[Triazolam is different: it is a PAF antagonist].
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Biomedical subjects
Publications and source records attributed to K Adam.
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A review of texture types of calcium oxalate calculi and a pattern of 4 basic texture types was presented. A method of texture classification as a part of the routine polarization microscopy urinary calculus analysis was developed. Thereby a representative material could presented on the distribution of texture types. A connection between pathological urinary parameters and the texture type was demonstrated.
In 1961-1986 at the Surgical Clinic of the Institute for Postgraduate Medicine in Prague 49 colectomies were performed with ileorectal anastomosis. The operations were usually made in several stages. The remote results were evaluated after an interval of 10 to 26 years in 33 patients and were good to satisfactory in 82%. Malignant degeneration in the rectum was not observed. The relatively favourable results can be ascribed to careful selection of patients and frequently also the multi-stage procedure. Ileorectal anastomoses are still justified in the surgical treatment of proctocolitis.
Nine subjects who believed themselves to be poor sleepers, of mean age 58 years, took a placebo for 7 days, then ritanserin 5 mg for 20 days, followed by 3 days on placebo. Sleep was recorded electrophysiologically on 2 nights during baseline, 2 early drug nights, 2 late drug nights and the 2nd and 3rd withdrawal nights. Ratings of sleep quality were collected each morning. Ritanserin, a 5HT2 antagonist, caused a persistent doubling of the amount of EEG slow wave sleep, without altering the total duration of sleep. Ritanserin decreased the frequencies of awakening and after about a week it appeared to improve the subjective quality of sleep. Sleep was then impaired during withdrawal, as indicated by decreased duration and poorer subjective quality, being worst on the 3rd withdrawal night.
Forty-two women and 18 men of mean age 54 years had their sub-lingual oral temperature measured hourly from 0700 h to 2300 h. Mean oral temperature (averaged over the 17 readings) was inversely correlated with body mass in the group as a whole (r = -0.44, df = 58, p = 0.0003). The women had significantly higher mean oral temperatures than the men, but the inverse relationship between mean oral temperature and body mass was still significant when the data from the women were analyzed separately (r = -0.37, df = 40, p = 0.013). The results suggest that in humans, mean body temperature is inversely related to body mass, irrespective of gender.
To test further the conclusions of preliminary reports that regular use of a rapidly-eliminated hypnotic might cause daytime anxiety, 82 women and 38 men, mean age 53, who claimed to be poor sleepers, took a capsule nightly for 45 nights. On 25 consecutive nights the capsule contained triazolam 0.5 mg (40 subjects), lormetazepam 2 mg (40 subjects) or continued placebo (40 subjects). Both drugs improved sleep, but compared with placebo or lormetazepam-takers, triazolam-takers became more anxious on self-ratings, were judged more often to have had a bad response by an observer, more often wrote down complaints of distress, and suffered weight loss. After about 10 days of regular triazolam they tended to develop panics and depression, felt unreal, and sometimes paranoid. The very short life of triazolam, leading to daytime withdrawal symptoms, may account for some of the observations, but enhancement of benzodiazepine inverse agonist activity is also hypothesized.
Intravenous pancuronium bromide was administered into the umbilical cord by funipuncture to effect temporary fetal paralysis. Neuromuscular blockade was achieved in 12 fetuses undergoing a total of 34 intrauterine procedures for the treatment of severe red-cell alloimmunization. The same initial dose of 0.2 mg/kg fetal weight estimated by ultrasound was used in all cases, but anemic fetuses did not resume movement for prolonged periods. A relationship among fetal hematocrit, adjusted dose, and duration of paralysis was described by the equation: Duration (hours) = 5.24 + 10.30 adjusted dose (mg/kg) - 0.16 hematocrit (%) (R2 = 0.49; P less than .001). Intravenous pancuronium was found to be a safe and effective method for cessation of fetal movement during intrauterine procedures.
When intravenous magnesium sulfate is infused in women with pregnancy-induced hypertension, the hypermagnesemia does not result in lower Apgar scores. The mean maternal serum and cord magnesium levels at delivery were 5.3 +/- 0.72 and 5.3 +/- 1.1 mEq/dl, respectively. The most common negative Apgar score was assigned for color, not for muscle tone.
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Thirty-six volunteers of mean age 52 years had their sleep recorded in the laboratory on 5 consecutive nights. Eight factors were investigated as possible correlates of percentage REM sleep and of total minutes of REM sleep: age, height, weight, bedtime, arising time, oral temperature at bedtime and on arising, and total sleep time. REM percentage correlated significantly with body weight and with oral temperature at bedtime and correlated negatively with age. Owing to intercorrelations among the factors investigated, partial correlational analyses were done and revealed that body weight was the only factor that remained significantly correlated with REM percentage. Similarly, total sleep time and body weight were the only factors that remained significantly correlated with total minutes of REM sleep, whereas age and bedtime temperature just missed significance when other factors were held constant.
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Eighteen poor sleepers and 18 good sleepers of mean age 52 yr, selected on the basis of their stated opinions about their sleep, were studied as pairs matched for sex, age, height and weight, on five consecutive nights and two consecutive days. Using EEG measures, the poor sleepers woke more often in the early hours of sleep and achieved half an hour less sleep. They had higher body temperatures by day and night and were more anxious. They tended to have higher urinary cortisol and adrenaline excretion. The groups did not differ in reaction time nor in excretion of urinary 3-methylhistidine. The poor sleepers over-estimated their sleep latency and both groups under-estimated their total sleep, the poor sleepers being significantly more inaccurate. It is concluded that those who complain of poor sleep have also metabolic differences from good sleepers.
Twelve volunteer poor sleepers of mean age 59 years took placebo on one night, promethazine 20 mg on one night and promethazine 40 mg on one night, in a double-blind balanced order study. Sleep in the EEG laboratory was increased by nearly 1 h after either dose of promethazine, and sleep interruptions were reduced. Slow-wave sleep was unaffected, but the larger dose reduced the percentage of sleep spent as REM sleep. Sleep was improved subjectively by both doses of promethazine which appears to be an effective hypnotic.
Twelve volunteer poor sleepers of mean age 57 years took placebo on each of 3 consecutive nights, and temelastine 100 mg on 3 consecutive nights in a double-blind balanced order study. Sleep in the EEG laboratory was unaffected by the drug.
In a first double-blind, balanced order study, 12 subjects, mean age 57 years, took placebos at bedtime on 2 nights, paroxetine 15 mg on 2 nights and paroxetine 30 mg on 2 nights. In a second study, 12 subjects, mean age 56 years, took placebos on 2 mornings and paroxetine 30 mg on 2 mornings. Electrophysiological measures of all-night sleep were made on each night subsequent to medication. Paroxetine caused more frequent awakenings, reduced total sleep and strongly suppressed REM sleep, especially the 30 mg dosage. When it had been taken in the morning, paroxetine additionally delayed sleep onset and increased slow-wave sleep.