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Biomedical subjects

G Nyberg

Publications and source records attributed to G Nyberg.

At least 145 records · Page 8Linked to original sources
PubMed1988

Anti-anginal efficacy of a controlled-release formulation of isosorbide-5-mononitrate once daily in angina patients on chronic beta-blockade.

The anti-anginal effect of a controlled-release (Durules) formulation of isosorbide-5-mononitrate (5-ISMN) 60 mg, Imdur, once daily was evaluated in a randomised double-blind, placebo-controlled, crossover study with a placebo run-in period. Each period lasted for 2 weeks. A total of 70 patients (58 men and 12 women) with stable exertional angina pectoris on beta-blockade, mean age 59 years (range 39-71), were included. Exercise testing was performed on a bicycle ergometer 3 hours after the dose at the end of each period. Anginal attacks and intake of sublingual nitroglycerin tablets were noted. Imdur in combination with a beta-blocker significantly increased the total exercise capacity, the time and total work until the onset of chest pain and at 1 mm ST-depression compared with beta-blockade alone. The attack rate and the nitroglycerin consumption were significantly decreased. Headache was the only significant side-effect. In conclusion, the addition of Imdur once daily to beta-blockade significantly increased the anti-anginal effect.

Adrenergic beta-Antagonists↗
PubMed1988

Glomerular structural quantities in baseline biopsies from cadaveric donor kidney pairs.

Glomerular structural parameters were estimated in kidney biopsies from 11 cadaveric donors at the time of transplantation. The main purpose was to compare the biopsies from the right and left kidney from each donor. Mean glomerular volume was determined by light microscopy. The ultrastructural parameters were basement membrane thickness and volume fractions of mesangial regions with either the tuft or total glomerulus, (i.e. the tuft plus the urinary space in between the capillaries) as reference spaces. Further, the mesangial composition was determined as the volume fraction of basement membrane-like material to total mesangial regions (Vv(BMLM/mes]. The structural quantities conformed with those obtained in living kidney donors. The coefficient of variation (CV) for the group of 11 cases was highest for the mean glomerular volume (0.26) and lowest for the Vv(BMLM/mes) (0.10). The coefficient of error (CE) of the two independent determinations of structural parameters in each individual was well below 5%. The findings therefore demonstrate that, with the methods used, a renal biopsy gives valid and reliable information for that particular individual - at least in cases with 'normal' structures.

Adult↗
PubMed1987

Unbound plasma concentrations, total plasma concentrations, and red blood cell concentrations of thioridazine and its main metabolites: an in vitro study.

The relationships between, on the one hand, the unbound plasma concentrations of thioridazine and thioridazine metabolites and, on the other, the total plasma concentrations and the red blood cell concentrations were studied in vitro. The relationships between the unbound and total plasma concentrations were curvilinear, while those between the unbound concentrations and the red blood cell concentrations within a broad range were closer to rectilinear. Profound changes were seen in the relationship between unbound and total plasma concentrations at varying concentrations of alpha 1-acid glycoprotein, while the rectilinear relationship between the unbound plasma concentrations and the red blood cell concentrations remained essentially unchanged.

Adult↗
PubMed1987

Impact of metabolic control in progression of clinical diabetic nephropathy.

Renal clearance of 51Cr-EDTA as a measure of glomerular filtration rate was followed prospectively for 21 months in 18 Type 1 (insulin-dependent) patients with juvenile-onset diabetes and nephropathy. Hypertension was treated aggressively, attaining a mean blood pressure of 154/88 mmHg in the supine and 126/82 mmHg in the standing position. The mean glycosylated haemoglobin value (HbA1c) during the observation period was found to correlate well with the mean of random blood glucose values (r = 0.72). It also correlated to the rate of glomerular filtration rate decline over time, whether the latter was calculated as slope coefficient for all available data (r = -0.52, p less than 0.05) or based on the first and last observations only (r = -0.57, p less than 0.05). In a multiple linear stepwise regression analysis also including mean arterial blood pressure, the correlation between glomerular filtration rate decline and HbA1c was significant at p less than 0.01; this explained one-third of the progression, while mean arterial pressure could not be shown to contribute. It is concluded that hyperglycaemia, contrary to the general belief, is a risk factor for the progression of clinical diabetic nephropathy with reduced glomerular filtration rate.

Adult↗
PubMed1987

Pilin independent binding of Neisseria gonorrhoeae to immobilized glycolipids.

The adherence process in pathogenesis involves the attachment of bacteria to structures present on eukaryotic cell surfaces. To investigate components necessary for this interaction, we have characterized the binding of N. gonorrhoeae to eukaryotic glycolipids immobilized on thin layer chromatograms. The gonococci specifically bind to a subset of glycolipids consisting of lactosylceramide, gangliotriosylceramide, and gangliotetraosylceramide. This binding was identified in both piliated and nonpiliated cells, and is postulated to be mediated by a nonpilin lectin-like adhesin protein.

Bacterial Adhesion↗
PubMed1987

Total plasma concentrations, red blood cell concentrations, and radioreceptor assay values compared with unbound plasma concentrations of thioridazine and thioridazine metabolites in psychiatric patients.

Neuroleptic drug concentrations at the receptor sites are likely to be reflected more closely by the unbound than by the total plasma concentrations. The aim of this study was to establish whether or not the unbound plasma concentrations of thioridazine and its main nonconjugated metabolites show a stronger correlation to the red blood cell (RBC) concentration than to the total plasma concentration of the drug. The total and unbound plasma concentrations and the RBC concentrations of thioridazine and its metabolites were therefore determined in thioridazine-treated patients. "Calculated unbound concentration values" were derived from the determined total concentrations of the drug, the concentrations of drug-binding proteins, and previously determined kappa values. Since the RBC concentrations showed the best correlation to the unbound plasma values, they may be a more accurate tool than the total plasma concentrations for monitoring thioridazine treatment. The determined unbound plasma concentrations were better correlated to the calculated unbound concentrations than to the total plasma concentrations. The total plasma concentrations, but neither the unbound plasma nor the RBC concentrations, were significantly correlated to the concentrations of the drug-binding protein alpha 1-acid glycoprotein. Radioreceptor assay values were strongly correlated to the weighted sum of the total and unbound plasma concentrations of thioridazine and its metabolites.

Adolescent↗
PubMed1987

Estimation of renal function in diabetic nephropathy. Comparison of five methods.

Plasma as well as renal clearance of 51Cr-EDTA, serum creatinine, plasma beta-2-microglobulin and endogenous creatinine clearance were compared and evaluated in patients with diabetic nephropathy and in control patients with renal disease of other origin. The difference between the plasma clearance and the renal clearance of 51Cr-EDTA, that is the extrarenal clearance, was found to be higher in diabetics than in control patients (7.0 vs. 3.5 ml/min; p less than 0.001). The serum creatinine correlated well with the glomerular filtration rate (GFR), but in the individual case the GFR was not at all predictable from serum creatinine. The plasma beta-2-microglobulin did not correlate better than serum creatinine to 51Cr-EDTA clearance, and did not permit an earlier diagnosis of renal insufficiency. Endogenous creatinine clearance overestimated GFR by 0-180%. Due to residual urine, the coefficient of variation was higher in diabetic patients than in controls, but the effect of this imperfection was reduced by using multiple collection periods. In conclusion, the renal clearance of 51Cr-EDTA was found to be preferable to the other methods.

Adult↗
PubMed1987

Mononitrates as monotherapy in the prophylactic treatment of angina pectoris.

This article reviews the results of double-blind comparative studies on the therapeutic use of isosorbide 5-mononitrate as monotherapy in the prophylaxis of angina pectoris. Isosorbide 5-mononitrate appears at least as effective as the same dosage of isosorbide dinitrate and is probably superior to the calcium antagonists. Recent data have shown that isosorbide 5-mononitrate in a controlled-release formulation given once daily has a significantly better antianginal effect than placebo without inducing the development of tolerance.

Angina Pectoris↗
PubMed1987

Abrupt withdrawal of isosorbide 5-mononitrate (Imdur) after long term treatment in stable angina pectoris. A preliminary report.

32 patients with stable angina pectoris who had been receiving a controlled-release formulation Durules of isosorbide 5-mononitrate (Imdur) 60 to 120 mg daily with concomitant beta-blocker therapy for at least 1 year were entered into a study to evaluate possible rebound phenomena from the abrupt withdrawal of isosorbide 5-mononitrate and to determine whether nitrate tolerance had developed. Isosorbide 5-mononitrate was abruptly withdrawn and substituted with placebo for 2 weeks, after which the active drug was reintroduced. No deterioration of exercise performance could be detected during withdrawal of therapy, but an increase was seen after reinstitution. No tolerance was found for systolic blood pressure and ST segment changes or for the number of anginal attacks and short-acting glyceryl trinitrate tablets consumed. Three patients had to be hospitalised because of a sudden deterioration of symptoms on withdrawal of isosorbide 5-mononitrate. It was concluded that isosorbide 5-mononitrate in Durules has a beneficial effect and that tolerance does not appear to be clinically relevant.

Adrenergic beta-Antagonists↗
PubMed1987

Clinical evaluation of felodipine in patients with refractory hypertension.

The calcium antagonist, felodipine, was used to treat 21 patients with severe uncontrolled hypertension: 13 had renoparenchymatous hypertension, 5 essential hypertension and 3 renovascular hypertension. Mean arterial blood pressure of patients was 195 +/- 8/122 +/- 3mm Hg in spite of treatment with 3 or more antihypertensive drugs. The majority of the patients (n = 17) were treated with an ACE inhibitor. Mean glomerular filtration rate (GFR) for 20 patients was 39 +/- 6 ml/min/1.73m2 body surface area (Cr-EDTA clearance) before felodipine administration. All patients had an immediate blood pressure fall after 5-10mg of felodipine administered orally. This fall persisted when the drug was given 2 or 3 times daily in combination with previous medication except the former vasodilating drugs. 15 patients are on long term treatment with felodipine and their blood pressure after 1 year (n = 14) was 152 +/- 4/89 +/- 2mm Hg. Patients with moderately impaired renal function and no signs of progressive kidney disease (n = 8) improved their GFR significantly after 1 year on felodipine. Six patients stopped felodipine therapy within 3 months (4 because of adverse reactions, 1 died of scleroderma and 1 became normotensive after the start of dialysis treatment). In patients with renoparenchymatous disease and documented progressive deterioration of renal function the addition of felodipine did not prevent a decline in filtration rate but did slow the rate of deterioration (from 9 +/- 2 to 5 +/- 1 ml/min/year).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Advanced diabetic glomerulopathy. Quantitative structural characterization of nonoccluded glomeruli.

Quantitative ultrastructural data were obtained from kidney biopsy material of 12 long-term insulin-dependent diabetics. All patients had overt diabetic nephropathy with increased urinary albumin excretion and reduced glomerular filtration rate. Renal clearance of 51Cr-EDTA was in the range of 16-50 ml X min-1 X 1.73 m-2. All patients received antihypertensive treatment. A combined light- and electron-microscope study was performed. A significant proportion of the glomeruli was totally occluded (mean 36%, range 24-67%). Structural data presented relate only to the open, still-functioning glomeruli. Comparison with data previously obtained showed that the thickness of the peripheral basement membrane [647 nm, coefficient of variation (C.V.) 0.22] was more than twice the normal value (310 nm, C.V. 0.08); the width of epithelial foot processes (352 nm, C.V. 0.07) was significantly greater than in normal biopsies (224 nm, C.V. 0.06); and the mean volume of the open glomeruli was markedly increased compared with normal and clearly exceeded that in the early diabetic hypertrophy. Total mesangial volume and total basement membrane material per open glomerulus were increased by 277 and 614%, respectively. However, capillary length and surface per open glomerulus were similar to those observed in early diabetic hypertrophy. These findings suggest that a late glomerular hypertrophy with preservation of capillary surface occurs as a compensatory phenomenon, prolonging renal survival for diabetic nephropathy patients.

Adolescent↗
PubMed1987

Morbidity and mortality in diabetic and non-diabetic recipients of living related donor kidneys.

The results of kidney transplantation in juvenile-onset diabetic patients were compared to those of an age-matched control group of non-diabetic patients, all of whom were transplanted with kidneys from living related donors during the period 1977-1982, and managed by the use of conventional immunosuppression. The 5-year actuarial patient and graft survival rates did not differ significantly between the groups: 79% and 68% in diabetic patients and 88% and 72% in non-diabetic patients, respectively. The graft function was stable in both diabetic and non-diabetic patients. Early surgical complications in both groups were few. Peripheral vascular insufficiency leading to amputation occurred only in diabetic patients, while hyperparathyroidism was recorded only in non-diabetic recipients. Primary cytomegalovirus infections were more common in diabetic patients. Providing good graft function was achieved, heart complications were a minor problem in both patient groups. However, cardiovascular complications were a leading cause of death in patients whose graft failed. The initial hospital stay was, on average, one week longer in diabetic patients, but the accumulated hospital stay in the three years following transplant was twice as long (1 month per year) in the diabetic group as in the non-diabetic. Rehabilitation during the last six months of follow-up was good in both groups and about 60% of diabetic and 90% of non-diabetic patients were working full- or part-time. Thus, the prospects for survival and rehabilitation were similar in diabetic and non-diabetic patients in the 5 years following transplant, but at a higher price in diabetes.

Adolescent↗