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Biomedical subjects

R Haasis

Publications and source records attributed to R Haasis.

At least 37 records · Page 2Linked to original sources
PubMed1987

[Digitalis therapy in medical practice. Research on indications and dosage criteria in general practice].

Two hundred digitalized patients under nine freely practising physicians were investigated. One hundred and ninety-six patients received digoxin or one of its derivatives. Of these, 50% did not have therapeutic serum glycoside concentrations, 48% were in the mostly subtherapeutic range and 2% were in the potentially toxic range. Signs of glycoside intoxication were not found. A substantiated indication for glycoside therapy was found in the final analysis in 55% of the patients. In 128 patients, the methyldigoxin dose calculated (0.16 +/- 0.030 mg/d) was markedly in excess of that actually prescribed (0.13 +/- 0.050 mg/d; p less than 0.001), so that there were indications of a general underdigitalization. In addition, it was not possible to anchor the restrictive kidney function as a reason for reduction of digoxin dosage in the prescription behavior. In the long run, only 36% of the patients with justified indication and therapeutic serum glycoside concentration as well as (with reservations) the 3% with potentially toxic serum glycoside concentration profited from the glycoside therapy.

Atrial Fibrillation↗
PubMed1987

Exercise blood pressure and heart rate reduction 24 and 3 hours after drug intake in hypertensive patients following 4 weeks of treatment with bisoprolol and metoprolol: a randomized multicentre double-blind study (BISOMET).

In a 4-week randomized, double-blind study, 87 patients with essential hypertension received either 10 mg bisoprolol (B) or 100 mg metoprolol (M) once daily (o.d.). The effects of the beta blockers on systolic blood pressure, heart rate and rate-pressure product during exercise, 24 h (E2) and 3 h (E3) after administration (p.a.) were compared with the values obtained in the baseline exercise test (E1). 24 hours p.a. the effects of B were significantly stronger than of M (E1-E2: B vs M; P less than 0.01) whereas 3 h p.a. no significant differences were detectable between B and M. The residual effects 24 h p.a. in relation to the effects 3 h p.a. (E1-E2/E1-E3) were significantly greater with B (86-93%) than with M (53-66%). In contrast to the findings with 100 mg M o.d., 10 mg bisoprolol o.d. guarantees a persistent reduction in exercise blood pressure and heart rate throughout the entire dosage interval of 24 h.

Adolescent↗
PubMed1984

[Spontaneous regression of residential stenosis of the infarct vessel following successful percutaneous transluminal coronary recanalization].

In 64 out of 90 patients with thrombolysis by intracoronary streptokinase (PTCR) in the acute stage of myocardial infarction coronary angiography was performed in the chronic stage after 28 +/- 20 days. 52 of 56 successfully treated patients had a patent infarct vessel in the chronic stage. 36 of these patients showed a spontaneous regression from the subacute to the chronic stage. In 49 of the 56 patients (age: 53.4 +/- 10.4 years) a residual stenosis of more than 75% after PTCR was found; in the chronic stage only 31 patients had a stenosis of more than 75%. Of 10 patients with a spontaneous regression of 25% or more (age: 48.0 +/- 14.9 years) 8 had a one-vessel disease. The infarct vessel was in 6 patients the left anterior descending, in 4 patients the right coronary artery and in no case the left circumflex branch. The results suggest that the indication for invasive interventions, such as acute coronary angioplasty or bypass surgery, does not only depend on the degree of the residual stenosis directly after reperfusion. If possible, the decision for further invasive treatment should depend on the clinical follow-up.

Adult↗
PubMed1982

[Indications and contraindications for therapy with cardiac glycosides].

Today glycosides have 3 indications: manifest and chronic cardiac insufficiency, arrhythmia absoluta and paroxysmal supraventricular tachycardia. Glycosides are no longer important in the therapy of acute cardiac insufficiency. There are also absolute and relative contraindications which should be recognized; in coronary heart disease glycosides should only be used if there is really a latent of manifest cardiac insufficiency.

Action Potentials↗
PubMed1980

[Variable acute effects of prazosin on left ventricular failure (author's transl)].

The effect of 2.5 mg prazosin orally was monitored for one hour by cardiac catheterisation in 11 patients with cardiac insufficiency as a result of primary cardiomyopathy. Mean pressures of the pulmonary capillary bed and pulmonary artery decreased on average by 9 mm Hg, of the right atrium by 2.5 mm Hg and systemically by 8 mm Hg. Judging by the increase of cardiac index patients were divided into a group of 7 "responders", all showing congestive cardiomyopathy, and a group of 4 "nonresponders" with various cardiomyopathies. During prazosin treatment cardiac index increased by 23% and pulmonary arteriole resistance decreased by 4% and pulmonary arteriole resistance increased by 41%. It is concluded that not all forms of left ventricular failure respond favourably to prazosin. Divergent effects of prazosin may possibly be caused by unequal effects on pre- and after-load of both ventricles and on variable behaviour of lung arteriole resistance.

Adult↗
PubMed1980

[Glycoside therapy in elderly patients (author's transl)].

Despite decreasing renal function with increasing age, an elevated level of serum glycoside concentration is not noted in elderly patients after undergoing continuous therapy with 0,2 or 0,3 mg beta-methyldigoxin, 0,4 mg beta-acetyldigoxin or 0,5 mg digoxin respectively, as long as the serum creatinine is still normal. Therefore, it is sufficient to determine the serum creatinine level before initiating glycoside therapy with digoxin or digoxin derivates. As a rule, a continuous oral therapy using 0,2 mg beta-methyldigoxin, 0,3 mg beta-acetyldigoxin or 0,375 mg digoxin can be carried out on elderly patients having a normal serum creatinine level, without risk and without danger of toxic side-effects. There is evidence that glycoside tolerance is decreased in the elderly. In elderly patients with a serum concentration level of 2,3 ng/ml or higher, 87% showed toxic side-effects, whereas in the younger age group only 72% of the patients with equally high serum glycoside concentrations were intoxicated. Therefore, oral doses exceeding 0,2 mg beta-methyl-digoxin, 0,3 mg beta-acetyldigoxin, or 0,375 mg digoxin should be carefully controlled by EKG in elderly patients. The most frequent cause of intoxication in elderly patients (75% of the cases) was an impaired renal function with elevation of the serum creatinine level,--a factor which was not taken into consideration in determining the glycoside dosage.

Acetyldigoxins↗
PubMed1979

Reversal of digitalis effects by specific antibodies.

Highly digoxin-specific or ouabain-specific antibodies can readily be obtained by immunizing rabbits or sheep with repeated injections of the glycoside coupled to protein carriers. By virtue of their binding capacity digoxin-specific antibodies are capable of removing digoxin concentrations from red blood cells and renal tissue specimens. As evidenced by various experiments with human erythrocytes and isolated cardiac preparations in vitro, digoxin effects are rapidly reversible in the presence of digoxin-specific antibodies. In vivo antidigoxin antibodies can protect animals from digoxin effects and promptly abolish established toxic effects, associated with marked alterations of digoxin pharmacokinetics. However, due to the large molecular weight, complete antibodies cannot be eliminated via the renal route. The use of antigen-binding (Fab) fragments of digoxin-specific antibodies offer the advantage of rapid renal elimination of bound and inactivated digoxin. So far, due to potential immune reactions, the clinical use of purified digoxin-specific antibodies of Fab fragments is restricted to life-threatening accidental or suicidal digoxin or digitoxin poisoning.

Animals↗
PubMed1978

[Familial coincidence of hypertrophic cardiomyopathies and thyroxine-binding globulin deficiency (athyropexinemia) (author's transl)].

A twenty-five year old man was found to have simultaneous total deficiency of thyroxine-binding globulin ("thyropexin") and hereditary hypertrophic obstructive cardiomyopathy (HOCM). The thyroxine-binding capacity (RT3U), thyroid hormone levels, PB127I, PB131I and TBG (RIA) in serum were very low and TBG cap was zero. Trapping of radioiodine in the thyroid was enhanced. Clinically, the patient appeared euthyroid. The case seems to be similar to another one described earlier by Ingbar. An investigation of the family showed that in one uncle and two nephews of the patient thyropexin was absent whilst the mother, one sister and one female cousin had partial thyropexin deficiencies. One of these nephews also suffers from asymmetric septal hypertrophy (ASH), the mother of the propositus has a non-obstructive hypertrophic cardiomyopathy (HCM).

Adult↗
PubMed1977

[Fibre type and glycoside concentrations of human skeletal muscle (author's transl)].

In 2 patients digitalized with digoxin or betamethyldigoxin, postmortal glycoside concentrations were determined in 7 different skeletal muscle specimens by radioimmunoassay. In the same specimens, planimetric measurements of histochemical fibre types I and II were carried out. There were higher glycoside concentrations in predominantly type I fibre muscle biopsies.

Aged↗
PubMed1977

[Determination of glycoside concentrations in human tissue by means of radioimmunoassay (author's transl)].

After extraction of myocardial and skeletal muscle biopsy and autopsy specimens tissue glycoside concentrations can be determined by radioimmunoassay. Total tissue extraction of digoxin and beta-methyl-digoxin varies between 87 and 95%, the variation coefficient for repeated determinations is 10.2%. Glycoside concentrations of left ventricular papillary muscle obtained after mitral valve replacement were 69.0 +/- 25.05 ng/g with a tissue to serum relation of 46.6 +/- 8.96:1 and a correlation coefficient of r = 0.8442. In autopsy left ventricular papillary muscle glycoside concentrations were 105.2 +/- 27.35 ng/g with an almost identical tissue to serum relation of 46.2 +/- 9.57:1 and a corresponding serum concentration of 2.3 +/- 0.63 ng/ml. In adults glycoside concentrations of autopsy specimens of the right ventricle were significantly lower by 28 to 30% than those of the left ventricle. Glycoside concentrations of skeletal muscle specimens (m. pectorialis major) were 14.7 +/- 10.35 ng/g with a tissue to serum relation of 9.7 +/- 3.00:1 (r = 0.8377), which corresponds to approximately 1/5 to 1/4 of the concentrations of the left ventricular myocardium.

Aged↗
PubMed1975

[Serum concentration of glycosides and digitalis intoxication(author's transl)].

Serum glycoside concentration was 2.3 ng/ml or more in 299 patients digitalised with digoxin or digoxin derivatives. Mean serum glycoside concentration was 3.4 +/- 1.3 ng/ml (range 2.3-11.00 ng per ml). Usually, high serum concentrations were associated with advanced den or digoxin-derivative overdosage occurred in only 10% of patients. Almost three quarters of those with intoxication had impaired renal function. There was some evidence that low body-weight increased the potential risk of intoxication.

Arrhythmias, Cardiac↗
PubMed1975

[Cardiac effects and glycoside concentrations in serum and urine after oral administration of beta-methy-digoxin to healthy individuals (author's transl)].

Six healthy individuals were digitalized orally with beta-methyl-digoxin. The serum glycoside concentration, determined radioimmunologically at the end of the digitalization period was 1.2 +/- 0.22 ng/ml. At this period of time renal excretion attained 55.9% of the daily administered oral dose. The calculated renal clearance of beta-methyl-digoxin was 63 +/- 8.1 ml/min e. g. 57.5 +/- 8.3 ml/min/1.73 m2. After discontinuation of the glycoside the serum half life was 54 h. During the digitalization period the cardiac glycoside effects could be measured by ECG changes, especially a shortening of the QT interval as well as a shortening of the left ventricular ejection time and the pre ejection period, corrected for the heart rate.

Administration, Oral↗