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Biomedical subjects

J Leppert

Publications and source records attributed to J Leppert.

47 records · Page 3Linked to original sources
PubMed1990

The effect of felodipine on cold-induced digital vasospasm.

Felodipine, a calcium antagonist with pronounced vascular selectivity, was given to 10 patients with cold-induced, digital vasospasm. Placebo and increasing doses of felodipine (2.5, 5, and 10 mg b.i.d.) were given for 2 weeks each. There was a significant decrease in systemic, but not in digital, blood pressure and a significant increase in heart rate during felodipine treatment. The subjective rating of symptoms improved significantly on all doses. No significant effect on cold-induced digital vasospasm during local cooling to 15 and 10 degrees C was registered. Typical side effects of calcium-entry blockers were reported. Moreover, two postmenopausal women reported recurrence of menstrual bleeding and one woman reported vaginal hemorrhagic discharge during treatment. In conclusion, felodipine, although causing a significant, symptomatic relief, had no significant effect on cold-induced digital vasospasm when objective measures were used.

Blood Pressure↗
PubMed1990

Lower serum magnesium level after exposure to cold in women with primary Raynaud's phenomenon.

Serum levels of magnesium (s-Mg), calcium (s-Ca), potassium (s-K) and sodium (s-Na) were measured in 80 women with primary Raynaud's phenomenon (RP) and in 24 age-matched female controls recruited from a population survey. The blood samples were taken after a 40-min standardized whole body cooling test. The mean s-Mg level in the group with RP was significantly lower than in the controls (0.81 +/- 0.05 vs. 0.86 +/- 0.07 mmol l-1, P less than 0.05). One year later, 66 members of the RP group and 22 members of the control group were investigated further, but without any exposure to cold. No differences in mean s-Mg values were found between the groups. The mean s-Mg level was significantly higher in the blood samples taken later without cold exposure than at the initial examinations after exposure to cold in the RP group, but not in the controls. The s-Mg level was lower after exposure to cold in 82% of the women with RP, compared to 45% of the controls (P less than 0.001). No differences in the other electrolytes were found. It is concluded that exposure to cold under standardized conditions may decrease the s-Mg level in women with primary RP. Further studies of the role of magnesium in patients with RP are required.

Adult↗
PubMed1990

Proctosigmoidoscopy in primary health care.

Of 282 patients who underwent rigid proctosigmoidoscopy (PSS) in primary care in the city of Västerås during 1985, 5.7% had polyps or tumours in the rectum. Barium examination of the large bowel was performed on 194 of these 282 patients and showed polyps or tumours in 6.2%. Use of these two methods led to diagnosis of polyps or tumour in the large bowel in 9.6% (27/282). Polyps were found by both methods in only one patient. Of four patients with tumours, two were discovered by barium examination and two by PSS. Barium examination and PSS complement each other in the search for polyps and tumours in the large bowel.

Adenoma↗
PubMed1989

The effect of isradipine, a new calcium-channel antagonist, in patients with primary Raynaud's phenomenon: a single-blind dose-response study.

Isradipine is a new potent calcium-channel blocking agent with highly selective action on peripheral vessels. In this single-blind study, its dose-related effect on cold-induced changes in finger systolic pressure (FSP) was investigated in ten female patients with primary Raynaud's phenomenon, and the side effects of isradipine treatment were evaluated. The patients were studied during 9 weeks of treatment. After 3 weeks of placebo, isradipine was given in doses of 1.25 mg b.i.d. and 2.5 mg b.i.d. for 3 weeks each. FSP was measured on local finger cooling to 10 degrees C. FSP at 10 degrees C expressed in percent of the value of 30 degrees C increased from 21 +/- 16% (M +/- SD) after placebo to 42 +/- 28% (p less than 0.05) and 62 +/- 25% (p less than 0.001) after treatment with isradipine 1.25 mg and 2.5 mg b.i.d., respectively. The subjective efficacy of the treatment was assessed with a visual analogue scale (VAS). The VAS rating increased from 17 (range 0-66) after placebo to 39 (range 12-88) (NS) and 68 (range 25-99) (p less than 0.001) after isradipine treatment with 1.25 mg and 2.5 mg b.i.d., respectively. Adverse effects of isradipine therapy were few and did not differ from those reported after the placebo period. This single-blind, dose-response study showed that isradipine in doses of 1.25 mg and 2.5 mg b.i.d. had favorable objective and subjective effects in patients with primary Raynaud's phenomenon and had no serious side effects.

Adult↗
PubMed1989

Limitation of finger systolic pressure measurement as a diagnostic test for primary Raynaud's phenomenon in a female population.

The diagnostic value of measurement of the finger systolic pressure (FSP) was assessed during combined local and whole body cooling in a population-based sample of women with a medical history of primary Raynaud's phenomenon. Forty women had mild Raynaud's phenomenon and 40 had pronounced Raynaud's phenomenon. The results were compared with subjective assessments of complaints from Raynaud's phenomenon as indicated on a visual analogue scale (VAS) in the same group of women. The mean FSP at 10 degrees C was significantly lower in the patients than in 24 age- and sex-matched controls, but there was a large overlap in individual responses. The sensitivity of the FSP method was only 51% for the whole group with primary Raynaud's phenomenon. There was no significant difference in FSP at 10 degrees C between subjects with mild and those with pronounced Raynaud's phenomenon. The subjective severity of the symptoms as indicated on VAS was significantly higher in these two combined groups than in the controls. The mean VAS value was significantly higher in the group with pronounced Raynaud's phenomenon (P less than 0.01) than in that with the mild type. The low sensitivity of FSP measurement implies that this method is of limited value as a diagnostic test in subjects with primary Raynaud's phenomenon. Furthermore, there was no significant correlation between FSP and the VAS values (r = 0.23).

Adolescent↗
PubMed1988

Antihypertensive effect of felodipine or hydralazine when added to beta-blocker therapy.

In a double-blind randomized study, hydralazine (n = 59) or the new dihydropyridine calcium antagonist felodipine (n = 61) was added to previous treatment with beta-adrenoceptor blocking agents in a group of 120 patients with essential hypertension. Active treatment with either hydralazine or felodipine was given for 8 weeks after a 4-week placebo run-in period, at the end of which all patients had supine diastolic blood pressures greater than 95 mm Hg. Assessment of the results according to the intention to treat principle showed that felodipine was significantly more effective than hydralazine at the doses employed, reducing systolic blood pressure 10-19 mm Hg more than hydralazine and reducing diastolic blood pressure 5-11 mm Hg more than hydralazine (95% confidence intervals). The number of patients complaining of side effects, the number of complaints, and the number of patients that had to be withdrawn from treatment were numerically higher during treatment with hydralazine than with felodipine, but these differences were not statistically significant. Against this background it is concluded that felodipine is superior to hydralazine when added to an antihypertensive regimen consisting of beta-adrenoceptor blocking agents.

Adrenergic beta-Antagonists↗
PubMed1987

The effect of the calcium-entry blocker nifedipine on cold-induced digital vasospasm. A double-blind crossover study versus placebo.

The effects of the calcium-entry blocker nifedipine 20 mg, two 10 mg capsules, t.i.d. in patients with cold-induced digital vasospastic disease of idiopathic or traumatic origin was tested in 28 patients, using double-blind crossover technique on both symptoms and test results. The effect of treatment on digital blood pressure during local cooling was assessed using the Nielsen-Lassen method. Symptomatic improvement was reported by 5 patients during placebo treatment and 17 during nifedipine treatment (p less than 0.01). The symptomatic improvement was significant in the total group of patients and in the group of patients with idiopathic vasospastic disease. The digital blood pressure during local cooling improved significantly with nifedipine at 5, 10, 15 (p less than 0.001) and 20 degrees C (p less than 0.05) for the total study population and for the two subgroups except for the change at 20 degrees C in the IDIOP group. At a digital temperature of 10 degrees C, 2 patients reached normal digital blood pressure during placebo treatment compared to 16 during nifedipine treatment (p less than 0.001). The number of side-effects increased significantly (p less than 0.05) during nifedipine treatment. We consider the use of nifedipine in patients with cold-induced digital vasospastic disease to be of great value, especially in patients with digital vasospastic disease of idiopathic origin.

Adult↗
PubMed1987

Raynaud's phenomenon in a female population: prevalence and association with other conditions.

In a random sample of 3000 women of ages eighteen to fifty-nine years in the city of Västerås, Sweden, 19% of the 2705 responders to a questionnaire complained of cold and white fingers with or without numbness. On the basis of interview and examination, 79% of these women were diagnosed as having Raynaud's phenomenon (RP), giving a prevalence of 15.6%. A significantly higher rate of family members with cold, white fingers was found only in the group of women with pronounced RP (p less than 0.001). A significantly higher frequency of women with pronounced RP than of the control group had a history of recurrent muscle/joint pain (p less than 0.05). Laboratory tests that might indicate an active connective tissue disease did not, however, confirm a diagnosis of rheumatoid arthritis. All three subgroups differed significantly from the control group in terms of recurrent chest pains; subgroups 2 and N differed significantly from controls in terms of recurrent headaches.

Adolescent↗
PubMed1982

New design for clinical trial of antihypertensive drugs applied to pindolol, clopamide, and combinations thereof.

A beta-blocker (pindolol) and a diuretic (clopamide) were given in different dosages, singly and in two different combinations, to 71 patients with mild to moderate essential hypertension. The trial design was such that patients took both drugs singly and in combination, and in different doses, according to a set plan. The best regimen for each patient was determined by taking into account not only blood pressure but also resting heart-rate, body-weight, serum potassium, and serum urate. For 19 patients (27%) monotherapy was best--pindolol for 16 and clopamide for 3. For the remaining patients, a combination of pindolol 10 mg and clopamide 5 mg was best for 39, and in 35 of these one tablet daily was sufficient. All patients reached the preset target blood-pressure. The differences in proportions responding best to the following pairs of regimens compared--monotherapy vs combination, and combination of clopamide 5 mg and pindolol 5 mg vs combination of clopamide 5 mg and pindolol 10 mg--were significant (2p less than 0.01). The process by which the best treatment is chosen according to this study design resembles much more closely that followed in general medical practice, than does the process in the conventional hypertension trial, in which only average effects are reported and compared.

Adult↗
PubMedDate not supplied

Orientational information from TEDOR spectral sidebands.

In a dipolar-coupled spin-1/2 network of the type 15N1-(13)C-15N2, an assessment of the sensitivity of the N --> C and C --> N TEDOR sideband intensities to the Euler angles defining the orientation of the two heteronuclear dipolar vectors in the 13C and 15N chemical shift (CS) tensor principal axes system has been carried out via numerical calculations. The results clearly indicate the potential of TEDOR MAS NMR spectroscopy for the characterization of the CS tensor orientation in the molecular frame. The efficacy of the method has been experimentally illustrated by TEDOR studies on a polycrystalline sample of [1, 3-(15)N2, 2-(13)C]uracil, which is one of the four bases in RNA.

Carbon Isotopes↗