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Biomedical subjects

D S Blondheim

Publications and source records attributed to D S Blondheim.

13 recordsLinked to original sources
PubMed2001

Outcome of patients with post acute myocardial infarction ischemia hospitalized in intensive cardiac care units with and without on-site catheterization laboratories.

BACKGROUND: This study addresses the impact of availability of on-site catheterization laboratories on the 1-year survival of patients with post-acute myocardial infarction ischemia (P-AMI-I), a high-risk subgroup of AMI patients. METHODS: A prospective 5 month national survey was conducted in 1996 in all operating intensive care units (ICCUs) in Israel (N=26) and included 2377 patients. Four hundred and three (17%) had P-AMI-I, 317 of them were admitted to 18 ICCUs with on-site catheterization laboratories (CATH+) and 86 patients to 8 ICCUs without such facilities (CATH-). A retrospective analysis was performed comparing the in-hospital course and 7 day, 1 month and 1 year mortality data of CATH+ vs. CATH- patients. RESULTS: Patient characteristics in both groups were similar with regard to age, gender AMI location, risk factors, hemodynamic parameters on admission and rate of thrombolytic therapy. Of patients in CATH+, 79% were catheterized before hospital discharge vs. 42% in CATH- (P<0.0001), 45 vs. 15% had PTCA (P<0.0001) and 19 vs. 9% had CABG (P<0.05). At 30 days, patients in CATH+ still had significantly more revascularization procedures (71 vs. 48%, P<0.001). Patients hospitalized in ICCUs with CATH+ and CATH- facilities had similar cardiac mortality rates at 7 days (2.0 vs. 2.3%), 30 days (5.7 vs. 4.7%) and at 1 year (7.6 vs. 7.0%). CONCLUSIONS: Despite a more invasive strategy used during the index hospitalization of patients with P-AMI-I hospitalized in CATH+ ICCUs, their survival was similar to CATH- patients at 7 days, 30 days and at 1 year follow-up.

Aged↗
PubMed2001

The dietary composition of pre-fast meals and its effect on 24 hour food and water fasting.

BACKGROUND: Fasting is required by the Jewish and Islamic religions, and may sometimes be necessary for non-religious reasons as well. Very little empiric data are available on the effect of 24 hours of food and water deprivation. OBJECTIVES: To compare the effects of the dietary composition of different pre-fast meals on subjective discomfort and various other parameters of a 24 hour food and water fast. METHODS: Thirteen volunteers of both genders participated in a non-randomized crossover study. Each consumed three different equicaloric pre-fast meals in which the main source of calories was protein (49% of calories), carbohydrate (86%), or fat (69%). Weight, heart rate, blood pressure, blood and urine were tested before and after 24 hours of fasting, and the subjective evaluations of the discomfort during the three fasts were compared. RESULTS: After the protein-rich meal greater discomfort and more side effects were reported. Weight and blood pressure decreased at the end of the fasts that followed each of the three meals; heart rate increased after the high fat and carbohydrate meals but not after the protein meal. The main laboratory findings were a 40% increase in blood urea nitrogen and higher urine osmolarity after the protein-rich meal than after the other meals. CONCLUSION: A protein-poor pre-fast meal is likely to be followed by easier fasting.

Adult↗
PubMed2000

Familial idiopathic dilatation of the right atrium with complete atrio-ventricular block: a new syndrome?

Familial occurrence of idiopathic dilatation of the right atrium is extremely rare. This is the first description of a family in which 2 siblings had a syndrome of idiopathic dilatation of the right atrium associated with complete atrio-ventricular block. The family workup did not show other family members to be affected, and the question we raise is whether or not this might be a new syndrome.

Adolescent↗
PubMed1996

Acute myocardial infarction complicating viper bite.

An acute myocardial infarction was induced by Vipera palaestinea venom in a young patient. The diagnosis was confirmed by cardiac catheterization, which showed a segmental contraction abnormality but normal coronary arteries.

Adult↗
PubMed1991

Dilated cardiomyopathy with mitral regurgitation: decreased survival despite a low frequency of left ventricular thrombus.

Ninety-one patients with dilated cardiomyopathy were studied by two-dimensional, pulsed, and color Doppler echocardiography (1) to detect and quantify mitral regurgitation (MR), (2) to record apical flow velocities in systole and diastole, and (3) to detect the presence of left ventricular thrombi. MR was detected in 57% of the patients and thrombi were present in 40%, but the occurrence of both MR and thrombus was rare (8%). Apical flow velocity was significantly higher throughout the cardiac cycle in the group with MR (diastole 15 +/- 7 vs 9 +/- 7 cm/sec; systole 29 +/- 12 vs 16 +/- 13 cm/sec; p less than 0.001 for both), accounting for the rarity of thrombi in this group. Follow-up data on 89% of the patients showed markedly decreased survival in the group with MR (22% vs 60% at 32 +/- 6 months, p less than 0.005), and this was evident even in patients with mild MR. Thus although MR is a noninvasively obtainable marker of a large subgroup of patients with dilated cardiomyopathy "protected" from left ventricular thrombus formation, it is a sensitive marker of decreased survival.

Aged↗
PubMed1987

Method for noninvasive measurement of central aortic systolic pressure.

A method for noninvasive generation of central aortic systolic pressure curves is presented. The method is based on plotting the occlusive pressure values applied at the brachial artery level against the time intervals needed for the aortic pressure wave to equalize and break through the occlusive pressure at the brachial artery level. These time intervals were obtained by measuring the time from the beginning of depolarization (the QRS complex) to the detection of the pressure wave at the temporarily occluded brachial artery. The validity of the method was documented by 3 different approaches. The pressure values measured by a device developed by us were superimposed on the simultaneously measured central intra-aortic pressure waves and all values were within one standard deviation from the central aortic recordings in 8 of the 10 patients studied. At the same time, the noninvasively recorded pressure waves were completely different from the peripheral artery pressure recorded simultaneously at the femoral artery site. The DP/DT values derived from the central aortic recordings and the noninvasive device correlated (r = 0.83). These results indicate that the noninvasive device measures the central aortic pressure or a close approximation of it. By combining noninvasive pressure measurements with volume measurements obtained by radionuclide angiography, noninvasive pressure-volume curves were generated in 10 subjects. Possible clinical application of the systolic noninvasive pressure-volume curves is suggested.

Aorta↗
PubMed1985

Early detection of diastolic impairment in long-standing hypertension by a noninvasive volume challenge method.

A simple, easily reproducible, noninvasive, provocative test for the assessment of early diastolic impairment in long-standing hypertension is presented. Volume challenge of the heart was produced by elevating the subject's legs to 45 degrees for 5 minutes, thus increasing the venous return to the right heart. Using gated radionuclide ventriculography and Fourier analysis, the atrial structures were delineated and time-activity curves were generated. Early diastolic emptying slope of the left atrium was used to assess left ventricular compliance changes in hypertensives. The left atrial early diastolic emptying rate was markedly reduced in 38 hypertensive patients (45.5 +/- 15.4 counts/s) when compared with 14 healthy subjects (78 +/- 16 counts/s). The legs-up procedure induced subsequent decrease in left atrial emptying rate in patients with long-standing hypertension and left ventricular hypertrophy (-27.4 +/- 11%). In patients with recent onset hypertension there was a depressed early diastolic emptying rate (55.79 +/- 10 counts/s), but a "normal" response to the legs-up procedure (an increase in left atrial emptying rate: 12.84 +/- 7%). Global ejection fraction was normal in all subjects studied, decreasing after induction of augmented venous return in long-standing hypertension. Reduction in left atrial early diastolic emptying rate, caused by the legs-up manoeuvre appears to be an early and sensitive indicator of the left ventricular diastolic impairment in essential hypertension.

Blood Volume↗
PubMed1984

Trichinosis in southern Lebanon.

An outbreak of trichinosis in two villages in southern Lebanon affected over 100 patients, aged 3 to 70 years, who celebrated Christmas and New Year's of 1981 by feasting on rare pork. Six were hospitalized in Israel. The diagnosis was made on clinical and histological grounds. The clinical picture included the classical features, but was unusual in that rarely reported pedal or pretibial edema, pruritus and vertigo, were prominent. There was one case with suspected myocarditis. Two women in the first trimester of pregnancy had miscarriages. All patients recovered. With the unstable political situation in Lebanon in recent years, veterinary and sanitary supervision has deteriorated, and most pigpens are infected with trichinosis.

Abortion, Spontaneous↗
PubMed1979

Effect of a 24-hour food-and-water fast on viscosity of whole blood and plasma.

As a result of abstaining from food and water for 24 h during the midsummer Tishah-b'Ab fast, blood viscosity increased by 16.5% in 27 subjects studied; plasma viscosity increased by 10.3% in nine; hematocrit, by 3.1% in 27; serum total protein, by 6.3% and albumin, by 7.7%, both in 29 subjects. These changes were statistically significant. Plasma fibrinogen did not increase significantly. Fasting-induced changes could impair blood supply to vital organs in patients with vascular insufficiency.

Adult↗