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Biomedical subjects

J Bagatin

Publications and source records attributed to J Bagatin.

At least 37 records · Page 2Linked to original sources
PubMed1983

Diazoxide vs labetalol: a cross-over comparison of short-term effects in hypertension.

In a randomized cross-over study the acute effects of intravenous labetalol (1-2 mg/kg; mean dose 86.5 mg) were compared with those of diazoxide (3-5 mg/kg; mean dose 253.8 mg) in 13 severely hypertensive patients with diastolic blood pressure above 110 mm Hg (36.3 kPa) and a mean arterial pressure (MAP) of 165.4 mm Hg (22.0 kPa). Within five minutes following injection of both drugs an immediate fall in arterial pressure was observed (P less than 0.05), which was even more pronounced during subsequent minutes (P less than 0.01). The reduction in MAP after 30 minutes averaged 20% (P less than 0.01), with no significant differences between the drugs under trial or administration schedules. Diazoxide did not increase the heart rate as much as expected (P greater than 0.10), while labetalol slowed it down moderately but significantly (P less than 0.05). There were no notable changes in the blood levels of glucose and potassium and no particular side-effects were observed. It is concluded that the acute effects of intravenous labetalol are comparable to those of diazoxide and that labetalol can be used with advantage as a complemental alternative to diazoxide in the emergency treatment of some hypertensive crises.

Adult↗
PubMedDate not supplied

[Controlled comparison of nicardipine and propranolol in the treatment of arterial hypertension].

A randomized collective comparative study between nicardipine (N) and propranolol (P) was conducted over a period of 7 weeks in thirty hypertensive patients of both sexes, aged from 20 to 65 years, with the diastolic pressure over 100, but below 120 mmHg. Thirteen examinees were given N (60-120 mg daily) and seventeen P (120-240 mg daily); the groups were comparable according to a series of relevant parameters. In the placebo-period the mean arterial pressure (MAP) was slightly lowered, by 4.4% (p greater than 0.20). MAP was, however, considerably lowered already at the end of the second week of active treatment both in the N group (from 135.1 +/- 7.4 to 116 +/- 10.8 mmHg, or by 19.1%; P less than 0.01), as well as in the P group (from 131.6 +/- 8.1 to 117 +/- 9.1 mmHg, by an average of 11.1%; P less than 0.05). The values continued to decrease, and at the end of the seventh week of the study MAP averaged 108.5 +/- 6.5 mmHg (-19.7%; P less than 0.01) in the N group, while it was 109.7 +/- 9.1 mmHg (-16.6%; P less than 0.01) in the P group. The heart rate became considerably slower in the P group only, from the initial 84.5 +/- 9.2 to 66.9 +/- 2.7 beats per minute at the end of the seventh week (-20.8%; P less than 0.01), but it was unexpectedly, although not significantly lowered also in the N group, from the initial 78.3 +/- 6.5 to 74.2 +/- 4.0 beats (-5.2%; P greater than 0.20).(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Pressure↗
PubMedDate not supplied

[Diagnostic characteristics of myxoma of the left atrium].

Three middle-aged patients (38, 40 and 41 years old; two women and one man) with left atrial myxoma diagnosed by echocardiography and successfully operated on are presented. Two patients had tumor embolus as the dominant presenting symptom. The time span between the first symptoms and the echocardiographic diagnosis was 6 months, 12 months, and 12 days, respectively. From that moment to surgery the average lag was 6.3 days only, including the complex transportation to distant surgical centres. All the patients are now alive, all with normal findings more than 2 years after the operation.

Adult↗
PubMedDate not supplied

[Changes in left ventricular function and structure in hypertensive patients treated with methyldopa and urapidil].

In a randomized cross-over and double-blind trial twenty mild-to-moderate hypertensives (11 males, 9 females, mean age 48.4 +/- 7.6 years) were receiving methyldopa (250 mg b.i.d.) or urapidil (30 mg b.i.d.) for 7 weeks and then treated with alternative drug for additional 7 weeks, separated by one week of wash-out period. Both antihypertensives induced significant reduction (P less than 0.01) in systolic and diastolic arterial pressure, while no significant changes (P greater than 0.20) in the body weight and the heart rate were observed. The echocardiographic features of left ventricular hypertrophy (LVH) did not decrease significantly (P greater than 0.05) on either drug, except for the left ventricular posterior wall thickness (LVPWd), which decreased on methyldopa from 10.4 +/- 1.3 to 9.8 +/- 1.4 mm (P less than 0.05). The drugs under study did not change significantly the echocardiographic indices of left ventricular function. Echocardiography resulted to be more sensitive in detecting LVH than electrocardiography. It is concluded that methyldopa might successfully reduce LVH, while direct and indirect vasodilators (such as urapidil) are less effective.

Adult↗
PubMedDate not supplied

[The role of the diagonal ear lobe crease in the clinical evaluation of coronary risk].

Two hundred and forty-three prospective patients (143 with proved coronary heart disease and 100 without coronary disease) were analysed for the presence or absence of ear lobe crease, a possible aural sign of coronary artery disease. The crease was present in 72.7% of the coronary and 48% of the noncoronary examinees (p less than 0.001). The crease was more prevalent in older (greater than 50) than in the younger patients. The positive predictive value of this sign averages 70% and the negative one 60%.

Coronary Disease↗
PubMedDate not supplied

[Comparison of single and double doses of hydrochlorothiazide in the treatment of arterial hypertension with special emphasis on changes in vascular reactivity].

The hypotensive effects of 100 and 50 mg hydrochlorothiazide (HTZ) were evaluated in 30 mild-to-moderate hypertensives, divided into two groups, with diastolic pressure between 95 and 110 mmHg. In both groups, the average MAP reduction was 15% (P less than 0.05). There were no significant differences in antihypertensive effects between single (50 or 100 mg o.d.) and double (25 or 50 mg b.i.d.) doses of the same drug. Blood pressure control was better after two than after one month on each of the various dosing schedules. Side-effects were mild and well tolerated: observed was a significant increase in triglyceride level from 3.0 +/- 1.8 to 4.8 +/- 2.4 mmol/L under the treatment with 100 mg HTZ o.d. and a statistically significant decrease in potassium level from 4.4 +/- 0.3 mmol/L to 4.1 +/- 0.3 mmol/L after two months treatment with 50 mg HTZ o.d. Unexpectedly, these changes were not dose-related. The venous reflexes showed atenuated response to norepinephrine after HTZ treatment, while arterial inflow, venous capacity and venous outflow increased significantly (P less than 0.05). It is concluded that HTZ exhibits some direct vasodilator activity and that the pharmacokinetic features of this drug do not correlate with the pharmacodynamic ones. At least in the management of mild-to-moderate arterial hypertension single daily dosage is quite adequate.

Adult↗
PubMedDate not supplied

[The vasodilating effect of chlorthalidone in mild hypertension evaluated by impedance venous plethysmography].

Thirty hypertensive outpatients of both sexes having diastolic blood pressure below 110 mmHg were included in a randomized trial. Their mean age was 50.4 +/- 8.6 years. After a two-week placebo period, the patients were treated with chlorthalidone in a single daily dose of 25 or 12.5 mg over the one-month period, and the next month the alternative dose (i.e. 12.5 or 25 mg) was administered. Changes in vascular reactivity were measured by occlusive plethysmography (mercury strain-gauge) at the end of the placebo period, and then post the first and second month of therapy. All the observed parameters, i.e. rest flow (RF), peak flow (PF), venous capacity (VC), and maximal venous outflow (MVO) increased with 25 mg of chlorthalidone, and similar findings were registered when a dose of 12.5 mg was given. There was a significant increase in venous capacity of both groups (from 2.6 to 3.2 and from 3.0 to 3.4 ml/100/min) and in peak flow of the group that was on 25 mg of chlorthalidone as the first dose (from 18.6 to 23.9 ml/100ml/min). Both doses had similar antihypertensive effect. It is concluded that antihypertensive effect of chlorthalidone is partly due to changes in vascular reactivity in the sense of vasodilation which is more prominent at the venous side of the blood flow, Low-dosed chlorthalidone is equipotent in antihypertensive efficiency, its side effects are rare, and the cost of therapy is by far the lowest.

Chlorthalidone↗
PubMedDate not supplied

[Anterior septal myocardial infarct impairs cardiovascular function more than inferior septal myocardial infarct].

The functional ability, expressed as percentage of expected oxygen uptake, measured on the tread-mill according to the Bruce protocol, was assessed in 30 patients with anteroseptal, and in 30 patients with inferior myocardial infarction (MI), 4 months after the incident. In comparison to those with inferior MI, the patients with anteroseptal localization exhibited significantly lower values of functional ability (68.37% +/- 14% versus 75.63% +/- 11%, p < 0.05), significantly higher activities of creatine kinase (CK: 894.7 +/- 441 versus 603 +/- 330 IU, p < 0.01), significantly lower left-ventricular ejection fraction (53% +/- 6.4% versus 58.7% +/- 6.3%, p < 0.01) and higher negative correlation between CK and functional ability (r -0.85 versus r -0.72). In conclusion, anteroseptal infarction is associated with a greater decrease in functional ability then the inferior one, which is partly due to more extensive necrosis with greater deterioration in left ventricular contratility; the mere site of infarction is probably also a contributing factor.

Exercise Test↗
PubMedDate not supplied

[Orthostatic hypotension. Case report of the Bradbury-Eggleston syndrome].

A case of a 71-year-old woman with idiopathic orthostatic hypotension is presented. Several diagnostic procedures which can detect sympathetic pathway lesion are reported. The value of blood pressure measurement and heart rate response to the supine and standing position deep breath, Valsalva maneuver and cold pressor test in differential diagnosis are emphasized. The venoconstriction, venous reflexes and tyramine tests are described, as well. The authors favour an individual therapeutic approach with no limitation of mineralocorticoid dosage. Nonpharmacological measures, such as an increased salt intake, elastic support stockings and swimming are highly recommended.

Aged↗
PubMedDate not supplied

[Association of platelet aggregation with the extent of myocardial infarction].

The aim of this study was to evaluate the association between the type of myocardial infarction (MI) and the circulating platelet aggregates [circulating aggregates of thrombocytes (CAT)]. The size of MI was assessed by the maximal values of creatine-kinase (CK). In 80 patients in the acute phase of MI the values of CAT and CK were manifold increased, mostly in 30 patients with anteroseptal MI (CAT 34.1 +/- 8.3%, CK: 920 +/- 340 IU), less markedly in 30 patients with inferior MI (CAT: 25 +/- 6.7%, CK: 739 +/- 263 IU) and in 20 patients with non-Q-wave MI (CAT: 20.7 +/- 1.9%, CK 518 +/- 224 IU). The differences between the groups were significant (p < 0.05). There was a significant linear correlation between CAT and CK in anteroseptal MI (r = 0.57, p < 0.01) and in inferior MI (r = 0.54, p < 0.01), but not in non-Q-wave MI (r = 0.15, p > 0.05). The results are concordant with the hypothesis that thrombotic event contributes more significantly to the pathogenesis of transmural acute myocardial infarction.

Adult↗
PubMedDate not supplied

[Comparison of amlodipine and the nifedipine retard preparation in the treatment of arterial hypertension].

The efficacy and acceptability of amlodipine (5-10 mg o.d.) and sustained-release nifedipine (20-40 mg b.i.d.) were compared in a multicenter, double-blind clinical trial. After a two-week placebo period, 71 essential hypertensives of both sexes, aged 51.7 +/- 8.5 years, having diastolic blood pressure of 95-114 mmHg were randomly allocated to either amlodipine 5 mg once daily (group A) or nifedipine 20 mg twice daily (group B). With respect to the blood pressure response, the initial dose was doubled after two weeks. No significant differences in blood pressures recorded at baseline and at the end of the placebo period were demonstrated. A significant reduction in both systolic and diastolic blood pressures in the supine position was observed already two days after the start of treatment. In the group A it decreased from 163.2 +/- 21.4/102.7 +/- 8.5 to 155.7 +/- 20.7/98.2 +/- 8.9 mm Hg (p < 0.05) and in the group B from 160.5 +/- 16.2/100.5 +/- 12.2 to 152.2 +/- 17.0/95.4 +/- 9.5 mm Hg (p < 0.05). The similar changes of blood pressure were observed in the standing position, as well. At the end of the study, the overall reduction of the supine diastolic blood pressure was 12.5% in the group A versus 5.2% in the group B (p < 0.05). In the standing position, amlodipine decreased diastolic blood pressure by 8.8% and nifedipine by 6.4% (p < 0.05). Furthermore, amlodipine decreased the standing diastolic blood pressure to a greater extent (8.8% versus 6.4%; p < 0.05) than nifedipine.(ABSTRACT TRUNCATED AT 250 WORDS)

Amlodipine↗