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Biomedical subjects

E D Gallery

Publications and source records attributed to E D Gallery.

71 records · Page 4Linked to original sources
PubMed1979

Randomised comparison of methyldopa and oxprenolol for treatment of hypertension in pregnancy.

Fifty-three pregnant women with moderately severe hypertension were randomly allocated to treatment with methyldopa or oxprenolol. There were no significant differences between the groups in age, height, weight, parity, or stage of gestation at the start of treatment. The outcome of pregnancy was better in the group treated with oxprenolol, with greater maternal plasma volume expansion and placental and fetal growth. No intrauterine deaths occurred in either group, and antepartum fetal distress, detected by oxytocin challenge testing, was evident in only one patient, who received methyldopa. This infant, and one other in the methyldopa group, died in the neonatal period. No neonatal deaths occurred in the oxprenolol-treated group. Even in this small number of patients these results were considerably better than those in untreated women with hypertension of similar severity. Apgar scores in both groups were equivalent at birth, while blood sugar concentrations were higher in the oxprenolol group. Oxprenolol appears to be safe and effective in controlling hypertension during pregnancy. There was no evidence of harmful effects on the fetus, and oxprenolol may offer a selective advantage over methyldopa for fetal growth and wellbeing in utero.

Adult↗
PubMed1979

Cryoactivation of renin in plasma from pregnant and nonpregnant subjects, and its control.

Plasma renin activity increased by a mean of 7% from baseline values when blood from nonpregnant persons was kept at 0 degrees C for 5 h before incubation. Freezing chilled plasma and thawing it before incubation resulted in a mean increase of 11%. The same procedures used on plasma from normal pregnant women produced mean increases in plasma renin activity of 44 and 89%, respectively. If blood from pregnant women was kept at 0 degrees C for 5 h, and the plasma then separated, frozen, and thawed before incubation, the resulting mean increase in plasma renin activity from baseline values was 160%. We conclude that plasma from pregnant women should be handled at room temperature, or, if samples must be stored, they must be rapidly frozen, then thawed as rapidly as possible before incubation and assay if results are to be reproducible.

Enzyme Activation↗
PubMed1979

Plasma volume contraction: a significant factor in both pregnancy-associated hypertension (pre-eclampsia) and chronic hypertension in pregnancy.

The role of plasma volume in hypertension in pregnancy (pre-eclampsia) was investigated. Significant volume expansion from non-pregnant levels (16.5 +/- 1.60 ml/cm height) was present throughout pregnancy in 189 normal women, reaching 23.1 +/- 1.21 ml/cm at 33-36 weeks amenorrhoea. In another 40 initially normotensive pregnant women who developed hypertension, similar early volume expansion was followed by significant volume contraction in the third trimester, before evaluation of blood pressure in 29 (20.6 +/- 1.26 ml/cm), after it in 11 (18.6 +/- 1.27 ml/cm). Equivalent volume contraction was present in another 44 women studied only after hypertension developed in the third trimester. Oedema had no value as a clinical sign. In another 30 women with chronic hypertension, blood pressure was inversely related to plasma volume (r = 0.822) and to fetal growth (r = -0.710), which was directly related to plasma volume (r = 0.701). Plasma volume depletion plays a significant role in hypertension in pregnancy.

Blood Pressure↗
PubMed1978

Improvement in foetal growth with treatment of maternal hypertension in pregnancy.

1. A highly significant inverse relationship was found between blood pressure in untreated hypertensive subjects in late pregnancy and birth weight. 2. Reversal of this intrauterine growth retardation was achieved in 19 patients by treatment of hypertension with oxprenolol. 3. No adverse effects from oxprenolol were found in the patients or in their babies.

Birth Weight↗
PubMed1978

Immunoglobulin deposition in the kidney in pre-eclampsia: its significance.

Renal biopsies from two patients with classical toxaemia of pregnancy demonstrated heavy deposition of IgG and IgA in a predominantly finely granular pattern. It is suggested that this may be a manifestation of immune complex formation and may provide further evidence for an immunological basis for the renal lesion of this poorly understood disease process.

Adult↗
PubMed1977

Predicting the development of pregnancy-associated hypertension. The place of standardised blood-pressure measurement.

82 initially normotensive pregnant women with no known history of renal disease were seen at monthly intervals from 16 weeks' amenorrhoea onwards, and their blood-pressure (B.P.) was measured sitting and lying on their left side. 15 developed hypertension (B.P. greater than 135/85 mm Hg lying on the left side) in late pregnancy. When these women were compared with the 67 who remained normotensive throughout, their B.P.s were found to be significantly higher even in early pregnancy, although individual patients were not always separable in this way. When B.P. measured in this rigidly standardised manner was compared with routine antenatal clinic values, it was apparent that the latter did not detect the difference between the two groups. Women who develop hypertension in the third trimester of pregnancy (pre-eclampsia) may represent a separate group from entirely normal pregnant women from the beginning of pregnancy.

Adolescent↗
PubMed1976

Analgesic abuse and kidney disease.

The analgesic syndrome, comprising renal disease, hypertension, peptic ulcer, anaemia and recurrent headache, accounts for wide-spread morbidity and mortality especially in Queensland and New South Wales. Epidemiological and clinical evidence gathered from many Western societies implicates unsupervised consumption of compound analgesic preparations, particularly those containing phenacetin, in the causation of the majority of cases. Laboratory experiments so far have failed to produce an entirely satisfactory model of clinical analgesic nephropathy. In small animals, papillary necrosis results from prolonged feeding with large doses of aspirin and a number of other anti-inflammatory agents more readily than when phenacetin, paracetamol or phenazone is given alone. The apparently conflicting deductive and experimental data may be reconciled if, as indicated by preliminary observations, salicylates enhance the toxicity of phenacetin derivatives. In planning a programme of prevention for the analgesic syndrome, the central aetiological role of non-narcotic drug dependency must be recognized. As the analgesics to which addiction commonly occurs are the compound powders and tablets, or those containing a stimulant, these preparations should be available only in circumstances where their use can be monitored. Suspected unsupervised and unwarranted consumption of analgesics should be checked by urinary testing for drug metabolites. Because the underlying problem of analgesic dependency is behavioural and environmental in origin rather than medical, the physician must combine forces with the social engineer to devise a definitive solution for this condition.

Analgesics↗
PubMed1972

Acute zinc toxicity in haemodialysis.

A country patient on home haemodialysis suffered acute nausea, vomiting, and fever during dialyses when she used water stored in a galvanized tank. She subsequently was found to have severe anaemia with raised plasma and erythrocyte zinc concentrations. Intercurrent hospital haemodialyses and subsequent home dialyses with deionized water were symptom-free.Experimental haemodialyses of dogs against small concentrations of zinc showed a disproportionate rise in plasma zinc and possible uptake of zinc by the liver.

Adult↗
PubMedDate not supplied

Haemodynamics of hypertension in pregnancy assessed by M-mode echocardiography.

1. Echocardiographic haemodynamic and left ventricular parameters were determined in twenty-one normontensives and thirty-six hypertensives during the last trimester of pregnancy. 2. Equivalent blood pressure control was obtained in hypertensives with bet rest only, oxprenolol or methyldopa, but remained above normotensive levels. 3. Cardiac output was elevated in the last trimester of pregnancy in normotensivves and hypertensives. 4. Left ventricular mass was increased in normal pregnancy, but displayed an exaggerated increase in hypertensives. 5. Total peripheral resistance was inappropriately elevated in hypertensive pregnancy, but was normalized in the oxprenolol-treated group. 6. There was no reduction in heart rate or cardiac output in the beta-adrenoreceptor blocker-treated group. This feature, in combination with lowered peripheral resistance, may contribute to the improvement in foetal outcome observed in maternal hypertension of pregnancy treated with oxprenolol.

Adrenergic beta-Antagonists↗
PubMedDate not supplied

Capillary permeability in normal and hypertensive human pregnancy.

Capillary permeability (CP) is elevated in late normal pregnancy, when compared to postpartum values. In women with pregnancy associated hypertension (PAH), pregnancy CP levels are not different from postpartum and are less than in normal pregnancy. These changes in capillary permeability are not explained by alterations in serum albumin.

Adult↗
PubMedDate not supplied

Blood pressure responses to dietary sodium manipulation during normotensive human pregnancy.

Short-term salt loading and salt restriction in a group of normal pregnant women produced no changes in lying, sitting or standing blood pressures or heart rates. Home blood pressures showed no trend to change over the periods of altered salt intake. Although plasma volume and plasma renin activity changed with altered salt intake, there were no relationships between changes in these parameters and changes in mean arterial pressures (MAP) between the low and high salt diets. Capillary permeability and echocardiographic dimensions were unchanged by salt intake once sodium balance had been established.

Adolescent↗
PubMedDate not supplied

Hyaline membrane disease and early neonatal aldosterone metabolism in infants of less than 33 weeks gestation.

We studied urine excretion of free and conjugated aldosterone by 12 control infants and 14 infants with hyaline membrane disease (HMD) on the first and seventh days after birth. Both groups had a mean gestational age of 29 weeks. Total urine aldosterone excretion (UAE) and percent excreted as conjugate were similar for both groups on both study days, and did not relate to the severity of respiratory failure in infants with HMD. Sodium intake was higher for infants with HMD on both study days (p less than 0.02), but their urine sodium excretion was only significantly (p less than 0.01) higher on day 7. For total UAE values greater than 3 nmol/kg/d, there was no significant difference between estimated sodium-potassium exchange by control (22 +/- 5%, n = 8) and HMD (31 +/- 5%, n = 10) groups. These data suggest that neither the magnitude of excretion of aldosterone in the urine, the ability to conjugate aldosterone nor the degree of relative distal tubular unresponsiveness to aldosterone are related to the severity of pulmonary immaturity in preterm infants.

Aldosterone↗
PubMedDate not supplied

Effects of hypoxia on regulation of prostanoid production in decidual endothelial cells in normal and preeclamptic pregnancy.

OBJECTIVES: To examine the effect on prostacyclin and thromboxane production of incubating decidual endothelial cells under hypoxic conditions, comparing cells from normal and preeclamptic pregnancies. Furthermore, to determine whether hypoxia is deleterious to cell growth, and test the effects of stimulation and inhibition on prostanoid production. METHODS: Decidual endothelial cells were exposed for a total of 40 hours to normoxic (20% O2) or hypoxic (2% O2) conditions. Prostacyclin and thromboxane secretion over the final 24 hours of incubation was measured and cell numbers after incubation determined. Lipopolysaccharide (LPS) (1.0 microgram/mL) was used as a stimulator and pirmagrel (1.0 mumol/L) and tranylcypromine (10.0 mumol/L) as prostanoid synthase inhibitors. RESULTS: Incubations in hypoxia resulted in increased thromboxane (P < .05) but no change in prostacyclin production. This thromboxane increase was abrogated by pirmagrel. LPS caused significant stimulation of prostacyclin and thromboxane secretion and both LPS and hypoxia resulted in lower cell numbers. Decidual endothelial cells from normal and preeclamptic pregnancies were generally not different. CONCLUSIONS: This study indicates that in preeclampsia, where decidual endothelial cells are in a relatively more hypoxic environment, thromboxane production by these cells is likely to be increased and the prostacyclin/thromboxane ratio decreased. The thromboxane synthase inhibitor, pirmagrel, was able to reverse this abnormal increased secretion of thromboxane in vitro.

Adult↗
PubMedDate not supplied

Plasma from preeclamptic women stimulates decidual endothelial cell growth and prostacyclin but not nitric oxide production: close correlation of prostacyclin and thromboxane production.

OBJECTIVE: To examine the effect of plasma from preeclamptic women on production of the vasoactive substances prostacyclin, thromboxane, nitric oxide, and cyclic guanosine monophosphate (cGMP) by decidual endothelial cells; to determine any effects on cell growth and health; and to examine whether cells from preeclamptic women are activated compared with cells from normal women. METHODS: Decidual endothelial cells from normal and preeclamptic women were incubated for 24 hours in media containing 10% plasma from preeclamptic women or matched normal women. Prostacyclin and thromboxane production was measured, as was nitric oxide and cGMP production after a further 45-minute generation period in 2% test plasma. Cell numbers and lactate dehydrogenase release were also determined. RESULTS: In plasma from preeclamptic women, cells grew significantly faster (P <.05), prostacyclin production was increased (P <.05), and lactate dehydrogenase release was reduced (P <.01). Production of thromboxane, nitric oxide, and cGMP was not significantly affected. Decidual endothelial cells from preeclamptic women had increased growth (P <.0001) and produced more prostacyclin (P <.05) and nitric oxide (P <.001) than normal decidual endothelial cells. There were highly significant correlations between prostacyclin and thromboxane production for incubations in plasmas from preeclamptic women and between background levels of prostacyclin in each plasma from preeclamptic women and the prostacyclin produced in incubations containing that plasma (P <.0001). CONCLUSION: We found that plasma from preeclamptic women contained a factor that stimulated endothelial cell growth and regulated production of related amounts of prostacyclin and thromboxane. The plasma level of this factor appeared to be related to background levels of prostacyclin. The results also indicated that decidual endothelial cells from preeclamptic women were in a relatively activated state.

Adult↗