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Biomedical subjects

A Oriol

Publications and source records attributed to A Oriol.

At least 55 records · Page 3Linked to original sources

Five years of angiographic and clinical follow-up after successful percutaneous transluminal coronary angioplasty.

The first 67 consecutive patients (77 lesions) who underwent successful coronary angioplasty (PTCA) at our hospital were clinically followed with serial exercise testing over a 5-year (4 to 7) observation period. Two sequential angiographic controls were performed 6.9 +/- 4.6 (64 patients) and 49.5 +/- 21.6 (42 patients) months after PTCA. The 5-year risk of cardiac death was 8%, of myocardial infarction 2%, or coronary artery bypass grafting 16% and of repeat PTCA 8%. At 5 years, 67% of the patients remain asymptomatic. Restenosis greater than or equal to 70% diameter was observed within the first year after PTCA in 30% of the patients. Progression of coronary artery disease (CAD) was observed in 13 patients (20%). In the first angiographic control, CAD progression was 4% (3/77) in dilated and 3% (3/115) in non-dilated arteries (ns). In the second angiographic control, it was 7% (3/45) and 10% (8/81), respectively (ns). Thus good clinical and angiographic results are still observed after 5 years. Restenosis is an early, self-limited, time-restricted phenomenon that occurs in 30% of patients. Angioplasty does not appear to accelerate CAD progression.

Angina Pectoris↗

Gardnerella vaginalis and mosaic colposcopic pattern of the cervix: casual or causal association?

We made a retrospective study of the flora found in the vaginal smears of sexually active women who presented with a mosaic colposcopic pattern of the uterine cervix in an attempt to study some of its epidemiologic factors. Of the 195 cervicovaginal cytologies of patients with mosaic, 61 revealed an abnormal flora (31.2%) while of the 9,856 patients without mosaic, only 2,234 cytologies had an abnormal flora (22.7%) demonstrating a statistically significant higher frequency (p less than 0.0001) of an abnormal flora in women with a mosaic pattern on the cervix. A statistically significant association (p less than 0.02) was encountered between the presence of Gardnerella vaginalis and the mosaic colposcopic pattern, and surprisingly a statistically greater frequency (p less than 0.05) of biopsied dysplasias in the same group. At the moment we can interpret these observations as nothing more than interesting initial findings.

Adult↗

Hemodynamic evaluation of the integral monostrut Björk-Shiley prosthesis in the aortic position.

Between May, 1983, and November, 1984, the new integral monostrut Björk-Shiley prosthesis was used for aortic valve replacement in 62 patients. The prosthesis is machined from a solid piece of cobalt alloy and has no welded joints. The traditional U-shaped outlet strut has been replaced by a projecting metal finger that holds the disc in place. The disc opens to 70 degrees and is convexoconcave. Successful transseptal heart catheterization was performed in 23 patients an average of 6 months following operation to evaluate the hemodynamic performance of the prosthesis. The mean peak-to-peak gradient was 7.73 +/- 7.49 mm Hg (+/- standard deviation). In five valves it was 0, and in only three was it higher than 15 mm Hg. Significant peak gradients were directly related to the valve index (valve area/body surface area). Mean systolic gradient at rest was 12.7 +/- 6.27 mm Hg and did not increase after exercise. Effective orifice areas were adequate, and the discharge coefficient ranged from 0.77 for the 21-mm prosthesis to 0.48 for the 29-mm prosthesis. Minimal regurgitation, which was washed out on the next systole, was observed with all sizes of the prosthesis. Disc opening was maximal (70 degrees) in all but one of the observed instances. Longer clinical follow-up is required, but the new integral monostrut Björk-Shiley prosthesis, with its important design changes and excellent hemodynamic performance, appears to be a promising aortic valve substitute.

Adult↗

Haemodynamic effects of molsidomine in patients with severe chronic coronary disease.

The haemodynamic effects of a single dose of intravenous molsidomine were assessed in 12 patients with severe coronary disease. The investigation was carried out at rest during angina induced by pacing and after molsidomine during pacing at the rate at which angina had been produced. During angina, left ventricular systolic and end-diastolic pressure rose, left ventricular stroke work fell and coronary flow and myocardial oxygen consumption increased by 58.3% above the control levels. After the administration of molsidomine, atrial stimulation was not followed by angina and there were no significant changes in systolic blood pressure. Left ventricular end-diastolic pressure fell sharply and coronary flow and myocardial oxygen consumption were only 38% and 33% higher, respectively, than the control levels. The beneficial effects of molsidomine in ischaemic heart disease, therefore, are the result of peripheral vasodilation which, by reducing the preload and afterload, lowers the oxygen requirements of the myocardium and thus increase the threshold for angina. A direct action on the coronary network can not be excluded but if such an action does exist it must be very small in the light of the marked systemic effect.

Adult↗