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Biomedical subjects

P Boutros

Publications and source records attributed to P Boutros.

7 recordsLinked to original sources

Role of nitric oxide in the attenuated pressor responses of pregnant or sodium-deplete sheep.

Reduced pressor responsiveness to angiotensin II (Ang II) during pregnancy and sodium depletion is a well-known but little understood phenomenon; whether the same mechanisms are involved in both situations is unclear. In pregnant humans, altered vascular reactivity to norepinephrine (NE) has also been demonstrated. Nitric oxide (NO) has been implicated in the modulation of blood pressure (BP) and the maintenance of vascular tone and may be involved in these attenuated responses. We examined the role of NO in the pressor responses to (a) Ang II (5, 10, 25, 50 micrograms/h) and NE (0.32, 0.65, 1.62, 3.24 mg/h) in pregnant and postpartum sheep, and (b) to Ang II (5, 7, 5, 10, 25, 50 micrograms/h) in sodium-replete sheep and sheep made sodium deplete by 24 h of parotid salivary drainage. Vascular NO production was inhibited by pretreatment with N omega-nitro-L-arginine (NOLA 10 mg/kg), a NO-synthase inhibitor. Pregnancy significantly reduced (p < 0.001) pressor responses to Ang II, which ranged from 5.1 +/- 0.2-30.6 +/- 1.2 mm Hg as compared with postpartum increases of 10.3 +/- 0.5-52.2 +/- 3.4 mm Hg. Pretreatment with NOLA partially restored Ang II responses to postpartum levels. Pregnancy did not alter pressor responses to NE. Sodium depletion also significantly reduced responses to Ang II by the same amount as in pregnancy, and these responses returned to normal with pretreatment with NOLA. NO thus has a role in modulating the attenuated pressor responses to Ang II in pregnant and sodium-deplete sheep.

Angiotensin II↗

Bacteriuria localization and response to single-dose therapy in women.

One hundred women with bacteriuria had the infection localized by the "bladder-washout" technique. Thirty-six of the 39 with infection confined to the bladder were cured with a single intramuscular injection of 500 mg of kanamycin sulfate, whereas 47 of the 65 patients with infection originating from their upper tract relapsed almost immediately. None of the seven patients with abnormal pyelograms and associated upper tract infection was cured with kanamycin. These results suport the hypothesis that bladder infections in women can be readily cured with a very short course of therapy. Women who relapse after a single injection of kanamycin almost always have renal infection.

Adolescent↗

A comparison of trimethorprim-sulfamethoxazole with sulfamethoxazole alone in infections localized to the kidneys.

Ninety patients with urinary tract infections were treated in a randomized double-blind study with either a combination of trimethoprim and sulfamethoxazole (TMP-SMX) or sulfamethoxazole alone (SMX). Thirty of 42 patients treated with TMP-SMX were cured by the time of follow-up compared with 26 of 48 treated with SMX alone. Of the 29 patients infected with SMX-resistent organisms, the combination TMP-SMX cured 12 of 17, whereas SMX alone cured 2 of 12. Of the 61 patients infected with SMX-sensitive organisms, TMP-SMX cured 18 of 25; SMX alone cured 24 of 36. In 50 women the infection was found localized to The upper urinary tract by the use of the Fairley bladder washout technique. TMPsmx cured 16 or 24 of these patients with proved upper tract infections and SMX alone cured 11 of 26. Although none of these differences were significant, TMP-SMX appears to be an effective drug combination for the therapy of proved upper tract infection and is also effective in eradicating sulfonamide-resistant organisms.

Administration, Oral↗