| 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
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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
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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. |
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| 5. |
- Aspenberg, P., et al.
(författare)
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Drug test chamber : a titanium implant for administration of biochemical agents to a standardized bone callus in situ
- 1988
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Ingår i: Journal of Biomedical Engineering. - : Elsevier BV. - 0141-5425. ; 10:1, s. 70-73
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Tidskriftsartikel (refereegranskat)abstract
- A titanium implant in which a conduit is gradually filled with ingrowing bone (the Bone Harvest Chamber) has been modified to allow continuous local treatment of the conduit tissue with biochemical agents. Implants were inserted bilaterally in rabbit tibiae. The tissue content of the bone ingrowth conduits was studied with histology, 99mTc-MDP scintimetry and measurements of total calcium content. Bone was formed in the conduit by endochondral formation starting at both ends and continuing until fusion in the middle. After 2 weeks the bone had not yet met in the middle where fibrous tissue was seen. In eight animals 3H-proline was applied via one of the chambers, with the contralateral chamber as a saline-treated control. The collagen of the harvested tissue from the 3H-proline treated side had a 3H-hydroxyproline content 1000 times greater than had the control side. The 'drug test chamber' makes possible the study of local effects of drugs on healing of mature bone in vivo.
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| 6. |
- 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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| 7. |
- 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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| 8. |
- 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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| 9. |
- 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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| 10. |
- Hellström-Westas, Lena, et al.
(författare)
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Lidocaine for treatment of severe seizures in newborn infants. I. Clinical effects and cerebral electrical activity monitoring
- 1988
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Ingår i: Acta Paediatrica Scandinavica. - : Wiley. - 0001-656X .- 0803-5253 .- 1651-2227. ; 77:1, s. 79-84
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Tidskriftsartikel (refereegranskat)abstract
- The anticonvulsive effect of lidocaine was evaluated in 46 newborn infants with severe, recurrent seizures. Before the lidocaine all infants were being given phenobarbital, and 22 infants were also treated with diazepam. Different dosages of lidocaine were tested. A loading dose of 2 mg/kg followed by i.v. infusion of 6 mg/kg/hour was the most effective dosage and had an immediate anticonvulsive effect in 18 of 25 infants; within 30 min the same effect was attained in another five of the infants, with an overall seizure control in 92% of the sample population. During the lidocaine treatment cerebral electrical activity was followed continuously with a cerebral function monitor (CFM), which also enabled evaluation of the treatment. No serious side effects on blood-pressure, heart-rate or cerebral electrical activity were registered. For newborn infants with severe recurrent seizures not responding to other drugs, lidocaine is an effective additional mode of treatment.
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