Abstract:
:Treatment of angina with a single drug often proves unsatisfactory because of dose-related unwanted effects or occasionally an adverse effect on the angina. A combination of a beta-blocking agent and a calcium antagonist drug might achieve satisfactory control of angina at acceptable doses of each drug. Widespread application of combination therapy would, however, be inappropriate if the beta-blocker component were to have adverse effects among patients with rest pain as a prominent symptom, suggestive of coronary 'spasm'. The reported adverse effects of beta-blocking agents are likely to be related to bradycardia and are not apparent if excessive slowing is avoided by individual dose adjustment or if bradycardia is corrected by pacing. Supposed failure of these agents to control cardiac pain not infrequently results from inadequate dosage. Combination therapy will attenuate the increases in heart rate and contractility resulting from stress while coronary perfusion will be maintained and the associated level of arterial blood pressure reduced. The theoretical benefits have been confirmed in clinical investigations in which the effect of combination therapy has been compared with that of one or both of the constituent drugs given alone. Reports of bradycardia (specific to inclusion of verapamil in the combination), hypotension or cardiac failure developing during combination therapy emphasize the need for careful dose titration of both beta-blocker and calcium antagonist in each patient. The possible additional role of nitrates is undefined, but inclusion of these agents is likely to prove especially valuable where left ventricular function is grossly impaired and in the management of unstable angina.
journal_name
Postgrad Med Jjournal_title
Postgraduate medical journalauthors
Geddes JSsubject
Has Abstractpub_date
1983-01-01 00:00:00pages
62-9eissn
0032-5473issn
1469-0756journal_volume
59 Suppl 2pub_type
杂志文章,评审abstract::Following the drinking of 150 g of alcohol and a large amount of intra-nasal cocaine a previously healthy 31 year old man developed severe retrosternal pain and circulatory failure. An electrocardiogram showed supra-ventricular tachycardia with widespread ischaemic changes. Following electrical cardioversion electroca...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.61.721.997
更新日期:1985-11-01 00:00:00
abstract::Fasting plasma and urinary calcium and urinary hydroxyproline are known to rise at the menopause, reflecting increased bone resorption. Oestradiol valerate and cyclic oestradiol valerate/DL-norgestrel are shown to reduce this evidence of increased bone loss. It is concluded that these preparations will be effective in...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00
abstract::Antiphospholipid syndrome is a disorder of recurrent vascular thrombosis, pregnancy loss and thrombocytopenia associated with persistently elevated levels of antiphospholipid antibodies. It was first described in a group of patients with systemic lupus erythematosus but has since been associated with a wide range of c...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.75.879.45
更新日期:1999-01-01 00:00:00
abstract::A 58 year old man presented with an anterior myocardial infarction requiring repeated resuscitation. He had impaired glucose tolerance. He died five weeks later and post-mortem examination revealed a myocardial abscess and sternal osteomyelitis due to Staphylococcus aureus. These had not been apparent clinically. The ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.65.766.589
更新日期:1989-08-01 00:00:00
abstract::Placebo, used here to mean an inert treatment given as if it was a real treatment, means lots of different things to different people. The structure of the article is that it begins by talking about the technical use of placebos in clinical trials, and the extent of the placebo response, then about the mechanism--"How...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2004.024737
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVE:Lactate dehydrogenase (LDH) anomaly is one of the macroenzymes. Macroenzymes are enzymes in serum that have formed high molecular mass complexes, either by self polymerisation or by association with other serum components. The aim of this study was to identify the properties of LDH anomaly and observe the cha...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.2003.015420
更新日期:2004-08-01 00:00:00
abstract::A case of post-thyroidectomy hypothyroidism is reported. The patient became euthyroid in three consecutive pregnancies, reverting to hypothyroid within three months of delivery on each occasion. The alteration in thyroid status is attributed to pregnancy related changes in antibody titres, though the laboratory data t...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pmj.77.911.591
更新日期:2001-09-01 00:00:00
abstract::Paget's disease of bone is a relatively common condition in the UK affecting up to 5% of the population over the age of 55 years with particularly high prevalence in the North West of England. The majority of those affected are asymptomatic. Its precise cause remains unknown, and until recently, choice of treatment of...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.73.856.69
更新日期:1997-02-01 00:00:00
abstract::The effect of cold in the manifestations of coronary heart disease is reviewed. The mechanisms involved which may include increased peripheral resistance and increased coronary vascular resistance are unclear. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract::In the 1920s Moynihan described acute pancreatitis as "..the most terrible of all intra-abdominal calamities". He established a practice of immediate surgical intervention to remove the toxic products accumulating in the peritoneal cavity, and this treatment was endorsed by most centres, remaining the standard therapy...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.72.847.277
更新日期:1996-05-01 00:00:00
abstract::A previously healthy 17 year old boy had Staphylococcus aureus endocarditis presenting as acute scrotal pain. There was no trauma or evidence of scrotal or epididymal infection. The pain subsided after therapy for endocarditis was started. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.63.741.585
更新日期:1987-07-01 00:00:00
abstract::Under certain circumstances, living wills or advance directives may carry legal force in the UK. This paper traces the development of advance directives, clarifies their current legal position and discusses potential problems with their use. Case histories are used to illustrate some of the common dilemmas which docto...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.74.869.151
更新日期:1998-03-01 00:00:00
abstract::Oral administration of 1 g of acetazolamide to 8 normal subjects studied at sea level and in normoxia caused an acute increase in cerebral blood flow (CBF). During the subsequent prolonged oral treatment with 1 g of acetazolamide daily, CBF returned to normal within 2 days. The alveolar CO2 tension decreased gradually...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.63.737.185
更新日期:1987-03-01 00:00:00
abstract::Two patients with severe dothiepin intoxication are described. The management of these cases is discussed and we draw attention to the prolonged elimination half-life of dothiepin and its metabolites, and the implication for treatment. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.60.704.442
更新日期:1984-06-01 00:00:00
abstract::A doubld-blind crossover study of oral domperidone (10 mg t.d.s.) involving 48 patients suffering from chronic postprandial dyspepsia, showed a significant relief of symptoms on active treatment compared to placebo. The trial lasted eight weeks, the crossover in medication taking place at four weeks. Side effects were...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1979-01-01 00:00:00
abstract::There is an increasing awareness on the part both of the media and the profession of the need to co-operate in providing information and education on medical matters. This co-operation should be strongly encouraged. Where children are concerned the opportunities for education are great. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.54.629.225
更新日期:1978-03-01 00:00:00
abstract::In a retrospective review of patients admitted to a coronary care unit, 809 patients had a definite myocardial infarction and plasma potassium was measured within 48 hr. The mean (+/- s.d.) plasma potassium was 4.04 (+/- 0.56) mmol/litre. A potassium concentration of less than 4.0 mmol/litre was found in 383 patients,...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.59.692.354
更新日期:1983-06-01 00:00:00
abstract:OBJECTIVE:To assess the general use of all non-steroidal anti-inflammatory drugs (NSAID) and their relation to upper gastrointestinal bleeding in view of National Institute for Clinical Excellence guidelines published in July 2001 in the UK. METHODS:Cross sectional study on all patients who were referred for endoscopy...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,多中心研究
doi:10.1136/pgmj.2004.024885
更新日期:2005-04-01 00:00:00
abstract::In order to assess the neurohormonal responses to oral administration of two drugs with different antihypertensive mechanisms, and their implications for long-term efficacy, we studied the changes in plasma renin activity, aldosterone, catecholamines and blood pressure after two cross-over periods of treatment with ca...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1986-01-01 00:00:00
abstract::Fibrosing colonopathy is a recently described complication of cystic fibrosis, of unknown aetiology but possibly related to treatment with high-dose pancreatic enzyme supplements. We have used a whole gut perfusion technique to study subclinical gut inflammation in cystic fibrosis patients; concentrations of haemoglob...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1996-03-01 00:00:00
abstract::Long intergenic non-coding RNA 01296 (LINC01296) has been reported to play an important role in many human malignancies, but a consistent perspective has not been established now. To explore the prognostic value of LINC01296 in different types of human solid malignant tumours, we performed this meta-analysis.An electr...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,meta分析,评审
doi:10.1136/postgradmedj-2019-136684
更新日期:2020-01-01 00:00:00
abstract::Strips form canine saphenous veins were incubated with (3H)-noradrenaline and mounted for superfusion. 5-Hydroxytryptamine (5-HT inhibited the release of tritium caused by sustained electrical stimulation (2 Hz, 150 mA, 0.1 msec) being about 10 times more potent than noradrenaline. 5-HT inhibited contractions induced ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1981-01-01 00:00:00
abstract::Three patients with Crohn's disease are described who were treated by ileal resection for intestinal obstruction. Histological examination of the resected specimen in each case established the diagnosis of adenocarcinoma of the small intestine complicating Crohn's disease. This diagnosis should be considered in patien...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.71.833.172
更新日期:1995-03-01 00:00:00
abstract::This report describes the case history of a middle-aged lady who presented with symptoms and signs over one year leading to a diagnosis of multiple sclerosis. During one of her relapses, she developed trismus--an association that has not been described before in multiple sclerosis. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.66.780.853
更新日期:1990-10-01 00:00:00
abstract::Interstitial nephritis is an inflammatory process within the renal interstitium, and was one of the first observations made in the description of renal histopathology. Many different conditions are associated with an interstitial nephritis, and as a clinical diagnosis the term has little use unless causation is define...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.73.857.151
更新日期:1997-03-01 00:00:00
abstract::We report what we believe is the first recorded case of Mondor's disease associated with metastatic lung cancer presenting in the breast. An association between Mondor's disease and primary breast cancer has been described previously. In patients with Mondor's disease and primary breast cancer has been described previ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.65.768.779
更新日期:1989-10-01 00:00:00
abstract::Medullary carcinoma of the thyroid commonly spreads to the lymphatics and later on in the disease process, to distant sites such as lung, liver and bone. Spread to the breast is rare (only two previous reported cases) and presents a major diagnostic dilemma. We report a case of metastatic medullary carcinoma of the th...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.71.842.744
更新日期:1995-12-01 00:00:00
abstract::Serum thyrotrophin has been measured before and after the intravenous administration of 200 micrograms of thyrotrophin-releasing hormone in 91 white subjects (33 stable diabetic patients and 58 healthy controls), none of whom had any clinical evidence of thyroid or pituitary dysfunction. Seven of the diabetic subjects...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.62.728.445
更新日期:1986-06-01 00:00:00
abstract::A 24-year-old man with primary Sjögren's syndrome presented with xerophthalmia, xerostomia, and marked parotid swelling. He had a previous history of selective IgA deficiency and ulcerative colitis treated with sulphasalazine. Immunosuppression and withdrawal of sulphasalazine resulted in rapid resolution of the parot...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.72.850.499
更新日期:1996-08-01 00:00:00
abstract::Since January 1974, alternate cadaveric renal transplants were treated with antilymphocyte globulin (Behringwerke) om addotopm to prednisone and azathioprine. Thirty patients were treated in this way. 53% of patients receiving ALG had a functioning graft at six months as opposed to 40% in the control group. This diffe...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章
doi:
更新日期:1976-01-01 00:00:00