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Biomedical subjects

Bjørn Bratland

Publications and source records attributed to Bjørn Bratland.

4 recordsLinked to original sources
PubMed2006

[Warfarin treatment in a general practice].

BACKGROUND: Warfarin treatment gives a well-documented reduction of the risk of thrombosis, but makes the patients more liable to bleedings. In Norway most patients are treated in general practice. MATERIAL AND METHODS: This study describes a 16-year-material (1988-2003) of 427 patients on warfarin in a practice with five general practitioners, based on retrospective analysis of patient files. A more detailed survey was done for the last four years (260 patients). RESULTS: The prevalence of warfarin treatment in the practice increased from 0.9% to 2.7%, mostly because of increased treatment of atrial fibrillation. The average age of patients increased from 64 years to 72 years. 57% of the INR measurements were within therapeutic range. There were 16 haemorrhages pr 100 patient years with the majority occurring on therapeutic INR values. 14 serious haemorrhages were registered (2.4 pr 100 patient years), including seven cerebral haemorrhages resulting in three permanent cases of paralysis and one death. 14 patients had new disease diagnosed due to the bleeding. Only 1 patient experienced a venous thrombosis during 572 patient years of treatment. However, on 3 occasions thrombosis occurred shortly after termination of warfarin treatment. INTERPRETATION: Prevalence of warfarin treatment was higher than usual. The numbers of INR values within therapeutic range and numbers of serious bleedings were comparable to other studies. In spite of risk of haemorrhage, warfarin is a worthwhile treatment and can be carried out in general practice.

Aged↗
PubMed2005

[Elevated serum ferritin and hemochromatosis in general practice].

BACKGROUND: We wanted to examine how many of our patients with elevated serum ferritin had undetected haemochromatosis. MATERIAL AND METHODS: Searches in our patient files showed that 519 persons aged 20-70 had tested positively for elevated serum ferritin over the five-year period 1996-2000. 379 of these (73%) were found suitable for follow up and were offered examination for serum ferritin and transferrin saturation. 291 of these (77%) came in. Patients with elevated transferrin saturation had a gene test for haemochromatosis. RESULTS: 23 of the 291 persons with elevated serum ferritin also had elevated transferrin saturation (8%). 12 out of 23 (52%) were homozygote for the haemochromatosis mutation C282Y. INTERPRETATION: In our opinion, persons with elevated serum ferritin should be offered a control of serum ferritin and transferrin saturation. If both these tests show elevated levels, a gene test for haemochromatosis should be performed. Persons who are homozygote for the haemochromatosis mutation should have a follow up with testing of serum ferritin with some years' intervals in order to secure that venesection is started in due time.

Adult↗
PubMed2004

[Treatment of hypertension in patients with left ventricular hypertrophy].

BACKGROUND: The LIFE study (Losartan Intervention For Endpoint reduction in hypertension) is a randomized, double-blind comparison of losartan and atenolol-based treatment. The study hypothesis was that losartan would reduce cardiovascular morbidity and mortality more than traditional antihypertensive treatment with atenolol. MATERIAL AND METHODS: The study included 9193 patients in seven countries. RESULTS: By the end of the study, the mean dose was losartan 82 mg and atenonol 79 mg, whereas 94% of patients in both groups received additional hydrochlorothiazide. Blood pressure was reduced 30/17 mmHg by losartan and 29/17 mm Hg by atenolol. Despite the same reduction in blood pressure, the primary combined endpoint (cardiovascular mortality, non-fatal stroke and myocardial infarction) was reduced by 13.0% (p = 0.021) in the losartan group. Non-fatal and fatal strokes were reduced by 24.9% (p = 0.001). In two pre-specified subgroup analyses, cardiovascular mortality was reduced by 46% (p = 0.01) in patients with isolated systolic hypertension (n = 1326), and total mortality was reduced by 39% (p = 0.002) in patients with diabetes (n = 1159). INTERPRETATION: Losartan prevented more cardiovascular complications than atenolol for the same reduction in blood pressure and have positive additional effects beyond blood pressure control in patients with hypertension and left ventricular hypertrophy.

Aged↗