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Biomedical subjects

S Dean

Publications and source records attributed to S Dean.

At least 55 records · Page 3Linked to original sources
PubMed1990

Doxazosin in combination with atenolol in essential hypertension: a double-blind placebo-controlled multicentre trial.

Doxazosin (mean dose 11 mg) given once daily in combination with 100 mg atenolol (n = 44) was compared with placebo and atenolol (n = 43) in a double-blind, multicenter study in patients with mild to moderate essential hypertension. In the atenolol/doxazosin-treated group, standing blood pressure significantly decreased by 17.0/12.3 mm Hg compared to 6.2/6.7 mm Hg in the atenolol/placebo group whereas supine blood pressure decreased by 13.2/9.8 mm Hg and 9.2/6.0 mm Hg, respectively in the two groups. Serum lipids did not change significantly in either group. The majority of side-effects reported were mild and transient. This study confirms that doxazosin may be safely combined with a beta-blocker. Doxazosin proved to be well tolerated and effective in patients with blood pressure refractory to atenolol alone.

Adolescent↗
PubMed1990

Outpatient or short-stay skin grafting with early ambulation for lower-extremity burns.

Lower-extremity burns and skin grafts to these wounds have traditionally required extended hospitalization. We have used early tangential excision of the burn wounds and application of an Unna boot to fresh skin grafts in an attempt to shorten the hospitalization for such patients. Over a six-month period, 9 patients were treated with Unna boots to fresh skin grafts on the lower extremity. The average hospital stay was 0.9 days (range, 0 to 3 days). Graft take was 85% to 100%; no regrafting was required. Ambulation was begun 24 hours postoperatively. The technique described is a safe, effective, and inexpensive alternative to prolonged immobilization and hospitalization in patients with lower-extremity skin grafts.

Ambulatory Care↗
PubMed1990

Transforming growth factor beta: a promotor of late connective tissue injury following radiotherapy?

Transforming growth factor beta (TGF-beta) is a peptide which has a fundamental role in controlling proliferation of many cell types. Its main effect upon connective tissues in vivo is to stimulate growth. It can result in endothelial cell proliferation but tends to inhibit epithelial cell growth. Damage to the connective tissues and the vasculature are the principal findings in late radiotherapy damage. Following the initial cellular depletion after radiotherapy, an abnormal proliferation of these tissues occurs, which does not respond to normal feedback mechanisms. Immunocytochemical staining for TGF-beta has been performed upon six patients who had received pre-operative radiotherapy and three patients who had surgery alone for large bowel tumours. Transforming growth factor beta was found in relation to the pathological changes of late radiation damage in the non-tumour-bearing tissues of four out of six previously irradiated patients, but in none of the non-irradiated patients. This paper proposes that TGF-beta activity may modulate late post-radiation changes.

Connective Tissue↗
PubMed1987

Heart rate reactions to standard laboratory challenges and a naturalistic stressor.

Extreme high and low heart rate reactors were selected on the basis of responses to two laboratory stressors; a video game, and mental arithmetic. The heart rates of the same subjects were then recorded during a public speaking competition. Heart rate reactions to this more naturalistic stressor were generally in line with the laboratory-based designations.

Adult↗
PubMed1985

Nadolol in combination with indapamide and xipamide in resistant hypertensives.

Twenty-four hypertensive patients have been studied. All had blood pressure recordings greater than 160/95 mmHg on 3 occasions whilst taking a beta blocker and two other antihypertensive agents in therapeutic doses. Compliance was checked by intermittent urine analysis for the relevant beta-blocker. These difficult to control hypertensives were treated with nadolol alone, nadolol plus indapamide and nadolol plus xipamide each for 2 months in random order. The aim was to reduce the blood pressure to below 160/95 mmHg. The supine blood pressure on nadolol alone (167/100 mmHg) was comparable to that on the previous three drug regimens (157/100 mmHg), the other two treatments were more effective (145/90 and 148/93 mmHg respectively). Hypokalaemia (serum potassium below 3.5 mmol/l) occurred in six individuals but occurred more frequently on xipamide than on indapamide.

Adult↗
PubMed1984

Hydrochlorothiazide in combination with potassium-sparing agents in the treatment of hypertension.

Twenty patients with mild to moderate hypertension participated in a single-blind crossover comparison of treatment with 25 mg hydrochlorothiazide plus 50 mg triamterene and 50 mg hydrochlorothiazide plus 5 mg amiloride in once-daily dosage regimens. After a 2-week run-in period without treatment, patients were allocated at random to receive one or other of the drug combinations, 1 to 2 tablets per day for 8 weeks, and were then crossed over after a 4-week wash-out period to the alternative treatment for a further 8 weeks. Blood pressure was monitored at monthly intervals. The results showed that both treatments effectively controlled blood pressure, regardless of the order in which they were given, and there was no significant difference in the number of medical adverse events or deviations from normal laboratory results recorded during either treatment.

Adult↗
PubMed1983

Nifedipine in the treatment of difficult hypertensives.

Nifedipine has been assessed as a possible alternative to other third line drugs in the management of patients with difficult to control hypertension. A group of 20 patients whose blood pressure was unsatisfactory on a 3 drug regimen had their third drug stopped and after a 2 week period nifedipine was added to their beta-blocker plus diuretic therapy. Eleven became normotensive on 30 mg nifedipine daily and a further 6 on 60 mg daily; giving on overall success rate of 85%. This result was achieved with a reduction in side effects and an absence of any haemodynamic or metabolic complications.

Adrenergic beta-Antagonists↗
PubMed1983

The use of nifedipine as third line therapy in the treatment of severe hypertension.

Twenty patients with essential hypertension difficult to control on a combination of beta blocker, diuretic and vasodilator (mainly hydralazine) drugs were subject to an open study. Replacement of the vasodilator by nifedipine appeared to produce a satisfactory antihypertensive response and a reduction in side effects.

Adrenergic beta-Antagonists↗
PubMed1982

Cardiovascular and metabolic effects of terbutaline.

Terbutaline is a selective beta 2 agonist used predominantly in the treatment of asthma. Since beta-mediated responses increase heart rate, dilate peripheral arteries, modify carbohydrate metabolism and the uptake of electrolytes into cells, the administration of terbutaline might be expected to produce widespread effects. In this study the intravenous administration of 0.5 mg terbutaline over 60 mn has been shown to produce marked changes without upsetting the volunteers. Heart rate, systolic blood pressure and plasma glucose all increase; diastolic pressure and serum potassium decrease. The data suggests that the terbutaline infusion may be a useful tool for the investigator. The results also quantitate some of the side effects which may result from the intravenous administration of a therapeutic dose of terbutaline given to asthmatics or to pregnant women to reduce uterine activity and delay childbirth.

Adult↗
PubMed1981

Platelet dysfunction in myeloproliferative syndromes.

The most common abnormality of the platelets in 43 patients with a variety of myeloproliferative syndromes was impaired or absent aggregation when stimulated with collagen and adrenaline. Eight unselected cases studied in more detail showed a normal prostaglandin synthesis pathway as evidenced by normal aggregation with arachidonic acid and the production of normal amounts of malonyldialdehyde. Mixing experiments with aspirin-tested platelets showed correction of the abnormal adrenaline and collagen responses and confirmed that the nature of the defect was different from that induced by aspirin. Stimulation of "myeloproliferative" platelets with thrombin after blocking the prostaglandin pathway with aspirin resulted in reduced aggregation, indicating either a deficiency of the storage pool of adenine nucleotides in the platelets or an abnormality of a membrane receptor for thrombin.

Aspirin↗
PubMed1981

The use of indapamide in resistant hypertensive therapy.

For this study hypertensive patients were selected who were taking at least a diuretic, a beta-blocker and a vasodilator. The diuretic was replaced by indapamide 2.5 mg daily. The objective was to assess the effect on blood pressure control and if possible reduce the total dose of the drugs administered, and also the side effects. 25 patients were admitted to the study. Four withdrew because of side effects. Of the remainder, blood pressure control improved in 10 patients, and in 7, some of the concomitant therapy was either withdrawn or reduced. Transient hypokalaemia developed in one patient byt the patient recovered without therapy. There was no significant increase in either serum uric acid or blood glucose.

Adrenergic beta-Antagonists↗