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PubMedDate not supplied

Hemodynamic responses of horses to anesthesia and surgery, before and after administration of a low dose of endotoxin.

Seven horses, which were part of an investigation of the effect of endotoxin administration on vascular reactivity, were anesthetized on two separate occasions for surgical excision of 4-cm sections of palmar digital artery and vein. On the first occasion, the horses were given an infusion of 1 L 0.9% NaCl solution intravenously (i.v.) just before induction of anesthesia (control); on the second occasion, the horses received an infusion of 1 L 0.9% NaCl containing Escherichia coli endotoxin, 0.1 microgram/kg (endotoxin). On both occasions, anesthesia was induced with xylazine, guaifenesin, and ketamine, and maintained with halothane in oxygen. Hemodynamic measurements were made with the horses under anesthesia immediately before beginning surgery (period 1), during skin incision (period 2), during dissection and excision of the vessels (period 3), during skin suturing (period 4), and after completion of surgery during bandaging (period 5). Hemoglobin concentration and mixed venous oxygen content were greater at all periods in horses that received endotoxin. Otherwise, there were no significant differences in hemodynamic parameters between control horses and horses administered endotoxin before beginning surgery (period 1). During surgery and bandaging, horses administered endotoxin had significantly higher heart rate (periods 3, 4, and 5), cardiac index (periods 3, 4, and 5), and oxygen delivery (periods 2, 3, 4, and 5) than did control horses, and mean arterial blood pressure (period 2) and systemic vascular resistance (periods 2, 3, 4, and 5) were less than in control horses. Compared with period 1, surgical stimulation in control horses was associated with increased mean arterial blood pressure and systemic vascular resistance (periods 2, 3, 4, and 5), but cardiac index and oxygen delivery were decreased (periods 3, 4, and 5).(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, General↗
PubMed1986

Different patterns of hemodynamic abnormalities in patients with ischemic heart disease compared with patients with congestive cardiomyopathy.

48 patients with chest pain or unexplained heart failure were examined with exercise test, systolic time intervals, apexcardiogram and left- and right-sided heart catheterization including coronary arteriography. The 23 patients with ischemic heart disease (IHD) and 19 patients with congestive cardiomyopathy (COCM) could as groups be separated by several of the parameters. Two major patterns of change were present when using the whole range of parameters, probably reflecting that the heart and circulation had compensated for left ventricular dysfunction in different ways in IHD and COCM. Comparing patients with the same ejection fraction (EF), preejection-period index (PEPI) pre-ejection-period/left ventricular ejection time (PEP/LVET) and systolic blood pressure/left ventricular end systolic volume index (SBP/LVESVI), were all more abnormal in patients with COCM than with IHD at most EF levels. The best separation between the diseases was obtained using exercise capacity in combination with PEP/LVET. The correlations between invasive and noninvasive parameters underlined that no single parameter can satisfactorily characterize the circulatory function in patients with individual differences in preload, afterload, pulse rate, cardiac volumes, compliance and contractility. No or poor correlations were found between exercise capacity and the different function parameters used.

Adult↗
PubMed1984

[Pharmacokinetics and cardiac effect of beta-acetyldigoxin and digitoxin in combination therapy with nifedipine].

The effect of nifedipine (N) on the pharmacokinetics and pharmacodynamics of beta-acetyldigoxin (AD; n = 11) and digitoxin (DGT; n = 10) was studied in 21 patients with cardiac insufficiency stage II-III NYHA. Glycoside plasma concentration and renal excretion as well as electrocardiogram heart rate, atrioventricular transconduction time (PQ), duration of electrical systole corrected for heart rate (QTc), mean amplitude of T waves in leads V2 to V6 (TV2-6) and systolic time intervals total electromechanical systole index (QS21), left ventricular ejection time index (LVETI), pre-ejection period index (PEPI), PEP/LVET-ratio were recorded repeatedly before and during co-administrations of 40-60 mg/day N. Plasma AD concentrations were 0.64 +/- 0.22 ng/ml (mean +/- SD) before and 0.61 +/- 0.21 ng/ml during co-administration of N over 10-14 days, plasma DGT concentrations 13.9 +/- 4.1 ng/ml before and 13.7 +/- 4.5 ng/ml during co-administration of N over 4-6 weeks. Daily glycoside excretion was not affected by treatment with N. Heart rate and PQ-interval were not significantly changed during co-administration of N whereas T-wave flattening was intensified and QT-duration was lengthened. Concomitant treatment of AD and N led to an increase of PEPI and PEP/LVET compared to AD alone in ten patients whereas the systolic time intervals after concomitant treatment of DGT and N in most patients did not differ from those after DGT alone. From our findings we conclude that N had no clinically significant effect on pharmacokinetics and pharmacodynamics of AD or DGT.

Acetyldigitoxins↗
PubMed1985

[Pharmacokinetic and cardiac efficacy of beta-acetyldigoxin and digitoxin in combination therapy with diltiazem].

The effect of diltiazem (D) on the pharmacokinetics and pharmacodynamics of beta-acetyldigoxin (AD; n = 12) and digitoxin (DGT; n = 10) was studied in 22 patients with cardiac insufficiency stages II-III by the New York Heart Association. Glycoside plasma concentration and renal excretion as well as electrocardiogram [heart rate, atrioventricular transconduction time (PQ), duration of electrical systole corrected for heart rate (QTc), mean amplitude of T-waves in leads V2 to V6 (TV2-6)] and systole time intervals [total electromechanical systole index (QS21), left ventricular ejection time index (LVETI), pre-ejection period index (PEPI), PEP/LVET ratio] were recorded repeatedly before and during co-administration of 180 mg/day D. In eight patients digoxin plasma levels increased continuously during additional D administration. After reaching a new steady state at 0.93 +/- 0.35 ng/ml digoxin concentrations were at an average 43% higher than before D administration (0.65 +/- 0.27 ng/ml) with a simultaneous increase in renal glycoside excretion. The other four patients showed neither changes in digoxin concentrations in plasma nor in renal glycoside excretion. Only half the patients treated with DGT and D revealed an increase in DGT plasma levels of 21.4%. Daily renal glycoside excretion was not altered by D administration. In accordance to the increasing AD plasma concentration, PQ-interval was prolonged and T-wave flattening was intensified, whereas the systolic time intervals after concomitant treatment of AD and D did not differ from those after AD alone.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetyldigoxins↗
PubMed2004

Serotonergic antidepressants are associated with REM sleep without atonia.

STUDY OBJECTIVES: Rapid eye movement (REM) sleep behavior disorder (RBD) is generally observed in older men and in individuals with specific neurologic diseases. There are case reports of RBD in individuals taking serotonergic antidepressants. Our objective was to assess electromyogram (EMG) activity during REM sleep in individuals taking serotonergic antidepressants and in a matched control group not on such medication. DESIGN: Chart review of clinical and polysomnographic data. SETTING: Sleep laboratory affiliated with a general hospital. PARTICIPANTS: 15 subjects taking a serotonergic antidepressant and 15 age-matched individuals not on such medication. MEASUREMENTS: Submental and anterior tibialis tonic and phasic EMG activity during REM sleep, REM latency, time in REM, apnea-hypopnea index, periodic leg movements of sleep index, and sleep-architecture measures. RESULTS: Tonic, but not phasic, submental EMG activity during REM sleep was significantly more common in the antidepressant-treated group than in the control group (P < .02). Tonic REM submental EMG activity correlated with REM latency (r = .42, P = .02) and inversely with REM time (r = -.36, P = .05). Subject age correlated with tonic REM submental EMG activity (r = .58, P = .02) in the antidepressant group There were also trends for more phasic activity in the anterior tibialis (P = .09) and submental (P = .07) EMG in REM sleep in the antidepressant group than in the control group. CONCLUSIONS: Subjects taking serotonergic antidepressants had more EMG activity in the submental lead during REM sleep than did controls. This correlated with measures of REM suppression and age. Individuals taking such medications may be at increased risk of developing REM sleep behavior disorder, particularly with increasing age.

Adult↗
PubMed1997

Class Ia antiarrhythmic drug cibenzoline: a new approach to the medical treatment of hypertrophic obstructive cardiomyopathy.

BACKGROUND: The class Ia antiarrhythmic drug disopyramide relieves the outflow tract obstruction of hypertrophic obstructive cardiomyopathy (HOCM). Disopyramide, however, has several adverse effects, such as dysuria and thirst, resulting from its anticholinergic activity. A new class Ia antiarrhythmic drug, cibenzoline, has little anticholinergic activity. The aim of this study is to elucidate whether cibenzoline attenuates left ventricular pressure gradient (LVPG) in patients with HOCM. METHODS AND RESULTS: Ten patients with HOCM (mean age, 59+/-12 years) participated in this study. LVPG and left ventricular functions were measured before and 2 hours after administration of a single oral dose of 150 or 200 mg cibenzoline. LVPG decreased from 123+/-60 to 39+/-33 mm Hg (P=.0026). The E/A ratio in transmitral Doppler flow increased from 1.20+/-0.84 to 2.00+/-1.72 (P=.029). Isovolumic relaxation time increased from 73+/-16 to 101+/-23 ms (P=.0026). Left ventricular diastolic dimension remained unchanged, but left ventricular systolic dimension enlarged significantly, from 21.6+/-2.4 to 26.2+/-3.3 mm (P=.0004). Fractional shortening decreased from 47.6+/-6.1% to 34.6+/-8.8% (P=.0007). Left ventricular ejection time index decreased significantly, and preejection period index increased in all the patients. Decreased LVPG remained maintained even in the long-term treatment with cibenzoline. Conclusions These results indicate that cibenzoline can markedly attenuate LVPG in patients with HOCM. A decrease in myocardial contractility seems to be closely related to a marked decrease in LVPG.

Aged↗
PubMed1997

[Spanish scientific production in biomedicine and health sciences during the period 1990-1993 (Science Citation Index and Social Science Citation Index) and comparison to period 1986-1989].

BACKGROUND: In 1993 a first study on the scientific production of Spain in 1986-1989 on Biomedicine and Health Sciences, through the Science Citation Index (SCI) was published. The analysis attained the level of centres, with special emphasis in those related to the Health Care System. This paper analyses the period 1990-1993, offers a wider coverage including the Social Science Citation Index (SSCI) database, and compares both time periods. MATERIAL AND METHODS: Documents indexed by SCI and SSCI, CD-ROM version, with at least one Spanish address, published in biomedical and medical journals during the years 1990, 1991, 1992 and 1993, have been studied. Quantitative and qualitative bibliometric indicators for the analysis by subject matter, geographic distribution, institutional sector and centre of origin have been used. Global data were also analysed according to economic and human resources. RESULTS: A total of 21,434 documents were studied, of which 67.9% were journal articles. The highest contributors were Universities (48.8% of the documents) and Hospitals (45.3%). The autonomous communities of Madrid (31.9%) and Catalonia (26.9%) concentrate more than half the production-developed principally by hospitals-followed by Andalucía (11.7%) and C. Valenciana (7.8%). The most active disciplines were biochemistry/molecular biology (13%), neurosciences/neurology (8.4%), pharmacology/pharmacy (8.4%) and medicine, general/internal (7.9%). Comparing the results with period 1986-1989, some of the differences observed could be explained by the fact of MEDICINA CLINICA being included in SCI since 1992. An increase in the number of citable items (72.9%), number of journals used (from 1,086 to 1,346) and international cooperation rate (13.5% to 18.3%) was detected. The institutional sectors with the highest growth rate were Hospitals (92.9%) and Consejo Superior de investigaciones Cientificas (CSIC) (119.3%). Scientific production and visibility of publications (measured as impact factor of journals used) grew in most disciplines, being the quantitative increase greater in cancer/oncology, gastroenterology/hepatology, genetics/heredity and cardiovascular system. No substantial changes as to geographic distribution of documents or most active centres were observed. CONCLUSIONS: Spanish scientific activity grew steadily every year and its visibility improved, being the Health sector one of the main actors. When comparing both four-year period. Spain moved up from the seventh to the sixth position in the ranking of EU countries according to its scientific output in biomedicine and health sciences.

Databases, Bibliographic↗
PubMed1991

Effect of disopyramide on systolic and early diastolic time intervals in patients with hypertrophic cardiomyopathy.

The present study clarified the effect of disopyramide on left-ventricular function in patients with hypertrophic cardiomyopathy (5 obstructive type: HOCM, 21 non-obstructive type: HNCM). The systolic and early diastolic time intervals were assessed 3 hours after a single oral administration of 100-mg disopyramide. The following parameters were evaluated at rest and after administration of disopyramide: 1) left-ventricular ejection time index (LVETI), 2) pre-ejection period index (PEPI), 3) the interval from aortic component of the second heart sound to mitral valve opening (IIA-MVO), and 4) the interval from MVO to O point of apexcardiogram (MVO-O). LVETI in HNCM did not change after disopyramide but that in HOCM was significantly shortened (P less than .05). PEPI in both HOCM and HNCM was significantly prolonged after administration of disopyramide. IIA-MVO time in both HOCM and HNCM was not influenced by disopyramide. MVO-O time in both HOCM and HNCM was significantly shortened after disopyramide. These results suggest that 1) shortening of LVETI in HOCM after disopyramide seemed to be due to the decrease in pressure gradient, 2) PEPI prolongation after disopyramide reflected the decrease in myocardial contractility, and 3) shortening of MVO-O time after disopyramide indicated the improvement of left-ventricular filling. The authors conclude that disopyramide may be an important new therapeutic agent in the treatment of patients with hypertrophic cardiomyopathy.

Adult↗
PubMed1976

Left ventricular performance in coronary artery disease evaluated with systolic time intervals and echocardiography.

Simultaneous determinations of systolic time intervals (preejection period index [PEPI], left ventricular ejection time index [LVETI] and ratio of preejection period to left ventricular ejection time [PEP/LVET]) and echographic measures of left ventricular performance (percent change in minor axis diameter [%delta D], circumferential shortening rate [Vcf] and end-diastolic diameter [Dd]) were obtained in 25 normal subjects and 37 patients with previously documented transmural myocardial infarction. The group with previous infarction demonstrated significant (P less than 0.001) differences from the normal group in each of the noninvasive measures. PEP/LVET and %deltaD were the most sensitive measures of left ventricular dysfunction. Deviation from the normal range in these measures occurred, respectively, in 70 and 65 percent of patients without dyspnea or fatigability (20 patients) and 85 percent of those without angina pectoris (13 patients). Abnormalities in systolic time interval and echocardiographic measures were related to the severity of dyspnea and fatigability but not to that of angina. Neither the presence of phonocardiographically documented third or fourth sound gallops nor an abnormal cardiothoracic ratio by chest roentgenogram reliably detected patients with abnormal left ventricular performance. The range of abnormality in left ventricular performance did not differ between patients with prior anterior or diaphragmatic myocardial infarction. The frequency of abnormal performance was greatest among patients with combined sites of prior infarction. Among 26 patients studied by coronary arteriography, abnormal left ventricular performance as determined by values for PEP/LVET and %deltaD occurred in fewer than 30 percent of those with 70 percent or greater obstruction of one coronary artery and in more than 80 percent of those with two or three vessel involvement. There was a high correlation between systolic time intervals, %delta D and Vcf, the closest correlation occurring between PEP/LVET and %deltaD (r = -0.93). These data document the sensitivity of the noninvasive systolic time intervals and echographic measures and their superiority over current clinical bedside methods in evaluating left ventricular performance in patients with prior myocardial infarction.

Adult↗
PubMedDate not supplied

Microfilarial periodicity of Wuchereria bancrofti in Vanuatu.

A study on the relationship between the microfilarial periodicity of Wuchereria bancrofti and vector biting activity was carried out in Penama province, Vanuatu from February to April 1999, to enable the design of a more efficient strategy to control filariasis transmission. The microfilarial periodicities of 22 W. bancrofti antigen-positive volunteers were studied. Microfilariae (mf) were counted every hour for 24 h for 6 volunteers and every hour for 12 h (from 18:00 to 06:00) for 16 volunteers. At the same time as the preparation of mf test slides, indoor human landing catches of the vector mosquito, Anopheles farauti, were conducted to assess the vector biting activity. The time of peak microfilaraemia was 01:32 and the microfilarial periodicity index was 112.3, confirming the nocturnal periodicity of Wuchereria bancrofti in Vanuatu. Nearly all (98.5%) of the mf appeared during the time periods when A. farauti were collected. The timing of vector biting activity corresponded to the time of mf circulation.

Adolescent↗
PubMed2006

Revascularization and cardioprotective drug treatment in myocardial infarction patients: how do they impact on patients' survival when delivered as usual care.

BACKGROUND: Randomized clinical trials showed the benefit of pharmacological and revascularization treatments in secondary prevention of myocardial infarction (MI), in selected population with highly controlled interventions. The objective of this study is to measure these treatments' impact on the cardiovascular (CV) mortality rate among patients receiving usual care in the province of Quebec. METHODS: The study population consisted of a "naturalistic" cohort of all patients > or = 65 years old living in the Quebec province, who survived a MI (ICD-9: 410) in 1998. The studied dependant variable was time to death from a CV disease. Independent variables were revascularization procedure and cardioprotective drugs. Death from a non CV disease was also studied for comparison. Revascularization procedure was defined as percutaneous transluminal coronary angioplasty (PTCA) or coronary artery bypass graft (CABG). The exposure to cardioprotective drugs was defined as the number of cardioprotective drug classes (Acetylsalicylic Acid (ASA), Beta-Blockers, Angiotensin-Converting Enzyme (ACE) Inhibitors, Statins) claimed within the index period (first 30 days after the index hospitalization). Age, gender and a comorbidity index were used as covariates. Kaplan-Meier survival curves, Cox proportional hazard models, logistic regressions and regression trees were used. RESULTS: The study population totaled 5596 patients (3206 men; 2390 women). We observed 1128 deaths (20%) within two years following index hospitalization, of them 603 from CV disease. The CV survival rate at two years is much greater for patients with revascularization, regardless of pharmacological treatments. For patients without revascularization, the CV survival rate increases with the number of cardioprotective drug classes claimed. Finally, Cox proportional hazard models, regression tree and logistic regression analyses all revealed that the absence of revascularization and, to a lower extent, absence of cardioprotective drugs were major predictors for CV death, even after adjusting for age, gender and comorbidity. CONCLUSION: Considering usual care management of MI in the province of Quebec in 1998, CV survival is positively correlated to the presence of a revascularization procedure and to the intensity of cardioprotective pharmacological treatment. These results are coherent with data from randomized control trials.

Adrenergic beta-Antagonists↗
PubMed1994

The microfilarial periodic pattern of Wuchereria bancrofti in Kenya.

Microfilarial periodic pattern of Wuchereria bancrofti in Kenya was confirmed by the statistical method proposed by Aikat and Das (1977). Fifteen microfilarial positive individuals were brought to Nairobi from Malindi, which is one of the filariasis foci on the coastal area of Kenya. From each individual a 60-microliter finger prick blood film was made every 2 hours throughout one complete 24-hour cycle. The blood films were dried for at least 48 hours and dehaemoglobinized. The fluid was filtered using Nuclepore membrane to recover any detached microfilariae. The films were stained with Giemsa and microfilariae were counted. The peak time was 0056 h (4 minutes to 1 a.m.) and the periodicity index was 117.08, confirming the nocturnal periodicity.

Adolescent↗
PubMed2006

High-temperature-recorded index gratings in periodically poled lithium niobate.

Holographic index gratings based on a zero-electric-field photorefractive effect are recorded at high temperatures in copper-doped periodically poled lithium niobate crystals. The interplay between the domain structure and the index grating is studied: the fundamental grating with spatial frequency K is strongly suppressed. Pronounced sideband gratings with K(s)=K+sG appear, where G is the domain grating vector and s is an integer number. After development, an additional grating based on the electro-optic effect shows up. In contrast with the previously mentioned gratings, this grating allows anisotropic diffraction.

Journal Article↗
PubMed1994

Concurrent use of more than one major psychotropic drug (polypsychopharmacy) in out-patients--a prescription database study.

1. In order to assess the prevalence of concurrent use of more than one major psychotropic drug (polypsychopharmacy) in out-patients, a prescription database study was conducted in the Odense area for a period of 2 years. 2. During the index period 5.12% of the inhabitants purchased major psychotropic drugs. Of these, 14% had a period of polypsychopharmacy recorded. The age-specific prevalence of users increased with age, the prevalence for over 90 years of age was 18%. Sixty-seven per cent of the psychotropic drug users were women. 3. For neuroleptic and antidepressant users, about 20% were subject to polypsychopharmacy, for lithium 61%. The most prevalent combination was neuroleptics-neuroleptics. In none of the 10 most prevalent combinations were the mean daily doses significantly lower on polypsychopharmacy compared with single drug regimens, in two they were higher. 4. Polypsychopharmacy with psychotropic drugs was frequent in out-patients. In polypsychopharmacy daily doses were not lowered in order to limit side effects.

Ambulatory Care↗
PubMed2005

Zero-n gap soliton.

Periodic structures consisting of alternating layers of positive-index and negative-index materials have a novel bandgap at the frequency at which the average refractive index is zero. We show that, in the presence of a Kerr nonlinearity, this zero-n gap can switch from low transmission to a perfectly transmitting state, forming a nonlinear resonance or gap soliton in the process. This zero-n gap soliton is omnidirectional, in contrast to the usual Bragg gap soliton of positive-index periodic structures.

Journal Article↗
PubMed1979

Oral therapy with phentolamine in chronic congestive heart failure.

Therapy with phentolamine can improve the condition of patients with congestive heart failure due to the inotropic effect of this drug, as well as its vasodilating action. The use of oral therapy with phentolamine has not been adequately investigated in patients with chronic heart failure. Therefore, nine patients with chronic heart failure due to underlying valvular disease received 50 mg of phentolamine four times a day for two weeks. Echocardiograms and measurements of systolic time intervals were obtained prior to administration of phentolamine and two weeks after the introduction of therapy with the drug. As a result of therapy with phentolamine, the ejection fraction, the percentage of change in the minor axis, and the velocity of circumferential fiber shortening significantly increased, while the left atrial dimension decreased. Therapy with phentolamine produced a significant decrease in the preejection period index, as well as the ratio of the preejection period over the left ventricular ejection time. Thus, oral therapy with phentolamine improves left ventricular function in patients with chronic heart failure.

Administration, Oral↗
PubMed1982

A study of malayan filariasis in Lubuk Mumpo and Datar Lebar villages in Lais Regency, North Bengkulu, Sumatera, Indonesia.

Filariasis surveys at Lubuk Mumpo and Datar Lebar, Bengkulu, Sumatera, showed microfilarial rates of 23.9% and 30% respectively. Periodicity studies showed the parasite to be nocturnally periodic B. malayi with a periodicity index of 82.17. However, unlike the Malaysian form of periodic B. malayi, 44-100% of the microfilariae in thick blood smears were sheathed. Mansonia annulata, M. bonneae, M. dives, M. uniformis and Anopheles nigerrimus are probably involved in the transmission of the disease. B. malayi infections were seen in 7.1% of domestic cats and 20% of Macaca fascicularis examined. In addition Edesonfilaria malayensis is reported for the first time in Indonesia, 60% of 5 M. fascicularis being infected.

Adolescent↗
PubMed1985

Regional hospital pharmacy information index.

An index system was developed that provides participating hospitals with an up-to-date list of regionally available written materials used in hospital pharmacy practice. Eight acute-care hospitals agreed to participate in developing the index to avoid duplication of effort in producing original materials. A regional drug information center agreed to maintain the index and serve as the central repository for the materials. Newsletters and bulletins were given high priority for coverage by the system, followed by drug monographs and directed studies and residency projects. A three-year back-index period was set for most categories to ensure that the index was current. Only active entries were listed for investigational drug lists, i.v. drug administration monographs, and extemporaneously compounded drug products. Other categories were drug administration policies, unusual drug information requests, and patient-oriented drug information. The representatives provided the relevant materials from their institutions, and it was categorized and indexed. The index was entered on a word processor, which permits efficient updating. The index has been useful to the participating hospital pharmacy departments. As the system is tested through use, it will be evaluated formally and refined.

Abstracting and Indexing↗