Biomedical subjects

H P Hurd

Publications and source records attributed to H P Hurd.

3 recordsLinked to original sources

PubMed1994

Emergency cardiopulmonary support with circulatory support devices.

Emergency cardiopulmonary support has been used in the United States since 1986, mainly by physicians at participating centers for the National Registry of Elective Supported Angioplasty. Data from the National Registry as well as the experience in three institutions from a number of operators were analyzed to assess the benefits of the emergency cardiopulmonary support application in patients with hemodynamic collapse. Patients who had experienced either cardiac arrest or hemodynamic collapse with cardiogenic shock unresponsive to pressors were placed emergently on cardiopulmonary support. They were either then treated with angioplasty or with revascularization surgery. Patients placed on cardiopulmonary support in less than 15 min experienced a 48% survival rate across the whole registry of the participating centers of the National Cardiopulmonary Bypass Registry. A two-center experience has demonstrated a 69% survival rate. Patients treated with emergency cardiopulmonary support who have experienced hemodynamic collapse have improved survivorship over any other hemodynamic support system. With increasing experience by the operators, the results have improved for survivorship, particularly in the early application group.

Angioplasty, Balloon, Coronary↗

PubMed1981

Comparative accuracy of electrocardiographic and vectorcardiographic criteria for inferior myocardial infarction.

Numerous criteria for the diagnosis of inferior wall myocardial infarction by electrocardiogram (ECG) and vectorcardiogram (VCG) have been published, but they have not been subjected to a systematic, independent evaluation. Accordingly, we studied 146 patients undergoing cardiac catheterization; 63 were normal and 83 had a history of infarction, a significant right coronary lesion and an inferior wall motion abnormality (inferior infarction group). No ECG or VCG criteria were considered in the designation of the two groups; rather, three sets of ECG and VCG criteria were evaluated for this purpose. Specificity was excellent (98-100%) and sensitivity was poor (4-34%) by all three sets of ECG criteria, but the 1949 ECG criteria of Meyers et al. are the least sensitive (4%, p less than 0.001). Specificity (90-100%) and sensitivity (82-84%) were very good by all three VCG criteria. The VCG criteria of Starr et al. gave no false-positive results in our normal group. Because of enhanced sensitivity, the overall accuracy of the VCG was higher than that of the ECG for the diagnosis of inferior infarction (90% vs 62%, p less than 0.001). We conclude that more recent ECG criteria for the diagnosis of inferior wall myocardial infarction are highly specific, but insensitive compared with VCG criteria.

Electrocardiography↗

PubMed1977

Hypothalamic-endocrine dysfunction in anorexia nervosa.

Multiple endocrine determinations were carried out on 101 patients with anorexia nervosa. Ninety-five percent of the patients studied were female, and in 94% of patients the anorexia nervosa began before 30 years of age. Evidence of gonadal dysfunction was the predominant manifestation, both clinically and by laboratory studies. Amenorrhea occurred before or concurrent with onset of weight loss in 65% of the women. The average weight loss was 28% of the weight before illness began. In an additional 11%, the disease began before menarche. The mean age of menarche in patients with secondary amenorrhea was 13 years. Urinary excretion of pituitary gonadotropin was undetectable in 44 of 65 patients and was below 19 rat units per 24 hours in the remaining patients. Serum luteinizing hormone level was below 8 microgram/dl in 15 of 27 patients studied and serum follicle-stimulating hormone was below 10 microgram/dl in 7 of 27 patients studied. Mean serum or urinary estrogens, or both, were low in more than 50% of the patients. Elevation of serum corticosteroids or loss or reversal of diurnal variation, or both, was noted in 50% of patients. Fasting serum growth hormone levels were elevated in 45% of the patients. Mean total and free serum thyroxine, thyroid-stimulating hormone, and triiodothyronine levels were low. These hormonal alterations in the hypothalamic-pituitary axis in patients with anorexia nervosa probably represent adaptive and protective mechanisms for chronic starvation and weight loss.

Adrenal Cortex Hormones↗