Acta medica Scandinavica. Supplementum最新文献

{"title":"Hypertension in pregnancy. Analysis of 261 consecutive cases.","authors":"A. Svensson, B. Andersch, L. Hansson","doi":"10.1097/00006254-198606000-00009","DOIUrl":"https://doi.org/10.1097/00006254-198606000-00009","url":null,"abstract":"In the years 1969 - 1973, 0.3% of 17000 unselected non-diabetic pregnancies were complicated by severe pre-eclampsia, 0.6% by mild pre-eclampsia and 0.6% by hypertension in pregnancy. Records from affiliated maternity centers and the hospital were studied for these 261 women and for 260 women with matched normotensive pregnancies. The women with pre-eclampsia/hypertension in pregnancy had higher blood pressure than the control group very early in pregnancy. The hypertensive women were more often primiparous and they had a slightly higher body weight. The patients with severe pre-eclampsia were older than the other women (30.4 vs 25.4 years for controls, p less than 0.001). Immigrants were not more commonly found in the hypertensive groups, but unmarried mothers were more often seen in the mild pre-eclampsia and pregnancy hypertension groups, 19.1% and 20.6% respectively compared to 7.7% in the control group (p less than 0.01). A family history of hypertension was frequently reported in all groups. The most striking characteristic of women with pre-eclampsia/hypertension in pregnancy was their elevated blood pressure before or very early in pregnancy.","PeriodicalId":75385,"journal":{"name":"Acta medica Scandinavica. Supplementum","volume":"693 1","pages":"33-9"},"PeriodicalIF":0.0,"publicationDate":"1986-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00006254-198606000-00009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61952559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myocardial infarction--secondary prevention.","authors":"A Hjalmarson","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75385,"journal":{"name":"Acta medica Scandinavica. Supplementum","volume":"712 ","pages":"35-9"},"PeriodicalIF":0.0,"publicationDate":"1986-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14016566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adrenergic mechanisms in congestive heart failure.","authors":"K E Andersson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The normal control of cardiovascular function exerted by the sympathetic nervous system is disturbed in congestive heart failure. The failing pump function of the heart evokes an increase in sympathetic activity which may be reflected in increased levels of plasma noradrenaline. However, these levels are generally below the concentrations needed to activate the adrenergic effector systems, indicating that the cardiovascular consequences of the increased sympathetic activity is not mediated by circulating noradrenaline. In the failing human heart there is a decrease in beta-adrenoceptor density which is related to decreasing ventricular function. This finding suggests that the myocardium is exposed to high concentrations of noradrenaline, inducing downregulation of the receptor number, despite the fact that in the failing heart the noradrenaline stores are reduced. In heart failure the plasma noradrenaline concentration was found to be directly related to mortality and was suggested to provide a better guide to prognosis than other commonly measured indexes of cardiac performance.</p>","PeriodicalId":75385,"journal":{"name":"Acta medica Scandinavica. Supplementum","volume":"707 ","pages":"37-44"},"PeriodicalIF":0.0,"publicationDate":"1986-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14011513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why exercise? An evolutionary approach.","authors":"P O Astrand","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75385,"journal":{"name":"Acta medica Scandinavica. Supplementum","volume":"711 ","pages":"241-2"},"PeriodicalIF":0.0,"publicationDate":"1986-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14590576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What are we trying to prevent--coronary atherosclerosis or ischaemic heart disease?","authors":"M F Oliver","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75385,"journal":{"name":"Acta medica Scandinavica. Supplementum","volume":"712 ","pages":"7-9"},"PeriodicalIF":0.0,"publicationDate":"1986-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14592467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endocrinology of cardiac failure. Pathophysiologic aspects--hemodynamics.","authors":"S Persson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The hemodynamic situation in congestive heart failure (CHF) is greatly influenced by compensatory mechanisms within the heart itself as well as released from the central nervous system and from the kidneys. These measures are intended to maintain the cardiac output at a level as beneficial as possible and to distribute the blood flow to regions with the largest metabolic demands. Thus the hemodynamic consequences of CHF are reflected in the central circulation as well as in the periphery. Within the heart the Frank-Starling mechanism, adrenergic stimulation causing increase of heart rate and contractility, and during the chronic course also myocardial hypertrophy are operating. The central nervous and peripheral adaptive measures include increased sympathetic outflow bringing about an increased vasomotor tone with augmentation of pre- and afterload, and activation of the renin-angiotensin-aldosterone system, where angiotensin II further augments vasoconstriction directly and through central nervous stimulation. This vasoconstriction may be counteracted by humoral factors with vasodilatory properties, such as dopamine, bradykinin, acetylcholine and the metabolic products adenosine and lactic acid. The exact role of these and the possible importance of the antidiuretic hormone, arginine vasopressin, the prostaglandin system and the recently discovered atriopeptin remains to be established. As the compensatory mechanisms may maintain a fairly satisfactory hemodynamic situation at rest, investigations should be performed not only at rest but also during exercise to get an over-all impression of the cardiac functional state.(ABSTRACT TRUNCATED AT 250 WORDS)</p>","PeriodicalId":75385,"journal":{"name":"Acta medica Scandinavica. Supplementum","volume":"707 ","pages":"7-14"},"PeriodicalIF":0.0,"publicationDate":"1986-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14077719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Symposium on the endocrinology of cardiac failure. Stockholm, Sweden, April 25-26, 1985.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75385,"journal":{"name":"Acta medica Scandinavica. Supplementum","volume":"707 ","pages":"1-99"},"PeriodicalIF":0.0,"publicationDate":"1986-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14585460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical activity in health and disease. Proceedings of the second Acta Medica Scandinavica International Symposium. Göteborg, Sweden, June 10-12, 1985.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75385,"journal":{"name":"Acta medica Scandinavica. Supplementum","volume":"711 ","pages":"1-244"},"PeriodicalIF":0.0,"publicationDate":"1986-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14589623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Some new positive inotropic agents.","authors":"K E Andersson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In the search for new effective positive inotropic agents for the treatment of congestive heart failure (CHF), interest has focused mainly on two groups of agents namely adrenoceptor agonists and drugs inhibiting phosphodiesterase. Common for drugs belonging to both groups is that their positive inotropic effects seem to involve an increase in the intracellular concentration of cyclic AMP. Drugs acting by stimulation of beta 1- and/or beta 2-adrenoceptors (e.g. dopamine, dobutamine, prenalterol, pirbuterol, salbutamol, terbutaline, fenoterol) have initial beneficial effects, but seem to be ineffective for long-term treatment. This has been suggested to be due to desensitization of the beta-adrenoceptors, and means, if this effect can be definitely established, that beta-adrenoceptor stimulation should be restricted to the acute treatment of CHF. Among drugs inhibiting phosphodiesterase, sulmazole, amrinone, milrinone, and fenoximone all have been shown to improve cardiac performance in patients with CHF during short-term treatment. However, results of long-term treatment with most of these drugs seem less encouraging. It has been suggested that these drugs may not be an effective approach to treatment of patients with CHF, since even if it is possible to achieve short-term gains, the long-term effects on the myocardium may be detrimental. Their ultimate place in the treatment of CHF remains to be established.</p>","PeriodicalId":75385,"journal":{"name":"Acta medica Scandinavica. Supplementum","volume":"707 ","pages":"65-73"},"PeriodicalIF":0.0,"publicationDate":"1986-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14011514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Central haemodynamics in acute myocardial infarction. Natural history, relation to enzyme release and effects of metoprolol.","authors":"P Held","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The aim of this investigation was to study central haemodynamics in initially uncomplicated acute myocardial infarction (AMI) with respect to natural history, relation to enzyme estimated infarct size, mortality and effects of metoprolol. A total of 212 patients with AMI but without clinical signs of serious heart failure or hypotension and with a mean delay from onset of pain to study entry of about 7 hours were studied. They were randomised to placebo or metoprolol (15 mg i.v. + 50 mg orally q.i.d.) treatment. Central pressures and cardiac output were evaluated by repeated measurements over 24 hours by means of pulmonary artery catheters. The pharmacokinetics of metoprolol were studied in further 20 patients with AMI. The natural history, as reflected by the placebo group, was observed to be a gradual significant fall in systemic artery pressures, pulmonary capillary wedge pressure (PCWP; 13.6-10.5 mmHg) and stroke volume, while heart rate increased, leaving cardiac output unchanged. The decrease in PCWP was confined to the group with baseline pressure above the median of 13 mmHg and was of equal magnitude in the group given concomitant medication to that of those who required no such therapy. Significant but weak correlations between the peak serum aspartate aminotransferase level and the baseline PCWP (r = 0.28) and stroke volume (r = 0.22) were found. Non-survivors had a significant baseline depression of cardiac output and stroke volume, while PCWP was increased. However, the overlap with survivors was large. The dosage of metoprolol used resulted in mean plasma levels of about 200 nmol/l, which should induce a rapid and sustained degree of beta-blockade. The patients randomised to placebo or metoprolol were assessed according to initial heart rate. The haemodynamic changes induced by metoprolol were similar but were more pronounced in patients with high heart rate compared to those with low rate. In patients with heart rate greater than 65 beats/min, the metoprolol treated group, in comparison to the placebo group, was characterised by a decrease of 10-20% in systolic artery pressure and heart rate, suggesting a decreased myocardial oxygen consumption. Cardiac index (2.9-2.2 l/min/m2) and stroke volume index (36-32 ml/beat/m2) decreased to a minimum after 30 minutes and gradually rose thereafter. The PCWP increased from 13.7 to 15.4 mmHg, 30 minutes after the injection of metoprolol. This increase was confined to the group with baseline low pressure and the difference compared to the placebo group disappeared after 8 hours.(ABSTRACT TRUNCATED AT 400 WORDS)</p>","PeriodicalId":75385,"journal":{"name":"Acta medica Scandinavica. Supplementum","volume":"709 ","pages":"1-47"},"PeriodicalIF":0.0,"publicationDate":"1986-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14655446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}