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Biomedical subjects

A A Carr

Publications and source records attributed to A A Carr.

At least 91 records · Page 5Linked to original sources
PubMed1986

Financial cost as an obstacle to hypertension therapy.

A home health interview, including blood pressure measurements, was conducted on 4,688 adults representing the noninstitutionalized population of Georgia. Subjects with diastolic blood pressure greater than or equal to 90 mm Hg or on antihypertensive medication were considered hypertensive. The prevalence of uncontrolled moderate or severe hypertension (diastolic greater than or equal to 105 mm Hg) was 1.9 per cent. With the exception of White women, all race-sex groups with uncontrolled moderate or severe hypertension reported substantially lower per capita income than their mild or controlled hypertensive counterparts. A larger percentage of the uncontrolled moderate to severe hypertensives on medication, as compared to their mild or controlled counterparts, reported economic barriers to pharmacologic and medical care on cost of medicines (36 per cent vs 22 per cent); refills (36 per cent vs 16 per cent); and office visits (26 per cent vs 16 per cent). Black women reported these barriers more than Whites. These findings suggest that costs of antihypertensive care may be an obstacle in blood pressure control for certain population subgroups.

Adult↗
PubMed1985

Use of a personal computer with an automatic noninvasive ambulatory blood pressure monitoring device.

Automatic ambulatory blood pressure monitoring is a valid and reliable tool for intermittent noninvasive assessment of blood pressure over a 24-hour period. However, reporting devices to retrieve data from the recording device are dedicated to one task and are expensive. Because of this, we have developed computer programs for a popular inexpensive microcomputer that retrieves data from the Del Mar Pressurometer III, an R-wave gated automatic ambulatory blood pressure monitoring device. Furthermore, the derived data may be edited, computed to derive statistics, stored, retrieved, displayed, and reported in both numerical and graphical format. This same hardware is used for multiple other tasks.

Blood Pressure↗
PubMed1985

Monotherapy with labetalol compared with propranolol. Differential effects by race.

The antihypertensive effect of oral labetalol and propranolol were evaluated in 65 black and 75 white patients with mild to moderate hypertension (standing diastolic blood pressure (StDBP) of 90-115 mmHg) in a double-blind multicenter clinical trial. Following a 4-week placebo phase, labetalol (n = 70) or propranolol (n = 70) was randomly assigned. During a 5-week titration phase, labetalol could be increased from 100 mg BID to 600 mg BID to achieve a StDBP of less than 90 mmHg and a decrement of greater than or equal to 10 mmHg. Propranolol could be titrated from 40 to 240 mg BID. A 3-month maintenance phase was followed by an optional 8-month maintenance phase. Hydrochlorothiazide (HCTZ) could be added at any time during the maintenance phase. Supine and standing blood pressures were measured at each visit. Statistical analysis revealed significant (ANOVA, p less than 0.05) treatment by race effects. Therefore, the treatment groups were stratified retrospectively by race. This study demonstrated that labetalol is equally effective in white and black patients, whereas, propranolol is significantly (p less than 0.05) more effective in white than in black patients. Moreover, labetalol is significantly more effective than propranolol in lowering the standing systolic/diastolic blood pressure of black patients (p less than 0.02/p less than 0.001). These blood-pressure effects were accompanied by a significantly greater (p less than 0.04) reduction in heart rate with propranolol. Furthermore, significantly more (p less than 0.05) black patients treated with propranolol compared to those treated with labetalol required the addition of a diuretic for control of their blood pressure.

Adult↗
PubMed1984

Exercise stress testing.

Before performing stress testing, it is necessary to have a clear understanding of what question one wishes to answer. Although the exercise stress test can provide useful information to guide the physician in the management of patients, awareness of the limitations of this procedure and of the need for a probability approach to its interpretation is essential. In particular, one must ask whether stress testing will provide the information necessary to guide clinical decision-making. For example, although it is not necessary for diagnostic purposes to perform a stress test in a patient who has a high likelihood of coronary atherosclerotic disease, one might elect to obtain objective evidence of ischemia or diminished functional aerobic capacity before instituting medical or surgical therapy. This would provide reliable data for assessment of the effects of therapy. On the other hand, restricting attention to the ST segment response to exercise fosters neglect of other important diagnostic and prognostic information available from the exercise test. Attention to the blood pressure and heart rate response and to combinations of relevant variables, as described in this article, is necessary for more effective and enlightened clinical decision-making.

Adult↗
PubMed1982

Idiopathic granulomatous nephritis in a patient with hypertension and an atrophic kidney.

A patient with hypertension and an abnormal urinalysis was found on intravenous pyelography to have a small nonfunctioning left kidney. An arteriogram showed no renal artery stenosis but the renal vein renin from the small kidney was four times higher than that from the right kidney. A left nephrectomy was performed and the left kidney was found to be infiltrated with noncaseating granulomas. There was no evidence of a systemic granulomatous disease. 2 similar cases are cited. Idiopathic granulomatous nephritis is an apparently rare condition whose relationship to other granulomatous diseases is unclear.

Adult↗
PubMed1982

Synthesis of terfenadine.

The synthesis of alpha-[4-(1,1-dimethylethyl)phenyl]-4-(hydroxydiphenylmethyl)-1- piperidinebutanol (terfenadine, RMI 9918, Triludan, Teldane, resp.) is described. A limited structure-activity analysis of the central nervous system-mediated side effects of this compound and related analogs is made relative to the antipsychotic agent, haloperidol. Modification of the piperidine 4-position substituents of haloperidol to give a 4-(alpha, alpha-diphenylmethanol) moiety has conveyed histamine H1 -antagonism to the anti-psychotic agent, haloperidol. Structural changes of this fluorobutyrophenone have progressively reduced and finally eliminated centrally-mediated side effects. The result of this exercise is terfenadine, a preferred antihistamine, potent and selective in antagonizing histamine H1-receptor-mediated responses but lacking the usual side effect profile of known histamine H1-receptor antagonists.

Animals↗
PubMed1977

Changes in the fasting blood sugar after hydrochlorothiazide and potassium supplementation.

A 20% or greater rise in the fasting blood sugar occurred in 11 of 24 patients treated with 50 mg hydrochlorothiazide twice daily for six to ten weeks. The blood sugar decreased when potassium was given in conjunction with the diuretic, but the mean fasting blood sugar remained higher than pretreatment levels. There was no correlation between the percent change in the blood sugar and the per cent change in the serum K or exchangeable 42K.

Adult↗
PubMed1976

Bis-basic-substituted polycyclic aromatic compounds. A new class of antiviral agents. 7. Bisalkamine esters of 9-oxoxanthene-2,7-dicarboxylic acid, 3,6-bis-basic ethers of xanthen-9-one, and 2,7-bis(aminoacyl)xanthen-9-ones-xanthenes, and -thioxanthenes.

3,6-Bis[2-(dimethylamino)ethoxy]-9H-xanthen-9-one dihydrochloride (4, RMI 10874DA) and 1,1'-(9H-xanthene 2,7-diyl)bis[2-(dimethylamino)ethanone] dihydrochloride (16, RMI 11513DA) were found to prolong survival of mice infected with lethal challenges of encephalomyocarditis (EMC) virus. They were effective by oral as well as subcutaneous administration and showed broad-spectrum antiviral activity. They were selected for preclinical evaluation from the five series of compounds named in the title that were synthesized in analogy to tilorone and related fluorenone derivatives, described earlier. In addition to 4 and 16, compounds 11, 12, 17, and 18 showed high antiviral activity on oral as well as subcutaneous administration. High antiviral activity on subcutaneous admistration was found in the bisalkamine esters 1,2, and 14, the bis(aminoacyl)xanthenes 23 and 26, the bis(aminoalkylene)xanthene 31, the bis(aminoacyl)thioxanthenes 34-40, and the bis-basic ethers of 9-benzylide-nexanthenes 41 and 42. Structure-activity relationships showed a decrease of oral activity with increased length of side chains and increased molecular weight of dialkylamino substituents of 3,6-bis-basic ethers of xanthen-9-one and of 2,7-bis(aminoacyl)xanthenes and-xanthen-9-ones. At least one carbonyl or alkenyl function in conjugation to the xanthene nucleus either at the 9 position of the nucleus or in the side chains is required for high antiviral activity.

Administration, Oral↗