bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychosocial Risk Factors for Coronary Heart Disease
Authors: Jenkins C. David 
Published: August 2010

ABSTRACT. Four clusters of psychosocial risk factors for coronary heart disease (CHD) are reviewed. Socio–economic disadvantage acts through a number of influences to increase CHD risk. In advanced industrialized nations those in the lower social strata now have much higher CHD risk than persons in middle and upper social classes.Sustained disturbing emotions represent a second cluster. Anxiety, depression and other indices of neuroticism have frequently been found in association with angina pectoris and cardiac death, though not with myocardial infarction (MI). However, sleep disturbances are associated with angina, cardiac death and MI.The Type A behaviour pattern results from an interaction between a self–activating individual and an environment which rewards hurried and competitive activity. Despite a small number of negative findings, the Type A pattern has been shown in cross–sectional, retrospective and prospective studies by many research teams to be associated with a variety of manifestations of CHD.A fourth, and more recently recognized cluster of psychosocial risk factors, may be grouped together under the general heading of »overload«. Many investigations have now shown, for example, that excessive workload is a powerful predictor of CHD risk.It is suggested that all four clusters share the common property of exposing the individual, either chronically, or in frequently recurring episodes, to excessive psychological demands. They appear to exert their pathogenic influence through long–term mechanisms such as atherosclerosis or plaque formation, rather than by precipitating sudden coronary events.
Psychological and Physiological Responses of Individuals Displaying Type A Behaviour*
Authors: Glass David C. 
Published: August 2010

ABSTRACT. Earlier findings on the relationship between the coronary–prone behaviour pattern Type A and coronary heart disease (CHD) are briefly reviewed, with particular reference to the underlying pathophysiological mechanisms linking the two.Results obtained during the playing of competitive games with or without harassment from the opponent suggest that competition alone does not distinguish between Type A and Type B individuals. The Type A pattern appears to be associated with exaggerated cardiovascular responses only as the result of hostile interactions.The primary need to study the Type A pattern as a psychological construct is emphasized. Analysis of structured interview responses suggests that hostility and competitive drive are the two components of the pattern associated with cardiovascular disease. A model is proposed in which Type A subjects, faced with threats to their control, exhibit first hyper–responsive and then hypo–responsive efforts to regain it, and experimental evidence in support of this model is presented. However, such hyper–responsive reactions might be linked more closely to coping and defence mechanisms than they are to Type A. It is proposed that the Type A pattern be regarded as an aspect of the per son–situation interaction and that efforts be made to establish those classes of environmental stimuli likely to elicit it.
Compartment model of prenalterol
Authors: Klein G. , Wirtzfeld A. , Bozler G. , Rönn O. , Graffner C. 
Published: August 2010

ABSTRACTIn previous pharmacokinetic studies in healthy subjects the time course of plasma concentration of prenalterol was described by a short distribution phase (α–phase) with a mean half–life of about 8 minutes and an elimination phase (β–phase) with an average half–life of about two hours [1, 2]. The aim of this joint study was to check the pharmacokinetic data obtained after intravenous single dose administration with the computer program TOPFIT [3] using different compartment models and to test the predictive power of the chosen kinetic model for plasma concentration data after repetitive intravenous prenalterol dosing.
Electrophysiological studies with prenalterol
Authors: Weisswange A. , Csapo G. , Kalusche D. , Keck M. 
Published: August 2010

ABSTRACTElectrophysiological studies with prenalterol in 19 patients (6 women, 13 men, 5 with sinus node disease, 4 with AV node disease, 7 with double node disease, 2 with conduction disturbance below His bundle, 1 normal) showed that sinus node function (heart rate, sinus node recovery time) is uniformly improved by this β–stimulator.Also AV conduction is significantly and uniformly improved (shortening of AH interval and of the functional refractory period of AV conduction).There is no or little influence on intra–atrial conduction and on conduction below the His bundle. However, spontaneous depolarisation in His–Purkinje fibers – as tested in patients with complete AV block and ventricular demand pacemaker – is increased through β–stimulation with prenalterol as reflected by shorter escape intervals and higher frequency escape rhythm.Prenalterol may be of clinical use in patients with cardiomyopathies who developed bradycardia under digitalisation or patients with severe bradyarrhythmia either with or without digitalis.It might also be useful in rare emergency situations, when complete pacemaker failure develops.
Haemodynamic effects of prenalterol in patients on dialysis
Authors: Lustenberger N. 
Published: August 2010

ABSTRACTHaemodialysis hypotension occurs with particular frequency in bilateral nephrectomised patients. This reflects the importance of the renin–angiotensin–aldosterone system for maintaining normal blood pressure. Failure of vascular access (due to clotting and thrombosis of shunts) and ischaemic necrosis of transplanted kidneys in hypotensive patients prompted us to treat them orally with a new β1–adrenergic agent (prenalterol). Blood pressure was normalised in 4 out of 5 patients. Because of delayed renal elimination of the drug, daily dosage must be reduced to prevent symptoms of adrenergic stimulation. A study of the pharmacokinetics of prenalterol in uraemia is in preparation.
Echocardiographic comparison between prenalterol and dobutamine
Authors: Wester H. A. , Oltmanns D. 
Published: August 2010

ABSTRACTPrenalterol, a new cardioselective β1–adrenoceptor agonist, was compared with the β–stimulator dobutamine by computer–assisted echocardiography. Prenalterol decreased preload, increased heart rate and induced an increase in contractility for a longer time in comparison with dobutamine. The small influence on blood pressure and after load indicates selective β1–receptor–effect by a result of slight changes in the peripheral vascular resistance.
Short and long–term effects of hydralazine and combined hydralazine and prenalterol therapy in patients with congestive heart failure
Authors: Drexler H. , Löllgen H. , Just H. 
Published: August 2010

ABSTRACTWe evaluated the acute and chronic (3–4 weeks) effects of slow–release hydralazine (HSR) and combined hydralazine and prenalterol (HSR+P) therapy in patients with severe congestive heart failure at rest (R) and at exercise testing (E) with supine bicycle ergometer (n=6).Measurement of haemodynamics (Swan–Ganz thermistor catheter) including pulmonary wedge pressure (PCP), cardiac output (CO), heart rate (HR) and systemic arterial pressure (MAP), was performed before, after HSR–treatment and after combined HSR+P–therapy. C = control.
Pharmacokinetics of Calcium Blockers in Patients with Renal Insufficiency and in Geriatric Patients
Authors: L. Larsen Storstein , Midtbø A. , Sævareid L K. 
Published: August 2010

SummaryCalcium antagonists have been used in the treatment of various medical disorders for more than 10 years, but their pharmacokinetics properties are poorly investigated. Available data on the pharmacokinetics of calcium antagonists in normal men are summarized in the present paper. Information on the influence of renal impairment and old age on the handling of calcium‐antagonists are only available for verapamil. Patients with advanced renal disease had a significant reduction in the apparent volume of distribution, a shortened serum elimination half life, a decreased total body clearance of verapamil due to a decrease in the renal excretion of verapamil and its active metabolite norverapamil and also to a decrease in metabolic clearance. Pharmacokinetic parameters obtained after oral administration were not significantly different from those after intravenous dosing. The mean biologic availability (22.8%) was in the same range as reported for normal persons, but individual variations would seem to be greater. Elderly patients with a mean age of 87 years also had a significantly reduced volume of distribution of verapamil and decreased total body clearance of the drug, although this last change did not reach statistical significance. The biologic availability in the elderly was higher than in younger persons with a mean value of 37.69% and a wide range from 9.16 to 82.76%. These findings imply that verapamil dosage should be reduced in patients with impaired renal function and elderly patients.
Evaluation of Verapamil and High Dose Nifedipine in Patients with Chronic Stable Angina with Objective Methods
Authors: Subramanian V. Bala , Bowles M.J. , Khurmi N. S. , Davies A. B. , Raftery E. B. 
Published: August 2010

SummaryThe efficacy and safety of verapamil and nifedipine were objectively assessed in patients with chronic stable angina. Twenty four patients entered a double blind randomized cross over trial of nifedipine (10 mg thrice daily) and placebo. In this dosage nifedipine did not show any significant change in exercise duration and the variables obtained using computer assisted exercise testing when compared to placebo. The next stage consisted of another double blind randomized cross over trial comparing the effects of verapamil (120 mg thrice daily) and nifedipine (20 mg thrice daily) with an initial placebo run‐in period in 32 patients. At this dose level nifedipine showed a definite and significant improvement in all the objective variables; however an increase in side effects was observed resulting in withdrawal of the drug in seven patients. A common problem was tachycardia precipitating angina after nifedipine ingestion. On the other hand verapamil produced a marked improvement in exercise tolerance and other variables as compared to placebo and nifedipine, was well tolerated and produced a mild bradycardia. This study clearly indicates that verapamil is distinctly superior to nifedipine in efficacy side effects and safety in patients with chronic stable angina. This may be attributable to the differential effect on heart rates induced by these drugs.
Effects of Intravenous Verapamil on the Haemodynamic Response to Exercise in Patients with Angina Pectoris
Authors: Sadick N. M. B. , Roubin G.S. , Harris P.J. , Hiroe M. , Meares S. , Bautovich G. , Kelly D.T. 
Published: August 2010

SummaryThe effects of intravenous Verapamil (V) on exercise haemodynamics and ventricular function were compared in 13 patients with stable effort angina. Intravascular pressures, thermodilution cardiac output and radionuclide ejection fraction were measured simultaneously at rest and during exercise.At rest Verapamil produced systemic vasodilation. During exercise at identical workloads compared to control, Verapamil increased cardiac index (CI) and decreased AVO2 difference. Pulmonary artery wedge pressure was lower. Ejection fraction was higher (control‐55 ±11% vs V‐64 ± 11%) as the disproportionate increase in end systolic volume relative to the end diastolic volume was prevented.Verapamil is effective in exercise induced angina and alters haemodynamics primarily through its vasodilating properties associated with an increased CI.
The Role of a Slow Channel Inhibitor, Verapamil, in the Management of Hypertension
Authors: Gould B.A. , Mann Stewart , Kieso H. , Balasubramanian V. , Raftery E.B. 
Published: August 2010

Summary

The ‘Oxford’ system for continuous monitoring of the ambulatory blood pressure was used to assess the changes in blood pressure following therapy with the slow channel inhibitor, verapamil.
Sixteen patients were studied on no therapy and following a minimum of 6 weeks therapy (dose range 120–160 mg t.d.s.). During each study patients underwent standardized physiological tests including tilt, isometric handgrip and dynamic bicycle exercise.
Verapamil was demonstrated to produce a consistent reduction of blood pressure over most of the 24 h period studied but this was most marked during the day. Heart rate was also reduced.
There was no postural hypotension and the absolute responses to dynamic and isometric exercise were reduced.
The results demonstrate the antihypertensive efficacy of ‘slow channel inhibitors’ as represented by verapamil.
The Prognosis for Patients Referred with Suspected Acute Myocardial Infarction
Authors: ENGBY BIRGER , STRUNGE POUL , OLSEN JØRN 
Published: August 2010

ABSTRACT. Engby B, Strunge P, Olsen J. (Department of Internal Medicine, Horsens Hospital, Horsens, Denmark.) The prognosis for patients referred with suspected acute myocardial infarction.A follow‐up investigation of the prognosis of 381 patients admitted with suspected acute myocardial infarction (AMI) has been carried out in respect of later AMI or death. During hospitalization the patients were divided into groups with particular attention to patients with no demonstrable myocardial infarction but with ischaemic heart disease (non‐AMI) and patients with confirmed AMI. All patients were subjected to follow‐up for 43 months (range 37–54). The mortality from cardiovascular causes after four years was 26.2% of 130 non‐AMI patients and 25.8% of AMI patients. The majority of new infarctions were found in the AMI patients, but with even increase in both groups, 50% occurring within the first 12 months. The groups were studied with regard to earlier manifestations of ischaemic heart disease and heart failure during hospitalization, without any difference being observed. Due to the poor prognosis the question is raised whether non‐AMI patients as a group should be offered prophylactic therapy.
The Significance of ST and T Changes for the Development of Coronary Events in Patients with Acute Coronary Chest Pain, Treated in a Coronary Care Unit without Verified Acute Myocardial Infarction
Authors: LINDBERG KJELL , NYQUIST OLOF , EDHAG OLOF 
Published: August 2010

ABSTRACT. Lindberg K, Nyquist O, Edhag O. (Cardiac Division of the Department of Internal Medicine, Karolinska Institute, Huddinge University Hospital, Huddinge, Sweden.) The significance of ST and T changes for the development of coronary events in patients with acute coronary chest pain, treated in a coronary care unit without verified acute myocardial infarction.The one‐year prognosis for patients with a confirmed diagnosis of acute myocardial infarction (AMI) was compared with that of non‐AMI patients treated in the coronary care unit (CCU). The one‐year incidence of coronary events (CE) after discharge from CCU was 37% in the 51 AMI patients and 20% in the 81 non‐AMI patients. The one‐year mortality rates were 27 and 4%, respectively. Among the non‐AMI patients, well known risk factors such as hypertension, previous AMI, congestive heart failure, smoking, diabetes and hyperlipaemia were not more common in those who developed a CE. ST segment depression and T wave inversion, each of at least 0.1 mV, in three or more ECG leads were selective criteria for a high‐risk group with respect to CE. Preventive measures should be considered in this group of patients without verified AMI.
INTRACELLULAR ELECTROLYTES IN CARDIAC FAILURE
Authors: Wester Per Olov , Dyckner Thomas 
Published: August 2010

Abstract In congestive heart failure (CHF) there are several compensatory mechanisms operating which may influence electrolyte metabolism. The activation of the renin‐angiotensin‐aldosteron system causes retention of sodium (Na) and losses of potassium (K) and magnesium (Mg). The secondary hyperaldosteronism may give rise to high intracellular Na and low intracellular K through a direct permeability effect on the cell membrane. The Mg deficiency may lead to a further increase of intracellular Na and decrease of intricellular K since Mg is a necessary ion for the function of the Na‐K pump.In 297 patients with diuretic treated CHF we found that 42% had hypokalemia, 37% hypomagnesemia and 12% hyponatremia. We also found that 57% had excess muscle Na, 52% had depletion of muscle K and 43% had low muscle Mg. We have also shown that the low muscle K cannot be corrected by K supplementation when there is a concomitant Mg deficiency and that Mg infusions may change the disturbed relation between extra‐ and intracellular electrolytes towards normal.
Plasma Potassium and Phosphate Concentrations—Influence by Adrenaline Infusion, β‐blockade and Physical Exercise
Authors: LJUNGHALL SVERKER , JOBORN HENRIK , RASTAD JONAS , ÅKERSTRÖM GÖRAN 
Published: August 2010

ABSTRACT. Ljunghall S, Joborn H, Rastad J, Åkerström G (Departments of Internal Medicine, and Surgery, University Hospital, Uppsala, Sweden). Plasma potassium and phosphate concentrations—influence by adrenaline infusion, β‐blockade and physical exercise. Acta Med Scand 1987; 221:83–93.Infusion of adrenaline into healthy male subjects reduced the plasma concentrations of both potassium and phosphate to a similar extent, in a dose‐dependent manner, an effect which was prevented by the administration of propranolol. Ergometer bicycling until exhaustion, which caused marked accumulation of lactic acid in the blood and reduction of pH, induced great elevations of both plasma potassium and phosphate with close relationships between the raised plasma concentrations and the reduction in pH, also during β‐blockade. However, longer‐term aerobic exercise, without acidosis, also caused some rise of the potassium and phosphate concentrations. During recovery from anaerobic, but not from aerobic, exercise there was a rapid decrease of the plasma potassium levels while the phosphate values normalized gradually together with pH. From measurements of the ion concentrations both in the femoral effluent of one leg, which carried out maximal isokinetic work, and in the opposite antecubital vein it could be calculated that there was for potassium, but not for phosphate, a post‐exercise uptake both in the exercised muscle and in the entire organism, indicating the participation of systemic factors.
Autonomic and Peripheral Nerve Function in Early Diabetic Neuropathy
Authors: SUNDKVIST GÖRAN , LILJA BO , ROSÉN INGMAR , AGARDH CARL‐DAVID 
Published: August 2010

ABSTRACT. Sundkvist G, Lilja B, Rosén I, Agardh C‐D (Departments of Internal Medicine and Clinical Physiology, Malmö General Hospital, and Departments of Clinical Neurophysiology and Internal Medicine, University Hospital, University of Lund, Lund, Sweden). Autonomic and peripheral nerve function in early diabetic neuropathy. Possible influence of a novel aldose reductase inhibitor on autonomic function. Acta Med Scand 1987; 221:445–53.Autonomic and peripheral nerve functions as well as the possible short‐term effect of a novel aldose reductase inhibitor (ARI) on neuropathy were evaluated in 30 male type I diabetics (age 25–44 years, mean 34; duration of diabetes 10–20 years, mean 34) with neurographic signs of peripheral neuropathy (PN). Autonomic neuropathy (AN) was established by the heart rate reactions to deep breathing (E/I ratio = vagal function) and to tilt (acceleration index = sympathetic and vagal functions; the brake index = vagal function). Twenty‐nine patients, 13 with AN, completed the study. Among neurographic variables, only sural nerve function tests correlated with autonomic functions. Patients with AN showed significantly lower mean sensory action potential amplitudes (SAPA) sural, indicating axonal losses, than patients without AN (3.58±0.79 μV vs. 7.34±1.12 μV; p<0.01). PN as measured by neurography did not improve during ARI treatment. On the other hand, vagal function (brake indices) improved (p<0.05) during ARI in AN patients.
Familial Dysalbuminemic Hyperthyroxinemia
Authors: JENSEN IVAN W. , FABER JENS 
Published: August 2010

ABSTRACT. Jensen IW, Faber J (Department of Endocrinology, Aalborg Hospital North, Aalborg, and Departments of Internal Medicine and Clinical Chemistry, Frederiksberg Hospital, Copenhagen, Denmark). Familial dysalbuminemic hyperthyroxinemia. Acta Med Scand 1987; 221:469–73.A family with familial dysalbuminemic hyperthyroxinemia is described. The syndrome is inherited as an autosomal dominant trait and is characterized by marked elevation of serum thyroxine, due to increased binding of thyroxine to albumin, whereas serum triiodothyronine is normal. Serum free thyroxine is normal when measured with ultrafiltration or equilibrium dialysis, but artefactually high when measured with an analogue assay. The importance of the condition, which is harmless, lies in the misinterpretation of values with subsequent erroneous treatment of thyrotoxicosis. By using an ultrasensitive TSH method it is possible to discriminate between euthyroid and hyperthyroid patients and thereby to avoid incorrect diagnosis in subjects with euthyroid hyperthyroxinemia.
Effect of Regulatory Withdrawal of Drugs and Prescription Recommendations on the Pattern of Self‐poisonings in Oslo
Authors: EKEBERG ØIVIND , JACOBSEN DAG , FLAATEN BORGAR , MACK ASBJØRN 
Published: August 2010

ABSTRACT. Ekeberg Ø, Jacobsen D, Flaaten B, Mack A (Medical Department 7 and Division of Clinical Pharmacology and Toxicology, Central Laboratory, Ullevaal Hospital, Oslo, Norway). Effect of regulatory withdrawal of drugs and prescription recommendations on the pattern of self‐poisonings in Oslo. Acta Med Scand 1987; 221:483–7.A two‐year prospective study of 1350 admissions for self‐poisoning, covering the Oslo area was undertaken to identify the sources of the toxic agents. After the first year of the study, four barbiturates were withdrawn from the Norwegian market and recommendations were made by the Health Authorities to promote more restrictive attitudes when prescribing psychoactive drugs. The patterns of self‐poisonings in the two periods were compared. The withdrawal of four barbiturates resulted in a 55% decrease in the rate of barbiturate poisonings in general (p<0.001). No increase could be detected in the rate of self‐poisoning with benzodiazepines and other hypnotics, but the incidence of self‐poisonings with antidepres‐sants (p<0.01) and neuroleptics (p<0.01) was found to have increased significantly. The regulations and recommendations resulted in a significant decrease in drugs obtained from doctors randomly consulted (p<0.01), and a significant increase in drugs prescribed by psychiatrists (p<0.01). Drugs obtained from non‐medical sources increased from 28% in the first period to 33.2% in the second. The total number of admissions and toxic agents taken remained unaltered. Thus, regulatory measures can influence the pattern of self‐poisoning but do not seem to influence the tendency to abuse drugs or to take an overdose.