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Query: UMLS:C0009443 (cold)
 92,137 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a controlled double-blind crossover study followed by an open longterm continuation period, the antihypertensive effect of timolol (Blocadren), a new beta-receptor antagonist, was investigated in 24 ambulatory patients with mild to moderate essential hypertension who were concomitantly receiving Moduretic as baseline diuretic therapy. The addition of timolol to one tablet daily Moduretic resulted in a clinically and statistically significant further reduction of supine and upright systolic and diastolic blood pressures. The average total daily dosage schedule for timolol ranged between 15 and 20 mg, with the same blood pressure lowering effect whether the divided dose was given twice or three times. Significant sinus bradycardia was consistently observed but well tolerated, with only one patient requiring dose reduction. After 48 weeks of treatment (comprising 46 weeks Moduretic and 36 weeks timolol) 20 of 22 patients were normotensive (supine diastolic blood pressure below 90 mm Hg) while in two the hypotensive response proved inadequate. One patient was dropped from the study after 3 days of timolol treatment because of acute bronchial asthma. When specifically questioned, one-third of the patients admitted experiencing cold extremities. One patient exhibited Raynaud's syndrome which was treated symptomatically while continuing in the study. In terms of electrolyte balance, the fixed combination of hydrochlorothiazide and the antikaluretic amiloride (Moduretic) as baseline therapy essentially proved adequate. On occasion, however, two subject revealed hypokalemia requiring short-term oral potassium supplement. During the initial 10 to 16 weeks a steady decline in serum potassium was observed but this stabilized itself thereafter. The concomitant administration of Moduretic and timolol (Blocadren) was shown to be an effective therapeutic regimen in patients with mild to moderate essential hypertension. This combination is particularly suitable for patient compliance in longterm therapy, as timolol can be given twice daily.
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PMID:[The anti-hypertensive effect of timolol maleate (blocadren) in gradated combination with a diuretic]. 101 66

Improving the thermoelectric Seebeck coefficient, while simultaneously reducing thermal conductivity, is required in order to boost thermoelectric (TE) figure of merit (ZT). A common approach to improve the Seebeck coefficient is electron filtering where 'cold' (low energy) electrons are restricted from participating in transport by an energy barrier (Kim and Lundstrom 2011 J. Appl. Phys. 110 034511, Zide et al 2010 J. Appl. Phys. 108 123702). However, the impact of electron tunneling through thin barriers and resonant states on TE properties has been given less attention, despite the widespread use of quantum wells and superlattices (SLs) in TE applications. In our work, we develop a comprehensive transport model using the Wigner-Rode formalism. We include the full electronic bandstructure and all the relevant scattering mechanisms, allowing us to simulate both energy relaxation and quantum effects from periodic potential barriers. We study the impact of barrier shape on TE performance and find that tall, sharp barriers with small period lengths lead to the largest increase in both Seebeck coefficient and conductivity, thus boosting power factor and TE efficiency. Our findings are robust against additional elastic scattering such as atomic-scale roughness at side-walls of SL nanowires.
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PMID:Thermoelectric properties of periodic quantum structures in the Wigner-Rode formalism. 2923 41

With increasing availability of valve surgery, a pool of patients requiring chronic anticoagulation is emerging in our environment. The lower blood coagulability with low temperatures, though rare, can occur, putting patients at risk of bleeding. Recently, the author lost two patients with prosthetic valves on anticoagulation at the peak of the cold harmattan season. Before their death, despite dose reduction, the International Normalised Ratio (INR) kept increasing and they were reported to have died suddenly at home. This triggered the need to draw attention of clinicians especially in the tropics to this difficulty, so as to anticipate and confront it when necessary. Case 1 was a 42-year-old male hypertensive on life-style measures with Moduretic once daily and weekly 20 mg Propranolol to control his blood pressure. He had surgery in India for aortic aneurysm with placement of prosthetic valve in 2013, and was placed on an oral anticoagulant - Acitrom. In 2015 while on 3 mg daily dose, he had an INR of 2.8. By October, INR rose to 3.95 prompting a dose reduction to 2 mg daily. Early in January 2016 (peak of cold harmattan season), the INR went higher to 4.19. He was asked to skip doses on Saturday and Sunday. After a forthnight he was reported to have died suddenly at home and no autopsy was done. Case 2 was a 40-year-old female with mitral stenosis. She had mitral valve surgery with prosthetic valve placement in India in 2010 where she was put on warfarin. In 2015, she had episode of ecchymosis and INR returned 2.07. With dose reduction, the INR dipped to 1.21 prompting a dose increase to 6 mg. The INR increased to 2.73. By October of 2015, her INR rose to 3.72, prompting de-escalation to 5 mg daily. While on this, she presented in a peripheral centre with haemoptysis where her Warfarin was further de-escalated and Co-trimoxazole prescribed. Again, within a fortnight she was reported to have died suddenly; and no autopsy was done The curious similarity here is the increasing INR despite anticoagulant de-escalation in the cold harmattan season. This experience has not been reported locally to the knowledge of the author. Some workers have reported that clotting times are longer with cold; clotting times being 3 times longer at 27 degrees Centigrade than 37 degrees.1 The phenomenon of decreasing temperature progressively delaying thrombus initiation began at 30 degrees Centigrade, progressing rapidly below that; and reaching statistical significance at 24 degrees.2 However, significant inter-individual variability in this response has been observed and explains conflicting result of studies on this subject.3 One could understand, therefore, why such observation may be made in Jos where harmattan temperatures can drop to single digits.
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PMID:Anticoagulation During the Cold Harmattan Season:Need for Extra Caution. 3318 71