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- Cardiovascular Journal of Africa
- OA African Journal Archive
- Volume 9, Issue 2, 1998
Cardiovascular Journal of Africa - Volume 9, Issue 2, 1998
Volumes & issues
Volume 9, Issue 2, 1998
Urinary levels of tissue kallikrein in black and Indian hypertensives and their implications for therapySource: Cardiovascular Journal of Africa 9, pp 73 –78 (1998)More Less
It is accepted that blacks differ from white and Indian hypertensives in their response to hypotensive agents. Black hypertensives in the USA have lower urinary tissue kallikrein (TK) excretion levels than white hypertensives. It has been suggested that blacks respond better to thiazide diuretics than to f)-blockers because. Thiazides increase TK excretion whereas f)-blockers decrease it. This study compares the excretion of urinary TK in black and Indian hypertensive and normotensive subjects. Urinary TK levels were measured with the selective, synthetic peptic substrate with the sequence of H-D-Val- Leu-Arg-pNA. Ten hypertensive patients on placebo therapy and 10 normotensive black and Indian subjects provided 3 samples at weeks 0, 2 and 4 for the determination of urinary TK. The results were analysed and analysis of variance was used to compare the two racial groups. There were no significant differences in urinary TK values of the three biweekly individual samples. Urinary TK values (ng TK/ug protein) in Indian hypertensives were generally lower than in black hypertensives.
Source: Cardiovascular Journal of Africa 9, pp 81 –84 (1998)More Less
By modifying left ventricular remodelling, improving endothelial dysfunction, interfering with neurohormonal activation and a host of other effects, angiotensin-converting enzyme (ACE) inhibitors have the potential to provide benefits to a large number of patients who have had a myocardial infarction. An impressive series of eight major Clinical trials demonstrates that, apart from extremely early intravenous treatment, an ACE inhibitor is the major factor improving survival after an acute myocardial infarction, whether given in the short or in the long term. The same series of trials have also demonstrated clearly that morbidity from heart failure is reduced. It is controversial whether re-infarctions are also less common. The SAVE study analyses of one of three available endpoints for this event showed re-infarctions to be reduced. Two other endpoints for acute myocardial infarction were not reduced. In contrast, re-infarctions were not significantly reduced in the AIRE and TRACE studies, which both had only one definition of a re-infarction. This discussion of which patients to select for ACE inhibition after acute myocardial infarction begins by examining the option to treat (nearly) everyone and then considers selective treatment for certain categories of patients.
Source: Cardiovascular Journal of Africa 9, pp 87 –90 (1998)More Less
Umbilical vein catheterisation (UVC) should not routinely be used in the neonatal intensive care unit, and when it is used special precautions should be taken and guidelines followed. We present an unusual complication which occurred following use of an umbilical vein catheter in a term neonate. This case highlights another potentially lethal complication of UVC, and emphasizes the risks associated with the procedure. In order for the benefits of UVC to outweigh the risks, certain guidelines are reviewed. The importance of confirming the position of the catheter tip with both anteroposterior and lateral radiographs is emphasised.
Author A.D. Schamroth, C.L. & SacksSource: Cardiovascular Journal of Africa 9, pp 91 –93 (1998)More Less
Aneurysms of aortocoronary saphenous bypass grafts are an unusual and rare complication of coronary artery bypass surgery. Approximately 30 such cases have been reported in the literature. Atheromatous aneurysms usually appear late (more than 10 years after grafting). They are usually asymptomatic, but may manifest for investigation as a lesion altering the mediastinal contour. We report a further case of an atherosclerotic aortocoronary saphenous vein graft aneurysm in which the patient presented with angina due to aneurysmal compression of the host vessel.
Source: Cardiovascular Journal of Africa 9, pp 96 –98 (1998)More Less
Halothane has been shown to be a powerful protectant ,against ischaemic injury. It has also been shown to improve metabolic, functional and structural recovery significantly during reperfusion of hearts previously subjected ""to normothermic cardioplegia,)"" regardless of the mode of its-administration (before and after arrest or intermittently during arrest). In the latter studies a crystalloid solution, Plasmalyte B (to which excess KCI was added) was used as cardioplegic solution. The most likely reason for these beneficial effects of halothane is its effects on intracellular Ca2+ movements; it has been shown to inhibit the accumulation of this ion during ischaemia as well as during reperfusion. In the course of our studies on myocardial protection during cardioplegia we noted that the functional recovery of hearts arrested with St Thomas Hospital (STH) cardioplegic solution was significantly better than that of hearts exposed to Plasmalyte B. In view of the proven efficacy of the former, 7.8 the question arose whether halothane would be able to afford additional protection to hearts arrested with STH. The purpose of this study was therefore to compare the effects of halothane on the functional recovery of hearts subjected to normothermic cardioplegic arrest induced by either Plasmalyte B or STH.
Source: Cardiovascular Journal of Africa 9, pp 107 –114 (1998)More Less