Biomedical subjects

G Verdel

Publications and source records attributed to G Verdel.

6 recordsLinked to original sources

PubMed1997

Addition of felodipine to metoprolol vs replacement of metoprolol by felodipine in patients with angina pectoris despite adequate beta-blockade. Results of the Felodipine ER and Metoprolol CR in Angina (FEMINA) Study. Working Group on Cardiovascular Research, The Netherlands (WCN).

AIMS: The study aimed to compare the addition of felodipine to metoprolol, and of the replacement of metoprolol by felodipine, with continuation of metoprolol, in patients with angina pectoris despite optimal beta-blockade. METHODS AND RESULTS: The study was double-blind, parallel, randomized and controlled, and comprised 363 patients from 27 outpatient cardiology clinics in the Netherlands. The patients had angina and positive bicycle exercise tests despite optimal beta-blockade (resting heart rate < 65 beats.min-1). Randomization was to three treatment groups: continuation of metoprolol (control), addition of felodipine to metoprolol, and replacement of metoprolol by felodipine. Exercise tests were repeated after 2 and 5 weeks. The main outcome measure was: exercise result after 5 weeks, compared with baseline, between-group comparison of changes vs control. There were no significant differences in exercise duration and onset of chest pain vs control. The addition of felodipine increased time until 1 mm ST depression (43 s, 95% confidence interval 20-65 s), and decreased both ST depression at highest comparable work load (0.46 mm, 95% confidence interval 0.19-0.72), and maximal ST depression (0.49 mm, 95% confidence interval 0.23-0.74). Exercise results after replacement of metoprolol by felodipine were not different from control, apart from a significant increase in rate pressure product. Significantly more patients experienced adverse events in the felodipine monotherapy group. CONCLUSION: Combination of metoprolol and felodipine is to be preferred to felodipine monotherapy in patients who have signs and symptoms of myocardial ischaemia despite optimal beta-blockade.

Adolescent↗

PubMed1988

A patient with a spontaneous factor VIII:C autoantibody: successful treatment with cyclosporine.

A 65-year-old man was admitted to the hospital because of extensive spontaneous ecchymoses of the trunk and huge hematomas of the arms and legs. He had no personal or family history of a hemorrhagic diathesis. Coagulation studies revealed a prolonged APTT, no detectable factor VIII:C activity, and a high titer of anti-factor VIII:C antibodies. A diagnosis of acquired hemophilia was made. No underlying disorder could be found. The inhibitor was an IgG antibody. Long-term management of bleeding including immunodepletion by plasma exchange and immunosuppression by corticosteroids and cytotoxic drugs alone and in combination had no effect on the bleeding tendency and coagulation data. The administration of Cs (10 mg/kg/d) in combination with prednisone induced a remission. After a stormy course and a 5-month stay in the hospital the patient could be discharged. A relapse occurred after the Cs and prednisone dosages were reduced. Increasing the Cs dosage induced a remission again.

Aged↗

PubMed1984

A computer-aided method to evaluate the function of implanted Björk-Shiley prosthetic heart valves.

Evaluation of the function of implanted prosthetic valves is important in early diagnosis of valve dysfunction. Björk-Shiley valves contain two radiopaque rings, which are projected as ellipses in cineradiography. From these ellipses the actual valve opening angle can be calculated. A computer-aided method was developed that enables measurement of ellipse characteristics reliably, independent of projection angle and valve opening. It is demonstrated that calculated and real opening angles differ less than 2 degrees with this method. Using the same technique the tilting angle of the valve ring during the cardiac cycle is computed for evaluation of progression of valve dehiscense in case of a paravalvular leak. Application of the method to patient data is illustrated by three cases. The method is suitable for use by technicians. It can be implemented on a small microprocessor system. The method proved to be a powerful tool in the evaluation of patients with implanted Björk-Shiley valves.

Aortic Valve↗

PubMed1984

[Bonded pontics].

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Acrylic Resins↗

PubMed1984

[Clasp bridges].

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Denture Precision Attachment↗

PubMed1983

Assessment of the opening angle of implanted Björk-Shiley prosthetic valves.

A method has been developed in which cineradiography is used for the assessment of the opening angle of implanted Bjork-Shiley prosthetic valves. The method is based on the fact that the ring and the disc, which are known to be circular, appear to be elliptical on x-ray films. The spatial position of the valve can be retrieved from the characteristics of these ellipses when vectoranalysis is applied. The method's accuracy does not depend on the position of the patient with respect to the direction of the x-ray beam. The accuracy of the method was demonstrated with the use of a phantom valve. The difference between the measured and the real opening angle was -0.7 +/- 1.8 degrees (mean +/- SD). Results were reproducible in patients to within -0.1 +/- 1.8 degrees. In 18 patients with normally functioning valves it could be demonstrated with frame-by-frame analysis (interval between frames 20 msec) that the valves opened very rapidly up to about 60 degrees. Closing patterns varied. In one of our patients with valvular thrombosis insufficient valvular opening could be demonstrated by our method before the patient's complaints drew attention to the valvular dysfunction.

Cineradiography↗