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Biomedical subjects

M Sanders

Publications and source records attributed to M Sanders.

At least 127 records · Page 7Linked to original sources
PubMed1983

Single catheter technique for accurate cardiac outputs from left ventricle.

We report our experience in cardiac output measurements using a single catheter for left ventricular green dye injection with sampling from the side arm of a femoral artery introducer sheath. This technique is compared to thermal dilution (20 patients) and pulmonary artery green dye injection (20 patients). There were no significant differences between the single catheter left ventricular method and the other two accepted methods for measuring cardiac output.

Cardiac Catheterization↗
PubMed1983

Bundle branch block in acute myocardial infarction.

The management of patients with acute myocardial infarction complicated by bundle branch block is a significant clinical problem and represents 8% to 13% of patients with acute infarction. This study reviews the records of 606 patients with myocardial infarction admitted to our coronary care unit. Forty-seven (8%) had complete bundle branch block. The risk of developing high-degree AV block in these 47 patients was reviewed. There are no established therapeutic guidelines for patients with pre-existing bundle branch block and left bundle branch block in acute myocardial infarction. We found a high risk of progression in patients with pre-existing bifascicular block in the presence of anterior wall infarction (25%) as well as in patients with left bundle branch block with acute anterior wall infarction (100%). On the basis of our data and careful review of the literature, we recommend prophylactic pacemaker insertion in these high-risk groups.

Bundle-Branch Block↗
PubMed1983

Clinical significance of slow paroxysmal atrial tachycardia.

This study examines the clinical setting, characteristics, and follow-up of 173 patients who had slow paroxysmal atrial tachycardia (SPAT) (greater than 4 beats, rate less than 150 bpm) during 24-hour Holter monitoring. These episodes were classified by probable mechanism according to recognized ECG criteria and included AV nodal reentry (AVNR), sinoatrial nodal reentry (SANR), and automatic (A). There were 76 males (44%) with a mean age of 72 years and 97 females (56%) with a mean age of 73 years. The indications for Holter recording revealed that the SANR and A subgroups had a higher frequency of cerebral symptoms compared to AVNR (p less than 0.01). Chest pain was more common in the SANR group as compared to the other two groups (p less than 0.01). There was no difference in the frequency of palpitation in the three subgroups. The mean rate of SPAT for the entire group was 115.2 +/- 14 and these episodes had a mean duration of 5.58 +/- 3.07 seconds. The SANR subgroup had a significantly slower rate (107.1 +/- 9.2) as compared to the AVNR subgroup (p less than 0.01). One hundred fourteen patients were available for follow-up. The average period of follow-up was similar for all three groups. At follow-up the frequency of sick sinus syndrome as determined clinically and permanent pacemaker insertion was significantly greater in the SANR subgroup (p less than 0.01) as compared to the other subgroups which did not differ from each other.

Aged↗
PubMed1983

Efficacy of sustained-release buccal nitroglycerin in patients with angina pectoris. New and long-acting therapy demonstrated by exercise.

The antianginal efficacy of a single sustained-release buccal nitroglycerin (BNTG) tablet was assessed in 16 patients with known coronary artery disease. Patients were trained in bicycle ergometry to induce angina pectoris within three to five minutes. A hemodynamically effective dose of BNTG was identified. Patients were tested at baseline and given placebo and BNTG in a randomized, double-blind manner on consecutive days. They were tested at 0.5, 1, 3, and 5 hours after drug administration. The average increase in exercise duration with BNTG compared with placebo at 0.5 hours was 40 percent (p less than 0.01); at 1 hour was 31 percent (p less than 0.01); at 3 hours was 27 percent (p less than 0.01); at 5 hours was 15 percent (p = NS). In a subset of ten patients in whom the tablet was maintained in the buccal pouch for five or more hours before dissolving, increase in exercise duration was significant at all times tested (p less than 0.05). We conclude that BNTG is an effective modality of administering nitroglycerin for rapid and prolonged effect with reduction in angina pectoris and increase in exercise duration which may persist for at least five hours.

Adult↗
PubMed1982

An epidemiologic study of neural tube defects in Los Angeles County I. Prevalence at birth based on multiple sources of case ascertainment.

Epidemiologic studies of the neural tube defects (NTDs), anencephalus and spina bifida, have for the most part been based on single sources of case ascertainment in past studies. The present investigation attempts total ascertainment of NTD cases in the newborn population of Los Angeles County residents for the period 1966-1972. Design of the study, sources of data, and estimates of prevalence rates based on single and multiple sources of case ascertainment are here discussed. Anencephalus cases totaled 448, spina bifida 442, and encephalocele 72, giving prevalence rates of 0.52, 0.51, and 0.08 per 1000 total births, respectively, for these neural tube defects--rates considered to be low. The Los Angeles County prevalence rates are compared with those of other recent North American studies and support is provided for earlier suggestions of low rates on the West Coast.

Anencephaly↗
PubMed1982

Current incidence of postmyocardial infarction (Dressler's) syndrome.

This study examines the current incidence of postmyocardial infarction (Dressler's) syndrome. During 1980, 282 patients with documented myocardial infarction were admitted to our coronary care unit. Early postmyocardial infarction pericarditis was present in 18 patients (6.4%). Six of these patients received steroids and the remainder were treated with salicylates or other anti-inflammatory drugs. Anticoagulation was used in 149 patients (53%) during hospitalization. One hundred forty-four (51%) were receiving heparin and 133 (47%) received no anticoagulation. Information on the patient's status at 6 months was available in 229 patients who were discharged alive. Sixteen patients had died within 6 months after discharge and 4 patients were lost to follow-up study. There were no documented cases of Dressler's syndrome. It is concluded that Dressler's syndrome has decreased in incidence and perhaps disappeared. This decrease is most likely related to decreased use of oral anticoagulants and to more aggressive treatment of postmyocardial infarction pericarditis.

Anti-Inflammatory Agents↗
PubMed1982

Visual-field differences in picture-word interference.

Picture-word interference refers to the fact that if a picture (i.e., line drawing) is presented centrally with a word superimposed, picture-naming latency is longer than if that same picture is presented alone. This phenomenon, like the Stroop phenomenon, seems to be strongly influenced by the nature of the to-be-ignored word. That is, if the word names a member of the picture's semantic category additional interference is observed; however, if the word is replaced by a phonetically unviable consonant string interference is reduced. In the present experiments these effects were examined in the situation where the picture-word stimuli were presented unilaterally in either the left or right visual field. For right-visual-field presentations, phonetic and semantic factors both influenced performance just as in central presentations. As such, these results can be satisfactorily explained in terms of response competition processes. However, the results for the left-visual-field presentations were quite different. Although substantial interference was observed for all types of stimuli, the amount of interference was essentially independent of the linguistic nature of the superimposed letter string. These results do not appear to be explainable in terms of response competition processes. Instead, it is suggested that the best way to explain these results is in terms of the perceptual capabilities of the right hemisphere.

Cerebral Cortex↗
PubMed1982

Relationship between QRS width and the presence of neoplasm.

This study examines the relationship between QRS width and the presence of neoplasia. The QRS width was measured in 236 consecutive ambulatory patients. The patients' body surface area, CBC, SMA 6, and SMA 12 were also recorded. There were 17 out of 34 (50%) patients with neoplasia in the group with QRS less than 0.08 seconds. There were only 19 out of 78 (24%) with neoplasia in the group with QRS greater than or equal to 0.08 seconds (P less than 0.01). We conclude that there is a higher incidence of neoplasia in patients with a QRS less than 0.08 seconds than in patients with a QRS greater than or equal to 0.08 seconds. This difference cannot be explained by age, body surface area, hemoglobin, or any variable in SMA 6 or SMA 12.

Aged↗
PubMed1982

Natural history of severe sinus bradycardia discovered by 24 hour Holter monitoring.

This study follows patients with severe sinus bradycardia (40 beats per minute for 6 seconds or greater) in order to evaluate mortality and the effectiveness of permanent pacemaker insertion. Severe sinus bradycardia was noted on a 24-hour Holter in 95 patients. There were 64 males and 31 females with a mean age of 69 +/- 10 years. All were available for follow-up at 26 +/- 13 months. Twenty-eight required a permanent pacemaker at an average of 2 +/- 3 months after the Holter. Of this group 12 had the Holter for arrhythmia, 11 for cerebral symptoms, 4 for palpitations and 1 for chest pain. Only 1 was taking digitalis and no patients were taking Inderal. Six (21%) died at a mean interval of 21 +/- 15 months following pacemaker insertion. Sixty-seven did not require pacemaker insertion. The indications for Holter monitoring were arrhythmia in 16, palpitations in 19, cerebral symptoms in 20 and chest pain in 12. Four of these patients were on digitalis, 8 on Inderal, and 4 on both. Eleven (16%) died at a mean interval of 12 +/- 7 months after the initial Holter recording. Dizziness and/or syncope reoccurred in 22. Five had these symptoms even after pacemaker insertion. We conclude that severe sinus bradycardia is associated with a significant mortality. Insertion of a permanent pacemaker may decrease recurrent symptoms and slightly increase time of survival, but does not appear to influence the overall survival rate.

Aged↗
PubMed1982

Coronary artery spasm appearing as syncope.

A 56-year-old man had coronary artery spasm. The initial manifestation of the disease was syncope that occurred at night. Coronary artery spasm was documented by Holter recording and cardiac catheterization. The patient was effectively treated with nitrates and calcium-blocking agents.

Angina Pectoris, Variant↗
PubMed1982

Determination of lead and cadmium in foods by anodic stripping voltammetry: I. Development of method.

Food samples are dry ashed at 500 +/- 50 degrees C with a 10% aqueous K2SO4 solution used as an ashing aid. The ashed sample is dissolved in 50 mL 2% HNO3. Anodic stripping voltammetry is used to determine lead and cadmium in a mixture of the sample solution and an acetate electrolyte at pH 4.3 +/- 0.3. The estimated quantitation limits, based on a 10 g food sample, are 0.005 ppm for cadmium and 0.010 ppm for lead.

Cadmium↗
PubMed1982

Determination of lead and cadmium in foods by anodic stripping voltammetry: II. Collaborative study.

A dry ash anodic stripping voltammetric method for determining lead and cadmium in foods was collaboratively studied by 20 laboratories. The food commodities studied were strained green beans, beef (baby food), fish (mackerel), infant formula (milk base), apple juice, and cereal (wheat farina). Each collaborator analyzed 3 commodities, each consisting of 2 duplicate lead and cadmium fortification levels, for a total of 4 samples for each commodity. The low fortification levels ranged from 0.03 to 0.08 ppm for cadmium and from 0.05 to 0.15 ppm for lead. The high fortification levels ranged from 0.12 to 0.28 ppm for cadmium and from 0.24 to 0.45 ppm for lead. Each commodity was analyzed by 10 collaborators. The average overall reproducibilities of the low level fortifications were 24% for lead and 21% for cadmium; for the high level fortifications, average overall reproducibilities were 18% for lead and 16% for cadmium. The average accuracies of the collaborative results as measured by comparison to reference values were 96 and 97% for cadmium and lead, respectively. This method has been adopted official first action.

Cadmium↗
PubMed1981

Gray scale ultrasonography and transhepatic cholangiography in evaluation of obstructive jaundice: a comparative study.

A total of forty-four jaundiced patients were studied by one or both diagnostic modalities (Gray Scale Ultrasonography or Transhepatic Cholangiography--THC--). The thin needle transhepatic cholangiography permitted in vivo correlation of the ultrasonographic findings. Patients with obstruction were confirmed by surgery. Many of the non-obstructive cases underwent liver biopsy. The accuracy of Gray Scale Ultrasonography in differentiation of surgical from medical jaundice dependent on the serum bilirubin level at the time of the examination. For serum bilirubin levels of seven or more milligrams percent, the accuracy was almost one hundred percent. For serum bibiribuin levels of less than seven milligrams percent, the accuracy was approximately eighty-three percent. THC using the thin needle is the ultimate diagnostic procedure and complements the ultrasound information, especially in cases with minimal to moderate icterus. A proposed flow chart for evaluation of the jaundiced patient is presented. The ability to determine the presence of obstruction by demonstrating dilated bile ducts at different levels of serum bilirubin with Gray Scale Ultrasonography was evaluated. Percutaneous TCH using the thin needle (Chiba Needle) made possible the in-vivo correlation of many of the ultrasound findings, as well as the demonstration of surgical jaundice in patients with normal sized bile ducts.

Bilirubin↗