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Biomedical subjects

A Serradimigni

Publications and source records attributed to A Serradimigni.

At least 73 records · Page 4Linked to original sources
PubMed1986

[Ambulatory recording of blood pressure. Study of the reproducibility of findings in 25 subjects].

The reproducibility of a novel ambulatory blood pressure (B.P.) monitoring was tested, for clinical trial in hypertension. The spacelabs apparatus is based on standard auscultatory and oscillometric blood pressure measurements. Ten normotensive patients and 15 hypertensive patients were investigated as follows: their blood pressure was monitored twice over a 24 hr period at an interval of 30 and 15 days respectively. The monitoring data were expressed as the mean of the average blood pressure over day-time (7 hr-22 hr) and 24 hr as well as 24 hr. B.P. profiles (means of 4 measurements per hour). The statistical analysis of the two subpopulations of patients showed a satisfaction reproducibility of both the 24 hr B.P. curves (normotensive patients: PAS: r = 0.94; PAD: r = 0.92; Hypertensive patients PAS: r = 0.82; PAD: r = 0.64 p less than 0.001). and blood pressure levels (normotensive patients: J1: 113 +/- 10/70 +/- 6 mmHg; J30: 110 +/- 10/68 +/- 6 mmHg. Hypertensive patients: J1: 150 +/- 10/98 +/- 9 mmHg; J15: 155 +/- 15/96 +/- 8 mmHg). In contrast, analyzing each patient individually exhibited a correct reproducibility of the B.P. levels but the 24 hr--profiles of either the diastolic or systolic blood pressure could not be correlated with sufficient reliability (normotensive patients: 7 times out of 10 for PAS, and 4 times out of 10 for PAD; hypertensive patients: 5 times out of 15 for PAS, and 3 times out of 15 for PAD). In addition, the patient activity, should be carefully controlled during ambulatory blood pressure measurements.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

[Thromboembolic disease and anomalies of fibrinolysis].

Quantitative abnormalities of fibrinolytic system factors (tissue plasminogen activator (t-PA), plasminogen activator inhibitor (PA-inhibitor) are often found in the patients exhibiting an idiopathic thromboembolic pathology. Exploration of fibrinolytic system is performed by taking blood samples prior and after stimulation (after venous occlusion or DDAVP injection). Patients can be "good responders" (that is presenting with an increase of fibrinolytic activity after stimulation) or "bad responders". Among these latter (that is 30 p. 100 of cases), there are two groups: patients exhibiting an increase of PA inhibitor level, this concealing fibrinolytic role of t-PA released by stimulation (20 p. 100 of cases), patients failing to present any t-PA release through endothelial cells stimulation (10 p. 100 of cases). Furthermore, an hypofibrinolysis was demonstrated a long time ago, in certain thrombogenic conditions (post-operative period, obesity, elderly patients). Hypofibrinolysis was recently demonstrated, according to such conditions, as liable to an increase in the PA inhibitor levels. As pathogenic role of hypofibrinolysis is then demonstrated, therapeutic studies reducing the PA inhibitor level or increasing the t-PA rate produced and released by endothelial cells are to be developed.

Fibrinolysis↗
PubMed1986

[Detection of arterial thrombi using blood platelets labeled with indium-111].

Scintigraphy with Indium 111-labelled platelets was carried out in 62 patients (37 transient cerebral ischaemic accidents, 21 lower limb ischaemic episodes and 4 aortic aneurysms) to detect arterial thrombi. The results of this investigation were compared with the surgical findings and showed this to be a satisfactory method of detecting haematologically active thrombi.

Blood Platelets↗
PubMed1986

Time-dependence of clobazam and N-demethylclobazam kinetics in healthy volunteers.

The pharmacokinetic behavior of clobazam and its main metabolite, norclobazam, was investigated in healthy subjects after single dose administration, repeated dose administration (28 days) and discontinuation of the treatment (15-day follow-up). The aim of the study was to confirm the time-invariance of the clobazam and/or norclobazam kinetics, in order to evaluate the predictive value of the single dose parameters for chronic administration of this drug. The comparisons of parameters after single dose and for 15 days following cessation of chronic administration, experimental and simulated plasma level-time courses, experimental and calculated steady-state minimum plasma concentrations, and half-life values at apparent and deep elimination phase, indicate a time-invariant behavior of clobazam, whereas the norclobazam pharmacokinetics appeared to be clearly time-dependent. The clinical importance of this difference cannot be adequately assessed until more is known about the contribution of norclobazam to the overall effect of the parent drug.

Adult↗
PubMed1986

[Role of phlebography in the diagnosis of deep venous thromboses of the legs].

Phlebography makes the diagnosis of lower limbs venous thrombosis possible, and points out as well both site and extension. The technique used is the "free flow" technique which is modified so as to visualize the iliac veins as well as inferior vena cava. The presence of lacunar image or cupula-shaped interruption demonstrates a recent thrombosis above all if associated with venous dilatation; absence of a main venous trunk and collateral circulation do demonstrate a previous thrombosis. Phlebography fails to explore easily some veins, especially pelvic and deep femoral veins, as well as to determine the clot initial appearance. Non-invasive methods, such as labelled fibrinogen, Doppler ultrasonography and rheoplethysmography are less sensitive and specific; only Doppler ultrasonography associated with ultrasound can supply quite good results. Despite such efficient methods, especially ultrasound combined with Doppler ultrasonography, phlebography appears as the main examination in the patients presenting with various thrombosis or pulmonary embolism.

Humans↗
PubMed1986

[Value of thrombolytic agents in venous thrombotic states].

Fibrinolytic efficiency in the treatment of deep venous thrombosis is superior to heparin efficiency, but appears as more expensive. It must thus been used only if strongly required. Thrombolytic role is then demonstrated on the clot lysis, as far as the latter is recent, near, and not really obstructive. Such a thrombosis can be performed such a treatment, thus reducing sequelae of post-phlebitic disease. However, it increases by 2.9 the hemorrhagic risk, thus requiring extreme caution as for fibrinolysis and by 70 for SK and up to 200 for UK as for the cost. On a practical point of view, using SK (100,000 U/h) UK (4,000 U/kg/h) after an initial dose or UK (2,000 U/kg/h) combined with heparin, the treatment will be performed at least three days and followed up every 6 hours thanks to a fibrinemia, biological control as for therapeutic efficiency, numeration and a TCK. Fibrinolytics are thus prescribed to young patients presenting with a recent phlebitis demonstrated thanks to phlebography.

Fibrinolytic Agents↗
PubMed1985

[Evaluation of the effectiveness of medical treatment of intermittent claudication].

The effectiveness of drugs to improve the walking distance in intermittent claudication patients is looked into five points: pathophysiology, drugs, methodology of clinical trials, sample survey among the members of the hemodynamic section of the French College of Vascular Diseases and biometric aspects. Finally, some important points of a clinical trial in this field are presented.

Biometry↗
PubMed1985

[Repeated coronarographies in 122 medically treated patients].

122 patients treated medically 115 men and 7 women aged 51.9 +/- 8.51 years (range 32 to 79 years) underwent repeat coronary angiography 34 +/- 26 months (1 month-11 years) after the initial investigation Patients with normal coronary arteries were excluded. The repeat investigation was performed for aggravation and persistance of symptoms in 74 cases, myocardial infarction in 14 cases, with a view to aortocoronary bypass in 23 cases, for cardiac failure in 8 cases and for ventricular arrhythmias in 3 cases. Three groups of patients could be distinguished: Group I: the coronary angiography was unchanged (41 patients, 33.6 p. 100). The interval between the two investigations was 30.7 +/- 24.8 months. Group II: the coronary lesions had regressed in 12 patients (9.8 p. 100). The interval between the two investigations was 29.4 +/- 23 months. The degree of stenosis was reduced in 6 cases; recanalisation of an occluded artery was demonstrated in 3 cases; coronary spasm was diagnosed in 3 cases. Paradoxically, 4 patients had developed lesions on other coronary segments. Group III: the coronary lesions had progressed in 69 patients (56.6 p. 100). The interval between the two investigations was 36.8 +/- 26.9 months. The progression was observed on a pre-existing stenosis in 51 cases and on an initially normal segment in 34 cases. Left ventricular function had worsened in 21.7 p. 100 of patients compared to only 5.6 p. 100 of patients in groups I and II (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Chemical blockade of the cardiac autonomic nervous system. Effects on the coronary arterial vasomotor activity].

The results of cardiac plexectomy in spastic angina are controversial. This study was undertaken to evaluate the effects of blocking the cardiac autonomic nervous system (CANS) in this syndrome in 61 patients presenting with chest pain and angiographically normal coronary arteries. All patients underwent a methyl-ergometrine provocation test with a sequential protocol. They were then divided into two groups: Group 1 (13 patients): positive response to ergometrine. Group 2 (48 patients): negative response to ergometrine. Three sub-groups were identified: 2: 1: 9 patients with coronary spasm demonstrated by another method: 2: 2: 6 patients with myocardial infarction: 2: 3: 33 patients with chest pain alone. The results of these tests were compared with those obtained after blocking the CANS by intravenous injection over 3 minutes of an alpha and beta-blocker (labetalol 2 mg/kg) and a parasympathetic blocker (Atropine. 0.04 mg/kg). The CANS blockade was confirmed by two facts: the basal heart rate of 66.38 +/- 9.91 rose to ots intrinsic rate of 89.76 +/- 10.5 (p less than 0.01) and remained at that rate after ergometrine and trinitrate administration and myocardial ischaemia; changes in blood pressure were greater after CANS blockade: + 30.62 +/- 16.13 mmHg instead of + 8.62 +/- 0.33 mmHg after ergometrine (p less than 0.01) and -43.16 +/- 16.32 mmHg instead of -25.16 +/- 3.64 mmHg after trinitrate (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Simultaneous appearance of precordial pain and effort-induced left bundle branch block. A study of 6 patients with normal coronary angiography].

6 patients, 4 men and 2 women, aged 38 to 60 years, were hospitalised for chest pain on effort, labelled as angina. The resting electrocardiogram was normal, except in 2 cases with incomplete left bundle branch block. Exercise stress testing induced simultaneous chest pain and complete left bundle branch block (LBBB) (at a rate of 15 to 160 beats/min, mean 115). The pain lasted as long as the LBBB was present and eased as it disappeared. All patients had normal coronary angiography and negative provocative tests of coronary spasm with atrial stimulation (4 cases), isoprenaline test (2 cases), atropine injection (2 cases) and nitroglycerin (1 case). A 2D echocardiogram performed in all the patients, showed no signs of myocardial disease. Myocardial perfusion on effort was studied by Thallium 201 scintigraphy in all 6 patients. There were no perfusion defects. An exercise stress test was performed after beta-blocker treatment in 3 patients. LBBB appeared each time and the pain was always present. The induction of bradycardia with propranolol (5 cases) or verapamil (3 cases) did not reduce the frequency of chest pain. No serious complications were observed during follow-up (myocardial infarction, death). The syndrome of painful LBBB is not related exclusively to tachycardia. Myocardial ischaemia does not seem to be the underlying mechanism judged by the negative thallium studies.

Adult↗
PubMed1985

[Antihypertensive effect of a new form of nifedipine compared to a beta-blocker during chronic administration].

The aim of this study was to test the efficacy of a 20 mg tablet preparation of nifedipine alone in twice daily dosage, in the treatment of moderate hypertension (95 greater than or equal to DBP less than or equal to 115 mmHg). Efficacy was defined as the ability to maintain treatment for 6 months with a fall in DBP of a least 5 mmHg after the first month, and with a DBP 100 mmHg from the second month. One hundred and seventy seven patients were recruited from november 1981 to december 1982, 55% during the first three months of the trial. There were 95 men (54%) and 82 women, with a mean age of 55.6 +/- 10 years. The DBP ranged from 96 to 111 mmHg in 80% of cases. The patients were randomly allocated in lots of 6, to three groups: placebo (58 patients), nifedipine (57 patients) and acebutolol (61 patients). The comparability of 21 parameters amongst these 3 groups was verified. After 1 month of placebo, 25 patients did not meet the criteria of inclusion and were excluded from the study. During this phase, 19 patients (10.5%) complained of at least one side effect. Of the 152 patients who received active treatment, 34 (22.4%) were "wrongly included", 17 did not complete the test period for undefined reasons and were considered to have been "lost to follow-up", and 6 patients "deviated" from the protocol. These 3 groups were taken into account in the statistical analysis of the graphs of non-failure.

Acebutolol↗
PubMed1985

Treatment of mild to moderate essential hypertension with muzolimine. Two years of follow-up.

This study was carried out in association with medical practitioners who were responsible for observing the patients. In a first phase, 58 subjects younger than 70 years with moderate essential hypertension were allotted at random to treatment with either indapamide (2.5 mg per day) or muzolimine (20 mg per day). The double blind-double dummy study lasted for six months and demonstrated that the two drugs were similar in efficacy and tolerance. At the end of this phase 42 patients whose supine diastolic blood pressure fell to below 100 mmHg were selected to continue the trial with 20 mg per day muzolimine in an open long-term study. The survey comprised two periods: the first lasted for six months, the patients being examined every two months, and the second lasted for one year and patients were seen quarterly. However, 8 subjects entered directly into the second period. At each examination standing and supine blood pressure, heart rate and body weight were noted; blood was sampled to allow measurements of serum plasma parameters. Thus 15 patients were treated with muzolimine over two years and 15 over 18 months. Clinically the fall in blood pressure observed initially was maintained throughout the rest of the trial; but 3 patients needed another drug, i.e. central hypotensor (2 cases) and beta-blocker (1 case). Two subjects complained of transitory cramps, but 3 other complications not imputable to the treatment were observed: one myocardial infarction and 2 strokes. Biologically there was no change in mean plasma potassium level, but 3 patients received a potassium supplement.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Pressure↗