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Biomedical subjects

J E Pohl

Publications and source records attributed to J E Pohl.

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

Improvement of renal function during long-term treatment of severe hypertension with minoxidil.

Sixty-nine patients with refractory hypertension were treated with minoxidil and in 66 good control of blood pressure was achieved. Renal function was stabilized in 31 patients in whom the serum creatinine was normal at presentation. Twenty-eight patients with impaired renal function had a substantial fall in serum creatinine (25 per cent) during the first three to six months of treatment and this improvement was maintained. In contrast, renal function in six out of seven patients with primary renal disease continued to deteriorate despite adequate control of blood pressure. Effective control of blood pressure prevents or reverses impairment of renal function in patients with refractory hypertension not associated with primary renal disease.

Blood Pressure↗
PubMed1982

Treatment of refractory hypertension.

126 patients with blood pressure which was unacceptably high despite a conventional stepped-care regimen (diuretic, beta-blocker, and vasodilator) took part in a comparative assessment of different approaches to the treatment of refractory hypertension. One of four regimens was used: oral diazoxide, minoxidil, captopril, or quadruple therapy (diuretic + beta-adrenoceptor blocker + hydralazine + prazosin). Despite the severity of hypertension, blood pressure could be controlled in almost all these patients, and no patient died from cerebrovascular disease while on treatment. 2 patients died of renal failure and 5 patients required long-term haemodialysis. Ischaemic heart disease remained a problem and caused the death of 10 patients. Diazoxide was the most effective treatment but was the most difficult and unpleasant to use. Captopril was the best-tolerated but failed to control blood pressure in 6 of 15 patients. Our experience indicates that there are now sufficient therapeutic alternatives to achieve acceptable blood-pressure control in almost all patients with "refractory" hypertension, although no treatment is ideal.

Adrenergic beta-Antagonists↗
PubMed1978

Blood alcohol and impairment of judgment.

1. The cerebral depressant effect of 30 ml of aqueous ethanol diluted to 25% and administered orally to 16 volunteer subjects was compared with a control group of 15 volunteer subjects. 2. The two parallel forms of the Watson--Glaser Critical Thinking Appraisal tests were employed as a measure of cerebral function. 3. The control group showed a small but statistically insignificant improvement on retesting with Watson--Glaser test form ZM after preliminary administration of form YM. 4. The relationship between the blood alcohol time curve and the alcohol effect was analysed for each individual subject, each subject being used as his own control. 5. The main peak cerebral depressant effect was substantial and occurred on average 25.5 min before the attainment of the peak blood alcohol concentration. 6. There was no significant correlation between blood alcohol concentration and contemporaneous cerebral impairment (r = -0.01). 7. There was a highly significant correlation (r = 0.60) between the effect upon cerebral function and the gradient of the blood alcohol curve at that time.

Adult↗
PubMed1978

Diazoxide in treatment of primary pulmonary hypertension.

Three patients with primary pulmonary hypertension and one man with suspected thromboembolic pulmonary hypertension were given up to 300 mg diazoxide by injection into the pulmonary artery. The three patients with primary pulmonary hypertension responded with a fall in total pulmonary resistance and a rise in cardiac output. The patient with suspected thromboembolic pulmonary hypertension did not respond. Haemodynamic and clinical improvement was maintained by oral diazoxide in two of the responders, and in one the prognosis appeared to be greatly improved.

Adult↗
PubMed1978

Renin subgroups in essential hypertension: an analysis and critique.

It has been claimed that measurement of renin levels in patients with essential hypertension enables identifiable subgroups of patients to be demarcated and that these subgroups exhibit important differences in prognosis and response to therapy. Accordingly, plasma renin activity (PRA) was measured in 181 patients referred to hospital outpatients for treatment of hypertension. Fifteen of these were excluded from study because of abnormality of renal function, an abnormal pyelogram or incidental disease. PRA of the remainder showed a smooth unimodal distribution with a 'tail' of high values (17%) which lay above the range of values observed in normotensive subjects. Following seven days treatment with bendrofluazide the percentage rise in PRA was much less than that of age-matched controls. A group of 55 patients (33%) fell below the range encountered in normotensive matched subjects treated similarly, although the distribution of PRA was still smooth and unimodal. Patients were divided into 'high', 'normal' and 'low' renin subgroups. Whilst there were significant differences in age between the high, normal and low renin groups, there were no significant differences in basal blood pressure, response to diuretics or beta blockers. It is concluded that renin levels in hypertension are influenced by several factors and that any attempt to subdivide patients into renin subgroups is therefore arbitrary. Measurement of renin does not significantly assist predicting the blood pressure response to either diuretics or beta-blockers combined with diuretics.

Angiotensin II↗
PubMed1973

Development of extrapyramidal symptoms in hypertensive patients treated with diazoxide.

Extrapyramidal symptoms developed a variable time after the start of treatment with oral diazoxide in 15% of a series of 100 severely hypertensive patients. Six illustrative cases are described. Treatment with diazoxide could be continued in four of these. The symptoms are usually controllable either by dosage adjustment or by the use of diazepam or procyclidine. There was no evidence of irreversibility of the extrapyramidal syndromes observed.

Adult↗