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G Rorive

Publications and source records attributed to G Rorive.

At least 37 records · Page 2Linked to original sources
PubMed1998

[The pharmaco-economics of the treatment of arterial hypertension: data and controversies].

The cost benefit ratio of antihypertensive therapy motivated many researches and discussions these last years. The treatment of this very frequent and chronic abnormality is of importance in this time of shortage of money available for health care. Its cost benefit ratio appears to decrease with age and the severity of hypertension: but these calculations rest on several hypotheses, that need scientific demonstrations by prospective data retrieval.

Age Factors↗
PubMed1998

[Measurement of arterial pressure].

The casual determination of blood pressure remains the basis of the diagnosis of arterial hypertension and the criteria for usefulness of drug therapy. The reference values usually in use concern determinations by the doctor in very well defined conditions, rest, size of the bladder, etc.... The poor reproductibility of the determinations made by the doctor in casual conditions has produced a large interest for new approaches: autodetermination by the patient at home, and ambulatory blood pressure determinations using automatic devices. These new approaches have their own reference values, specific indications and limitations.

Adult↗
PubMed1998

[Pharmaco-economic aspects of the treatment of hypertension].

Hypertension affects a large proportion of the adult population. Subsequently any change in treatment strategy may have a drastic impact on health expenditure especially when one decides to decrease the limits of arterial pressure beyond which a treatment is started. Results of pharmaco-economic studies are often controversial because they are mainly based on an evaluation of short-term absolute risks, maybe underestimating the benefit of a treatment in younger population with mild to moderate hypertension. All groups of antihypertensive drugs are able to reduce the blood pressure and most of them can induce a light improvement of patient quality of life. Diuretics and beta-blockers have a lower cost/effectiveness ratio. ACE inhibitors and calcium antagonists may be preferred when other drugs are badly tolerated or when some other morbidities affect the patient.

Adrenergic beta-Antagonists↗
PubMed1997

Histological prevalence of beta 2-microglobulin amyloidosis in hemodialysis: a prospective post-mortem study.

The histological prevalence of beta-2 microglobulin amyloidosis (A beta 2m) was evaluated in a prospective study of joint samples obtained at autopsy in 54 patients on hemodialysis (HD) for 2 to 163 (median 47) months, aged 20 to 80 (median 63) years at HD onset. Carpal tunnel syndrome surgery or radiological signs of A beta 2m were present in 2 and 4% of them, respectively. A control group of 34 patients without end-stage renal disease, autopsied during the same period was used as a reference. The 153 sampled joints (1 to 8, median 2 per patient) were sternoclavicular joints (N = 77), shoulders (N = 35), knees (N = 28), others (N = 13). A beta 2m was diagnosed (positive Congo red with typical birefringence and positive immunostaining of deposits for beta 2m) in 26 of 54 (48%) patients. Prevalence reached respectively 21%, 33%, 50%, 90% and 100% within two years, after 2 to 4 years, 4 to 7 years, 7 to 13 years and more than 13 years HD. The calculated sensitivity of the various joints for A beta 2m detection is significantly higher (P < 0.03) for sternoclavicular joints (97%) and knees (91%) than for shoulders (57%). Multivariate stepwise logistic regression with discriminant analysis identified both HD duration (P = 0.0008) and age at HD onset (P = 0.0093) but not diabetic nephropathy (P = 0.23) or gender (P = 0.25) as independent risk factors for A beta 2m. The probability of joint A beta 2m was quantitated as a function of age and HD duration. In conclusion, A beta 2m may be observed in the large joints early after HD onset. Overall prevalence reaches 48% of the patients on HD for a median of 47 months. It is much higher than that reported on the basis of clinical or radiological evidence. The sternoclavicular and knee joints are more frequently (P < 0.03) involved than the shoulder. The easily accessible sternoclavicular joint therefore appears to be the best site for the early detection of A beta 2m. Both HD duration and age at HD onset, but not diabetic nephropathy, are independent risk factors for A beta 2m.

Aged↗
PubMed1996

Reversal of acute renal failure by kidney revascularisation.

OBJECTIVES: To assess whether acute renal failure, due to total or subtotal renal artery occlusion, can be reversed by kidney revascularisation. DESIGN: A retrospective review of surgery for kidney salvage in anuric patients at a University Hospital. METHODS: From 1983 to 1993, eight patients were operated on for occlusive renal artery disease as a cause of acute renal failure, requiring preoperative haemodialysis. On admission the mean serum creatinine was 40 mg/l (354 mumol/dl). The oligoanuria lasted from 12 h to 3 weeks. Renal length of 8 cm or more and visualisation of a patent distal renal artery branches on aortography were arguments that return of renal function could be expected after revascularisation of these non-functioning kidneys. RESULTS: Revascularisation restored immediate urine flow in six cases, with no further need for dialysis in four. Two patients remained oliguric despite successful reperfusion. One of them could be weaned from dialysis after 1 month. Two patients died postoperatively. Five of the eight patients left the hospital with restored renal function. CONCLUSIONS: Patients with acute renal function deterioration due to ischemia of a single or both kidneys can benefit from prompt revascularisation, with significant recovery of renal function in most of them.

Acute Kidney Injury↗
PubMed1996

Hypertension and left ventricular hypertrophy.

In response to high blood pressure, left ventricular hypertrophy develops. But in hypertension, the myocardial hypertrophied structure is abnormal. The prevalence of this hypertrophy is influenced by age, gender, weight, race, genetics and the severity of high blood pressure. By echocardiography, it has been possible to detect non invasively and more precisely this hypertrophy and its anatomical pattern which is not uniform. This cardiac response is influenced by hemodynamic but also by non hemodynamic factors, but the exact mechanisms are not yet well understood. The humoral and tropic factors particularly affect the cardiac remodeling. Left ventricular hypertrophy has been noted by itself to be an independent risk factor for sudden death, ventricular arrhythmias, myocardial ischemia, and heart failure. Very early hypertension, diastolic dysfunction is noted. The progression to systolic failure in moderate hypertension usually occurs over several decades. According to the worse prognosis of left ventricular hypertrophy, it has been suggested that the reversibility of this anatomical modification by antihypertensive treatment is beneficial. Preliminary data support this idea.

Echocardiography↗
PubMed1995

Quantitative assessment of erythropoiesis in haemodialysis patients demonstrates gradual expansion of erythroblasts during constant treatment with recombinant human erythropoietin.

Recombinant human erythropoietin (rHuEpo) has been shown to be effective in correcting the anaemia of chronic renal failure. It has been reported that reticulocytes as well as erythroid progenitors increase within 1-2 weeks, with no further elevation beyond this time interval. However, the erythroblast pool is quantitatively the most important compartment of erythropoiesis, and the rate, extent and duration of the expansion of erythropoietic activity in response to rHuEpo is not known. Treatment with rHuEpo was given to 64 patients i.v. thrice weekly after haemodialysis. The effect of rHuEpo was obvious from the early elevation of reticulocyte counts, but much of this increase was due to a rapid output of shift reticulocytes which levelled off after a few weeks. Serum transferrin receptor (TfR), a quantitative measure of erythropoiesis, increased progressively over 6 weeks to reach a plateau phase at about twice baseline values. The Hct increased progressively and continued to rise steadily after the TfR plateau was reached. The speed and extent of the expansion of erythropoietic activity correlated with the later haematological response to rHuEpo. When rHuEpo was discontinued, erythropoietic activity returned progressively to baseline values, to rise again gradually when treatment was resumed. Part of the Hct increase was also due to haemoconcentration. The results indicate that changes in the various erythroid compartments vary considerably in intensity and speed, and that the erythroblast compartment in particular is slow to respond to modifications in the erythropoietin stimulus.

Adult↗
PubMed1995

Wegener granulomatosis is associated to exposure to silicon compounds: a case-control study.

Wegener granulomatosis is a rare disease of unknown aetiology. In the majority of these patients the kidney is involved in the disease process. We performed a case-control study to evaluate the role of occupational exposure in the development of Wegener granulomatosis with renal involvement. The occupational histories of 16 cases with clearly established diagnosis of Wegener granulomatosis with renal involvement were compared with those of 32 age- and sex-matched controls. It was observed that inhalation of silicon-containing compounds such as silica and grain dust gave a nearly sevenfold risk for Wegener granulomatosis. Further epidemiological and experimental work needs to be performed in order to corroborate these findings.

Adult↗
PubMed1994

Influence of chronic haemodialysis on the mechanical properties of skin.

Certain features of the skin of patients undergoing chronic haemodialysis suggest an ageing process. Seventy-two haemodialysed patients were studied by a non-invasive technique using the Cutometer SM 474 to determine biomechanical properties of the skin. Patients undergoing chronic haemodialysis showed some impairment of changes in viscous properties of skin similar to chronological age, while specific changes directly related to elasticity were minimal.

Adult↗