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Biomedical subjects

E Grossman

Publications and source records attributed to E Grossman.

At least 91 records · Page 5Linked to original sources
PubMed1997

Elevated levels of serum creatine kinase induced by hyponatraemia.

Elevated serum creatine kinase levels are one of the major criteria for the diagnosis of myocardial injury. Noncardiac causes such as muscular and brain damage may also be associated with elevated serum creatine kinase levels. Hyponatremia may induce increased serum creatine kinase in association with rhabdomyolysis or with hypothyroidism. A patient is described where three episodes of hyponatraemia not associated with rhabdomyolysis or hypothyroidism induced transient elevations of serum creatine kinase levels. The association between hyponatraemia and elevated creatine kinase levels should be emphasized to prevent erroneous diagnosis of myocardial injury.

Aged↗
PubMed1997

Nifedipine GITS replacing nifedipine SR: ambulatory blood pressure assessment of efficacy.

The relative efficacy of two formulations of nifedipine, slow release (SR) and gastrointestinal therapeutic system (GITS), to lower blood pressure in hypertensive patients was evaluated in a prospective study. Nifedipine GITS 30 mg/day replaced nifedipine SR, 20 mg b.i.d. in 38 patients, 23 monitored by routine blood pressure measurements and 15 by ambulatory monitoring. Nifedipine GITS achieved a marked reduction in blood pressure with a smaller dose than nifedipine SR: 30 versus 40 mg/day, respectively. It is concluded that patients with hypertension controlled on a twice-daily dose of nifedipine prolonged action can be converted to a lower once-daily dose of nifedipine GITS without experiencing any increase in blood pressure. Tolerability and compliance improved when switching to the GITS formulation.

Adult↗
PubMed1997

A comparison of the efficacy and safety of an electric and a manual children's toothbrush.

Effective plaque control of the primary dentition can be particularly difficult to achieve because of problems with motivation and manual dexterity in some children. This study compared plaque control efficacy of a new electric toothbrush designed specifically for use by children with a children's manual brush. Results showed that in a pediatric population aged between 8 and 12 years, the electric brush achieved significantly greater plaque removal from both primary and permanent dentition.

Analysis of Variance↗
PubMed1996

Diabetic and hypertensive heart disease.

OBJECTIVE: To review the literature on the cardiac effects of diabetes mellitus and hypertension. DATA SOURCES: A MEDLINE search of English-language articles published between 1980 and January 1996 was done using the terms diabetes mellitus, hypertension or blood pressure, and heart. References cited in identified articles were also reviewed. STUDY SELECTION: Selected studies were divided into those addressing coronary artery disease or myocardial ischemia and those addressing nonischemic cardiomyopathy and its sequelae. Preference was given to articles about the cardiac complications of both diabetes mellitus and hypertension. RESULTS: Patients with diabetes and hypertension have a higher incidence of coronary artery disease than do patients with diabetes or hypertension alone. The former patients also show impaired systolic and diastolic function and have more severe left ventricular hypertrophy as documented by echocardiography and at autopsy. The structural myocardial damage seen in these patients has been attributed primarily to hypertension; the myocellular dysfunction has been attributed primarily to diabetes. In diabetic hypertensive patients with cardiomyopathy, coronary artery disease as well as structural and functional cardiac abnormalities are more pronounced than would be expected from either diabetes or hypertension alone. CONCLUSIONS: Considerable evidence from both experimental animal models and humans points to hypertension as a critically important factor in the pathogenesis of severe heart disease in persons with diabetes. The pathogenetic sequelae of diabetes and hypertension are devastating to the heart and often lead to premature congestive heart failure, sudden cardiac death, and acute myocardial infarction. Strict control of arterial pressure and glycemia may prevent or even ameliorate heart disease in patients with hypertension and diabetes.

Animals↗
PubMed1996

Arterial and venous compliance in obese and nonobese subjects.

Arterial compliance and central blood volume were evaluated in obese and nonobese patients with and without hypertension. Arterial compliance was lower in the hypertensive group, although obese subjects, regardless of their blood pressure, had higher arterial compliance. The ratio of central blood volume to total blood volume was highest in hypertensive patients, whether obese or lean, indicating increased venoconstriction.

Adult↗
PubMed1996

Reduction in left ventricular mass in patients with systemic hypertension treated with enalapril, lisinopril, or fosenopril.

There are still conflicting data as to whether reduction in LV mass is beneficial. In the present study, no deterioration in LV systolic function occurred in patients in whom regression of LV mass was achieved. Impairment in LV compliance has been shown in hypertensive patients, even in the presence of preserved systolic function and normal LV mass. In our study, improvement in diastolic function was observed only in patients whose LV mass decreased, and it was related to reduction in mass and not to a decrease in mean arterial pressure. Therefore, we suggest that because diastolic function is the first activity to deteriorate in hypertensive patients, it may be the first activity to improve, and this improvement may be related to reduction in LV mass with ACE inhibitors.

Adult↗
PubMed1996

Survey of cardiovascular risk factors in newly arrived Yemenites to Israel.

Blood pressure (BP), glucose and lipid profile were examined in 108 adult Yemenite immigrants within a few weeks after their arrival in Israel. Mean systolic BP was 105.8 +/- 15.21 mm Hg and mean diastolic BP was 69.74 +/- 12.25 mm Hg. Glucose was 81.4 +/- 30.49 mg/dl; total cholesterol was 167.54 +/- 44.54 mg/dl and triglycerides 137.11 +/- 94.9 mg/dl, while the small size of the group preclude drawing definitive conclusions, it can be said that BP as well as lipids level in this group were lower than in Yemenite immigrants who stepped off the magic carpet more than 45 years ago.

Adolescent↗
PubMed1996

The prevalence and awareness of hypertension among Israeli Arabs.

The prevalence and awareness of hypertension among Israeli Arabs was evaluated by measuring blood pressure (BP), heart rate, height and weight in a group of 412 subjects, 176 women and 236 men, mean age 38.4 +/- 18 (range 12-87 years) residing in Northern Israel. All subjects completed a questionnaire that included medical and family history and habits. Hypertension was defined when the subject used antihypertensive treatment or measured systolic BP was > 140 mm Hg and/or diastolic BP was > 90 mm Hg. BP was related to age, body mass index, gender, place of living (urban or rural), tobacco use, and level of physical activity. It was not related to coffee and alcohol use, and dietary sodium. The prevalence of hypertension in this group was 26.7%, similar to that in the general Israeli population. Only 9.7% were aware of their hypertension. The level of unawareness was significantly higher in the urban dwellers than in rural dwellers: 20.7% vs 12.8% (P < 0.05). This especially high rate among urban dwellers should be taken into account in designing screening programmes to detect hypertension in this population.

Adolescent↗
PubMed1996

Felodipine in the treatment of severe refractory hypertension.

The efficacy of felodipine and tolerance of this drug was examined in 52 patients, 23 men and 29 women, 18-76 years of age, in whom it either replaced previous therapies of nifedipine and other vasodilators, or was added to a constant dose of beta blockers and diuretics or another previous therapy, which was unchanged. Felodipine significantly reduced blood pressure (BP), from 192.3 +/- 31.9/114.3 +/- 18.0 to 155.7 +/- 19.5/93.8 +/- 11.5 mm Hg, with no change in pulse rate. There were no significant biochemical changes, renal deterioration or blood sugar disequilibrium. Adverse reactions including flushes and leg edema could be tolerated by most of the patients, however six patients dropped out. Orthostasis dictated a decrease in felodipine dosage. Felodipine appears to be a highly potent, well tolerated drug and offers a substitute treatment for severe hypertensives refractory to other vasodilators.

Adolescent↗
PubMed1996

[Indapamide--a substitute diuretic for hypertensives with hyperglycemia and/or dyslipidemia].

Diuretics are among the first drugs offered to the hypertensive patient. However, they can induce metabolic changes resulting in cardiovascular insult. Especially noteworthy are increased levels of glucose and lipids. Indapamide is a diuretic and vasodilator that does not raise blood glucose or lipid levels. We therefore investigated its use as a substitute diuretic in patients whose treatment had resulted in hyperglycemia and/or hyperlipidemia. In 24 hypertensives, Indapamide, 2.5 mg daily, replaced the diuretic therapy they were receiving. Blood pressure, blood glucose, hemoglobin A1C and lipid profile were measured before and every month during the 6 months of Indapamide treatment. Replacement of diuretics with Indapamide significantly reduced blood glucose from 148 +/- 53 mg/dl to 127 +/- 37, p = 0.05 HbA1C from 8.42 +/- 0.4 mg/dl to 7.7 +/- 2.0, p = 0.05; total cholesterol from 253 +/- 45 mg/dl to 228 +/- 43, p < 0.05; and triglycerides from 224 +/- 145 mg/dl to 176 +/- 91, p < 0.05. Blood pressure was better controlled with Indapamide than with previous medications. It was reduced from an average of 155 +/- 1 systolic and 89 +/- 8 diastolic (mm Hg), to 142 +/- 13 and 83 +/- 7, respectively, p < 0.05. We conclude that Indapamide is safe and effective in lowering blood pressure and contributes to better control of blood glucose and lipid levels in diabetic and dyslipidemic patients, compared to standard diuretics.

Antihypertensive Agents↗
PubMed1996

A comparative clinical study of extrinsic tooth stain removal with two electric toothbrushes [Braun D7 and D9] and a manual brush.

PURPOSE: To evaluate the efficacy and safety of two oscillating/rotating toothbrushes, (Braun Oral-B Plaque Remover-D7 and Braun Oral-B Ultra Plaque Remover-D9) and a manual toothbrush with respect to removing extrinsic dental stain. MATERIALS AND METHODS: This randomized, three-way cross-over study investigated 24 subjects entering the trial, which was divided into three, 5-day periods. Over the first 4 days of the study, an intense chlorhexidine/tea rinsing regimen was employed to induce extrinsic tooth staining. On day 5, each subject was assessed for tooth stain; they then brushed for a total of 2 minutes with one of the three randomly allocated toothbrushes. Stain evaluations were repeated after 30 seconds, 1 and 2 minutes brushing, with the intensity of stain, area of stain and number of sites with < 10% stained tooth area, being recorded at each assessment. RESULTS: Analysis of the results showed that the two electric toothbrushes were significantly better at removing stain than the manual toothbrush. In addition, the D9 was consistently more effective than the D7, with the difference with respect to stain area achieving statistical significance (P < 0.05) after 2 minute's brushing. All three brushes were found to be safe, and there was no evidence of any soft or hard tissue abrasion. It was concluded that the oscillating/rotating electric toothbrushes were more effective in removing extrinsic dental stain than a manual brush, and that compared with the D7, the newly designed Braun Oral-B Ultra Plaque Remover has an increased potential for stain removal.

Adolescent↗
PubMed1995

High blood pressure. A side effect of drugs, poisons, and food.

A variety of therapeutic agents or chemical substances can induce either a transient or a sustained increase in blood pressure. These agents increase arterial pressure by either causing sodium retention and extracellular volume expansion or directly or indirectly activating the sympathetic nervous system. Some agents act directly on arteriolar smooth muscle. For certain agents, the mechanism of pressure elevation is mixed or unknown. Paradoxically, some agents that are used to lower arterial pressure may acutely increase arterial pressure. Also, a rebound increase in pressure may be encountered after discontinuation of certain antihypertensive agents. In general, these chemically induced increases in arterial pressure are small and transient; however, severe hypertension involving encephalopathy, stroke, and irreversible renal failure has been reported. Careful evaluation of a patient's drug regimen may identify chemically induced hypertension and prevent the need for evaluation and therapy. This study reviews the therapeutic agents or chemical substances that elevate blood pressure and their mechanisms of action.

Drug-Related Side Effects and Adverse Reactions↗
PubMed1995

The effect of enalapril with and without hydrochlorothiazide on insulin sensitivity and other metabolic abnormalities of hypertensive patients with NIDDM.

The effect of 20 mg of enalapril with and without 12.5 mg of hydrochlorothiazide on glucose metabolism insulin sensitivity and lipids was evaluated in hypertensive non-insulin-dependent diabetes. Ten mild to moderate hypertensive patients with non-insulin-dependent diabetes mellitus were treated for 8 weeks with 20 mg enalapril once a day, and then divided into two groups of 5 patients each for a second 8 weeks of treatment with enalapril alone or in combination with hydrochlorothiazide, 12.5 mg once a day. Blood pressure, fasting plasma glucose, lipids and insulin, glycosylated hemoglobin, and insulin sensitivity were measured at baseline and after 8 and 16 weeks. Results were analyzed by the ANOVA test for repeated measures and all values are given as mean +/- SD. Diastolic blood pressure decreased significantly after the first and second period of enalapril and after the combination of enalapril and hydrochlorothiazide. Glycosylated hemoglobin dropped significantly after the first and second period of enalapril monotherapy. Plasma triglycerides and fasting plasma insulin decreased significantly after the 16 weeks of enalapril. Insulin-mediated glucose uptake increased significantly after 8 and 16 weeks of monotherapy with enalapril. No significant difference was observed in any of the metabolic characteristics, including insulin sensitivity, between the values after 8 weeks of enalapril alone and the final values of the enalapril-treated and the enalapril/hydrochlorothiazide-treated groups. It is concluded that enalapril improves some of the metabolic parameters, including insulin sensitivity, of hypertensive diabetic patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Hypertensive heart disease and the diabetic patient.

Patients with diabetes mellitus are particularly vulnerable to cardiovascular disease. Although structural and functional myocardial complications are present in patients with diabetes alone, they are particularly severe in patients with both diabetes and hypertension. Considerable evidence--both in experimental animal models and in humans--points to hypertension as of critical importance in the pathogenesis of severe diabetic heart disease. In diabetic hypertensive cardiomyopathy, coronary artery disease as well as structural and functional abnormalities are more pronounced than would be expected from either process alone. The myocardial damage is attributed mainly to hypertension, whereas the myocellular dysfunction is attributed mainly to diabetes. Together, the consequences to the myocardium are devastating. Strict control of the hypertension and diabetes may have an ameliorative effect on the subsequent development of diabetic heart disease.

Animals↗