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Biomedical subjects

M Anlauf

Publications and source records attributed to M Anlauf.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Primary Sjögren's syndrome and glomerulonephritis].

HISTORY AND CLINICAL FINDINGS: An 82-year-old woman with hypertension for 20 years developed a nephrotic syndrome with severe oedema followed by acute oliguric renal failure after a bout of bronchitis and a gastrointestinal infection. She also complained of xerostomia and dry eyes of recent onset. INVESTIGATIONS: Biochemical tests showed a serum creatinine level of 6.1 mg/dl, a 1:5120 antinuclear antibody (ANA) titre, and positive values for Ro(SS-A) and La(SS-B) antibodies. HLA-DR typing demonstrated HLA-DR3 (HLA-DRB1*0301) and DR13 (HLA-DRB1*13) antigens. Renal biopsy revealed minimal glomerular lesions with focal and segmental glomerulo-sclerosis as well as (hypertension-induced) benign nephrosclerosis and focal tubular atrophy with interstitial fibrosis. TREATMENT AND COURSE: After two hemofiltrations and concomitant administration of 100 mg prednisone renal function quickly improved and the proteinuria fell to 1 g/dl. At the same time the xerostomia improved. The nephrotic syndrome recurred 7 months later after the prednisone dose had been reduced to 10 mg/d, but after the dose had been raised to 50 mg/d and cyclosporin A (150 mg/d) had been added a lasting remission occurred and renal function became stable though impaired. CONCLUSION: The relatively rare association of glomerular disease (here focal segmental glomerulosclerosis) with Sjögren's syndrome can, as in this case, be triggered by a viral infection. A genetic predisposition for Sjögren's syndrome is suggested by the demonstration of HLA-DR3 alleles. Administration of steroids is indicated for the treatment of the nephrotic syndrome and, in case of recurrence, can be combined with cyclosporin A. Both drugs also influence the symptoms of Sjögren's syndrome.

Aged↗
PubMed1997

Randomised, double blind, multicentre comparison of hydrochlorothiazide, atenolol, nitrendipine, and enalapril in antihypertensive treatment: results of the HANE study. HANE Trial Research Group.

OBJECTIVE: To compare the effectiveness and tolerability of hydrochlorothiazide, atenolol, nitrendipine, and enalapril in patients with mild to moderate hypertension. DESIGN: Randomised multicentre trial over 48 weeks with double blind comparison of treatments. SETTING: 48 centres in four countries. PATIENTS: 868 patients with essential hypertension (diastolic blood pressure 95-120 mm Hg) INTERVENTIONS: Initial treatment (step 1) consisted of 12.5 mg hydrochlorothiazide (n = 215), 25 mg atenolol (n = 215), 10 mg nitrendipine (n = 218), or 5 mg enalapril (n = 220) once daily. If diastolic blood pressure was not reduced to < 90 mm Hg within four weeks, doses were increased to 25 mg, 50 mg, 20 mg, 10 mg, respectively, once daily (step 2) and after two more weeks to twice daily (step 3). The eight week titration phase was followed by an additional 40 weeks for patients who had reached the target diastolic pressure. MAIN OUTCOME MEASURES: Blood pressure by means of an automatic device with repeated measurements. RESULTS: After eight weeks the response rate for atenolol (63.7%) was significantly higher than for enalapril (50.0%), hydrochlorothiazide (44.7%), or nitrendipine (44.5%). After one year atenolol was still more effective (48.0%) than hydrochlorothiazide (35.4%) and nitrendipine (32.9%), but not significantly better than enalapril (42.7%). The treatment related dropout rate was higher (P < 0.001) in the nitrendipine group (n = 28). CONCLUSIONS: There is no evidence of superiority for antihypertensive effectiveness or tolerability of the "new" classes of antihypertensives (calcium channel blockers and angiotensin converting enzyme inhibitors). As these drugs are now widely used as treatment of first choice, our results further emphasise the need for studies confirming that they also reduce morbidity and mortality, as has been shown for diuretics and beta blockers.

Adult↗
PubMed1996

Devices for blood pressure self measurement: tested in comparison.

OBJECTIVE: Comparative clinical evaluation of instruments designed for the self-measurement of blood pressure. METHOD: The usefulness of 27 different, exclusively oscillometric, automated devices were tested on a single group of 24 test persons without pressure-reducing arterial stenoses in the upper extremity. The cuff was to be put on the upper arm with 20 devices, on the wrist with five devices and on the left index finger with two devices. Per device and test person, six sequential comparative measurements were carried out using automated self-measurement and standard method with a double stethoscope in the same arm. RESULTS: On average, the devices measured the systolic pressure between 13.2 mmHg lower and 3.5 mmHg higher than the standard procedure; the diastolic pressure was measured between 17.4 and 0.2 mmHg lower. Using a scoring system, in which a device only got points for a comparative measurement if the differences to the control in systolic and diastolic measurement both were < or = 10 mmHg, the devices gained between 67 and 259 out of a maximum of 576 points. If each of the test persons had opted to buy just those devices which revealed a mean systolic and diastolic error of < or = 5 mmHg in his or her case, younger test persons would have found zero to five suitable devices older persons three to 13. The site of cuff application had no significant influence on results. CONCLUSIONS: Standard measurements and measurements with automated blood pressure self-measurement devices can differ considerably. In young test persons less suitable instruments are found than for older persons.

Adult↗
PubMed1995

[Amlodipine in long-term treatment of mild and moderate hypertension. A multicenter study].

METHOD: An open, multicenter study was conducted to investigate the antihypertensive efficacy and safety of amlodipine in the long-term treatment of patients with mild to moderate essential hypertension of a period of 178 weeks (3.4 years). RESULTS: 92 of the 110 patients participating in the study received amlodipine treatment throughout the total study period, with 77 patients on amlodipine monotherapy (mean daily dose 6.3 mg), and 15 patients on combination antihypertensive therapy including amlodipine (mean daily dose 7.1 mg). After 8 weeks of treatment the diastolic target blood pressure of < or = 90 mmHg was achieved in 86 out of 92 patients (93.5%). The mean diastolic blood pressure reduction was retained throughout the treatment, both in patients receiving monotherapy and those on combination therapy. The incidence of adverse events was highest during the first 12 weeks of treatment (30.0%); after another 54 weeks it dropped to 18.1%, and to 7.3% during the last 112 weeks. The side effects reported most frequently were headaches and edema. CONCLUSION: These results indicate that amlodipine effects sustained reduction in diastolic blood pressure over a period of more than 3 years in patients with mild to moderate hypertension.

Adult↗
PubMed1993

[Circadian antihypertensive effect of sustained-release isradipine in patients with essential hypertension in comparison to placebo].

In this multicenter, placebo-controlled study, 16 patients with mild to moderate essential hypertension were treated with 10 mg/day isradipine retard (PN 200-110, Lomir SRO, CAS 75695-93-1) for 3 weeks. The study started with a 2 week placebo wash out phase. 13 patients were randomised to an exclusive placebo therapy. After the placebo wash out phase, following the 1st medication in active therapy and after the end of therapy, 24-h blood pressure profiles were recorded. The profile under placebo on the 1st medication was separated by a one-week intervening placebo therapy for all patients. On active therapy, the systolic as well as the diastolic blood pressure (day time, night time and 24-h mean values) were significantly reduced. The antihypertensive effect of the active therapy became already manifest after the 1st medication and was augmented after 3 weeks of therapy. In the placebo group no parameter of the 24-h profiles changed significantly. The tolerability of treatment was excellent in 14 (87.5%) of the isradipine patients and in 10 (76.9%) of the placebo group. In one of 16 patients in the active group, adverse events (flush and ankle oedema) were observed. However, therapy could be continued. In one patient of the placebo group, oedema of the fingers was noticed, in another headache was documented. In the placebo group two patients discontinued the study due to inefficacy, in the isradipine group one patient for the same reason; a second patient was excluded from this group due to a concomitant disease unrelated to the study drug.

Adult↗
PubMed1992

[Self measurement of blood pressure: automation and management problems].

In the Federal Republic of Germany, the introduction of clinical testing of devices designed for the self-measurement of blood pressure resulted in an improvement of quality of these devices during the last ten years. Further progress seems to be possible by more restrictive administrative prescriptions. Now, electronic devices have the same accuracy as stethoscope devices. They facilitate self-measurement especially in handicapped persons. Devices working by the oscillometric method do not measure blood pressure more accurately than Korotkow devices, but they are a bit less sensitive for wrong placing of the bladder. In most devices automation of the prescribed deflation rate (2 to 3 mmHg/s) was successful.

Blood Pressure Determination↗
PubMed1990

[Prevalence, causes and effects of increased iron storage in patients with kidney transplantation].

Patients on chronic hemodialysis often need blood transfusions due to erythropoietin deficiency. Even after successful kidney transplantation iron overload may persist. Former histological studies have revealed siderosis of the liver in 69% of all patients whose serum ferritin was above 1100 ng/ml. The aim of the present study was to evaluate the influence of iron overload on liver function. In 146 symptom free patients with renal allografts serum ferritin was determined to detect possible iron overload. Serum ferritin between 4 and 5480 ng/ml were found (women: 358.7 +/- 105.3; men 282.4 +/- 63.3 ng/ml; x +/- SEM). Twelve patients (8.1%) had ferritin levels higher than 1100 ng/ml. These twelve patients as well as another group of eight patients with renal allografts whose serum ferritin was known to be higher than 1100 ng/ml were included for further evaluation. Their data were matched and compared with those of a control group also patients with renal allograft (same age and sex) whose serum ferritin was lower than 1100 ng/ml. Transaminases (SGPT 22.6 +/- 3.6 vs. 15.4 +/- 6.0 U/l; SGOT 14.7 +/- 2.0 vs. 13.0 +/- 4.8 U/l) and plasma glucose (90.5 +/- 7.1 vs. 76.8 +/- 3.7 mg/dl) were found to be significantly higher (p less than 0.05) in patients with serum ferritin levels above 1100 ng/ml. Elevated transaminases were significantly more frequent in patients with high serum ferritin (9 vs. 2; p less than 0.02) as compared with the control. Ferritin levels significantly correlated with the number of preceding blood transfusions (p less than 0.002). Hbs-persistence was detected in six out of 20 patients with high ferritin levels but only in one out of 20 in the control group (p less than 0.05) whereas anti-Hbs prevalence was not different in the two groups. These data indicate that chronic iron overload should be considered as a possible cause of chronic liver disease in patients with renal allografts.

Adolescent↗
PubMed1989

Changes in muscle blood flow after smoking a cigarette determined by a new noninvasive method.

In 9 healthy subjects the effect of smoking one cigarette (nicotine content 0.9 mg) on blood pressure, heart rate and total and muscle blood flow in the forearm was measured. Blood flow was measured by a new noninvasive plethysmographic method that simultaneously gives quantitative data about total and muscle blood flow. Smoking the cigarette did not significantly affect blood pressure or heart rate. Total blood flow in the forearm did not change but the flow to the muscle was increased and resistance in this vascular bed was decreased. The pattern of haemodynamic changes in the forearm indicates that epinephrine may be the mediator of the circulatory effects of nicotine.

Adult↗
PubMed1989

Vasodilation in the vascular bed of skeletal muscle after intravenous nifedipine in normotensives and hypertensives.

The aim of the study was to investigate the effect of nifedipine on blood flow and resistance in the forearm vascular bed of skeletal muscle in 10 male patients with primary hypertension and 10 age-matched male normotensives. We measured the effects of increasing doses of intravenous nifedipine on blood pressure, heart rate, total forearm blood flow and muscle blood flow. Muscle blood flow was determined by a combination of computed tomography and strain-gauge plethysmography. The nifedipine-induced increases in total forearm blood flow were the same in both groups. However, both the increase in muscle blood flow and the decrease in the resistance of the muscle vasculature were more pronounced in the hypertensives than in the normotensives (P less than 0.05). The data provide an explanation for the blood pressure reduction induced by nifedipine in hypertensives and support the hypothesis that elevated vascular resistance is an important functional component in primary hypertension.

Adult↗
PubMed1985

Beta-adrenoceptor subtype of the venous capacity system: characterization by venous occlusion plethysmography.

In order to characterize the beta-adrenoceptor subtype of the venous vessel wall, venous occlusion plethysmograph studies were carried out in 7 healthy volunteers. Venous distensibility (VD) was considered to be a measure of venous tone. Infusion of the beta 1- and beta 2-adrenoceptor agonist isoproterenol (I), of the predominantly beta 2-adrenoceptor agonist fenoterol (F) and of the predominantly beta 1-adrenoceptor agonist dobutamine (D) in increasing doses led to a significant increase in VD by I and F but not by D. Administration of the beta 1-adrenoceptor antagonists betaxolol (B) and metoprolol (M) did not significantly change VD. Neither beta-adrenoceptor antagonist prevented the increase in VD provoked by subsequent administration of I or F. It is concluded that beta-adrenoceptors in the venous vessel wall belong to the beta 2-adrenoceptor subtype.

Adrenergic beta-Agonists↗
PubMed1985

[Comparison of the measurement accuracy of electronic blood pressure self measurement devices 1980-1983].

The accuracy of 21 new electronic devices designed for self-measurement of blood pressure has been tested on an average of 22-24 subjects each by simultaneous measurements on the same arm. Compared with electronic devices made in 1980 the accuracy has improved, especially with regard to the estimation of diastolic blood pressure. Nevertheless, most devices still give too low a value for diastolic blood pressure. In agreement with former results the systolic differences are greater in women and in normotensive subjects, whereas the diastolic differences are more pronounced in younger subjects, in males and in hypertensive patients. Despite the differences due to different sites of auscultation, the results of the best devices tested show that electronic devices may estimate the same blood pressure values over the brachial artery as measured by auscultation in the antecubital fossa. We therefore suggest stronger regulations for the licensing of new electronic devices.

Blood Pressure↗