[Current use of beta-blockers in coronary artery disease].

This article presents the results of a retrospective analysis of the use of beta-blockers and current dosing of these agents in patients with coronary artery disease. While 70 to 78% of patients admitted to Norwegian university hospitals during 1990-1997 for angiographic evaluation of chest pain used beta-blockers, only 43-60% of patients with stable coronary artery disease enrolled in the 4S study in Norway received such treatment. High risk groups such as diabetics and patients with peripheral artery disease were less likely to receive beta-blockers during the early period, but were not treated differentially compared to low risk patients during recent years.

[Serum digitoxin in concomitant use of antiepileptics in routine therapy].

Concomitant use of digitoxin and enzyme-inducing antiepileptics may lower serum levels, and accordingly the effect of digitoxin, unless the higher metabolic clearance is compensated for by higher dosage. Use of digitoxin is almost always guided by serum concentration measurements. Information on a possible enzyme-inducing effect of phenobarbital, phenytoin and carbamazepine is easily accessible.

[Heart rate variability. Parameters for risk stratification after myocardial infarction].

Reduced heart rate variability (HRV) is an independent risk factor after myocardial infarction, indicating higher risk of fatal and nonfatal arrhythmias and of cardiac death in general. Analysis of HRV is also a valuable tool in clinical research, providing a non-invasive measurement of fluctuations in sympathetic and parasympathetic activation. We expect increased use of these methods, since new 24-hour: ECG-monitoring equipment is to be delivered with software for HRV as an option.

[Reduced physical tolerance in patients with heart failure. Mechanisms and therapeutic effects].

Physical performance is markedly reduced in patients with congestive heart failure, but the reason has not been precisely defined. It has been generally assumed that reduced exercise performance is related to ventricular systolic performance, or as more recently suggested, to impaired left ventricular diastolic function. However, there is no clear relationship between the indices of left ventricular performance and exercise capacity, and there is a dissociation between improvement in haemodynamic parameters and exercise performance.

[Paracetamol--kidney and urinary tract. A cause of analgetic nephropathy or cancer?].

In Norway, the total consumption of non-opioid analgesics has not changed during the last ten years and was 36 defined daily doses/1,000 inhabitants/day in 1992. However, there has been a clear switch from acetyl-Salicylic acid (ASA) to paracetamol during this period. The consumption of phenazone is relatively high.

[Acute endocrinology].

The author presents a practical guide for diagnosis and management of some common emergencies. The most common are hypoglycaemia in persons with diabetes, diabetic ketoacidosis and non-ketotic hyperosmolar diabetic coma. Acute adrenocortical failure is also quite common.

[Loop-diuretics anno 1992. Mechanisms of effect and current therapeutic principles].

Loop-diuretics inhibit the Na+/K+/2Cl(-) -cotransport system in the thick ascending loop of Henle, and are the most potent of the diuretic agents. They also increase production of prostaglandins and, when given intravenously, reduce pulmonary capillary pressure. The clinical effects, and side effects, of loop diuretics are reviewed.