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Biomedical subjects

H Lardoux

Publications and source records attributed to H Lardoux.

At least 73 records · Page 4Linked to original sources
PubMed1983

[The syndrome of compression of the left iliac vein at the promontory level; a new, serious anatomo-clinical entity?].

A new case of pseudo-Cockett syndrome is reported. Both the clinical picture and the anatomic characteristics were unusual. Apparently, no similar cases have been reported in the medical literature. The relation between the cause of venous compression and it's results (thrombosis upstream and embolism downstream) could not be stated from data reviewed in the literature. No well-defined plan of management has been described. However, in the case reported here, therapeutic decisions gave satisfactory results.

Aged↗
PubMed1983

Hypertension in pregnancy: evaluation of two beta blockers atenolol and labetalol.

There is a major controversy over the relative value of anti-hypertensive drugs in hypertension in pregnancy. Our purpose was to study two different beta-adrenolytic drugs, atenolol, a cardioselective beta blocker, and labetalol, an alpha-beta blocker. Fifty-six hypertensive (BP greater than 140/90 mmHg) pregnant women were treated either with atenolol or labetalol. The patients were divided into two subgroups for which there were no statistical differences with regard to age, number of previous pregnancies, initial level of blood pressure and uricemia, proteinuric pre-eclampsia, beginning of therapeutic trial and delivery. The average daily dosage was 144.6 +/- 47.8 mg day-1 with atenolol and 614 +/- 47.8 mg day-1 with labetalol. This study shows: the same anti-hypertensive effect of the two drugs with control of blood pressure in 82% of the cases; a birth-weight significantly higher with labetalol (3280 +/- 555 g) than with atenolol (2750 +/- 630 g) (P less than 0.001); two still-births with atenolol; no adverse effects of the drugs during pregnancy and the neo-natal period; the trans-placental passage of atenolol and labetalol as shown by plasma dosages in the mothers and the new-born. It is concluded that atenolol and labetalol are safe and they are usually effective in the control of the hypertension complicating pregnancy. But labetalol appears to be better able to prevent the appearance of fetal growth retardation.

Adolescent↗
PubMed1983

[Effect of 2 beta-blockers on arterial hypertension during pregnancy. Results of a prospective study on 56 pregnant hypertensive women treated with atenolol and labetalol].

This study reports the results that were obtained in 56 cases of arterial hypertension in pregnancy solely by beta-blocking with Atenolol or Labetalol. Any pregnant woman whose arterial blood pressure rises to or exceeds 140/90 mm mercury in two successive examinations at intervals of 8 days with rest is considered to be hypertensive. As soon as treatment is started mothers' supervision is assured regularly by clinical and biological examinations and the dose of drug is adapted to each case. Fetal monitoring is ensured by ultrasound, cardiac rhythm tracings and hormone estimations. As far as the newborn is concerned, blood sugar and electrocardiogram measurements are taken to add to the normal examination at birth. Finally plasma levels of beta-blockers are estimated at birth in the mother and in the cord blood. The analysis of these results shows: for the mother: a fairly constant antihypertensive effect which is about the same for either drug in pregnancy. Further complementary injection therapy was needed, however, in 8 cases in labour. There were alterations in the method of delivery and in particular the Caesarean section rate rose to 12.5% and induction had to be carried out more frequently, triggered off by the slightest sign of fetal distress. As far as the child was concerned: 2 died in utero, the Apgar score was comparable to a control series, there was no bradycardia or broncho-spasm or teratogenic effect, mean weight at birth was significantly higher with Labetalol (3280 g +/- 555) than with Atenolol (2750 g +/- 630), the blood sugar levels at birth were in six cases lower than 1.4 mmol (0.25 g/l) but these were easily pu right by transfusion. The plasma levels of beta-blockers showed that there was a linear relationship between the maternal and fetal concentrations which confirmed that the two molecules pass through the placenta. This study confirms therefore that it is worth while using beta-blockers in cases of hypertension in pregnancy so long as careful observation is carried out, and it seems that the alpha constituent of Labetalol has advantages over the other.

Adolescent↗
PubMed1983

[Supraventricular tachycardias induced by swallowing].

The authors report the case of a 34 year old woman admitted to hospital for attacks of atrial tachycardia inducing very poorly tolerated junctional tachycardia at 260 beats/min. The attacks were always induced by swallowing and could be reproduced at will. Electrophysiological studies could only be undertaken after the administration of large doses of amiodarone. An exclusively retrograde rapidly conducting paranodal accessory pathway was demonstrated with triggering of runs of reentrant tachycardia. No underlying gastro-oesophageal or cardiac disease apart from thromboembolism was found. Swallowing-induced supraventricular tachycardia is rare and possible mechanisms are discussed. The arrhythmia may be triggered by direct mechanical stimulation, by changes in vagosympathetic tone, or by an association of the two phenomena. Previously published reports describe similar clinical situations resulting from a variety of different mechanisms.

Adult↗
PubMed1982

[Role of surgery in the treatment of thromboembolic disease and deep phlebitis of the legs. Apropos of 12 surgical cases].

In reviewing a series of twelve cases treated surgically for deep venous thrombosis, with an admittedly short follow up (2 months to 2 years), the authors stress the beneficial effects of venous surgery. The postoperative mortality rate was zero and the morbidity rate marginal. They underline the importance of phlebographic exploration leading to earlier diagnosis, and list the therapeutic indications which vary according to the case and may include a supporting heparinotherapy and fibrinolytic treatment in a specialized center. They advocate venous surgery which has the twofold merit of preventing embolic complications and attenuating postphlebitic sequelae.

Adult↗
PubMed1980

[Essential arterial hypertension. Effects of labetalol on blood pressure and renin-angiotensin system (author's transl)].

The effects of labetalol, an alpha- and beta-adrenoceptor blocking drug, on blood pressure, heart rate, plasma renin activity (PRA) and plasma aldosterone were studied in 17 adult patients with essential hypertension. Following a total dose of 1 g labetalol administered over a 48-hour period, there was a rapid and significant fall in systolic and diastolic BP averaging 16,5 +/- 7,9%/14,8 +/- 7,5% respectively supine, 18,7 +/- 8,3%/17,8 +/- 7,2% standing and 23,9 +/- 7,1%/16,8 +/- 10,3% after moderate exercise; 24 hours after labetalol was discontinued, the BP had gone up but was still below pretreatment values. Bradycardia remained slight throughout. During treatment a significant decrease in PRA (mean : 45%) was observed in all patients and found to correlate in standing position with changes in standing and post-exercise mean arterial pressure. There was no significant changes in plasma aldosterone. Side-effects were mild and limited to tingling of the scalp in 5 patients. No clinical symptoms of postural hypotension were recorded.

Adult↗
PubMed1980

[Role of the renin-angiotensin system in arterial hypertension with aortic coarctation in young adults].

The renin-angiotensin system (RAS) was evaluated in 7 hypertensives with pure isthmic coarctation of the aorta. RAS was studied under basal conditions, standing, after saralasine (a specific angiotensin II antagonist) and after acebutolol (a cardioselective beta-blocker and an inhibitor of renin secretion). Plasma volume was measured by radio isotopic methods and cardiac catheterisation was performed to assess the pressure gradient across the coarctation. On a normal salt diet on orthostatism, plasma renin activity (PRA) was increased in 5 patients and normal in the other 2. After moderate salt depletion, saralasine injection caused a significant fall in diastolic blood pressure (89,2 +/- 4,4 to 77,3 +/- 6,6 mmHg; p < 0,02) with an associated rise in PRA (5,7 +/- 4,4 to 17,1 +/- 9,1; p < 0,01). There was no correlation between these two parameters or their variations. The test was negative in two patients. The antihypertensive effect of acebutolol was moderate due partly to the absence of salt depletion. Inhibition of renin secretion by acebutolol was significant (4,7 to 1,95 +/- 1,10 ng AI/ml/h; p < 0,02) but did not correlate with variations of arterial blood pressure. There was no correlation between the antihypertensive effect of saralasine and acebutolol (R = 0,51). Plasma volume (n = 5) was almost always increased (47,15 +/- 5,4 ml/kg). No correlations were observed between the different levels of PRA, plasma volume, and the systolic and/or diastolic gradient. In conclusion, this study underlines the limitations of isolated peripheral assessment of PRA and the acebutolol test. On the other hand, the effectiveness of saralasine, a specific RAS antagonist, and the demonstration of the effective participation of this system associated with the usual increase in plasma volume, seems to liken coarctation of the aorta to the single kidney Goldblatt experimental model.

Adolescent↗
PubMed1977

[The renin-angiotensin-aldosterone system in hypertensive subjects. III- The use of beta-blockers in reno-vascular hypertension (author's transl)].

Six patients with permanent hypertension with renal artery stenosis were treated by conservative reparative surgery appart from one of them (unilateral nephrectomy) and were all seen again at the 8th month at the earliest in the absence of any anti-hypertensive therapy. Study of the renin-angiotensin system carried out on a normal sodium diet, after stopping all anti-hypertensive treatment for at least 15 days, was combined with the anti-hypertensive response under the influence of a beta-blocker. There were two types of response pre-operatively: firstly, with beta-blockers alone a normal blood pressure which remained normal postoperatively; the second group of patients remained hypertensive, requiring the addition of diuretics, and remained hypertensive after surgery. This response, although non-specific, would appear to represent an important element in assessing the curability of reno-vascular hypertension.

Adrenergic beta-Antagonists↗
PubMed1975

[Disorders of intra-cardiac conduction and hypothyroidism in adults. A systematic study of 42 cases].

The rate of occurrence of disturbances of intracardiac conduction in association with adult hypothyroidism is not well known. On the basis of routine study of the electrocardiograms of 42 non-treated patients, disturbances of conduction were found in almost one third. Left anterior hemiblock (6/42) and first degree atrioventricular block (5/42) are the commonest. Bifascicular involvement is rare. Neither a trifascicular lesion nor complete AV dissociation were seen. There was no evident effect of hormone therapy on conduction disturbances. Their prognosis is good but they should perhaps be taken into consideration when the indications for beta-blockers are weighed.

Adolescent↗
PubMedDate not supplied

[Prognostic value of normal coronary angiography].

Coronary angiography is the "gold standard" for coronary artery disease (CAD). It is considered either normal or subnormal without any lesion (endocoronary echography often demonstrates atheroma), or in presence of a < 50% stenosis. Nevertheless, the risk of plaque rupture is not well correlated with the degree stenosis. Despite the frequent presence of non-significant atheroma, is a normal coronarography really of a good prognosis? Between January and September 1997, 136 of 600 (22.6%) angiographies were considered as normal. The indications were: "CAD suspicion" (n = 77), "preoperative angiography of valvulopathy" (n = 38), and "angioplasty control" (n = 22). The arteries were strictly normal for 86 patients (63%) and a < 50% stenosis was found in 50 patients (37%); 108 patients (80.1%) were followed for 18 +/- 3 months: eight non coronary deaths were reported: four postoperative deaths in "valvular group", two pulmonary embolisms and two pulmonary neoplasm's in "CAD suspicion group". No myocardial infarction was reported and one unstable angina was documented. Despite the frequency of non-significant atheroma, an acute coronary syndrome exceptionally complicates a "normal" coronarography.

Coronary Angiography↗