Search PubMed⌕ Search

Biomedical subjects

A Pelech

Publications and source records attributed to A Pelech.

8 recordsLinked to original sources
PubMed1996

Stroke volume during exercise in cystic fibrosis.

Previous studies comparing cardiac output (Q) and stroke volume (SV) between cystic fibrosis (CF) patients and control subjects have shown conflicting results: some found lower SV in CF patients with severe airflow limitation, and others showed no difference between CF and control subjects. Methodologic problems could explain these discrepant findings. The aim of this study was to better characterize Q and SV with exercise in CF patients with mild as well as severe airflow obstruction. Subjects included 18 CF patients with FEV1 ranging from 28 to 80% of predicted without pulmonary hypertension, and 16 matched control subjects. Cardiac output was measured at three levels of upright cycle exercise using the indirect Fick (CO2) method with blood gas sampling. Q on exercise was similar among control and CF subjects. SV was lower in CF patients, particularly those with FEV1 < or = 55% predicted, than in control subjects. Stepwise regression of SV on height, percent ideal body weight, and FEV1 showed a significant effect of relative underweight on SV. Despite this, well-nourished patients with FEV1 56 to 80% of predicted also had lower SV. As these findings were consistent across the range of severity of lung disease and age, even in the absence of malnutrition, they imply that another mechanism accounts for SV limitation during exercise in CF.

Adolescent↗
PubMed1990

Fetal echocardiography in Manitoba: a regional perspective.

In order to investigate the impact of detailed fetal echocardiography on perinatal care at a tertiary health care centre, the records of all 29 cases referred for fetal echocardiography during the years 1987-88 were reviewed. All patients had risk factors for offspring with congenital heart disease. A family history of congenital heart disease led to fetal echocardiography in about two-thirds of the cases, while the remainder were referred on the basis of abnormal cardiac screening examinations during fetal assessment. Forty examinations were performed on patients at gestational ages of 16 to 37 weeks. Detailed fetal echocardiography did not alter the perceived severity of major structural cardiac defects previously identified by an experienced fetal assessment unit and did not change or influence intrapartum care. The value of fetal echocardiography in the diagnosis and treatment of fetal tachyarrhythmias was confirmed. Also, fetal echocardiography provided reassurance of cardiac normality in cases with familial and maternal risk factors for congenital heart disease. Fetal echocardiography appears to be an inappropriate screening tool in view of its limited availability and focus. Comprehensive fetal assessment with four chamber cardiac imaging is the appropriate first-line screening test for patients with risk factors for offspring with congenital heart disease.

Echocardiography↗
PubMed1988

Thoracic electric bioimpedance measurement of cardiac output in the newborn infant.

To evaluate thoracic electric bioimpedance as a noninvasive method for measuring cardiac output, we compared the bioimpedance measurements with those obtained by means of the thermodilution indicator cardiac output technique in seven preterm and term lambs; we also studied 17 term and preterm infants. Sixty-seven simultaneous bioimpedance and thermodilution cardiac output measurements were obtained in the animals after intravascular volume expansion (saline solution infusion) and contraction (phlebotomy). A significant correlation between the cardiac output measurements by the two methods (0.82; p less than 0.001) was observed. In neonates, the observed cardiac output was 198 +/- 46 ml/kg.min in the preterm infants and 178 +/- 46 ml/kg.min in the term infants. Extrapolating animal data to the neonates, we found the thoracic segment length recommended (the average of 29% of body length and electrode distance) to be accurate. These data indicate that bioimpedance cardiac output measurement (1) is comparable to measurement by the thermodilution indicator technique in the newborn animal and (2) may be suitable for use in infants and children.

Animals↗
PubMed1985

The progressive nature of subaortic stenosis in congenital heart disease.

Data derived from serial hemodynamic and angiocardiographic investigations on pediatric patients not subjected to intervening intracardiac operations support the view that subaortic stenosis in congenital heart disease tends to be a progressive disorder. Our data are obtained from two groups of patients. The first comprised 22 patients with discrete subaortic stenosis in relative isolation. The second was made up of 19 patients with the fibrous or fibromuscular forms of discrete subaortic stenosis associated with a perimembranous ventricular septal defect. The results from both groups support our initial contention. The progressive character of subaortic stenosis in these two situations illustrates the dynamic nature of congenital heart disease, and the tendency of a changing form and function.

Angiocardiography↗
PubMed1984

Bilateral ductus arteriosus (or remnant): an analysis of 27 patients.

Bilateral ductus arteriosus (DA) was clinically recognized in 27 patients studied angiographically from 1963 through May 1983. Distal bilateral DA origin of non-confluent pulmonary arteries was identified in 15 patients, ectopic or distal ductal origin of 1 pulmonary artery in 9 patients (5 without evidence of intracardiac disease) and isolation of the left subclavian artery in 3 (all 3 of whom had a right aortic arch). Other conditions reported to be associated with bilateral DA include interruption of the aortic arch with isolation of a subclavian artery, aortic atresia with interruption of the aortic arch in which bilateral DA supports the entire systemic circulation, bilateral DA complicating forms of congenitally malformed hearts other than those just stated, and, rarely, bilateral DA in isolation. Understanding the symmetric or paired nature of the primitive aortic arch system in the developing human heart facilitates recognition of the patterns of fourth and sixth arch anomalies seen with bilateral DA.

Angiography↗
PubMedDate not supplied

Implantable cardioverter defibrillator therapy in children with long QT syndrome.

We report our experience with implantable cardioverter defibrillator (ICD) implantation and follow-up in high-risk patients with congenital long QT syndrome (LQTS). Congenital LQTS is associated with significant risk of malignant ventricular arrhythmias and sudden cardiac death (SCD). ICD implant is recommended for prevention of SCD in this patient population, but there are few published data regarding the efficacy and side effects of such therapy. We report our experience with 12 patients who underwent ICD implant for high-risk LQTS at our center in the past 5 years with respect to implant complications, appropriate and inappropriate therapies, device follow-up, and the impact on lifestyle. During a follow-up of 34.7+/-16.6 months, appropriate therapies were noted in 5, inappropriate therapies in 4, and no therapies in 3 patients. Clusters of appropriate therapies were seen in 3 patients, 1 of whom subsequently died. Female sex and congenital deafness appear to be associated with a higher risk of appropriate therapies. One patient experienced two complications at implant that were successfully treated. ICD implantation in LQTS patients presenting with SCD or recurrent syncope despite beta-blocker therapy appears to be justified in preventing SCD risk. In asymptomatic siblings of SCD patients, the benefits of ICD implant are not clear from our data.

Adolescent↗
PubMedDate not supplied

Public awareness of the risks of drinking alcohol during pregnancy: the effects of a television campaign. Child Health Committee, Manitoba Medical Association.

OBJECTIVE: To evaluate the impact of a television public awareness campaign on knowledge of the dangers of drinking alcohol during pregnancy. DESIGN: A survey with five questions on alcohol and pregnancy and five health questions unrelated to alcohol was administered before and after the campaign. PARTICIPANTS: Three thousand women aged 15-45 years. INTERVENTION: A 30-second announcement with a message on alcohol and pregnancy was broadcast over ten weeks by five television stations in Manitoba. RESULTS: More respondents after the campaign thought that alcohol consumption in pregnancy would put the baby at risk, and attributed this information to "television". There were no differences in the responses to the five health questions unrelated to alcohol. CONCLUSIONS: An increase in awareness of the risks of drinking alcohol during pregnancy was observed after a mass media campaign.

Adolescent↗