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Biomedical subjects

J Bernheim

Publications and source records attributed to J Bernheim.

At least 235 records · Page 13Linked to original sources
PubMed1984

Effect of acute cimetidine administration on indices of parathyroid hormone action in healthy subjects and patients with primary and secondary hyperparathyroidism.

To evaluate the acute effect of histamine H2-receptor blockade with cimetidine on PTH concentrations and its endogenous biological activity, we studied the effect of iv administration of cimetidine (50-mg bolus followed by 500 mg/60 min infusion) in normal subjects and patients with primary and secondary hyperparathyroidism. No significant changes in serum concentrations of calcium, phosphate, or immunoreactive C-terminal PTH were found in any group. However, the control group had decreased calciuria, increased phosphaturia, and decreased tubular reabsorption of phosphate, while the primary hyperparathyroid group had increased phosphaturia, increased nephrogenous cAMP excretion, and decreased tubular reabsorption of phosphate. In both of these groups, the finding suggest an increase in PTH-like biological activity. These findings suggest that cimetidine is not useful in the diagnosis or medical management of hyperparathyroidism. In fact, the changes in renal calcium and phosphorous excretion indicative of PTH-like biological activity along with a decrease in creatinine clearance in the primary hyperparathyroid group suggest a relative contraindication to the use of this drug in these patients.

Adult↗
PubMed1984

Adrenal insufficiency in a general hospital over a 14-year period.

Over a 14-year period, 26 patients with adrenal insufficiency of multiple etiology were evaluated. Eight were diagnosed at autopsy, six of whom had acute bilateral adrenal hemorrhage. Nine had chronic adrenal insufficiency. Of these, five were idiopathic and three had polyglandular disorders. Four others had tuberculosis. Six of nine patients with chronic adrenal insufficiency were hyperpigmented. Unusual manifestations of adrenal hypocorticism included hypercalcemia, flaccid paralysis, and joint contractures. The presence of multiple hormonal deficiencies focused the diagnosis on hypopituitarism. Two cases of isolated ACTH deficiency were detected. Patients with familial Mediterranean fever with amyloidosis commonly presented with reduced adrenal reserve rather than overt insufficiency. Metastatic cancer of the adrenal glands was a rare cause of reduced adrenal reserve.

Adolescent↗
PubMed1983

[Epidemiology of pulmonary tuberculosis in the prison environment].

Despite the decline in pulmonary tuberculosis in industrial countries since the beginning of the century, screening remains important, particularly in population groups at special risk such as jail inmates. A 1-year prospective study in 865 prisoners in Geneva shows that the prevalence of active and residual tuberculosis is five to ten times higher than in the general population. The reasons for this high prevalence are low socio-economic status and lack of a regular job or fixed residence for many prisoners. These facts illustrate the importance of introducing systematic diagnosis and, if necessary, rapid therapeutic measures in jails, with the triple purpose of contributing to the fight against tuberculosis among prisoners, prison staff and the population as a whole.

Adult↗
PubMed1983

The urinary excretion of prostaglandins E2 and F2 alpha in essential hypertension.

The 24 h urinary excretions of prostaglandins E2 (E2/d) and F2 alpha (F2 alpha/d) were measured in twenty-five normal subjects and in thirty-five patients with essential hypertension [seventeen with low renin (LRH) and eighteen with normal renin (NRH) hypertension]. E2/d was lower in patients with LRH than in normal subjects (P less than 0.01), whereas no difference was found between patients with NRH and the controls. F2 alpha/d was similar in patients with LRH and in the normal subjects, but was significantly greater in patients with NRH (P less than 0.02). The ratio of prostaglandin E2 to prostaglandin F2 alpha was decreased in hypertensive patients (P less than 0.02), although in the NRH subgroup the difference was not statistically significant. It appears that LRH is associated with impaired production of prostaglandin E2, while a deranged relationship between the two prostaglandins exists in all the patients with essential hypertension. These changes in prostaglandin production could possibly contribute to the pathogenesis of hypertension, by increasing renal vascular resistance and decreasing sodium excretion. Alternatively, they might be a secondary phenomenon, reflecting changes in renal prostaglandin metabolism induced by the hypertensive state.

Adult↗
PubMed1983

The protective effect of dimethyl sulfoxide in experimental ischemia of the intestine.

Experiments with two models of intestinal ischemia were performed in order to examine the protective effect of dimethyl sulfoxide (DMSO). Segmental ischemia of the small intestine for 150 minutes caused necrosis of the affected bowel in 90% of the animals. Intravenous administration of DMSO or impregnation of the peritoneum with this substance prevented the development of gangrene in 28 of 29 rats. 30 or 60 minutes of complete ischemia of the small intestine, produced by clamping of the superior mesenteric artery, resulted in partial or complete necrosis of bowel segments with a high incidence of perforation and peritonitis and a high mortality rate within the first 24 hours. Intravenous DMSO, given upon declamping of the artery, effectively protected the bowel from the ischemic damage. There were no deaths among DMSO-treated animals and at 24 h there was no evidence of ischemic damage to the intestine. Though the exact mechanism of action of DMSO is unknown, the results of these and other experiments may warrant clinical trials especially in cases of mesenteric thrombosis.

Animals↗
PubMed1983

Successful management of severe paraquat poisoning.

A case of paraquat poisoning was successfully treated which would have been considered lethal according to a reported prognostic index. Main features in the treatment were removal of paraquat by gastric lavage, forced diuresis, hemodialysis, and charcoal hemoperfusion. Early ventilation with low FIo2 and with positive end-expiratory pressure (PEEP) were also utilized.

Charcoal↗
PubMed1983

Assessment of the calcium loading test in differentiating between various forms of idiopathic hypercalciuria.

The oral calcium loading test for the differential diagnosis of the various forms of idiopathic hypercalciuria has raised much interest, since it might provide the basis for a selective, optimal treatment of the different hypercalciuric states. We have assessed the ability of this test to differentiate between the two major forms of idiopathic hypercalciuria: renal and absorptive hypercalciuria. The test was performed in 32 idiopathic hypercalciuria patients. Based on generally accepted criteria that have been established according to the results of calcium and cAMP measurements in plasma and urine, 31% of the patients could be classified as having renal hypercalciuria and 13% as having absorptive hypercalciuria, whereas the remaining 56% did not fit either of these categories. In view of the expense and logistics involved in performing the test, the finding of an approximately 50% efficacy rate in distinguishing between the forms of idiopathic hypercalciuria raises serious doubts regarding the value of its routine implementation.

Adult↗
PubMed1983

Effect of atenolol treatment on urinary prostaglandins E2 and F2 alpha in essential hypertension.

The urinary excretion of prostaglandins (PG) E2 and F2 alpha was measured by radioimmunoassay in 15 patients with essential hypertension, before and after 2 and 4 weeks of treatment with the selective beta 1-adrenergic blocker, atenolol. Systolic and diastolic blood pressure, pulse rate and plasma renin activity decreased significantly during the treatment. No change was observed in renal function and electrolyte balance. The 24-hour excretion of PGE2 and PGF2 alpha was also unaffected by the antihypertensive treatment. The above findings, in contrast with those previously observed with another beta-blocker, propranolol, suggest that tubular beta-receptors are not involved in the synthesis of PGs. The different hemodynamic effects of the two drugs are the most likely explanation for the different responses in prostaglandin excretion.

Adult↗
PubMed1983

[Clinical and histological study of 25 cases of hydronephrosis caused by primary stenosis of the pyeloureteral junction].

The authors report 25 cases of primary stenosis of the pyelo-ureteric junction (PUJ) in terms of their clinical and histological features. Based on a semi-quantitative study of the histological modifications, the authors attempt to determine whether these modifications are primary and therefore responsible for the stenosis of the PUJ or wether, on the contrary, these changes are secondary to the stenosis. After studying 25 children and adults, it appears that these histological signs are primary and responsible for the malformation: rarefaction of the muscle layers (24 cases out of 25), fibrosis of the sub-mucosa or intermuscular layer in every case, presence of valvular mucosal folds in every case but one.

Adolescent↗
PubMed1983

Successful parathyroid gland autotransplantation after total parathyroidectomy in dialysis patients.

Secondary hyperparathyroidism is one of the major complications encountered in patients on maintenance dialysis. Medical management is frequently unsuccessful, and there is often a need to perform a parathyroidectomy. Recurrent clinical secondary hyperparathyroidism may occur as a sequela of subtotal parathyroidectomy and necessitate a reexploration of the neck. Total parathyroidectomy followed by autotransplantation of parathyroid tissue into the patient's forearm bypasses the need for a second operation, and it provides a simple ambulatory procedure, under local anesthesia, for the removal of hyperplastic parathyroid tissue. The results in six patients indicate that this new procedure should be considered the treatment of choice for this condition.

Adult↗
PubMed1982

Effect of chronic and acute changes in sodium balance on the urinary excretion of prostaglandins E2 and F2 alpha in patients with essential hypertension.

The 24-hour urinary excretion of prostaglandins (PGs) E2 and F2 alpha, plasma renin activity (PRA), and aldosterone were measured in 7 normal subjects and 8 patients with essential hypertension before and after 5 days of a diet containing less than 20 mmol/day of sodium. Subsequently, sodium was infused intravenously for 4 h (77 mmol/h), and urinary PGs measured in hourly urine collections. Plasma renin activity and aldosterone were measured at hours 2 and 4. In the normal subjects, PGE2 increased significantly (p less than 0.0005), with the diet, while PGF2 alpha did not change. The E/F ratio was increased significantly (p less than 0.01). In contrast, in the hypertensive patients no changes were observed in PGs excretion or in the E/F ratio. PRA and aldosterone were in the normal range after the diet in 4 patients and low in the other 4. Apart from PRA and aldosterone levels, there were no differences between these two subgroups of patients, with regard to change in body weight, blood pressure or electrolyte excretion. PG excretions were also similar. With the Na infusion, PGs returned to control values in the normal subjects. In the hypertensive patients, PG excretion decreased to almost undetectable levels. This coincided with the phenomenon of exaggerated natriuresis. It is concluded that: (1) in hypertensive subjects PGs synthesis is not influenced by chronic changes in the volume status, and (2) renin secretion is relatively independent of PG production in the hypertensive subjects. We suggest that the changes in PG synthesis in hypertension are possibly related to altered sodium handling by the hypertensive kidney.

Adult↗
PubMed1982

Increased renal prostaglandins in normal pregnancy and in pregnancy with hypertension.

The 24-hour urinary excretion of prostaglandins (PGs) E2 and F2 alpha (which reflects the renal synthesis of these substances) was measured by radioimmunoassay in normal nonpregnant women (NW, n = 23), nonpregnant women suffering from essential hypertension (HW, n = 23), normal pregnant women (NP, n = 24) and women with hypertension in pregnancy (HP, n = 14). All pregnant women were in the third trimester of their pregnancy (week 24-40). The excretion of both PGE2 and PGF2 alpha was increased in NP as compared to NW. PGF2 alpha was relatively more elevated, leading to a decreased PGE2/PGF2 alpha ratio. In HP, PGE2 and PGF2 alpha excretions were even greater, and the PGE2/PGF2 alpha ratio was even lower than in NP. This contrasted with the lowered PGE2 excretion in HW. The increased renal PGs synthesis in normal pregnancy could be related to the effects on the kidney of several hormonal changes peculiar to pregnancy. In addition, the lowered PGE2/PGF2 alpha ratio suggests the possibility of an increased activity of the PGE2-9-ketoreductase, which could be related to the changes in renal sodium handling observed in pregnancy. The pattern of PGE2 excretion in HP is opposite to that observed in HW (i.e. increase rather than decrease). However, both groups share the lowered PGE2/PGF2 alpha ratio with respect to the normotensive counterparts. The causes of altered PG synthesis in pregnant women with hypertension are presently unclear.

Adult↗
PubMed1982

Effect of propranolol treatment on the urinary excretion of prostaglandins E2 and F2 alpha in patients with essential hypertension.

The 24-h urinary excretion of prostaglandins (PG) E2 and F2 alpha, which reflects the renal synthesis of these substances, was measured by radioimmunoassay in 10 patients with essential hypertension before and after treatment with propranolol. In addition, changes in the urinary excretion of PGE2 and PGF2 alpha after furosemide injection were also studied before and after propranolol treatment. The urinary excretion of PGE2 was significantly increased after propranolol treatment, whereas that of PGF2 alpha did not change. An enhanced response in PGE2 excretion after furosemide injection was observed after propranolol treatment. In contrast PGF2 alpha increased in response to furosemide before, but not after, propranolol treatment. Changes in renal hemodynamics induced by propranolol seem to be the main factor in PGE2 alpha increase. However, an indirect effect of beta-blockade or a direct effect on the enzymes governing renal PG synthesis cannot be ruled out.

Adult↗