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Biomedical subjects

J Pool

Publications and source records attributed to J Pool.

At least 73 records · Page 4Linked to original sources
PubMed1984

Clinical value of exercise testing in elderly patients.

Between 1978 and 1983, 1391 exercise tests were performed by 1083 males and 308 females over 64 years of age. This represents 17% of the total number of 8213 exercise tests. A history of myocardial infarction was present in 53% of the males and 30% of the females, while 12% of patients had previous heart surgery. Exercise was performed on a bicycle ergometer with stepwise workload increments of 10 or 20 W min-1. In 10% of patients the physician stopped the test because of serious arrhythmias or abnormal blood pressure response. The test was terminated because of fatigue (40%), angina (12%), dyspnea (18%) or tired legs and claudicatio (18%). Peak workload averaged 115 W in males and 85 W in females, which corresponds to 120% of the predicted normal values. Heart rate increased on average to 130 beats min-1 and systolic blood pressure increased to 180 mmHg. ECG changes compatible with myocardial ischaemia were observed in 42% of patients. Although elderly patients constitute a small fraction of the population referred for exercise testing, these findings indicate that the clinical value of the test when performed is similar to that in younger patients. The observation that most patients achieved higher than 'normal' maximum workloads may be due to unreliability of the reference values.

Aged↗
PubMed1984

Continuing education.

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Education, Nursing, Continuing↗
PubMed1983

Differential recognition of the serologically defined HLA-A2 antigen by allogeneic cytotoxic T cells. II. Definition of three HLA-A2 subtypes by CTLs.

A comprehensive analysis of human alloimmune cytotoxic T lymphocytes (CTLs) specific for the HLA-A2 antigen identified 11% of HLA-A2 positive cells as outliers. In total, 11 unrelated serologically indistinguishable, but distinguishable by cell-mediated lympholysis (CML) HLA-A2 positive outlier cells were identified. The outlier cells could be subdivided in two subgroups according to reactivity patterns obtained with CTLs directed against the HLA-A2 antigen of outlier cells and their inhibitory capacity in specific competitive inhibition experiments. Thus, the serologically defined HLA-A2 specificity can be divided into at least three subtypes using CTLs specific for the HLA-A2 antigen. Moreover, CTLs specific for an HLA-A2 subtype could be induced when responder cells expressed a different HLA-A2 subtype antigen. On the basis of several family studies, we conclude that the subtype HLA-A2 antigens are inherited in a codominant way.

Epitopes↗
PubMed1982

Eggs, serum cholesterol, and coronary heart disease.

The Framingham Study has investigated the effect of host and environmental factors on the development of coronary heart disease since 1949. Serum cholesterol level was determined to the one of the risk factors for coronary heart disease. The nutrient intake, in a subsample of the study population, was determined in 1957. A review of this material has permitted an estimate of egg consumption on each of 912 subjects. The serum cholesterol distribution curves of the subjects according to tertile of egg intake were almost identical, and no relationship between egg intake and coronary heart disease incidence was found. It is concluded that within the range of egg intake of this population differences in egg consumption were unrelated to blood cholesterol level or to coronary heart disease incidence.

Adult↗
PubMed1980

Heart rate levels and ventricular ectopic activity during cardiac rehabilitation.

The heart rate levels and the incidence and types of premature ventricular complexes (PVCs) during the rehabilitation of 40 patients with coronary artery disease, were compared with those during 24-hour ambulatory monitoring and during a symptom-limited exercise test. Thirty-six patients were studied 3 months or later after a myocardial infarction and four patients were studied after coronary bypass surgery. The last patient suffered from moderate angina pectoris. Peak heart rates during rehabilitation exceeded those during other activities in 34 out of 40 patients. Half of the patients reached even higher heart rate levels during the exercise test. Twenty-three patients had PVC during rehabilitation; frequent, multiform or repetitive PVC occurred in nine of these. During the exercise test, 24 patients had PVCs, while PVCs were observed on the ambulatory tape recording in 34 patients. Frequent, multiform, and repetitive PVCs occurred in eight patients during exercise testing and in 20 patients during monitoring. No relation was found between either the incidence or the type of PVC in individual patients under these three conditions. Thus, selection of patients with a high risk for arrhythmias during rehabilitation is not feasible by either exercise testing or ambulatory tape recording.

Adult↗
PubMed1980

Acute myocardial infarction: an easy diagnosis in general practice?

In the imminent myocardial infarction Rotterdam (IMIR) study, contacts by patients with their general practitioners for symptoms of potential coronary artery disease were registered. Those who had acute myocardial infarction were diagnosed on the basis of the modified World Health Organization criteria, and those with this definite diagnosis were then compared with the initial diagnosis made by the general practitioner at the moment of contact without laboratory assistance.Of the 1,343 patients included in the study, 93 (seven per cent) had ;definite' acute myocardial infarction and another 37 (three per cent) had ;possible' acute myocardial infarction according to the diagnostic criteria used.At the time of contact with the general practitioner 41 (44 per cent) of the 93 patients with definite myocardial infarction were recognized as such by the general practitioner, while in another 31 (33 per cent) the general practitioner diagnosed ;imminent' myocardial infarction.Of the 1,213 patients free of acute myocardial infarction at the time, 40 (three per cent) were incorrectly diagnosed by the general practitioner as having ;acute' myocardial infarction.In the 22 patients who in fact had acute myocardial infarction but in whom the general practitioner did not make this diagnosis at the time, it was found that there was an absence of physical signs and, similarly, in patients who subsequently did not have infarction the presence of physical signs was related to a falsepositive general practitioner diagnosis of myocardial infarction.In view of the inaccuracy of the general practitioner's provisional diagnosis of acute myocardial infarction, we believe that electrocardiogram and enzyme tests should be carried out systematically in all patients who present to general practitioners with symptoms of potential coronary artery disease. Laboratory support should be readily available and we support the idea of having a special diagnostic service.

Adult↗
PubMed1979

[Risks of jogging].

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Cardiovascular Diseases↗
PubMed1978

Two monitored cases of sudden death outside hospital.

Two patients known to have coronary artery disease died suddenly outdoors while active. Neither had symptoms or signs of acute myocardial infarction. They were being monitored by continuous tape recording of the electrocardiogram at the time of death. In one patient the cause of death was cardiac arrest, preceded by bigeminy and multiform ventricular ectopic beats, in the other ventricular fibrillation preceded by atrial fibrillation, multiform ventricular ectopic beats, and ST depression. These observations are added to the limited reported cases in which the mechanism leading to sudden death outside the hospital is recorded.

Aged↗
PubMed1977

Absence of blocking antibody in non-inhibitor haemophilic plasma.

This study examined the hypothesis that non-inhibitor haemophilic plasma contains antibodies which are specific for sites other than the active procoagulatn site on factor VIII, and that some of them might be sufficiently close to the active site that pre-incubation of such plasma with factor VIII would block the subsequent binding of inhibitor antibody. Among the 26 non-inhibitor plasmas examined, none was found to contain such blocking antibody. This result does not eliminate the possibility that antibody is present in such non-inhibitor plasmas which is neither specific for the active enzyme site of factor VIII nor capable of blocking the binding of antibody which does have that specificity.

Antibodies↗
PubMed1976

The estimation of the number of binding sites for antibody on antigen molecules with reference to factor VIII and its antibody.

The theoretical basis for determining the number of antibody sites on antigen molecules is examined. The theoretical considerations are applied to factor VIII molecules. Examples based on data available at the Oxford Haemophilia Centre are calculated to illustrate the approach. It is concluded that there are few sites on each factor VIII molecule for human antibody. The three antibodies for which reasonable data were available suggest 1-3 sites for human antibody. The data for rabbit antibody suggest 5-6 sites per factor VIII molecule.

Absorption↗