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Biomedical subjects

O Edhag

Publications and source records attributed to O Edhag.

At least 55 records · Page 3Linked to original sources
PubMed1989

[Rapid care after myocardial infarction crucial for the prognosis].

Treatment in cases of acute myocardial ischaemia is currently undergoing dynamic changes. Several studies, involving thousands of patients with acute cardiac infarction, have shown beneficial effects of beta blockers, thrombolysis, and treatment with platelet aggregation inhibitors. Current research is focused on the definition of subgroups among those with acute myocardial ischaemia who are best served by a particular treatment or combination of treatments.

Adrenergic beta-Antagonists↗
PubMed1988

Effects of intermittent treatment with aspirin on thromboxane and prostacyclin formation in patients with acute myocardial infarction.

Thromboxane and prostacyclin formation were monitored in twenty patients with acute myocardial infarction. Ten received 500 mg acetylsalicylic acid (ASA) orally starting 12 h after admission and then intermittently every third day for one month; the other ten did not receive ASA or any other drug known to interfere with the synthesis of prostanoids. In the ASA group thromboxane formation, initially raised, fell rapidly and remained low. In the control group thromboxane formation decreased very slowly and was not normal by the end of the study period. Prostacyclin formation seemed identical in the two groups. Thus intermittent ASA, in this dosage, efficiently inhibited the enhanced thromboxane formation in acute myocardial infarction without interfering with prostacyclin formation.

Administration, Oral↗
PubMed1988

HLA-B27: an important genetic risk factor for lone aortic regurgitation and severe conduction system abnormalities.

PURPOSE: HLA-B27, an immunogenetic marker that is present in 8 percent of the white population around the world, has been found to be an important risk factor for the development of a group of rheumatic disorders, the seronegative spondyloarthropathies. Our objective was to assess the possible role of HLA-B27 and the associated inflammatory disease process in the development of lone aortic regurgitation. PATIENTS AND METHODS: A group of 91 patients with lone aortic regurgitation were studied by HLA typing and clinical and roentgenologic examination. RESULTS: The HLA-B27-associated inflammatory disease process was found to be the probable underlying cause in 15 to 20 percent of patients with lone aortic regurgitation of different degrees of severity. Furthermore, HLA-B27 was found in 88 percent of the male patients with the combination of aortic regurgitation and severe conduction system abnormalities. CONCLUSION: We suggest that this cardiac syndrome should be regarded as an HLA-B27-associated syndrome, sometimes part of ankylosing spondylitis or Reiter's disease, but just as often presenting without obvious rheumatic disease. The marker is thus an important and widely distributed risk factor not only for the development of rheumatic disease but also for acquired aortic regurgitation and sever conduction system abnormalities.

Aortic Valve Insufficiency↗
PubMed1987

Cost-effectiveness comparison of estrogen therapy and orchidectomy in patients with prostatic cancer.

This study compares the cost of antitumor therapy and adverse cardiovascular effects during the first year of treatment with either exogenous estrogens or orchidectomy of patients with prostatic cancer. We found that the higher costs for the orchidectomy patients were partially outweighed by the costs of treating cardiovascular complications in the estrogen-treated patients; the net overcost of orchidectomy is balanced after two and a half years by the ongoing costs of estrogen treatment. The fact that 25% of the patients treated with estrogen suffered cardiovascular complications, but no difference in mortality rates between the two groups was observed, speaks in favor of orchidectomy as the preferred treatment for prostatic carcinoma.

Cost-Benefit Analysis↗
PubMed1987

Deleterious effects of low-dose oestrogen therapy on coronary status in patients with prostatic cancer.

The effects of oestrogen therapy and of orchidectomy on coronary status, as reflected by exercise ECG-testing before and after one year of treatment, were assessed in a randomized study of patients (N = 100) with prostatic cancer. Oestrogen was given as polyestradiol phosphate 80 mg i.m. per month in combination with 150 micrograms ethinylestradiol p.o. per day. There were no significant inter-group differences in conventional risk factors or in pre-treatment exercise test results. Twelve months after the start of therapy the oestrogen group showed a significantly greater depression of the ST-segment during maximal exercise in leads CH2 (P less than 0.0005) and CH5 (P less than 0.01) compared with the pre-treatment depression. Twenty-five per cent (N = 13) of the patients in the oestrogen group suffered cardiovascular complications during the year of therapy, whereas no such complications were observed in the orchidectomy group. However, even the patients in the oestrogen group who had not suffered cardiovascular complications had significantly greater depressions of the ST-segment during exercise both in lead CH2 (P less than 0.0005) and in CH5 (P less than 0.05). There was no significant change in the ST-segment level in the orchidectomy group twelve months after surgery. In summary, we found evidence of an induction of myocardial ischaemia during treatment with exogenous oestrogens at low dosage in patients with prostatic cancer. This deleterious effect of oestrogen on the coronary status argues against oestrogen therapy, since oestrogen has not been shown to be more beneficial than orchidectomy against prostatic carcinoma.

Aged↗
PubMed1987

Long-term ECG recordings in thyroxine-substituted hypothyroid subjects.

Bradyarrhythmias are sometimes observed in hypothyroid patients. This phenomenon could either be due to the disease process with structural changes of the heart or to an abnormal hormone level. The purpose of the present paper was to study the prevalence of bradyarrhythmias in hypothyroid patients on long-term substitution therapy. Nineteen subjects were studied 9-53 months after they had reached the final thyroxine substitution level. Ambulatory ECG registrations were performed during 48 hours. Ventricular ectopic beats were observed in 10 of the 19 patients, but no bradyarrhythmias were detected. The results support the notion that arrhythmias found in hypothyroid patients are at least mainly due to the low thyroid hormone level.

Adult↗
PubMed1987

Mortality in pacemaker-treated patients. A follow-up study of the impact of HLA B27 and associated rheumatic disorders.

The mortality in pacemaker-treated patients is due to underlying disorders, and is increased in patients with ischemic heart disease, congestive heart failure, diabetes and renal dysfunction. We have recently shown that the HLA B27-associated inflammatory disease process is the probable underlying cause in 15-20% of permanently paced men. Consequently, we undertook this study to evaluate any impact on mortality of HLA B27 and associated rheumatic disorders. The mortality among pacemaker patients was compared with that of the general population. Comparisons were also made between pacemaker patients with and without HLA B27 and associated disorders. We did not find any influence on mortality associated with the immunogenetic marker HLA B27 or with HLA B27-associated rheumatic disorders.

Aged↗
PubMed1986

Activators and inhibitors of coagulation and fibrinolysis in patients with prostatic cancer treated with oestrogen or orchidectomy.

The treatment of prostatic cancer with oestrogen has been reported to be associated with cardiovascular side effects. Twenty patients with recently diagnosed prostatic cancer were randomly allocated to oestrogen therapy or orchidectomy. As compared to healthy age matched controls the patients with prostatic cancer had increased base-line levels of fibrinogen (5.2 +/- 1.9 g/l versus 3.7 +/- 1.0 g/l; p less than 0.002) and factor VIII:C (166 +/- 62% versus 110 +/- 29%; p less than 0.001). During oestrogen therapy factor VII increased from 99 +/- 22% to 150 +/- 47% (p less than 0.001), while the antithrombin III level fell from 93 +/- 10% to 81 +/- 13% (p less than 0.001). Both these changes are in the direction of a hypercoaguable state. Concomitantly plasminogen increased from 113 +/- 14% to 142 +/- 18% (p less than 0.001), urokinase inhibiting activity fell from 105 +/- 10% to 90 +/- 9% (p less than 0.001) and C1-esterase inhibitor fell from 110 +/- 17% to 86 +/- 22% (p less than 0.05) in the oestrogen therapy group. After orchidectomy there were no changes in the activators and inhibitors of coagulation and fibrinolysis studied as compared to base-line values. Furthermore the D dimer, a specific degradation product of crosslinked fibrin increased from a normal to a pathological value in 4 out of 8 tested patients after 6 weeks of oestrogen therapy, but in none out of 9 tested patients in the orchidectomy group. Briefly stated, patients with prostatic cancer treated with oestrogen have increased levels of factor VII, factor VIII:C and fibrinogen and a decreased level of antithrombin III.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1986

Orchidectomy versus oestrogen for prostatic cancer: cardiovascular effects.

One hundred consecutive patients aged up to 75 with newly diagnosed cancer of the prostate suitable for hormonal treatment were included in a controlled study of the cardiovascular effects of oestrogen versus orchidectomy. In all cases pre-existing cardiovascular morbidity was excluded. Of the 100 patients, 91 were strictly randomised to receive either oestrogen (n = 47) or orchidectomy (n = 44) and 9 (6 given oestrogen, 3 orchidectomy) either chose their own treatment (five cases) or had it selected for them by the urologist (four). Oestrogen was given in the lowest recommended dosage in Sweden--namely, as 160 mg polyestradiol phosphate intramuscularly every month for the first three months, then 80 mg monthly, plus ethinyloestradiol 1 mg by mouth daily for the first two weeks, then 150 micrograms daily. At entry to the study the two treatment groups showed no difference in demographic characteristics or conventional risk factors for cardiovascular disease. During the first year, however, 13 (25%) of the patients given oestrogen suffered major cardiovascular events as compared with none of the patients after orchidectomy. Patients in the oestrogen treatment group who did not have minor signs of atherosclerosis at entry to the study suffered a similar incidence of cardiovascular complications to those who did have these signs at entry. The substantially increased risk of cardiovascular complications in patients given oestrogen for prostatic cancer warrants careful consideration when choosing treatment for this disorder.

Aged↗
PubMed1986

Haemodynamic effects of intravenous sotalol in acute myocardial infarction.

There are few placebo controlled studies in acute myocardial infarction concerning the haemodynamic effects of beta blockade. In a controlled, double-blind randomized study, the haemodynamic effects of sotalol were evaluated in 20 patients with acute myocardial infarction within 24 hours of the onset. Sotalol was administered to 10 patients over 12 hours by a continuous infusion including three different infusion rates. A serum level around 1.4 microgram ml-1 was achieved after one hour of infusion. The placebo patients were given saline infusion. The patients were monitored invasively using a thermodilution catheter in the pulmonary artery. In the sotalol group, there was a significant reduction in heart rate, systolic blood pressure, cardiac output and stroke volume compared to placebo. A slight increase in the mean pressures of right atrium, pulmonary artery systolic and diastolic pressures was also seen. The infusion was well tolerated and no adverse reaction was seen.

Aged↗
PubMed1986

Reduced incidence of myopotential pacemaker inhibition by abdominal generator implantation.

Myopotential inhibition during permanent pacing with unipolar leads is a well-recognized clinical problem. A study was undertaken to determine if implantation of the generator in abdominal subcutaneous tissue instead of the conventional pectoral implantation site would reduce the incidence of this inhibition. Forty patients with either an abdominal (group A, n = 20) or a pectoral (group P, n = 20) generator implantation site were subjected to a standardized protocol of muscle provocation and 24-hour ECG. Pulse generators were programmed to the lowest sensitivity level (average, 2.0 mV). Pauses exceeding the stimulation interval were analyzed. During muscle provocation 85% of the patients in group P displayed inhibition, as against 5% in group A (p less than 0.001). During 24-hour ECG, the corresponding values were 95% and 15%, respectively (p less than 0.001). We concluded that abdominal generator implantation significantly reduces the incidence of myopotential inhibition in patients with unipolar pacemaker leads.

Abdomen↗