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Biomedical subjects

T Pindborg

Publications and source records attributed to T Pindborg.

At least 19 recordsLinked to original sources
PubMed1999

[Hypertension in general practice].

A group of 15 Danish general practitioners performed a medical audit on hypertension control consultations consisting of three registrations of each 15 days during 1995 through 1997. Between the first and second registration an interventional programme was set up by establishing different kinds of CME activity and by publishing local guidelines for discovering, diagnosing, treating and controlling hypertension. The blood pressure reductions achieved were only moderate even though the doctors were rather compliant to the recommendations; in 1997 no less than 70% of the patients were above the recommended target value for systolic blood pressure (140 mmHg) whereas 20% were above the target value for diastolic blood pressure (90 mmHg). Present aspects of the epidemiology of hypertension and its treatment as performed by general practitioners today are described, and possible reasons for shortcomings are discussed.

Adult↗
PubMed1998

Benazepril versus felodipine as supplement to bendroflumethiazide: evaluation by office and ambulatory blood pressure.

OBJECTIVE: To compare a combination of a thiazide diuretic and an angiotensin converting enzyme inhibitor with a thiazide diuretic and a calcium antagonist. DESIGN: A double-blind randomized trial with subjects in two parallel groups administered either 10-20 mg benazepril once daily or 5-10 mg extended-release felodipine once daily, both titrated according to diastolic office blood pressure. During run-in and all 12 weeks of the study members of both groups were administered 2.5 mg bendroflumethiazide once daily. We measured 24 h ambulatory blood pressure with thiazide alone and after 12 weeks of combination therapy. SETTING: General practices. PATIENTS: We studied 96 hypertensive patients (50 women and 46 men), aged 25-75 years, whose blood pressures were insufficiently regulated (i.e. office diastolic blood pressure >/= 95 mmHg) despite treatment with a thiazide diuretic for at least 3 months. RESULTS: The responses of office blood pressure after 12 weeks of treatment did not differ between the groups and neither did the proportions of responders. The ambulatory recordings revealed, after 12 weeks of treatment, a fall in daytime blood pressure of 16.3/10.3 mmHg in members of the benazepril group compared with a fall of 8.5/5.2 mmHg in members of the felodipine group (P < 0.001/<0.001). Analysis of variance showed that the systolic but not the diastolic office blood pressure in members of the benazepril group was significantly lower during the 12-week study period. When evaluating rising single quote, left (low)white-coat-positive' patients separately, there was a tendency for there to be a more pronounced reduction of their (normal) blood pressure with benazepril therapy. There was a significant reduction in weight of patients in the benazepril group (by 0.9 kg), but not of patients in the felodipine group. We observed no difference in side effects between the two treatment groups.CONCLUSION: Add-on therapies both with benazepril and with felodipine are effective and both drug regimens are well tolerated, but ambulatory blood pressure monitoring yielded differing results.

Journal Article↗
PubMed1993

[Treatment of primary hypercholesterolemia with pravastatin. A placebo-controlled trial].

We present the results of a multicentre, placebo-controlled, randomized double-blind comparison of the treatment of primary hypercholesterolaemia with pravastatin (Pravachol), an HMG-CoA-reductase inhibitor. The study was conducted in both general practice and hospital settings. Two hundred and eighty-six patients who despite oral and written dietary instructions and advice on healthy living had elevated total serum cholesterol levels of between six and eight mmol/l were randomized to treatment with either parvastatin (Pravachol) or placebo. The study showed a significant reduction in both total serum cholesterol (of 16%) and serum LDL-cholesterol among those treated with pravastatin (Pravachol), as well as a small increase tin serum HDL-cholesterol of six percent. Advice on diet and healthy living resulted in a reduction of serum cholesterol of only 1.5%. There were no important differences between those treated from the hospital and those treated in general practice. The incidence of side-effects was low and comparable to placebo levels, and only two percent of the pravastatin (Pravachol) treated patients had to have the treatment stopped. All side-effects were reversible. No side-effects relating to the central nervous system were registered, and no elevations of serum creatinine phosphokinase were observed amongst the pravastatin treated patients, presumably because of the drug's selective inhibitory effect on cholesterol synthesis in the liver.

Adult↗
PubMed1993

Atrial natriuretic peptide in congestive heart failure after acute myocardial infarction.

The concentration of atrial natriuretic peptide, a newly discovered hormone produced in the atrial wall, was measured in 55 patients during the first 72 h after acute myocardial infarction. 37 patients became clinically congested, while 18 patients avoided this complication. 13 patients (9 congested and 4 uncongested) experienced tachycardia, known to raise the concentration of atrial natriuretic peptide both with and without congestive heart failure. In the remaining 42 patients, the congested group had a significantly higher plasma atrial natriuretic peptide concentration than the uncongested group (p < 0.05) on all 3 days. In the congested group the concentration of atrial natriuretic peptide did not normalize after initiation of treatment. We conclude that the concentration of atrial natriuretic peptide is increased in all patients with acute myocardial infarction and that the level of atrial natriuretic peptide declines during the first 24 h in all patients and normalizes in the uncongested patients while the level of atrial natriuretic peptide is still elevated (at least for 72 h) in the congested patients.

Adult↗
PubMed1992

[Cardiac arrhythmias. Diagnosis and treatment].

This review is a task force report prepared by a working group appointed by the Danish Society of International Medicine. The report gives guidelines for the pharmacological and non-pharmacological treatment of tachyarrhythmias and bradyarrhythmias and for the referral of patients to centers with electrophysiological experience.

Arrhythmias, Cardiac↗
PubMed1992

Plasma concentration of atrial natriuretic peptide at admission and risk of cardiac death in patients with acute myocardial infarction.

OBJECTIVE: To compare the concentration of plasma atrial natriuretic peptide in patients with acute myocardial infarction with a healthy population and to determine whether a raised concentration of plasma atrial natriuretic peptide at admission was a predictor of mortality after acute myocardial infarction. DESIGN: Patients with acute myocardial infarction were divided into a group with no congestion (class I) and a group with congestion (class II-IV) according to their highest Killip classification in the first 24 hours after infarction. The concentration of plasma atrial natriuretic peptide was measured at admission. On the basis of the concentration of atrial natriuretic peptide measured in the healthy population, patients were separated into two groups: a group with a high (greater than 200 pg/ml) and a group with a low concentration of atrial natriuretic peptide (less than or equal to 200 pg/ml). The patients were followed for three years. PATIENTS: 55 patients admitted to the coronary care unit within 12 hours of the appearance of symptoms of acute myocardial infarction were compared with 51 healthy individuals. MAIN OUTCOME MEASURES: Plasma atrial natriuretic peptide, Killip class, mortality. RESULTS: The patients had significantly higher concentrations of atrial natriuretic peptide than the healthy controls. Furthermore, patients with congestion had a significantly higher concentration of atrial natriuretic peptide than the uncongested group of patients. Total mortality was 34.5%. In the group with a low concentration of atrial natriuretic peptide the mortality was only 13.6%, whereas mortality was significantly higher (48.5%) in the group with a high concentration. CONCLUSIONS: The measurement of atrial natriuretic peptide separated the patients into low and high risk groups after acute myocardial infarction.

Adult↗
PubMed1987

Atrial natriuretic peptide in relation to physical exercise.

The effect of physical exercise on atrial natriuretic peptide (ANP) was studied in 10 healthy young volunteers. The subjects were exercised on a bicycle ergometry until exhaustion. Blood samples were drawn at rest, at maximal load and in the following resting period. ANP concentrations were measured by radio-immunoassay. The level of ANP rose from 6.7 +/- 0.5 at rest to 33.2 +/- 7.0 pmol/l (mean +/- SEM) (p less than 0.05) at maximal load and returned to normal after 45 min. It was not possible to demonstrate a correlation between a change in ANP concentration and changes in pulse rate, blood pressure, maximal physical load, volume of urine, the amount of urine sodium, urine potassium or urine creatinine during the exercise load.

Adult↗
PubMed1981

Non-invasive monitoring of cardiac function during haemodialysis.

The cardiac function during haemodialysis has been studied using a non-invasive method in a prospective investigation of 7 elderly patients, all of whom had an enlarged heart on the chest X-ray and in all of whom experience had shown that a fall in blood pressure developed during haemodialysis. The cardiac output was determined by impedance cardiography and showed no significant changes during dialysis. A significant rise was observed in the heart rate and this was found to reach a maximum during the periods in which the blood pressure was lowest. Left ventricular function was evaluated from the systolic time intervals, PEP/LVET (PEP = pre-ejection period and LVET = left ventricular ejection time) and the noninvasive contraction index BP diastolic/PEP. The electromechanical systole (QS2), LVET and the non-invasive contraction index all decreased significantly during dialysis, while PEP and PEP/LVET were significantly increased. All the changes were most pronounced at the time when the blood pressure was lowest. It is concluded from the investigation that the cause of the fall in blood pressure during haemodialysis of elderly patients with impaired cardiac function may be ascribed to transient reduction in left ventricular performance.

Aged↗
PubMed1978

Peritoneal dialysis and heparin.

In a prospective, controlled and double-blind investigation the influence of heparin--added to the dialysis solution--on the lapse of peritoneal dialysis is studied. The material comprises 9 patients, all of whom had 2 peritoneal dialysis, one with and one without heparin added to the dialysis solution. A significantly higher inflow and outflow were found in the heparin group. Further the total length of one dialyted procedure--which according to literature never seems to have been exposed to an investigation-the results of the present investigation supports the theoretical considerations of adding heparin to peritoneal dialysis solutions.

Adult↗
PubMed1977

Bullous dermatosis among patients with chronic renal failure of high dose frusemide.

Twelve of 56 patients with chronic renal failure, all treated with frusemide (Lasix) in daily doses of 0.5-2 g, developed bullae in areas exposed to light. In most cases the bullae developed during summer months and disappeared later in the year whether the frusemide treatment was continued or not. In two patients the eruption reappeared when treatment was resumed. Disturbance of the porphyrin metabolism was not found, neither could a change in the frusemide metabolism be demonstrated. Tissue typing and blood groups showed no difference from the average population. It is concluded that the condition presumably is a photo reaction due to the frusemide treatment but it cannot be said whether it is allergic or toxic.

Adult↗