Search PubMed⌕ Search

Biomedical subjects

B Meilhac

Publications and source records attributed to B Meilhac.

At least 19 recordsLinked to original sources
PubMed1992

Use of a microprocessor-equipped tablet box in monitoring compliance with antihypertensive treatment.

Compliance with antihypertensive therapy is usually monitored by questionnaire, tablet counts, or estimation of drug levels in blood or in urine. The aim of this study was to examine patient compliance by means of an "electronic monitor." After 2 weeks of run-in on placebo, 34 moderately hypertensive patients were included in an open, randomized, crossover trial examining the efficacy and tolerance of nitrendipine, 20 mg as a single daily dose (morning or evening) for 1 month. We analyzed the results in 26 patients. Patients were supplied with tablet boxes equipped with a microprocessor (MENS) that registered the timing and duration of opening of the box over both the placebo and nitrendipine periods. Compliance (%) was calculated as the ratio of the number of days that the pill box was opened to the number of days between visits. The compliance was analyzed for each treatment group, namely placebo and nitrendipine morning and evening, over 1 month. Compliance (mean + SD) was 96.5 +/- 7.4% on placebo and 94.4 +/- 10.7% in the morning and 90.6 +/- 15.4% in the evening. Nitrendipine was taken in the morning at 0700 h +/- 2 h and in the evening at 1859 h +/- 2 h 12 min. The frequency of 24 h +/- 1 h intervals between medication was 83.5% on placebo. This frequency was 72.6% for morning dosage and 71.8% for evening dosage on nitrendipine. There were no differences in compliance between the morning and evening groups when analyzed according to age and sex. There was a negative correlation with time (r = -0.57, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Pressure↗
PubMed1988

[Ambulatory blood pressure and heart rate at 60 +/- 5 years. Differences between men and women].

Ambulatory measurements of systolic and diastolic arterial pressures and heart rate were performed during daytime in 68 subjects (37 men and 31 women) of mean age 55 +/- 5 years. These subjects had no history of cardiovascular or cerebral disease and no clinical or biochemical abnormalities. Bar charts for ages showed unimodal distribution with a 59-year mode in both sexes. Hourly profiles of arterial pressures and heart rate from 09:00 to 22:00 h were established in both groups. Throughout that time ambulatory arterial pressures were constantly higher in men than in women, especially in the morning (about 09:00 - 10:00 h; p less than 0.01), late in the afternoon and in the evening (17:00 to 22:00 h; p less than 0.01). In contrast, women always had a higher heart rate than men, the difference being greatest in the morning till early afternoon (10:00 to 15:00 h; p less than 0.01) and in the late evening (22:00 h; p less than 0.01). A difference in arterial pressures between men and women has already been recognized in younger subjects. It would be interesting to find out whether it increases or decreases in subjects older than those of the present study.

Age Factors↗
PubMed1988

Effects of muzolimine on the late distal tubule of necturus kidney.

The in vivo effects of the diuretic muzolimine were studied in the late distal tubule of the amphibian Necturus. Conventional and ion-selective microelectrodes were used to determine basolateral membrane potential, intracellular Cl- activity and luminal activities of Cl- and K+. Muzolimine depolarized basolateral membrane potential by about 30 mV in 1 min, in a reversible fashion. We attributed this depolarization to blockade of a K+ conductance, because the effects of muzolimine and barium on the highly K-selective basolateral membrane were not additive. In addition, muzolimine elicited a reversible increase of intracellular Cl- activity from 7.5 +/- 0.5 to 14.5 +/- 2.6 mM (concomitant to the basolateral membrane potential depolarization) and of luminal activities of Cl- from 12.4 +/- 1.5 to 22.3 +/- 2.5 mM, within approximately 1 min; both disturbances relaxed toward control values after withdrawal of the diuretic. That muzolimine increases Cl- activity in both the cell and the lumen of the late distal tubule (Cl- is accumulated in these compartments), indicates that retention of Cl- results from hindrance of the basolateral exit step rather than of apical Cl- uptake. Inasmuch as muzolimine failed to increase the luminal activity of K+, Cl- is believed to accumulate in the lumen as NaCl, not KCl.

Animals↗
PubMed1985

[Hemodynamic effects of intravenous acebutolol in the acute phase of myocardial infarction].

The haemodynamic tolerance of intravenous acebutolol was evaluated during the acute phase of myocardial infarction. This is a beta-blocker with an intrinsic beta-stimulant effect. The study consisted of 14 patients (10 cases of inferior infarction and 4 cases of anterior infarction) with a mean capillary pressure of less than 20 mmHg and a cardiac index greater than 2 l X min-1 X m-2. The minimal dose of acebutolol was 0.05 mg X kg-1 X h-1 and the maximal dose was 0.125 mg X kg-1 X h-1. The intravenous infusion of acebutolol was commenced between 3 and 12 hours (average: 7.5 hours) after the infarction and was continued for 48 hours, at which time it was replaced by oral administration. The mean total intravenous dose was 409 mg (from 190 to 510 mg). Two patients were excluded from the protocol because of the development of 2nd degree atrioventricular block several minutes after the beginning of the infusion. The basal values of the cardiac index (2.7 l X min-1 X m-2 +/- 0.37), the mean capillary pressure (9.4 mmHg +/- 2.7) and the systolic index (38.3 ml/m2 +/- 6.4) did not change significantly during the infusion, in the 14 patients studied. The double product, heart rate x blood pressure, decreased from the mean basal value of 9,443 to 7,680 at 24 hours and to 7,000 at 48 hours (p less than 0.05). Acebutolol does not depress left ventricular function, provided that it is reserved for patients with class I or II disease according to Killip and Kimball's classification.(ABSTRACT TRUNCATED AT 250 WORDS)

Acebutolol↗
PubMed1984

[Incidence of antinuclear antibodies during treatment with acebutolol. A 1-year prospective study in 45 hypertensive patients treated by monotherapy].

Determinations of antinuclear antibodies (ANA) were performed before treatment, then every 3 months for one year, in 45 hypertensive patients treated with acebutolol alone in daily doses equal or superior to 800 mg. Non significant ANA titers (1/10 to 1/40) were detected before treatment in 8.8% of the patients. After one year of treatment, 15.5% of the patients were found to have antinuclear antibodies. In 4 (8.8%) female patients (3 of whom were ANA-negative before treatment) the ANA titers were above 1/40. Treatment was discontinued in one of these due to the occurrence of bronchospasm. No lupus-like syndrome was observed during the course of the study. Prolonged prospective studies with acebutolol alone would be required to determine whether in the long term the incidence of significant ANA titers remains at the 8.8% level or increases.

Acebutolol↗
PubMed1978

[Comparison of 24 hours ambulatory electrocardiography and endocavitary recording in the diagnosis of heart rate disorders].

Ninety symptomatic patients aged between 16 and 90 years were investigated by ambulatory continuous 24 hour electrocardiography. 75 of these patients underwent endocavitary exploration of atrioventricular conduction and sinus node function within 48 hour of ambulatory electrocardiography. Symptoms occurred during the recording in 30% patients, enabling the mechanism of the malaise to be determined. Every time that abnormalities in the zone surrounding the Tawara node were demonstrated by endocavitary recordings, the 24 hour electrocardiogramme showed the symptoms to be due to other causes than complete heart block. In 70% patients no symptoms were experienced but 58% of them had cardiac arrhythmias and particularly sinus node dysfunction (24 out of 37 patients) on the 24 hour electrocardiogramme. Comparing the results of these two methods of investigation, continuous electrocardiography appears to be a better technique for the diagnosis of sinus node dysfunction but endocavitary study of sinus node function would seem more suited to determine its severity. Endocavitary recordings seem more reliable in the investigation of paroxysmal atrioventricular blocks. These results demonstrate the complementary nature of these two methods in determining the causes of syncope and dizziness.

Adolescent↗
PubMed1978

[The double ventricular response phenomenon in 2 cases of Wolff-Parkinson-White syndrome].

The authors report two cases of "true" consecutive double ventricular response caused by a single premature atrial stimulation; both were young men with Wolff-Parkinson-White syndrome. In both cases, the presence of a bundle of Kent was confirmed. The phenomenon of double ventricular response arising successively from the bundle of Kent and node-His pathway is rare, being mentioned in only two cases in the literature. It is only found when there is the combination of a good bundle of Kent, fair forward conduction, and a relative ventricle-His retrograde block. Amongst the other mechanisms for double ventricular repsonse, re-entry from branch to branch presents the most difficult differential diagnosis. From our observations, the forward characteristics of the spread through the bundle of His which always procedes the bundle of His which always precedes the second ventricular complex have been confirmed, especially in view of the freat variation in the position of this potential which can easily be explained by variations in intra-nodal conduction. In one of these cases, the atriogram, taken after the second ventriculogram, was provided by retrograde activity in the bundle of Kent.

Adolescent↗
PubMed1977

Congestive cardiomyopathy in uraemic patients on long term haemodialysis.

Five uraemic patients who developed progressive cardiac failure with clinical evidence of congestive cardiomyopathy at the start or during haemodialysis treatment were studied. The diagnosis of cardiomyopathy, for which there was no apparent cause, was confirmed by angiocardiographic and haemodynamic studies. These showed a significant increase in left ventricular end-diastolic volume over normal values obtained in 12 patients without uraemia. The mean velocity of myocardial fibre shortening was significantly decreased, as was the index of normalised rigidity. Three of the five patients presented the complete picture of the disease. The other two also had considerable ventricular dilatation and a decreased index of normalised rigidity but normal ejection fraction and only moderately decreased myocardial contractility indices. This suggests that there may be primary involvement of normalised heart muscle rigidity followed by secondary changes in myocardial contractility in uraemic patients with congestive cardiomyopathy.

Adult↗
PubMed1976

[Sinus node function in man. Statistical analysis].

The sinus function of 60 patients was studied by atrial stimulation at a fixed rate, and also at a rate linked with the preceding sinus cycle. These patients were divided into 3 groups according to the surface-recorded ECG; 10 had clear evidence of sinus dysfunction, 23 had an isolated sinus bradycardia, and 27 were considered as controls a their sinus rate was above 60/min., with a normal PR interval. Calculation of the limits of tolerance showed that at the 5% level, 95% of the values for all the controls fell between 96.8 and 568.7 ms for the corrected post-stimulatory pause, and between 114.5 and 434.3 ms for the corrected maximum return cycle. A study of the distribution zones of the graph CT/CR-AA/AA proved that an absent zone II is a pathological finding. In the group of sinus bradycardias the limits of what constitutes pathology are less clear, and the situation is not improved by noting whether atrial "echos" are present or absent. Because there is a narrow positive correlation between the values given by the two methods, the physio-pathology of sinus dysfunction can be discussed.

Bradycardia↗
PubMed1976

[Disorders of sino-atrial and auriculo-ventricular conduction in Steinert's disease. Apropos of one case].

The authors report a case of Steinert's disease with disordered sino-atrial and atrio-ventricular conduction. The presence of sudden syncopal attacks and the absence of a cardiomyopathy (excluded by right- and leftsided haemodynamic studies and coronary arteriography) indicated the insertion of a definitive intra-cavitary pacemaker, especially as the life expectancy of this 54 year old patient did not seem to have been significantly reduced by his disease.

Atrioventricular Node↗
PubMed1976

[Contractility and diastolic complicance of the left ventricle in patients with coronary insufficiency without myocardial necrosis].

The 19 coronary patients studied were found to have a "normalised" rigidity k = dp/(dVP) identical to that of normal subjects, and a lowered instantaneous end-diast-lic compliance (dV/dP)TD. The increase in end-diastolic pressure is due to a small increase in end-diastolic volume, and brings about Starling's phenomenon to compensate for a diminution in contractility. The maximimum speed of shortening of the myocardium (VCFmax) shows up the baseline contractility, and appears to be more sensitive than the mean speed of myocardial shortening (VCF) and the ejection fraction.

Adult↗
PubMed1975

[Indications for permanent electrosystolic pacing in arrhythmia revealed or aggravated by treatment].

The authors report 25 cases of patients, average age 67 years with severe coronary or valvular heart disease, with conduction disorders. The conduction disorder occurred alone in 8 cases and was associated with a disorder of excitability in 17 cases. It was either obvious, as in 14 cases, or latent, as in 11 cases, and precipitated by various forms of treatment, the disadvantage of which was the negative dromotrope effect. This treatment was prescribed for permanent resting angina (amiodarone and prenylamine), heart failure (digitoxin) or excitability disorder (beta-blockaders or procainamide). 11 patients had one or several fainting attacks. Permanent electro-systolic pacing with stimulation on demand, is necessary in all patients to palliate the consequences of treatment. In 11 cases out of 25, prior temporary pacing permitted the authors to assess the efficacy of treatment. The high post-operative mortality (40%) is not due to the apparatus but depends on the severity of the coronary heart disease or heart failure in these patients, In 60% of cases, the result of stimulation was excellent and was maintained permanently.

Aged↗
PubMed1975

[Measurement of mean pulmonary pressures and right systolic ventricular pressure by radiocardiography].

Computer exploitation of some parameters of the radiocardiogram and of the pressures measured by catheterization in a series of 678 subjects, studied both in Paris and in Prague, has made it possible to establish regression equations providing the rates of mean pulmonary arterial and wedge pressures together with the systolic right ventricular pressure on the basis of the radiocardiogram data. The latter was obtained by the conventional technique of the isotope dilution curves or by gamma-angiocardiography. Easy repetition of radiocardiography makes it an interesting investigation for the haemodynamic follow-up of the patients with heart disease.

Barium↗
PubMed1975

[Radioisotope measurement of coronary flow with atrial stimulation in the normal subject and in patients with coronary disease].

The induction of atrial systole by stimulation is a means of demonstrating insufficiency of myocardial perfusion, even where there is a normal coronary flow under basal conditions in a genuine case of coronary atherosclerosis. The method, which entailed the use of radiocardiography with potassium 42, was first checked for reproducibility. The coronary flow was then measured under basal conditions, and subsequently during or after atrial stimulation at 150/min. in a group of 50 controls and coronary patients. Under atrial stimulation, the value increases by an average of 15 per cent in the controls, and decreases by an average of 32 per cent in cardiac patients with vessels which are patent on coronary angiography. The coronary moiety of the cardiac output increases by an average of 27 per cent in the controls, but does not change significantly in the coronary group. After aorto-coronary by-pass, the coronary moiety of the cardiac output is increased significantly during stimulation when the by-pass is patent.

Adult↗