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  • 1
    Electronic Resource
    Electronic Resource
    SPECIFIC, NONGENOMIC ACTIONS OF STEROID HORMONES (1997)
    Palo Alto, Calif. : Annual Reviews
    Annual Review of Physiology 59 (1997), S. 365-393 
    Details
    ISSN: 0066-4278
    Source: Annual Reviews Electronic Back Volume Collection 1932-2001ff
    Topics: Medicine , Biology
    Notes: Abstract Traditionally, steroid hormone action has been described as the modulation of nuclear transcription, thus triggering genomic events that are responsible for physiological effects. Despite early observations of rapid steroid effects that were incompatible with this theory, nongenomic steroid action has been widely recognized only recently. Evidence for these rapid effects is available for steroids of all clones and for a multitude of species and tissues. Examples of nongenomic steroid action include rapid aldosterone effects in lymphocytes and vascular smooth muscle cells, vitamin D3 effects in epithelial cells, progesterone action in human sperm, neurosteroid effects on neuronal function, and vascular effects of estrogens. Mechanisms of action are being studied with regard to signal perception and transduction, and researchers have developed a patchy sketch of a membrane receptor-second messenger cascade similar to those involved in catecholamine and peptide hormone action. Many of these effects appear to involve phospholipase C, phosphoinositide turnover, intracellular pH and calcium, protein kinase C, and tyrosine kinases. The physiological and pathophysiological relevance of these effects is unclear, but rapid steroid effects on cardiovascular, central nervous, and reproductive functions may occur in vivo. The cloning of the cDNA for the first membrane receptor for steroids should be achieved in the near future, and the physiological and clinical relevance of these rapid steroid effects can then be established.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1146/annurev.physiol.59.1.365
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  • 2
    Electronic Resource
    Electronic Resource
    Pharmacotherapy for hypertonia in pregnancy (1999)
    Springer
    Der Gynäkologe 32 (1999), S. 443-449 
    Details
    ISSN: 1433-0393
    Keywords: Key words Pregnancy • Hypertonia • Antihypertension therapy ; Schlüsselwörter Schwangerschaft • Hypertonie • ; Antihypertensive Therapie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Für die Therapie des arteriellen Bluthochdruckes ist eine Unterscheidung in chronische Hypertonie, Gestationshypertonie und Präeklampsie wesentlich. Die Prognose für Mutter und Kind ist gut, sofern es sich um eine chronische oder Gestationshypertonie handelt. Während die Gestationshypertonie meist ohne medikamentöse Therapie auskommt, müssen bei der chronischen Hypertonie nur die schweren Formen behandelt werden. Die Pharmakotherapie mit Antihypertensiva besonders im Hinblick auf die chronische Hypertonie erlaubt es der Frau, die Schwangerschaft auszutragen. Die Präeklampsie stellt eine potentielle Gefahr für Mutter und Feten dar, die sich nur unbefriedigend mit Antihypertensiva beeinflussen läßt. Nur eine engmaschige medizinische Überwachung und eine frühzeitige Entbindung als einzige kausale Therapie stellen adäquate Maßnahmen dar. Als Antihypertensivum der Wahl für die Langzeittherapie gilt das alteingeführte Medikament Methyldopa, das hinsichtlich seines Nebenwirkungsprofil bei der Mutter gegenüber modernen Antihypertensiva im Nachteil ist; es bietet aber einen höheren Schutz für den Feten. Bei Unverträglichkeit und Ineffektivität von Methyldopa kann auf den β-Blocker Metoprolol ausgewichen werden. Für die Akutsituation ist besonders Dihydralazin geeignet. Als Mittel der 2. Wahl gilt Clonidin.
    Notes: Summary The distinction between chronic hypertension, gestational hypertension, and preeclampsia is essential for the choice of the adequate pharmacotherapy. In chronic and gestional hypertension there is a positive prognosis for mother and child. Mostly, there is no need for pharmacotherapy in gestational hypertension and in chronic hypertension pharmacotherapy is only necessary in serious cases. Particularly in chronic hypertension the application of antihypertension drugs allows the woman to carry the child to full term. In contrast, preeclampsia represents potential danger for mother and fetus. In this case pharmacotherapy rarely shows satisfactory results. Only frequent clinical control and a premature delivery are considered adequate measures. Methyldopa is a well known antihypertensive drug for long-term therapy. Concerning adverse events in the mother modern antihypertensive drugs have disadvantages in relation to but there are advantages in terms of protection for the fetus. Of methyldopa ineffective is or cannot be tolerated of the β-blocker metoprolol can be alternatively applied. In case of emergency dihydralazine or – as as second choice – clonidine is appropiate.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00003252
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  • 3
    Electronic Resource
    Electronic Resource
    Assuming the worst may not be bad at all Carvedilol in heart failure treatment (1998)
    Springer
    European journal of clinical pharmacology 54 (1998), S. 281-285 
    Details
    ISSN: 1432-1041
    Keywords: Key words Chronic heart failure ; Mortality ; Carvedilol
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Abstract Objective: Carvedilol, a β-adrenoceptor blocking agent with additional α1-adrenoceptor blocking properties, has been shown to improve left ventricular function in chronic heart failure (CHF). However, its effect on mortality has recently been the subject of controversial discussion. The aim of this meta-analysis is to review the data on mortality from two large study programs (the US Carvedilol Heart Failure Study and the study by the Australia/New Zealand Heart Failure Research Collaborative Group) on additional carvedilol treatment in CHF standard therapy and to analyse the design and limitations of the individual studies. Methods and Results: For determination of overall, mortality, all patients who died and all patients who were withdrawn for other reasons during the open run-in phase of the studies were assigned to the carvedilol group to create a “worst-case analysis.” Meta-analysis of mortality data using the random effects model shows a significantly reduced relative risk of 0.55 × 95%-confidence interval 0.325–0.924; p 〈 0.05 of death in patients treated with carvedilol compared with patient on standard treatment only. Conclusion: Treatment of CHF using carvedilol significantly reduces mortality in patients with CHF, even if the “worst case” is assumed by assigning all deaths in the open run-in phase to carvedilol.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002280050460
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  • 4
    Electronic Resource
    Electronic Resource
    Looking beyond the dogma of genomic steroid action: insights and facts of the 1990s (1995)
    Springer
    Journal of molecular medicine 73 (1995), S. 439-447 
    Details
    ISSN: 1432-1440
    Keywords: Steroids ; Membrane receptors ; Nongenomic action ; Cellular signaling
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The genomic theory of steroid action has been the unquestioned dogma for the explanation of steroid effects over the past four decades. Despite early observations on rapid steroid effects being clearly incompatible with this theory, only recently has nongenomic steroid action been more widely recognized and led to a critical reappraisal of unsolved questions about this dogma. Evidence for nongenomic steroid effects is now coming from all fields of steroid research, and mechanisms of agonist action are being studied with regard to the membrane receptors and second messengers involved. A prominent example of a receptor/effector cascade for nongenomic steroid effects has been described for rapid aldosterone effects in various cell types, including lymphocytes and vascular smooth muscle cells. Rapid in vitro effects of aldosterone on the sodium proton antiport have been found in human lymphocytes, cultured vascular smooth muscle, and endothelial cells involving nonclassical membrane receptors with a high affinity for aldosterone, but not for cortisol, and phosphoinositide turnover. Another important second messenger, [Ca2+]i, is consistently increased by aldosterone within 1–2 min. In vascular smooth muscle cells, calcium is released from perinuclear stores while in endothelial cells a predominant increase of subplasmalemmal calcium is seen. Effects are half-maximal at physiological concentrations of free aldosterone (0.1 nM), while cortisol is inactive up to 0.1 μM; the classical mineralocorticoid antagonist canrenone is ineffective in blocking the action of aldosterone. The data show that intracellular signaling for nongenomic aldosterone effects also involves calcium, but pathways of cell activation may vary between different cell types. Further evidence for nongenomic steroid effects is encountered presently for various groups of steroids such as neurosteroids, mineralocorticoids, vitamin D3, and sex hormones. Future research will have to target the cloning of the first membrane receptor for steroids and evaluate the clinical relevance of these rapid steroid effects.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00202262
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  • 5
    Electronic Resource
    Electronic Resource
    Der Einsatz von Thrombozytenaggregationshemmern in der Kardiologie (1997)
    Springer
    Der Internist 38 (1997), S. 1242-1246 
    Details
    ISSN: 1432-1289
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001080050135
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  • 6
    Electronic Resource
    Electronic Resource
    Wichtige Unterschiede im Metabolismus von CSE-Hemmern (1999)
    Springer
    Der Internist 40 (1999), S. 235-236 
    Details
    ISSN: 1432-1289
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Diese Unterschiede im Metabolismus der CSE-Hemmer darzustellen, ist die Aufgabe des vorliegenden Beitrags.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001080050328
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  • 7
    Electronic Resource
    Electronic Resource
    Sekundärprävention atherosklerotischer Erkrankungen in der täglichen Praxis (1998)
    Springer
    Der Internist 39 (1998), S. 1080-1097 
    Details
    ISSN: 1432-1289
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Koronare Herzerkrankung, Schlaganfall und periphere arterielle Verschlußkrankheit Herz-Kreislauferkrankungen zählen zu den häufigsten Ursachen für eine vollstationäre Behandlung, wobei ischämisch bedingte Herzerkrankungen die größte Behandlungsgruppe darstellen [Statistisches Bundesamt 1998]. Trotz deutlichem zahlenmäßigen Rückgang der kardiovaskulären Mortalität (jährlich etwa –1,5%) in den letzten Jahrzehnten repräsentieren Herzinfarkte, ischämischer Schlaganfall und periphere arterielle Verschlußkrankheit die häufigsten Todesursachen von Erwachsenen in den Industrienationen Europas [Sans et al., 1997] und Nordamerikas [Kannel 1994]. Die Inzidenzen dieser Erkrankungen können durch rationale und rationelle Therapiestrategien reduziert werden. In Abhängigkeit von der ärztlichen Spezialisierung werden jedoch bereits seit vielen Jahren etablierte Therapien häufig aus Angst oder auch Unwissenheit nicht eingesetzt oder nur unzureichend dosiert [Jollis et al., 1996].
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001080050279
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  • 8
    Electronic Resource
    Electronic Resource
    β-Blocker Stellenwert bei kardiovaskulären Erkrankungen (1999)
    Springer
    Der Internist 40 (1999), S. 680-685 
    Details
    ISSN: 1432-1289
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Die Substanzklasse der β-Blocker hat eine besondere Bedeutung in der Pharmakotherapie von kardiovaskulären Erkrankung wie der arteriellen Hypertonie, der koronaren Herzerkrankung, Herzrhythmusstörungen oder der Herzinsuffizienz gewonnen. Die Erkenntnis, daß die Effekte der Katecholamine durch die Aktivierung verschiedener α- und β-Rezeptoren vermittelt sind, setzte die Entwicklung zahlreicher β-Rezeptor-blockierender Substanzen in Gang, die bis heute anhält. Ziel des folgenden Artikels ist es, die Einsatzmöglichkeiten der Substanzklasse der β-Blocker besonders unter dem Aspekt kardiovaskulärer Erkrankungen darzustellen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001080050389
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