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P Hoffman

Publications and source records attributed to P Hoffman.

142 records · Page 8Linked to original sources
PubMedDate not supplied

Transgastric imaging: a valuable addition to the assessment of congenital heart disease by transverse plane transesophageal echocardiography.

Multiview transgastric imaging was performed with standard single transverse plane transesophageal probes in 16 patients to assess its potential additional value in defining the complexities of congenital heart disease. The age of patients studied ranged from 1.1 to 32 years (mean of 10.4 years). Their body weight ranged from 8.3 kg to 69 kg (mean of 29 kg). In all studies, a complete range of transesophageal and transgastric views could be obtained. The information thus obtained was correlated with the findings of prior precordial echocardiography and subsequent cardiac catheterization or surgical inspection. The pathologic conditions studied included tetralogy of Fallot, (4), isolated ventricular septal defect (4), valvular aortic stenosis (1), subvalvular and valvular aortic stenosis (1), supraaortic stenosis (1), total atrioventricular septal defect (1), secundum atrial septal defect (1), double-outlet right ventricle (1), double-chambered right ventricle (1), and pulmonary atresia, ventricular septal defect, and superoinferior ventricles (1). The single-plane data provided by transgastric scanning were compared and contrasted with that obtained from transesophageal scanning. Transgastric views were shown to be superior to transesophageal imaging in demonstrating the anatomy of the right ventricular outflow tract, the left ventricular outflow tract, and the apical and anterior aspects of the ventricular septum. In addition, these views offered a favorable angle of incidence for spectral wave Doppler studies of flow in both outflow tracts. We conclude that transverse plane transgastric imaging is an important addition to the transesophageal assessment of congenital cardiac disease. Its main additional benefit is in the study of lesions that involve either the right or left ventricular outflow tract or the anteroapical ventricular septum. Its main clinical value is likely to be in the evaluation of the perioperative patient in whom diagnostic precordial imaging is frequently impossible.

Adolescent↗
PubMedDate not supplied

The transesophageal echocardiographic features of double-orifice left atrioventricular valve.

Three adult patients with a double-orifice left atrioventricular valve (AV) were studied by both precordial and transesophageal ultrasound imaging, (two transverse plane and one biplane studies) to compare and contrast the information obtained by either imaging modality. In two patients, this pathologic condition was associated with other congenital heart malformations--a muscular inlet ventricular septal defect in the first, atrioventricular and ventriculoarterial discordance and an unrestrictive ventricular septal defect in the second. In the third patient, the double-orifice left AV valve existed as an isolated lesion. In the first and second case, both orifices were of similar size; in the third the additional orifice was of diminutive size and was demonstrated only by transesophageal longitudinal plane scanning. In summary, in this adult patient group, transesophageal echocardiography with color flow mapping was superior to precordial scanning in the assessment of both the morphology and functional status of a double-orifice left AV.

Adult↗
PubMedDate not supplied

Change in heart rate and heart rate variability during treatment for depression in patients with coronary heart disease.

OBJECTIVE: Major depression is a common problem in patients with coronary heart disease (CHD) and is associated with an increased risk for cardiac morbidity and mortality. It is not known whether treating depression will improve medical prognosis in patients with CHD. Depression is also associated with elevated heart rate and reduced heart rate variability (HRV), which are known risk factors for cardiac morbidity and mortality that may explain the increased risk associated with depression. The purpose of this study was to determine whether treatment for depression with cognitive behavior therapy (CBT) is associated with decreased heart rate or increased HRV. METHODS: Thirty depressed patients with stable CHD, classified as either mildly or moderately to severely depressed, received up to 16 sessions of CBT. The 24-hour heart rate and HRV were measured in these patients and in 22 medically comparable nondepressed controls before and after treatment of the depressed patients. RESULTS: Average heart rate and daytime rMSSD (reflecting mostly parasympathetic activity) improved significantly in the severely depressed patients, but remained unchanged in the mildly depressed and the control patients. However, only rMSSD improved to a level comparable to the control patients. None of the remaining indices of HRV showed improvement. CONCLUSIONS: The results suggest that treating depression with CBT may reduce heart rate and increase short-term HRV. Thus, CBT may have a beneficial effect on a risk factor for mortality in depressed patients with coronary heart disease. A randomized, controlled study is needed to confirm these findings.

Cognitive Behavioral Therapy↗
PubMedDate not supplied

[Malignant lymphoma with centrofollicular cells associated with pseudomyelomatous lytic bone lesions].

The authors report on 3 cases of malignant lymphoma associated with well-defined lytic lesions of the skull and limbs that were identical to lesions observed in patients with multiple myeloma. In two patients, subcutaneous nodules were found opposite the site of bone lysis. Histologic examination diagnosed centrofollicular cell malignant lymphoma in all 3 cases. The exceptional nature of such lesions in patients with malignant lymphoma is discussed in connection with literature data. The suggested physiopathologic mechanism is secretion of an "osteoclast activation factor" (OAF) by malignant lymphoid B cells.

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