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Biomedical subjects

Y Drory

Publications and source records attributed to Y Drory.

At least 73 records · Page 4Linked to original sources
PubMed1987

Exercise testing in juvenile borderline hypertension.

Exercise testing has emerged as an important method for improved evaluation of the cardiovascular system. However, juvenile patients presenting resting borderline hypertension have not been extensively studied. Therefore, this study evaluated the response to exercise in this group of patients. Nine hundred men aged 16 to 29 years performed a multistage near-maximal exercise test. The control group consisted of 338 age- and weight-matched, asymptomatic, healthy, normotensive individuals. Mean physical working capacity (+/- SD) was 129 +/- 28 W (82 +/- 18% of the normal according to our standardization) in the hypertension group, and 153 +/- 29 W (102 +/- 18%) in the control group (P less than 0.001). Mean systolic blood pressures at termination of exercise were 181 +/- 25 and 164 +/- 25 mm Hg in the hypertensive and the control groups, respectively; the mean diastolic values at termination of exercise were 49 +/- 32 and 32 +/- 29 mm Hg, respectively. The magnitude of the changes in blood pressure from rest to near-maximal values was smaller in the borderline-hypertensive individuals demonstrate a clear hypertensive pattern of reaction to physical activity, thus emphasizing the importance of exercise testing as part of the routine workup of such patients. The relationship between borderline hypertension and the risk of myocardial events has been established, and early hygienic or even pharmacological measures are necessary.

Adolescent↗
PubMed1986

Pressure/volume ratio and pressure/volume ratio exercise quotient: an echocardiographic comparative study of left ventricular function indicators.

Noninvasive evaluation of left ventricular function (LVF) has been performed with two-dimensional echocardiography (TDE). Ejection fraction (EF), end systolic volume index (ESVI) and systolic blood pressure/end systolic volume index ratio (PVR)--an indicator which is independent of preload and afterload changes in a wide physiologic range--were assessed at rest and after exercise. Twenty-seven postmyocardial infarction (MI) patients were compared to 27 normal controls in an attempt to examine the above parameters of LVF in each group, measured by TDE. Correlation of TDE EF with radionuclide angiography EF proved the reliability of TDE. Rest and postexercise values of EF and PVR showed highly significant differences between the two groups. Using ESVI, a relatively lesser significant difference was found. PVR values at rest were 4.86 mm Hg/ml/m2 in the study group and 9.51 in the control group. These values increased to 5.34 and 15.15, respectively, after exercise. The ratio of PVR after exercise to PVR at rest, expressed as percentage change (PVREQ), seemed to be an additional tool in separating between both groups. This indicator merges pressure, volume, and the influence of exercise on both; a PVREQ of at least 145% correlated well with absence of MI in most of our patients.

Adolescent↗
PubMed1983

Complete heart block and physical performance.

Complete heart block (CCHB) is a very rare finding. The problems in such patients are: additional heart malformations, the appearance of Stokes-Adams or syncopal attacks, and the occurrence of different grades of ectopy. Most patients with CCHB without structural heart disease develop normally and can lead a normal life. If there are no Stokes-Adams attacks or high grades of ectopy at rest and exercise, they have a normal physical capacity and can perform strenuous work and sports. Increased stroke volume, cardiac enlargement, and extraction of very large amounts of oxygen from the blood were found to be compensatory mechanisms of adaptation. Some authors have discussed the possible role of training in this adaptation.

Adams-Stokes Syndrome↗
PubMed1980

Adjusted single load exercise test. A new exercise test for improved diagnosis of coronary heart disease.

A new adjusted single load exercise test (ASLET) is presented. The test is aimed to improve diagnosis of coronary heart disease and should not be used in patients with a well-established diagnosis. 60--120 min after a multistage near-maximal ergometric test with a negative electrocardiographic outcome ASLET is performed. The single load used in ASLET is based on the last load reached at the multistage procedure. If for example a heart rate of 150 beats/min (end point parameter of the multistage test for the age group above 40 years) is reached at 100 W (after performing 25, 75, and 100 W) the ASLET will be a sudden load of 100 W. This procedure has proved to increase the sensitivity of our exercise test. In about one third of false negative results at the multistage procedure the ASLET test was positive in symptomatic patients.

Adult↗
PubMed1980

Exercise tolerance in patients on chronic hemodialysis.

Twenty-two patients on chronic hemodialysis were tested on a bicycle ergometer to determine their near-maximal physical work capacity. The patients were found to have low physical work capacity that averaged 51.6 +/- 3.8 (SE)% predialysis and 50.3 +/- 3.7% postdialysis, when compared with the physical work capacity of healthy control subjects. The exercise was stopped when patients complained of muscular fatigue, and the work load at this point was considered their subjective maximal work capacity. At this stage the patients had high blood lactic acid levels and an increased double product (systolic blood pressure x heart rate), the latter indicating a high stage of cardiac output. The oxygen consumption and oxygen pulse were similar to those obtained from control individuals at the same work load. This study suggests that limited physical work capacity of chronic hemodialysis patients is due to early muscular fatigue. This phenomenon is associated with the rapid onset of anaerobic metabolism and may thus be caused by limited maximal oxygen uptake.

Adult↗
PubMed1978

Utilization of an automated ECG interpretation system in an ambulatory health service.

A computerized ECG interpretation system was incorporated into a large ambulatory health care service. The central unit has several terminals located at various regional cardiological clinics. In each clinic 80--120 ECG's are taken daily, of which 56% are interpreted as normal tracings. The interpretation system is currently utilized to separate automatically normal from abnormal tracings. Normal tracings are not re-checked by a cardiologist and the report is delivered directly to the family physician. In order to evaluate the reliability of the computer interpretation of normal ECG's (i.e., the percent of false-negative readings), 500 tracings interpreted by the program as normal were selected at random and read independently by three cardiologists. It was found that in 4.6% of the cases additional remarks were supplemented to the computer statement by at least one of the cardiologists. Most of the computer-cardiologist disagreements were of limited clinical importance. It was concluded that this system could be used as an effective tool for simultaneously processing ECG's from several remote locations, serving large ambulatory populations. By using the assistance of the computer system, marked reduction in cardiologists' time and cost could be achieved.

Ambulatory Care↗
PubMed1978

Rehabilitation of patients with NCA (neurocirculatory asthenia) through a short term training program.

Twenty-two patients, 18 years old, with the predominant somatic type of NCA, and a control group of 22 healthy subjects participated in a short term training course lasting three weeks. Following the training the NCA subjects showed a significant change in the systolic and diastolic blood pressure after 5 minutes of recumbency as well as in the systolic blood pressure after 5 minutes of standing, diastolic pressures during 50 W load and submaximal effort (100-150 W) - all the values being significantly lower following the training, except the diastolic pressure during 50 W load which was higher following the course. The prominent training effect was on the heart rate during light work loads (50 W) in which a decrease from a mean of 151.2 +/- 13.9 to 118.3 +/- 16.3 beats/min was recorded. This decrease indicates the better adaptation of the NCA patients to physical effort. Similarly, a significant increase in the mean VO2max from 31.5 +/- 6.1 to 37.7 +/- 5.9 ml O2/kg B.W./min was observed. No changes were recorded in the ECG after the short training course. Following the training all the symptoms typical of the NCA syndrome vanished. A short physical training of 3 weeks can start the procedure of rehabilitation of a well selected group of NCA patients with predominant somatic complaints. The rehabilitation must be continued throughout life by continued physical training.

Adolescent↗
PubMed1978

Orthostatic hypotension in amputees and subjects with spinal cord injuries.

Orthostatic examinations were performed with a tilt table on 64 male volunteers, of whom 21 had sustained amputation of one or both lower limbs and 23 were paraplegic due to spinal cord injuries (SCI), with 20 healthy subjects as controls. Following tilting, signs and symptoms of fainting appeared in five of the SCI subjects, four of whom had spinal injuries above the level of D5. These phenomena appeared in only two of the controls and in none of the amputees. The mean systolic and diastolic blood pressures of the amputees at rest and standing were higher than those recorded in the other two groups. The mean pulse pressures were lower in the amputees than in the other two groups. The changes in the systolic, diastolic, and pulse pressures were more profound in those subjects with high spinal cord injuries than in subjects with lower cord injuries. ECG changes and fainting were more frequent among the SCI subjects than in the other two groups.

Adult↗
PubMed1977

[Hypoplasia of the right ventricular myocardium (Uhl's disease). Report of a case with review of the literature (author's transl)].

A rare case of congenital hypoplasia of the right ventricular myocardium ("Parchment Right Ventricle" or Uhl's disease) diagnosed by angiocardiography is presented. The predominant clinical feature was recurrent paroxysms of severe arrhythmias which could be controlled only by electric shock. Right heart failure was also present. After a follow-up period of 8 years, the patient, now 27 years old, on diuretic and antiarrhythmic treatment, is well. The literature on Uhl's disease is reviewed and classified into two clinical types; a fatal infantile type in which extreme hypoplasia is present, and a milder adult type in which the anatomical lesion is usually more limited. In the infantile type intractable heart failure was invariably present; in the adult type severe arrhythmias often constituted the major clinical problem. Some of the difficulties in diagnosis and treatment are emphasized.

Adolescent↗