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Biomedical subjects

R Ilia

Publications and source records attributed to R Ilia.

At least 73 records · Page 4Linked to original sources
PubMed1993

Abnormal thallium stress test and normal coronary angiograms: catheterization and clinical characteristics.

Left ventricular end-diastolic pressure at rest, left ventricular ejection fraction, thallium segmental abnormalities, as well as sex, age and presence of diabetes mellitus, hypertension, hypercholesterolemia and smoking excess were analyzed in 40 patients with abnormal thallium stress test and normal coronary angiograms. Of these patients, 25 had elevated left ventricular end-diastolic pressure and "low normal" ejection fraction (group 1), while the other 15 had normal left ventricular end-diastolic pressure and "high normal" ejection fraction (group 2). The left ventricular end-diastolic pressure was 18.1 +/- 4.5 mm Hg in group 1 vs. 8.5 +/- 2.4 mm Hg in group 2 (P < 0.000). The ejection fraction was 57.6 +/- 8.3% in group 1 vs. 63.9 +/- 9.1% in group 2 (P < 0.05). There was no difference between the groups in relation to the abnormal segment on thallium stress tests, aged and sex. Although the number of patients was too small for meaningful statistical analysis, most of the patients with diabetes mellitus, hypertension, hypercholesterolemia or smoking history were in group 1. Thus, the patient population with abnormal results on radionuclide exercise tests and angiographically normal coronary arteries probably comprises two groups: a) patients with decreased diastolic and relatively decreased systolic performances which might reflect coronary flow disturbances, and b) patients with normal diastolic and systolic performances, probably reflecting "true false positive thallium stress test".

Adult↗
PubMed1992

[Rheumatic fever among children in the Negev].

Between 1977-1989, 143 children with acute rheumatic fever were hospitalized here. In contrast to western countries, there has been no decline in the absolute number of hospitalizations for this disease here. A high prevalence of rheumatic fever was found among Bedouins and non-Ashkenazi Jews (2.5 and 1.5 times greater than the expected incidence, respectively). The affected children were usually from large families and lived in crowded conditions. Recurrences of rheumatic fever were more frequent among girls, and they were affected at an older age. The manifestations, in order of frequency, were arthritis, carditis and chorea. Chorea was found only among girls.

Acute Disease↗
PubMed1992

Renin and aldosterone levels and hypertension following envenomation in humans by the yellow scorpion Leiurus quinquestriatus.

Renin activity and aldosterone blood levels were measured in ten patients following scorpion envenomation by the scorpion Leiurus quinquestriatus. All patients were hypertensive on admission, with clinical signs of systemic intoxication. The blood renin and aldosterone levels were elevated in all ten patients. The observation of high blood pressure and elevated levels of renin suggests that in addition to increased circulating catecholamines following scorpion envenomation, sympathetically induced renin release may play an important role in the pathogenesis of hypertension. This observation re-emphasizes the importance of afterload reduction in the treatment of the cardiovascular manifestations of scorpion envenomation.

Adult↗
PubMed1992

Percutaneous transluminal coronary angioplasty in unstable and stable angina pectoris: a comparison of immediate success and complications.

To determine the success rate and the safety of percutaneous transluminal coronary angioplasty in patients with unstable angina pectoris (group 1) versus stable angina (group 2), we studied 299 consecutive patients who underwent coronary angioplasty of 373 consecutive lesions. Of these patients, 149 had unstable angina pectoris and dilation of 188 arteries. The success rate was high and similar in both groups (95 and 93%, respectively). The groups did not differ in regard to the lesion characteristics, vessels and number of sites dilated except for an increase in the presence of thrombus in the unstable angina group (p < 0.03). Although there was a higher incidence of coronary thrombus and more acute myocardial infarction in group 1, the major complication rate did not differ from that of group 2 and was low in both of them (3 and 2%, respectively). No deaths occurred. Six patients (3 in each group) needed urgent coronary artery bypass grafting while 3 additional patients developed acute Q-wave myocardial infarction (all of them in group 1). Thus, percutaneous transluminal coronary angioplasty is a safe and successful procedure in patients with unstable angina as well as in patients with stable angina pectoris.

Aged↗
PubMed1992

The cardiovascular system after scorpion envenomation. A review.

Scorpion envenomation is a common medical problem and life hazard in many countries of the world. Scientific investigations have addressed the interrelationship between the stimulatory effects of the venom on the autonomic nervous system and adrenals and the subsequent effects of released transmitters on the cardiovascular system. A number of clinical cardiovascular syndromes may dominate the initial clinical presentation after envenomation: the syndromes usually vary with the age of the victim, the size of the offender and the season. Central nervous system dysfunction is seen in children but rarely observed in adults; if accompanied by severe hypertension the clinical picture is consistent with acute hypertensive encephalopathy. Heart failure, pulmonary edema or a shock-like syndrome has been observed in 25% and hypertension in 30% to 77% of our patients. The electrocardiographic abnormalities recorded in the majority of the patients after envenomation include an "acute myocardial infarction-like pattern." Rhythm disturbances are frequent but conduction abnormalities are rare. Echocardiographic, radionuclide and experimental hemodynamic observations have provided evidence that heart failure and pulmonary edema after envenomation are multifactorial with diminished systolic performance following the initially increased left ventricular contractility and decreased ventricular diastolic compliance. Clinical laboratory data reporting increased catecholamine metabolite excretion and elevated plasma renin and aldosterone are consistent with the stimulatory effects of the venom on the autonomic nervous system. Treatment, including our experience with vasodilators and calcium channel blockers, is reviewed.

Angiography↗
PubMed1991

Effects of rapid volume expansion on the right filling pressures after prosthetic valve surgery.

The effects of rapid intravascular volume expansion were studied in 12 patients, 4 to 14 years after single prosthetic heart valve replacement. The data observed showed a statistically significant mean difference before and after volume expansion of right atrial mean pressure and right ventricular end diastolic and pulmonary capillary pressures. However, right atrial and pulmonary capillary pressures equilibration was not detected. The right atrial pressure form showed abnormal variations during inspiration. Dip and plateau right ventricular diastolic pressure configuration was recorded in 6 patients after expansion, was absent in 2 and questionable in 4. A deep Y descent with an M-shaped right atrial pressure form was recorded in all 12 patients. The explanation for these phenomena is unclear. Thus, in the absence of pressure equilibration and clinical evidence of constriction, the abnormalities recorded during rapid volume expansion should be cautiously interpreted.

Adult↗
PubMed1991

Variations in blood supply to the anterior interventricular septum: incidence and possible clinical importance.

The variations of the blood supply to the anterior interventricular septum in a series of 1,089 patients are described. Special attention has been given to variations and frequency of occurrence of the septal perforators originating from the left anterior descending artery. These variations may have clinical significance in this era of coronary angioplasty and coronary bypass surgery.

Coronary Angiography↗
PubMed1991

Mid left anterior descending coronary artery originating from the right coronary artery.

Dual connection of the left anterior descending coronary artery to the left and right coronary arteries is a very rare congenital anomaly. In this report we describe two cases in which the mid-position of the left anterior descending coronary artery is connected to the right coronary artery, one directly and the second by way of the infundibular artery. To the best of our knowledge, connection of the mid-position of the left anterior descending to the infundibular artery has not been previously described.

Adult↗
PubMed1991

Filling of multiple vessels by injection of dye into a single bypass graft.

We describe the unusual filling of two coronary bypass grafts by a single injection in a patient who underwent coronary arterial bypasses surgery. The injection, made in the left internal mammary artery, filled the left anterior descending artery, a diagonal branch, and the graft of saphenous vein placed to that artery. In contrast, injection in the saphenous vein graft to the diagonal artery filled the diagonal artery, the left anterior descending artery and the left internal mammary to its point of origin. We emphasize the importance of this phenomenon.

Coloring Agents↗