Prime vendor systems: an analytical approach.
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Biomedical subjects
Publications and source records attributed to W Pitts.
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Thirty men, mean age 55 years, known to have treadmill-induced ischemic ST-segment depression, performed static and dynamic effort, i.e., forearm lifting and treadmill exercise, separately and combined. Static effort was sustained at 20%, 25% or 30% of maximal forearm lifting capacity. Two symptom-limited treadmill tests, one with and one without added static effort, were performed on each of two visits. Compared with dynamic effort alone, combined static-dynamic effort decreased treadmill work load and increased heart rate, systolic blood pressure and rate-pressure product at the onset of ischemic ST-segment depression or angina pectoris: 7.1 +/- 0.4 vs 8.0 +/- 0.5 (SEM) multiples of resting oxygen consumption (mets), estimated; 141 +/- 3 vs 134 +/- 3 beats/min; 170 +/- 4 vs. 162 +/- 4 mm Hg and 239 +/- 8 vs 218 +/- 9 (p less than 0.001). The prevalence of angina pectoris was significantly less with combined static-dynamic effort than with dynamic effort alone. Static effort causes a resetting of the threshold at which ischemic abnormalities appear during dynamic effort.
A 54-year-old woman had muscle disease that terminated fatally with complete body paralysis. The patient had renal failure, which progressed concurrently with her muscle weakness. Myoglobinuria was not demonstrated during the active stage of her illness. Renal biopsy specimens demonstrated immune deposits in the glomeruli, and, at autopsy, there was a generalized glomerulonephritis. We believe the muscle disease was a consequence of acute rhabdomyolysis, hyperacute polymyositis, or virus infection. Regardless of the nature of the muscle disease, an immune mechanism may have been responsible for the associated renal failure.
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