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Biomedical subjects

D El Allaf

Publications and source records attributed to D El Allaf.

13 recordsLinked to original sources
PubMed2000

Effects of controlled-release metoprolol on total mortality, hospitalizations, and well-being in patients with heart failure: the Metoprolol CR/XL Randomized Intervention Trial in congestive heart failure (MERIT-HF). MERIT-HF Study Group.

CONTEXT: Results from recent studies on the effects of beta1-blockade in patients with heart failure demonstrated a 34% reduction in total mortality. However, the effect of beta1-blockade on the frequency of hospitalizations, symptoms, and quality of life in patients with heart failure has not been fully explored. OBJECTIVE: To examine the effects of the beta1-blocker controlled-release/extended-release metoprolol succinate (metoprolol CR/XL) on mortality, hospitalization, symptoms, and quality of life in patients with heart failure. DESIGN: Randomized, double-blind controlled trial, preceded by a 2-week single-blind placebo run-in period, conducted from February 14, 1997, to October 31, 1998, with a mean follow-up of 1 year. SETTING: Three hundred thirteen sites in 14 countries. PARTICIPANTS: Patients (n = 3991) with chronic heart failure, New York Heart Association (NYHA) functional class II to IV, and ejection fraction of 0.40 or less who were stabilized with optimum standard therapy. INTERVENTIONS: Patients were randomized to metoprolol CR/XL, 25 mg once per day (NYHA class II), or 12.5 mg once per day (NYHA class III or IV), titrated for 6 to 8 weeks up to a target dosage of 200 mg once per day (n = 1990); or matching placebo (n = 2001). MAIN OUTCOME MEASURES: Total mortality or any hospitalization (time to first event), number of hospitalizations for worsening heart failure, and change in NYHA class, by intervention group; quality of life was assessed in a substudy of 741 patients. RESULTS: The incidence of all predefined end points was lower in the metoprolol CR/XL group than in the placebo group, including total mortality or all-cause hospitalizations (the prespecified second primary end point; 641 vs 767 events; risk reduction, 19%; 95% confidence interval [CI], 10%-27%; P<.001); total mortality or hospitalizations due to worsening heart failure (311 vs 439 events; risk reduction, 31%; 95% CI, 20%-40%; P<.001), number of hospitalizations due to worsening heart failure (317 vs 451; P<.001); and number of days in hospital due to worsening heart failure (3401 vs 5303 days; P<.001). NYHA functional class, assessed by physicians, and McMaster Overall Treatment Evaluation score, assessed by patients, both improved in the metoprolol CR/XL group compared with the placebo group (P = .003 and P = .009, respectively). CONCLUSIONS: In this study of patients with symptomatic heartfailure, metoprolol CR/XL improved survival, reduced the need for hospitalizations due to worsening heart failure, improved NYHA functional class, and had beneficial effects on patient well-being.

Adrenergic beta-Antagonists↗
PubMed1984

Two-dimensional echocardiographic guiding of endomyocardial biopsy.

Two-dimensional echocardiography provides adequate spatial orientation and anatomic definition. Eighteen consecutive patients undergoing myocardial biopsy had concomitant two-dimensional echocardiography during 22 biopsies of five to six samples each. The transducer was placed at the apex and in the subcostal area and four-chamber views were used. The bioptome was seen entering the right atrium and crossing the tricuspid valve to the right ventricle. The catheter was then manipulated under two-dimensional echocardiography and the tip's position was strictly adapted, using two different classic views before sampling. The success rate in visualizing the forceps and in defining the site of sampling was 100 percent, and no complication was noted. Radiation exposure was largely reduced. Two-dimensional echocardiography to guide endomyocardial biopsy may reduce the risk of perforation by a better anatomic definition of the sampling site. It permits sampling from different ventricular sites or from the same site during serial procedures for monitoring evolution or treatment.

Adult↗
PubMed1984

[Development of urea, creatinine and creatinine clearance as a function of age and sex].

Serum urea and creatinine concentrations were determined in 150 healthy subjects. The formula of Cockcroft and Gault was used in order to calculate creatinine clearance. Such estimation of creatinine clearance is widely used as a parameter for individualization of dosage of drugs secreted primary via the kidneys. The effects of age and sex were then assessed on serum urea, serum creatinine and on creatinine clearance.

Adult↗
PubMed1984

Pulmonary lymphangiomyomatosis.

Pulmonary lymphangiomyomatosis is a rare disease of smooth muscle proliferation in the walls of lymphatic vessels and in the interstitial areas of the lungs. It only affects women of reproductive age. The majority of patients die from respiratory failure within 10 years. A new observation of pulmonary lymphangiomyomatosis is reported in a woman of 36 years. The disease was discovered at an advanced stage of respiratory failure. Left-sided pleurectomy and treatment with medroxy-progesterone and tamoxifen did not improve the patient's condition.

Adult↗
PubMed1983

Effect of age and sex on the N-demethylation rate of 14C-aminopyrine, studied by the breath test.

The effect of age and sex on the N-demethylation rate of 14C-aminopyrine was studied by breath test in 28 normal subjects (12 men, 16 women) aged 26 to 86. It was found that demethylation of aminopyrine was inversely related with age and unaffected by sex. 6 out of 8 patients aged 70 or over, had breath test values within the range of values obtained in 31 patients with alcoholic cirrhosis. In the elderly, a breath test can therefore be considered abnormal only if it is compared with a control group of the same age.

Adult↗
PubMed1983

Correlation between the demethylation rate of 14C-aminopyrine (breath-test) and haemodynamic parameters in congestive heart failure.

In 18 patients with congestive heart failure, the 14C-aminopyrine demethylation rate was studied by the breath-test, 24 hours after the measurement of haemodynamic parameters. In the 12 patients with a cardiac index higher than 2.2 l/m2/min, the half life of 14CO2 specific activity in breath was found to be significantly correlated (p less than 0.001, r = 0,82) with the telediastolic pressure of the right ventricle. On the other hand, in the 6 patients with a cardiac index below 2.2 l/m2/min the 14C-aminopyrine half life was higher than the value predicted by this correlation. Congestive heart failure probably reduces hepatic demethylation of aminopyrine through altered hepatic microsomal function associated with congestion and possibly hypoxia.

Aged↗
PubMed1982

[Leptospirosis].

Explore the source record for details and available documents.

Adult↗
PubMed1982

Pharmacokinetics of mexiletine in renal insufficiency.

1 The aim of this study was to evaluate the influence of renal insufficiency on the plasma pharmacokinetics of mexiletine, a new antiarrhythmic agent, in human beings. 2 Mexiletine was administered orally three times daily for 10 days to 15 patients with chronic renal failure (creatinine clearance lower than 30 ml/min) and to 9 subjects with normal renal function. 3 The use of low doses of mexiletine was possible owing to the development of a new fluorescence h.p.l.c. method with a limit of sensitivity lower than 20 gn/ml. 4 Our results clearly indicate that the plasma kinetics of mexiletine are not modified when the renal clearance of creatinine is higher than 10 ml/min.

Aged↗
PubMed1980

Pharmacokinetics of mexiletine in renal insufficiency.

Mexiletine (Mexitil) is an effective antiarrhythmic drug for the treatment of ventricular dysrhythmias. The therapeutic plasma level is situated between 0.75 and 2 microgram/ml. For concentrations higher than 2 microgram/ml, the percentage of severe side effects is rapidly increasing without improvement of the therapeutic efficacy. The main pharmacokinetics parameters of mexiletine are reviewed in the first part of this publication. Contrary to lidocaine, mexiletine may be administrated orally (or intravenously). It is largely and rapidly distributed in the body. The apparent volume of distribution (Vd) is greater than 500 1. The plasma half-time is 10 to 12 hours in healthy volunteers with a 70% plasma protein fixation. Mexiletine is largely metabolized to conjugates after N-methylation and hydroxylation. In the second part of the work, the influence of renal insufficiency on the plasma half-time of mexiletine has been investigated in 11 patients presenting a creatinine clearance situated between 2 and 38 ml/min. The mean plasma half-time for these patients is 11.1 +/- 1.7 hours after a single i.v. injection of 1.5 mg/kg. This value is comparable to the normal values found in the literature. Our control group containing convalescents from acute myocardial infarct has a plasma half-time of only 5.9 hours. In conclusion, the renal insufficiency has not modified the plasma elimination half-time of mexiletine after a single i.v. injection.

Administration, Oral↗