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Biomedical subjects

J P Pascal

Publications and source records attributed to J P Pascal.

At least 127 records · Page 7Linked to original sources
PubMedDate not supplied

Assessment of short-term prognosis after variceal bleeding in patients with alcoholic cirrhosis by early measurement of portohepatic gradient.

Seventy-two consecutively admitted patients with biopsy-proven alcoholic cirrhosis and a bleeding episode endoscopically proven to originate from ruptured esophageal varices were studied. Hemodynamic assessment was performed within 48 hr of admission using the transjugular approach. Mean portal pressure was found to be significantly greater in the group of patients who died than in those who survived for 1 week, 2 weeks or 1 month after admission. We conclude that: The portohepatic pressure gradient and portal pressure have short-term prognostic value in patients with alcoholic cirrhosis bleeding from ruptured esophageal varices. Owing to a high early mortality, any delay between the occurrence of a bleeding episode and the measurement of portal pressure appears to select a sample of survivors with a significantly lower mean level of portal pressure than in those measured earlier. When evaluating portal pressure, the time of study is one of the most important variables which may affect the conclusions.

Esophageal and Gastric Varices↗
PubMedDate not supplied

Atrial natriuretic peptide, plasma renin activity, plasma volume, systemic vascular resistance and cardiac output in patients with cirrhosis.

The present study aimed to assess relationships between plasma levels of atrial natriuretic peptide (ANP) and plasma volume, systemic vascular resistances, cardiac output and plasma renin activity in patients with cirrhosis. Thirty patients were included: eight with no history of liver disease were used as controls; 22 patients had biopsy-proven alcoholic cirrhosis without ascites (n = 11) and with ascites (n = 11). Mean ANP plasma level was significantly higher in both groups of cirrhotic patients than in controls (P less than 0.05). In the control group, ANP and plasma renin activity were inversely correlated (P less than 0.05) but no correlation was found in cirrhotic patients. In the group of patients with ascites, ANP plasma levels were inversely correlated to plasma volume (P less than 0.05) and to cardiac output (P less than 0.01) and directly correlated to systemic vascular resistances (P less than 0.01). Using multiple regression analysis, ANP remained correlated only with systemic vascular resistances (P less than 0.05). These results suggest that cirrhotic patients have high plasma levels of ANP whether or not they have ascites. In the light of current knowledge of ANP actions, the relationships between ANP plasma levels and plasma volume, cardiac output, and systemic vascular resistances are paradoxical in cirrhotic patients with ascites. ANP does not seem to play a critical role in the pathogenesis of sodium and water retention observed in these patients.

Ascites↗