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Biomedical subjects

P Grande

Publications and source records attributed to P Grande.

At least 127 records · Page 7Linked to original sources
PubMed1980

Enzyme activities in serum after extensive exercise, with special reference to creatine kinase MB.

It is well documented that elevations of serum enzymes used as criteria in establishing the diagnosis of acute myocardial infarction (AMI) often show a pattern of AMI after physical exercise without other clinical signs of myocardial damage. Since a clinical condition resembling AMI sometimes appears after strenuous physical exercise, this study was designed to show if the new, almost heart-specific, isoenzyme creatine kinase MB (CK-MB) would solve the diagnostic problems. Ten well trained volunteers took part in a 26 km jogging race. None of them had any cardiovascular symptoms, but the 'old' cardiac enzymes rose in some of them above the discriminatory levels, whereas CK-MB was below these levels in all cases. It is concluded that CK-MB determination is a valuable diagnostic tool, also in patients who have recently exercised extensively.

Adolescent↗
PubMed1980

Optimal diagnosis in acute myocardial infarction. A cost-effectiveness study.

The predictive value of a diagnostic test estimates the likelihood for presence or absence of disease in a patient with a positive or negative test result (PVpos or PVneg). We evaluated the predictive values of serum activities of the heart-specific creatine kinase isoenzyme MB (CK-MB), aspartate aminotransferase, lactate dehydrogenase, CK, and ECG in 401 consecutively admitted patients suspected of acute myocardial infarction (AMI). The study showed that CK-MB (PVpos = 0.98, PVneg = 1.00) was better than the other enzymes (single as well as serial) and ECG, evaluated both separately and in combinations. In all cases of AMI CK-MB was positive within 17 hours from admission. Replacement of the standard enzymes with CK-MB provides a faster and safer diagnosis of AMI and reduces hospitalization time considerably for patients without AMI.

Acute Disease↗
PubMed1980

An easy and reliable estimation of acute myocardial infarct size from serum CK-MB measurements.

The purpose of this study was to determine a simple and reliable procedure of estimating acute myocardial infarct (AMI) size by measuring serum creatine kinase MB (CK-MB) in few daily blood samples. In 13 patients with AMI blood samples were drawn every second hour for 60 h for determination of serum CK-MB activity. Infarct size was calculated using the CK-MB values of all samples and compared to the size calculated according to various models based on enzyme levels in few samples. Two models, using 3 daily samples, showed very high correlations and satisfactory standard errors of estimate when compared to the infarct size calculated from all samples. One of the 2 models was based on a computerized log-normal curve fit programme and one on accumulation of serum activities of CK-MB. The coefficient of variation of infarct size estimated from thrice-daily sampling was 7.4 and 9.4 for the 2 models. Considering the twenty-fold variation in infarct size a satisfactory quantitation is achieved from 3 daily samples.

Aged↗
PubMed1980

Cardio-specific serum enzyme CK--MB following physical exercise in acute myocardial infarction.

The possible harmful effect of physical activity on the extent of myocardial damage in patients with fresh myocardial infarction (AMI) has been a matter of debate. In this paper, serial determinations of serum creatine kinase (CK) isoenzymes are presented from 20 unselected patients with AMI, in 14 of them complicated by congestive heart failure or/and significant rhythm disturbances. During the acute phase, the cardiospecific MB-isoenzyme of CK in all patients rose above the upper reference limit of 30 U/l, the peak values ranging from 39 to 741, and returned to normal range within a few days. During the third week a maximal, symptom-limited exercise test was performed, with renewed serial determinations of CK-isoenzymes. Following the exercise an ST-segment deviation in the ECG was noted in 14 patients, anginal pain in 4, and a significant rise in serum CK--MM activity in 9 patients, whereas the CK--MB isoenzyme remained at zero level in all 20 patients. Thus, no evidence was found that even a maximal physical effort during the third week after AMI did cause any myocardial damage.

Acute Disease↗
PubMed1979

Creatine kinase isoenzyme MB assay by electrophoresis.

A method for determination of the creatine kinase isoenzyme MB (CK-MB) is reported: separation of the isoenzymes was done by electrophoresis and the activity of the isoenzyme bands quantitated by scanning fluorometry. Total CK activity was used for calculation of CK-MB level. The precision of the method was satisfactory: coefficient of variation 5-10%. Its accuracy good: CK-MB was consistently found in high concentrations in tissue extracts of myocardium, but was virtually absent in skeletal muscle and could not be demonstrated in serum from patients with skeletal muscle damage. The sensitivity of the method fitted its clinical use: CK-MB was undetectable (less than 5 U/l) in normal sera, below 30 U/l in seventy-six out of seventy-seven patients in whom the diagnosis of acute myocardial infarction (AMI) was disproved, and above 30 U/l in all seventy-two patients with AMI according to WHO criteria. The CK-MB concentration in serum rises to a maximum about 20 h after onset of clinical symptoms of AMI and reaches baseline levels 20-30 h later. The electrophoretic CK-MB method is easy, fast and reliable and is considered as an important diagnostic test for AMI.

Adult↗
PubMed1977

[Preventing complications due to dilatation by intracervical application of a prostaglandin-gel (author's transl)].

Mechanical injuries by dilatating the cervix uteri for artificial abortion may lead to intra- and postoperative complications; of these cervical insufficiency during subsequent pregnancy is of main importance. In order to prevent this complication 160 patients in the 8th to 18th week of pregnancy, who were going to have a legal abortion, were treated with a gel consisting of 3--5 mg Prostaglandin F2alpha which was applicated in the cervix uteri. In more than 90% of these cases a mechanical dilatation was not necessary afterwards. Generally the cervix uteri was softened and dilatated to Hegar 12. 32% of the patients had a spontaneous abortion. Therefore only a curettage without a dilatation had to be performed. Complications due to the application of the gel did not occur. The combined application of the gel with the extraamnial instillation of Prostaglandin for artificial abortion during the second trimenon reduced by half the period of indwelling of the intrauterine foley-catheter and therewith the risk of infection as well as the period of labour pains. Further possible ways of applicating the Prostaglandin gel in gynecology and obstetrics concern missed abortion, intrauterine death, and cervical dystocia during delivery.

Abortion, Induced↗