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Biomedical subjects

P Baumgart

Publications and source records attributed to P Baumgart.

At least 73 records · Page 4Linked to original sources
PubMed1985

Primary aldosteronism: diagnosis and noninvasive lateralization procedures.

In 72 patients with primary aldosteronism who were classified on the basis of adrenal pathology after adrenalectomy, analysis of routine clinical and laboratory data, of supine and upright plasma aldosterone, and of plasma renin activity were of limited value in differentiating patients with aldosterone-producing adenoma(s) (APA, n = 59) from those with idiopathic adrenal hyperplasia (IAH, n = 13). Normokalemic aldosteronism occurred in 6 patients (3 APA, 3 IAH). A correct classification of the adrenal lesion(s) was obtained in 80% of the patients by computed tomography and only in 69% by adrenal scintiscan. In addition, adrenal scintiscan was hampered by a relatively high rate of incorrect results independent of whether dexamethasone was used or not. Small adenomas (less than 1 cm) and more often adrenal hyperplasia may escape visualization by computed tomography.

Adenoma↗
PubMed1985

Pathogenetic aspects of hypertension in Cushing's syndrome.

Abnormalities of the renin-angiotensin-aldosterone system (RAAS) were observed in hypertensive patients suffering from Cushing's syndrome. In 12 patients with different etiology of Cushing's syndrome renin substrate concentration and urinary-free cortisol, as well as the circadian rhythms of plasma cortisol, aldosterone and plasma renin activity were measured. Plasma renin substrate concentrations were found elevated in all but 1 patient, while plasma renin activity was elevated, normal or lowered. Plasma aldosterone values were found in the lower normal range. A physiological rhythm of cortisol secretion was not observed in any patient with Cushing's syndrome, while plasma aldosterone was secreted episodically mostly within the normal range. We conclude that changes of the RAAS may not be predominantly responsive for hypertension in Cushing's syndrome; other factors like circulating catecholamines are probably of greater importance for the pathogenesis of blood pressure elevation in hypercortisolemic patients.

Adolescent↗
PubMed1985

Intracellular sodium and calcium during antihypertensive treatment.

In 49 untreated essential hypertensives the effects of the loop diuretic, piretanide, in a dose of 12 mg daily (n = 14) and of 6 mg daily (n = 18) as well as of beta blockers (pindolol, metipranolol, atenolol, n = 17) on blood pressure, intracellular Ca++ and Na+ activity in red blood cells were examined. Intracellular ion activities were measured by ion-selective electrodes. The higher dose of piretanide caused a decrease of intracellular Ca++ activity and an increase of intracellular Na+ activity. Under the lower dose of piretanide there was a comparable decrease of intracellular Ca++ activity but no significant change of intracellular Na+ activity. Beta blockers decreased intracellular Ca++ activity but left intracellular Na+ activity unchanged. It is concluded that intracellular free Ca++ plays an important role in the regulation of vascular tone in essential hypertension. There seems to be no direct relation between intracellular free Na+ and blood pressure under antihypertensive therapy.

Adrenergic beta-Antagonists↗
PubMed1984

[Glomerular proteinuria in pregnancy hypertension].

In view of the lack of reliable diagnostic parameters for predicting pregnancy-induced hypertension (PIH) the aim of this study was to test the prognostic value of electrophoretic urinary protein patterns. Based on experience with this method in nephrology, molecular weight related polyacrylamide-gel-electrophoresis (PAGE) of urinary proteins was used to distinguish between the different kinds of renal lesions (glomerular, tubular, combination, extrarenal). The analysis was carried out in two independent groups: urines of 126 non-selected pregnant women (1st group) were analysed at regular intervals. By chance, none of them had a history of previous PIH or hypertension, nor any signs of impaired renal function before or during the present pregnancy. In a 2nd group 124 women after severe PIH (pd greater than or equal to 110 mm Hg) were examined in part using PAGE, postpartum renal biopsy and long-term clinical follow up (greater than or equal to 1 year after PIH). In 29/124 cases data for all mentioned parameters was collected. 24 women of the prepartum group developed an electrophoretic pattern characteristic of glomerular proteinuria, which was persistent once found. PIH appeared greater than or equal to 8 weeks after the appearance of this pathological pattern in 15/24 women of this subgroup; 5 of 9 remaining women developed PIH in a subsequent pregnancy. None of the 102 women with other protein patterns developed PIH. In the 2nd group a close relationship was found between the glomerular protein patterns 0.5 to 3 years after PIH, clinical long-term follow up and renal biopsies about 1 year after PIH.(ABSTRACT TRUNCATED AT 250 WORDS)

Electrophoresis↗
PubMed1984

Intracellular calcium in essential hypertension. A parameter for assessing effective antihypertensive treatment.

The effects of the loop diuretic piretanide on blood pressure and intra-erythrocytic free Na+ and Ca2+ were examined in 14 essential hypertensives. Intra-erythrocytic Ca2+ activity was found to decrease (P less than 0.01) and Na+ activity to increase (P less than 0.05). In spontaneously hypertensive rats (SHRs) hypovolaemia abolished the humoral transmission of hypertension to normotensive rats. Therefore the decrease in intracellular Ca2+, which may be responsible for the diminished vascular tone under diuretic treatment, could be mediated by a suppression of humoral factors due to diuretic-induced hypovolaemia.

Adult↗
PubMed1983

[Clonidine transdermal therapeutic system in essential hypertension: effect and tolerance].

The antihypertensive efficacy and side effects of a transdermal therapeutic system containing 2.5 mg clonidine (clonidine-TTS) was investigated in 21 patients with essential hypertension over a period of 10 weeks. The system was designed to release 0.1 mg clonidine/24 h. Mean systolic and diastolic blood pressure fell from 160 +/- 17/106 +/- 7 mm Hg to 139 +/- 16/91 +/- 8 mm Hg after 4 weeks and to 135 +/- 14/89 +/- 8 mm Hg after 10 weeks (p less than 0.001). Sufficient blood pressure control was achieved by one clonidine-TTS weekly in 24% and by 2 clonidine-TTS in 33% of the patients. 43% of all cases required additional oral therapy with 50 mg hydrochlorothiazide/day. However, antihypertensive action was accompanied by a high incidence of local skin reactions. These skin reactions with erythema, itching and red papules occurred in 6 of the 21 patients (29%) after treatment with TTS for at least 4 weeks. Patch testing with the various components of clonidine-TTS in 4 patients identified clonidine-allergy of delayed type in 3 cases. Typical clonidine side effects such as fatigue, dry mouth, constipation and sexual disturbances were moderate. It is concluded that clonidine-TTS has a good and continuous antihypertensive action. However, the high incidence of skin reactions limits its use in the treatment of essential hypertension.

Adult↗
PubMed1983

Obesity, hypertension and intracellular electrolytes.

Intracellular activities of sodium and calcium were determined in red cells of patients with obesity. Compared to normal people mean intracellular sodium and calcium were higher in obese patients. However, increased intracellular sodium and calcium could only be observed in those patients with obesity suffering from hypertension or showing a familial disposition to hypertension. In contrast there was no difference in intracellular sodium and calcium between obese normotensives lacking a familial disposition to hypertension and normal people. Thus, our results suggest, that the observed variations in intracellular sodium and calcium in obesity are due to an enhanced blood pressure or a familial disposition to hypertension and not specific for obesity.

Calcium↗
PubMed1983

Epithelial abnormalities in the renal pelvis in experimental hydronephrosis and pyelonephritis.

Unilateral hydronephrosis was induced by temporary ligature of the left ureter in 29 rabbits. In 21 animals so treated, chronic pyelonephritis was simultaneously induced by intravenous application of a suspension of E. coli. Histologic examination of renal pelvic epithelia in animals killed four weeks after the surgical intervention, revealed the following features: 1. Simple hyperplasia of urothelium in 12 cases, 2. atypical hyperplasia - (dysplasia) of urothelium in 10 cases, 3. v. Brunn's nests in 20 renal pelvises; 11 cases of cystic pyelitis, all combined with Brunn's nests, 4. metaplastic transformation of visceral mono- or bilayered epithelium into multi-layered urothelium-like structures in 19 renal pelvises. These changes are observed almost exclusively in the left renal pelvis of animals subjected to temporary ureteral ligature. Atypical urothelial hyperplasia is found only together with chronic pyelonephritis. Hyperplastic and dysplastic epithelial changes in the renal pelvis, the formation of Brunn's nests, and cystic pyelitis are interpreted as sequelae of postrenal obstruction or concomitant chronic inflammation.

Animals↗
PubMed1983

Clonidine through the skin in the treatment of essential hypertension: is it practical?

The antihypertensive effects and side-effects of a clonidine transdermal therapeutic system (clonidine-TTS) were examined over 10 weeks in 22 patients with essential hypertension. The clonidine-TTS containing a 2.5 mg drug reservoir was designed to release 0.1 mg clonidine/24 h for seven days through a micropore rate-controlling membrane. In the total group mean systolic and diastolic blood pressure decreased from 162 +/- 14/106 +/- 4 mmHg to 137 +/- 17/92 +/- 8 mmHg after four weeks and 136 +/- 13/90 +/- 7 mmHg after 10 weeks (P less than 0.001). Five patients (23%) responded well to one clonidine-TTS (diastolic blood pressure less than or equal to 95 mmHg) and seven patients (32%) needed two clonidine-TTS. Additional oral therapy with 50 mg hydrochlorothiazide/day resulted in reduction of blood pressure to normal in six of the remaining 10 patients. This good pressure response was, however, accompanied by a high incidence of local allergic skin reactions of delayed type (type IV) in seven (32%) of the 22 cases. Patch testing with various components of clonidine-TTS which was performed in four of the seven patients showed in three cases allergic contact dermatitis to clonidine. Our results demonstrate a good and sustained antihypertensive action of clonidine-TTS. However, the extraordinarily high incidence of skin allergy to clonidine limits its use in the treatment of essential hypertension.

Administration, Topical↗
PubMed1983

Sodium and calcium in lymphocytes and erythrocytes in essential hypertension.

The present study compared protein-related sodium concentrations in lymphocytes with the sodium and calcium activities in erythrocytes from 12 untreated patients with essential hypertension and 15 normal control subjects. It appeared that protein-related Na+ in lymphocytes was elevated about threefold in essential hypertensives. Comparable increases were also noted in intracellular Na+ and Ca2+ activities. The correlation between Na+ in lymphocytes and in erythrocytes was not close. These results suggest that the determination of protein-related Na+ in lymphocytes discriminates between normotensives and essential hypertensives as well as measurements of ion activities in erythrocytes. Altered intracellular ion binding may be partly responsible for the changes in intracellular protein-related Na+.

Calcium↗