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Biomedical subjects

I Holme

Publications and source records attributed to I Holme.

At least 73 records · Page 4Linked to original sources
PubMed1994

Randomized response estimates for the purchase of smuggled liquor in Norway.

The randomized response technique is applied on a voluntary basis for estimating the purchase of smuggled liquor in Norway. Of a total sample of 2330 respondents, aged 15 and over, about one half chose the protective option of the RR-technique. The other half responded directly to the supposed sensitive questions. The estimates from the two groups were weighted together to give population estimates for the percentage of buyers, and the quantities bought, of smuggled liquor. The resulting estimates were found to be considerably higher than estimates from a contemporary survey based on direct response only.

Adolescent↗
PubMed1994

The relation of coronary and peripheral arterial disease to the severity of femoral atherosclerosis in hypercholesterolaemia.

OBJECTIVES: The extent of atherosclerosis in the superficial femoral artery and the severity of arterial disease in the aorto-iliac and femoro-popliteal arterial districts were related to clinical diagnosis of coronary and peripheral atherosclerosis in hypercholesterolaemic patients. DESIGN: The study constitutes baseline cross-sectional data of a randomized double-blind clinical trial on Probucol, using both computer based and visual estimations of angiographies as endpoints. SUBJECTS: Two hundred and ninety men and women (mean age 54 years) with hypercholesterolaemia. MAIN OUTCOME MEASURES: Atherosclerosis was estimated with arteriographies. Lumen volume and edge roughness (vessel inner wall irregularity) of a 20 cm segment of the femoral artery were estimated by computer. A visual atherosclerosis score of the abdominal aorta to the popliteal arteries was made on both sides. RESULTS: Patients with peripheral arterial disease had significantly more advanced disease according to all three angiographic variables than those without symptoms of peripheral vascular disease. Both men and women with coronary artery disease had significantly lower femoral lumen volume and higher roughness values than patients without. Men with previous myocardial infarction had significantly higher mean visual scores of atherosclerosis than those without, while lumen volume and roughness did not differ in either sex. CONCLUSIONS: Femoral atherosclerosis is an expression of a generalized disease, associated with clinical symptoms of coronary artery disease. Femoral atherosclerosis is often accompanied by atherosclerosis also in the coronary arteries.

Adult↗
PubMed1994

Effect of cimetidine on gastrointestinal symptoms in patients taking nonsteroidal anti-inflammatory drugs. A large double-blind placebo controlled study.

The effect of cimetidine on gastrointestinal (GI) symptoms in patients taking non-steroidal anti-inflammatory drugs was studied in a multicentre, double-blind, placebo-controlled 4 week trial. Five hundred and seventy osteoarthritis patients received cimetidine 400 mg bid or placebo. Seventy-nine % in the cimetidine group had no GI symptoms at week 4 compared to 72% in the placebo group (p = 0.07). Only 5.6% in the cimetidine group reported heartburn compared to 19.2% in the placebo group. Diarrhoea was more pronounced in cimetidine treated patients; 18.5% compared to 2.7%. In a subgroup of patients with previous GI discomfort on NSAID therapy (N = 123), 63% reported disappearance of symptoms in the cimetidine group compared to 45% in the placebo group (p = 0.05). In patients with GI symptoms starting NSAID therapy and in patients on NSAID with a heartburn problem, cimetidine seems to be of value.

Adult↗
PubMed1993

The natural course of acute sciatica with nerve root symptoms in a double-blind placebo-controlled trial evaluating the effect of piroxicam.

To study the natural history of acute sciatica, 208 patients with obvious symptoms and signs of a lumbar radiculopathy (L5 and S1) were examined within 14 days of onset. A concomitant double-blind investigation of the effect of the nonsteroidal anti-inflammatory drug piroxicam was performed. The results measured by visual analog scale and Roland's functional tests showed a satisfactory improvement throughout the 4 weeks of observation. The piroxicam-treated group had same results as the control group. Based on questionnaires at months 3 and 12 approximately 30% of the patients still complained about back trouble and 19.5% were out of work after 1 year. Four patients underwent surgery during this period.

Adult↗
PubMed1993

[Doxazosin (Carduran)--a research survey].

4,260 patients were included in an open surveillance study simultaneously with the introduction of doxazosin for treatment of essential hypertension in Norway. The main aim of the study was to systematically collect information on side effects and events in patients being treated with a new drug. The effect on blood pressure, heart rate and lipids was also recorded. The study lasted for one year. 21 deaths were reported. 53% of the patients reported side effects and/or events. The frequency of side effects was particularly high during the first month of treatment. No new types of side effects were found. The initial higher frequency of reported side effects referred to all organ systems, and was also of the same magnitude in the different systems. A relation was found between certain cardiac side effects and/or events and cessation of previous medication upon starting treatment with doxazosin. The study shows that certain safety precautions should be observed in patients with coronary heart disease and heart failure. In three patients, doxazosin should be used only in combination with more specific treatment. Special caution should be observed when changing the specific basic treatment. Doxazosin had a very favourable antihypertensive effect. A drop in cholesterol and triglycerides was observed, as expected. The HDL-cholesterol value declined, which was unexpected. The results are difficult to interpret, owing to lack of a control group. On the other hand, the study shows how high blood pressure is being treated with drugs in ordinary practice. The authors discuss the methodology of surveillance studies.

Aged↗
PubMed1993

The predictability of risk factors with respect to incidence and mortality of myocardial infarction and total mortality. A 12-year follow-up of the Oslo Study, Norway.

OBJECTIVES: To study the prognostic value of several risk factors on incidence and mortality of myocardial infarction (MI) and total mortality in men. DESIGN: Prospective cohort study of 12 years' follow-up. SETTING: All men in Oslo aged 40-49 and a 7% sample of men aged 20-39 were invited for screening. SUBJECTS: Of all 30,025 invited men, of whom 25,015 were aged 40-49, a total of 16,209 men aged 40-49 attended the screening and risk factors were recorded for these men. MAIN OUTCOME MEASURES: Incidence of first MI (non-fatal and fatal), mortality of MI, total mortality. RESULTS: When examining the rate ratio of the fifth to the first quintile of risk factors we found that systolic and diastolic blood pressures were stronger predictors for mortality than incidence of MI. The rate ratios (95% confidence interval) of systolic blood pressure were 3.73 (2.56, 5.44) and 2.56 (2.01, 3.25) respectively. For diastolic blood pressure the corresponding rate ratios were 4.14 (2.84, 6.04) and 2.78 (2.18, 3.54). Small differences in the rate ratios for these end-points were found for total serum cholesterol and triglycerides. Daily cigarette smoking versus non-cigarette smoking was a stronger predictor for MI mortality than incidence, with rate ratios of 3.16 (2.45, 4.24) and 2.34 (2.00, 2.79) respectively. The Cox proportional hazards regression analysis confirmed the above results. CONCLUSIONS: Total serum cholesterol and triglycerides predicted incidence and mortality of MI equally well. Whereas blood pressure and daily cigarette smoking predicted mortality of MI more strongly.

Adult↗
PubMed1993

Risk factors of stroke incidence and mortality. A 12-year follow-up of the Oslo Study.

BACKGROUND AND PURPOSE: The objective of this study was to determine the risk factors of stroke incidence and mortality. METHODS: Our data are based on a prospective cohort study of men aged 40 to 49 years after 12 years of follow-up. RESULTS: In age-adjusted Cox proportional-hazards regression analysis of 14,403 healthy men, diastolic blood pressure was a stronger predictor for stroke incidence and mortality than systolic blood pressure. Smoking was a stronger predictor of mortality than of incidence. However, there was no dose-response relation among smokers by increased cigarette consumption. Total serum cholesterol was a significant (P < .05) risk factor for stroke mortality and of borderline significance (P = .08) for stroke incidence. Increased physical activity at leisure was associated with reduced stroke incidence but not mortality. The myocardial infarction risk score comprising systolic blood pressure, total serum cholesterol, and daily cigarette smoking was a strong predictor of mortality and incidence. Body mass index, triglycerides, blood glucose, and physical activity at work were not found to be risk factors for stroke. CONCLUSIONS: Reduction of blood pressure, cessation of smoking, lowered cholesterol, and increased physical activity at leisure are individual measures to reduce the risk of stroke.

Adult↗
PubMed1993

Repeated measurements over time: statistical analysis of the angiographic outcomes in the Probucol Quantitative Regression Swedish Trial (PQRST).

An increasing use of non-invasive techniques and arteriographies of the coronary, carotid or femoral arteries has taken place during recent years. This has prompted researchers to perform long-term randomized trials aiming at reducing atherosclerosis progression or achieving regression by cholesterol lowering in high risk populations. These trials are designed to use outcomes such as various indices of atherosclerosis which are assessed repeatedly over time. There are major decisions to be made contingent on the data structures in these trials, such as sphericity, interaction, development over time, missing data, non-normality etc. So, the statistical analysis of such data needs to be planned and specified a priori in a unified manner. This is demonstrated for the Probucol Quantitative Regression Swedish Trial (PQRST) which is designed to answer the question whether the drug probucol, given in combination with diet and cholestyramine, can delay development of atherosclerosis in hypercholesterolemic patients up to 70 years old. Change in atheroma volume is assessed by a newly developed quantitative angiographic technique based on digitized angiograms.

Analysis of Variance↗
PubMed1993

Reproducibility of quantitative arteriographic assessment of atherosclerosis in the femoral artery.

Results from computer-analysed angiograms in the Probucol Quantitative Regression Swedish Trial (PQRST) were analysed to determine the reproducibility of the method and any drift in the analysing system. The precision index (P(mu)) for 2 angiography series, made at 10 min intervals, of the femoral artery in 276 patients was 10.5 for lumen volume and 21.9 for roughness (edge irregularity). No difference in reproducibility was found between patients with and without symptoms of peripheral atherosclerosis or when looking at the reproducibility over years. A drift of 0.67% per year in the radiographic equipment (but not in the analysis system) was found, confirmed by use of phantoms. Computer-based analysis of femoral atherosclerosis is a reliable method for follow-up trials, giving high reproducibility even if the trial spans over several years and involves different centres. The use of phantoms is essential for checking the method over time.

Adult↗
PubMed1992

Cholesterol lowering and the reduction of CHD incidence and total mortality: results from a meta-analysis of randomized trials.

This editorial reports on a meta-analysis done on cholesterol-lowering trials. Coronary heart disease incidence is reported for 16 trials and total mortality for 19 trials. The cholesterol benefit ratio, i.e., the percent risk reduction divided by the percent cholesterol reduction, was analyzed in terms of total vs. potential modifying factors. For coronary heart disease the benefit ratio was 2.8 (95% CL: 1.5, 4.2), and for total mortality it was 1.2 (95% CL: -0.1, 2.3). Cholesterol reduction had to be at least 8-9% to outweigh the negative impact of treatment on total mortality.

Cholesterol↗
PubMed1992

Apolipoprotein B and A-I in relation to serum cholesterol and triglycerides in 43,000 Swedish males and females.

Automated methods for the determination of apolipoprotein B and apolipoprotein A-I were developed, tested, and applied in screening programs of large populations to improve information about the composition and degree of hyperlipoproteinemia. Apolipoproteins B and A-I, total cholesterol, and triglyceride levels were measured in 25,659 males and 18,144 females between 20 and 79 years of age, the majority subjectively healthy. The immunoturbidimetric methods used for apolipoproteins B and A-I were shown to be stable over time, and the errors of the methods were below 7%. Apolipoprotein B correlated with total cholesterol (r = 0.86, P less than 0.001) for each age decile group and for both sexes (r = 0.82-0.87, P less than 0.001). For a subsample comparable to the large population, apolipoprotein B correlated with cholesterol in low density (i.e., the atherogenic particle), r = 0.89, P less than 0.001. The mean values for apolipoprotein B increased with age for both sexes, with much higher levels in males than in females under 50 years of age. Apolipoprotein A-I was lower in males than in females in all age-groups. At all cholesterol levels males had higher apolipoprotein B, and at the same triglyceride level, also lower apolipoprotein A-I and hence a higher B/A-I ratio than females. Using apolipoprotein B and A-I (high-density lipoprotein cholesterol) particles and adopting Swedish consensus criteria for the diagnosis of risk of ischemic heart disease, examples are given showing that many individuals, especially females, with high or borderline total serum cholesterol can be excluded from further investigation/treatment for hypercholesterolemia.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Co-variation of alanine aminotransferase levels with relative weight in blood donors.

The association between alanine aminotransferase (ALAT) and body mass, sex and age was examined in 6036 consecutively tested blood donors. ALAT, age and body mass were higher in male donors than in female donros. The non-normal ALAT distribution curve normalized after 1n transformation, which made statistical analysis of the data more feasible. Multiple regression analysis demonstrated that ALAT was influenced by sex and relative weight, in that order, and very poorly by age. It is concluded that obesity is a major cause of raised ALAT in this predominantly healthy donor population.

Adult↗
PubMed1992

Cholesterol reduction in single and multifactor randomized trials: relationship to CHD incidence and total mortality as found by meta analysis of twenty-two trials.

This paper reports on a meta analysis in twenty-two randomized both single and multifactor trials regarding the effect of designed cholesterol reduction on total mortality and CHD incidence. Per cent reduction in CHD incidence was 2.5 for every per cent associated net reduction in total cholesterol, but was only 0.74% for total mortality. Since total net reduction in cholesterol was about 5% in all trials combined, the number of participants was far too small to demonstrate a significant expected reduction of 4% in total mortality. However, the 4% reduction lies just outside the observed 95% confidence limits of the overall estimate of effect on total mortality (OR = 1.02; CL 0.97, 1.07). It is concluded that cholesterol reduction must be much larger than 5% to be able to reduce the relative risk of CHD substantially and total mortality moderately.

Cholesterol↗
PubMed1992

High cholesterol and triglyceride values in Swedish males and females: increased risk of fatal myocardial infarction. First report from the AMORIS (Apolipoprotein related MOrtality RISk) study.

In over 300,000 Swedish males and females aged 20 to 79 years total cholesterol and triglycerides were measured consecutively between 1985 and 1989. In a subsample of about 35,000 individuals apolipoprotein (apo) B (indicating atherogenic) and apo A-I (anti-atherogenic) were also measured. In the age group 40-49 years, 24% of the males and 12% of the females had hypercholesterolemia (> or = 6.5 mmol/L) and 14% and 3%, respectively had hypertriglyceridemia (> or = 2.3 mmol/L). Combined hyperlipidemia occurred in this age group in 7% of the males and in 1% of the females and was more common in males. In the same age group, 21% of the males and 8% of the females had high atherogenic apo B values (> 1.5 g/L). Low apo A-I was found in the whole population (20-79 years) in 13% of the males and in 10% of the females and varied only little with age. In the AMORIS (Apolipoprotein related MOrtality RISk) study these individuals are followed prospectively. The relations between lipids and apo B and apo A-I levels and risk for fatal acute myocardial infarction (AMI) are analyzed to investigate which of these lipids/apolipoproteins best predict AMI either as single determinants or in combination. After a mean observation time of about 22 months there is a 3-6-fold increase in AMI in relation to increasing cholesterol levels in males of 40-59 years. The largest increase was seen in the 40-49-year age group. A similar relationship was also found for triglycerides and AMI.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[The effect of doxazosin on blood pressure, lipids, fibrinogen and plasminogen activator inhibitor. A comparative study among smokers and non-smokers with essential hypertension].

Hypertensive cigarette smokers run particularly high risk of coronary heart disease. Doxazosin, which has beneficial effects on haemodynamic factors and lipid metabolism, may be a suitable agent for treating these patients. The effects on blood pressure and metabolic parameters were investigated in a 16-week, open, parallel, comparative study comprising 64 heavy cigarette smokers and 69 non-smokers who received doxazosin after four weeks on placebo. Eight patients (three smokers and five non-smokers) dropped out due to adverse effects. Blood pressure was significantly reduced in both groups, but there was no change in heart rate. Doxazosin induced a decrease in the triglyceride, total cholesterol and LDL-cholesterol levels, and an increase in HDL-cholesterol concentration. Thus, doxazosin has favourable effects on atherogenic factors in smoking hypertensive patients. There was also a significant lowering of plasma fibrinogen levels and plasminogen activator inhibitor (PAI-1) concentration in non-smokers.

Adult↗
PubMed1991

Preliminary results of the Norwegian doxazosin postmarketing surveillance study: a twelve-week experience.

The study was designed to investigate the safety and efficacy of doxazosin in the control of blood pressure in general medical practice; the results presented concern the first 748 patients evaluated over a 12-week period. Blood pressure was significantly reduced after treatment with doxazosin (-13/-9 mm Hg), and heart rate was not significantly altered. In addition, doxazosin significantly reduced total cholesterol levels (-6.7%), reduced triglyceride levels (-19.8%), increased high-density lipoprotein cholesterol levels (+2.5%), and the high-density lipoprotein:total cholesterol ratio (+9.7%). The calculated risk of coronary heart disease was reduced by 20.5% over a 12-week period. Thirty-five percent of patients reported at least one side effect, and the number of patients experiencing severe adverse reactions was small. Twenty patients (2.7%) discontinued treatment because of adverse events, and 2.7% had the dose of doxazosin reduced.

Antihypertensive Agents↗
PubMed1991

Benefit of a stroke unit: a randomized controlled trial.

In a randomized controlled trial we compared the clinical outcome of acute stroke patients, 110 of whom were allocated to treatment in a stroke unit and 110 to treatment in general medical wards. No significant difference existed between these groups with regard to sex, age, marital status, medical history, or functional impairment on admission. Outcome was measured at 6 and 52 weeks after the stroke by the proportion of patients at home, the proportion of patients in an institution, the mortality, and the functional state. After 6 weeks 56.4% of the patients randomized to the stroke unit and 32.7% of the patients randomized to the general medical wards were at home (p = 0.0004), and after 52 weeks 62.7% and 44.6%, respectively, were at home (p = 0.002). After 6 weeks 36.3% of the patients from the stroke unit and 50.0% from the general medical wards were in an institution (p = 0.02); after 52 weeks 12.7% and 22.7%, respectively, were institutionalized (p = 0.016). After 6 weeks mortality was 7.3% for the stroke unit group and 17.3% for the general medical wards group (p = 0.027). After 52 weeks mortality was 24.6% for the stroke unit group and 32.7% for the general medical wards group (difference not significant). Functional state was significantly better for patients treated in the stroke unit after both 6 and 52 weeks. We conclude that care of patients with acute stroke in a stroke unit improves clinical outcome compared with treatment in general medical wards.

Cerebrovascular Disorders↗