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Biomedical subjects

H Milon

Publications and source records attributed to H Milon.

At least 91 records · Page 5Linked to original sources
PubMed1987

[Are there risk factors for pure systolic hypertension?].

Pure systolic hypertension (PSH) is mainly observed in subjects over 60 years of age, and it is always due to a loss of compliance of the greater arteries. Blood pressure itself is partly responsible for loss of compliance, but other factors have been suggested. We have investigated this matter in a study of 3,388 subjects aged from 20 to 69 years. In a first stage, PSH patients (systolic BP greater than or equal to 160; diastolic BP less than 95 mmHg), aged from 50 to 59 years, were compared with normotensive subjects (systolic BP less than 140; diastolic BP less than 95 mmHg) and with other types of hypertensive patients with regard to cigarette smoking, alcohol consumption, obesity and plasma cholesterol, triglycerides, gamma-GT, glucose and uric acid levels. Several of these variables were significantly higher in all hypertensive patients than in normotensive subjects, but cigarette smoking and gamma-GT levels were predominantly or exclusively higher in PSH patients. In a second stage, correlations between differential BP and the variables listed above were studied in subjects with two levels of diastolic BP: 70-79 and 80-89 mmHg, thus taking into account all degrees between normal BP and PSH proper. Weakly positive correlations were found with alcohol consumption, plasma gamma-GT and glucose levels, and with percentages of smokers or ex-smokers. It is therefore conceivable that in addition to BP itself other factors, such as alcohol consumption, cigarette smoking and hyperglycaemia, contribute to the loss of arterial compliance progressively leading to pure systolic hypertension.

Adult↗
PubMed1987

[Case-controlled study of the prognosis of cardiac insufficiency in treated hypertensive patients].

The aim of this study is to compare the long-term mortality of hypertensive subjects (HT) hospitalized with early heart failure (HF), and HT control without HF. The study is based on a population of 2,050 HT consecutively hospitalized for the first time for high blood pressure, between oct. 1969 and nov. 1983. Among them, 115 presented with early HF (symptoms for less than 3 months, the diagnosis being made mainly on interview data, physical exam, and radio); they were matched with Controls (C) belonging to the same hypertensive population, on the following criteria: same sex, same age (+/- 3 years), same date of entry (+/- 3 months), no HF at entry, 94 Cases (CHF) could be matched: 64 men and 30 women (mean age: 50 +/- 11). A mortality survey was done in April 1985, with response rates of 96 p. 100 (CHF) and 98 p. 100 (C). The mean follow-up period was 11 years. At entry, CHF differed highly significantly form C in many ways, and mainly in higher systolic BP, more frequent ECG changes (LV voltage, J-ST-T changes), more severe fundus oculi changes. The survival rate was assessed by life-table method. As a whole, it was significantly reduced in CHF vs C (p/0.005); the 10-years survival rates were respectively 51% (CHF) and 71% (C). Case-control comparison was examined for both sexes, and after division by the median age (50 years): CHF survival was significantly reduced in women, and in subjects aged 50 and more (p/0.03); no significant difference was observed for men and before 50. CHF were dichotomized for each available item at entry, and lifetable comparison was compared in both issuing sub-groups; no significant difference was observed, but for the age, with a better survival in youngest subjects (p/0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗
PubMed1986

[Prognosis of surgically corrected chronic aortic insufficiency].

It is difficult to determine the surgical indications of asymptomatic chronic aortic regurgitation (AR). This study was undertaken in 205 patients with pure AR, operated between 1970 and 1982: 136 patients were symptomatic (Classes III and IV of the NYHA, +/- cardiac failure +/- angina, mean age: 49.5 years). Sixty nine asymptomatic patients (Classes I and II of the NYHA without cardiac failure or angina, mean age: 42 years). The prognostic value of 58 variables was studied in these two groups. The mortality during the first postoperative month was 14% in the symptomatic patients and the 5 year survival rate was 68.7%; this was significantly lower in patients with ECG changes of systolic left greater than or equal to ventricular overload, with radiological cardiomegaly (cardiotolerance index 0.60) with calcific aortic valve disease, with raised arterio-venous difference and/or low cardiac output, and with a low ejection fraction. In the asymptomatic group, the hospital mortality was zero and the 5 year survival rate 86.8%. This was significantly decreased in patients with an increased PR interval and a low cardiac index. It is possible that the small number of patients did not demonstrate the predictive value of left ventricular function in asymptomatic patients (a hypothesis suggested by the causes of secondary mortality which were the same in both groups of patients).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

[Sports and blood pressure: association in a population of wage-earners].

In a cross-sectional epidemiological survey, we examined the association between the practice of sports and blood pressure (BP). The study included 3,388 male employees (representing 90.1% of the target population) who were questioned about their habitual sports activity, in terms of average duration per week and intensity. The proportion of subjects who stated to engage in sports activity decreased with age, from 50.9% in the age class 20-29 years to 16.4% in the age class 50-59 years. We found a negative relationship between both systolic and diastolic BP and the weekly duration of sports activity. However this association increased with age and reached the statistical significance only in the age classes 40-49 years and 50-59 years (p less than 0.01 and p less than 0.001, respectively). Similar results were obtained when intensity of sports was used instead of duration. In order to test the independence of the observed association, the duration of sports activity (hours/week) was included as an independent variable in a multiple linear regression analysis, along with the following potential confounders: age, Quetelet index, alcohol consumption, cigarette smoking, heart rate, and level of education. In this analysis the sports-BP relationship was considerably attenuated or entirely disappeared. It remained statistically significant only in the age class 50-59 (p less than 0.01 for systolic BP an p less than 0.05 for diastolic BP). Our results support those of others showing a modest beneficial effect of leisure time physical exercise on BP.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

[The Lyons Hypertension Control Program (1972-1978). Community analysis].

A Community Control Program of Hypertension was undertaken in Lyon, as part of a WHO program. It dealed with two occupational, Study (S) and Reference (R), communities, each amounting to about 12,500 subjects. Its goal was to improve the level of treatment of hypertension in S, by stimulating the usual health care system without modifying it. It began in 1972 by a baseline total survey of both communities. Its aim was to check that the percentage of treated hypertensive subjects (HT) was the same in S and R (respectively 10.9% and 11.7%, n.s.), and to detect all HT's (subject being given an antihypertensive drug treatment, and/or BP greater than or equal to 160 and/or 94, or greater than or equal to 150 and/or 90 before age 30). The S intervention involved: detection of "new HT's" during the whole program; information of HT's, and referral to the treating physician of their choice, who was informed about the aim of the program and received later periodic information about hypertension management; periodic follow-up reconvocations. A leaflet including advices for C-V prevention was distributed to the whole S community in 1976. Evaluation was performed by a terminal total survey of both communities, from 1977 to 6/1978 (examination rates: 94.4 and 91.6% in S and R). The evaluation involved two analysis of 1977 data. -Cohort analysis (reported before): the percentage of treated HT's in the cohorts of 1972 HT's, still present in the community and hypertensive, was higher in S (63.0) than in R (46.1) (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

[Atrial fibrillation: some current practical problems].

We emphasize: the great frequency of atrial fibrillation, present in approximately 10% of men and more than 20 p. cent of women hospitalized in a cardiology department; the advantage of a comprehensive etiological survey, reducing to less than 10 p. cent the percentage of idiopathic permanent atrial fibrillations, in this department; the need to take into account all factors determining the prognosis of atrial fibrillation: ventricular contractility and hemodynamic consequences of the rhythm disorder, volume of the left atrium, condition of the valvular orifices, risk of thrombo-emboly, etc., as well as the difficulty of therapeutic indications, linked on the one hand to the multiplicity of etiologies and prognosis factors, and on the other hand to the diversity of the therapeutic approaches, of which we are here reminded.

Adult↗
PubMed1985

[Long-term antithrombotic treatment in patients with valve prostheses. Practical management and complications].

The cumulative annual risk of thrombo-embolic and haemorrhagic complications due to anticoagulants in patients with mechanical prostheses is in the order of 3 to 9 p. cent for mitral prostheses and mitral and aortic prostheses and 2 to 5 p. cent for aortic prostheses. Anticoagulant drugs should be chosen in terms of the type and the site of the implanted prosthesis and the coefficient of the thrombo-embolic and haemorrhagic risk of each subject. In patients with mechanical prostheses, the most effective prevention of the thrombo-embolic risk is ensured by the anti-vitamin K drugs associated with dipyridamole, with a low haemorrhagic risk if the treatment is correctly controlled. In patients with bioprostheses, the anticoagulant treatment (anti-vitamin K or anti-platelet drugs) should be maintained for three to six months after the operation; the anti-vitamin K drugs should not be prolonged indefinitely, except in patients at high risk of thrombo-embolism (atrial fibrillation with a very dilated left auricle, in particular). The management of a pregnant woman with a valve prosthesis and the problems of patients with prostheses undergoing extracardiac or dental operations or invasive investigations are still open to discussion.

Anticoagulants↗
PubMed1985

[Prognostic value of the exercise test performed less than 40 days after the first infarction].

Stress testing was performed in 159 men (mean age 49.83 years) between the 10th and 40th day after primary myocardial infarction. The average work achieved was 79 watts with a heart rate of 121/min, systolic blood pressure of 169 mmHg, and a double product of 20 544. The result was negative in 53 p. 100 of cases, and positive in 47 p. 100: the positive response was ischaemic in 23 p. 100 and non ischaemic in 24 p. 100 of cases. In the 2 years which followed, post-infarction angina was observed in 44 p. 100 of cases (14 p. 100 unstable angina), recurrent infarction in 7 p. 100 and death in 4 p. 100; coronary angiography was performed in 19 p. 100 of cases and coronary bypass surgery in 6 p. 100; 53 p. 100 of patients remained asymptomatic. The difference in predictive value between negative stress testing for an asymptomatic outcome and a positive ischaemic test for post-infarction angina and bypass surgery was important (p less than 0.001). The correlation was not as significant for death and recurrent infarction. The non-ischaemic positive result was of less value. There was no relationship to age but the prediction was more accurate in postero-inferior (p less than 0.001) than anterior infarction (p less than 0.05). The timing of the test affected the performance and patient comfort but had less influence on the results. Nevertheless, the predictive values were less good at 2 weeks than later on and significantly improved when testing was performed between the 10th and 11th week. However, early stress testing was valuable for identifying high risk subgroups.

Adult↗
PubMed1985

[Contribution of digital venous angiography to the evaluation of arterial hypertension. Cost evaluation].

Concerning 100 intravenous digital subtraction angiographies (IV DSA) performed for the study of arterial hypertension, the results are discussed according to two different achievements: diagnostic and economic. One hundred patients have been examined after the intravenous (IV) injection of contrast material, seventy times in peripheral and thirty times in central venous system. Out of 94 examinations that could be interpreted, 10 revealed stenosis of renal arteries higher than 50 per cent, one revealed fibromuscular dysplasia. IV DSA generally permits the correct study of renal arteries and compared to conventional angiography it gives only a small number of false negative results. However, the reliable study of intrarenal vascularisation can be obtained only by renal arteriography. The renal arteriography remains therefore necessary: when renal IV DSA gives insufficient data; to estimate the degree of stenosis in fibro-muscular dysplasia; to evaluate intrarenal vascularisation before renovascular surgery or angioplasty. To estimate the economic validity of renal IV DSA for the study of arterial hypertension, we have investigated: the actual cost of the examination for a department of radiology, compared with the cost of conventional examination; on the other hand, the influence of this examination on the duration of hospitalisation for evaluation of arterial hypertension. According to our investigation, this examination allows the average reduction of expenses for 180 F per patient with arterial hypertension, and shortens the time of hospitalisation for about one day. Owing to this diagnostic and economic contribution, renal IV DSA is becoming the first examination to be done for the evaluation of renovascular hypertension.

Angiography↗
PubMed1985

[Prediction and prognosis of diabetes incidence in treated hypertensive patients].

The study is based on a clinical population of 1962 hypertensive men and women consecutively examined as in- or out-patients in our clinic from Jan. 1967 to Dec. 1976. Those having a diabetes (treated for diabetes, or fasting glycemia greater than or equal to 7.75 USI) at initial exam were excluded. In february 1977, all were contacted by mail. 89 p. 100 of the subjects still living at the same address answered. 74 "cases" had developed a diabetes (clinical diagnosis, or fasting glycemia greater than or equal to 9.5 USI); they were matched with "controls" according to sex, age (+/- 2), and date of entry (+/- 4 months); all the controls had answered that they were not diabetic in Feb. 1977. At initial exam, the following abnormalities were significantly more pronounced in cases than in controls (by decreasing level of significance): glycemia 1 h. after glucose load, weight index (W/H2), fasting glycemia (p less than 0.001); ECG abnormalities of T (Minnesota code 5.1-3), and J-ST (4.1-3) (p less than 0.01); angina (p less than 0.05). Incidence of diabetes was studied in the basal population, by life table method, according to two abnormalities: relative weight greater than or equal to 115 p. 100, glycemia after load greater than or equal to 8.33. At five years, the estimations were: 0 p. 100 in both sexes, when both abnormalities were absent; 20 p. 100 in men and 31 p. 100 in women when both abnormalities were simultaneously present; 4 p. 100 in men and 2 p. 100 in women in other cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Benzothiadiazines↗
PubMed1984

Prognosis of native valve infective endocarditis: a review of 253 cases.

Forty years after the first 'recoveries' obtained by antibiotherapy and twenty years after the first success of early valvular replacement, the mortality of infective endocarditis (IE) is still significant. The present study has been undertaken to clarify the factors which influence the prognosis of IE.

Acute Disease↗
PubMed1984

[Course of the results observed in the 1st 100 coronary angioplasties performed in 96 patients. Experience in Lyons].

TCA is an original method of myocardial revascularisation which, when successful, enables coronary bypass surgery to be avoided. However, a certain number of failures and complications are inherent to the development of a new therapeutic technique. The object of this study is to analyse the evolution of our results with this technique to determine which factors changed as our experience increased. The methodology used was that initially described by A. Gruntzig. TCA was carried out 72 times on the left anterior descending, 20 times on the right coronary and 8 on the left circumflex coronary artery (72 single vessel, 28 multivessel disease). The primary success rate was 75% (72% for the first 50 and 78% for the second 50 procedures). Coronary bypass surgery was required within the first 24 hours of TCA in 7% of cases. Myocardial infarction (Q wave changes) was observed in 5% of cases. One patient died on the third day (occlusion of an aorto-coronary venous graft). In retrospect, taking into account the experience gained and the development of the material now available, a certain number of failures and complications could probably have been avoided. However, a certain number of complications seems to be unavoidable. TCA remains an inviting but not infallible alternative in the treatment of coronary artery disease and should be included in the medico-surgical management of this condition.

Adult↗
PubMed1984

[Hypertension refractory to treatment. Case-control study].

From a clinical population of 1290 subjects consecutively hospitalized between oct. 1969 and dec. 1976, 343 were re-examined at least three times during the four subsequent years, and their blood pressure at the 2nd and 3rd re-examinations were averaged (BPfu). Two types of refractory hypertensive were arbitrarily defined; type A: 58 subjects whose BPfu was greater than or equal to 200 and/or 120 mmHg, and type b: 53 subjects whose BPfu was greater than or equal to 107,5% of the average BP during the first four days of the initial hospitalisation. Two case-control studies showed that type A cases had initially significantly more severe hypertension (higher systolic and diastolic BP, and for the same BP, more severe cardiac and retinal involvement) than the controls; the mortality in 8,7 years reached 36%, for the cases and only 18% for the matched controls (p less than 0,05). Two similar case-control studies showed that type B cases had initially significantly lower systolic and diastolic BP, were significantly less treated and more prone to side-effects; the mortality in 8,9 years reached 25,6% for the cases, and 20,5% for the matched controls (n.s.).

Adult↗
PubMed1983

Mass spectrometry of biogenic catecholamine ion pairs by direct liquid introduction.

The mass spectrometry of ion pairs of dopamine, noradrenaline and 3,4-dihydroxyphenylacetic acid with n-octylsulphonate has been investigated by direct liquid introduction in an acidic buffer currently used for their high-performance liquid chromatographic separation. In order to follow the fate of the ion pairs, they were first studied by desorption/chemical ionization as dichloromethane extracts or in the buffer. The results show that characteristic spectra of the solutes can be obtained by direct liquid introduction provided that the interface between the chromatographic system and the mass spectrometer permits the desolvation of the ion pairs from the cluster of solvent molecules.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1983

Serotonin and dopamine afferents to the rat locus coeruleus: a biochemical study after lesioning of the ventral mesencephalic tegmental-A10 region and the raphé dorsalis.

The monoamine levels in the locus coeruleus (LC) were determined by HPLC following specific lesions of the ventral mesencephalic tegmental-A10 regions (VMT-A10) and raphé dorsalis (RD). Only lesions in the VMT-A10 area decreased the dopamine (DA) content, which strongly suggests that the projection from this region to the LC is of dopaminergic nature. Lesions of the RD increased DA metabolism in the LC and provoked significant decreases in the serotonin (5-HT) levels.

Animals↗
PubMed1983

Energy metabolism of medium-chain triglycerides versus carbohydrates during exercise.

Medium-chain triglycerides (MCT) are known to be rapidly digested and oxidized. Their potential value as a source of dietary energy during exercise was compared with that of maltodextrins (MD). Twelve subjects exercised for 1 h on a bicycle ergometer (60% VO2 max), 1 h after the test meal (1MJ). The metabolism of MCT was followed using 1-13C-octanoate (Oc) as tracer and U-13C-glucose (G) was added to the 13C-naturally enriched MD. After MCT ingestion no insulin peak was observed with some accumulation of ketone bodies (KB), blood levels not exceeding 1 mM. Total losses of KB during exercise in urine, sweat and as breath acetone were small (less than 0.2 mmol X h-1). Hence, the influence of KB loss and storage on gas exchange data was negligible. The partition of fat and carbohydrate utilization during exercise as obtained by indirect calorimetry was practically the same after the MCT and the CHO meals. Oxidation over the 2-h period was 30% of dose for Oc and 45% for G. Glycogen decrements in the Vastus lateralis muscle were equal. It appears that with normal carbohydrate stores, a single meal of MCT or CHO did not alter the contribution of carbohydrates during 1 h of high submaximal exercise. The moderate ketonemia after MCT, despite substantial oxidation of this fat, led to no difference in muscle glycogen sparing between the diets.

Adolescent↗
PubMed1983

Development of hypertension in spontaneously hypertensive rats fed L-tyrosine-supplemented diets.

The blood pressure of spontaneously hypertensive rats (SHR) was measured by tail-plethysmography. Feeding SHR a diet supplemented with 0.6 g% L-tyrosine, for 15 weeks after weaning, resulted in a slower increase of blood pressure than in rats fed the control diet (no tyrosine added). The blood pressure stabilized, after about 8 weeks, at values lower by about 10 mm Hg than in the control SHR group. Diets with a higher content of free L-tyrosine (1.2 or 2.4 g%) produced no greater hypotensive effects, despite the fact that the plasma level of the amino acid, at the time of blood pressure measurements, was related to the tyrosine content of the diet. In addition, providing 2.4 g% free L-tyrosine to the diet of SHR with established hypertension, produced within a few days a decrease of blood pressure similar to the one recorded in rats fed the tyrosine-supplemented diet during the whole period of development of hypertension. A maximal effect of L-tyrosine, in decreasing the blood pressure of SHR, is thus obtained at relatively low concentrations of the amino acid in the diet, and after a short period of consumption. However, this effect is rather small, and rapidly reversed upon removing free L-tyrosine from the diet.

Animals↗