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Biomedical subjects

D Bialostozky

Publications and source records attributed to D Bialostozky.

At least 37 records · Page 2Linked to original sources
PubMedDate not supplied

[Study, using non-invasive methods, of prostheses manufactured at the Instituto Nacional de Cardiología Ignacio Chávez].

We study the phonocardiogram, M mode, two-dimensional and Doppler pulsed echocardiogram of 30 patients, who underwent implantation of a bovine pericardial bioprosthesis manufactured at the Instituto Nacional de Cardiología Ignacio Chávez. We describe 26 patients with prosthesis in mitral position, 22 females and 4 males, with age between 19 to 60 years. After surgery, 22 were in functional I and 2 in class II of the New York Heart Association Criteria. Two patients (6.6%) died of extracardiac complications. Phonocardiogram: Mitral prosthesis closing click (MPCC) were recorded at all, the interval Q wave-MPCC was of 0.09 +/- 0.02 sec. The interval second sound-mitral prosthesis opening click (S2-MPOC) measured 0.10 +/- 0.01 sec. Mid-diastolic murmur were recorded in 8 patients (30.7%). The O-F slope of the apexcardiogram was of 82 +/- 40 mm/sec. Ten patients had tricuspid insufficiency. Echocardiogram: The D-E velocity of mitral prosthesis opening was of 318 +/- 99 mm/sec and the E-F slope velocity of 15 +/- 6.2 mm/sec. All patients except one showed paradoxical motion of the intraventricular septum. The prosthesis stents distance was of 14.1 +/- 2 mm, the internal diameter of 17.8 +/- 2.9 mm and the valvular area was calculated in 2.5 +/- 0.08 cm2. The flow velocity/diameter was 62.6 +/- 26.8 cm/sec/mm and the flow velocity/opening area of 52.5 +/- 26.1 cm/sec/cm2.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Pulmonary eosinophilia and pulmonary arterial hypertension].

Pulmonary artery hypertension is a rare feature in the eosinophilic pulmonary syndrome, it had been observed only in some cases of tropical pulmonary eosinophilia. A case of prolonged pulmonary eosinophilia with reversible pulmonary hypertension is presented.

Humans↗
PubMedDate not supplied

[Pneumonitis caused by hypersensitivity to the antigen(s) of pigeons. I. Clinical study].

We studied twenty six patients with hypersensitivity pneumonitis due to pigeon antigens (pigeon breeder's disease). This insidious illness, causes an interstitial lung disease, with restrictive pattern and also pulmonary hypertension. Most of the cases showed circulating antibodies against pigeon serum proteins, polyclonal hypergammaglobulinemia and rheumatoid factor. Treatment based on avoidance of pigeon droppings and glucocorticoids gave good results.

Adolescent↗
PubMedDate not supplied

[Clinical and coronary angiographic characteristics of hypertensive angina].

The sample studied consisted of 46 patients with systemic hypertension. Of these, 21 had angor pectoris and constituted group I; 12 showed left ventricular hypertrophy, constituting group II; the other 13 subjects did not have complications and they formed group III. All patients, aside from the usual clinical evaluation, were submitted to exercise electrocardiography, coronary angiography and cineventriculography. The average age of patients in group III was lower than in the others (38.6 +/- 8.4 years), and so was the percentage of smokers (15.3%), and of patients with diabetes (23.0%). The number of smokers in group II represented 41.3% and in group I, 38%. The percentage of patients with diabetes was 33.3% in group II and 52.3% in group I. Pain in the patients of group I had the following characteristics: retrosternal pain was present in all cases, while referred pain to the neck and left arm appeared in 61% of the subjects. In 66.3% of the individuals the pain lasted between 5 and 15 minutes. In 52.3% of the group, pain was not always related to effort, but appeared also at rest. Temporal periodicity was present in 52.7% of the patients. Also in group I, 95.2% of the cases had a depression of the S-T segment in the leads corresponding to the anterior aspect of the left ventricle. In 86.6% of the subjects, there was a positive exercise test. The Sokoloff's index was 26.4 +/- 7.9 mm. In 75% of the subjects in group II, a depression of the S-T segment was present, and a positive exercise test was found in 50% of them. Their sokoloff's index was 26.7 +/- 6.4. None of the patients in group III had depressions of the S-T segment and 20% resulted with a positive exercise test. Their sokoloff's index was 13.3 +/- 2.9. The coronary angiography results showed stenosis in 28% of the subjects in group I and tortuosity of the vessels was apparent in 94.8% of them. None of the patients of group II and III had stenosis of the coronaries, but tortuosity was observed in 74.9% of the individuals in group II and in 69.1% of the cases in group III. Based in these data we conclude that there is a type of angor pectoris in hypertensive subjects which is related to hypertrophy of the left ventricle, but not to coronary stenosis. The management of this type of patient should be different to the regular one.

Adult↗
PubMedDate not supplied

[Usefulness of echocardiography in the diagnosis of infectious endocarditis].

Thirty-four patients with clinical diagnosis of infective endocarditis were studied with M mode and/or two-dimensional echocardiography. of them. Twenty-two were men; their ages ranged from 9 to 67 years. In 23 cases surgical or post mortem confirmation of the echocardiographic diagnosis was obtained. The clinical features as well as history of previous cardiopathy (94.1%) and its type (congenital 38.2%, rheumatic 29.4%, rheumatic with valvular prosthesis 23.5%) were analyzed. In the 23 patients with proven endocarditis, the echocardiographic diagnosis was positive in 19 (82%); vegetations were evident in 13. In 6 patients vegetations were not found. There were 3 false positive cases and one false negative, giving a sensitivity of 0.81 and a specificity of 0.85. The causes of false negative and false positive findings were analyzed. These were closely related to the duration of the disease and time which elapsed between the echocardiographic study and confirmation in surgery or necropsy as well as the size of the vegetations. The echocardiographic diagnosis was difficult when a valvular prosthesis was present. Echocardiography is a useful technique for diagnosis and follow up of patients with infective endocarditis.

Adolescent↗
PubMedDate not supplied

[Acquired systemic arteriovenous fistulas. Experience of 33 cases].

We analyzed 33 cases of Acquired Systemic Arteriovenous Fistulas (FAVSA) seen in the INC-ICH between 1945 and 1981. The most frequent causes were traumatic (gunshot and knife wounds) and iatrogenic (surgery). The most affected vessels were femoral, carotid, axillary and subclavian. The FAVSA produced a hyperkinetic hemodynamic syndrome of high output that frequently resulted in fistular cardiopathy. Fistular cardiopathy and heart failure became evident from 4 days to 31 years after the initial insult and was related to the magnitude of the arteriovenous shunt. The latter depended on the distensibility of the communicating ring (the development of perifistular fibrosis did not allow dilatation of the fistular opening). Heart failure was a result of the magnitude of the shunt, even when the patient was young with a healthy heart. A detailed traumatic or surgical history was extremely important in the diagnosis. Relevant physical signs included: bounding pulses, a wide pulse pressure, the presence of a continuous murmur and thrill, a positive Nicoladoni-Branham's sign with a decrease in the heart rate and an increase in systemic blood pressure when the FAVSA was compressed. The existence of the condition became suspicious when heart failure appeared otherwise unexplained by an obvious cardiac lesion. Other important signs included the development of distal venous insufficiency and the presence of a palpable pulsatile mass. Fistular cardiopathy was observed in 60% of the cases studied, although the ECG was normal in 33%; 73% had cardiomegaly which improved with correction of the FAVSA. The treatment is necessarily surgical and required the appropriate technique.

Adolescent↗
PubMedDate not supplied

[Pulmonary arterial hypertension of unknown etiology. Study of the cardiopulmonary function].

Thirty two cases of pulmonary arterial hypertension of unknown etiology (PAH-UE) were studied. The diagnosis was established by exclusion after the results of hemodinamics studies. Ninety percent of cases had severe PAH (100 mmHg). The end diastolic right ventricular pressure was elevated in 46% of cases. The total pulmonary vascular resistance was increased in the order of the 1700 dinas. seg. cm-5. The cardiac index was 3.3 1/m2 with a right ventricular work index of 3.96 K gm min. The total lung capacity (TLC) was normal, with a vital capacity (VC) of 78% of the predicted value. The residual volume was increased. The mean value of the maximal midexpiratory flow rate (MMFR) was 78%. The A-a gradient of O2 was 30 mmHg, with a venous mixture expressed as a percentage ratio of the cardiac output (Qva/Qt) of 26%. The mean paO2 mmHg and the anatomical pulmonary artery to vein shunt (Qs/Qt) was 9%, with a DLco normal. The clinical hemodinamic correlation was in good agreement. Our results suggested that PAH-UE "per se" has effect in pulmonary function changing slight lung mechanics, and in a moderate degree lung gas exchange. The hipoxemia results meanly from V/Q imbalance.

Adolescent↗
PubMedDate not supplied

[Respiratory function in extrinsic allergic alveolitis caused by pigeons. Clinical, pathological and functional correlation].

Lung function tests (LFT) were performed in 71 patients with proven extrinsic allergic alveolitis due to pigeons (EAA-P), and they were correlated with lung biopsy (LB) findings. Lung function studies were analyzed to evaluate the clinical course of these patients treated with corticosteroids. Restrictive pulmonary function impairment was found in all cases (vital capacity 38 +/- 4%), residual volume was increased in 9 out of 14 patients (64%) (RV = 0.51 +/- 0.06 L.) and bronchial obstruction was a feature in 11/14 patients (78%) (MMEF = 53 +/- 4%). In all cases a low Pa02 was observed (44 +/- 2 mmHg) and in six an increase in PaC02 was detected. The vital capacity did not correlate with the degree of inflammation or fibrosis observed by LB. A significant negative correlation was found between Pa02 and the degree of inflammation (r = 0.68, p X 0.05) as well as with fibrosis + inflammation degrees (r = -0.63, p less than 0.05). In general, initial LFT and clinical improvement occur simultaneously. Lung function tests support the diagnosis of EAA-P, but are not capable of separating inflammation from lung fibrosis.

Adolescent↗