Search PubMed⌕ Search

Biomedical subjects

I Holme

Publications and source records attributed to I Holme.

At least 91 records · Page 5Linked to original sources
PubMed1990

[Should we perform long-term cohort studies on the use of antihypertensive agents?].

The 1-year PMS Carduran study included more than 4,500 hypertensive patients treated by more than 600 general practitioners. The objective was to study side effects and treatment efficiency. The Research Board of General Practitioners has criticised this and similar PMS studies because they tend to serve marketing purposes and are of low scientific value. It is argued in this paper that large independent prospective pharmaco-epidemiological studies, if well performed, may provide important information on the use (and possibly misuse) of new drugs in general practice, information which may not be known prior to registration. Also, the great potential in providing long term information on disease prognosis is underlined. An example of a 5-year study of Carduran-treated hypertensive patients is outlined.

Antihypertensive Agents↗
PubMed1990

The effect of warfarin on mortality and reinfarction after myocardial infarction.

BACKGROUND AND METHODS: The use of oral anticoagulation in the long-term treatment of survivors of acute myocardial infarction has been highly controversial. We therefore randomly assigned 1214 patients who had recovered from acute myocardial infarction (mean interval from the onset of symptoms to randomization, 27 days) to treatment with warfarin (607 patients) or placebo (607 patients) for an average of 37 months (range, 24 to 63). RESULTS: At the end of the treatment period, there had been 123 deaths in the placebo group and 94 in the warfarin group--a reduction in risk of 24 percent (95 percent confidence interval, 4 to 44 percent; P = 0.027). A total of 124 patients in the placebo group had reinfarctions, as compared with 82 in the warfarin group--a reduction of 34 percent (95 percent confidence interval, 19 to 54 percent; P = 0.0007). Furthermore, we observed a reduction of 55 percent (95 percent confidence interval, 30 to 77 percent) in the number of total cerebrovascular accidents in the warfarin group as compared with the placebo group (44 vs. 20; P = 0.0015). Serious bleeding was noted in 0.6 percent of the warfarin-treated patients per year. CONCLUSIONS: Long-term therapy with warfarin has an important beneficial effect after myocardial infarction and can be recommended in the treatment of patients who survive the acute phase.

Cerebrovascular Disorders↗
PubMed1990

An analysis of randomized trials evaluating the effect of cholesterol reduction on total mortality and coronary heart disease incidence.

The primary aim of this study was to estimate the relation between cholesterol reduction and total mortality and coronary heart disease (CHD) incidence. Secondarily, the clinical issues of whether the efficacy of cholesterol lowering is dependent on the treatment modality, presence of CHD at baseline, or the simultaneous introduction of other interventions was explored. All randomized clinical intervention trials of cholesterol reduction were used in an overview analysis of total mortality rate and CHD incidence; analysis was performed with weighted linear regression. The trials include those that used primary and secondary intervention, diet and drugs, and single or multifactor design. Nineteen trials were analyzed for total mortality, and of the 19, 16 were analyzed for CHD incidence rate. Net difference in cholesterol change between study groups was used as the independent variable, and the three previously mentioned dichotomous design characteristics were used as additional independent variables. For every 1% reduction in cholesterol, an estimated 2.5% reduction in CHD incidence is indicated (95% CL: 1.1, 3.9). With regard to CHD drug trials tended toward better efficiency in cholesterol lowering than did dietary trials. With regard to total mortality, this efficiency was higher in secondary than in primary preventive trials. The efficiency was also somewhat dependent on the baseline cholesterol level. This study shows that cholesterol reduction is effective in lowering CHD incidence, but cholesterol reduction must be at least 8-9% to be effective in lowering total mortality.

Anticholesteremic Agents↗
PubMed1990

Survival of AIDS patients in Norway.

The survival function of the 100 first AIDS patients in Norway is presented and analyzed with respect to four factors obtained at the time of diagnosis; a) year of diagnosis b) initial AIDS related disease c) knowledge of HIV seropositivity prior to onset of AIDS and d) age at time of diagnosis. The median survival was 9.3 months. Among the known seropositive AIDS patients there were almost twice as many with Pneumocystis carinii pneumonia as initial AIDS related disease, as among the not known seropositives (relative risk 1.8). With Cox regression analysis we found that known seropositivity and age are factors that appear to influence survival, whereas year of diagnosis and initial AIDS related disease apparently do not. The mechanism whereby prior knowledge of HIV seropositivity leads to apparent increase in survival may be due to better follow-up and thereby an earlier date of diagnosis.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Seasonal variations of pigmented naevi. Intercorrelations of clinical and histological variables with special reference to seasonal variation.

During 1984, junctional and compound naevi were registered significantly more often during the summer half-year (May-October) than the total number of naevi, which showed no seasonal variation. A series of 342 of these junctional and compound naevi have been the subject of a blind histological classification. Clinical information was obtained by a questionnaire mailed to the patients. The intercorrelations of 19 histological and 10 clinical variables were studied by chi 2-test. The seasonal variation of these variables was further studied by chi 2-test and by Hewitt's test. Patient's hair colour, eye colour and sex as well as mitoses and localization showed a significant correlation to season of the year. The trends of these findings, compared with the information about tumour duration, indicate a short-term latency effect of UV light on naevi which are excised during the summer half-year.

Adolescent↗
PubMed1990

Selective alpha 1 inhibition with doxazosin in hypertensive smokers and non-smokers: haemodynamic and metabolic effects.

Hypertensive cigarette smokers have an especially high risk of coronary heart disease. Doxazosin, which has beneficial effects on haemodynamic factors and lipid metabolism, may be suitable for treating these patients. The haemodynamic and metabolic effects of doxazosin were investigated in a 16-week open, parallel, comparative study of 64 heavy cigarette smokers and 69 non-smokers after a 4-week placebo period. Of the 133 patients who entered, six patients (one smoker and five non-smokers) withdrew due to adverse events. Doxazosin significantly reduced blood pressure without reflex tachycardia in both the smokers and the non-smokers. The therapeutic success rates (reduction in sitting diastolic blood pressure to less than or equal to 90 mmHg and greater than or equal to 5 mmHg reduction, or greater than or equal to 10 mmHg reduction from baseline) were similar for the smokers (93.3%) and the non-smokers (92.5%). Doxazosin significantly decreased total cholesterol and low-density lipoprotein (LDL) cholesterol, but increased high-density lipoprotein (HDL) cholesterol and the HDL:total cholesterol ratio in both smokers and non-smokers. Doxazosin corrected the reduction in HDL cholesterol caused by smoking; compared with baseline, doxazosin increased HDL cholesterol by 19% in hypertensive smokers. The beneficial effects of doxazosin on blood pressure and the lipid profile were apparent in the change in the 10-year probability of developing coronary heart disease as calculated by the Framingham equation; the calculated risk of coronary heart disease decreased by 39% in smokers and by 33% in non-smokers. Plasma fibrinogen and plasminogen activator inhibitor, which independently contribute to atherosclerosis, were significantly reduced by doxazosin in the non-smokers but not in the smokers.

Adrenergic alpha-Antagonists↗
PubMed1990

A randomized study on hormone-resistant prostatic cancer: estramustine phosphate versus low dose epirubicin with or without medroxyprogesterone acetate. A Norwegian multicenter study.

A prospective randomized study has been carried out in order to compare three different treatment modalities for symptomatic metastatic hormone-resistant prostatic cancer. A total of 79 patients were included. One group was treated with estramustine phosphate, another with Epirubicin plus Medroxyprogesterone acetate (MPA), while the third arm consisted of Epirubicin plus placebo. Best palliation was obtained by the combination of Epirubicin and MPA. This combination also seemed to be associated with the longest response duration.

Administration, Oral↗
PubMed1989

Serum triglycerides as an independent risk factor for death from coronary heart disease in middle-aged Norwegian men.

The relation between nonfasting serum triglycerides and death from coronary heart disease was studied in 37,546 men aged 35-49 years who were examined during 1972-1977 in four counties in Norway. During an average follow-up period of nine years, 369 deaths from coronary heart disease occurred. In univariate analysis, log(triglycerides) were a weak, but statistically significant predictor of coronary death in the age groups 40-44 and 45-49 years. Within-area analysis showed that a high triglyceride area represented no extreme. When other coronary risk factors were adjusted for, log(triglycerides) remained a significant independent predictor at ages 45-49 years and at higher levels of serum cholesterol. The predictive strength of serum cholesterol was largely the same whether log(triglycerides) were taken into account or not, whereas the predictive strength of log(triglycerides) depended on whether serum cholesterol was accounted for. The strength of coronary death prediction of the logarithm of serum triglycerides was hardly greater than might be explained by the fact that triglycerides are an indicator of the usual cholesterol level of the subject.

Adult↗
PubMed1988

Correlates of systolic and diastolic blood pressure in men 40 to 59 years of age sampled from United States of America and Union of Soviet Socialist Republics Lipid Research Clinics populations.

The correlates of blood pressure (BP) were investigated in 2 samples using common protocols, one from a Union of Soviet Socialist Republics study in 2 locations and one from a United States of America study in 9 locations. Age, heart rate, Quetelet index, high density lipoprotein cholesterol, natural logarithm of triglycerides and fasting glucose were positively related to systolic BP in both samples. In diastolic BP, alcohol consumption, heart rate, Quetelet index and natural logarithm of triglycerides were positively associated, and number of cigarettes smoked was negatively related in both samples.

Adult↗
PubMed1988

Drug treatment of mild hypertension to reduce the risk of CHD: is it worth-while?

Although hypertension is regarded as a causal factor for coronary heart disease (CHD) a reduction in the risk of CHD as a result of lowering blood pressure in mild hypertension could not be demonstrated. This conclusion is based on an overview analysis of all published randomized trials in mild hypertension, including more than 25,000 subjects contributing over 125,000 person years of observation. There is evidence that treatment reduces the risk of CHD in moderate to severe hypertension. In addition the pooling of four clinical trials with treated control groups indicates a reduction in the risk of CHD of borderline significance with beta-blockers or aggressive treatment when compared with standard treatment (mostly diuretics). The failure of drug treatment to reduce the risk of CHD in mild hypertension is consistent with the results from epidemiological studies because of derangement of the lipid profile induced by diuretics and beta-blockers.

Adrenergic beta-Antagonists↗
PubMed1988

Piroxicam and naproxen in patients with osteoarthritis of the hip waiting for total hip replacement.

Two-hundred and fifty-two patients waiting for a total hip replacement for degenerative hip disease were randomized to two groups of nonsteroidal anti-inflammatory medication using piroxicam, 20 mg per day, and naproxen, 750 mg per day, after exclusion for severe dyspepsia or peptic ulcer, asthma, idiosyncracy, dissent, age below 50 years, Harris hip score above 50, or significant contralateral disease. A significant improvement in the pain and daily activity parameters was obtained in both groups. The effect was better in the piroxicam group one month after the commencement of the treatment, and equal in the groups later during the observation period of 2-5 months. We conclude that continuous medication is beneficial in patients with severe osteoarthritis scheduled for operation. However, the side effects of the medication have to be carefully considered and followed up.

Activities of Daily Living↗
PubMed1988

Correlates of blood pressure change in middle-aged male mild hypertensives: results from the untreated control group in the Oslo hypertension trial. The Oslo Study.

The never-treated control group in the Oslo Study hypertension trial of middle-aged men 40-49 years old at entry (n = 379) was studied with respect to five-year change in blood pressure and its correlates. The study began in 1972 and ended in 1979, and each patient was followed for five years. Both baseline and rate of change of correlates were analyzed as independent variables versus rate of change in blood pressure as the dependent variable. Rate of change in serum triglycerides were found to be the strongest correlate of rate of change in blood pressure in this population of healthy mild hypertensives. In addition, rate of change in serum cholesterol and body weight made significant contributions in some analyses, but to a lower degree than did rate of change in triglycerides. The model predicts a substantial decrease in blood pressure if lipids and body weight are reduced. Rate of change in sodium, uric acid, and chloride concentrations were also associated with blood pressure change, but total degree of explanation of all explaining variables only accounted for 11-15% of total variation in annual blood pressure change.

Adult↗
PubMed1988

Increased fibrinolytic potential after diet intervention in healthy coronary high-risk individuals.

Twenty healthy individuals (15 men and 5 women) with initial fasting serum triglycerides greater than or equal to 1.80 mmol/l and euglobulin clot lysis time after venous occlusion greater than or equal to 60 min (upper normal limit 45 min) were tested for fibrinolytic response to venous occlusion and intravenous injection of desmopressin (DDAVP), serum lipids, serum glucose and relative body weight before and after a minimum of 3 to a maximum of 12 months' diet intervention. In order to be defined as a good diet responder, at least 20% reduction of the initial serum triglyceride concentration was required. At the end of the study, half of the participants (7 men and 3 women) met the criteria of good diet responders. All of these showed an improved fibrinolytic response to DDAVP injection, and 7 out of 10 had a normalized fibrinolytic response to venous occlusion. We conclude that, through dietary measures with substantial reduction of hypertriglyceridaemia, it is possible to improve and even normalize the fibrinolytic potential.

Adult↗