The Syva ETS and Abbott ADx urine drug testing immunoassay systems were evaluated for analytical performance, ease of operation, data processing, and time of analysis. Urine specimens were analyzed by each system for six drugs of abuse. Discrepancies in drug detection were due to variations in the cut-off concentrations between ADx and EMIT d.a.u. (ETS) reagents. The ETS was found to have several major advantages over the ADx: greater sample load, more convenient "random access," and real time data processing. When analyzing multiple specimens, the turnaround time for the ETS as compared to the ADx was twice as fast for the six-analyte assay. The ADx assay calibrations were stable for two weeks, while the ETS required daily calibration with verification by cut-off calibrators every eight hours. The ETS was found superior to the ADx for multianalyte urine drug screening.

Evaluation Studies as Topic↗

PubMedDate not supplied

Ranitidine interference with the monoclonal EMIT d.a.u. amphetamine/methamphetamine immunoassay.

The interference of ranitidine with the monoclonal EMIT d.a.u. amphetamine/methamphetamine immunoassay (ME) was investigated. Urine specimens collected from 23 patients receiving 150-300 mg of ranitidine daily were found to contain 7-271 mg/L of the drug when analyzed by Remedi automated high pressure liquid chromatography. Only patient specimens and urine samples with ranitidine added at concentrations greater than 91 mg/L gave false positive ME results. Of the 63 patient urine samples analyzed by ME, 12 gave false positive results. All false positive results occurred in the first or second void after ingestion. No false positive results occurred with the polyclonal EMIT d.a.u. amphetamine or TDx amphetamine/methamphetamine II assays.

Amphetamine↗

PubMedDate not supplied

Bypass to the tibial and peroneal arteries using the great saphenous vein in situ.

In 22 patients with extensive atherosclerotic disease of the lower extremities 24 long bypasses have been performed. The main indications for surgery were rest pain and imminent or manifest gangrene. The semiclosed in situ vein technique was used in all except one case. Five grafts thrombosed within 2 weeks postoperatively, one of them was successfully reopened. At discharge 20 grafts were patent, and most of the patients had relief of their ischemic symptoms. After 5 years 26% of the long vein grafts were patent. In comparison, almost 70% of in situ femoro-popliteal vein grafts were patent. One patient is still living with an open long vein graft 14 years after surgery. The in situ vein technique is especially suited for long bypasses. The poorer results in the present series is probably due to an extremely advanced atherosclerotic disease and a high percent of small fibrotic veins with a diameter of 3 mm or less.

Adult↗

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Intra-aortic balloon pumping support in surgically treated valvular heart disease: prognostic factors and survival.

Prognostic factors of Low Output Syndrome (LOS) requiring operative circulatory support by intra-aortic balloon-pumping (IABP) counterpulsation, were analysed in a population of 841 patients who underwent heart valve replacement surgery between June 1977 and May 1985. The incidence of IABP circulatory support was 6.8%. Mean survival time of patients who needed IABP was 2.35 years +/- 0.425 vs 6.30 years +/- 0.103 for patients who didn't have this complication. A multivariate analysis using the logistic model was done to pinpoint factors predictive of IABP support. The prognostic factors were pre-operative functional class, presence of prior valve replacement, presence of concomitant surgery and presence of endocarditic etiology. The subgroup of 58 patients undergoing balloon counterpulsation was analysed for factors predictive of survival using a multivariate analysis of the Cox' model. Presence of aortic or mitral regurgitation was found to be the independent risk factor of mortality. Using a combination of prognostic factors, we pinpointed groups of patients at high risk of needing post-operative balloon pump counterpulsation support. The necessity of an alternative procedure for the mechanical support of the failing circulation is underlined.

Aortic Valve↗

PubMedDate not supplied

Prognostic variables in late follow-up of aortic valve replacement using the proportional hazard model: a study on patients using the Medtronic-Hall cardiac prosthesis.

An alternative approach to the study of the follow-up of patients with heart prostheses is the use of the reliability theory (hazard function) and proportional hazard model (Cox's model). In a population of 480 patients who underwent AVR in the period from June 1977 to January 1983, with a mean follow-up time of 2.8 years, 16 preoperative variables were considered. From this pool of variables, six entered the regression model in a time-independent mode. These were age at operation, sex, preoperative NYHA classification, presence of AI, presence of endocarditis and presence of atrial fibrillation on ECG, none of which entered the model in the time-related mode. Another multifactorial approach, using a stepwise regression analysis to examine primary predictive factors that independently correlate with survival, while simultaneously accounting for the other previous variables, showed that the variables with additive prognostic value were age at operation, presence of AI and presence of endocarditis. Based on this model, a forecast five-year survival rate ranging from 88 to 14 per cent was found at the end of the fifth year. For the most favourable and the worst combinations of these prognostic variables, a patient-specific forecast five-year survival rate was drawn up. Our results were compared, using univariate and multivariate methods, with the results found in the literature, and the implications of this comparison were discussed.

Aortic Valve↗

PubMedDate not supplied

Bypass procedures in the treatment of obstructions of the abdominal aorta.

Explore the source record for details and available documents.

Adult↗

PubMedDate not supplied

Complete replacement of the ascending aorta and the aortic valve with coronary reimplantation.

In 6 patients with cystic medial necrosis of the ascending aorta and the aortic root complete elective replacement of these structures with coronary reimplantation was performed. Two patients died from postoperative left ventricular failure, 4 patients survived and were hemodynamically unaffected at follow-up. Also the heart size in these patients decreased postoperatively. Survival seemed mainly related to the degree of preoperative cardiac failure and cardiomegaly.

Adolescent↗

PubMedDate not supplied

The great saphenous vein used in situ after vein valve extirpation. Long term results.

In 227 patients 252 extremities were operated on with femoropopliteal bypass using the in situ vein technique. The valves were extirpated through incisions in the vein. At discharge 14 grafts were thrombosed, mainly because of inadequate size of the vein graft. Ten years after surgery more than 50% of the patients had died, and only 25% of the implanted grafts were patent. The dominating cause of death was coronary infarction. Thirty one limbs were amputated. At the end of follow-up 51 grafts were patent 10 to 17 years after surgery, mean 10.84 ears. With regard to mortality and long term patency the most important factors were: Preoperative history of myocardial disease, smoking, size of the vein graft and peripheral "run-off".

Adult↗

PubMedDate not supplied

Morphological changes in the saphenous vein after dilatation with silastic tubes. An experimental study.

In an attempt to make veins more suitable for bypass grafting, an experimental model in dogs was developed. The saphenous vein on the hind limbs was cannulated with a silastic tube, a ligature was placed proximally and distally, and the tube was left in situ for 1 to 9 weeks. Morphological studies including electron microscopy revealed "arterialization" of the veins with fibromuscular hyperplasia, increased deposition of collagen and preserved vasa vasorum. The endothelium was replaced by irregular cells, probably altered fibroblasts coated by an amorphous material. It is suggested that the "arterialized" veins may become more suitable for bypass grafting. But the luminal surface may be thombogenic and thus the usefulness of the graft may be diminished by thrombosis.

Animals↗

PubMedDate not supplied

The Hall-Kaster disc valve prosthesis: clinical and hemodynamic observations in patients undergoing aortic valve replacement.

In a series of 113 patients receiving Hall-Kaster aortic valve prostheses intraoperative- and postoperative hemodynamic studies revealed favourable utilization of the valve orifice for transvalvar forward flow. Angiography demonstrated optimal disc opening and minor valvar regurgitation. A significant clinical improvement and improvement of left ventricular function were observed postoperatively.

Aged↗