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Biomedical subjects

D Koev

Publications and source records attributed to D Koev.

At least 37 records · Page 2Linked to original sources
PubMed1989

Involvement of prostaglandins in the action of captopril in type II diabetic patients.

Twelve well-controlled, type II diabetic patients without hypertension and advanced diabetic complications and 12 age-matched healthy control subjects were treated for 4 days with captopril 25 mg three times daily. The pretreatment values of plasma renin activity, plasma aldosterone, urinary 6-keto prostaglandin F1 alpha and thromboxane B2 were similar in both groups. Urinary prostaglandin E2 was significantly reduced in diabetics. After captopril plasma renin activity increased significantly in the diabetics and control subjects. Plasma aldosterone was not significantly decreased in both groups. Urinary prostaglandin E2 increased significantly in both diabetic and control groups. Other measured prostaglandins remained unchanged. After captopril systolic blood pressure decreased significantly in diabetics and not significantly in the control group. The results indicate that captopril was an effective drug for lowering blood pressure in diabetic patients, too. It is possible that the antihypertensive effect of captopril in diabetics could be due at least partly to prostaglandin E2.

6-Ketoprostaglandin F1 alpha↗
PubMed1989

Effect of nifedipine on renin-angiotensin-aldosterone system and renal prostaglandins in diabetic patients.

The present study investigated the short-term effect of calcium blocker nifedipine in 13 healthy subjects and in 13 patients with insulin-dependent diabetes mellitus. Nifedipine induced an increase in plasma renin activity in the control group, as well as in the diabetics. Plasma aldosterone did not change after nifedipine in either group. Urinary prostaglandin E2 and 6-keto prostaglandin F1 alpha increased significantly after nifedipine in the normal subjects. The diabetics showed a significant decrease of blood pressure without a concomitant change of the urinary prostaglandins. These findings suggest that the hypotensive effect of nifedipine in the diabetics is not mediated by prostaglandins.

Adult↗
PubMed1989

Effect of verapamil on renin-angiotensin-aldosterone system, urinary 6-keto prostaglandin F1 alpha and aldosterone response to metoclopramide in normal man.

Seven healthy male volunteers were studied at the end of 7 days placebo period and after 7 days treatment with verapamil (120 mg twice daily). Verapamil increased significantly plasma renin activity and urinary excretion of 6-keto prostaglandin F1 alpha without significant modification of plasma aldosterone. Metoclopramide (10 mg i. v.) induced a significant increase of plasma aldosterone with the peak values 15 min after the injection of the drug. The results indicate that verapamil does not lead to secondary hyperaldosteronism which is characteristic of most other vasodilators. The increase of prostacyclin, measured as 6-keto prostaglandin F1 alpha can contribute to the efficacy of verapamil in patients with ischemic heart disease and hypertension. The present study suggests that the aldosterone response to metoclopramide is not directly dependent on calcium, but an indirect effect of calcium through renin-angiotensin system cannot be excluded.

6-Ketoprostaglandin F1 alpha↗
PubMed1989

[An improvement in insulin efficacy in patients with type-1 diabetes mellitus following treatment using an insulin infusion pump].

In 8 patients with diabetes mellitus type I two methods for intensified insulin treatment were compared: method of numerous insulin applications and treatment with a subcutaneous insulin pump (Microjet model of "Miles" company). The following were taken into consideration: daily insulin dose, residuary beta-cell secretion (determined by a venous Tolbutamide test and dynamic follow up of C-peptide), peripherial insulin efficiency (M) determined in vivo by an euglycemic hyperinsulinemic clamp-technique (Biostator). The infusion pump treatment imitates the beta-cell function better than the numerous insulin applications. This method of treatment helps in overcoming the insulin deficiency and the jatrogenic hyperinsulinemia and as a result the metabolic compensation and insulin efficiency are improved.

Blood Glucose↗
PubMed1989

[Effect of antihypertensive drugs on insulin secretion and efficacy].

The action of some of the most frequently used antihypertensive drugs (reserpine, clonidine, furosemide, propranolol, verapamil) on carbohydrate metabolism in diabetics was studied in an acute experiment with the help of artificial endocrine pancreas (Biostator). The aim of the study is to facilitate the selection of the most suitable drug to be used in the combination of diabetes and hypertension. 42 patients with diabetes mellitus type II were studied divided into 5 groups of 7 patients each according to the number of drugs examined and a control group also of 7 patients. The drugs propranolol and furosemide exert an unfavourable action both on the beta-cell function and the peripheral insulin efficiency. Verapamil and clonidine influence mainly the insulin secretion by a minimum effect on insulin efficiency. Only the drug reserpine practically does not influence the insulin secretion and efficiency.

Adult↗
PubMed1989

[The relationship of HLA antigens to certain clinical forms of diabetes mellitus].

In 79 diabetic patients, 37 patients with diabetes mellitus type I and 42 patients with diabetes mellitus type II, the HLA-A, B and DR antigens were examined. An association of diabetes mellitus type I with HLA-B8, DR3 and DR4 was found. For the first time a relation between diabetes mellitus type I and HLA-B21 antigen was established. The early onset of the disease and the exhaustion of the endogenic insulin secretion are linked with B8 and DR3 carrier state while the late manifestations of diabetes mellitus and the preservation of one's own insulin production correlate with antigen B21. In the patients with diabetes mellitus Type II the frequency of antigen B21 and DR1 is increased and the carriers of B21 develop in the course of the disease relative insulin insufficiency and a secondary resistance toward sulfanilurea drugs.

Adolescent↗
PubMed1989

[Factors affecting stability in the course of insulin-dependent diabetes mellitus].

The patients with diabetes mellitus type I show a different course of the disease. In one group of patients diabetes runs a smooth and metabolic compensation is easily achieved and maintained. In another group of patients metabolic compensation is very difficult to achieve or it cannot be achieved at all. In 51 patients with diabetes mellitus type I the role of the residual beta-cell secretion and the insulin sensitivity for the stability of diabetes is studied. The endogenic insulin insufficiency, iatrogenic hyperinsulinemia and the related peripheral insulin resistance are the basic factors determining the stability of the insulin-dependent diabetes mellitus.

Adolescent↗
PubMed1989

[Effect of captopril on the plasma aldosterone response to metoclopramide in normal subjects].

The effect of captopril on the response of plasma aldosterone (PA) and plasma renin activity (PRA) to 10 mg metoclopramide i.v. was studied in 9 normal subjects. In the same conditions the prolactine response was studied in 6 healthy males. Metoclopramide induced a significant increase of PA during control study, as well as after treatment with captopril. The maximal increase of PA was of similar magnitude and occurred 15 mn after injection of metoclopramide on both occasions. PRA did not change appreciably after metoclopramide neither during control study nor during captopril. The prolactin response to metoclopramide was blunted by treatment with captopril. In conclusion, captopril did not alter the aldosterone response to metoclopramide, which suggests that dopaminergic control of aldosterone secretion is independent of modifications in the renin-angiotensin system.

Adult↗
PubMed1989

Effect of captopril on urinary excretion of prostaglandins and renin-angiotensin-aldosterone system in normal subjects.

The effect of captopril on urinary excretion of prostaglandin E2, 6-keto prostaglandin F1 alpha, thromboxane B2 and renin-angiotensin-aldosterone system was studied in 13 healthy volunteers during normal and low sodium diet. Angiotensin converting enzyme inhibition led to marked increase in plasma renin activity during both dietary periods without significant modification of plasma aldosterone during normal sodium diet. Prostaglandin E2 significantly increased after captopril during both sodium intakes. Captopril did not change significantly urinary excretion of 6-keto prostaglandin F1 alpha and thromboxane B2. The results indicate that the hypotensive response to captopril in normal subjects is related to the state of sodium balance. Although renin-angiotensin-aldosterone system is the major contributor to this response, it is possible that prostaglandin E2 mediates at least partly the hypotensive and diuretic response to captopril.

6-Ketoprostaglandin F1 alpha↗
PubMed1989

[Effect of sodium depletion on the renin-angiotensin-aldosterone system and prostaglandins in patients with insulin-dependent diabetes mellitus].

The effects of 5 days sodium-free diet associated with furosemide administration were studied in 12 diabetic patients with insulin-dependent diabetes mellitus and 12 healthy control subjects. Plasma renin activity was significantly lower in diabetics compared with that of normal subjects. Plasma aldosterone was similar in both groups. Urinary excretion of prostaglandin E2 was significantly lower in diabetics before and after sodium depletion in comparison with normal subjects. Urinary excretion of 6-keto prostaglandin F1 alpha and thromboxane B2 was similar in both groups. It is concluded that the lower excretion of prostaglandin E2 in diabetics is related to the decreased activity of renin-angiotensin system. Decreased production of prostaglandin E2 may contribute to the development of arterial hypertension in the diabetes mellitus.

Adult↗
PubMed1988

[Incidence, diagnosis, prevention and treatment of insulin allergy].

In the Scientific Institute for Endocrinology, Geriatrics and Gerontology, Sofia, 1723 diabetic patients were treated with insulin during the last 3 years. In 150 of them insulin allergy was supposed. The patients sensitivity toward the various insulin preparations was determined by intradermal test. Insulin allergy was found in 29 patients (1.68%). Insulin allergy was found more frequently in patients using acid insulin preparations and by frequent changes of the type of preparation. It is recommended that in special categories of diabetic patients--such as growing up, pregnant women, with complications of insulin treatment--only neutral, swine and purified insulin preparation should be used.

Adolescent↗
PubMed1988

[Clinical efficacy of a Minidiab preparation (glipizide) in an acute experiment].

The hypoglycemic action of Minidiab (Glipizide) and maninil (Glibenclamide) were studied in an acute experiment. 10 patients with type 2 diabetes mellitus (6 men and 4 women, mean age 49.1 years, were examined. The blood sugar level and the insulinemia were followed up after a 10 mg morning dose of each drug. The hypoglycemic action of both drugs is identical but is reached in different ways. Minidiab has a faster, shorter but stronger insulinotropic action. Maninil exerts a better peripheral effect.

Adult↗
PubMed1988

[Treatment of patients with postmenopausal osteoporosis and steroid-induced osteoporosis with the preparation Rocaltrol (1,25/OH/2 vitamin D3)].

A clinical trial of the drug "Rocaltrol" was carried out on 16 patients with osteoporosis, II of them with menopause osteoporosis and 5 with steroid-induced osteoporosis. The mean age of the patients was 53.1 +/- 11.1 years. The mean daily dose of the drug was 0.46 +/- 0.08 mg/24h. The treatment lasted 6 months. All patients showed improvement of the general condition and of calcium balance. Reliable increase of the total calcium and phosphorus levels and of the 24-hour calcium urine excretion were established, the maximal values being at the end of the third month. The X-ray examination showed stabilization of the bone changes and lack of new compression fractures. It is supposed that the drug improves the intestinal resorption of calcium and phosphorus and suppresses the bone resorption. This is proved by the reliable decrease of serum alkaline phosphatase level after the 6 month treatment. In all patients clinical improvement was established with diminishing of the bone aches and retaining the body height before and after the treatment.

Adrenal Cortex Hormones↗
PubMed1987

[Possibility of transferring patients with type-II diabetes mellitus treated with small doses of sulfonylurea preparations to diet therapy].

Nine patients with diabetes mellitus, type II (6 males and 3 females) were studied. The average duration of the disease was 7.1 years. The patients were perorally treated with glibenclamide (5-10 mg daily). Beta-cellular function was studied with glucagon as well as the peripheral insulin sensitivity of the patients on the background of the peroral treatment and after its two-week discontinuation--on the background of dietetic treatment. No significant difference in beta-cellular function, insulin sensitivity and metabolic compensation was established. Part of the patients with diabetes mellitus, type II, treated with low and medium doses of glibenclamide, could well be compensated only by an adequate diet.

Adult↗
PubMed1987

[Fibrinogen-fibrin degradation products in diabetes mellitus].

The fibrin split products, soluble fibrin monomer complexes and other coagulation indices were studied in 38 diabetic patients. In these patients there is a tendency towards hypercoagulation. The patients with retinopathy show higher values of fibrin split products and soluble fibrin monomer complexes than the patients without retinopathy. In 24 diabetic patients with ketoacidosis the follow up showed significant increase of the indices studied and correlation of fibrin split products with blood pH. In patients with severe ketoacidosis and diabetic coma disseminated intravasal coagulopathy was found. The early prophylactic treatment of these complications with antiaggregants and anticoagulants is discussed and recommended.

Blood Coagulation Tests↗