 4 months to 33 years before the change-over to a Kock pouch. Improvement was reported in social activities (96.2%), athletic endeavors (87.5%), and sexual relations (76.2%). Patients spent less time caring for the stoma (92.5%) and wore street and beach attire with greater ease (97.5%). An average reduction of 75% was noted in ileostomy maintenance costs. The overall patient satisfaction with the Kock pouch was 98.7% despite an appreciable incidence of pouchitis and revisional operations. In our experience, the readier acceptance by patients of a continent internal reservoir over an external fecal-filled appliance has led to the performance of proctocolectomies for ulcerative colitis at an earlier stage of the disease.

Adolescent↗
PubMed1984

Effects of treatment with diuretics on serum lipoproteins.

Diuretics, when used for antihypertensive therapy, may also affect lipoprotein metabolism. The following observations were made after 1-12 months of treatment. Various thiazide-type diuretics significantly increased the potentially atherogenic serum low-density lipoprotein cholesterol (LDL-C) and/or very-LDL-C (V-LDL-C) fractions, while the antiatherogenic high-density lipoprotein cholesterol (HDL-C) level was largely unchanged. Certain loop diuretics also increased the LDL-C/HDL-C ratio. Both types of diuretics elevated serum triglyceride (Tg) levels in some, but not all, studies. Levels of LDL-C were increased in diuretic-treated men and in chlorthalidone-treated postmenopausal women, but not in chlorthalidone-treated premenopausal women. Only two diuretics evaluated, indapamide and spironolactone, had no apparent influence on lipoproteins. A tendency for increased Tg levels and lower HDL-C concentrations was apparent during combined thiazide-type diuretic-beta-blocker treatment; these changes resembled those observed during beta-blocker monotherapy. Diuretic-induced increases in LDL-C were prevented or reversed by concomitant beta-blockade, but not by combination treatment with sympatholytics such as reserpine, methyldopa, and clonidine. Prospective studies are needed to clarify the long-term course and the pathogenic and prognostic relevance of lipoprotein changes induced by various diuretics. In the meantime, it is of clinical interest that premenopausal women may be protected from thiazide-induced increases in LDL-C, certain diuretic agents have no significant effect on serum lipoproteins, and beta-blockers may prevent or reverse increases in LDL-C in men and postmenopausal women during diuretic treatment.

Adolescent↗
PubMed1984

Correction of cardiovascular hypersensitivity to norepinephrine by potassium supplementation in normotensive members of hypertensive families and patients with essential hypertension.

Blood pressure (BP), plasma levels of norepinephrine (NE) and epinephrine, the chronotropic effect of isoproterenol, and the relationship between variations in BP and concomitant plasma NE levels obtained during NE infusion were studied under control conditions and after 10 days of dietary potassium supplementation (100 mmol/day) in 12 normotensive subjects with negative family history (FH) of hypertension (mean BP 111/70 +/- 9/7 mmHg), 11 normotensive subjects with positive FH (112/73 +/- 8/6 mmHg), and 10 subjects with untreated borderline to mild essential hypertension (131/89 +/- 15/9 mmHg). Under control conditions, the increase in circulating NE required to elevate mean BP by 20 mmHg was significantly lower in hypertensive subjects (6.1 +/- 4.0 nmol/l) or normotensive subjects with positive FH (5.0 +/- 2.4 nmol/l) than in normal subjects with negative FH (9.9 +/- 6.4 nmol/l); the other study parameters were similar. After potassium supplementation, plasma and urinary potassium increased and body weight decreased slightly in all groups; basal plasma NE and epinephrine levels and cardiovascular effects of isoproterenol were unchanged. However, in normotensive subjects with positive FH and hypertensive subjects, the increase in plasma NE required to elevate mean BP by 20 mmHg was normalized (to 8.9 +/- 5.9 and 9.9 +/- 6.9 nmol/l, respectively), while BP tended to decrease slightly. These findings indicate that dietary potassium supplementation may favorably modify noradrenergic BP-regulation in hypertension prone individuals.

Adult↗
PubMed1983

The Kock continent ileal reservoir for supravesical urinary diversion. An early experience.

The most commonly employed urinary diversion operations are associated with a high incidence of complications and the disadvantage of requiring an external appliance to collect urine. The Kock continent ileal reservoir, introduced in 1975, provides an intraabdominal receptacle for storage of urine and two nipple valves which maintain continence and prevent ureteral reflux. The reservoir is emptied by self-catheterization; no external appliance is necessary. This operation provides a more ideal substitute for the lower urinary tract than any other urinary diversion procedure thus far reported. The seven patients reported herein have been followed for up to 3 years and enjoy completely continent ileal reservoirs. Follow-up studies have demonstrated that the kidneys are adequately protected from ureteral reflux and ascending infection. Metabolic acidosis has presented no serious problem. All of the patients enjoy a far better quality of life since discarding their external appliances.

Adolescent↗