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T Talseth

Publications and source records attributed to T Talseth.

At least 37 records · Page 2Linked to original sources

[Treatment of chronic kidney failure with dialysis and transplantation. Development, need and organization in Norway].

Treatment of chronic renal failure by dialysis and renal transplantation has been developed over the last 20 years in Norway. 17 local nephrological units with dialysis departments cooperate with one transplantation center in Oslo. The number of new patients starting renal replacement therapy has increased only slightly during the last five years. The mean number of new patients in the period was 52 per million inhabitants per year. The proportion of elderly patients accepted for renal replacement therapy was high (39% above 60 years of age) and approximately 15% of the patients had diabetic nephropathy. Due to an active transplantation policy, the proportion of patients alive on dialysis is low (18%), compared with 82% alive with a functioning graft. The number of patients on dialysis has declined slightly the last four years. The proportion of patients on chronic ambulatory peritoneal dialysis (CAPD) is low (13%), and the number of patients on home hemodialysis has declined in the last five years. Predialytic transplantation has been performed in 18% of the patients starting renal replacement therapy during the last five years. Due to a high transplantation rate and a large number of predialytic transplantations, it has not been necessary to increase the capacity for dialysis in the last five years.

Hospital Departments↗

Isolated cavernous bodies.

Corpus cavernosography in a patient with erectile dysfunction revealed absence of communication between the 2 cavernous bodies. No similar case was found in a review of 100 consecutive cavernosograms or in the literature. The abnormality may be a source of error in pressure recordings or in intravenous injection of pharmaceutical agents.

Adult↗

Long-term effects of doxazosin and atenolol on serum lipids and blood pressure in hypertensive smokers.

On the basis of a 1-year double-blind comparative study of doxazosin and atenolol in hypertensive patients, we have previously described sustained and significantly different drug effects on the blood lipid profile. The present paper presents a retrospective analysis of the smoking subgroups for each drug regimen, for both the original 12-month double-blind period and for a further 12-month open-label period. The changes in blood lipids were qualitatively and quantitatively similar in both the smoking subgroup and in the full study population (smokers and non-smokers). In the hypertensive smokers doxazosin increased high-density lipoprotein (HDL) cholesterol (+9.4%) and decreased triglycerides (-10.9%) whereas atenolol had the opposite effect, decreasing HDL cholesterol (-5.6%) and increasing triglycerides (+20.7%). The antihypertensive effects of doxazosin (n = 24) and atenolol (n = 23) were comparable over 24 months of treatment. Eighteen (75%) doxazosin and 17 (73.9%) atenolol patients reached the blood pressure goal (sitting diastolic blood pressure less than or equal to 90 mmHg with at least a 5-mmHg reduction, or a greater than or equal to 10-mmHg reduction from baseline). As a consequence of the lowered blood pressure and favourable lipid changes, doxazosin decreased the risk of coronary heart disease (as calculated from the Framingham risk equation) by -24.4% (P less than 0.05). However, the calculated risk was not significantly reduced by atenolol (-2.1%). It is concluded that the smoking status of the patient has no obvious implications for the safety, efficacy or metabolic effects of doxazosin.

Adolescent↗

A long-term study of atenolol and doxazosin in mild and moderate hypertension.

The efficacy and tolerability of doxazosin and atenolol in the management of mild and moderate hypertension were compared in a multicentre, parallel study, the first year of which was randomized and double-blind. Patients who completed this first year were invited to enter a two-year extension phase; the results after the first year are presented. A total of 228 patients entered the double-blind phase (118 received atenolol). A reduction in dose was required by 4% in each group; eight patients on doxazosin and 11 on atenolol were withdrawn due to adverse effects. Ninety-three of the 100 doxazosin patients and 88 of the 104 atenolol patients who completed the double-blind phase agreed to participate in the open extension study. At 24 months, the mean dose of doxazosin was 5.2 mg/day, and of atenolol 66.7 mg/day. From baseline levels of BP of 158/104 mmHg in the doxazosin group and 161/103 mmHg in the atenolol group, average reductions at 24 months were -16/-14 and -19/-15 mmHg respectively. Neither drug had a significant effect on total cholesterol levels. At all four points of measurement over the two years, doxazosin decreased blood triglyceride levels and increased high density lipoprotein (HDL) cholesterol and the HDL: total cholesterol ratio. Atenolol had the opposite effect on each of these lipid values with the differences between the treatment groups being significant. Doxazosin was well tolerated and was shown to be effective as monotherapy in mild and moderate hypertension. Its effect on blood lipids was potentially favourable, and it should therefore be regarded as an alternative first-line drug in hypertensive patients.

Adolescent↗

Renal effects of trimethoprim in ciclosporin- and azathioprine-treated kidney-allografted patients.

Sixteen stable renal transplant patients on chronic ciclosporin (CS, n = 8) or azathioprine (AZA, n = 8) treatment were given trimethoprim (TMP) 160 mg twice a day for 7 days. This TMP dose did not affect glomerular filtration, as 99mTc-DTPA clearance was unchanged in both groups. TMP did, however, increase serum creatinine and reduce creatinine clearance in all patients. This effect was most pronounced in CS-treated patients. We conclude that even at the moderate dosage, as employed presently, TMP blocks tubular secretion of creatinine. This route for creatinine excretion is quite important as the clearance ratio between creatinine and DTPA averaged 1.21 in CS-treated patients and 1.05 in AZA-treated patients before TMP treatment. During TMP the ratio was reduced to 0.95 and 0.99, respectively, suggesting a complete cessation of tubular creatinine secretion by TMP. TMP did not, however, significantly affect other markers of renal tubular function.

Adult↗

Renal replacement therapy in elderly patients.

The results of renal replacement therapy (RRT) in elderly patients in Norway were evaluated. During the 5-year period between 1981 and 1985, 368 patients at least 60 years of age (mean, 66.7 years) at the start of RRT were included and followed until 15 February 1987. Transplantation was planned for 249 patients; of these 127 were not grafted. The actuarial survival in this group was 64%, 44%, and 7% at 6, 12, and 48 months, respectively. Survival in 122 grafted patients was 93%, 87%, and 62%, respectively, and the corresponding graft survival was 70%, 67%, and 48%. The remaining 119 patients were allocated to long-term dialysis, with a survival of 63%, 48%, and 13%, respectively. Our results describe the outcome of a treatment program available to the entire elderly population accepted for RRT. In two-thirds of the patients transplantation was planned, and one-third of all patients were actually grafted, with good patient and graft survival. The results suggest that transplantation is the treatment of choice for most elderly patients.

Aged↗

Comparison of the effects of doxazosin and atenolol on blood pressure and blood lipids: a one-year, double-blind study in 228 hypertensive patients.

The efficacy and toleration of doxazosin and atenolol were compared over a 52-week period in a double-blind, multicenter study of 228 patients with mild-to-moderate hypertension. Over the treatment period, both drugs significantly reduced blood pressure, and there were no clinically or statistically significant differences between treatment groups for reductions in standing systolic and diastolic blood pressures or in sitting diastolic blood pressure. However, atenolol treatment caused significantly greater reductions in sitting systolic blood pressure and heart rate. Neither drug significantly affected total serum cholesterol concentrations. Doxazosin treatment lowered serum triglycerides, whereas atenolol treatment produced an increase in serum triglycerides (p less than 0.001, week 30; p less than 0.01, week 50, between treatment groups). Increases in high-density lipoprotein cholesterol and high-density lipoprotein to total cholesterol ratio were obtained with doxazosin treatment, whereas atenolol treatment decreased these lipid fractions (p less than 0.0001, weeks 30 and 50, between treatment groups). Using the Framingham equation, it was calculated that at week 50 the risk of developing coronary heart disease was reduced by 22% for the group taking doxazosin (p less than 0.001 vs baseline) and by 4% (not significant) for patients taking atenolol (p = 0.01, between treatment groups). It is concluded that doxazosin is a well-tolerated and effective antihypertensive drug with a favorable effect on blood lipids. Doxazosin provides an attractive, new alternative first-line drug for the treatment of mild-to-moderate hypertension.

Adolescent↗