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Biomedical subjects

R Bajaj

Publications and source records attributed to R Bajaj.

40 records · Page 3Linked to original sources
PubMedDate not supplied

Beneficial effect of oral verapamil on exercise induced silent myocardial ischemia.

Twelve consecutive patients (all males, age 40-72 years) of asymptomatic angiographically proven coronary artery disease who showed exercise induced regional wall motion abnormalities (RWMA) on Radionuclide Ventriculography were restudied by the same method after 208 weeks treatment with oral Verapamil 240 mg/day. Resting and peak exercise global ejection fractions and RWMA were compared using paired t-test. Without verapamil therapy, the resting mean ejection fraction was 64.75% (SD 9.45%), and fell with exercise (mean fall 5.25%, range - 25% to + 4%). On Verapamil therapy, the resting ejection fraction was 62.75% (SD 8.35%), and rose with exercise (mean rise 1.18%, range - 24% to + 18%). These changes in exercise ejection fractions with and without verapamil therapy were statistically significant (p = 0.01). Four of 5 resting, and 8 of 15 peak exercise induced RWMA improved on therapy. There were no significant differences in resting or peak-exercise double products with and without verapamil. We conclude that oral verapamil improves exercise induced ventricular dysfunction and regional wall motion abnormalities in patients with silent myocardial ischemia.

Administration, Oral↗
PubMedDate not supplied

Silent myocardial ischaemia in patients with angiographically proven coronary artery disease.

Twenty patients with angiographically proven coronary artery disease (CAD) were evaluated by Holter monitoring for assessment of total ischaemic burden during daily activities. Thirteen patients revealed ischaemia on Holter monitoring (symptomatic-2, silent-4 and both types-7). As compared to symptomatic ischaemia, the silent myocardial ischaemic episodes were more frequent (25 vs 10 episodes), longer in duration (15-53 minutes vs 8-45 minutes), occurred at lower heart rates (65-75/minute (mean 68) vs 70-90 per minute (mean 76) and silent ischaemic episodes exceeded symptomatic ones in both morning (10 vs 4) and evening (15 vs 6) peaks. Occurrence of symptomatic as well as silent ischaemia had no relation to rest, activity, left ventricular functions, and there was no difference in the extent (1-3mm) and type (horizontal or downsloping) of ST-segment depression. We conclude that in patients with significant coronary artery disease, silent myocardial ischaemia is more frequent than the symptomatic ischaemia during daily activities. It occurs at lower heart rates, lasts longer, and bears no relation to rest, activity or left ventricular function. Evening peaks may be as frequent or more than the morning peaks. Holter monitoring thus is helpful for assessment of total ischaemic burden in CAD patients.

Activities of Daily Living↗
PubMedDate not supplied

Prognostic implications of c-Ki-ras2 mutations in patients with advanced colorectal cancer treated with 5-fluorouracil and interferon: a study of the eastern cooperative oncology group (EST 2292)

PURPOSE: Mutations in c-Ki-ras2 (ras) occur in about 40% of patients with colorectal cancers and occur early in the pathogenesis of this disease. To evaluate the prognostic value of mutations in ras, the Eastern Cooperative Oncology Group (ECOG) conducted a retrospective study (EST 2292) to determine the frequency of mutations in patients with advanced colorectal cancer, and to determine whether ras mutations were associated with altered response to therapy and survival. PATIENTS AND METHODS: Patients were enrolled from four studies: P-Z289, an ECOG phase II trial of 5-fluorouracil (5-FU) and interferon (IFN) in patients with advanced colorectal cancer; P-Z991, an ECOG phase I trial of 5-FU and IFN in patients with advanced malignancies; and two trials from the Albert Einstein College of Medicine in patients with advanced colorectal cancer treated with 5-FU and either IFN-alpha or IFN-beta. All patients had advanced colorectal carcinoma and had sufficient histologic material available for analysis for the presence and type of ras, using polymerase chain reaction and dot-blot analysis with sets of probes sufficient to detect all the common mutations of ras at codons 12, 13, and 61. RESULTS: Seventy-two patients were enrolled in this trial. Mutations in ras were detected in 25 (35%), including 17 (23%) in codon 12, four (6%) in codon 13, and four (6%) in codon 61. There was no correlation between the presence of a ras mutation and age, sex, Dukes' stage, histology, or tumor markers. Thirty-one of 72 patients (43%) responded to therapy with 5-FU and IFN, and 10 of 31 responders (32%) and 15 of 41 nonresponders (37%) had mutations in ras. There was no difference in response rates or overall survival between the groups with and without ras mutations. CONCLUSIONS: It is unlikely that ras mutations will have significant prognostic value for either response to therapy or survival in patients with colorectal carcinomas treated with 5-FU and IFN.

Adult↗