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Biomedical subjects

G Boner

Publications and source records attributed to G Boner.

159 records · Page 9Linked to original sources
PubMedDate not supplied

Labetalol in the treatment of essential hypertension: a single-blind dose ranging study.

The hypotensive efficacy of labetalol was evaluated in 29 patients with essential hypertension in a single-blind dose ranging study. After a two-week period of placebo treatment, labetalol was given in oral doses of 0.6 g/d, 0.8 g/d, and 0.8 g/d combined with 25-50 mg/d of hydrochlorothiazide. Each regimen lasted four weeks. The decrease in blood pressure was dose dependent: 90% of patients showed a significant reduction in diastolic blood pressure and 75% showed a significant reduction in systolic blood pressure. In 69% of the patients, side effects of the drug were noted, and in five patients (17%), treatment was discontinued because of the side effects. Seven patients received labetalol intravenously before the oral treatment. Their heart rate and blood pressure reductions were similar to those found in patients only taking the medication orally. We conclude that labetalol is an efficient and safe antihypertensive agent in both oral and intravenous administration. However, the high incidence of side effects makes labetalol a drug of second choice in uncomplicated hypertensive patients.

Adult↗
PubMedDate not supplied

Renal lithium reabsorption in man: physiologic and pharmacologic determinants.

In order to evaluate the premise that renal lithium reabsorption may reflect proximal tubular sodium reabsorption, the fractional excretion of lithium (FELi) was measured, during a variety of experimental maneuvers known to affect renal cation reabsorption, in normal volunteers who had been pre-loaded with lithium. Furosemide increased FELi, as well as sodium, calcium, and magnesium excretion, during the first hour following diuretic administration. Subsequently, sodium, calcium, and magnesium excretion continued to remain elevated after furosemide, despite progressive volume depletion, but FELi values usually declined at least to pretreatment levels. Oral glucose ingestion increased lithium, calcium, and magnesium excretion while sodium and potassium excretion decreased concomitantly. Increases in FELi during volume expansion with saline were correlated with changes in fractional flow (V/GFR) in natriuretic subjects. Parathyroid extract (PTE) increased both FELi and fractional phosphate excretion (FEphos). FELi and FEphos were correlated significantly in the studies with furosemide and PTE, but not after saline volume expansion. In persons who previously had undergone unilateral nephrectomy, FELi was not increased over values in normal subjects. These results indicate that changes in lithium reabsorption may be dissociated from the reabsorption of other cations. They are consistent with the hypothesis that FELi may reflect proximal tubular sodium rejection, but do not exclude other more distal sites of lithium reabsorption.

Adolescent↗
PubMedDate not supplied

Management of diabetic nephropathy: epidemiology, pathogenesis of nephropathy and factors influencing progression.

Diabetes mellitus is a major scourge of the modern world and the complications of this disease are important causes of morbidity and mortality. It is expected that the prevalence of this disease will increase several fold in all regions of the world over the coming decades. The prevalence of type 2 diabetes (initial resistance to endogenous insulin, usually found in obese adults) is about nine times greater than that of type 1 diabetes (absence of insulin, usually found in children and young adults) and thus the burden of this disease is mainly of patients with type 2 diabetes. The many complications of diabetes mellitus include cardiovascular disease, retinopathy, nephropathy, peripheral neuropathy and peripheral vascular disease. These complications appear in patients with either type of diabetes. This monograph will be devoted to the discussion of diabetic nephropathy (DN).

Diabetic Nephropathies↗
PubMedDate not supplied

Mechanisms of the early and late response of the kidney to contralateral nephrectomy.

The immediate (1 day, D1) and late (90 days, D90) effects of unilateral nephrectomy on contralateral renal hemodynamics, and the renal handling of electrolytes and water were investigated in the whole animal. The immediate and late ability of the remnant kidney to autoregulate perfusate flow and glomerular filtration rate (GFR) was studied in the isolated perfused kidney of the rat. In the whole animal, in D1 rats as compared to controls, GFR calculated for a single kidney increased from 0.85 +/- 0.3 to 1.1 +/- 0.2 ml/min (p less than 0.05). In D90 rats GFR increased further and was similar to prenephrectomy GFR (1.4 +/- 0.5 vs. 1.7 +/- 0.5 ml/min, p NS). Urinary prostanoid excretion in 24 h, calculated for one kidney, increased by 50-500% in D1 rats, but returned to prenephrectomy values in D90 rats. In the isolated perfused kidney, decreasing perfusion pressure (PP) from 100 to 70 mmHg did not change the renal vascular resistance (RVR) in control and D90 kidneys, but in D1 kidneys RVR decreased from 8.6 +/- 1.3 to 7 +/- 1.3 mm Hg/ml/min (p less than 0.05). In D90 kidneys RVR was significantly lower as compared to control and D1 kidneys at all perfusion pressures. Decreasing PP from 100 to 70 mm Hg resulted in a significant decrease in perfusion flow in control, D1 and D90 kidneys, while with the increase in PP from 100 to 130 mm Hg the perfusion flow increased significantly in all three kidney groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

Cell-mediated immunity in uremic patients prior to and after 6 months' treatment with continuous ambulatory peritoneal dialysis.

The number of circulating T-lymphocytes and their functional activity were studied in a group of 14 uremic patients prior to and after 6 to 9 months of treatment with continuous ambulatory peritoneal dialysis (CAPD). Low absolute T cell counts were found on initial examination in five of eight patients tested. There was no change in T cell counts after CAPD. The functional activity of T cells was tested by the local xenogeneic graft vs. host reaction (GVHR). Of the 14 patients tested with this technique, 10 initially showed impaired T cell functional activity. After CAPD a clear improvement in functional activity of the T cells was found in 4 of 10 patients with impaired GVHR. In three of these four patients, an inhibitory factor that had been present in the serum disappeared after CAPD.

Aged↗
PubMedDate not supplied

Treatment of end-stage renal failure due to diabetes mellitus with peritoneal dialysis--treatment of choice?

End-stage renal failure (ESRF) is a common complication of diabetes mellitus, especially the insulin-dependent form. Treatment of these patients with dialysis and/or transplantation has become widespread and it has been suggested that peritoneal dialysis has several advantages when compared to hemodialysis. This report describes the results of therapy using peritoneal dialysis in seven ESRF patients. These patients did not do well and only two were alive at the end of the follow-up period. Diabetic retinopathy did not progress during treatment and peritonitis was not more common in diabetics than nondiabetics. Renal transplantation is the preferred mode of treatment in diabetic ESRF patients. In our experience there is no difference between hemodialysis and peritoneal dialysis.

Adult↗
PubMedDate not supplied

Terminal uremia and arteriovenous fistula patency.

One hundred and twenty-five arteriovenous fistulas for chronic hemodialysis are reviewed and their patency is related to the etiology of terminal uremia and other factors. A significant difference was found between the patency of fistulas of patients with chronic glomerulonephritis (CGN) and those of patients with chronic pyelonephritis (CPN). The average number of A-V fistulas in the CGN group was 1.30, while in those with CPN, 2.14 fistulas per patient necessitated construction. A pattern similar to that of the CGN group was observed in a third group of patients, who had an unclear diagnosis. The average number of fistulas was the same, and the mean survival 20 months in both groups, compared with the four months mean survival in the CPN group. Higher blood pressure levels were observed in the groups with a higher patency rate. The survival of patients with A-V fistulas appears to be related more directly to the etiology of the terminal uremia and care taken during hemodialysis than to the type of vascular connection. Anticoagulation and larger anastomoses are advisable in patients with increased risk of fistula deterioration. These patients should be included in the transplantation priority list.

Arteriovenous Shunt, Surgical↗