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Biomedical subjects

B Knick

Publications and source records attributed to B Knick.

15 recordsLinked to original sources
PubMed1992

Subcutaneous lidocaine affects inducibility in programmed electrophysiology testing in children: a follow-up study.

Invasive cardiac electrophysiology testing during cardiac catheterization requires local anesthesia at the point of entry for the catheters. Frequently, lidocaine is employed for this purpose. A prospective study completed in 1990 indicated that subcutaneous administration of lidocaine adversely influenced the inducibility of arrhythmias in pediatric patients. Upon completion of that study, lidocaine concentration was reduced from 1% to 0.5%, and extra caution was taken to avoid deep penetration during administration. A follow-up, prospective study was performed to evaluate inducibility under these changed conditions. Because the depressant effect of lidocaine on inducibility was age- and weight-related, the second study group was required to have statistically indistinguishable age and weight distributions from the first group to eliminate these variables as factors in inducibility. A total of 177 subjects were collected in the second group before a periodic random computer match with the first group produced 99 individuals with the required age and weight distributions. Analysis of the electrophysiology tests in the second study revealed that: (1) incidence of inducibility was higher in the second group (58 of 99 versus 43 of 99, p < 0.05); (2) average lidocaine dose per kilogram was lower (1.8 mg/kg versus 3.28 mg/kg, p < 0.0001); (3) average lidocaine serum concentration was also lower (0.58 micrograms/ml versus 1.47 micrograms/ml, p < 0.0003); (4) in contrast to the first study, neither lidocaine dose nor serum concentration had any effect on inducibility. We conclude that the new procedures for lidocaine administration effectively removed lidocaine as a factor in inducibility.

Adolescent↗
PubMed1991

Oral antidiabetic combination therapy with sulphonylureas and metformin.

In a multicentre trial in general practice, a total of 1823 type 2 diabetics, not adequately controlled by diet and maximal sulphonylurea therapy, were treated with additional metformin 850--2 550 mg/d for 12 weeks. The average postprandial blood sugar decreased from 15.48 mmol/l to 10.43 mmol/l, HbA1 fell from 11.0% to 9.1%. Serum triglycerides decreased from an initial level of 2.87 mmol/l to 2.41 mmol/l an mean total cholesterol from 6.76 mmol/l to 6.16 mmol/l. In addition, body weight and blood pressure declined steadily. All the described changes were statistically significant. The metformin-sulphonylurea combination therapy was generally well tolerated. Gastrointestinal side effects occurred in about 7% of patients, but mainly in the first week of treatment, generally disappearing spontaneous as therapy was continued. Side effects led to a discontinuation of the treatment in 4.2% of patients.

Administration, Oral↗
PubMed1979

[Present day problems in the diagnosis of diabetes (author's transl)].

The results of a longterm study showed that only a relatively small percentage of patients with limiting disturbance of glucose tolerance progressed in the direction of diabetic manifestation. There seems therefore to be grounds for the diagnostic term diabetes to be used only for clinically overt diabetes mellitus and to allow the definitions "subclinical diabetes, chemical diabetes, latent diabetes and symptomatic diabetes" to fall into disuse. On the question of quantity for the glucose tolerance test a 75 g load was proposed as a compromise because of the occasional poor tolerance of the 100 g load. For reasons of international comparability it seems better to adhere to the 50 to 100 g load as before.

Diabetes Mellitus↗
PubMed1979

[The effect of metipranolol on the carbohydrate metabolism in diabetics treated with glibenclamide (author's transl)].

Previous investigations on the effect of beta-receptor blockers on the carbohydrate metabolism of diabetics have reported varying effects, the most frequent being hypoglycaemic symptoms which were interpreted as potentiating effects caused by interference with the antidiabetic agents. For this reason, the effect of the beta-receptor blocker metipranolol on the carbohydrate metabolism of diabetics treated with glibenclamide was investigated in a double blind cross-over study comparing metipranolol with placebo. The results do not show any significant difference between the placebo and the metipranolol with respect to the blood or urinary sugar values or the plasma insulin levels. Whether or not this is a substance-specific property needs to be clarified by further comparative investigations using other beta-receptor blockers. There were similarly no significant differences in the most important parameters of hepatic and renal function.

Adult↗