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Biomedical subjects

J Jervell

Publications and source records attributed to J Jervell.

At least 73 records · Page 4Linked to original sources
PubMed1986

Therapeutic traditions in Northern Ireland, Norway and Sweden: I. Diabetes. WHO Drug Utilization Research Group (DURG).

A questionnaire survey was carried out to explore differences in the approach to treatment of patients with Type II diabetes between physicians in Northern Ireland, Norway and Sweden, and to discover to what extent it could account for the three-fold difference in drug use between the countries. A representative sample of 400 physicians in each country was asked to give their opinions on the choice of therapy for three model cases designed to cover the spectrum of treatment - from diet alone to insulin. Significantly more Swedish (65%) than Northern Irish (51%) and Norwegian (52%) doctors suggested diet alone for uncomplicated diabetes recently discovered in a middle aged, overweight man. For symptomatic diabetes in a 76 year old over-weight woman with few retinal microaneurysms, the majority of physicians in all three countries suggested treatment with sulphonylureas. Biguanides were here a more common alternative in Northern Ireland than in Scandinavia. For suspected secondary treatment failure in a 63 year old woman with no signs of complications, insulin was suggested by 71% of the Norwegian doctors but only by 44 and 49% of those in Northern Ireland and Sweden, respectively. General practitioners tended to suggest oral treatment earlier and to maintain it longer than hospital physicians. The study has demonstrated significant differences in the approach to treatment of Type II diabetes mellitus between physicians in the three countries. However, the differences were more prominent in the choice of drugs than in the threshold of drug treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Diabetes Mellitus↗
PubMed1986

Therapeutic traditions in Northern Ireland, Norway and Sweden: II. Hypertension. WHO Drug Utilization Research Group (DURG).

A questionnaire survey based on hypertension case histories was performed among a representative sample of 400 GP's and hospital doctors in Northern Ireland, Norway and Sweden, countries having markedly different utilization of antihypertensive drugs. We found a greater propensity to start antihypertensive drug treatment in Northern Ireland than in Norway and Sweden. This was true both in mild diastolic and isolated systolic hypertension. Yet the utilization of antihypertensive drugs in Sweden is about 60% higher than in Northern Ireland and 30% higher than in Norway. Swedish physicians preferred beta-blockers as their first choice to a greater extent than physicians in Northern Ireland and Norway who selected thiazides more often. In general, the choice of drugs agreed with the sales and prescribing patterns in the three countries. Besides providing more insight in therapeutic traditions the study indicates that the lower prescribing of antihypertensive drugs in Northern Ireland, and to some extent in Norway, compared to Sweden, might be due to differences in true or apparent morbidity.

Antihypertensive Agents↗
PubMed1985

Transcapillary colloid osmotic gradient, plasma volume and interstitial fluid volume in long-term type 1 (insulin-dependent) diabetes.

Plasma and subcutaneous colloid osmotic pressure, transcapillary escape rate of albumin, plasma volume and extracellular fluid volume were measured in 10 long-term Type 1 (insulin-dependent) diabetic patients without clinical nephropathy. Interstitial colloid osmotic pressure was reduced compared with normal subjects (12.9 +/- 3.0 versus 15.8 +/- 2.7 mmHg, p less than 0.05) and the transcapillary colloid osmotic gradient increased (17.0 +/- 2.4 versus 12.8 +/- 2.7 mmHg, p less than 0.01). Plasma volume was in the normal range and interstitial fluid volume increased by approximately 21% compared with normal subjects (p less than 0.01). Transcapillary escape rate of albumin was significantly increased compared with normal subjects (8.9 +/- 1.9 versus 5.1 +/- 1.6% h, p less than 0.01). A negative correlation was found between the transcapillary colloid osmotic gradient and interstitial fluid volume (r = 0.6, 0.01 less than p less than 0.05). These results suggest that the increased small vessel permeability in long-term diabetes leads to wash-out of interstitial proteins and the resulting increased transcapillary colloid osmotic gradient tends to preserve the plasma volume and to limit the tendency to increased interstitial fluid volume.

Adult↗
PubMed1985

HLA-DR3 and -DR4 control T-lymphocyte responses to mumps and Coxsackie B4 virus: studies on patients with type 1 (insulin-dependent) diabetes and healthy subjects.

To study the relationships between the responses to viral antigens and the HLA-DR3 and -DR4 associations in Type 1 (insulin-dependent) diabetes mellitus, the frequency of T-lymphocyte proliferating in response to mumps, Coxsackie B4 and varicella-zoster antigens was determined. A decreased frequency was found in T lymphocytes able to respond to mumps or Coxsackie B4 when presented together with DR3, as compared with the frequency of T lymphocytes able to respond to these viruses together with other DR determinants. This was not found for varicella-zoster or purified protein derivative of tuberculin. In contrast, an increased frequency was found in T lymphocytes responding to mumps or Coxsackie B4 together with DR4, compared with other DR determinants. The results were similar in Type 1 diabetic and healthy individuals. The results suggest that elements on the DR3 and DR4 molecules may control T-lymphocyte responses to mumps and Coxsackie B4 viruses.

Adult↗
PubMed1985

Prednisolone pharmacokinetics in cushingoid and non-cushingoid kidney transplant patients.

Prednisolone pharmacokinetics and protein binding have been compared in 16 cushingoid and 46 non-cushingoid long-term kidney transplant recipients. After oral administration of 10 mg prednisolone, the cushingoid patients had a significantly higher peak prednisolone serum concentration (P less than 0.03), a longer elimination half-time (P less than 0.03), and a larger area under the time-concentration curve of total (P less than 0.01) and free (P less than 0.03) prednisolone. The apparent total body clearance of total and free prednisolone was significantly lower in the cushingoid than in the non-cushingoid patients (P less than 0.02 and less than 0.05, respectively). There was no significant difference in time of peak concentration, apparent volume of distribution or serum protein binding of prednisolone. It is suggested that the development and persistency of some cushingoid features may be related to a decreased total body clearance of prednisolone, which, in turn, may be influenced by impaired renal function.

Adult↗
PubMed1983

Different prednisolone pharmacokinetics in Cushingoid and non-Cushingoid kidney transplant patients.

Prednisolone pharmacokinetics have been compared in 16 Cushingoid and 46 non-Cushingoid long term kidney transplant recipients. The Cushingoid patients had a significantly (p less than 0.05) higher peak concentration, a longer elimination half-time, a greater area under the time-concentration curve of total and free prednisolone, and a lower total body clearance of prednisolone. It is suggested that prednisolone pharmacodynamics may be influenced by pharmacokinetic differences, and that differences in renal function may be an important contributing factor.

Adult↗
PubMed1983

Tolerability and usefulness of iohexol in cardioangiography. II. A double blind comparison with metrizoate.

The new non-ionic contrast medium iohexol (Omnipaque) was compared with the ionic medium sodium meglumine calcium metrizoate (Isopaque Coronar) in a double blind, two-group trial. Iohexol resulted in significantly fewer and smaller subjective reactions than metrizoate. Changes of left ventricular and aortic pressure were statistically significantly less after injection of iohexol than of metrizoate. ECG recordings did not significantly differ in the two groups. Analysis of biochemical parameters showed no statistical differences between the two groups. Determination of serum enzyme activities revealed no signs of myocardial injury, and no impairment of glomerular filtration rate was detected by radionuclear renal function test. Similar radiographic quality was obtained with both media.

Adult↗
PubMed1982

Prognostic value of renal vein renin determination in suspected renovascular hypertension.

Surgical correction of unilateral renal artery stenosis was performed in 31 hypertensive patients. Preoperative renal vein renin ratios (RVRR) before and after dihydralazine stimulation were measured in all patients. Postoperative blood pressure were normal in 12, improved in 17 and unchanged in 2 patients. Six patients did not have renin lateralization, but all were cured or improved after surgery. RVRR was a poor predictor of the results of surgery in patients with unilateral renal artery stenosis.

Adolescent↗