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Biomedical subjects

B L Pentecost

Publications and source records attributed to B L Pentecost.

At least 37 records · Page 2Linked to original sources

Effect of intravenous insulin infusion on mortality among diabetic patients after myocardial infarction.

A review of the records of 353 diabetic patients after a myocardial infarction confirmed the high mortality associated with the condition. The influence of improved diabetic control achieved by intravenous insulin was assessed in 64 patients and compared with earlier experience in a diabetic control group. The frequency of the major complications of myocardial infarction was unchanged and the death rate in both groups was identical (33%); even the patients with blood glucose concentrations greater than 20 mmol/l on admission failed to benefit. Thus careful control of blood glucose concentrations after myocardial infarction in diabetic patients fails to improve the outcome of this high risk group.

Aged↗

The Birmingham blood pressure school study.

Four-hundred and twenty-eight school leavers of 3 ethnic groups (white, black and Asian) were screened for blood pressure, resting pulse rate and general anthropometric characteristics. Asian pupils were both shorter and lighter than the other two groups whilst black males were heavier and taller. There was no significant difference in the mean systolic or diastolic blood pressure between the 3 groups, although the black pupils had a stronger family history of hypertension, particularly on the mother's side. These observations differ in some respects from other ethnic blood pressure studies and establish values for the local population.

Adolescent↗

Effect of GL enzyme (a highly purified form of hyaluronidase) on mortality after myocardial infarction.

The influence of intravenous GL enzyme (hyaluronidase) on the outcome of myocardial infarction was assessed in a controlled trial among 483 patients presenting within 6 h of the onset of symptoms. There was a consistent trend towards reduced mortality throughout the period of follow-up among GL enzyme treated patients. When the fate of all patients entering the trial was considered, irrespective of final diagnosis, the reduction in mortality at 6 months (27 of 240 GL enzyme patients, 45 of 243 placebo) was statistically significant (p = 0.025).

Clinical Trials as Topic↗

Reappraisal of lignocaine therapy in management of myocardial infarction.

The use of lignocaine in the prevention of ventricular fibrillation among patients admitted to a coronary care unit has been reviewed over the 12-year period 1967 to 1978 inclusive. The practice of suppressing warning ventricular ectopic activity has gradually been abandoned with the result that whereas in 1967 to 1968 33 per cent of all patients received lignocaine therapy, in 1972 to 1973 the number had fallen to 15 per cent, and in 1977 to 1978 to 4 per cent. The incidence of ventricular fibrillation was not significantly changed at 9.1, 7.7, and 7.8 per cent, respectively. Approximately 80 per cent of all patients suffering ventricular fibrillation within the coronary care unit were initially resuscitated and approximately 50 per cent survived hospital admission. Death was rarely a result of recurrent ventricular fibrillation and for the most part took the form of pump failure or late unexpected death. Experience suggests that the use of lignocaine to suppress ventricular ectopic activity observed in the first few hours of admission to hospital with acute myocardial infarction has no therapeutic value.

Aged↗

Cardiovascular effects of single oral doses of the new beta-adrenoceptor blocking agents betaxolol (SL 75212) in healthy volunteers.

1 The effects of betaxolol (SL 75212), a new beta-adrenoceptor blocking agent, on the cardiovascular response to exercise have been studied in six normal subjects after placebo and single oral doses of 5, 10, 20 and 40 mg given double-blind in a randomized sequence. 2 All doses reduced exercise heart rate, with a significant reduction persisting to 23 h after doses of 20 mg and 40 mg. Systolic blood pressure on exercise was reduced after all doses, with a reduction continuing to 23 h after doses of 10 mg and above. 3 The mean elimination half-life of SL 75212 was 17.5 +/- 3.9 h. The plasma clearance ranged from 0.15--0.48 1 kg-1 h-1 and the volume of distribution from 5.8--13 1 kg-1. 4 There was a significant correlation between the peak blood levels and change in exercise heart rate (r = 0.53, P less than 0.05) and between the area under the blood concentration curve and the effect of the exercise heart rate (r = 0.55, P less than 0.01).

Adrenergic beta-Antagonists↗

Intravenous and oral practolol in the acute stages of myocardial infarction.

The influence of routine administration of the beta adrenoceptor blocking drug practolol on the outcome of acute myocardial infarction has been studied in 94 patients. The study was restricted to patients under the age of 70 experiencing their first myocardial infarction and in whom there was no contraindication to beta blockade. In the treated group an initial dose intravenous practolol 15 mg was followed by five oral doses of practolol 200 mg at 12 h intervals. A significant reduction in heart rate and systolic blood pressure was apparent in the treated group within 2 h. No difference was detectable in the course of the acute stage of the illness between treated and control patients, apart from a significant reduction in the incidence of atrial fibrillation among those receiving practolol. Patients with inferior infarctions showed a tendency to develop potentially harmful bradycardia and hypotension on receiving practolol which lead to withdrawal of the drug in many cases. At regular review over 7 mth no detectable difference emerged between the treated and control groups in the incidence of cardiac failure, death or reinfarction.

Acute Disease↗

Changes in systolic time intervals during treatment of diabetes mellitus.

The cardiovascular response to the control of diabetes by sulphonylurea drugs has been investigated using systolic time intervals in a group of 19 diabetics. Before treatment a significantly greater heart rate and shortening of QS2 interval and left ventricular ejection time index were encountered among the more hyperglycaemic diabetic patients requiring drug therapy while all diabetics had a reduction of pre-ejection period index. There was a gradual return of resting heart rate and systolic time intervals to control values along with the fall in plasma sugar concentration during treatment. A likely explanation of the findings is that uncontrolled diabetics, particularly those more severely affected, are subjected to an increased adrenergic stimulus to the cardiovascular system which disappears with therapy. There is no evidence of positive inotropic action of sulphonylurea drugs in this study.

Blood Glucose↗