Comparaison de l'association hydrochlorothiazide amiloride (moduretic) et de la furosemide dans le traitement de l'œdème cardiaque

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Effects of non-pharmacological sympathetic sudomotor denervation on sweating in humans with essential palmar hyperhidrosis

Objectives: Quantitative sweat production and -ionic composition in Essential Hyperhidrosis (EH), and the effects of T2-T3 thoracoscopic sympathicolysis (TS) hereon, are unknown. Standardised pilocarpine iontophoresis sweat tests were performed before and after TS in order to study these issues. Design and Methods: Pilocarpine iontophoretic sweat tests measuring maximal sweat production (rag) and sweat Na+, K+ and CIconcentrations (mMol/L) were performed on both forearms of 10 EH patients, before and six weeks after TS, and in normal volunteers. Results: As compared to normals, preoperative maximal sweat production was 30% higher (199.4 ± 68.8 (SD) vs. 150.6 ± 45.6 Mg) in EH patients; due to type II error, however, statistical significance was not reached. Na+ and Cl- concentrations were similar, and K+ concentration was slightly lower in EH patients. After TS, sweat production had decreased to equal levels as in normals (149.1 ± 52.1 mg), whereas the Na+ (from 33.6 ± 6.9 to 51.0 ± 6.4 mMol/L), Cl- (from 21.5 ± 6.6 to 37.2 ± 7.1 mMol/L) and K+ (from 7.5 ± 1.3 to 8.6 ± 2.2 mMol/L) concentrations had increased. Conclusions: EH patients present 30% higher maximal sweat production at their forearms. This increase may be due to an increased activity of the adrenergic component of sweat gland innervation. The post-TS increase in Na+, Cl- and K+ concentrations suggests that the adrenergic component of sweat gland innervation in itself decreases sweat ion concentrations.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Plasma catecholamine concentrations in essential hyperhidrosis and effects of thoracoscopic D2-D3 sympathicolysis

Essential hyperhidrosis (EH) is caused by a poorly understood overactivity of the sympathetic fibres passing through the upper dorsal sympathetic ganglia D2 and D3. These ganglia are also in the pathway of the sympathetic innervation of the heart and lungs. Therefore, although the predominant sympathetic neurotransmitter at the eccrine sweat glands is acetylcholine, the plasma concentration of noradrenaline (NA) (which is the main sympathetic neurotransmitter at the end organs including the heart and the lungs) may be elevated. Furthermore, as there are some indications for generalized sympathetic overactivity in EH, the plasma concentration of adrenaline (A) may also be elevated. Plasma levels of NA and A were therefore determined in 13 EH patients before and after thoracoscopic D2-D3 sympathicolysis (TS). Preoperative NA and A plasma levels were all within the normal limits used in our laboratory. After TS, mean NA plasma levels are significantly decreased. whereas mean A are unchanged. We conclude that sympathetic overactivity in EH is limited to the upper dorsal sympathetic ganglia and that some of the cardiovascular and pulmonary effects that are observed after TS may be associated with the decrease in NA.SCOPUS: ar.jFLWINinfo:eu-repo/semantics/publishe

Transient elevation of sweat electrolytes in anorexia nervosa: a sweat gland steroid receptor defect?

SCOPUS: le.jinfo:eu-repo/semantics/publishe

Lorazepam fast-dissolving drug formulation (FDDF) and intravenous administrations as anaesthetic premedicants: A pharmacokinetic analysis

The pharmacokinetics of lorazepam premedication were studied in 16 patients using two different formulations (intravenous and FDDF oral administrations). Arterial blood samples were taken at intervals for up to 600 min after administration of 4 mg of each formulation, and plasma lorazepam concentrations were determined by gas-chromatography with electron capture detection. Concentration-time data for individual subjects were analysed by model-independent methods. The derived pharmacokinetic parameters indicated a rapid distribution (median T( 1/2 ) λ1 i.v. = 15.2 min, median T( 1/2 ) λ1 oral = 31.6 min) into a steady-state volume of distribution approximating total body water, with long elimination half-life and a low clearance. V(dss) and clearance were similar with both treatments. The absorption of FDDF lorazepam was rapid in half of the patients and provided a high plasma concentration of lorazepam (C(max) = 61.8 ng ml-1) in a short time interval (T(max) = 58 min), but there were considerable inter-individual differences. This variability in absorption might explain why premedication with FDDF lorazepam is sometimes less effective than expected.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

The respective effects of serum thyroxine and triiodothyronine on serum thyrotropin and lipid parameters in endemic juvenile hypothyroidism.

The respective effects of serum total T4 concentration and of serum total T3 concentration on serum TSH concentration and on lipid parameters were compared in 84 7- to 16-year-old children of the Northern Zaire goitre endemia classified in group A (T4 greater than 77 nmol/l and T3 greater than 1.69 nmol/l), B (low T4, normal T3) and C (low T4, low T3). Mean serum TSH level was normal in group A (2.3 mU/l), it raised to 39.4 mU/l in group B (p less than 0.001) and to 166.3 mU/l in group C (p less than 0.001 vs A and B). Low density lipoprotein cholesterol and apoprotein B were increased in group B vs A (p less than 0.05) and in group C vs A (p less than 0.001) and B (p less than 0.001 for apoprotein B; not significant for cholesterol). High density lipoprotein cholesterol and apoprotein A1 were similar in the three groups. Mean serum triglyceride level, not different in groups A and B, was doubled in group C (p less than 0.001). Multiple regression analysis showed that serum TSH, apoprotein B, and triglyceride levels were influenced by both thyroid hormones concentrations with a predominant effect of serum T4 on the first two parameters and of serum T3 on the last one. In conclusion, low serum T4 with normal T3 concentrations resulted in an increase in serum TSH and in an altered lipid metabolism; it clearly represented an hypothyroid state.Journal ArticleSCOPUS: ar.jinfo:eu-repo/semantics/publishe