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Biomedical subjects

J F Toole

Publications and source records attributed to J F Toole.

191 records · Page 11Linked to original sources
PubMedDate not supplied

Risk factors for extracranial carotid artery atherosclerosis.

We related risk factors, cardiovascular symptoms, and coronary status to the extent of extracranial carotid atherosclerosis as measured by B-mode ultrasonography in 376 volunteers hospitalized for elective coronary angiography. In a first analysis, we correlated risk factors and cardiovascular symptoms with carotid atherosclerosis. Univariate analysis showed that relations between many continuous risk factors and carotid atherosclerosis were graded and consistent for men and women. Multivariate analysis identified 6 significant variables (age, hypertension, pack-years smoked, and inversely, plasma concentrations of high density lipoprotein cholesterol and uric acid, and Framingham Type A score) that together accounted for 35% of the variability in extent of carotid atherosclerosis. In a second multivariate analysis, addition of coronary status (presence or absence of coronary stenosis as evaluated by coronary angiography) to the roster of candidate independent variables produced a new equation that accounted for an additional 5% of the variability in carotid atherosclerosis extent. Although much of the variability in extent of carotid atherosclerosis remains unexplained, these data define an association between coronary and carotid atherosclerosis that depends partly on shared exposure of both arteries to the same risk factors. They are also consistent with the concept that as yet undiscovered risk factors and/or genetic (e.g., arterial wall) factors common to both arterial beds also contribute to the relation between coronary and carotid atherosclerosis in human beings.

Age Factors↗
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A comparison of betahistine hydrochloride with placebo for vertebral-basilar insufficiency: a double-blind study.

To test the effectiveness of betahistine HC1 in reducing the frequency of transient ischemic attacks (TIAs) caused by vertebral-basilar artery insufficiency, we randomly assigned 26 patients with a typical history of the condition to a placebo-drug or a drug-placebo sequence, each sequence lasting two months. During the study, the frequency of TIAs did not differ significantly between the placebo and the drug groups. Subjective responses indicated some value for betahistine as a palliative agent.

Adult↗
PubMedDate not supplied

Kinks, coils, and carotids: a review.

Kinking and coiling of the internal carotid artery (ICA) sometimes may result in symptomatic cerebrovascular disease, but indisputable evidence linking the two conditions is lacking. However, there is enough evidence to warrant careful consideration of surgical correction in patients who have features of the carotid artery syndrome and kinking of the ICA as shown on angiography. Kinking or buckling of the artery is due to atherosclerosis and is to be distinguished from coiling, which is ascribed to embryological causes. Definite recommendations regarding the advisability of surgery for infants who are discovered to have coils cannot be made, but coiling is generally asymptomatic. Adults with kinks in their carotid arteries who have recurrent transient ischemic attacks (TIAs) benefit most from surgical correction, particularly if symptoms are aggravated on head rotation, which may cause the kink to obstruct.

Adult↗
PubMedDate not supplied

Long-term EKG monitoring in patients with cerebrovascular insufficiency.

Cardiac dysrhythmia may be responsible for signs of cerebrovascular insufficiency in some patients. Ten patients with cerebrovascular insufficiency were monitored for up to 24 hours with the Holter EKG monitor. Eight of the patients had transient ischemic attacks and two had mild deficits from a completed stroke. Eight of the ten patients had associated abnormal cerebral angiography, the most frequent finding being carotid stenosis. Holter EKG monitor in these ten patients showed no abnormalities in four patients. The remaining six had a variety of cardiac dysrhythmias. Although there were a variety of cardiac, cerebrovascular, and neurological abnormalities in these ten patients, six of these patients had a disturbance in cardiac rhythm or conduction which could have been directly associated with or suggest an etiology for the patient's neurological event.

Arrhythmias, Cardiac↗
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Bruits, ophthalmodynamometry and rectilinear scanning on transient ischemic attacks.

One hundred seventeen patients with clinical signs and symptoms of transient ischemic attacks (TIAs) were evaluated. All underwent clinical evaluation for bruit, ophthalmodynamometry, rapid sequence scintiphotography with rectilinear scanning and four-vessel cerebral angiography. The results of these tests were compared for reliability in predicting location of lesions causing transient ischemic attacks. Angiography remains the most accurate procedure in evaluating extracranial vascular lesions. When determination of bruits, ophthalmodynamometry and brain scanning are done together, accuracy is greater than when any one of the procedures is done alone.

Auscultation↗
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Xenon-133 inhalation method for regional cerebral blood flow measurements: normal values and test-retest results.

The purpose of this investigation is to determine the normal values for regional cerebral blood flow (rCBF) as determined by the xenon inhalation method of Obrist. Normal values for all rCBF parameters were measured in 15 healthy individuals. Our data are compared with the normal data obtained by other investigators. In addition, test-retest rCBF measurements were performed to determine the reproducibility of the method. Our results show that the method is highly reproducible when carried out in serial studies over a short period of time.

Adult↗
PubMedDate not supplied

Neuroradiologic aspects of cerebral disseminated intravascular coagulation.

Six patients with neurovascular disseminated intravascular coagulation (DIC) illustrate the diversity of neuroradiologic changes in that condition. Emphasis is placed on the involvement of large cerebral vessels, especially as reflected by cerebral vein or sinus occlusions. The latter occurred in four of the six cases reported; deep or superficial veins, larger lobar draining veins such as the superficial middle cerebral vein, or large bore vessels such as the superior sagittal sinus or jugular bulb were involved. Radionuclide sinography or computed tomography (CT) was useful in revealing large vessel occlusions or their sequelae; in two cases CT showed focal hemorrhage in an unusual location. Although DIC has classically been envisioned as occurring within the arterial microcirculation, these cases attest to the occurrence of large vessel, especially venous, involvement in neurovascular DIC.

Adolescent↗