Biomedical subjects

J Diament

Publications and source records attributed to J Diament.

At least 37 records · Page 2Linked to original sources

PubMed1994

[Randomized, double-blind comparative study between pravastatin and lovastatin. Evaluation of efficacy and safety].

PURPOSE: To verify eventual difference observed in the efficacy and safety of lovastatin (L) when compared to pravastatin (P), considering increasing doses up to the maximum and recommended ones in clinical practice. METHODS: Forty-eight hypercholesterolemic patients (LDL-C > 160 mg/dl after a placebo seven-day period) were studied and randomly assigned to constitute groups of 24 patients (GL and GP groups). The patients from GL group received L 20 mg/day and those from GP group P 10 mg/day, in a double-blind fashion. Six and 12 weeks later, the those were doubled. At the end of the placebo period and at weeks 6, 12 and 18 they were evaluated for clinical data and laboratorial parameters, such as: lipid profile (TC, TG, HDL-C and LDL-C); enzymes AST, ALT, CPK, gamma-GT, alkalin phosphatase); biochemical data (urea, creatinine, bilirubin, uric acid, glucose); complete blood count and urinalysis. RESULTS: Both drugs have shown significant reductions in TC and LDL-C levels at the lowest clinical doses (L 20 mg/day; P 10 mg/day), which became more marked as doses were gradually increased. However, the responses were always significantly greater for L in all doses employed. No adverse effects requiring treatment discontinuation were observed for both drugs. CONCLUSION: L showed a higher TC and LDL-C lowering effect than that observed with P, when the doses recommended by the respective manufacturers were compared.

Adult↗

PubMed1993

Exercise tolerance is lower in type I diabetics compared with normal young men.

The present investigation was conducted to study metabolic and hormonal responses to prolonged exercise to exhaustion in insulin-dependent diabetic subjects. Sixteen healthy subjects (control) and 15 diabetics with no-insulin administration for 12 hours were studied. They were submitted to short-term exercise to exhaustion on a cycle ergometer at 55% to 60% of maximum oxygen consumption (VO2max). Exercise tolerance was significantly lower in diabetic subjects (66 +/- 6.7 v 117 +/- 9.4 minutes), and glucose concentration was significantly higher in these subjects. At exhaustion, only diabetic subjects showed a significant decrease in glycemia (142 +/- 20 v 111 +/- 16 mg/dL). Lactate concentration increased significantly during exercise up to 30 minutes, but at exhaustion only control subjects showed a reduction. No significant difference in free fatty acid (FFA) concentrations was observed between the groups during a 30-minute exercise period; however, at exhaustion levels were significantly higher in control subjects. Prolactin and C-peptide concentrations were significantly lower in diabetic subjects, whereas glucagon concentration was higher. No significant differences between the groups were observed for cortisol and growth hormone (GH) concentrations. We conclude that (1) diabetic subjects show reduced exercise tolerance when no insulin is administered for 12 hours, and (2) exercise to exhaustion reduces serum glucose concentrations in insulin-dependent diabetics.

Adult↗

PubMed1993

[Chronotropic and pressoric response in myocardiopathy in patients with heart failure during ergometric test. Correlation of spirometry variables with effort].

PURPOSE: To correlate the variables heart rate (HR), blood pressure (BP) and double product (DP) during the ergometric test with the variables oxygen consumption (VO2) and pulmonary ventilation (VE) of spiroergometry. METHODS: A study was carried out with 40 male patients suffering from cardiomyopathy with heart failure (functional class II-IV of NYHA)-of ischemic (IS), Chagas' disease (CH) and idiopathic (ID) etiology. These three groups were compared to a group of 10 normal individuals (N). The 4 groups were evaluated under 4 different conditions: rest (RES), anaerobic threshold (LA), power peak of exercise (P) and in the fourth minute recovery (REC). The investigation was carried out with the data obtained through spiroergometry (using a treadmill and spiroergometric equipment specific for the effort), as well as data related to HR, BP, DP, VO2 and VE. RESULTS: There were significant differences observed in the ergometric evaluate of the HR, BP and DP responses in the IS, CH and ID groups as compared with the N group. There were significant difference observed in the spirometric evaluation to the VO2 and VE efforts in the IS, CH and ID groups as compared with the N group. CONCLUSION: The HR, BP and DP variables studies, obtained by means of classic ergometry, unaided by direct methodology (spiroergometry) enabled them to infer valuable data for the control and evaluation of cardiomyopathies with IC, taking into consideration the low chronotropic and pressoric responses in the various phases of evaluation during this study, corresponding to the concomitant low performance of O2 consumption and pulmonary ventilation.

Adult↗

PubMed1993

[Pravastatin: efficacy and safety in elderly patients with primary hypercholesterolemia. Open multicenter study].

PURPOSE: To analyze the response of hypercholesterolemic elderly patients to pravastatin. METHODS: Two hundred and sixty six primary hypercholesterolemics, 65 to 80 years of age, after ingesting a standard diet for four weeks, received 10mg of pravastatin for 12 weeks. RESULTS: Average reductions of 24% or more were observed for TC and LDL-C, and more than 60% of those reductions were considered good or excellent (above 20%). Increases in HDL-C (6.6%) and the reduction of TG (21.2%) were significant. Patients 65 to 70 years old compared to patients 71 to 80 years old did not show significant response differences, however, the 71 to 80 year old patients had smaller reductions in TC and LDL-C but greater increases in HDL-C. The drug was very well tolerated, with an incidence of adverse events of only 10.5%, none of which resulted in the discontinuation of drug administration. There were significant increases in hepatic enzymes (SGOT and SGTP), however the variations did not have clinical significance. For CK changes were not significant. CONCLUSION: Primary hypercholesterolemic elderly seem to respond to pravastatin in a similar way as middle age patients. The effects on the lipid fractions are significant, adverse effects are rare and the drug is very well tolerated. Thus it should be considered a first line hypolipidemic drug.

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PubMed1992

[Prevalence of primary dyslipidemia in subjects with and without family history of coronary disease, based on the reference values of the "National Cholesterol Education Program" (NCEP)].

PURPOSE--To compare the prevalence of primary dyslipidemia in 2 groups, based on NCEP guidelines: a) first degree relatives of revascularized patients and b) hospital employees without family history of coronary heart disease (CHD). METHODS--1162 subjects aged over 20 years, were divided in two groups: G Fam consisted of 312 women and 221 men, mean age 30.8 years, siblings, brothers or sisters of revascularized patients (under 55 years old); G Serv consisted of 425 women and 204 men, mean age 30.7 years, all of them being healthy employees of Hospital das Clínicas (Clinics Hospital) with no family history of CHD. There were performed clinical, electrocardiographic and laboratory tests (total blood cholesterol--CT, triglycerides--TG and HDL cholesterol--HDL-C): and VLDL-C and LDL-C values were calculated according to Friedwald, besides CT/HDL-C and LDL-C/HDL-C ratios. Based on NCEP guidelines, the frequencies on values ranges for each parameter were determined. RESULTS--G Fam group showed a higher incidence of women and men with CT and LDL-C levels above 240 mg/dl and 160 mg/dl, respectively; CT/HDL-C and LDL-C/HDL-C values over 5.0 and 3.5, respectively, were seen more often in G Fam group. There were no significant differences on HDL-C and TG. About 35% of men and women in G Serv group showed CT levels higher than 200 mg/dl. CONCLUSION--First-degree relatives, aged over 20 years, from revascularized patients under 55 years old, showed more often lipid levels above those established by NCEP. In accordance to them, 62% of men and 28% of women of this group should undergo to LDL-C analysis, as well as 35% of men and 28% of women in teh G Serv group. It is called the attention for the importance of cholesterolemia evaluation in high risk groups for CHD.

Adult↗

PubMed1991

[Ergospirometry as a method for predicting the clinical course of ischemic, Chagas and idiopathic myocardiopathy].

PURPOSE: To compare and evaluate the modifications variables obtained through spyroergometry in groups of patients with ischemic cardiomyopathy (IS), Chagas' disease (CH), and idiopathic cardiomyopathy (ID). To study tolerance to anaerobic conditions of patients from the above groups who died. METHODS: A study was carried with 50 male patients, 10 of which were found in normal conditions whereas 40 presented cardiomyopathy with compensated heart failure. We observed that from the 40 patients from the cardiomyopathy groups, nine died, subgroups OB--during the study period of 1.005 days. These were compared to subgroups NOB--the remaining 31 patients. These patients were evaluated under 4 conditions--Rest (Rep), anaerobic threshold (LA), power peak of the exercise (P) and in the fourth minute recovery (REC). The investigation was based on data collected by means of spyroergometry: oxygen consumption (MET), production of CO2-(VCO2), respiratory equivalent of oxygen (VE/VO2), oxygen pulse (VO2/FC) and the time elapsed between LA and P. RESULTS: There were significant differences when the three pathological groups (IS, CH, ID) were compared with the control groups (N). There were no significant differences when the three pathological groups compared among themselves. In relation to tolerance to anaerobic conditions significant differences were found among the patients of subgroup OB--1.33 min--who died when compared to subgroup NOB--3.26 min (time elapsed between LA and P). CONCLUSION: The authors conclude that the variables studied, obtained through spyroergometry may indicate important data towards the prognosis with heart failure.

Adult↗

PubMed1990

[Simvastatin (MK-733), a new HMG-CoA reductase inhibitor, in the treatment of hypercholesterolemia in elderly patients with atherosclerosis].

PURPOSE: To evaluate the efficacy and tolerability of simvastatin, a new and potent HMG-CoA reductase inhibitor, in the treatment of hypercholesterolemia in elderly patients. PATIENTS AND METHODS: Twenty patients, 14 female and 6 male, aged 65 to 72 years (x = 69 +/- 3), with total cholesterol (TC) above 260 mg/dl and triglycerides below 350 mg/dl were studied. All patients presented clinical evidences of atherosclerotic disease and were followed up for 6 months. Monthly visits were required for clinical and laboratory evaluation. The initial dosage of simvastatin was 10 mg/day; dosage was titrated up to 10 mg/day or to a minimum of 5 mg/day in intervals of at least 4 weeks, in order to maintain LDL-cholesterol below 140 mg/dl. To evaluate the changes on plasma lipid levels, the mean value of determinations during the placebo baseline period was compared to the mean value of determinations during the active treatment period. RESULTS: There were significant reductions of total cholesterol (-26.4%), triglycerides (-16.0%), LDL-cholesterol (-35.2%), VLDL-cholesterol (-15.4%), TC/HDL-C (-30.7%), and LDL/HDL-C (-39.5%). There was significant elevation of HDL-cholesterol (+5.2%), although this response was not uniform. The drug was well tolerated: only five patients reported transient clinical adverse experiences that subsided spontaneously. Two patients had elevation of CPK and one of TGP. The drug did not have to be discontinued in any case. Ophthalmological examinations performed before treatment compared to examinations at the end of the study showed no signficant alterations. CONCLUSION: Simvastatin in elderly patients appeared to be a potent TC and LDL-C lowering drug and presented mild but significant effect on the elevation of HDL-C. There was good tolerability, with low incidence of adverse experiences. This fact is important when one considers drug therapy for hypercholesterolemia in this age group.

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PubMed1988