Glycoprotein IIb/IIIa inhibitors: therapeutic applications in acute ST-segment elevation myocardial infarction.
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Coronary Circulation↗
Biomedical subjects
M Sketch
Publications and source records attributed to M Sketch.
[Prostaglandin E1 for prevention of contrast medium-induced kidney dysfunction].
PURPOSE: Acute renal failure is a known complication of contrast media (CM) application in risk patients. Therefore an efficient prevention is highly desirable. The purpose of this pilot study was a) to demonstrate the efficacy and safety of prostaglandin E1 (PGE1 = alprostadil) in the prophylaxis against CM associated renal dysfunction in patients with renal disease, and b) to identify the adequate dose. METHODS: A total of 130 patients with renal dysfunction who were scheduled for intravascular CM administration were enrolled. They received PGE1 (10, 20, or 40 ng/kg/min) or placebo intravenously over a period of six hours (beginning one hour prior to exposure). Efficacy was determined by measuring serum creatinine and creatinine clearance. Safety was assessed by recording adverse experiences throughout the study and close monitoring of vital parameters especially during study drug administration. RESULTS: PGE1 proved to be superior to placebo in all doses. The dose of 20 ng/kg/min was most promising due to the lowest increase of serum creatinine 48 hours after CM administration. With respect to creatinine clearance, no relevant differences between study and control groups were observed. CONCLUSION: Our results suggest that intravenously administered PGE1 may be efficient in preventing CM-induced renal dysfunction in patients with renal impairment.
Acute Kidney Injury↗
Transient increase in plasma quinidine concentrations during ketoconazole-quinidine therapy.
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Aged↗
Serial ambulatory monitoring in patients with unstable angina pectoris.
We performed a prospective study by dual-channel ambulatory monitoring performed for 24 to 72 hours immediately after hospitalization for unstable angina. The incidence of ST-segment depression or elevation or ventricular tachycardia or complex premature ventricular complexes (PVCs) in 42 consecutive patients with unstable angina due to coronary artery disease (39 by coronary arteriography) was investigated. During ambulatory monitoring, 28 of 42 patients (67%) exhibited ST-segment depression or elevation, 13 of 42 patients (31%) had ventricular tachycardia or complex PVCs, and 31 of 42 patients (74%) had either ST-segment depression or elevation, ventricular tachycardia, or complex PVCs. Ventricular tachycardia or complex PVCs occurred in 10 of 20 patients (50%) with abnormal left ventricular function and in 3 of 22 patients (14%) with normal left ventricular function (p less than 0.025). We found that 72 hours of ambulatory monitoring was not more useful than 48 hours in detecting the incidence of ST-segment depression or elevation, ventricular tachycardia, or complex PVCs. Ambulatory monitoring did not help in clinically differentiating patients with left main or 3-vessel disease from 1-vessel or 2-vessel disease. In addition, ambulatory monitoring did not help in predicting which patients with unstable angina would require coronary artery surgery.
Aged↗
Hereditary progressive atrioventricular conduction defect.
New data on genetics, including an extensive pedigree and certain aspects of natural history, have been compiled on Family S, which is characterized by a hereditary progressive atrioventricular (A-V) conduction defect. Concordance analysis of heart block in affected parents and their offspring suggests as a working hypothesis transmission of diathesis for the defect by means of a Mendelian autosomal dominant factor. Regression of the defect in several relatives, including reversion from first degree heart block to normal A-V conduction, defies explanation at this time. However, rapport established with the unusually large (1,067 members) and cooperative kindred will permit longitudinal evaluation of these findings.
Adolescent↗