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Biomedical subjects

S Laniado

Publications and source records attributed to S Laniado.

At least 181 records · Page 10Linked to original sources
PubMed1979

Arterial oxygen tension changes in elderly patients undergoing upper gastrointestinal endoscopy. I. Possible causes.

Measurement of arterial oxygen tensions in elderly patients undergoing upper gastrointestinal endoscopy and in a matched control group undergoing colonoscopy showed a slight but significant fall in the PaO2 in both groups following premedication. The initial fall in PaO2 was probably due to the intravenous atropine, diazepam, and meperidine, mainly the latter. This fall of the oxygen tension continued in the gastroscopy group until the instrument was removed, while the controls rapidly returned to basal levels. This persistently reduced PaO2 in the former group is therefore most likely due to the physical presence of the endoscope in the pharynx. To minimize the occurrence of hypoxemia during gastroscopy, narcotics should probably not be used in the premedication of elderly patients. The procedure should be carried out after optimal oxygenation of the patient and be of short duration, and a narrow instrument may be useful in this group.

Aged↗
PubMed1978

Furosemide-induced forced diuresis in digoxin intoxication.

In three cases of attempted suicide by massive digoxin ingestion, a therapeutic attempt was undertaken to shorten the duration of toxicity of the drug by accelerating the removal of the glycoside from the body. Early administration of intravenous (IV) furosemide and fluids appeared to increase digoxin excretion in one case, which resulted in a substantially shortened digoxin half-time of eight hours. In two cases this therapy, initiated after a delay of 12 and eight hours was ineffective. The half-times were 51 and 43 hours, respectively. At an early preequilibrium stage, higher serum-tissue ratios of digoxin are present; thus, greater amounts of free digoxin are available for glomerular filtration and excretion. The prompt treatment by IV furosemide may be beneficial in the management of massive digitalis overdose.

Aged↗
PubMed1977

Pericardial effusion and mitral valve involvement in systemic lupus erythematosus. Echocardiographic study.

Echocardiography was used in 30 women and 2 men with systemic lupus erythematosus (SLE) in order to determine the incidence and severity of pericardial effusion and mitral valve involvement. 31 patients showed normal thickness of the mitral valve leaflets, only one patient showed irregular thickening of the leaflets suggesting the presence of vegetations. Mitral valve motions were normal in all patients. These results indicate that myocardial and valvular involvement in SLE is usually not severe enough to result in haemodynamic abnormalities. Pericardial effusion was found in 2 patients who were symptom free, whereas 4 of the patients with a past history suggestive of pericarditis showed no echocardiographic evidence of pericardial effusion. These suggest the transient nature of pericarditis in SLE, and the value of echocardiography as a diagnostic tool in detecting clinically inapparent lupus pericarditis.

Adolescent↗
PubMed1977

Magnet noncontact apexcardiography. A new technique for registering chest motion.

A new apexcardiographic recording system has been developed which is free of certain technical limitations. This noncontact magnetic transducer was tested alternately with a commonly used pneumatic piezoelectric transducer in a comparative study on ten normal subjects. The magnetic registration offered a more accurate timing and configuration of the ACG. Signal distortion, such as peaked waves and an early fall of the systolic wave, was eliminated. The magnetic transducer was capable of recording directional apex point tracings, as well as pulsations of a larger apical area. The new system proved to possess definite advantages and eliminated some of the inconveniences inherent in the pneumatically coupled system.

Humans↗
PubMed1977

Incidence and significance of the low-voltage electrocardiogram in acute myocardial infarction.

In a retrospective study of 304 patients with acute transmural myocardial infarction admitted to the coronary care unit, 22 percent (67 patients) exhibited low voltage on their electrocardiograms within 72 hours of admission. The course of hospitalization of these patients was compared with an equal number of consecutive patients with transmural infarctions and normal electrocardiographic voltages. Among the patients with low voltage, there was a significantly higher incidence of previous infarction or present extensive infarction, congestive heart failure, and cardiogenic shock. This group of patients also demonstrated a markedly higher mortality. This study substantiates the clinical impression that acute myocardial infarction complicated by a low-voltage ECG implies a poor prognosis. It is speculated that this electrocardiographic pattern may reflect decreased ventricular performance as a result of widespread myocardial damage.

Acute Disease↗
PubMed1977

Hemodynamic effects of chlorpromazine in patients with acute myocardial infarction and pump failure.

The intravenous administration of chlorpromazine in 12 patients with acute myocardial infarction and altered pump function was followed by a significant reduction in systemic vascular resistance (28.4%) and an increased cardiac index (23.0%). The drug also produced a significant decline in mean pulmonary capillary wedge pressure (38.2%), while the heart rate and mean stroke work index did not change significantly. Although the mean blood pressure decreased by 18.3%, the transymocardial pressure gradient was not affected. A significant reduction in the major determinants of myocardial oxygen consumption, such as arterial blood pressure and left ventricular wall tension, suggested a decrease in myocardial demand for oxygen. Improvement of left ventricular performance was associated with a sedative effect in most of the patients. Intravenous administration of chlorpromazine proved to be of benefit in patients with moderate to severe congestive heart failure and cardiogenic shock.

Acute Disease↗
PubMed1977

Self-poisoning with digitalis glycosides: successful treatment of three cases.

Three patients who attempted suicide with massive digoxin overdoses are described. Peak plasma digoxin levels in the three patients reached 21, 8.2 and 6.2 ng/ml. The clinical condition of the patients was correlated with their plasma digoxin levels. Control of digitalis-induced arrhythmias was achieved with i.v. diphenylhydantoin.

Aged↗
PubMed1976

Hemodynamic correlates of the normal aortic valve echogram. A study of sound, flow, and motion.

The aortic valve echogram was recorded in open chest dogs simultaneously with aortic flow, acceleration of flow, aortic and left ventricular pressures, and intracardiac phonocardiograms. Comparison of echographic with hemodynamic data showed the following: The aortic valve started its opening with the onset of flow, at the same point that left ventricular pressure exceeded aortic pressure. Complete valve opening preceded peak aortic flow by an average of 43 msec and the cusps started to move toward closure while flow was still accelerating. Final closure of the valve was achieved at the time of zero flow and preceded the aortic second sound by 4-10 msec. The echographically determined "valve orifice area" correlated well with aortic stroke volume (r = 0.94). The intensity of the aortic first sound was related to peak acceleration of aortic flow. The intensity of the second sound was not related to the amplitude of cusp motion but correlated well with the aortic pressure at the time of closure and with peak flow deceleration.

Animals↗
PubMed1976

Herpes simplex encephalitis simulating systemic embolism.

A case of herpes simplex virus encephalitis is described in a patient known to suffer from chronic atrial fibrillation and whose clinical symptoms suggested cerebral embolism of cardiac origin. The final diagnosis was based on the presence of herpes simplex virus type 1 antibodies in the cerebrospinal fluid and a significant rise in antibody titers in the serum. The patient regained consciousness after craniotomy and treatment with idoxuridine. The case emphasizes that the possibility of herpetic encephalitis should be considered in patients presenting with typical signs of a cerebrovascular accident.

Adult↗
PubMed1975

A study of the dynamic relations between the mitral valve echogram and phasic mitral flow.

Echocardiographically recorded mitral valve motion was compared with phasic transmitral flow in 17 open chest dogs. The normal mitral valve opening started with the onset of mitral flow and reached its full excursion while flow was still accelerating. Complete valve opening occurred .044 sec (plus or minus .002 sem) before peak flow, during which time an average of 17.6 percent of total mitral filling volume had passed through the valve. In contrast to the opening movement, the closing motion of the anterior mitral valve cusp lagged behind the deceleration of mitral flow. The E-F phase of the mitral valve echogram started while mitral flow was still increasing and resulted from a combined posterior motion of the cusp and the ring. The E-F slope of the normal valve was found to decrease with reduced cardiac output. The amplitude of the anterior cusp excursion did not reflect the amount of mitral flow. Prolonged P-R interval may induce a mid-diastolic reversal of mitral flow which, in turn, may be accompanied by partial or complete valve closure, occurring before the onset of ventricular contraction. Such premature closure of the mitral valve may be accompanied by a certain amount of regurgitant flow.

Animals↗