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Biomedical subjects

G Olsson

Publications and source records attributed to G Olsson.

At least 127 records · Page 7Linked to original sources
PubMed1986

Reduction of nonfatal reinfarctions in patients with a history of hypertension by chronic postinfarction treatment with metoprolol.

The Stockholm Metoprolol Trial is a prospective double-blind placebo-controlled postmyocardial infarction study of 301 patients treated with metoprolol, 100 mg b.i.d., or matching placebo for three years. From this study we have retrospectively evaluated the outcome in patients with a history of treatment for hypertension prior to the index infarction. There were 41 such patients in the placebo group and 35 in the metoprolol group. Blood pressures during follow-up were nearly identical in the two groups. During the three years 11 patients died in the placebo group and 7 in the metoprolol group. Corresponding figures for nonfatal events such as reinfarction, coronary artery bypass surgery, cerebrovascular events and lower limb amputation were 12 vs. 1 (p less than 0.005), 3 vs. 0, 4 vs. 0 and 1 vs. 0, respectively. The numbers of patients with fatal and nonfatal events were 24 vs. 8 (p less than 0.01). In a retrospective subgroup analysis the results must always be interpreted with caution. The present results may, however, imply that postinfarction treatment with metoprolol reduces nonfatal atherosclerotic complications, especially nonfatal reinfarctions, in patients with a history of hypertension.

Clinical Trials as Topic↗
PubMed1986

Effects on angina pectoris and exercise tests of a 2% nitroglycerin gel adhesive in patients on chronic beta-blockade. A placebo-controlled study.

Twenty patients on chronic beta-blockade for angina pectoris were included in a double-blind randomized cross-over placebo-controlled study on a 2% nitroglycerin gel administered transdermally by an adhesive. Topinitro. The dose, 2.5-10 mg/day, was individually titrated and each treatment period was 28 days. The effect was evaluated by exercise tests and diary cards for anginal attacks and nitroglycerin tablets consumed. Results. In the 17 patients who completed the trial, active treatment did not influence systolic and diastolic blood pressure or resting and maximal heart rate. Maximal performance increased insignificantly from 92 +/- 23 to 96 +/- 20 W. The level at which 1 mm of ST depression appeared increased from 62 +/- 26 to 73 +/- 28 W (p less than 0.05). The number of attacks decreased significantly, from 92 +/- 30 to 14 +/- 28/4 weeks. The reduction in the number of sublingual nitroglycerin tablets consumed was insignificant. Conclusion. Nitroglycerin adhesive, in individual dosages, may improve signs and symptoms of ischemia.

Administration, Topical↗
PubMed1985

Long-term treatment with metoprolol after myocardial infarction: effect on 3 year mortality and morbidity.

The effects of metoprolol treatment in patients surviving acute myocardial infarction have been investigated in a double-blind randomized study. The patients were stratified according to age, infarct size and type of ventricular arrhythmias before administration of metoprolol, 100 mg twice daily (n = 154), or placebo (n = 147). All patients were followed up for 36 months. There were 31 (29 cardiac) and 25 (20 cardiac) deaths in the placebo and metoprolol groups, respectively. Subgroup analyses showed a significant reduction of cardiac death in patients with a large infarct (32.1% with placebo versus 12.5% with metoprolol, p less than 0.05) as a result of active treatment. Sudden death rates were 14.7% in the placebo versus 5.8% in the metoprolol group (p less than 0.05). The incidence of nonfatal reinfarction was 21.1% in the placebo versus 11.7% in the metoprolol group (p less than 0.05). The reduction in nonfatal reinfarction was similar in all pretreatment risk strata. The difference between the two groups in cumulative number of cardiac deaths and patients experiencing nonfatal reinfarction increased throughout the study. Furthermore, cerebrovascular events (p less than 0.05) and coronary bypass surgery (p = 0.058) were more frequent in the placebo group. In conclusion, after 36 months of metoprolol treatment after myocardial infarction, there was a significant reduction of nonfatal reinfarction and sudden death in all patients and a reduction of cardiac death in those with a large infarct.

Aged↗
PubMed1985

Ventricular fibrillation in myocardial sarcoidosis.

A 35 year old male with intractable ventricular fibrillation due to myocardial sarcoidosis is described. Myocardial involvement in patients with sarcoidosis is not uncommon. Since severe ventricular arrhythmias due to myocardial sarcoidosis are often refractory to conventional antiarrhythmic treatment, steroids should be tried.

Adult↗
PubMed1984

Rebound phenomena following gradual withdrawal of chronic metoprolol treatment in patients with ischemic heart disease.

Metoprolol or placebo was gradually withdrawn during 1 week in 115 patients participating in a 3-year, double-blind, postinfarction study. During the first month after withdrawal mental symptoms and increased cardiac symptoms occurred significantly more frequently in the metoprolol group. Disabling symptoms requiring reinstitution of treatment were seen in 14 of 58 in the metoprolol group vs 4 of 57 in the placebo group (p less than 0.05). In the metoprolol group, there was a rebound increase of basal heart rate and of the heart rate response to orthostatic testing during 3 weeks after withdrawal, when compared to values obtained 6 months later. In 27 patients plasma catecholamine levels were analyzed during repeated exercise tests and orthostatic provocations. Plasma norepinephrine and epinephrine responses to exercise were reduced 1 week after completion of withdrawal. At this time norepinephrine levels tended to be lower in relation to heart rate at all work loads. Our laboratory findings may be related to increased beta-adrenoceptor responsiveness, but unmasking of ischemic symptoms probably contributed to the clinical findings.

Aged↗
PubMed1984

Comparative investigation of the antiarrhythmic effect of propafenone (Rytmonorm) and lidocaine in patients with ventricular arrhythmias during acute myocardial infarction.

Propafenone, a new class I antiarrhythmic drug, given as a bolus injection followed by oral medication, or lidocaine were given to 20 consecutive patients admitted with chest pain suggesting acute myocardial infarction and showing high grades, i.e. multiform, pairs or R-on-T premature ventricular complexes or short runs of ventricular tachycardia. Before institution of therapy the mean number (+/- 1 SD) of premature ventricular contractions (PVCs) per hour was 169 +/- 123 in the lidocaine group and 324 +/- 440 in the propafenone group. During the next 24 hours lidocaine reduced the numbers of PVCs by 73% and propafenone by 75%. The mean number (+/- 1 SD) of 5-minute periods with high grade PVCs was 4.3 +/- 2.9 in the lidocaine group and 5.8 +/- 4.5 in the propafenone group. During therapy this number was equally reduced in both groups to 2.4. One patient in the lidocaine group developed ventricular fibrillation and three patients in the propafenone group were excluded because of increasing numbers of PVCs. One patient in the propafenone group showed a torsade-de-pointes ventricular tachycardia.

Aged↗
PubMed1984

Unchanged peripheral sympathetic activity following withdrawal of chronic metoprolol treatment. A study of noradrenaline concentrations and kinetics in plasma.

Noradrenaline plasma kinetics were assessed in 17 male patients, who had been treated with metoprolol 100-200 mg daily (n = 8) or placebo for 3 years after an acute myocardial infarction, before and 1 week after gradual withdrawal (during 1 week) of the study treatment. Endogenous noradrenaline concentrations in plasma were measured by high performance liquid chromatography. Noradrenaline spillover rate, plasma clearance and the t1/2 for the rapid removal from plasma were determined by radio-tracer methodology. During treatment the plasma noradrenaline concentrations and noradrenaline plasma kinetic variables were similar in the two groups. Venous plasma noradrenaline concentrations were more closely correlated to the spillover rates of noradrenaline to plasma than to the clearance of noradrenaline from plasma, but the spillover rates were correlated to the clearance rates. Following the withdrawal of metoprolol noradrenaline clearance from plasma increased slightly (by 18 +/- 5%, P less than 0.05), but the plasma concentrations and spillover rates of noradrenaline were unchanged. In the placebo group withdrawal did not result in any significant changes. Our results indicate that a generalised increase in sympathetic nerve activity is not the cause of so-called rebound phenomena following withdrawal of chronic beta-adrenoceptor blockade.

Aged↗
PubMed1984

Ventricular arrhythmias during the first year after acute myocardial infarction: influence of long-term treatment with metoprolol.

Three hundred and one patients who had been hospitalized for acute myocardial infarction, were less than 70 years old, were in sinus rhythm, and did not have complete bundle branch block were stratified before discharge according to age, size of infarction, and type of ventricular arrhythmias as determined on a 6 hr electrocardiogram (ECG). They were thereafter randomly assigned to double-blind treatment with 100 mg bid metoprolol or placebo. Repeat 6 hr ECGs were recorded 3 days and 1, 6, and 12 months after treatment had begun. In the placebo group there was a significant increase in the proportion of patients with complex premature ventricular complexes (PVCs) (i.e., multiform, paired and R-on-T PVCs, or ventricular tachycardia) as well as increased numbers of PVCs in the patients during the follow-up. In contrast, an initial decrease in the number of PVCs (p less than .001) was found in the metoprolol group, whereas the complexity of PVCs was constant in those patients who continued on metoprolol therapy throughout the follow-up period. We conclude that the increase in complexity and number of PVCs that is part of the natural clinical course after myocardial infarction is counteracted by long-term treatment with metoprolol.

Aged↗
PubMed1983

Crystallization and preliminary X-ray diffraction data of two crystal forms of bovine heart creatine kinase.

Two crystal forms of bovine heart creatine kinase, which are suitable for X-ray diffraction studies, have been grown at room temperature using 2-methyl-2,4-pentanediol as the precipitant at pH 7.2. The space group of the orthorhombic form is P2(1)2(1)2, with unit cell dimensions a = 133 A, b = 128 A and c = 65 A, and there is one dimeric molecule in the asymmetric unit. The space group of the tetragonal form is P4(2)2(1)2, with unit cell dimensions a = b = 132 A and c = 75 A, with one subunit in the asymmetric unit. The tetragonal crystals diffract to at least 2.0 A resolution.

Animals↗
PubMed1983

Comparative study of tocainide and lidocaine in patients admitted for suspected acute myocardial infarction.

The antiarrhythmic effects of tocainide, administered as a bolus injection of 750 mg followed by oral therapy, and conventional lidocaine therapy were evaluated in 40 patients admitted for suspected acute myocardial infarction (AMI) and showing high-grade premature ventricular complexes (PVCs). The mean hourly PVC rate before therapy was 928 and its reduction was equally significant in the tocainide group, 73%, and in the lidocaine group, 68%. The number of 5-minute periods with multiform, paired and R/T PVCs or ventricular tachycardia was also significantly reduced, by 78% in the tocainide group and by 71% in the lidocaine group. Ten patients in the tocainide group reported moderate side-effects, compared to 13 in the lidocaine group, where the infusion had to be discontinued in 5 patients and the rate had to be reduced in 4. Tocainide, an amine analogue of lidocaine, is considered just as effective as lidocaine in patients with high-grade PVCs and suspected AMI.

Adult↗
PubMed1983

Dust exposure challenge test as a measure of potential allergenicity and occupational disease risk in handling of Ispaghula products.

It is known that workers in the pharmaceutical industry, and nurses, can become sensitized and develop allergic respiratory symptoms by handling bulk laxatives containing Ispaghula powder. Fifteen individuals allergic to Ispaghula were challenged with a commercially available Ispaghula product and three other products manufactured in a way to make them less dusty. The results show that the use of products with smaller amounts of airborne particles results in a lower incidence of symptoms and thus probably reduces the potential occupational risk of sensitization to the Ispaghula allergen.

Allergens↗
PubMed1983

Cathectic orientation, goal setting and mood.

Investigated the reliability and validity of a new verbal cathexis test, based on objectively scored achievement data. Criteria were based on interviews about goal orientations and mood ratings, performed three times a day for a week. Goals were scored analogously with the cathexis test, viz. in the three dimensions hetero-homo, active-passive, and positive-negative. Average mood scores and mood variabilities were estimated. The Oedipal and combined cathexis adjustment indices correlated with goal ratings. Moods correlated with cathectic balance indices. Strong correlations were found to exist between average moods and goal ratings in both active-passive and positive-negative dimensions, as well as sex differences in mood variability and Oedipal orientation as measured by the cathexis test.

Journal Article↗
PubMed1982

Sudden death precipitated by psychological stress. A case report.

A 70-year-old man, taking part in a post infarction study, died suddenly out of hospital while Holter-monitored. Death was preceded by immediate major psychological stress but there were no cardiac symptoms. ECG showed a 15 min period of sinus tachycardia with increased ventricular ectopic activity prior to the initiation of ventricular fibrillation. There were no signs of recent myocardial damage at autopsy. It is proposed that an increased catecholamine stimulation due to psychologic stress, in combination with myocardial ischemia, may have precipitated the fatal arrhythmia.

Aged↗
PubMed1981

Volitional problems in carrying through a difficult decision: the case of drug addiction.

Attempts by young drug addicts to decrease or quit drug consumption were studied by means of a series of interviews. Interest was focused on volitional problems arising due to difficulties in living up to commitments in the face of temptations and various types of emotional stress. It was found that relapses occurred mostly under the influence of emotional stress and that they were preceded by various forms of twisted reasoning, a finding similar to those for other types of addictive behaviors such as smoking and alcoholism. The techniques used by the drug addicts to fight temptations were similar to those reported by other patients. Knowledge of techniques seemed to be rather scarce. There was a correlation between knowledge of technique and success in quitting drug habits. Strong stimulus pull factors were evident in some cases and were apparently counteracted by more or less successful attempts by the patients to escape the tempting situation.

Adolescent↗