RESUMEN
188 patients undergoing long-term hemodialysis and a control group of 371 patients without kidney diseases were examined with regard to changes of the connective tissue of the skin. The following alterations were observed: increased sensibility to low temperatures and Raynaud's syndrome (42%), Dupuytren's contracture (22.4%), sclerosis of the dorsum of the fingers (17.6%). Carpal tunnel syndrome was seen in 24.4% of the cases, significantly correlating with the duration of hemodialysis.
Asunto(s)
Diálisis Renal , Enfermedades de la Piel/etiología , Femenino , Humanos , Fallo Renal Crónico/complicaciones , Fallo Renal Crónico/terapia , Cuidados a Largo Plazo , Masculino , Persona de Mediana EdadRESUMEN
1. Sixteen patients with essential hypertension were treated with guanfacine and with clonidine for 5 weeks each in a double-blind, placebo-controlled, cross-over trial. Dosage ranged from 2 to 6 mg guanfacine and from 0.3 to 0.9 mg clonidine daily in two or three divided doses. 2. Both compounds caused a significant and comparable decrease in blood pressure. Patients whose blood pressure was not reduced to normal by 2 to 3 mg guanfacine daily did not respond better to an increase in the dose. 3. Dryness of the mouth and constipation occurred with about equal frequency with both agents, but sedation and orthostatic circulatory effects were considerably more frequent with clonidine. 4. A withdrawal syndrome was observed on discontinuation of clonidine in one patient as opposed to no rebound hypertension on stopping guanfacine treatment. 5. Guanfacine caused a significant decrease in plasma noradrenaline and adrenaline, suggesting a decrease in sympatho-adrenal activity.
Asunto(s)
Antihipertensivos/uso terapéutico , Clonidina/uso terapéutico , Guanidinas/uso terapéutico , Fenilacetatos/uso terapéutico , Adolescente , Adulto , Anciano , Antihipertensivos/administración & dosificación , Antihipertensivos/efectos adversos , Presión Sanguínea/efectos de los fármacos , Peso Corporal/efectos de los fármacos , Ensayos Clínicos como Asunto , Clonidina/administración & dosificación , Clonidina/efectos adversos , Método Doble Ciego , Quimioterapia Combinada , Epinefrina/sangre , Femenino , Guanfacina , Guanidinas/administración & dosificación , Guanidinas/efectos adversos , Humanos , Hidroclorotiazida/administración & dosificación , Hipertensión/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Fenoxibenzamina/administración & dosificación , Fenilacetatos/administración & dosificación , Fenilacetatos/efectos adversos , Triantereno/administración & dosificaciónRESUMEN
1. To gain insight into the mechanism of mineralocorticoid-induced blood pressure rise in man we performed haemodynamic studies in six normotensive volunteer subjects before and during administration of the synthetic steroid 9 alpha-fluorocortisol (0.8 mg daily) for a period of 6 weeks. In a further study, performed in seven subjects, plasma noradrenaline concentration and reactivity to exogenous noradrenaline were determined before and during administration of the mineralocorticoid. 2. Within the first week of steroid administration an increase in mean arterial blood pressure could be demonstrated, which was due to an increase in cardiac output. After the sixth week the elevated blood pressure was the consequence of an increased total peripheral resistance. 3. Plasma noradrenaline concentration decreased and reactivity to exogenous noradrenaline increased during steroid administration. 4. The mechanism underlying the increase in total peripheral resistance during long-term mineralocorticoid administration remains unclear. Increased sympathetic tone does not seem to be a factor since plasma noradrenaline decreased considerably. Pressor response to noradrenaline increased probably due to decreased sympathetic tone.
Asunto(s)
Presión Sanguínea/efectos de los fármacos , Fludrocortisona , Adulto , Angiotensina II/sangre , Gasto Cardíaco/efectos de los fármacos , Epinefrina/sangre , Frecuencia Cardíaca/efectos de los fármacos , Humanos , Norepinefrina/sangre , Renina/sangre , Sistema Nervioso Simpático/efectos de los fármacosRESUMEN
1. Renal hypertensive rats with a normal or suppressed activity of the renin-angiotensin system develop vascular lesions which are similar to those observed in spontaneously hypertensive rats on high sodium diet. 2. Exposure of a vascular bed to high blood pressure results in a rapid damage of the vascular wall, irrespective of the state of the renin-angiotensin system.
Asunto(s)
Angiotensina II/fisiología , Hipertensión Renal/fisiopatología , Renina/fisiología , Animales , Trastornos Cerebrovasculares/etiología , Hipertensión Renal/complicaciones , Ratas , Arteria Renal/patología , Sodio/fisiología , Enfermedades Vasculares/etiologíaRESUMEN
1. Isolated hind limbs of rats were perfused and vascular smooth muscle sensitivity to noradrenaline, methoxamine and potassium chloride was measured and dose-response curves were obtained. 2. The sensitivity of vascular smooth muscle to noradrenaline is attenuated by adrenalectomy and low sodium diet; it is enhanced by corticosterone. High sodium diet or administration of deoxycorticosterone did not alter the dose-response curve significantly. 3. The increased sensitivity of vascular smooth muscle after corticosterone treatment is not related to changes in the contractile protein or alterations in the neuronal uptake and extraneuronal metabolism of noradrenaline. 4. These results suggest that the increased sensitivity in corticosterone-treated rats may be due to the number of receptors, receptor affinity to noradrenaline, or changes in the functional link between receptor and contractile apparatus.