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Biomedical subjects

J Mueller

Publications and source records attributed to J Mueller.

At least 145 records · Page 8Linked to original sources
PubMed1987

Arterial vasodilator, systemic and coronary hemodynamic effects of nisoldipine in congestive heart failure secondary to ischemic or dilated cardiomyopathy.

The systemic and coronary hemodynamic and neurohumoral effects of nisoldipine, a calcium antagonist drug with high vascular specificity, were investigated in 17 patients with chronic congestive heart failure (CHF). Brachial artery infusions (n = 9) decreased forearm vascular resistance in a dose-dependent manner, attesting to its powerful arterial vasodilator properties. A dose of 3 micrograms/kg intravenously decreased mean blood pressure 16% and systemic vascular resistance 33%, while increasing stroke index 19% and ejection fraction 21% at rest and similarly during exercise. Pulmonary capillary wedge pressure decreased significantly during exercise. Intravenous infusion of nisoldipine increased rest coronary sinus flow 10% (p less than 0.05, n = 7), decreased rest and exercise coronary vascular resistance 28% and 19% (p less than 0.01) and rest myocardial oxygen consumption 14% (p less than 0.05). In 13 patients similar systemic hemodynamic results were found after treatment with oral nisoldipine, 2 X 20 mg for 4 weeks. Stroke index and stroke work index increased long-term more than acutely (31% and 12.4% vs 19% and 4.5% at rest, both p less than 0.05), which may indicate a compensated mild cardiodepressant effect of intravenous nisoldipine. Changes in forearm vascular resistance after intra-arterial administration did not correlate with changes of systemic vascular resistance after intravenous administration, suggesting that factors other than vascular calcium entry blockade importantly influence hemodynamic responses. Elevated control plasmas norepinephrine and renin levels, on average, did not change during chronic therapy but individual changes were compatible with a reduction of sympathetic activity in patients with hemodynamic improvement.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1987

The onset of Munchausen's syndrome.

Although Munchausen's syndrome is well known, its mode of onset and development are poorly understood. The authors describe an individual whose developmental history was notable for dyslexia and pathological lying from early childhood, and who later developed Munchausen's syndrome following an explosive separation from his terminally ill father. The patient's simulated genitourinary problems related directly to his father's renal malignancy. The development of his Munchausen syndrome is discussed with reference to his traumatic separation from his father as well and to his preexisting character pathology and probable central nervous system dysfunction.

Adult↗
PubMed1987

The Neurobehavioral Cognitive Status Examination: a brief but quantitative approach to cognitive assessment.

The Neurobehavioral Cognitive Status Examination (NCSE), a screening examination that assesses cognition in a brief but quantitative fashion, uses independent tests to evaluate functioning within five major cognitive ability areas: language, constructions, memory, calculations, and reasoning. The examination separately assesses level of consciousness, orientation, and attention. This instrument quickly identifies intact areas of functioning, yet provides more detailed assessment in areas of dysfunction. Standardization data are provided for 119 healthy adults (age range, 20 to 92 years) and for 30 patients receiving neurosurgical care for brain lesions (range, 25 to 88 years). Cognitive profiles for several common neuropsychiatric conditions illustrate the usefulness of this examination in clinical practice.

Adult↗
PubMed1987

The Neurobehavioral Cognitive Status Examination: comparison with the Cognitive Capacity Screening Examination and the Mini-Mental State Examination in a neurosurgical population.

Studies to determine the validity of the Mini-Mental State Examination (MMSE) and the Cognitive Capacity Screening Examination (CCSE) have indicated unacceptably high false-negative rates for these tests. To determine whether a new examination, the Neurobehavioral Cognitive Status Examination (NCSE), is more sensitive in the detection of cognitive dysfunction, we compared the three examinations in 30 patients with documented brain lesions. The CCSE had a false-negative rate of 53%; the MMSE, of 43%; and the NCSE, of 7%. The sensitivity of the NCSE is derived from two features of its design: the use of independent tests to assess skills within five major areas of cognitive functioning, and the use of graded tasks within each of these cognitive domains.

Adult↗
PubMed1987

Tissue welding using a low energy microsurgical CO2 laser.

A low energy, CO2 laser adapted specifically for microsurgery can be used to assist in anastomosis by "welding" tissue through thermal coagulation. Which tissue constituents contribute to the bond are not known, and different constituents may be important in welding different organs.

Anastomosis, Surgical↗