PubMed Health⌕ Search

Biomedical subjects

K P O'Brien

Publications and source records attributed to K P O'Brien.

At least 37 records · Page 2Linked to original sources
PubMed1994

Once daily lisinopril and captopril in hypertension: a double blind comparison using ambulatory monitoring.

AIM: To validate and compare the 24-hour antihypertensive efficacy of the angiotensin-converting-enzyme inhibitors, captopril and lisinopril. METHODS: A randomised, doubleblind, doubledummy crossover study was performed with single-blind placebo run-in and washout periods and titration opportunities during therapeutic phases (captopril 25mg, 50mg and 100mg daily, lisinopril 10mg, 20mg and 40mg daily). The study was monitored using standard office blood pressure measurements, clinical and laboratory assessment. 24 patients of either sex and between 18 and 70 years with essential hypertension were enrolled, 20 met randomisation criteria (of sitting diastolic pressure 95-115mmHg), 3 withdrew from the study during its active phase and one was excluded from analysis having been found retrospectively to have not met randomisation criteria at the appropriate visit. Predetermined endpoints were blood pressure levels during different time periods of ambulatory monitoring performed at the end of each placebo or treatment phase. RESULTS: In the 17 patients who completed the protocol, lisinopril produced a greater reduction of blood pressure at all time periods although the differences were not all statistically significant. The differences were most marked 19-24 hours post dosage time when pressures (systolic/diastolic) during lisinopril therapy were lower than during captopril by 18.0/14.5 mmHg (p < 0.001 for both). As measured by clinic pressures, lisinopril also achieved a considerably higher degree of blood pressure control with less dose titration. CONCLUSION: In this study, lisinopril proved a more effective once daily antihypertensive agent than captopril, especially in the last 6 hours of the 24-hour dosage interval.

Adult↗
PubMed1988

Factorial structure and factor reliability of the Hamilton Rating Scale for Depression.

Identical principal components factor analyses of total Hamilton Rating Scale for Depression scores were conducted for two separate sub-samples (N = 183 and N = 182) drawn from the same clinic population of moderately depressed outpatients. A comparison of the two factor analyses revealed substantial agreement for four factors across the two sub-samples (i.e., four factors from the first sub-sample correlated at least 0.80 with a homologous dimension in the second sub-sample). The four factors were labelled Somatic Complaints, Anorexia, Sleep Disturbance, and Agitation/Retardation. Some additional factors emerged in the analysis of one sub-sample but failed to appear in the other. Overall, these results suggest that the HRS exhibited a relatively stable factorial structure based on a large sample of outpatients with unipolar depressive disorders. Methodological problems with earlier research are discussed in light of the current findings.

Adolescent↗
PubMed1985

Disabling neurological complications of amiodarone.

Five patients developed neurological symptoms during treatment with amiodarone for intervals ranging between five and 40 months. In each case the daily maintenance dose did not exceed 600 mg. The neurological manifestations included gait ataxia, tremor, polyneuropathy, and myopathy. In all five patients, the neurological symptoms were severe and disabling. In one patient with a myopathy, there was no improvement after amiodarone was withdrawn. The neurological side effects of amiodarone may be disabling and are not always reversible with drug withdrawal. Neurological complications may arise during treatment with usual maintenance doses.

Aged↗
PubMed1979

Distribution and interrelations of coronary risk factors in a community sample of Auckland men.

Distributions and interrelations of blood pressure, serum cholesterol, triglycerides, urate and glucose, cigarette and alcohol consumption and ECG characteristics were assessed in a community sample of 524 Auckland men aged 30-55. The distributions of these variables were generally similar to those found in other New Zealand samples, indicating that New Zealand levels of coronary risk factors lie in the upper reaches of the US and European range. Notable amongst the interrelations found were the pattern of relationships between serum cholesterol, triglycerides and urate, and the association of both body mass and alcohol intake urate level.

Adult↗
PubMed1978

Antinuclear antibodies in patients receiving non-practolol beta-blockers.

Antinuclear antibodies (ANA) were found in 54 (7.0%) out of 767 treated hypertensive patients compared with 59 (2.4%) out of 2470 healthy controls. Inclusion of a non-practolol beta-blocker in the treatment regimen did not significantly affect the incidence of ANA. ANA was found in significantly more patients being treated with methyldopa (13.0%) than patients receiving other hypotensive agents (3.8%). Non-practolol beta-blockers in combination with methyldopa did not increase the incidence of ANA further.

Adrenergic beta-Antagonists↗
PubMed1977

Surgical resection in idiopathic hypertrophic subaortic stenosis with a combined approach through aorta and left ventricle.

The operative technique and the immediate and long-term results are described in 49 patients who have undergone myectomy for IHSS. There was a 4 percent early and 12 percent late mortality rate and surviving patients have been followed for up to 13 years. The operation has resulted in a striking symptomatic improvement in most patients in association with relief of outflow obstruction and mitral regurgitation. Chronic atrial fibrillation was poorly tolerated but has not occurred as a late complication in any of the patients operated upon.

Adolescent↗
PubMed1976

Comparison of a slow release formulation of oxprenolol with conventional oxprenolol in the treatment of hypertension.

Patients with moderate to severe hypertension were studied during a 12-week period, during which they were given a slow release formulation of oxprenolol once daily, in a dosage equal to their previous total daily dose of oxprenolol given in divided doses. There were no systematic differences between blood pressures at the beginning and end of the 12-week period. The once-daily dosage was well tolerated and was preferred by the patients. This regime offers advantages in terms of patient compliance with lifelong therapy in what is usually a symptomless condition.

Adult↗
PubMed1976

Comparison of a slow-release formulation of oxprenolol with conventional oxprenolol in the treatment of hypertension.

1. Patients with moderate to severe hypertension were studied during a 12 weeks period, while taking a slow-release formulation of oxprenolol once daily, in a dose equal to their previous total daily dose of oxprenolol given in divided doses. 2. There were no significant differences between blood pressure at the beginning and end of the 12 weeks period. 3. Once-daily dosage offers advantages of patient compliance.

Adult↗
PubMed1975

Timolol maleate (Blocadren) in the treatment of essential hypertension.

The antihypertensive activity of timolol (Blocadren, FROSST-MSD), a new beta blocking agent, was assessed in a single blind crossover placebo-controlled study in 14 patients with essential hypertension. Ten patients completed the trial. The average standing pressure during the placebos periods was 168/109mmHg and during the periods on treatment with timolol the average standing pressure was 139/92mmHg. All 10 patients showed some hypotensive response. The average daily dosage was 21 mg with a range of 15-30 mg. Four patients achieved optimal levels of blood pressure by the end of one week's therapy with the maximum time required being four weeks. Timolol appears to be an effective antihypertensive agent. Side effects were insignificant.

Adrenergic beta-Antagonists↗
PubMed1975

Intravenous diazoxide in treatment of hypertension associated with recent myocardial infarction.

Twenty patients with blood pressure over 180/110 mm Hg one hour after admission to a coronary care unit with recent acute myocardial infarction were given intravenous diazoxide in a bolus of 300 mg. The average blood pressure before diazoxide was 194/122 mm Hg. Blood pressure fell considerably in all patients, though six patients required two injections. The average fall was 58 mm Hg systolic and 40 mm Hg diastolic. No patient became severely hypotensive. The heart rate increased by an average of 10 beats/min. In nine patients the electrocardiographic changes immediately after the administration of diazoxide suggested an increase in myocardial injury. Though none of the patients seemed to deteriorate clinically from the diazoxide the electrocardiographic changes suggested that the use of intravenous diazoxide to lower blood pressure in patients with acute myocardial infarction might possibly be deleterious.

Acute Disease↗
PubMed1975

The effect of local anesthetic, lidocaine, on guinea pig trachealis muscle in vitro.

The effect of lidocaine was studied in guinea pig trachealis muscle by dose-response reversal and protection of agonist-induced contractures in a superfusion system. Lidocaine reversed histamine, acetylcholine, and depolarizing hypertonic potassium contractures with the median effective doses of 2.8, 6.0, and 3.2 mg. Lidocaine presuperfusion shifted in a nonparallel fashion (P less than 0.05) the dose-response of histamine, acetylcholine, depolarizing potassium, and supramaximal electrical stimulation by contact electrodes. Pretreatment with 7 x 10(-6) M atropine did not modify lidocaine's inhibition of the hypertonic potassium contractions. These findings and the decrease in maximal response indicated noncompetitive antagonism. In contrast to isoproterenol, the action of lidocaine was not influenced by beta-blockade induced by superfusate propranolol, 1.0 mug per ml (P = 0.2). Lidocaine's effect on trachealis smooth muscle was facilitated by a decrease in hydrogen ion activity from pH 6.71 to 7.90, consistent with enhanced penetration of the free base. Low bolus dose lidocaine-induced contractures were noted in many studies. The potency of isoproterenol in comparison to lidocaine, as indexed by median effective doses, was 10(5) greater for reversal of histamine contractures and 10(4) greater for acetylcholine. The data were consistent with a nonspecific, reversible antagonism on the smooth muscle cell and may involve an effect on calcium activity.

Acetylcholine↗