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Biomedical subjects

M Bellet

Publications and source records attributed to M Bellet.

At least 55 records · Page 3Linked to original sources
PubMed1985

Effect of nicardipine in elderly hypertensive patients.

The purpose of this study was to test tolerance and the antihypertensive effect of nicardipine, a new calcium antagonist, in 31 elderly patients aged 57-95 years. The study was conducted as a double-blind trial. The patients were allocated randomly to either active or placebo treatment. Sixteen patients were given 10-30 mg of nicardipine three times a day (mean dose, 69.4 mg per day); 15 other patients received a matching placebo. After 4 weeks, nicardipine lowered mean blood pressure, and the changes in systolic and diastolic blood pressure were significantly greater in the nicardipine group than in the placebo group. Nicardipine was tolerated very well, and orthostatic hypotension was never observed. There was no change in heart rate. Plasma renin activity (PRA) was measured in eight patients. There was no correlation between PRA and the antihypertensive effect of nicardipine. A pharmacokinetic study performed in 15 elderly patients showed a fast rate of absorption and also higher plasma levels than those observed in hypertensive adults (mean age, 54 years). This trial demonstrates the effectiveness of nicardipine in elderly hypertensive patients.

Age Factors↗
PubMed1985

[Right ventricular function during the convalescence phase of posterior primary infarction].

Right ventricular extension is very common in inferior myocardial infarction and the resulting haemodynamic changes are well documented. The aim of this prospective study was to assess the consequences on regional and global right ventricular function at a distance from the initial episode. The study population included 32 patients (29 men and 3 women; mean age 52.7 +/- 6 years) admitted consecutively to the coronary care unit for acute inferior wall myocardial infarction with right ventricular extension (group A: 14 patients) or without (group B: 18 patients), based on the initial haemodynamic data. All patients underwent right and left cardiac catheterisation with selective biplane right and left ventriculography and coronary angiography, 2.9 +/- 1 months after the acute episode. In group A, there was a normalisation of the haemodynamic changes observed during the acute phase of myocardial infarction, complete occlusion (10 cases) or a significant residual stenosis (3 cases) of the right coronary artery proximal or immediately distal to the right marginal artery and persistence of an alteration of global right ventricular systolic function when compared with group B (increased end systolic volume: RVESV = 43 +/- 11 ml/m2 vs 35 +/- 9 ml/m2, p less than 0.02, and a decreased ejection fraction: RVEF = 49 +/- 7 p. 100 vs 57 +/- 9 p. 100, p less than 0.01, resulting from hypokinesia or akinesia of the right ventricular inferior wall; mean shortening delta R = 11 +/- 6 p. 100 vs 17 +/- 7 p. 100, p less than 0.01.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Acute and chronic effects of a new calcium blocker, nicardipine, on renal hemodynamics in arterial hypertension].

Renal hemodynamics and natriuresis were studied in 9 hypertensive patients without renal failure, 2 hours and 4 hours after oral intake of Nicardipine 30 mg; sodium intake was kept constant during the study (100 mmol per day). Then, Nicardipine was given at a dose of 30 mg three times a day and the hemodynamic study was repeated on the 6th day (2 hours after the morning dose). Renal blood flow (RBF) and glomerular filtration rate (GFR) were measured by the clearance methods using 131I-hippuran and 125I-iothalamate respectively. Results are as follows: (Table: see text). These results confirm the potent renal vasodilatory effect of Nicardipine; GFR was not significantly altered while RBF and FF returned to normal levels. An early and transient natriuretic effect was observed after the first dose of Nicardipine and body weight showed a significant decrease during the study indicating that no sodium retention was induced by Nicardipine.

Calcium Channel Blockers↗
PubMed1985

[Arterial hypertension in heart transplant patients treated with cyclosporin].

Amongst 40 patients undergoing cardiac transplantation between 1981 and 1984 and treated with cyclosporin A, 23 had hypertension. Fifteen of these patients, aged 39 years (16-57 years), without cardiac failure, treated with 8 +/- 3 mg kg-1 d-1 of cyclosporin A and 0.27 +/- 0.1 mg kg-1 d-1 of prednisolone were studied on average 288 days after transplantation (63-788 days). Blood pressure in the out-patients department of these 15 patients was 164 +/- 14/112 +/- 13 mmHg, in the absence of any antihypertensive treatment for more than 15 days, with a urinary sodium of 104 +/- 48 mEq/d and a urinary potassium of 55 +/- 13 mEq/d (mean +/- standard deviation). Two abnormalities accompany the raised blood pressure: a reduced creatinine clearance of 63 +/- 30 ml min-1 and an increased plasma volume of 445 +/- 686 ml (p less than 0.05) with reference to Hurley's norms (1975). By contrast, urinary excretion of VMA and metanephrines were invariably normal. Plasma renin activity (PRA) was normal in a lying position (1.02 +/- 0.42 ng ml-1 h-1) and after orthostatic stimulation (2.55 +/- 1.31 ng ml-1 h-1). Renin release was not stimulated by acute inhibition of converting enzyme (1.11 +/- 0.70 ng ml-1 h-1). Plasma aldosterone (110 +/- 52 pg ml-1), plasma angiotensinogen (924 +/- 213 ng/ml) and converting enzyme activity (30 +/- 6 mU ml-1) were normal. In these patients with a denervated heart, the orthostatic position increased heart rate from 85 +/- 11 to 93 +/- 12 beats/min.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

Right ventricular function in healed myocardial infarction in man. A cineangiographic assessment.

To evaluate the frequency of right ventricular dysfunction following recovery from myocardial infarction (MI) and the relationship of segmental right ventricular (RV) wall motion abnormalities to left ventricular (LV) function or location of coronary arterial stenosis, biplane right and left ventricular cineangiograms were obtained in 100 consecutive patients (4 +/- 3 months post MI). Thirty (group A) had anterior MI and significant stenosis or obstruction of left anterior descending artery (LAD). The remaining 70 patients had inferior MI. They were divided into three groups according to the site of the main coronary stenosis or obstruction and corresponding LV akinesia: right coronary artery (RCA) proximal to the acute marginal artery (RMA), (group B: 32 patients), RCA distal to the RMA (group C: 18 patients), left circumflex artery (LCF), (group D: 18 patients). RV and LV end-diastolic volume index (EDV), end-systolic volume index (ESV), stroke volume (SV) and ejection fraction (EF) have been determined. RV segmental wall motion was assessed in RAO and LAO projection by determining the percentage of systolic shortening (+ delta R) along 11 hemiaxes. Mean axial shortening (delta R) of the RV inferior and free walls were considered. When compared with that in 10 normal subjects, RV end-diastolic volume (RVEDV), RV end-systolic volume (RVESV) were increased and RV ejection fraction (RVEF) was lower in patients with anterior or inferior MI. Inferior delta R exhibited comparable sequential changes in the three groups of inferior MI and similar LVEF alteration.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Dosimetric study of radiographs produced in the neonatal intensive care unit in newborn infants from 1 to 30 days of age].

This work is part of general program of the diagnostic radiation dosage monitoring in the C.H.U. of Brest. The aim of these measurements is to precise the doses delivered to the sensitive organs in infants from one to thirty days of age in the intensive care pediatric Department. We present in this paper the technology used and the results of these controls. We complete this experimental work with a statistical study of the number of radiographies made in the intensive care pediatric Department on 623 children. We insist on the use of leaded protection in the radiodiagnostic practice, as often as it is possible.

Evaluation Studies as Topic↗
PubMed1984

Ventilatory and occlusion pressure responses to hypercapnia in patients with chronic renal failure.

Little is known of the effect of chronic renal failure (CRF) on ventilatory regulation. In 38 subjects (19 healthy, 19 with CRF before and after dialysis), we performed measurements of ventilation (VE) and occlusion pressure (P0.1) while the subjects were breathing air and hypercapnic gas mixtures. The results have shown that (1) during air ventilation, CRF patients exhibited lower values of VE and P0.1, which returned to normal after dialysis; (2) during hypercapnic ventilation, CRF patients had the same response as healthy subjects for VE but higher P0.1; hemodialysis induced an upward shift of the CO2 response curve in CRF patients. A twofold mechanism is probably involved: pulmonary edema, which reduces lung elasticity, and neuromuscular hypoexcitability, both implying a stronger central command.

Adult↗
PubMed1984

[Treatment of arterial hypertension in the aged with a calcium antagonist: nicardipine].

The purpose of this study was to test in double-blind trial the tolerance and antihypertensive effect of nicardipine versus placebo in 32 elderly patients (mean age: 84 years). Nicardipine was given three times a day (mean dose: 69.4 mg per day). After four weeks, nicardipine lowered blood pressure (BP) from 186 +/- 4 mmHg/99.5 +/- 3 mmHg to 150 +/- 6/84 +/- 3 mmHg (p less than 0.001). 10 out of 16 patients were normalized (BP less than 160-95 mmHg). The placebo group remained hypertensive: 181 +/- 7/96 +/- 4 mmHg versus 183 +/- 4/101 +/- 3 mmHg (NS). 3 placebo treated patients were nevertheless normalized. The changes in systolic BP and diastolic BP were significantly greater in the Nicardipine group: respectively -36 +/- 4 versus -2 +/- 6 mmHg (p less than 0.001), -16 +/- 3 versus -5 +/- 4 mmHg (p less than 0.05). Treatment was very well tolerated. Orthostatic hypotension, change in heart rate, variation in biological parameters were never observed. These data agree with Buhler's statement suggesting that calcium channel inhibitors can represent an interesting alternative to diuretics as first line monotherapy in the treatment of hypertension in the elderly.

Aged↗
PubMed1983

[Pulmonary toxicity of bleomycin in the rabbit: histophysiological and anatomo-radiological correlations].

This work was made to study the eventual modifications of breathing pattern induced by an experimental interstitial fibrosis. In this aim, breathing pattern and lung radiology from 6 rabbits have been studied at different times (1, 3, 7, 15, 20, 45 days) after an intratracheal infusion of Bleomycin (7 U.kg-1). At the end of each observation period, a rabbit was killed and prepared for a pathologic study (light and electronic microscopy). Despite the early interstitial and alveolar radiologic syndrome, there is no significant modification of the breathing pattern. However the histologic study is in agreement with the radiologic pictures and reveals an early development of large exsudative injury with hyaline membranes, interstitial and alveolar oedema. The alterations trend to an interstitial diffuse fibrosis. The absence of correlations between the physiological and histological events is discussed.

Animals↗
PubMed1983

[Echographic aspects of biliary lithiasis and its complications].

Ultrasonic appearances of various types of gallbladder stones are described and findings on ultrasonic imaging of the main complications of biliary lithiasis analyzed. New possibilities for examination of the principal biliary pathway are being opened up by progress in improving resolution of the ultrasonoscope and by advances in knowledge of ultrasonic anatomy of the biliary tracts.

Biliary Fistula↗
PubMed1982

[Implication of enkephalins in central cardiovascular regulation in the rat].

[D-ala2]-met-enkephalinamide injected intracisternally in anaesthetized rats induced a centrally-mediated increase in blood pressure. The pressor response appeared to be due to activation of opiate receptors and mediated through the sympathetic nervous system. The hypotension observed with high doses may be induced by the respiratory depression. The intracisternal injection of an antagonist of opioid compounds (diprenorphine) caused a similar blood pressure decrease in spontaneously hypertensive rats (SHR) and normotensive control Wistar Kyoto rats (WKY). Our data suggest a central pressor effect of enkephalins in anaesthetized rats. This represents an important argument concerning a role of endogenous opioids in blood pressure control but suggests that brain stem endogenous opioids may not be involved in the mechanism of hypertension.

Animals↗
PubMed1982

[Radiologic examination of the knee and ankle in stress positions (author's transl)].

The serious serious sequelae of sprains of the knee and ankle makes it imperative for the therapist to have an early and precise diagnosis. The authors propose a means of exploring these joints with the aid of a simple set up. This new technology allows the radiologist, secure from direct or indirect radiation, to carry out a standardized examination of the joint, usually unilaterally, and to make his interpretation more easily and more precisely. This method of x-raying in the stress position has its major indication in emergencies, but is equally useful in non emergencies, accomplishing a veritable over-all evaluation of the joint: varus, valgus, preternatural anterior and posterior sliding motion. The interpretation, based on direct reading of the films, differentiates the normal condition from physiological relaxation and mild and severe sprains. Naturally this method is to be used only after taking standard routine views to rule out any fractures.

Ankle Joint↗
PubMed1982

[Familial anomaly of the seventh cervical vertebra. Radio-clinic comparison in a fourteen member family].

We report a fourteen member family presenting with an anomaly of the seventh cervical vertebra. The symptoms associate pain and paresthesias, a C8-D1 syndrome or arterial manifestations. The radiologic lesions noticed are bilateral in twelve cases, either cervical ribs or apophysomegaly of the seventh vertebra's transverse process. There is no correlation between the severity of the clinical impairment and the importance of the radiologic image. We insist on the familial character rarely reported in the literature of an anomaly noticed in radiologic practice.

Adult↗
PubMed1981

Inheritance of abnormal erythrocyte cation transport in essential hypertension.

Net fluxes of sodium and potassium ions were determined in sodium-loaded, potassium-depleted erythrocytes from 370 white subjects, 194 of whom had essential hypertension or had been born to parents with essential hypertension. Findings were compared with those in 86 controls who were normotensive and did not have a family history of hypertension. Compared with controls all patients with essential hypertension had a low sodium to potassium ratio secondary to a deficit in the sodium-potassium cotransport system. A similar abnormality was found in subjects born to parents with essential hypertension, the prevalences of a deficient cotransport system in such subjects being 53.6% (52 out of 97) among those with one hypertensive parent and 73.7% (14 out of 19) among those with two hypertensive parents. Both sexes were equally affected. Studies in 14 families over two or three generations showed the erythrocyte cation abnormality in one or more members of each consecutive generation. No close association was evident between the deficient erythrocyte sodium-potassium cotransport system and either blood groups ABO, Rh, Kidd, Duffy, P, and MNS or the major histocompatibility HLA antigens. Out of 90 consecutive unrelated and normotensive white blood donors, 36 showed a low erythrocyte sodium-potassium net flux ratio. It is concluded that in white people abnormal erythrocyte cation transport is a biochemical disorder characteristic of essential hypertension and transmitted by a dominant and autosomal mode expressing a single abnormal gene.

Adolescent↗