Effect of bisoprolol and atenolol on endurance exercise capacity in healthy men.

OBJECTIVES: To compare the effects of a highly beta1-selective adrenoceptor antagonist bisoprolol with those of atenolol and placebo on endurance exercise capacity in young, healthy male volunteers. DESIGN: Twelve subjects randomly received oral placebo, atenolol (100 mg/day) or bisoprolol (10 mg/day) for 3 weeks, following a double-blind cross-over design. METHODS: At the end of each period, the subjects performed an endurance exercise test on the bicycle ergometer at 70% of maximal aerobic power. Cardiac output was measured by means of an automated CO2-rebreathing method. Venous blood was sampled before, during and after exercise. RESULTS: Exercise duration was not significantly different between the two drugs tested. Total exercise duration was significantly reduced by bisoprolol (-19.4 +/- 6.7%, P< 0.01) (mean +/- SEM) and by atenolol (-29.8 +/- 6.6%, P< 0.001), compared with placebo. Atenolol and bisoprolol were equally effective in lowering resting plasma renin activity, heart rate and systolic blood pressure. Resting and exercise stroke volume were significantly increased by both drugs, so that cardiac output was not significantly affected. Both drugs induced significant decreases in plasma-free fatty acid concentrations during recovery and blunted the exercise-induced increase. There were no significant relationships between the reduction of exercise duration and the haemodynamic changes or the degree of impairment of the exercise-induced increase in free fatty acid release resulting from beta-blockade. CONCLUSIONS: It is concluded that both drugs affect endurance exercise capacity in young, normotensive men, with a tendency to a smaller reduction during bisoprolol treatment. Haemodynamic variables are unlikely to be involved in the reduction of endurance exercise capacity. The role of the reduced availability of plasma free fatty acids remains unclear.

A quantitative biometrological assessment of acne and hormonal evaluation in young women using a triphasic low-dose oral contraceptive containing gestodene.

OBJECTIVE: To investigate the effect of a triphasic low-dose oral contraceptive pill containing gestodene on acne severity and hormone levels in young women over 13 menstrual cycles. METHODS: A total of 33 subjects aged 16-25 years with moderate facial acne were enrolled in the study. The primary efficacy end-points used in the clinical assessment of acne were the overall severity and number of lesions, sebum secretion and superficial follicular biopsy. Both physicians and patients evaluated acne status. Blood levels of sex hormone binding globulin (SHBG), estradiol, progesterone and androgens were monitored. RESULTS: By cycle 13, the total lesion count had been reduced by 80%. Physicians and patients assessed acne status in 90% and 95% of cases, respectively, as better or much better (p < 0.001). At the end of the study, SHBG levels had increased by 229% and total and free testosterone levels had decreased by 41% and 70%, respectively. CONCLUSION: An oral contraceptive containing triphasic gestodene has a beneficial effect on the severity ofacne, decreases major circulating androgen levels and is well tolerated.

Pneumococcal vaccination by general practitioners: an evaluation of current practice.

During the first two years following registration of the 23-valent pneumococcal vaccine in Belgium, the numbers of doses administered were 166 and 211 per 10,000 inhabitants, representing a vaccination coverage of nearly 20% of the recommended target population as defined by the High Council for Public Health. The time course of vaccine use showed a seasonal variation with up to 74 and 85% of the doses administered from September through November in 1996 and 1997, respectively. Vaccination practices by general practitioners and the profile of the patients who received the pneumococcal vaccine were studied during the September through December period each year. Among the 18,236 patients included, 82% were above 60 years of age (mean age 69.5 years). The main indications for vaccination were chronic bronchopulmonary disease (41%) and cardiovascular disorders (26%). Age as the sole criterion was mentioned for only 17% of vaccine recipients. Sixty percent of the patients received influenza vaccine concomitantly. The intensity of the mass media campaign correlated with the public awareness of the national recommendations. These observations provide insight into current practices for pneumococcal vaccination in Belgium and suggest opportunities for future vaccination campaigns.

Antagonizing the effects of experimentally induced sleep disturbance in healthy volunteers by lormetazepam and zolpidem.

The effects on sleep of two well known hypnotics, lormetazepam and zolpidem, during experimentally induced environmental noise were compared with placebo. In a double-blind, crossover study, 12 normal volunteers were subjected to prerecorded traffic noise with a mean noise level of 52 dB(A) and peaks to 77 dB(A) continuously for 8 hours in bed. Both hypnotics increased total sleep time, predominantly stage 2 sleep. A significant decrease in the number of sleep stage transitions, arousals, and awakenings longer than 3 minutes was found only with lormetazepam. No significant effects on rapid eye movement (REM) and slow wave sleep were observed. Latencies to persistent sleep and REM sleep onset were not different for either active treatment compared with placebo. Only after lormetazepam was performance on the morning reaction time test significantly affected. However, no differences were found in the subjective sleep quality and alertness ratings. Changes in the distribution of sleep stages throughout the night were related to the elimination half-life characteristics of the hypnotics, but few trends were detected. Both the protective properties against environmental noise of the hypnotics studied and the validity of the model of induced sleep disturbance in evaluating hypnotic agents are discussed.