An Audit of Nifedipine in a Hypertension Clinic

Gill, Jaswinder; Zezulka, A. V.; Beevers, M.; Beevers, D. G.

doi:10.1111/j.1365-2710.1986.tb00834.x

Cited by 2 publications

(2 citation statements)

References 29 publications

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“…Our results do not provide clear evidence that age or race is a determinant of response with combined therapy, nor could we see such an effect for single or combined therapy with nifedipine in clinical practice. 22 We conclude that the administration of a diuretic to patients whose blood pressure is uncontrolled with nifedipine treatment does have further antihypertensive effect. Adverse metabolic changes are those that would be expected from this combination.…”

Section: Discussionmentioning

confidence: 96%

The Effects of Bendroflumethiazide Added to Nifedipine in Patients With Hypertension

Zezulka

Gill

Beevers

1987

The Journal of Clinical Pharma

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It has been suggested that a diuretic added to a calcium antagonist may not reduce blood pressure further in patients with hypertension. Bendroflumethiazide 5 mg was given to 17 patients with essential hypertension who had persistent mild to moderate hypertension despite treatment with nifedipine slow-release tablets 20 mg bid. One group received bendroflumethiazide before (N = 8) and the other after placebo (N = 9) in a double-blind, randomized cross-over trial. Supine blood pressure following active bendroflumethiazide administration was significantly reduced in both groups compared with trial entry (166/105 to 150/96 mm Hg, P less than .01; 170/108 to 156/98 mm Hg, P less than .01). A reduction in serum potassium level and a rise in serum uric acid concentration were seen with combined treatment. We cannot substantiate theoretic arguments for the ineffectiveness of a bendroflumethiazide-nifedipine combination on blood pressure.

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Section: Discussionmentioning

confidence: 96%

The Effects of Bendroflumethiazide Added to Nifedipine in Patients With Hypertension

Zezulka

Gill

Beevers

1987

The Journal of Clinical Pharma

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“…One finding of our model is that phage that are only partially effective in killing bacteria in vitro may still be effective in vivo due to the synergistic effect with the host immune response. Current screening of phage strains for phage therapy relies on in vitro killing [53,54]. As a consequence, phage strains of therapeutic value may be overlooked.…”

Section: Discussionmentioning

confidence: 99%

Synergistic elimination of bacteria by phage and the innate immune system

2016

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Phage therapy has been viewed as a potential treatment for bacterial infections for over a century. Yet, the year 2016 marks the first phase I/II human trial of a phage therapeutic -to treat burn wound patients in Europe. The slow progress in realizing clinical therapeutics is matched by a similar dearth in principled understanding of phage therapy. Theoretical models and in vitro experiments find that combining phage and bacteria often leads to coexistence of both phage and bacteria or phage elimination altogether. Both outcomes stand in contrast to the stated goals of phage therapy. A potential resolution to the gap between models, experiments, and therapeutic use of phage is the hypothesis that the combined effect of phage and host immune system can synergistically eliminate bacterial pathogens. Here, we propose a phage therapy model that considers the nonlinear dynamics arising from interactions between bacteria, phage and the host innate immune system. The model builds upon earlier efforts by incorporating a maximum capacity of the immune response and density-dependent immune evasion by bacteria. We analytically identify a synergistic regime in this model in which phage and the innate immune response jointly contribute to the elimination of the target bacteria. Crucially, we find that in this synergistic regime, neither phage alone nor the innate immune system alone can eliminate the bacteria. We confirm these findings using numerical simulations in biologically plausible scenarios. We utilize our numerical simulations to explore the synergistic effect and its significance for guiding the use of phage therapy in clinically relevant applications.

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An Audit of Nifedipine in a Hypertension Clinic

Cited by 2 publications

References 29 publications

The Effects of Bendroflumethiazide Added to Nifedipine in Patients With Hypertension

The Effects of Bendroflumethiazide Added to Nifedipine in Patients With Hypertension

Synergistic elimination of bacteria by phage and the innate immune system

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