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Biomedical subjects

P Fievet

Publications and source records attributed to P Fievet.

At least 55 records · Page 3Linked to original sources
PubMed1986

Renin-angiotension-aldosterone system, urinary prostaglandins and kallikrein in pregnancy-induced hypertension: evidence for a dysregulation of the renin-angiotensin-prostacyclin loop.

Plasma renin activity (PRA) and aldosterone concentrations were measured simultaneously with urinary excretion of kallikrein and of four prostaglandins (PGE2, PGF2 alpha, 6-keto-PGF1 alpha and TXB2) in 23 patients with pregnancy-induced hypertension (PIH; 17 with permanent PIH (PH) and six with labile PIH (LH), i.e. patients whose hypertension was controlled only by home bed-rest) and in 16 normotensive pregnant women. Plasma renin activity was lower in PH than in controls or in LH. No difference between the three groups was observed for plasma aldosterone and urinary excretion of kallikrein and prostaglandins except that TXB2 was higher in LH than in PH. Thus patients with LH have a different biological profile from that of PH, since they have higher PRA and higher TXB2 excretion, an association that suggests a more pronounced ureteral compression by the gravid uterus in this group. Although no decreased synthesis of vasodilating prostaglandins was found in PH, a dysregulation of the renin-angiotensin-prostacyclin loop is suggested by a negative correlation between PRA and 6-keto-PGF1 alpha. An independent vasopressive substance which would stimulate PGI2 and suppress renin secretion is therefore postulated.

Female↗
PubMed1985

Critical role of oxalate restriction in association with calcium restriction to decrease the probability of being a stone former: insufficient effect in idiopathic hypercalciuria.

The probability of being a stone former (PSF) was calculated in 3 groups of idiopathic calcium stone formers [with normocalciuria (NC), dietary hypercalciuria (DH) and idiopathic hypercalciuria (IH)] in 4 conditions: while on a free diet; on a calcium- and oxalate-restricted diet during 4 days; after an oxalate load, while on a 1.5-gram calcium diet, and after an oxalate load while on a calcium-restricted diet. Combined calcium and oxalate restriction significantly decreased PSF only in NC and DH whereas the decrease was not significant in IH because of a concomitant significant increase in oxalate excretion. Increase of PSF with the oxalate load was significantly greater during a calcium-restricted diet than during the 1.5-gram calcium diet in all groups of patients (4, 6 and 12 times greater in NC, DH and IH, respectively). These data show the critical role of oxalate restriction when calcium is restricted in order to decrease the PSF. This combined restriction is however not sufficient in idiopathic hypercalciuric patients to decrease their PSF.

Calcium↗
PubMed1985

Plasma renin activity, blood uric acid and plasma volume in pregnancy-induced hypertension.

UNLABELLED: Plasma renin activity (PRA), plasma aldosterone (PA), blood uric acid (BUA), plasma concentrations of catecholamines (Pcat) and plasma volume (PV) were measured simultaneously in 24 patients with pregnancy-induced hypertension. This hypertensive group was divided into labile (LH) and permanent hypertension (PH) groups according to the response of their blood pressure to home bed rest. As compared to normal theoretical values, PV was decreased in both hypertensive groups (LH = -70%; PH = -14%). As compared to a control group of 16 normotensive pregnant women, PRA was higher in LH and lower in PH whereas PA was lower in both hypertensive groups. In both hypertensive groups, BUA was higher than in the control group. No difference in Pcat was found between the three groups. In the PH group negative correlations were found between BUA and PRA, as well as between BUA and PV, but no correlation between PRA and PV nor between Pcat and BUA were found. CONCLUSIONS: LH and PH are two pathophysiologically different entities in pregnancy-induced hypertension. In PH, renin secretion is not appropriate to hypovolemia and therefore not primarily involved in the pathogenesis of hypertension. The role of hypovolemia in the increase of BUA may be discussed.

Female↗
PubMed1985

Renin angiotensin aldosterone system, urinary prostaglandins and kallikrein in pregnancy induced hypertension. Evidence for a disregulation of the renin-angiotensin-prostacyclin loop.

Plasma renin activity and aldosterone concentrations were measured simultaneously with urinary excretion of kallikrein and four prostaglandins (PGE2, PGF2 alpha, 6 keto PFG1 alpha and TXB2) in 23 patients with pregnancy induced hypertension (17 with permanent PIH and six with labile PIH, since in these latter their hypertension was controlled only by home bed rest) and in 16 normotensive pregnant women at the same stage of gestation (31 +/- 3 weeks). PRA was lower in permanent PIH than in controls and in labile PIH. No difference between the three groups was observed for plasma aldosterone and the urinary excretion of kallikrein and of the prostaglandins except that TXB2 was higher in labile PIH than in permanent PIH. Correlation studies of kallikrein disclosed correlations with most prostaglandin excretions, explained by the physiological stimulation of phospholipase A2 by kallidin. Correlation studies of PRA disclosed unexpected negative correlation with PGE2 and 6 keto PGF1 alpha in the permanent PIH group. In conclusion, labile PIH has a different biological profile than permanent PIH since they have higher PRA and higher TXB2 excretion, an association which suggests a more pronounced ureteral compression by the gravid uterus in this group. Permanent PIH has a disregulation of the renin angiotensin-prostacyclin loop since PRA and 6 keto PGF1 are negatively correlated. This suggests the role of an independent vasopressive substance which would stimulate PGI2 and suppress renin secretion.

Female↗
PubMed1985

[Medical treatment of idiopathic calcium lithiasis (I)].

Calcium stones is responsible for 80 per cent of the stones in the upper track. It is a frequent and particularly recurrent disease and for this reason it is important to prevent its recurrence by medical treatment, dissolution of calcium stones being impossible. In the first part of this review, we have presented the theoretical basis and the clinical studies concerning conservative therapy involving high fluid intake and dietary advice on calcium and oxalate intake. Then, for the various drugs proposed for recurrence prevention we have reviewed their mechanisms of action and the controlled clinical trials concerning these drugs. Finally, the practical therapeutical choices for the management of these patients are presented according to the results of the previous metabolic evaluation.

Calcium Oxalate↗
PubMed1985

Magnesium renal wasting in calcium stone formers with idiopathic hypercalciuria contrasting with lower magnesium:calcium urinary ratio.

Plasma magnesium (PMg) and urinary calcium (UCaV) and magnesium (UMgV) were measured after four days of calcium-restricted diet in 60 controls and 82 patients classified according to their calcium excretion in three groups: normo-calciuric (NCa), dietary hypercalciuria (DH) and idiopathic hypercalciuria (IH). When compared to controls, higher UMgV (4.26 +/- 0.28 mmol/d versus 3.4 +/- 0.16, p less than 0.01), lower PMg (0.79 +/- 0.01 mmol/d versus 0.84 +/- 0.01, p less than 0.05) and lower UMg/UCa ratio (0.6 +/- 0.04 versus 1.68 +/- 0.15, p less than 0.001) were observed only in IH. A significant correlation between UMgV and UCaV was found in controls, in NCa and in DH but not in IH. In conclusion, (1) the coexistence of a higher UMgV and of a lower PMg in IH suggests that there is a magnesium depletion in this group of patients; (2) since the lower UMg/UCa ratio may favour a higher propensity for calcium crystallisation and is seen only in IH, magnesium supplements may be specially indicated in this group.

Calcium↗
PubMed1984

[Monitoring therapeutic arteriovenous fistulas in chronic hemodialysis patients. Value of the continuous Doppler test combined with real-time echotomography].

Continuous doppler investigation of functioning of therapeutic arteriovenous fistula is a well-established routine. The availability for the last few years of high frequency (10 mg/Hz) real-time ultrasound has enabled visualization of superficial arteries and veins. Total afferent and efferent branches of these therapeutic fistulae can be visualized. Examination should therefore include continuous doppler recordings combined with real-time ultrasound of both transverse and sagittal sections of the different arteries and veins participating in the fistula. The indication for examination is clinical in cases with low or high output or during the immediate postoperative period to detect early thrombosis.

Arteriovenous Shunt, Surgical↗
PubMed1984

[Physiopathology of pregnancy-induced hypertension].

Even though multiple factors are involved in arterial blood pressure elevation, during pregnancy-induced hypertension normal physiologic processes are occurring in the uteroplacental unit. These appear probably very early in pregnancy. Treatment of pregnancy-induced hypertension at the present time is directed simply at lowering the blood pressure. It should be emphasized that only one placebo-controlled study has demonstrated a beneficial effect of antihypertensive treatment for the fetus in moderate pregnancy-induced hypertension. Future treatment very likely will be preventive, administered from the onset of pregnancy in a high-risk patient.

Catecholamines↗
PubMed1983

Renovascular hypertension: easier diagnosis and treatment with intravenous renal arteriography and percutaneous transluminal dilatation.

For the diagnosis of renovascular disease, the authors propose the use of intravenous arteriography with photographic subtraction as the method of choice and advise the use of pyelogram wash-out to assess the functional significance of the stenosis. Furthermore they report their experience with percutaneous transluminal dilatation in 41 patients (10 fibrotic--31 atherosclerotic renal artery stenoses) and suggest that this method is valid alternative to surgery specially in poor risk patients. A controlled trial of this method versus surgery needs however to be undertaken to define the respective roles of these treatments.

Adolescent↗
PubMed1983

Plasma renin activity, blood uric acid and plasma volume in pregnancy-induced hypertension.

UNLABELLED: Plasma renin activity (PRA), plasma aldosterone (PA), blood uric acid (BUA), plasma concentrations of catecholamines (Pcat) and plasma volume (PV) were measured simultaneously in 24 patients with pregnancy-induced hypertension (PIH). This hypertensive group was divided into labile (LH) and persistent hypertension (PH) groups according to the response of their blood pressure to home bed rest. Compared to normal theoretical values, PV was decreased in both hypertensive groups (LH = -7%; PH = -14%). Compared to a control group (C) of 16 normotensive pregnant women, PRA was higher in LH and lower in PH whereas PA was lower in both hypertensive groups. BUA was higher than in C in both hypertensive groups. No difference in PCat was found between the three groups. In the PH group negative correlations were found between BUA and PRA, as well as between BUA and PV but no correlation between PRA and PV nor between Pcat and BUA were found. IN CONCLUSION: LH and PH are two pathophysiologically different entities in PIH. In PH renin secretion is not appropriate to hypovolaemia and therefore not primarily involved in the pathogenesis of hypertension. Hypovolaemia may play a role in the increase of BUA in PIH.

Adult↗
PubMed1983

[Blood gas and acid-base changes and rhythmologic tolerance of acetate and bicarbonate hemodialysis using a standard dialyser with high sodium and control of ultrafiltration].

In order to demonstrate a possible superiority of bicarbonate dialysis (HDB) over acetate dialysis (HDA) in conditions of standard dialysis (4 hours on a 1 m2 cuprophan dialyser) but with a bath rich in sodium (143 mEq/l) and control of ultrafiltration, we have compared 2 sequences of 3 runs of HDA and HDB with these conditions in 8 patients as regards their acido-basic and cardiologic parameters (continuous monitoring of ECG by Holter, regular measurement of blood pressure). Acid base balance study in AHD led to the distinction of 2 groups according to wether their plasma bicarbonate increased or decreased during the run. Rythmological tolerance was the same in BHD and AHD, wether all patients or both groups were considered. Heart rate was however slightly but significantly higher during AHD than during BHD, in the patients whose plasma bicarbonate decreased. In conclusion, the benefit of HDB is not remarkable when HDA is performed not only in standard conditions but also with a bath rich in sodium and with control of ultrafiltration.

Acetates↗