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Biomedical subjects

R Naeije

Publications and source records attributed to R Naeije.

At least 163 records · Page 9Linked to original sources
PubMed1979

Enhancement of the amylase-creatinine clearance ratio in pregnancy.

The renal clearance of amylase, expressed as a proportion of simultaneous creatinine clearance (Cam/-Ccr), was determined in 131 women in various stages of pregnancy. No abnormal serum levels of amylase were found. A moderate but significant increase in Cam/Ccr occurred during the last 15 weeks of pregnancy. Possible causes for this change were investigated in smaller groups of subjects. No increase in rapidly cleared isoamylase could be detected. No modification in renal tubular handling of protein could be evidenced, as assessed by measurements of the renal clearance of beta 2 microglobulin, expressed as a proportion of simultaneous creatinine clearance. An incrased glomerular permeability to amylase probably accounts for elevated Cam/Ccr in pregnancy.

Adolescent↗
PubMed1978

Is nasogastric suction necessary in acute pancreatitis?

Fifty-eight patients with mild to moderately severe acute pancreatitis were randomly allocated to treatment with or without nasogastric suction (27 and 31 patients respectively). Intravenous fluids and pethidine hydrochloride were also given. The two groups were comparable clinically at the start of the study. There were no differences between the two groups in the mean duration of the following features: abdominal pain or tenderness; absence of bowel movements; raised serum amylase concentration; time to resumption of oral feeding; and days in hospital. Prolonged hyperamylasaemia (serum amylase greater than 0.33 mU/l) occurred in one patient in the suction group and in three patients in the non-suction group. A mild recurrence of abdominal pain after resumption of oral feeding occurred in three patients in the suction group and in two patients in the non-suction group. Two patients in the suction group developed overt consumption coagulopathy and two others pulmonary complications. No patient in the non-suction group had complications. The findings suggest that most patients with mild to moderately severe acute pancreatitis do not benefit from nasogastric suction. The procedure should be elective rather than mandatory in treating this condition.

Acute Disease↗
PubMed1978

Pituitary-thyroid axis during short term, mild and severe, iodine depletion in the rat.

To investigate the most early events occurring during the adaptation of the pituitary-thyroid axis to iodine depletion, two rat populations were submitted to 4 week low iodine regimens of different severity. The variations of the following parameters were studied: pituitary thyrotropin (TSH) concentration, serum thyroxine (T4), triiodothyronine (T3) and TSH, thyroid weight and thyroid iodine concentration. In the first population, mildly iodine depleted, serum and pituitary TSH remained unchanged. The weight of the thyroid increased by the 12th day. Serum T4 dropped by the 26th day. Serum T3 tended to increase during the whole observation period. In the second population, more severely iodine depleted, the increase in thyroid weight appeared by the 4th day. Serum T3 increased from day 13 to day 20, then returned to normal. Serum TSH increased and serum T4 decreased by the 20th day. These results suggest that, in the adaptation to iodine deficiency in the rat, autonomous thyroid regulatory mechanisms play a major role at the onset of goiter growth. On the other hand, most likely a combined effect of serum T3 and T4 triggers variations in pituitary TSH secretion.

Animals↗
PubMed1978

A low T3 syndrome in diabetic ketoacidosis.

The pituitary-thyroid axis was investigated in nineteen euthyroid patients with severe diabetic ketoacidosis. A 'low T3 syndrome' was found, with the following characteristics: lowered serum concentrations of triiodothyronine (T3), increased reverse triiodothyronine (rT3), slightly low thyroxine (T4), normal thyrotrophin (TSH), slightly increased triiodothyronine uptake (RT3U) values, and a blunted TSH response to thyrotrophin-releasing hormone (TRH). These disturbances in thyroid-function tests required several days good control of the diabetes to be corrected, at least partially. The data suggest the presence of an abnormal extrathyroidal T4 metabolism as well as a pituitary defect. Caution is recommended in the interpretation of thyroid-function tests during and several days after the treatment of diabetic ketoacidosis.

Adult↗
PubMed1978

Thyrotrophin, prolactin and growth hormone responses to TRH in barbiturate coma and in depression.

The effects of 200 microgram thyrotrophin-releasing hormone (TRH) i.v. on thyrotrophin (TSH), prolactin (PRL), growth hormone (GH) and triiodothyronine (T3) were studied in eight patients with barbiturate coma due to attempted suicide, in the same patients after recovery, in eight depressive patients and in eight normal controls. The patients with barbiturate coma presented normal basal TSH and PRL, elevated basal GH and normal PRL but blunted TSH responses to TRH; their GH concentrations varied widely without consistent relation to TRH administration. The same patients after recovery from coma presented normal TSH and PRL, slightly elevated basal GH, and normal PRL but blunted TSH responses to TRH; in four of these patients, a clear-cut rise in GH (i.e. more than 10 ng/ml) occurred after TRH administration. The depressive patients presented normal basal TSH and PRL, slightly elevated basal GH, and normal PRL but blunted TSH responses to TRH; in four of these patients, a moderated rise in GH (less than 10 ng/ml) occurred after TRH administration. The increment in T3 concentrations 120 min after TRH was found reduced in the comatose patients only. Basal cortisol was measured in all the subjects and found elevated in the comatose patients only. It is concluded that the abnormal TSH and GH responses to TRH observed in patients with barbiturate coma are more likely related to depressive illness than to an effect of barbiturates at the pituitary level. Barbiturates might affect thyroid secretion.

Adolescent↗
PubMed1978

Morel's laminar sclerosis.

A 49-year-old alcoholic woman was admitted for convulsions. She died after a 4-week clinical course characterized by a persistent coma with diffuse muscular hypertonia. Post-mortem examination of the brain demonstrated a spongy degeneration and gliosis of the cerebral cortex, limited to the 3rd and the 4th layers. No other pathological lesion of the central nervous system could be objectivated. This is the first reported case in which Morel's laminar sclerosis was the only manifestation of 'alcoholic encephalopathy'. Morel's syndrome should be considered as a pathological entity separate from the Marchiafava-Bignami disease.

Alcoholism↗
PubMed1978

Impairment of pulmonary function in acute pancreatitis.

Arterial blood gas levels, lung volumes, and diffusing properties for carbon monoxide were measured in 22 patients with uncomplicated acute pancreatitis who had no clinical or radiographic evidence of pulmonary involvement. Mild arterial hypoxemia (less than 75 mm Hg) was present in four patients. The mean values of inspiratory lung volumes were clearly reduced, and the diffusing properties were sharply altered; the mean value for the diffusing capacity of carbon monoxide per unit of lung volume (Krogh's constant [KCO]) was 78 percent of predicted. Four patients with a low KCO in the first four days after an acute episode had normal values when reevaluated one week later. These findings suggest the occurrence, even in mild acute pancreatitis, of transient pulmonary injury mainly localized at the level of the capillaries, leading to decreased gas transfer.

Acute Disease↗
PubMed1977

Lactic acidosis complicating diabetic ketosis in a patient with hyperthyroidism.

The present report describes a patient with insulin-dependent diabetes who developed simultaneously lactic acidosis and ketoacidosis following insulin deprivation. Administration of insulin at low doses rapidly corrected both ketosis and lactic acidosis. There had been neither circulatory collapse, nor phenformin intake, and hepatic function was normal. The development of lactic acidosis in this case was possibly precipitated by hyperthyroidism. A review of the literature indicates that lactic acidosis is a very rare complication of diabetic ketosis per se.

Acidosis↗
PubMed1976

Treatment of diabetic coma with small intravenous insulin boluses.

The clinical efficacy of small intravenous boluses of insulin in treating diabetic decompensation was tested in 23 patients presenting in either a ketoacidotic or a nonketotic diabetic coma. In addition to the usual ionic and fluid replacement, the patients received hourly intravenous injections of insulin 5 IU. This dose lowered blood glucose levels in all but two patients. In the patients who responded the percentage decrease in glycaemia was similar whatever the initial glucose concentration and averaged (+/-SE of mean) 50+/-3% in five hours. Close monitoring of insulin and glucose concentrations after intravenous insulin in three patients showed that despite the short half life of insulin the effect of the intravenous bolus lasted for about 60 minutes. The overall clinical effectiveness of this type of treatment is comparable to that of the other low-dose regimens. Owing to its simplicity, this technique of insulin administration seems most suitable for the routine treatment of diabetic coma.

Blood Glucose↗
PubMedDate not supplied

Alterations in circulating thyroid hormones and thyroxine-binding globulin levels during diabetic ketoacidosis.

During diabetic ketoacidosis, in 17 adult patients, significant decreases in serum TBG and total T4 levels were observed, without significant alteration of the T4 to TBG binding property. In addition, serum free T4 (FT4) was moderately elevated and the TSH response to TRH was markedly blunted. No correlation, however, was found between TSH blunting and FT4 elevation. Correlation of these serum anomalies required at least 5 days of adequate control of the diabetes. Thus, diabetic ketoacidosis in euthyroid patients is characterized by multiple alterations in thyroid function parameters and caution is recommended in the interpretation of thyroid tests during and in the days following this severe metabolic disorder.

Adult↗
PubMedDate not supplied

Central and regional hemodynamic effects of nitrendipine in normotensive patients with chronic obstructive lung disease.

Central and regional hemodynamic studies were performed before and after administration of nitrendipine, a recently introduced calcium-channel blocker, in 10 normotensive patients with chronic obstructive pulmonary disease. None of them had a mean pulmonary artery pressure higher than 20 mm Hg. Ninety minutes after oral intake of 20 mg nitrendipine, cardiac output increased by 22%, heart rate increased by 12%, mean arterial pressure decreased by 7%, and pulmonary artery pressures as well as filling pressures of the heart did not change. Venous admixture and alveolar to arterial PO2 gradients increased by 54% and 22%, respectively. Hepatic blood flow increased by 33%. Renal blood flow remained unchanged and glomerular filtration rate decreased by 11%. Thus, in normotensive patients, nitrendipine administration induces systemic vasodilatation with an apparently reflex increase in cardiac output. These effects are accompanied by a deterioration in pulmonary gas exchange, increase in hepatic perfusion, no change in renal perfusion, and possibly a slight deterioration in renal function.

Adult↗
PubMedDate not supplied

Pulse pressure method and the area method for the estimation of total arterial compliance in dogs: sensitivity to wave reflection intensity.

We estimated total arterial compliance (C) in eight anesthetized mongrel dogs with (i) the area method (AM), (ii) the pulse pressure method (PPM), and (iii) the stroke volume-to-pulse pressure ratio (SV/PP). Average compliance was C(AM)=1.1+/-0.73 ml mm Hg(-1) using AM; C(PPM)=0.60+/-0.31 ml mm Hg(-1) using PPM and C(SV/PP)=0.87+/-0.49 ml mm Hg(-1) using SV/PP. Mean aortic pressure was 64+/-23 mm Hg. The overall agreement between C(AM) and C(PPM) was relatively poor (C(AM)=0.15+/-1.61 C(PPM); r2=0.48), with a consistent overestimation of the area method with respect to the pulse pressure method. There was a significant correlation (r=-0.78) between the relative difference between PPM and AM, and the modulus of the first harmonic of the wave reflection coefficient [gamma] which was low in our dog population (0.37+/-0.18). SV/PP overestimated PPM, but both methods were highly correlated (C(SV/PP)=0.06+/-1.60C(PPM); r2=0.97). C(SV/PP) and C(AM) were similar only for [gamma]>0.4. The effect of isolated changes of [gamma] on PPM, AM, and SV/PP was studied using the linear wave separation technique. The area method appeared very sensitive to the wave reflection intensity. For low reflection coefficients, the diastolic wave profile was flattened and compliance was overestimated. PPM and SV/PP were relatively independent of [gamma] and remained even applicable for [gamma]=0. We believe that the pulse pressure method is the most consistent method for the estimation of total arterial compliance in hemodynamic conditions characterized by a low wave reflection intensity.

Animals↗
PubMedDate not supplied

Effects of diethylcarbamazine and cromolyn sodium on hypoxic pulmonary vasoconstriction in dogs.

Evidence has recently been accumulated that leukotrienes might be involved in the still unknown biochemical mechanism of hypoxic pulmonary vasoconstriction. We therefore investigated the effects of i.v. cromolyn sodium, which prevents the release of leukotrienes from mast cells by a membrane stabilizing effect, and of i.v. diethylcarbamazine citrate (DEC), a leukotriene synthesis inhibitor, in 13 dogs challenged with the inhalation of 10% O2 in nitrogen (FIO2 0.1) during 10 min. The dogs were anaesthetized with pentobarbital, paralysed with pancuronium, ventilated with a FIO2 of 0.4 and equipped with catheters for the purpose of pulmonary and systemic vascular pressure measurements and thermodilution cardiac output determinations. Thirty minute infusions of DEC at respectively 100 mg, 400 mg, 2 g, 5 g, 10 g and 15 g (one dosage per dog) did not alter the hypoxic pulmonary pressor response. Dosages of 10 g and 15 g DEC were associated with systemic hypotension, and one additional dog given 20 g died in refractory shock. A continuous infusion of cromolyn sodium inhibited hypoxic pulmonary vasoconstriction, partially at 3 and 4.5 mg X kg-1 X min-1 (2 dogs) and completely at 6 mg X kg-1 X min-1 (3 dogs). A lower dosage of 1 mg X kg-1 X min-1 cromolyn sodium (one dog) had no circulatory effect. These results do not support the hypothesis that hypoxic pulmonary vasoconstriction is mediated by vasoconstricting leukotrienes in the dog. The mechanisms accounting for the inhibition of the pulmonary hypoxic pressor response by cromolyn sodium are uncertain.

Animals↗