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Biomedical subjects

W Hart

Publications and source records attributed to W Hart.

At least 73 records · Page 4Linked to original sources
PubMed1999

[Selective estrogen-receptor modulators (SERM's) in postmenopausal women].

Selective oestrogen receptor modulators (SERMs) constitute a group of new drugs which mimic oestrogen in some organs and tissues but have an oestrogen antagonistic mode of action in other tissues. In postmenopausal women these compounds have a favourable effect on lipoprotein cholesterol levels in the blood and bone mineral density, thereby reducing fracture risk, especially in the vertebral column. In contrast to oestrogen therapy SERMs reduce the risk of mammary carcinoma. Currently tamoxifen and raloxifene are the best known SERMs. Tamoxifen increases endometrial hyperplasia and the risk of endometrial carcinoma. Raloxifene inhibits uterine tissue proliferation and does not appear to influence the endometrium directly. Raloxifene appears to be finding a place for itself in the treatment and prevention of osteoporosis in postmenopausal women. At this moment it is not yet possible to foresee what the impact of SERMs will be in the treatment and prevention of cardiovascular diseases and breast cancer.

Aged↗
PubMed1999

Environment and behavior of 2.5-million-year-old Bouri hominids.

The Hata Member of the Bouri Formation is defined for Pliocene sedimentary outcrops in the Middle Awash Valley, Ethiopia. The Hata Member is dated to 2.5 million years ago and has produced a new species of Australopithecus and hominid postcranial remains not currently assigned to species. Spatially associated zooarchaeological remains show that hominids acquired meat and marrow by 2.5 million years ago and that they are the near contemporary of Oldowan artifacts at nearby Gona. The combined evidence suggests that behavioral changes associated with lithic technology and enhanced carnivory may have been coincident with the emergence of the Homo clade from Australopithecus afarensis in eastern Africa.

Animals↗
PubMed1999

[The percentage of articles which were accepted or rejected for publication in the Dutch Journal of Medicine in 1997].

OBJECTIVE: To determine the acceptance and rejection percentages of articles submitted to the editors of the Nederlands Tijdschrift voor Geneeskunde (NTvG) in 1997. DESIGN: Retrospective. METHOD: The data on all articles reviewed by the editors of the NTvG in 1997 were extracted from the registration system in April 1998. These included the outcome of the review process (rejection or acceptance for publication or no definite decision yet), the article category (e.g., original article, review article), and whether the article had been solicited by the editors or was a spontaneous submission. RESULTS: In 1997, 845 articles were received. Of these 28% (240) were rejected and 59% (497) were accepted for publication. On 13% (108) no decision had been made (in April 1998). Of the articles decided upon 36% were rejected (extrapolated). 705/845 (83%) articles were unsolicited: of these 33% (235) were rejected and 54% (382) accepted; on 13% (88) the decision was pending. The solicited articles numbered 140 (17%); of these 4% (5) were rejected and 82% (115) were accepted; on 14% (20) no decision had been made yet. CONCLUSION: The rejection of articles submitted to NTvG in 1997 was 36% (in 1990 38%). Solicited articles were rejected less frequently than unsolicited ones. The yearly number of articles submitted and the rejection percentage have not changed drastically during the last eight years.

Journalism, Medical↗
PubMed1998

[Fifty years of the column 'Question and Answer'].

The section 'Question and answer' in the Nederlands Tijdschrift voor Geneeskunde (Dutch Journal of Medicine) has existed for over 50 years. Medical questions of readers are published anonymously and answered by an anonymous expert consulted by the editorial staff. At first the column grew rather large but in the last few decades it shrank to only few publications a year. Due to improvements in communication (Internet) and provision of information (electronic databases) it appears that the column, as a medium for questions of readers, is becoming obsolete.

History, 20th Century↗
PubMed1997

Barnidipine, a novel calcium antagonist for once-daily treatment of hypertension: a multicenter, double-blind, placebo-controlled, dose-ranging study. Dutch Barnidipine Multicenter Study Group.

The antihypertensive effects and tolerance of once-daily barnidipine, a novel dihydropyridine calcium antagonist, were evaluated. A total of 190 patients with a sitting diastolic blood pressure (DBP) of 95-114 mmHg were investigated in this multicenter, double-blind, placebo-controlled, dose-ranging study. After a 4-week single-blind placebo run-in period, patients were randomized to placebo or barnidipine (10 mg, 20 mg, or 30 mg modified release capsules) once daily for 6 weeks. Nonresponders (sitting DBP > or =90 mmHg and a decrease of < 10 mmHg) were treated for an additional 6 weeks with a dose increase of 10 mg. At each clinic visit, sitting and standing blood pressure and heart rate were measured approximately 24 hours after the last dose of study drug was taken. Compared with placebo, barnidipine lowered blood pressure, with a trend toward a dose-response relationship over the dose range 10-30 mg. A dose increment of 10 mg in nonresponders resulted in additional reductions in blood pressure. At the end of the active treatment period, the responder rates were 41% and 57% for 10 mg and 20 mg barnidipine, respectively. Heart rate in both sitting and standing positions was not affected by barnidipine. Treatment with barnidipine was well tolerated, and the incidence of adverse events was dose related and consistent with vasodilatation. In conclusion, barnidipine (10-30 mg) administered once daily is well tolerated and reduces blood pressure in patients with mild to moderate hypertension.

Aged↗
PubMed1996

Mortality soon after discharge from a major teaching hospital: linking mortality and morbidity.

In this pilot study, data held by the Registrar of Births, Deaths and Marriages was linked to the Patient Master Index at St Vincent's Hospital Melbourne in order to identify early post discharge deaths, and inpatient records were linked with the Victorian Inpatient Minimum Database. Between July 1991 and December 1993 there were 831 deaths within 28 days of discharge. Injuries and poisoning were the commonest cause of death in younger patients who had attended the emergency department. These were responsible for 64% of deaths under the age of 40 years. There were deaths from cardiovascular disease which had been unrecognised during the hospital stay. There is also the need to identify in hospital those at risk of suicide. Amongst inpatients who were discharged home or transferred, the risk of death was greatest in the days immediately following discharge. Policies relating to the transfer of patients need to be reviewed as the study found that 30% of patients who had been transferred to long term care facilities died within four days. In conclusion, linking mortality and morbidity data can highlight areas of hospital care where there is the potential to prevent premature death, and improve management. The outcome of coronial investigations should be transmitted to hospitals for quality assurance purposes.

Adult↗
PubMed1996

Leaving hospital against medical advice.

Early post-discharge deaths were identified in a recent study based at St Vincent's Hospital, Melbourne, over a two and a half year period. As a result of linking patient records with the Victorian Minimum Database (VIMD) those who had discharged themselves against medical advice (ama) were identified. In this study information relating to all patients who discharged themselves ama from St Vincent's Hospital was obtained from the VIMD. We found that 1.5% of separations over the study period were discharges ama. Nearly half were over the age of 60 years. Injuries and poisoning, circulatory disorders and mental disorders were the most common diagnostic categories associated with discharge ama. The specific conditions contained within these included fractured neck of femur, cerebral occlusion and subarachnoid haemorhage. The study raises the important question of how discharge ama affects the clinical outcome in patients with such serious conditions. A follow up of such patients, which includes interviews with clinicians and families is suggested. The patients who died within 28 days were in the main elderly, suffering from malignancy. Even in these cases a knowledge of the attitudes and experiences of clinicians would be useful in order to manage optimally requests by critically ill patients for discharge.

Adult↗
PubMed1995

[Acute kidney insufficiency following administration of tiaprofenic acid].

A 62-year-old woman was admitted with acute renal failure, 3 weeks after starting intake of the nonsteroidal anti-inflammatory drug tiaprofenic acid (Surgam). A renal biopsy revealed tubulointerstitial nephritis. After discontinuation of the drug and correction of electrolyte disturbances, renal function recovered almost completely within 6 months.

Acute Kidney Injury↗
PubMed1994

[Psychotic reactions during administration of quinolones].

A 86-year-old woman became psychotic one day after starting treatment with 800 mg norfloxacin daily. Discontinuation and short-term treatment with haloperidol were followed by rapid disappearance of symptoms within two days. Since 1984, the Netherlands Centre for Monitoring of Adverse Reactions to Drugs received 19 similar reports of which 12 were attributed to norfloxacin, 3 to ofloxacin and 4 to pipemidic acid. The risk appears to be relatively high in the elderly, especially if they have fever, renal dysfunction and a psychiatric history. Lowering the doses may solve this problem provided the bacterial susceptibility is taken into account.

Adolescent↗
PubMed1994

[Neurological complications of infectious mononucleosis in 3 patients].

Neurological complications of infectious mononucleosis were seen in three patients, a boy aged 18 months and two women aged 70 and 51 years respectively: a Bell's palsy, polyradiculitis and transverse myelitis. In a patient with acute neurological symptoms without indications of any other cause, infectious mononucleosis should be considered.

Aged↗
PubMed1993

Inactivation of viruses during ultraviolet light treatment of human intravenous immunoglobulin and albumin.

A comparison of ultraviolet (UV) irradiation of two wavelength ranges UVB (280-320 nm) and UVC (lower than 280 nm) showed that UVC in particular could very effectively inactivate, in intravenous immunoglobulin (IVIG) and albumin preparations, non-enveloped and non-acid labile model viruses (i.e., Polio 2 and T4 phage) and dry heat-resistant viruses (vaccinia and T4 phage). This effective virucidal treatment (5 min, 5,000 J/m2 dose) was achieved before an unacceptable level of IVIG aggregates occurred. The use of UV irradiation to inactivate infectious agents could add safety and supplement current methods, e.g. solvent/detergent, low pH, which do not inactivate non-enveloped, non-acid labile or dry-heat-resistant viruses at present.

Antibodies, Viral↗
PubMed1993

ACE inhibition versus calcium antagonism in the treatment of mild to moderate hypertension: a multicentre study. Ireland-Netherlands Lisinopril-Nifedipine Study Group.

The efficacy of lisinopril 10-40 mg once daily was compared with that of nifedipine tablets 20-40 mg twice daily in a multicentre double-blind randomized parallel group study of 16 weeks duration involving 127 patients with mild to moderate hypertension. The groups randomized to lisinopril or to nifedipine were not significantly different with respect to any demographic variable. An analysis of the pooled data from all centres demonstrated a significantly greater fall in both lying and standing systolic blood pressure (SBP) on lisinopril than on nifedipine treatment (difference between treatments 7.70 +/- 3.34 mmHg; P = 0.02 and 10.2 +/- 3.30 mmHg; P = 0.003 for lying and standing SBP, respectively). However, this difference may be accounted for by the slightly higher mean SBP in the lisinopril treatment groups compared with the nifedipine group at the end of the placebo run-in period. Both treatments lowered lying and standing diastolic blood pressures (DBP) to the same extent and the response rates to the two treatments were the same. The effects of the two drugs on heart rate were indistinguishable from each other. There were six lisinopril and 12 nifedipine-treated patients withdrawn during randomized treatment (P = 0.22). Nineteen per cent of lisinopril patients reported an adverse event compared with 36% of nifedipine patients. The relative risk of an adverse event on lisinopril compared with nifedipine was 0.42 (confidence limits 1.027-0.172) a difference which approached statistical significance (P = 0.0573). Lisinopril produced a greater reduction in both lying and standing SBP than nifedipine and both were associated with equivalent reductions in DBP. Lisinopril may be better tolerate than nifedipine.

Adolescent↗
PubMed1993

Discitis in childhood. 12-35-year follow-up of 35 patients.

We report a follow-up of 35 children, on average 17 years after they had intervertebral discitis. 15 patients still complained of backache. Flexion of the low back was normal in 32 patients, while extension was markedly restricted in 30. 26 patients had a block vertebra, and 28 patients had narrowing of the vertebral canal. Mode of treatment did not appear to affect the outcome.

Adolescent↗
PubMed1993

Cardiolipin antibodies and lupus anticoagulant in young patients with a cerebrovascular accident in the past.

To determine whether young patients who suffered a stroke in the past, have a higher prevalence of ACA of LAC as compared to healthy controls, we evaluated 44 stroke patients and 46 controls in a case-control study for the presence of ACA and LAC. All the patients had had a stroke under the age of 50 yr and the stroke date was less than 5 yr ago (mean 2.5 yr). Stroke was defined as an ischaemic cerebral infarction and was confirmed by angiography, CT-scan or MRI. An age- and sex-matched group of healthy volunteers served as controls. The mean age of the patients was 41.4 yr (range 22-52 yr), and of the controls 36.8 yr (range 24-50 yr). Serum and plasma from both groups was examined for IgM- and IgG-ACA and LAC. One patient was positive for both IgG- and IgM-ACA, whereas 3 controls were found positive for IgG-ACA. For 2 patients and 5 controls an equivocal result was obtained for IgG-ACA or IgM-ACA. None of the patients or controls were positive for LAC. The differences between the patient and control group were statistically not significant. In conclusion, no difference was found in the prevalence of cardiolipin antibodies in sera from patients with a stroke within the last 5 yr and an age- and sex-matched control group. There was no correlation either between the presence of lupus anticoagulant and the occurrence of a stroke in the past.

Adult↗
PubMed1992

[Endothelins].

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Cardiovascular Diseases↗