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Biomedical subjects

N Roguin

Publications and source records attributed to N Roguin.

At least 19 recordsLinked to original sources
PubMed1999

Closure of the ductus venosus in premature infants: findings on real-time gray-scale, color-flow Doppler, and duplex Doppler sonography.

OBJECTIVE: Our objective was to use gray-scale, color-flow, and duplex Doppler sonography to study the anatomy, flow pattern, and time of closure of the ductus venosus in healthy premature infants. SUBJECTS AND METHODS: We prospectively examined the ductus venosus in 130 premature infants whom we divided into two groups: Group I comprised 27 neonates of gestational age 28-32 weeks, and group II comprised 103 neonates of gestational age 33-36 weeks. Neonates who had undergone umbilical vessel manipulation were excluded from the study. All examinations included gray-scale, color-flow, and duplex Doppler sonography. Patency, length, color flow, and Doppler characteristics of the ductus venosus were recorded. Neonates were examined 1-2 days after birth, 6-7 days after birth, and subsequently every 3-4 days until ductus closure was observed. The time of closure of the ductus for the two groups was compared using the chi-square test. RESULTS: The ductus venosus was patent during the initial examination in 128 of the 130 neonates. Doppler waveform was venous with little variation in velocity. Ductus length slightly exceeded 1 cm in both groups. We found a statistically significant difference in the percentage of infants having a patent ductus venosus after the initial examination: At 1 week after birth, ductus patency was shown in 85% of the infants in group I and in 56% of the infants in group II; at 2 weeks, the respective percentages were 42% and 14%; and at 3 weeks, 27% and 0%. CONCLUSION: The ductus venosus is patent 1-2 days after birth in virtually all premature infants. From 6 days after birth and onward, a significantly greater percentage of smaller premature infants (i.e., 28-32 weeks' gestational age) have a patent ductus venosus than do larger premature infants (i.e., 33-36 weeks' gestational age).

Blood Flow Velocity↗
PubMed1998

Spontaneous closure of muscular ventricular septal defect identified by echocardiography in neonates.

Muscular ventricular septal defects were diagnosed by echocardiography in 97 neonates within 7 days of birth. In 82 of the neonates (84.5%), the defect was solitary, while 15 had multiple defects. The solitary defects was located at mid-septal, apical, anterior and inlet locations in 42 (51.2%), 21 (25.6%), 14 (17.1%) and 5 (6.1%) neonates, respectively. Multiple defects occurred in the apical, anterior and mid-septal areas. The diameter of the solitary defects ranged from 1 to 6 mm (2.3 +/- 0.8 mm), while the multiple lesions were 1 to 4 mm in diameter (2.1 +/- 0.8 mm) in 28 instances in which they could measured. It proved possible to follow 79 of the patients for period of 10 to 13 months. The defects closed spontaneously in 56 (84.8%) of 66 patients with a single defect, and in 7 (53.8%) of 13 of those with multiple defects (P<0.05). For the solitary defects, the position and size were factors determining the likelihood and speed of closure. Defects located at the apical septum, or defects larger than 4 mm in diameter, closed slowly and at a later stage. Echocardiography is an useful technique in establishing of natural history of muscular ventricular septal defects encountered in neonates.

Echocardiography, Doppler↗
PubMed1997

Pulmonary hypertension in patients with thalassemia major.

To evaluate the pulmonary artery pressure in patients with thalassemia major, Doppler echocardiography was performed in 33 patients with thalassemia major (aged 2 to 24 years) and 33 normal controls. Pulmonary artery pressure was estimated by (1) measuring the systolic transtricuspid gradient from tricuspid regurgitation and adding it to the right atrial pressure, estimated by the response of the inferior vena cava to deep inspiration, and (2) measuring the time to peak velocity of pulmonary flow. The results showed that of 33 patients, 28 had tricuspid regurgitation with a pulmonary systolic pressure ranging from 18 to 94 mm Hg (47 +/- 15 mm Hg). Pulmonary systolic pressure was > 30 mm Hg in all 22 patients > 10 years old and in four of six patients < 10 years old. Pressure correlated with left ventricular ejection fraction (r = -0.74), the ratio of mitral peak early diastolic flow velocity and peak velocity during the atrial contraction (r = 0.52), age (r = 0.56), and total blood transfusion units (r = 0.59). The pulmonary time to peak velocity was shortened compared with controls (p < 0.05). We concluded that pulmonary hypertension, as another cardiovascular complication of multiple factors of cause, seems to occur more frequently and at an early stage of the cardiac involvement in patients with thalassemia major.

Adolescent↗
PubMed1997

Clinical and echocardiographic evaluation of neonates with heart murmurs.

In this study, 116 neonates (58M, 58F), aged 12h to 14d, with heart murmurs were examined by echocardiography: 26 were preterm and 90 full-term neonates. The clinical diagnosis was classified into definite heart disease, possible heart disease and innocent murmur. The final diagnosis was based on echocardiography and, in some cases, cardiac catheterization or surgery. The results showed that 97 (84%) neonates had heart diseases; 19 (16%) had a normal heart, including 7 with tricuspid regurgitation and 9 with physiological peripheral pulmonic stenosis. Out of 88 neonates with clinically definite heart disease, the final diagnosis was changed to normal heart in 9 (10%) cases and the lesion-specific diagnosis was changed in 9 (10%) neonates. In four cases, the clinical diagnosis of ventricular septal defect or pulmonary stenosis was changed to double-outlet right ventricle, single ventricle, hypoplastic left heart syndrome or tetralogy of Fallot. The clinical diagnosis was correct in 77-85% for varying simple lesions. In 5 of 21 neonates with clinically possible heart disease, the diagnosis was changed to normal heart. In one of six neonates with clinically innocent murmurs, the diagnosis was changed to small muscular ventricular septal defect. We concluded that 84% of heart murmurs in neonates were due to heart diseases and only 16% were innocent murmurs. Although clinical evaluation could determine the presence or absence of heart disease in most neonates, the lesion-specific diagnosis was not quite satisfactory. Echocardiography is necessary for neonates with a clinically diagnosed heart disease or possible heart diseases, and may be unnecessary for those with innocent murmurs diagnosed by paediatricians.

Diagnosis, Differential↗
PubMed1996

High prevalence of muscular ventricular septal defect in preterm neonates.

Isolated muscular ventricular septal defect was identified in 9 of 159 consecutive preterm neonates by color Doppler echocardiography, a prevalence of 56.6/1,000 live births. The neonates with ventricular septal defects appear clinically healthy, and in 87.5% of them the defect spontaneously closed within 6 to 11 months. The prevalence and rate of spontaneous closure are similar to those in full-term neonates.

Chi-Square Distribution↗
PubMed1996

Comparison of patients with acute myocardial infarction with and without ventricular fibrillation.

Among 1,590 patients with acute myocardial infarction from 1990 to 1994, the rate of primary ventricular fibrillation was 3.6%. The prevalence of smoking, complete left bundle branch block, hypokalemia, and decreased left ventricular function was higher in patients with ventricular fibrillation while those on thrombolytic therapy and those with non-Q-wave myocardial infarction were significantly lower.

Case-Control Studies↗
PubMed1995

High prevalence of muscular ventricular septal defect in neonates.

OBJECTIVES: This study sought to use echocardiography to evaluate the prevalence of muscular ventricular septal defect in neonates. BACKGROUND: Ventricular septal defect is usually asymptomatic and closes spontaneously. An increase in its prevalence has been noted recently. One reason is the improved detection of small defects, especially with the increased used of echocardiography. Therefore, one would expect a higher prevalence in neonates on the basis of echocardiographic screening. METHODS: Color Doppler echocardiography was performed in 1,053 consecutive neonates 6 to 170 h old at Western Galilee Hospital, Israel. Data on the neonates, parents and family were obtained to analyze the influencing factors. The identified patients were followed up for 1 to 10 months or until ventricular septal defect closure. RESULTS: Muscular ventricular septal defect was found in 56 (25 male, 31 female) of the 1,053 neonates, a prevalence of 53.2/1,000 live births. All neonates were asymptomatic. Six had a systolic murmur. Electrocardiographic findings were normal in 44 (97.8%) of 45 neonates followed up, and left ventricular hypertrophy occurred in 1 (2.2%). By echocardiography, 50 ventricular septal defects (89.3%) were single and 6 (10.7%) were multiple. The defects (range 1 to 5 mm in diameter, mean [+/- SD] 2.3 +/- 0.8) occurred anywhere along the muscular septum; 43 (76.8%) were detectable only on color Doppler imaging. The left atrium and left ventricle were mildly dilated. Of 45 neonates who were followed up for 6 to 10 months or until closure of the defects, 40 (88.9%) had defects that closed spontaneously. The risk of ventricular septal defect was not significantly associated with gestational age, birth weight, birth order, maternal age, diabetes, smoking, exposure to drugs or infection, paternal age, familial congenital heart disease, religion or consanguinity. CONCLUSIONS: There is a prevalence of muscular ventricular septal defect in neonates of 53.2/1,000 live births. The patients were asymptomatic, and 88.9% had defects that closed spontaneously within 1 to 10 months. These defects may be caused by environmental factors. In many cases, muscular ventricular septal defect may also result from delayed physiologic development.

Echocardiography, Doppler, Color↗
PubMed1995

Plasma fibrinogen levels and their correlates in 6457 coronary heart disease patients. The Bezafibrate Infarction Prevention (BIP) Study.

The association between fibrinogen measured in healthy individuals and subsequent development of ischemic heart disease is well established, but studies reporting fibrinogen levels in coronary heart disease patients are scarce. Plasma fibrinogen was determined for 5729 men and 728 women (aged 45 to 74) with established coronary heart disease, screened for participation in the Bezafibrate Infarction Prevention study, with the following lipid profile at the time of the first screening visit: total serum cholesterol < or = 270 mg/dl, high density lipoprotein cholesterol < or = 45 mg/dl and triglyceride < or = 300 mg/dl. Increased age was associated with augmented plasma fibrinogen values. Age-adjusted fibrinogen levels were higher in women than in men. A direct association was found between mean fibrinogen levels and low density lipoprotein cholesterol. On the other hand, the correlation with high density lipoprotein cholesterol was inverse. Fibrinogen was also associated with body mass index, behavioral variables and severity of coronary heart disease. In a multivariable linear regression analysis performed, risk factors considered explained merely 6 and 4% of fibrinogen variation for men and women, respectively. Therefore, most of the fibrinogen level variability in coronary heart disease patients is accounted for by factors that remain to be established by further research.

Age Factors↗
PubMed1993

Red cell filterability in cigarette smokers and its relations to cardiac hypertrophy.

The relationship among daily cigarette consumption, washed and non-washed RBC filterability time (FT) as an indicator of erythrocyte deformability and echocardiographic left ventricular mass (LVM) were examined in 25 clinically healthy smokers and in 25 non-smoking controls matched for sex and age. FT of non-washed RBC was significantly higher in smokers than in non-smokers (25.2 +/- 3.6 vs. 16.8 +/- 2.2 min, P < 0.001). A highly significant linear correlation between number of cigarette consumption and FT was found. These differences were not observed when RBC were washed three times with isotonic saline. LVM was significantly greater in smokers (85.5 +/- 13.4 g/m2) than in controls (61.8 +/- 6.7 g/m2, P < 0.001). A linear correlation between daily cigarette consumption and LVM was observed. A positive relationship between LVM and FT of non-washed RBC was also found. These results demonstrated that LVM is significantly elevated in smokers and is linearly correlated with both cigarette consumption and RBC filtratibility. The increased deformability found in smokers may be a determinant to the cardiac hypertrophy. The association of both elevated LVM and rheological impairment may indicate unfavourable prognosis.

Adult↗
PubMed1993

Transient mitral regurgitation in acute glomerulonephritis.

During an epidemic of acute glomerulonephritis (AGN) 15 patients were studied by M-mode, cross-sectional, and Doppler echocardiography. All 15 patients had the classical signs of the disease including hematuria, proteinuria, edema, and consistent laboratory findings. There were 10 boys and five girls with a mean age of 8 years. Ten of the 15 patients had an enlarged left atrium and five of these 10 also had transient mild to moderate mitral regurgitation. In the five patients with mitral regurgitation the ratio of left atrium/aorta was 1.48; in the five patients with an enlarged left atria without evidence of mitral regurgitation the left atrium/aorta ratio was 1.34. All the patients had normal left ventricular dimensions, as well as ejection and shortening fractions. The findings of left atrial enlargement and mitral regurgitation disappeared gradually in all patients within 3 months. There was no correlation between the level of systemic blood pressure and the development of mitral regurgitation. A possible cause for these changes is fluid overload in the oliguric phase of the acute glomerulonephritis. The changes are transient and probably functional. There was no significant mitral valve or left atrial anomaly 3 and 6 months after hospital discharge.

Acute Disease↗
PubMed1992

Closure of the ductus venosus in neonates: findings on real-time gray-scale, color-flow Doppler, and duplex Doppler sonography.

OBJECTIVE: Our objective was to document the anatomy, flow pattern, and time of closure of the ductus venosus in healthy full-term neonates. SUBJECTS AND METHODS: We examined the ductus venosus in 73 neonates by using gray-scale sonography, color flow imaging, and duplex Doppler sonography. Each neonate was examined 1-2 days after birth, 6-7 days after birth, and then every 3-4 days until closure was confirmed or the neonate was 18 days old. The length, width, and color flow and duplex Doppler characteristics of the ductus were noted. Closure of the ductus at 6-7 days after birth was examined with respect to birth weight, hemoglobin level, and gestational age. RESULTS: The ductus venosus, extending from the left portal vein to the inferior vena cava, was identified with all three techniques. The ductus was patent in all 73 neonates 1-2 days after birth. It was still patent in 41 (68%) of 60 neonates reexamined 6-7 days after birth and in two of three neonates (11% [7/60]) reexamined 17-18 days after birth. Blood flow within the ductus was cephalic, in a constant venous waveform. Initial flow velocity ranged from 0.15 to 0.70 m/sec and decreased consistently in subsequent examinations. There was no significant difference in birth weight, hemoglobin level, or gestational age between the group whose ductus was closed and the group whose ductus was open at 6-7 days after birth. CONCLUSION: The ductus venosus in neonates is consistently detectable on sonography. It is patent in a greater percentage of neonates, and for a longer time, than was previously shown with conventional radiographic studies with angiography.

Blood Flow Velocity↗
PubMed1990

Contraindication to thrombolytic therapy in accidental hypothermia simulating acute myocardial infarction.

A 35-year-old schizophrenic patient was admitted to the Coronary Care Unit with shock, bradycardia and ST-T changes mimicking acute myocardial infarction. The rectal temperature was 33.6 degrees C and the diagnosis of accidental hypothermia was established. Accidental hypothermia must be considered in the differential diagnosis of acute myocardial infarction before instituting thrombolytic therapy.

Adult↗