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Biomedical subjects

K Grauer

Publications and source records attributed to K Grauer.

At least 19 recordsLinked to original sources

Expanding applications of the 12-lead ECG in suspected acute infarction.

In the setting of acute myocardial infarction, the importance of the 12-lead electrocardiogram has increased tremendously. In addition to facilitating diagnosis of acute ischemic syndromes, including acute myocardial infarction, the 12-lead electrocardiogram may provide invaluable assistance in determining which patients are most suitable for thrombolytic therapy, and it may provide information that is useful in prognostic stratification.

Acute Disease

A systematic approach to Holter monitor interpretation.

A systematic approach to the interpretation of ambulatory electrocardiographic recordings facilitates analysis and improves accuracy. The method suggested includes a mnemonic and a standardized interpretation form. The mnemonic facilitates recall of key technical and patient-specific parameters involved in the preparation and evaluation of Holter monitor and other ambulatory electrocardiographic recordings. The standardized interpretation form consolidates essential findings from the study into a practical, easy-to-assimilate format.

Electrocardiography, Ambulatory

Newer antihypertensive agents.

Three recent additions to the list of antihypertensive agents have been approved for use as monotherapy or in combination with other drugs. Betaxolol hydrochloride (Kerlone) maintains its effect for 24 hours, making it a true once-a-day beta blocker. Penbutolol sulfate (Levatol) is as effective as other beta blockers and diuretics. Doxazosin mesylate (Cardura), a selective alpha 1 blocker, also allows once-a-day dosing and has produced favorable changes in lipid profiles. Two new drug delivery systems, one for verapamil hydrochloride (Verelan) and one for extended-release nifedipine (Procardia XL), allow less frequent dosing and may offer other advantages, such as greater compliance and a more tolerable side-effect profile.

Antihypertensive Agents

Problems of polypharmacy and intercurrent disease.

Preventing lethal sequelae rather than simply controlling blood pressure is the major goal of antihypertensive treatment. By that criterion, there is reason to question the efficacy of current stepped-care protocols. Alternate approaches that incorporate concerns about both intercurrent disease conditions and their multidrug demands are critically examined.

Antihypertensive Agents

New developments in cardiopulmonary resuscitation.

Since the last revision of the American Heart Association's guidelines in 1985, several new developments of clinical importance have occurred in the field of cardiopulmonary resuscitation. These include enhanced access to and earlier use of defibrillation, the use of high-dose epinephrine when standard doses fail, the assessment of resuscitative efforts with end-tidal CO2 monitoring and the addition of two new drugs, amiodarone (for refractory ventricular fibrillation) and adenosine (for paroxysmal supraventricular tachycardia). Time will determine the ultimate role of these advancements in the management of cardiac arrest.

Anti-Arrhythmia Agents

The new antimicrobial agents. When they're the best choice and when they're not.

The number of antibiotics available to the clinician for treatment of infectious diseases continues to increase. However, choosing an agent just because it is new is not always cost-effective and may encourage the development of bacterial resistance. The site of infection, pharmacokinetic data, minimum inhibitory concentration, and cost must all be considered in selecting the optimal antimicrobial agent for a particular clinical situation.

Anti-Bacterial Agents

Silent myocardial ischemia: dilemma or blessing?

Developing an optimal strategy for the evaluation and management of patients with silent myocardial ischemia is extremely difficult. Although otherwise healthy, asymptomatic individuals may be at risk of dying suddenly during exercise, neither exercise testing nor Holter monitoring reliably identifies those at greatest risk. In patients with underlying coronary artery disease, silent ischemia increases the risk of an adverse outcome.

Coronary Disease

The physician's reactions to patients with chronic pain.

Physicians may react negatively to patients with chronic pain syndrome. Feelings of frustration, anger, disapproval and uncertainty, while understandable, can compromise effective care or lead to rejection of the patient. Characteristics and attitudes of both the physician and the patient are contributing factors. Countermeasures include awareness, exploration of the causes of chronic pain behavior, implementation of specific strategies for dealing with negative reactions, and education for the patient and the physician.

Chronic Disease

Severe verapamil (sustained-release) overdose.

Vasodilators, specifically calcium-channel modulators, are currently in widespread use for the treatment of essential hypertension. Several reports of toxicity from immediate-release verapamil have appeared in the literature. We present a case of sustained-release verapamil overdose as a consequence of an attempted suicide. The treatment measures used in a verapamil toxicity are discussed, as well as a review of the current literature on verapamil overdose.

Adult

Ventricular arrhythmias, Part I: Prevalence, significance, and indications for treatment.

Evaluation and treatment of patients with ventricular arrhythmias are full of pitfalls for the unwary. In this series of articles we discuss how to recognize and avoid these pitfalls and present our approach to management. The prevalence and clinical significance of ventricular arrhythmias and indications for treatment are addressed in this initial installment.

Anti-Arrhythmia Agents