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Biomedical subjects

P Fievet

Publications and source records attributed to P Fievet.

65 records · Page 4Linked to original sources

Renin angiotensin aldosterone system and adrenergic system in normotensive and hypertensive pregnancy.

We have measured simultaneously plasma renin activity (PRA), aldosterone and catecholamines in the plasma of 3 groups of pregnant women after the 20th week: group 1 of 16 normotensive controls, group II of 17 women with rest responding hypertension (RRH), group III of 18 women with permanent hypertension (PIH). All the patients were ambulatory on a normal salt diet. PRA was significantly higher in the RRH than in the control and PIH groups (15,8 +/- 2,3ng/ml/l versus 6,7 +/- 0,5 and 8,9 +/- 0,9 respectively). Plasma epinephrine (PE) and norepinephrine (PNE) were significantly higher in the PIH than in the control and RRH groups (respectively 135 +/- 28 pg/ml versus 56 +/- 13 and 63 +/- 17 for PE and 387 +/- 91 versus 206 +/- 32 and 200 +/- 47 pg/ml for PNE). In the PIH group there was a negative correlation between PRA and blood uric acid. It is concluded that the adrenic system is activated in PIH whereas the renin angiotensin system is activated in RRH of pregnancy.

Adult↗

Lack of antagonism in the antihypertensive effects of clonidine and prazosin in man.

1. In four patients, whose hypertension was not controlled (supine blood pressure greater than 150--90 mmHg) by addition of 5 mg/day of prazosin to previous treatment (diuretics and beta-blockers), clonidine (150--450 microgram/day) led to control of hypertension in three cases. 2. In ten patients whose hypertension was not controlled by a treatment including clonidine (300--450 microgram/day), the progressive addition of prazosin to a maximal dose of 4--22.5 mg/day led to control of hypertension in nine cases (mean supine blood pressure decreased from 174--102 to 144--88 mmHg). 3. In 13 hospitalized patients, clonidine was abruptly interrupted whereas prazosin was continued. Mean blood pressure (+/- SEM) rose from 145 +/- 1/85 +/- 2 to 169 +/- 7/104 +/- 5 mmHg 48 h after clonidine withdrawal whereas plasma noradrenaline and adrenaline rose from 328 to 758 pg/ml and from 75 to 137 pg/ml. No subjective symptoms were noted. There was a negative correlation between blood pressure increase and the dose of prazosin. 4. It is concluded that (a) there is no antagonism between clonidine and prazosin in their antihypertensive action in man when used at usual clinical doses, (b) a protective effect of prazosin against an eventual clonidine withdrawal syndrome is suggested by the negative correlation between blood pressure increase and the dose of prazosin.

Adult↗

[Control of hypertension and blood lactate during exercise. Comparison of central antihypertensive agents with the cardio-selective beta blockers metoprolol and atenolol].

To assess whether betablockers (BB) would better control blood pressure than central antihypertensive drugs (CAD) clonidine or alpha methyldopa in hypertensive patients during exercise, comparable triangular ergometric bicycle exercises were performed by the same patients while their hypertension had been controlled at rest either with CAD or BB. Blood pressure, heart rate and blood lactate before and during exercise were compared in II patients treated with metoprolol and CAD, and in 12 other patients treated with atenolol and CAD. Systolic and diastolic blood pressure on exercise were significantly lower with BB than with CAD. Heart rate and rate-pressure product were always lower with BB than with CAD. Blood lactate increase was greater with BB than with CAD. The work capacity was greater with atenolol than with CAD, but comparable between metoprolol and CAD.

Adrenergic beta-Antagonists↗

[Intravenous pyelography with visualization of renal arteries and pyelogram wash-out, as the method of choice for the diagnosis of renovascular hypertension (author's transl)].

The authors review the various techniques of intravenous arteriography before an excretory urogram and discuss their role in the etiological diagnosis of hypertension. Detection of renovascular disease classically implied Seldinger arteriography, with its limited indications, because of side effects and cost. This classical approach should now be systematically replaced by the visualization of renal arteries during the intravenous pyelography procedure which appears to be a method more effective, as well as less expensive and hazardous. The pyelogram wash-out should still be performed when the visualization of the renal arteries is poor because of its value in the screening for renovascular hypertension. Furthermore, when a renal artery stenosis is clearly defined, the wash-out of the pyelogram should also be performed because of its prognostic value. As the classical approach for the etiological diagnosis of hypertension, this technique has limited indications. It is indicated in severe hypertension in the young, when medical treatment does not control blood pressure satisfactorily or when renal failure progresses rapidly. Furthermore, this technique allows a non traumatic follow up of operated or dilated stenoses.

Cost-Benefit Analysis↗

[Diuretics and vascular risk factors. Comparison between tienilic acid and chlorothiazide (author's transl)].

Tienilic acid (250 mg/day) was compared with chlorothiazide (500 mg/day) in 25 hypertensive patients in a randomized cross-over study (2 periods of 2 months). Mean supine arterial pressure was lower with tienilic acid than with chlorothiazide (106 +/- 3 vs 111 +/- 3 mm Hg, p less than 0.05) whereas no difference could be noted in body weight, natriuresis and plasma renin activity. Glucose tolerance tests were altered in the same fashion. Serum cholesterol (234 with tienilic acid and 239 mg/dl with chlorothiazide) and serum triglyceride levels (178 with tienilic acid and 179 mg/dl with chlorothiazide) were not different. Serum urate concentrations were lower with tienilic acid (4.8 mg/dl) than with chlorothiazide (7.8 mg/dl) whereas fractional excretion of urate was much higher with tienilic acid (17 +/- 2%) than with chlorothiazide (7 +/- 2%). Thus, the only metabolic advantage of tienilic acid over chlorothiazide is its hypouricemic effect which warrants long term studies to evaluate its vascular prognostic significance.

Adult↗

Response of ion-selective sodium and potassium electrodes in the Beckman Astra 4 and Astra 8 analyzers.

We tested the response of ion-selective sodium and potassium electrodes that are a part of the new multi-channel chemical analyzers, Astra 8 and Astra 4 (Beckman). For this we used plain and albumin-containing aqueous solutions of known Na+ and K+ concentrations, varied inversely so we could assess how the concentration of each electrolyte would affect the response of the other electrode. The stability of the electrodes with time was good and the electrodes are indeed selective for Na+ and K+.

Autoanalysis↗

Parallel evaluation of Astra 8 and Astra 4 multichannel analyzers in two hospital laboratories.

We evaluated the new Beckman multichannel analyzers Astra 8 and Astra 4. Both instruments performed the following tests: Na, K, Cl, CO2, urea, glucose, and creatinine in plasma and Na, K, Cl, and creatinine determinations in urine. We tested precision, accuracy, and linearity at the usual concentrations in plasma and urine. We compared the Astra 8 and Astra 4 with continuous-flow (SMA 6) and discrete analyzers such as IL 243, Beckman KLiNa Flame, Beckman System 1, Corning 920 M Chloride Meter, and the Corning Blood-Gas Analyzer 175. Special tests were performed on plasma-to-plasma and urine-to-plasma carryover. Both analyzers are easy to operate and suitable for both emergency and routine use.

Autoanalysis↗

[A case report of Cardiobacterium hominis endocarditis].

We here report a case of endocarditis due to Cardiobacterium hominis in a 53-year-old patient, who presented with large vegetations on the mitral valve. Good cooperation between clinicians and microbiologists and an efficient automated blood culture system were the decisive factors in establishing the diagnosis. Early and appropriate treatment prevented the septic embolisms often observed in this pathology.

Amikacin↗