Search PubMed⌕ Search

Biomedical subjects

S E Husted

Publications and source records attributed to S E Husted.

At least 55 records · Page 3Linked to original sources
PubMed1993

Doxazosin treatment in patients with prostatic obstruction. A double-blind placebo-controlled study.

The safety and efficacy of the selective alpha 1-blocking agent doxazosin 4 mg once daily in the symptomatic treatment of benign prostatic hyperplasia were evaluated in a randomized, double-blind and placebo-controlled 9-week study of 100 patients. By patients' overall assessment of voiding difficulties, 79% in the doxazosin group (DG) and 44% in the placebo group (PG) reported improvement (p = 0.001). In the DG, improvement was noted in 63% of obstructive symptoms compared to 32% in the PG (p = 0.015), whereas improvement was noted in 76% and 45%, respectively, of irritative symptoms (p = 0.12). Daytime frequency was reduced by 1.5 in the DG and increased by 0.3 in the PG (p = 0.001), and nocturia was reduced by 1.1 and 1.0, respectively (p = 0.12). Maximum urinary flow rate was improved by 1.5 ml/s in the DG, while it deteriorated by 0.3 ml/s in the PG (p = 0.11). Considering postvoid residual urine volume, cystometry variables (first sensation and bladder capacity) and adverse events there was no difference between the two groups. In conclusion, doxazosin 4 mg once daily is safe and effective in relieving symptoms in patients with BPH.

Aged↗
PubMed1992

Intravenous acetylsalicylic acid--dose-related effects on platelet function and fibrinolysis in healthy males.

Low-dose acetylsalicylic acid (ASA) has been shown to be beneficial in patients with acute myocardial infarction and unstable angina pectoris. Oral administration of ASA is difficult in the acute phase of these syndromes. In this study we evaluated the effect of 25 mg, 50 mg or 100 mg of ASA given as an intravenous bolus injection on platelet function and fibrinolysis in healthy males and related this to plasma concentrations of ASA. No adverse effects were found. A complete inhibition of serum thromboxane B2 synthesis was demonstrated 5 min after injection of 100 mg ASA intravenously. ASA disappeared from the circulation within 60 min after bolus injection and at this time thromboxane B2 synthesis was inhibited dose-dependently by 71%, 90% and 100% for doses of 25 mg, 50 mg and 100 mg, respectively. Inhibition of thromboxane B2 synthesis after 100 mg of intravenous ASA was still 96.5% at 24 h and 93.4% at 48 h after the injection. The bleeding time measured at 30 min after ASA administration was significantly prolonged on the average by 70 s, 144 s and 211 s after 25 mg, 50 mg and 100 mg of ASA, respectively. Minor, but significant changes were found in tissue plasminogen activator antigen and in plasminogen activator inhibitor within the first hour after injection of low dose ASA, but similar changes were found after injection of saline. No change in tissue plasminogen activator activity was found.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Apical hypertrophic cardiomyopathy].

Apical hypertrophic cardiomyopathy is a subtype of non-obstructive hypertrophic cardiomyopathy characterized by a unique spade-like configuration and apical obliteration in the left ventriculogram as well as in the long axis two-dimensional echocardiogram. The symptoms and electrocardiographic findings in apical hypertrophic cardiomyopathy are quite similar to ischemic heart disease and confusion of the two diseases is obvious. An illustrative case, in which ventriculographic and echocardiographic findings were diagnostic for apical hypertrophic cardiomyopathy, is presented.

Adult↗
PubMed1991

Principles of thromboprophylaxis in surgical patients.

Thromboprophylactic treatment during surgery reduces mortality and morbidity. The type of prophylaxis may be individualized according to type of operation and presence of major risk factors, such as prior thromboembolism, malignancy, long duration of immobilization, and medical conditions. All patients over the age of 40, or even younger, who have major risk factors, and whose operations will last for more than 1 hour, may benefit from thromboprophylaxis. Available prophylactic methods allow for treatment with an acceptably low level of side effects and economic cost, when compared with the cost of diagnostics and treatment of thromboembolism.

Humans↗
PubMed1990

[Venous thromboembolism. "The emperor's new clothes" or a silent menace?].

The clinical picture at deep venous thrombosis and lung embolism is unspecific and the diagnosis is confirmed in only about 50 per cent of the patients by phlebography and lung angiography respectively. New contrast media have reduced the side-effects at phlebography. Of the non-invasive methods B mode ultrasound is a rapid, simple procedure with great diagnostic accuracy but lower leg thromboses cannot be demonstrated with the present equipment. High diagnostic accuracy has been attained at lung embolism by means of perfusion ventilation scintigraphy and lung angiography. ECG, acid-base status and thorax X-ray provide guidance and are of major significance for differential diagnosis. All cases of deep venous thrombosis above knee level should be treated with anticoagulants but such therapy is probably unnecessary for lower leg thromboses. Heparin is frequently given for three to six days. At the same time peroral anticoagulation therapy may be introduced and continue for one to three months after heparin treatment. Lung embolism is treated with anticoagulants if the patients are hemodynamically stable. The value of thrombolysis has not been determined but it is recommended for massive multiple and peripheral lung embolisms. Embolectomy should be considered in cases of massive central lung embolisms.

Angiography↗
PubMed1989

[Fibrinolytic agents in acute myocardial infarction. Reperfusion--a two-edged sword? Advantages and disadvantages of various preparations].

An account is presented of the problems which occur on reperfusion of the myocardium in connection with fibrinolytic treatment and the present day possibilities for reducing the complications. Restenosing is mentioned in particular. The advantages and disadvantages of the individual fibrinolytic preparations are illustrated. The clinical investigations available demonstrate that the higher frequencies of reperfusion for "fibrin selective" plasminogen activator are observed mainly in patients with durations of AMI symptoms for more than three hours before the commencement of thrombolytic treatment. In a comparison between t-PA and streptokinase investigations regardless of the time of inclusion no difference could be demonstrated in the effect on the left ventricular function, lethality after 12 months and the risk of haemorrhage. Employing APSAC and streptokinase, significant reduction in the one year lethality was found and, where streptokinase was concerned, on treatment up to 24 hours after the commencement of symptoms. Acetylsalicylic acid has an additive effect, possibly as a result of the reduced risk for rethrombosing among other things. The current data provide, however, no final explanation of the relative efficacy of the individual fibrinolytic drugs because the various investigations have had different forms of selection of patients, initiation of treatment and parallel medication. Attempts will be made to elucidate these in future investigations where ISIS-3 compares t-PA, streptokinase and APSAC while GISSI-2 will compare t-PA and streptokinase. Simultaneously, the value of heparin will be investigated in connection with fibrinolytic therapy.

Fibrinolytic Agents↗
PubMed1989

[Acetylsalicylic acid in the treatment of arterial thromboembolic diseases. 1. Pharmacologic aspects].

The possible antithrombotic potential of acetyl salicylic acid (ASA) has been established in recent years and the preparation has been employed extensively in ischaemic cardiac disease and cerebrovascular conditions. The inhibiting effect of ASA on platelet function by means of blocking of cyclo-oxygenase is mentioned and, similarly, the presumed role in thrombosis development and atherogenesis is mentioned. ASA's pharmacokinetics are illustrated with emphasis on optimal anti-thrombotic ASA dosage, in particular, in relation to the effects of the preparation on the thromboxan A2 (TxA2)/prostacyclin (PGI2)-ratio. This is probably best achieved by means of low oral dosage in the form of sustained-release ASA formulation where the inhibition of platelet function probably occurs mainly in the presystemic circulation. It is concluded that a daily dosage of 80-100 mg ASA ensures effective and rapid inhibition of TxA2 production. Administration of 30-50 mg ASA daily results in a corresponding blockage of TxA2 production but not until after treatment for three to four days.

Aspirin↗
PubMed1989

[Acetylsalicylic acid in the treatment of arterial thromboembolytic diseases. 2. Clinical documentation].

A review of the literature is undertaken to account for the current status of acetylsalicylic acid (ASA) in the treatment of patients with arterial thrombo-embolic conditions. Employment of ASA monotherapy has been documented to be effective in clinically controlled investigations in patients with unstable angina pectoris, transient cerebral ischaemia, coronary by-pass and femoro-popliteal endarterectomy and introduction of vascular prostheses and, in addition, in primary and secondary prophylaxis of acute myocardial infarction (AMI). In combination with dipyridamol, ASA has been found to be effective in secondary AMI prophylaxis, coronary by-pass operation and in peripheral arteriosclerosis. In patients with cardiac valvular prostheses, conventional anticoagulation therapy must still constitute the basic treatment but dipyridamol may be employed to increase the antithrombotic efficacy of the treatment. The dosage of ASA in the majority of works has been about 1,000 mg daily while isolated investigations have shown good effect from doses as low as 60 mg daily. It appears to be important for the efficacy of the treatment with platelet inhibitors in the above-mentioned conditions that treatment is instituted rapidly and, in connection with operative intervention, preferably preoperatively. In other clinical conditions such as preeclampsia, hypertension in pregnancy, diabetic angiopathy and nephropathy, membranoproliferative glomerulonephritis and arterio-venous shunts with haemodialysis, treatment with ASA appears to be effective but documentation in extensive clinically-controlled investigations is not yet available. The duration of treatment with ASA in arterial thrombo-embolic disease does not appear to be illustrated unanimously in the articles published but, as the atherosclerotic lesion is not influenced by ASA, there are indications for life-long therapy.

Aspirin↗
PubMed1989

Bepridil versus verapamil in stable angina pectoris--a controlled clinical trial.

The calcium antagonist bepridil (bepridil monohydrochloride monohydrate, Org 5730, Cordium) was investigated in comparison with verapamil in a double-blind cross-over design in patients with angina pectoris. Exercise parameters, frequency of anginal attacks, consumption of nitroglycerin and subjective preference were analysed for 36 patients. The exercise capacity, estimated by exercise time and total work load during standard bicycle testing, was significantly more improved with bepridil treatment than with verapamil treatment. No significant differences were observed in frequencies of anginal attack, consumption of nitroglycerin and subjective preference. Side effects were mild and equally divided over both treatment groups.

Adult↗
PubMed1989

Antithrombin III activity, von Willebrand factor antigen and platelet function in young diabetic patients treated with multiple insulin injections versus insulin pump treatment.

In a prospective study with cross-over design 20 patients with insulin-dependent diabetes mellitus of more than 2 years duration were treated for 6 months with continuous subcutaneous insulin infusion (CSII) and multiple insulin injections (MII). Metabolic control, platelet aggregability, thromboxane B2 levels in serum and plasma as well as antithrombin III (ATIII) activity and von Willebrand factor antigen were evaluated. A good metabolic control was obtained by both intensified regimens. No difference could be demonstrated between either platelet function tests or serum level of von Willebrand factor antigen during treatment with CSII and MII. However, the plasma level of ATIII activity was significantly higher (P less than 0.01) during MII treatment as compared to CSII treatment. There was no correlation between ATIII activity and daily insulin requirement or serum fructosamine. In conclusion, long-term metabolic control with MII has a favourable effect on ATIII activity in plasma. This may be important for a delay in onset and progression of diabetic vascular complications.

Adult↗
PubMed1989

Acetylsalicylic acid 100 mg and 1000 mg daily in acute myocardial infarction suspects: a placebo-controlled trial.

Of 1078 patients admitted to the coronary care unit with acute chest pain, 293 who had possible acute myocardial infarction and symptoms of median 4 h duration were randomized to treatment with acetylsalicylic acid (ASA) 100 mg daily, 1000 mg daily or placebo for 3 months. During hospitalization, the combined incidence of cardiac death and non-fatal myocardial infarction on-treatment (withdrawals not included) was significantly lower (P less than 0.02) in the 100 mg group (7.1%) than in both the 1000 mg group (20.8%) and the placebo group (19.7%). During later time periods of treatment and at all time periods analysed according to the intention-to-treat principle (withdrawals included), data suggested the same trend, but differences were not statistically significant. Collagen-induced platelet aggregation and serum thromboxane B2 were reduced to the same degree in the two ASA groups and were normal in the placebo group. The data suggest that low-dose ASA could be cheap and safe as first-aid therapy in myocardial infarction suspects.

Aspirin↗
PubMed1989

Prazosin treatment of neurological patients with detrusor hyperreflexia and bladder emptying disability.

In a placebo-controlled clinical trial with cross-over design the effect of alpha-adrenoceptor blockade with prazosin was studied in 18 neurological patients with detrusor hyperreflexia and bladder emptying disability. During active treatment both the distance to maximal urethral closure pressure (MUCP) and MUCP were significantly reduced. In addition, the volume at first bladder contraction was increased. The urodynamic parameters measured during voiding were unaffected. We conclude that prazosin decreases detrusor hyperreflexia but only in rare cases may benefit bladder emptying in these patients.

Female↗
PubMed1989

Stress response and platelet function in minor surgery during epidural bupivacaine and general anaesthesia: effect of epidural morphine addition.

In a randomized study, thirty patients submitted to transarthroscopic meniscectomy were allocated to general or epidural anaesthesia with or without epidural morphine. Threshold concentration of collagen for platelet aggregation did not differ between the groups, but showed a similar pattern of increase, which was significant in the general anaesthesia group. Collagen-induced thromboxane-B2 synthesis was significantly lower in the epidural anaesthesia groups compared with the general anaesthesia group, and the addition of morphine caused a significant fall in thromboxane-B2 synthesis. The mean serum cortisol concentration increased in the general anaesthesia group, and decreased in the epidural groups. The difference between the groups was significant. Epidural morphine administration significantly decreased serum cortisol. During operation a thigh tourniquet was used. The removal of the tourniquet did not influence any of the measured variables. It can be concluded that the adrenocortical system is activated during general and inhibited during epidural anaesthesia. The addition of morphine during epidural anaesthesia further decreases the activity of the adrenocortical system, and the combined regime has an inhibiting effect on platelet function.

Adult↗