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Biomedical subjects

Z Rumboldt

Publications and source records attributed to Z Rumboldt.

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

Should glucose be administered before, with, or after insulin, in the management of hyperkalemia?

To assess the hypokalemic effect of intravenous glucose (25 g i.v. in 5 min) followed by regular insulin (10 U) bolus, as well as the incidence of hypoglycemia, a well-known side effect of this intervention, nine uremic patients on maintenance hemodialysis were studied. Measurements were done of plasma potassium, glucose, insulin, and C-peptide before, and 15, 30, 45, and 60 min after glucose and insulin. The intervention induced a significant fall in plasma potassium level, a significant rise and then fall in plasma glucose, and a significant increase in the insulin and C-peptide levels. These data suggest that hypertonic glucose infusion should precede, not follow, the insulin bolus in the management of hyperkalemia. Such an approach is clinically effective and well tolerated, with no hypoglycemic side effects.

Adult↗
PubMed1993

Controlled multicentre comparison of captopril versus lisinopril in the treatment of mild-to-moderate arterial hypertension.

The antihypertensive efficacy and safety of lisinopril (L), a novel ACE inhibitor, were compared to those of captopril (C), the familiar drug of the same class, in a multicentre controlled trial. The study included 91 mild-to-moderate, middle-aged hypertensives of both genders, 46 of which were randomized to C and 45 to L. After a two-week placebo period the examinees were receiving either L o.d. in increasing dosage of 10, 20, or 40 mg per day (amount necessary to achieve normotension), or C b.i.d. in a corresponding daily dose of 25, 50, or 100 mg. During the eight-week formal part of the trial, L decreased the systolic blood pressure from the initial values by an average of 14.9%, and the diastolic pressure by some 15.2%. The same parameters were lowered on C by 11.2%, and 11.7%, respectively. The mean arterial pressure from an initial average of 125.5 mmHg was lowered to 110.9 mmHg on C (11.6% reduction, p < 0.01), and from 125.3 mmHg to 108.2 mmHg on L (13.6% reduction, p < 0.01). Although the L effects were more pronounced, the observed between-group differences did not reach the level of statistical significance, except for the achievement of normotension, which disclosed the superiority of L (p < 0.05). The tolerability of both drugs was good and only one examinee had to be excluded because of side-effects (proteinuria). It is concluded that both ACEIs under study showed comparable efficacy and safety, L being marginally more potent and longer acting.

Adolescent↗
PubMed1993

The impact of meteorological factors on the onset of myocardial infarction in the coastal region of middle Dalmatia.

The influence of mediterranean climate on the onset of acute myocardial infarction (AMI) has been investigated in a study group comprised of 1306 AMI patients from the coastal part of middle Dalmatia (Croatia) admitted to the two Split hospitals in the 1981-1987 period. AMI incidence during the southern wind (0.62 per day) was significantly greater than during the northern wind (0.50 per day; p < 0.05), as well as during all non-southern-wind days (0.49 per day; p < 0.01). The coefficients of partial correlation showed a significant association of AMI incidence with increased air temperature (p < 0.05) and relative humidity (p < 0.05). Cross-correlation showed a positive link of AMI incidence to increased air temperature four days before, and on the day of the incident (p < 0.05). Analysis of the synoptic situations revealed characteristics of unstable weather in the days with 4 or more AMI patients. The results suggest that during the southern wind or the passing atmospheric front, coronary patients should stay at home, avoid both physical and psychological stress, and take antianginal drugs more frequently.

Aged↗
PubMed1990

[Comparison of the antihypertensive effects of bopindolol and metoprolol in the treatment of arterial hypertension].

A randomized, double blind clinical trial included 40 hypertension patients of both sexes, aged 18-70 years, with diastolic blood pressure persistently above 100 (13.33 kPa) and below 120 mm Hg (15.99 kPa). After a run-in period on placebo, one half of them was treated with bopindolol (single daily dose 1-3 mg), and the other half with metoprolol (100-300 mg daily in two divided doses). After 4 weeks of formal trial both beta blockaders had significantly decreased the elevated arterial pressure, e.g. the mean arterial pressure in the bopindolol group dropped from an average of 129.1 +/- 6.9 (17.20 +/- 0.92) to 111.6 +/- 6.1 mm Hg (14.87 +/- 0.81 kPa) or by 13.6% and in the metoprolol group from 129.8 +/- 7.1 (17.30 +/- 0.94 kPa) to 114.5 +/- 6.4 mm Hg (15.26 +/- 0.85 kPa) or by 11.8% (p less than 0.02). After 12 weeks the mean pressure was ulteriorly lowered to some 104.3 mm Hg (13.90 kPa) on bopindolol and to some 106.0 mm Hg (14.12 kPa) on metoprolol. The heart rate was expectedly slowed down, from an average of 95 to 69 b.p.m. with bopindolol (27.4% decrease, p less than 0.001) and from 99 to 67 b.p.m. with metoprolol (32.3% decrease, p less than 0.001). The other parameters, including the laboratory results did not change appreciably during this study. Clinically relevant side-effects were not registered, and the observed between-group differences did not reach the level of statistical significance. It is concluded that bopindolol and metoprolol are beta-adrenergic blockaders of comparable antihypertensive efficacy.

Adolescent↗
PubMed1990

Role of digoxin in right ventricular failure due to chronic cor pulmonale.

The effect of digoxin in the treatment of decompensated chronic cor pulmonale was investigated in a randomized double-blind, cross-over, placebo-controlled trial. A total of 34 successive patients with evident right heart failure were included in the study. The mean maintenance daily dose of digoxin was 0.30 +/- 0.03 mg with the mean serum level of 1.7 +/- 0.7 nmol/L. The severity of heart failure was assessed according to a clinicoradiographic scoring system (Heart Failure Score). The heart failure worsened during the placebo-period in eight (23.5%) patients (four with atrial fibrillation, two with a third heart sound (S3), one with a cardiothoracic ratio of more than 0.5 and one with sinus rhythm). By regression analysis, the heart failure significantly worsened only in the subgroup of patients with atrial fibrillation. Digoxin was successfully (without worsening of the heart failure) discontinued in 26 (76.5%) patients. No significant improvement was observed in the patients with S3 gallop. It was concluded that digoxin had no beneficial effect in chronic cor pulmonale patients with heart failure, except in those with atrial fibrillation.

Aged↗
PubMed1989

The influence of the atrial natriuretic factor on venous tone in man.

To assess the effect of the human atrial natriuretic factor (ANF) in vivo on human veins, a series of investigations was done on the dorsal hand vein of 11 healthy volunteers (ten men, one woman), aged from 25 to 49 years. In the case of intact veins the human ANF effect was evaluated by the "venoconstriction" test; on veins constricted by a reflex sympathetic discharge, the ANF effect was evaluated by the test of "venous reflexes", and on veins constricted with serotonin and angiotensin II by the "preconstriction" test. The results were expressed in venoconstrictive units (VCU). ANF was injected into the vein under study in increasing bolus doses (from 50 pg to 500 ng). The results indicate that this peptide did not affect either intact veins or these constricted by sympathetic discharge. On veins preconstricted with serotonin, ANF had a slight, statistically insignificant effect (848.57 +/- 378.67 VCU 30 sec before, compared to 670.00 +/- 460.25 VCU 30 sec after the injection of 50 pg; n = 7; p greater than 0.05), up to a maximal local dose of 500 ng. The same was true for the vein preconstricted with angiotensin II. It is concluded that the human atrial natriuretic factor has no significant influence on peripheral venous tone in man.

Adult↗
PubMed1988

Enalapril versus captopril: a double-blind multicentre comparison in essential hypertension.

A collective, multicentre (Ljubljana, Split, Zagreb) comparison of the antihypertensive effects between two angiotensin converting enzyme inhibitors (ACEI) captopril and enalapril was made in 69 hypertensives of both sexes, having a diastolic blood pressure (DBP), following two weeks on a placebo, of between 110 and 130 mm Hg (14.7 and 17.3 kPa). There were 35 patients on enalapril (20-40 mg), and 34 on captopril (50-100 mg). Both drugs under study decreased significantly the mean DBP already after the first week of ACEI treatment (p less than 0.001). By the end of the trial (9th week) captopril had decreased the DBP in the supine position from the initial 180.3 +/- 15.3/117.7 +/- 6.4 mm Hg to 151.6 +/- 11.1/96.8 +/- 7.2 mm Hg. Enalapril had lowered the DBP more efficiently: from 182.7 +/- 16.7/118.7 +/- 7.7 to 145.6 +/- 12.8/92.2 +/- 6.4 mm Hg (p less than 0.05). The average reduction in mean DBP was 16.9% on captopril, and 20.9% on enalapril. Low dose ACEI monotherapy (i.e. 50 mg and 20 mg) achieved DBP normalization in 11.8% on captopril and in 26.4% on enalapril (p less than 0.01). There were no significant heart rate changes. The laboratory results did not change appreciably and there were no relevant side-effects, although particular attention was paid to the expected adverse reactions, such as cough, ageusia or proteinuria. It is concluded that the ACEIs under study showed comparable effectiveness within the used dose range, enalapril being more potent, longer acting, and possibly safer.

Blood Pressure↗
PubMed1988

Nicardipine versus nifedipine: multicentre controlled trial in essential hypertension.

Ninety-five hypertensive outpatients of both sexes, aged 23 to 65 years with diastolic blood pressures above 105 but below 120 mmHg (greater than 14.0 but less than 16.0 kPa), after one week on a placebo were randomly assigned either to nicardipine plus a placebo (40 mg/day - 48 patients) or nifedipine sustained-release plus a placebo (20 mg/day - 47 patients) for an additional six weeks. The study groups were homogeneous and comparable. After the run-in period the average blood pressure was 181 +/- 17/116 +/- 9 mmHg (24.1 +/- 2.3/15.5 +/- 1.2 kPa) in the nicardipine and 177 +/- 22/116 +/- 9 mmHg (23.6 +/- 2.9/15.5 +/- 1.2 kPa) in the nifedipine group (p greater than 0.10). In the acute oral test (nicardipine 40 mg to all the subjects; blood pressure measured at 30 min intervals during two hours) almost identical hypotensive effects within and between groups were observed (mean arterial pressure decrease of 11%, after 120 min; p less than 0.05). At the end of this trial blood pressure decreased further to 152 +/- 12/94 +/- 11 mgHg (20.3 +/- 1.6/12.5 +/- 1.5 kPa) (mean decrease of 20%; p less than 0.01) on nicardipine and to 145 +/- 12/94 +/- 11 mmHg (19.3 +/- 1.6/12.5 +/- 1.5 kPa) (mean decrease of 20%; p less than 0.01) on nifedipine. There were no significant changes in pulse rate. The observed between-group differences were trivial (p greater than 0.10). The laboratory data did not alter appreciably during this study. Three patients on nicardipine and four on nifedipine reported headache, palpitations and flushing: one patient on nicardipine and two on nifedipine were as a result excluded from the trial. It was concluded that nicardipine and nifedipine sustained-release were comparably effective and well-tolerated drugs suitable as the first-line agents for the management of mild to moderate hypertension.

Administration, Oral↗
PubMed1985

Rapid dissolution of right atrial thrombus in a patient with congestive cardiomyopathy.

The AA describe a patient with congestive cardiomyopathy, probably alcoholic, who exhibited signs and symptoms of congestive heart failure and a pericardial rub, due to a right atrial thrombus (4 X 2 cm). The thrombus dissolved completely and the symptoms decreased markedly after 14 days of oral anticoagulant therapy alone. We suggest that anticoagulant therapy should be considered before surgery, if an intracardiac mass with no signs of pulmonary embolism is found in a patient with cardiomyopathy.

Cardiomyopathy, Dilated↗