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Biomedical subjects

M Jaeger

Publications and source records attributed to M Jaeger.

At least 109 records · Page 6Linked to original sources
PubMed1984

[Indications for implantation of pacemakers and their ambulatory follow-up].

In 1983 the indications for cardiac pacing to be considered by the physician are still the symptomatic sinus node dysfunctions ("maladie du sinus" and "maladie rythmique de l'oreillette") and the symptomatic or potentially symptomatic AV blocks (complete AV block, either permanent or intermittent, second-degree infranodal AV block, and even symptomatic Wenckebach type second-degree AV block). The choice of the type of cardiac pacemaker and of the pacing mode depends mainly on the implanting center. In the author's opinion the choice of multiprogrammable VVI models is justifiable in most cases. The increased price and fragility of the DDD models still seem to limit their use to particular cases involving about 10% of all implanted pacemakers. The selection of patients who could benefit most from the DDD mode of pacing is not always easy. Pacemaker follow-up should be performed in three stages: by the patient, by the physician and by the cardiologist specializing in cardiac pacing. The principles of this follow-up mode are reviewed.

Electrocardiography↗
PubMed1983

[Possibilities and limits of the diagnosis of coronary disease in general practice].

Among the various forms of angina pectoris related to coronary artery disease, the Prinzmetal type is only seldom within the diagnostic possibilities of the general practitioner. Angina pectoris recurring after coronary artery bypass surgery calls for prompt coronary angiography. An active approach is also justified in postinfarction angina because of the usually severe underlying coronary lesions. Therefore, failure of medical therapy calls for further early investigations. In typical primary angina pectoris in man, failure of medical therapy requires angiography mainly to determine whether surgery is feasible. The same attitude should be followed in women, but bearing in mind that the probability of intact coronary arteries is much greater. The goal of the examination is then to "calm" the situation. In atypical forms of primary angina pectoris there is a high probability of intact coronary arteries, especially if the ECG at rest and at exercise remains normal. Nevertheless, this probability is not sufficiently great to exclude further investigations (isotopic or angiographic, according to the adopted policy).

Angina Pectoris↗
PubMed1983

[Intracoronary thrombolysis as a treatment for evolving myocardial infarction].

Myocardial infarction is almost always the consequence of a thrombotic obstruction of one or more coronary arteries. We report our experience with the first 24 cases of intracoronary thrombolysis for recanalization of obstructed coronary arteries. 19 cases were successful, 1 case was partially successful and in 4 instances no reopening was observed. The amount of streptokinase used was 206 000 +/- 107 000 units, and reperfusion was achieved after 37 +/- 27.5 minutes. Recanalization of the vessel was accompanied by cessation of precordial pain and partial or complete normalization of the electrocardiogram. In one case bypass surgery was necessary because of reocclusion. Left ventricular function improvement after thrombolysis was dependent on the time-lag between occlusion and recanalization. These observations confirm others' experience that intracoronary thrombolysis appears to have favorable effects in patients with evolving myocardial infarction.

Coronary Disease↗
PubMed1982

A simple method for assessing the validity of the esophageal balloon technique.

The validity of the conventional esophageal balloon technique as a measure of pleural pressure was tested in 10 subjects in sitting, supine, and lateral positions by occluding the airways at end-expiration and measuring the ratio of changes in esophageal (delta Pes) and mouth pressure (delta Pm) during the ensuing spontaneous occluded inspiratory efforts. Similar measurements were also made during static Mueller maneuvers. In both tests, delta Pes/delta Pm values were close to unity in sitting and lateral positions, whereas in the supine position, substantial deviations from unity were found in some instances. However, by repositioning the balloon to different levels in the esophagus, even in these instances a locus could be found where the delta Pes/delta Pm ratio was close to unity. No appreciable phase difference between delta Pes and delta Pm was found. We conclude that by positioning the balloon according to the "occlusion test" procedure, valid measurements of pleural pressure can be obtained in all the tested body positions.

Adult↗
PubMed1981

[Rhythm troubles: when and how to treat them?].

The decision to treat arrhythmias can be based upon subjective symptoms or on the potential danger of the particular rhythm disturbance. The underlying myocardial condition has also to be considered. The main practical problem is to define which premature ventricular beats (PVB) require treatment in the hope of reducing the risk of sudden death. At the moment the answer can be given only for treatment of PVB's with beta-blockers in patients who have had myocardial infarction; the risk of sudden death is diminished in these cases. One may extend this approach to other cardiopathies or to other antiarrhythmic drugs, but thus far this has not been proven to be effective.

Anti-Arrhythmia Agents↗
PubMed1981

[National survey on cardiac stimulation in Switzerland in 1980].

The fifth national survey of cardiac pacemaking in Switzerland in 1980 can be summarized as follows: 95% replies; 200 first implants/year/million inhabitants, 85% of the patients being more than 60 years old at the time of the implantation; most of the leads (91.5%) were intraventricular, the majority being unipolar (95%). The indications are now sinusal disorders as often as atrioventricular blocks (45% each). They are based upon clinical and electrocardiographic criteria rather than upon complementary diagnostic tests. The most important developments are the growing number of programmable pacemakers and the introduction of physiological pacing.

Adolescent↗
PubMed1981

Prevention of hepatitis B virus transmission by the gastrointestinal fibrescope. Successful disinfection with an aldehyde liquid.

In a prospective study we examined the efficacy of a standardized disinfection method in preventing the transmission of hepatitis B virus by the gastrointestinal fibrescope. Four HBSAg- and Dane particle-positive patients who have been endoscoped served as possible sources of hepatitis B virus infection. We cleaned the instrument with a 10% aldehyde liquid and used it immediately thereafter in 10 HBSAg-negative patients. Eight of them were followed-up for 7 months after the endoscopic procedure. None of them showed serological evidence of an endoscopically transmitted hepatitis B virus infection. It is concluded that disinfection with an aldehyde liquid is effective in preventing the transmission of hepatitis B virus by the fibrescope.

Aldehydes↗
PubMed1980

[Effect of dynamic exercise on left ventricular hemodynamics in obstructive cardiomyopathy].

The behavior of left ventricular (LV) outflow tract obstruction in hypertrophic obstructive cardiomyopathy (HOCM) during dynamic exercise was studied in 9 patients during cardiac catheterization. Pressure measurements were carried out with high fidelity tip manometers and cardiac output was measured by the thermodilution method. Resting intraventricular pressure gradients varied from 5 to 75 mm Hg (mean 41 +/- 30 mm Hg) and all patients had postextrasystolic gradients of more than 100 mm Hg. Under supine bicycle exercise (mean work load 80 watts) heart rate increased from 74 +/- 9 to 97 +/- 10 min-1, cardiac output rose from 4.32 +/- 0.7 to 8.36 +/- 2.0 l/min, and LV intraventricular pressure gradient dropped significantly to 16 +/- 4 mm Hg. This improvement of LV outflow tract obstruction was associated with an increase in LV enddiastolic pressure from 14 +/- 5 mm Hg to 25 +/- 2 mm Hg, an augmentation of dP/dt max from 1225 +/- 300 to 1748 +/- 200 mm Hg/sec and a deterioration of systolic to diastolic pressure-time index ratio. These preliminary results indicate partial normalization of the LV outflow tract obstruction in HOCM during supine bicycle exercise; this favorable effect is probably due to an increased enddiastolic LV volume.

Adult↗
PubMed1979

[Electrocardiographic manifestations of myocardial ischemia].

The ECG is an indirect and non-specific test of myocardial ischemia, which means that the limits in respect to sensitivity and specificity must be evaluated. The dynamic Holter ECG is a useful method, particularly if pain appears during the recording time. The exercise test as an example of additional stress is of great general interest, especially in man; stress-testing is particularly useful in explaining the origin of atypical anginal pain. Hence the interpretation criteria must be closely followed rather than enlarged as long as the indication for diagnostic coronary-angiography is limited by the result of exercise testing. When other non-invasive methods are not readily available it should be possible to broaden the diagnostic criteria to increase sensitivity; by the same token, the number of false positive tests will be controlled by these complementary non-invasive methods.

Coronary Disease↗