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Biomedical subjects

I Holme

Publications and source records attributed to I Holme.

At least 109 records · Page 6Linked to original sources
PubMed1988

Clinical and histological intercorrelations in pigmented naevi indicating potential melanoma precursor lesions.

A series of 577 pigmented naevi from an equal number of patients has been studied histopathologically without access to clinical information. Later the histological findings have been compared with clinical information obtained by sending a questionnaire to the patients. The correlations between the many histological and clinical variables have been studied. Patients with a red or fair hair colour, a freckled, easily sunburnt skin type and/or a poor suntanning ability have the tendency to develop irregular and atypical naevi. Histological variables like nuclear atypia, mitoses, lymphocyte reaction, fibrosis and "shoulder"-phenomenon regarding the growth pattern of naevi are correlated to this delicate skin type. These findings support til theory that irregular and atypical naevi may be potential precursors to malignant melanomas as patients with this skin type belong to the melanoma risk group.

Adult↗
PubMed1988

The evaluation of possible melanoma risk groups of patients in a series of pigmented naevi. Clinical and histological intercorrelations.

The trends of the clinical/histological intercorrelations in two series of pigmented naevi have been compared. One series of naevi represents patients who are habitual sunbathers and/or who have travelled to Southern sunny climates. The other series includes naevi from easily sunburned patients. The sunburner-group is correlated to histological features such as mitoses, atypia and fibrosis of the tumour as well as to an irregular/atypical tumour type. Such trends are not found in the other target group. The sunburners have a poor ability to suntan, while the sunbather group includes good suntanners. This indicates the importance of the melanin UV-filter effect of the skin as a protection against the promotion of potential MM-precursors, such as irregular/atypical naevi.

Humans↗
PubMed1987

Treatment of acute low-back pain with piroxicam: results of a double-blind placebo-controlled trial.

Twenty-seven investigators participated in a double-blind, parallel placebo-controlled trial of piroxicam involving 278 patients with acute low back pain. Therapy commenced within 48 hours of the injury and continued for 7 days. The drug was given in the recommended regimen of 40 mg once daily for the first 2 days and 20 mg once daily thereafter. After 3 days of therapy, piroxicam patients showed a statistically greater amount of pain relief in the lying (P less than 0.001), sitting (P less than 0.01), and standing (P less than 0.01) positions, but after 7 days the difference between treatments was no longer significant. After 1 week's therapy, however, the requirement for additional analgesic was significantly lower in the piroxicam group (P less than 0.05), and more piroxicam than placebo patients (42 versus 28) had returned to work (P less than 0.05). Toleration was excellent in most patients, with only 13% of the piroxicam and 17% of the placebo group reporting adverse effects of mainly mild or moderate severity. The profile of the adverse effects was similar for both treatments. Piroxicam can provide effective relief of acute low-back pain with good toleration; it should be considered for use in the initial treatment of this condition.

Acute Disease↗
PubMed1987

A 24-week multicenter double-blind study of doxazosin and hydrochlorothiazide in patients with mild to moderate essential hypertension.

The new alpha1-adrenoceptor antagonist, doxazosin (DOX), was compared with hydrochlorothiazide (HCTZ), both drugs administered once daily, in a randomized double-blind study including 115 patients. The mean final daily doses used were DOX, 10.8 mg; HCTZ, 89.1 mg. There were no statistically significant differences between treatment groups for blood pressure (BP) changes except that HCTZ produced a significantly greater fall (p = 0.04) in supine systolic BP than DOX. The statistically significant mean differences in changes in lipid parameters (total cholesterol and total triglycerides) were in favour of DOX. The number of patients reporting side-effects were DOX, 27/57; HCTZ, 29/53, with two DOX- and five HCTZ-treated patients withdrawn due to side-effects. In the HCTZ-treated group, laboratory serum tests indicated 11 patients with abnormally low potassium and seven with abnormally high uric acid concentrations. The overall results suggest a benefit-to-risk ratio in favour of DOX.

Adult↗
PubMed1986

Oslo Study Diet and Antismoking Trial. Results after 102 months.

The five year (60-month) results from the Oslo Study Diet and Antismoking Trial were published in the Lancet in December 1981. The trial involved 1,232 healthy men, aged 40 to 49 years, at high risk for coronary heart disease, with serum cholesterol values in the range of 7.5 to 9.8 mmol/liter (enzymatic method: 6.9 to 9.0, mean value 7.8 mmol/liter). Eighty percent of the men were daily cigarette smokers at the start of the study, and all participants were normotensive, i.e., systolic blood pressure was less than 150 mm Hg. Subjects were randomly assigned to either a control or intervention group. Follow-up visits were scheduled every six months for the intervention group and yearly for the control group. Once the trial was completed, the regular six-month follow-up visits were discontinued, but eight to nine years (96 to 108 months) after the start of the trial, participants were called for a new follow-up. Risk factors were recorded, and clinical events were diagnosed according to the same procedure as during the trial. The mean serum cholesterol levels in the intervention group remained unchanged three years after the end of the trial, but the cholesterol levels in the control group declined. Daily cigarette smoking increased in the intervention group but remained stable in the control group. At the new follow-up, the difference in incidence of fatal and nonfatal myocardial infarction and sudden coronary death was the same as at the end of the trial three years earlier, yielding significant differences between the two groups for sudden death, total coronary death, and total coronary events. Although the study was not designed to show differences in total mortality, this difference became marginally significant, with 19 deaths in the intervention group and 31 in the control group. It is concluded that although net differences in risk factors between the two groups had been reduced during the three years after the regular intervention period, the significant difference in coronary events and sudden death was maintained.

Adult↗
PubMed1986

A double-blind multicentre trial of piroxicam and naproxen in osteoarthritis.

A multicentre, double-blind study of unprecedented size was conducted to compare the safety and efficacy of piroxicam and naproxen in the treatment of osteoarthritis. The study comprised 2,035 patients and a treatment period of 12 weeks. The dosage was 20 mg piroxicam and 750 mg naproxen daily with the option to reduce to 10 and 500 mg, respectively, at week 4 or 8. No major difference between the drugs was observed with regard to overall incidence of adverse events. The frequency of serious adverse events was about 1% for both drugs. A statistically significant decline of adverse events with age was found in both sexes. Piroxicam was significantly superior to naproxen for pain at rest and pain on movement at 12 weeks and degree of restriction in daily activity at 4 weeks. A significantly increasing beneficial effect was observed with both drugs between 4 and 12 weeks of treatment. The comparable safety observed for the two drugs is in contrast to perceptions based on spontaneous reports to official monitoring systems.

Aged↗
PubMed1986

Piroxicam and naproxen plasma concentrations in patients with osteoarthritis: relation to age, sex, efficacy and adverse events.

Piroxicam and naproxen plasma concentrations were obtained after 4 weeks active therapy between 3 and 12 hours post-dose in 640 and 629 patients, respectively. These patients are a subset of 2,035 patients with osteoarthritis on whom we have reported previously (11) in a double-blind multicentre safety and efficacy trial comparing piroxicam 20 mg/day and naproxen 750 mg/day. The purpose of the present study was to look for an association of plasma drug concentration with the variables of: age, sex, adverse events and efficacy. There was a statistically significant increase in plasma concentrations of both drugs with increasing age and females had higher concentrations than males. The increase in plasma concentration seen with increasing age was of a magnitude of 25% for piroxicam and 20% for naproxen when comparing a 50 year old to an 80 year old. However, less than 15% of the variability in plasma concentrations seen between patients is accounted for by age and sex. Within the plasma concentrations achieved with these doses, no association with adverse events, non-serious or serious, and efficacy was noted.

Age Factors↗
PubMed1985

Coronary risk factors and their pathway of action through coronary raised lesions, coronary stenoses and coronary death. Multivariate statistical analysis of an autopsy series: the Oslo Study.

From 1972 to 1973, 16,202 Oslo men, aged 40 to 49 years, were examined for cardiovascular disease and coronary heart disease (CHD) risk factors. This report describes the results of autopsy examinations from 204 of 471 men who died in this cohort with regard to associations between selected risk factors and (1) raised coronary atherosclerotic lesions (RL), (2) coronary artery stenosis, and (3) CHD death. Total serum cholesterol and blood pressure levels were positively associated with all 3 measures of coronary atherosclerosis and its complications, both in univariate and multivariate analyses, whereas high-density lipoprotein (HDL) cholesterol was highly and inversely related. Triglyceride levels, cigarette smoking, social class and physical activity at work and at leisure were not significantly associated with either of the 3 measures. When RL was added to the model with stenosis as the dependent variable, the risk factors no longer appeared as independent; this is consistent with the hypothesis that these factors, when significant, work through the development of RL to produce stenosis. HDL cholesterol was the only risk factor independently and significantly associated with CHD death when RL or stenosis or both were put into the model for CHD. This points to the possibility of HDL cholesterol also working through mechanisms other than the prevention of RL and stenosis toward CHD death.

Adult↗
PubMed1985

The Oslo Study: diet and antismoking advice. Additional results from a 5-year primary preventive trial in middle-aged men.

In this randomized, primary prevention trial of 1,232 high-risk, middle-aged Oslo men, advice during 5 years about diet and smoking brought about a significant reduction (47%) in incidence of first major coronary heart disease (CHD) events in the intervention group compared with controls. Data are presented indicating that the net difference of 10% in serum cholesterol between groups was the main cause for this achievement and that the antismoking factor, due to a rather small net difference in quit rates (17 and 24% in control and intervention groups, respectively), contributed to a lesser degree. Analysis of social class reveals that the favorable results in the intervention group were present in all social strata, despite the unexpected finding that lower class men experienced a lower CHD incidence than men of higher socioeconomic status. Antismoking advice was especially effective in lower class intervention group men. Among cigarette quitters, lower social class men reduced their serum cholesterol more than higher social class men. However, for the total intervention group, higher status men had at least as great a reduction in serum cholesterol as did lower status men. With endpoint follow-up extended to 8.5-10 years, additional cases of CHD (nonfatal and fatal myocardial infarction and sudden death) numbered 7 and 10 in the intervention and control groups, respectively; CHD cases throughout the trial totaled 25 and 45 (P approximately equal to 0.02). Total deaths numbered 19 and 31, respectively (P approximately equal to 0.05).

Body Weight↗
PubMed1985

Stenoses in the coronary arteries. Relation to atherosclerotic lesions, coronary heart disease, and risk factors. The Oslo Study.

Coronary heart disease is strongly associated with the presence of stenosis in the epicardial coronary arteries. This prospective autopsy study shows that the relationship between risk factors for coronary heart disease and the occurrence of stenosis is the same as between risk factors and coronary atherosclerotic lesions: serum cholesterol, systolic and diastolic blood pressure contribute to formation of coronary stenosis; high density lipoprotein cholesterol is inversely related to stenosis. None of the other risk factors for coronary heart disease, such as fasting triglycerides, smoking habits, social class, and physical activity at work and at leisure, was statistically associated with the occurrence of coronary stenosis. Additional statistical analyses show that these selected risk factors do not seem to have any independent influence on the development of coronary stenosis over and above that of the extent of raised atherosclerotic lesions.

Adult↗
PubMed1984

Treatment of mild hypertension with diuretics. The importance of ECG abnormalities in the Oslo Study and in MRFIT.

The Multiple Risk Factor Intervention Trial (MRFIT) showed that diuretic treatment of hypertensive men with certain ECG abnormalities at entry was associated with an increased coronary heart disease mortality in the special-intervention group as compared with the usual-care group. Following the same criteria for resting ECG abnormalities as in MRFIT, The Oslo Study trial of mild hypertension has been reanalyzed for similar effects. Although numbers of first coronary events are low in this study (20 cases in the treated group and 13 in the control group), similar trends are present in The Oslo Study. The excess of seven cases of coronary events in the Oslo treatment group can mainly be explained by introduction of the MRFIT ECG-Minnesota codes.

Adult↗
PubMed1984

Serum glucose levels during long-term observation of treated and untreated men with mild hypertension. The Oslo study.

Serum glucose levels, triglyceride levels, and body weight are reported from a controlled drug trial in men, aged 40 to 49, with uncomplicated mild hypertension. The drug treatment started with hydrochlorothiazide alone, and methyldopa was added when necessary. If side effects occurred, methyldopa was replaced by propranolol. No detailed advice about diet, smoking, or weight reduction was given to any group. The untreated control subjects had a small increase in serum glucose levels during five years, from 6.08 to 6.21 mmol/liter. Those treated with hydrochlorothiazide alone and those treated with hydrochlorothiazide plus methyldopa had a small increase in serum glucose levels of the same order as that in the control subjects. However, those receiving the thiazide/propranolol combination experienced a sizeable increase in glucose levels, from 5.96 to 6.53 mmol/liter (p less than 0.001). This increase was significantly greater than the increase in the other groups (p less than 0.001). The thiazide/propranolol group also showed a significant increase in serum triglyceride levels (p less than 0.05). There was no difference in serum potassium levels in the different drug groups. The results indicate that moderate thiazide doses do not have significant effects on serum glucose levels in this age group. Propranolol in combination with thiazide seems to increase the level of serum glucose.

Adult↗
PubMed1983

The Oslo study: CHD risk factors, socioeconomic influences, and intervention.

This article reviews the methods and results of the large-scale, 10-year Oslo study. Two controlled intervention trials are described, one in healthy, normotensive men at high risk for coronary heart disease (CHD), the other in healthy men with mild hypertension. Cause-specific mortality is related to the major CHD risk parameters of serum cholesterol, cigarette smoking, and blood pressure and was found to be highest among the lowest socioeconomic class. Morbidity from myocardial infarction and total cardiovascular incidence decreased with lowered blood lipid levels and cessation of cigarette smoking in one trial. There was no difference, however, in total cardiovascular incidence as a result of antihypertensive therapy in the other trial. The effects on blood lipids of six commonly used single antihypertensive drug preparations and five combination preparations were examined. The study concluded that the beneficial lipid-lowering effect of the alpha-adrenergic blocker prazosin made it the antihypertensive drug of choice.

Adult↗
PubMed1983

Blood lipids and antihypertensive drugs. The Oslo study.

The treatment of hypertension has failed to achieve a reduction of the incidence of coronary heart disease. Recently, attention has been drawn to the effects of antihypertensive drugs on the metabolism of lipoproteins. Of the beta-blockers only pindolol was lipid neutral while propranolol, atenolol and oxprenolol lowered cholesterol and increased serum triglycerides. Hydrochlorothiazide did not influence blood lipids. Prazosin lowered serum LDL + VLDL cholesterol and total triglycerides. The combination of pindolol + prazosin lowered LDL + VLDL cholesterol and increased triglycerides. Propranolol + prazosin lowered HDL cholesterol, methyldopa + hydrochlorothiazide and hydrochlorothiazide + amiloride had no effect on blood lipids.

Antihypertensive Agents↗
PubMed1982

Socio-economic status as a coronary risk factor: the Oslo study.

The association between socioeconomic status, measured by a combination of income and education, and CHD mortality has been studied in a cohort of 40-49 year old Oslo men. Socio-economic status was significantly associated with CHD mortality. However, the lowest CHD mortality was found in social status Group III (middle class) and this could not be explained by the risk factor gradients seen among those studied. Although the number of fatalities is small (68 CHD deaths during 4.5 years) socio-economic status seems to be independently associated with coronary risk after adjusting for serum cholesterol, systolic blood pressure and cigarette smoking.

Adult↗