| 1. |
- Andrén, Lennart, 1946, et al.
(författare)
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Diltiazem in hypertensive patients with type II diabetes mellitus.
- 1988
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Ingår i: The American journal of cardiology. - : Elsevier BV. - 0002-9149. ; 62:11, s. 114G-120G
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Tidskriftsartikel (refereegranskat)abstract
- Twenty-three patients with essential hypertension and diabetes mellitus type II were treated with the calcium antagonist diltiazem (120 to 180 mg twice daily). The mean dose was 307 mg/day. The study was a double-blind, placebo-controlled, crossover design. All measurements were performed 12 to 14 hours after drug intake. Blood pressure, heart rate and forearm blood flow were measured noninvasively. Platelet function was studied by measuring adenosine diphosphate-induced platelet aggregation and the platelet specific proteins, beta thromboglobulin and platelet factor 4. Thromboxane B2 formation in serum and the plasma concentration of diltiazem and its metabolites N-demethyldiltiazem, deacetyldiltiazem and N-demethyldeacetyldiltiazem were measured both during placebo and diltiazem treatment. Diabetic control was evaluated by following HbA1C, fasting blood glucose and urinary glucose. Diltiazem reduced both systolic and diastolic (supine and standing) blood pressure significantly. Forearm blood flow was significantly increased by 32%, p less than 0.05. Supine heart rate decreased significantly, while no such change was seen in the standing position. No significant changes were observed in platelet function during diltiazem treatment. There was no relation between the observed blood pressure reduction and the plasma concentration of diltiazem or its metabolites. A positive correlation between the change in heart rate and the metabolite N-demethyldeacetyldiltiazem was observed (r = 0.647, p = 0.005). Three patients were excluded during diltiazem treatment (skin exanthema, headache and atrial fibrillation) and 1 during placebo treatment (angina pectoris). No negative effect on diabetes control was observed. Thus, diltiazem could be used for treatment of hypertension in diabetic patients.
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| 2. |
- Dahlöf, Björn, 1953, et al.
(författare)
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Calcium antagonists combined with beta-blockers or ACE inhibitors in the treatment of hypertension.
- 1988
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Ingår i: Journal of cardiovascular pharmacology. - : Ovid Technologies (Wolters Kluwer Health). - 0160-2446. ; 12 Suppl 6, s. S104-8
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Tidskriftsartikel (refereegranskat)abstract
- During the last few years, there has been a growing awareness that treated hypertensive patients are still at substantially increased risks for cardiovascular morbidity and mortality and that one conceivable explanation for this is that their blood pressure has not been lowered to strictly normotensive levels. To obtain normotensive blood pressures, it may be necessary to skillfully combine antihypertensive drugs much more frequently than has been common so far. In this context, calcium antagonists in combination with beta-blockers are of special interest, since several controlled studies have shown that a combination between a beta-blocker and nifedipine, nitrendipine, isradipine, or felodipine have been remarkably potent as regards their antihypertensive effect. In controlled trials, such combinations have also been shown to be more effective and better tolerated than a combination between a beta-blocker and hydralazine. Marked efficacy has also been noted when a calcium antagonist has been combined with an angiotensin converting enzyme (ACE) inhibitor. So far, most studies have dealt with small numbers of patients and study design has not always been optimal. Results from controlled studies will presumably be ready for presentation in the near future. It can be concluded that combination therapy between calcium antagonists and beta-blockers or ACE inhibitors appear to be markedly effective and well tolerated. This would offer the possibility of reducing elevated arterial pressure to normotensive levels in many hypertensive patients.
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| 3. |
- Eggertsen, Robert, 1948, et al.
(författare)
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Screening for thyroid disease in a primary care unit with a thyroid stimulating hormone assay with a low detection limit.
- 1988
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Ingår i: BMJ (Clinical research ed.). - : BMJ. - 0959-8138 .- 1468-5833. ; 297:6663, s. 1586-92
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Tidskriftsartikel (refereegranskat)abstract
- In a study at a primary care centre in a predominantly rural area of Sweden the records of all patients with established thyroid disease were scrutinised and 2000 consecutive adult patients screened with an immunoenzymometric thyroid stimulating hormone assay. The aims of the study were fourfold: firstly, to assess the total burden of thyroid disease in primary care centres in Sweden; secondly, to assess the efficacy of clinical diagnosis of the disease in unselected populations of patients; thirdly, to assess the efficacy of clinical evaluation of treatment with thyroxine; and, lastly, to see whether a single analysis of the serum thyroid stimulating hormone concentration by recent methods would be enough to identify an abnormality of thyroid function. Of the roughly 17,400 adults in the study community, 111 women and 10 men were being treated for thyroid disease. Screening detected 68 patients (3.5%) not receiving thyroxine who had a serum thyroid stimulating hormone concentration of 0.20 mU/l or less, all of whom were followed up clinically. Fifty of these patients were also studied biochemically during follow up. Only nine of the 68 patients had thyroid disease (three with thyrotoxicosis requiring treatment), no evidence of the disease being found in the remainder. Sixteen patients had spontaneous hypothyroidism requiring treatment, and neither these nor three patients with thyrotoxicosis had been detected at the preceding clinical examination. Of 35 patients in whom thyroid disease was suspected clinically at screening, none had laboratory evidence of thyroid dysfunction. In this series 1.3% of all women in the study community (2.6% of all 50-59 year olds) and 0.1% of the men were being treated for thyroid disease at the primary care centre, roughly 1.0% of adults subjected to screening were found to have thyroid disease requiring treatment, and most patients with a thyroid stimulating hormone concentration of 0.20 mU/l or less did not have thyroid dysfunction. It is concluded that measuring the basal serum thyroid stimulating hormone concentration by present methods is insufficient for the biochemical assessment of thyroid dysfunction in unselected populations.
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| 4. |
- Frisén, Lars, 1939
(författare)
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Acuity perimetry: estimation of neural channels.
- 1988
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Ingår i: International ophthalmology. - 0165-5701. ; 12:3, s. 169-74
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Tidskriftsartikel (refereegranskat)abstract
- Measurements of peripheral visual acuity allow quantitative estimations of retino-cortical neural channels. Analysis of results from high-pass resolution perimetry revealed that about 2/3 of all channels are contained within 30 degrees of visual field eccentricity and that loss of 1/3 raises the average threshold level about 1 decibel. The analytical procedure can be applied to any type of visual field defect.
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| 5. |
- Frisén, Lars, 1939, et al.
(författare)
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Binocular summation in humans: evidence for a hierarchic model.
- 1988
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Ingår i: The Journal of physiology. - 0022-3751. ; 402, s. 773-82
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Tidskriftsartikel (refereegranskat)abstract
- 1. Binocular summation was studied in human subjects using a batter of vision tests. Two tests assessed detection, another three acuity, one hyperacuity and one pattern recognition. 2. The magnitude of summation was consistent with, or exceeded, the level predicted from quadratic summation for both detection tests. 3. The summation factor was significantly smaller in the resolution tests than in the detection tests. Hyperacuity showed a large individual variation. 4. Spatial filtering of acuity targets did not influence summation. 5. No summation was found in the pattern recognition test. 6. It is argued that the degree of summation is related to the complexity of the visual task. A simple task yields a larger binocular summation than a more complex one. This may be related to the level of processing in the primary visual cortex.
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| 6. |
- Frisén, Lars, 1939
(författare)
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Computerized perimetry: possibilities for individual adaptation and feedback.
- 1988
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Ingår i: Documenta ophthalmologica. Advances in ophthalmology. - 0012-4486. ; 69:1, s. 3-9
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Tidskriftsartikel (refereegranskat)abstract
- Computerized perimetry is often poorly accepted by the tested subjects, presumably because of sparse feedback and lack of adaptation to individual capacity. Several remedies are suggested, including visual response feedback, active correction of erroneous responses, various fixation prompts, and continuous adaptation to current reaction time. Intuitively intelligible result displays are also desirable. A novel format representing threshold level by symbol size may meet this need.
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| 7. |
- Frisén, Lars, 1939
(författare)
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Perimetric variability: importance of criterion level.
- 1988
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Ingår i: Documenta ophthalmologica. Advances in ophthalmology. - 0012-4486. ; 70:4, s. 323-30
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Tidskriftsartikel (refereegranskat)abstract
- Perimetry suffers from considerable variability of results. A new technique for estimating individual criterion levels in normal subjects exposes the important role of psychological variables. The analysis depends on features peculiar to acuity perimetry. It can be accommodated in the regular examination. The results can be used to compensate for practice effects in serial examinations and to tighten the range of normal limits. The reduction in variation between normal subjects amounted to 57 per cent.
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| 8. |
- Lindblom, B, et al.
(författare)
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Sahlgren's Saturation Test for acquired dyschromatopsia: increased lightness enhances sensitivity.
- 1988
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Ingår i: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie. - 0721-832X. ; 226:5, s. 447-8
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Tidskriftsartikel (refereegranskat)abstract
- Sahlgren's Saturation Test (SST) is a simple sorting test designed for the detection and grading of acquired color vision defects. Like other pigment-based color vision tests, the SST color samples have medium lightness, i.e., they belong to the intermediate part of the gray scale. We tested normal controls and subjects with congenital or acquired dyschromatopsia with five SST versions that differed only in the amount of lightness. The sensitivity of the test increased considerably with increasing lightness. Therefore, the lightness level of SST has now been changed from 30 to 10 Natural Color System units.
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| 9. |
- Wold, Agnes E, 1955, et al.
(författare)
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Attachment of Escherichia coli via mannose- or Gal alpha 1----4Gal beta-containing receptors to human colonic epithelial cells.
- 1988
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Ingår i: Infection and immunity. - 0019-9567. ; 56:10, s. 2531-7
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Tidskriftsartikel (refereegranskat)abstract
- The role of bacterial adhesion for the maintenance of the large-intestinal microflora has not been established. In this study, colonic cells from the adenocarcinoma cell line HT-29 or from surgical specimens were tested for the ability to bind Escherichia coli. The E. coli strains were manipulated by transformation or by mutagenesis to express either mannose-specific type 1 fimbriae (strains 506 MS and HU742) or Gal alpha 1----4Gal beta-specific P fimbriae (506 MR and HU824). Binding to HT-29 cells was seen with strains of either receptor specificity and was inhibited by alpha-methyl mannoside or globotetraosylceramide (GalNAc beta 1----3Gal alpha 1----4Gal beta 1----4Glc-ceramide), respectively. The Gal alpha 1----4Gal beta-specific strains interacted with a loosely surface-associated substance, which was sensitive to mechanical treatment and incubation at 37 degrees C, while the mannose-specific strains bound both directly to the cell and to the loosely associated substance. Isolated colonic epithelial cells bound the mannose-specific bacteria in high numbers, while the attachment of the Gal alpha 1----4Gal beta-specific strains depended on the elution method. Cells eluted sequentially with magnetic stirring were unable to bind the Gal alpha 1----4Gal beta-specific bacteria, while elution by a more gentle method resulted in binding of these strains to material loosely associated with the epithelial cells. Thus, the binding pattern of isolated colonic epithelial cells paralleled that of the HT-29 cell line. Conceivably, binding to mannose- and Gal alpha 1----4Gal beta-containing receptors could contribute to the maintenance of E. coli in the human large intestine.
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| 10. |
- Wennergren, Margareta, 1948, et al.
(författare)
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Obstetric characteristics and neonatal performance in a four-year small for gestational age population.
- 1988
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Ingår i: Obstetrics and gynecology. - 0029-7844. ; 72:4, s. 615-20
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Tidskriftsartikel (refereegranskat)abstract
- Obstetric and neonatal performance were analyzed in an ultrasound-dated small for gestational age (SGA) population from 1982-1985. Eighty-three percent of 160 SGA infants were identified antenatally by means of intrauterine growth retardation (IUGR) risk scoring, and the pregnancies were supervised at a high-risk clinic. Fifty percent were delivered electively, predominantly in gestational weeks 38-39. Thirty percent were born preterm. The cesarean section rate was 40%. Perinatal mortality was 6%, or 4% when lethal malformations were excluded, ten times higher than the corresponding total population figures. Eleven percent of the fetuses had severe malformations. In the remaining SGA population, one infant died after experiencing severe perinatal asphyxia and another developed cerebral palsy; no other major sequelae were found before the age of 18 months. Hypoglycemia and hypothermia occurred frequently, but these problems were managed satisfactorily. The mean hospital stay for term infants was twice that of appropriate for gestational age infants. We conclude that the extra attention paid to the SGA population is well motivated. Future efforts should be directed toward improving the diagnostic techniques for IUGR, as most of the perinatal mortality occurred among SGA infants not identified before birth.
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