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Biomedical subjects

A Thomson

Publications and source records attributed to A Thomson.

At least 163 records · Page 9Linked to original sources
PubMed1990

Cisapride and cimetidine in the treatment of erosive esophagitis.

The efficacy of cisapride, as compared with cimetidine, in the treatment of erosive esophagitis was studied in a double-blind trial. One hundred and twenty-nine patients were assigned to one of four dosage schedules: cisapride 10 mg b.i.d. (20 mg group) or q.i.d. (40 mg group), or cimetidine 400 mg b.i.d. (800 mg group) or q.i.d. (1600 mg group). Treatment lasted 8 to 12 weeks. The degree of esophagitis and the severity of diurnal and nocturnal heartburn and regurgitation were significantly (p less than 0.01) reduced in the four treatment groups. Endoscopy did not show any significant differences among the four groups, although cisapride tended to be more effective in moderate to severe esophagitis, in which cases mucosal healing (i.e. absence of erosions and ulcers) was observed in 69%, 64%, 55% and 55% of the patients treated with cisapride 40 mg, cisapride 20 mg, cimetidine 1600 mg and cimetidine 800 mg. Improvement in reflux symptoms in the two cisapride groups was not significantly different from that in the cimetidine 1600 mg group, but was better (p less than 0.05) than that in the cimetidine 800 mg patients. The severity score for all reflux symptoms had decreased by 79%, 74% (cisapride 40 mg and 20 mg), 69% and 57% (cimetidine 1600 mg and 800 mg) by the end of treatment. These results show that cisapride is at least as effective as acid-suppressing therapy in patients with reflux esophagitis, and is therefore a valuable alternative to it.

Cimetidine↗
PubMed1989

Computerized electrocardiographic interpretation: an analysis of clinical utility in 5110 electrocardiograms.

This study describes the initial experience with a computerized electrocardiographic interpretation system in a teaching hospital. The sensitivity and specificity of the 13,375 diagnostic statements that were used to describe the first 5110 electrocardiograms were analysed to determine the predictive accuracy of computerized electrocardiographic interpretation. Reviewing cardiologists inserted 1320 statements, deleted 1792 statements and modified 484 computerized statements. The over-all sensitivity and specificity (and standard error [SE]) of computerized diagnosis was 90.1% +/- 0.3% and 89.6% +/- 0.2%, respectively, with an over-all positive predictive accuracy (+/- SE) of 87.1% +/- 0.3% and a negative predictive accuracy (+/- SE) of 92.2% +/- 0.2%. Sensitivity and specificity were lowest for the category of ST-T wave changes (83.1% +/- 0.8% and 84.1% +/- 0.7%, respectively) and were highest for the category of sinus rhythm (96.6% +/- 0.3% and 97.0% +/- 0.6%, respectively). The positive predictive accuracy of computerized diagnosis was lowest for the category of hypertrophies (74.2% +/- 1.0%) and was highest for the category of sinus rhythm (99.5% +/- 0.1%), while for the category of myocardial infarctions it was 87.6% +/- 0.8%. The negative predictive accuracy ranged from 96.7% +/- 0.3% for the category of hypertrophies to 81.8% +/- 1.3% for the category of sinus rhythm. We conclude that the computerized analysis of electrocardiograms has a satisfactory predictive accuracy when used in an environment with a high prevalence of abnormalities. Electrocardiograms that are classified as normal by computerized analysis may not require checking; however, all electrocardiograms with abnormalities should be interpreted by a competent electrocardiographer.

Cardiology↗
PubMed1989

Exercise stress-induced changes in systemic arterial potassium in angina pectoris.

Large fluctuations in systemic arterial potassium have been found during and after exercise in normal subjects. To determine whether similar changes occur in patients with angina pectoris, arterial potassium levels were measured before, during and immediately after maximal bicycle exercise in 20 patients with exertional angina. In 10 of these patients, leg blood flow and arteriovenous potassium levels also were measured. During exercise, arterial potassium increased significantly both from rest to submaximal exercise (4.3 +/- 0.1 to 4.7 +/- 0.1 mmol/liter, p less than 0.01) and from submaximal to maximal exercise (5.4 +/- 0.1 mmol/liter, p less than 0.01). Within 1 minute of cessation of exercise, arterial potassium had decreased to 4.7 +/- 0.1 mmol/liter (p less than 0.001) and continued to decrease to a minimum of 4.1 +/- 0.1 mmol/liter between 3 and 5 minutes after exercise, significantly less than the rest value (p less than 0.05). At maximal exercise (99 +/- 9 watts), the calculated release of potassium from each leg reached 2.7 +/- 1.3 mmol/min. Four minutes after exercise, the leg muscles were resorbing potassium at 0.24 mmol/min. In these patients with exertional myocardial ischemia, the magnitude and rapidity of arterial potassium changes during and after exercise resemble those found in normal subjects, but occurred at much lower workloads. Release and resorption of potassium by exercising muscle in patients with angina pectoris may cause potentially arrhythmogenic arterial potassium fluctuations.

Adult↗
PubMed1989

Effects of nisoldipine on systemic and leg blood flow, oxygen transport and metabolism, and hemodynamics during exercise in effort angina pectoris.

The acute effects of 10 mg of oral nisoldipine on hemodynamics, oxygen transport and metabolism, and distribution of cardiac output, at rest and during semiupright bicycle exercise, were evaluated in 10 men with effort angina receiving long-term beta 1 blockade. Cardiac output and leg blood flow were measured using the thermodilution technique. At rest, nisoldipine decreased systemic resistance from 18.9 +/- 1.0 to 15.9 +/- 1.2 dynes.s.cm-5.10(2) (p less than 0.05) and cardiac output increased from 4.8 +/- 0.2 to 5.3 +/- 0.3 liters/min (p less than 0.05) without changing leg blood flow. During maximal exercise with nisoldipine, systemic resistance was reduced (10.6 +/- 0.9 to 8.6 +/- 0.5 dynes.s.cm-5.10(2), p less than 0.05) and cardiac output increased 18% (10.3 +/- 0.7 to 12.2 +/- 0.6 liters/min, p less than 0.05) when compared with control values. Exercise heart rate was higher with nisoldipine (113 +/- 4 vs 106 +/- 4 beats/min, p less than 0.01), but the mean arterial pressure was not significantly changed, giving a higher rate-pressure product. The increase in mean pulmonary artery wedge pressure was attenuated (26 +/- 3 vs 30 +/- 3 mm Hg during control exercise, p less than 0.05), but ST depression was unaltered. Exercise leg flow was reduced by nisoldipine from 4.3 +/- 0.4 to 3.9 +/- 0.3 liters/min (p = 0.07) and the proportion of cardiac output distributed to the legs was reduced from 42 +/- 3 to 33 +/- 3% (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Crisis on the streets.

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Acquired Immunodeficiency Syndrome↗
PubMed1989

Growth of rubella virus in a glass bead propagator.

A glass sphere propagator with an air lift pump to circulate the medium, has been successfully used to produce large volumes of rubella virus. The system was productive, flexible and easy to operate.

Animals↗
PubMed1989

A woman's lot.

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Female↗
PubMed1989

Two dimensional echocardiography and left ventriculography in cardiac sarcoidosis.

A 48-year-old woman with histologically proven pulmonary sarcoidosis presented with congestive heart failure. Two dimensional echocardiography showed a peculiarly ragged appearance at the left ventricular apex which was confirmed on left ventriculography. This echocardiographic finding has not been previously described in cardiac sarcoidosis.

Cardiomyopathies↗