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At least 721 records · Page 40Linked to original sources

[Usefulness of carotid sinus massage for Doppler quantification of mitral stenosis in sinus rhythm].

The quantification of mitral stenosis by pressure half-time method may be difficult in sinus rhythm with short deceleration slopes. To evaluate the usefulness of carotid sinus massage (CSM) for measuring mitral valve area by pressure half-time, 80 consecutive patients with mitral stenosis in sinus rhythm underwent a echo-Doppler study at basal heart rate and during right CSM. In both situations we measured: heart rate, mitral area by pressure half-time and E-F interval (time from E peak velocity to onset of atrial contraction). In 38 consecutive patients we also determined the mitral area by planimetry. The study group was divided into patients with basal E-F interval < or = 150 ms and a HR > or = 75 bpm (group A, 28 patients [35%]) and those with a basal E-F interval > 150 ms who showed a heart rate < 75 bpm (group B, 52 patients). In the group A, the values obtained at basal heart rate vs after CSM were: heart rate, 86 +/- 9 vs 61.6 +/- 10.5 lpm; E-F interval, 109 +/- 33 vs 372 +/- 136 ms; mitral area, 1.88 +/- 0.5 vs 1.23 +/- 0.29 cm2 (p < 0.001). In the group B, these values were: 69.7 +/- 6.6 vs 53 +/- 11 bpm, 253 +/- 60 vs 510 +/- 212 ms y 1.34 +/- 0.3 vs 1.18 +/- 0.32 cm2, respectively (p < 0.01). Mean differences in Doppler mitral areas between both situations for groups A and B were: 0.63 +/- 0.3 cm2 and 0.17 +/- 0.1 cm2, respectively (p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Successful emergency surgical management following cardiac massage in a patient with acute myocardial infarction due to total obstruction of the left main trunk].

The prognosis in patients manifesting shock following acute myocardial infarction due to total occlusion of the left main trunk (LMT) is usually very poor and so is the lifesaving rate. Accurate judgement and rapid response are key to the successful management of this disease. We experienced a successful case with emergency coronary artery bypass grafting (CABG) on the 14 the day after initial attack. The patient, who had total occlusion of LMT, underwent a PTCA (percutaneous transluminal coronary angioplasty) during the initial attack under cardiac massage. We think in situations where patients have cardiac arrest, shock, elevated CPK levels suggesting devastation of myocardium due either to LMT or severe triple vessels disease, early catheter intervention rather than emergency CABG would be much more tolerable as long as hemodynamic situation allows. Our previous experience taught us that immediate surgical intervention with CABG usually resulted in poor outcome. Further refinements regarding the surgical procedure, technique, assist circulatory supports, cardioplegia, etc., are indispensable before trying to have a successful emergency CABG.

Angioplasty, Balloon, Coronary↗

[The effect of reflex muscle massage on the body regulatory processes of peptic ulcer patients with concomitant diseases].

Compared to conventional treatment, the proposed method of deep reflex muscular massage for treatment of ulcer patients with associated diseases in combination with exercises for muscle strain, produce stronger positive changes in adaptive-compensatory systems. This may result in prolongation of the remission and in a decreased number of recurrences of ulcer and associated gastrointestinal diseases.

Adaptation, Physiological↗

The heart is under the lower third of the sternum. Implications for external cardiac massage.

Current guidelines for cardiopulmonary resuscitation in children state that the heart lies under the midsternum in infancy and descends with age. To verify this statement, we studied 55 patients, aged 1 day to 19 years, including eight premature infants, during either routine chest x-ray films or right-sided heart angiography. Using a Cartesian coordinate system determined by radiopaque markers placed on the chest, and computer digitization, we located the center of each patient's cardiac silhouette and/or right ventricle. Using descriptive statistics, we found that the heart lay under the lower third of the sternum in all age groups. Analysis of variance indicated that there was no significant difference in this location between age groups. These results suggest that recommendations for external cardiac massage in infants and children may need to be revised.

Adolescent↗

Begging for milk: evolution of teat massaging in suckling pigs.

We present a model that simulates the evolution of teat massaging (begging) by suckling piglets (Sus scrofa) and milk distribution among teats (provisioning) by their mothers. Contrary to previous begging models, this one incorporates an ontogenetic dimension in that the inherited begging and provisioning rules are repeatedly allowed to interact, and their consequences for milk intake, growth and death probability are assessed, during each nursing. We test the model under three selection regimes differing in the relative importance of the between-litter selection component. We show that the selection regime with the strongest between-litter selection component leads to lowest begging levels and most effective milk utilization, thus supporting the hypothesis that selection based on whole litters may attenuate sibling competition.

Animals↗

Sexually transmitted diseases in Japanese female commercial sex workers working in massage parlors with cell baths.

A cross-sectional study of Japanese female commercial sex workers (FCSWs) working in massage parlors with cell baths (MPCBs) was conducted between July 1999 and December 2001. The study subjects were 171 FCSWs aged from 19 to 36 years. A questionnaire included sexual characteristics in addition to working name and date of birth. We serologically or bacteriologically confirmed the prevalence of HIV-1, HIV-2, hepatitis B virus (HBV), hepatitis C virus (HCV), Chlamydia trachomatis, Neisseria gonorrhoeae, syphilis, and trichomoniasis. There were no differences in the clinical characteristics of FCSWs working in standard-class MPCBs (group A) and those working in expensive-class MPCBs (group B). With respect to sexual characteristics, HIV-1 and HIV-2 were not confirmed in any subjects, but N. gonorrhoeae was detected in 1.2%. Use of condoms was 98.4% in group A and 83.3% in group B ( P < 0.01). No HIV infection and an extremely low prevalence of sexually transmitted diseases (STDs) were recognized in Japanese FCSWs working in standard- and expensive-class MPCBs.

Adult↗

Neurally mediated syncope detected by carotid sinus massage and head-up tilt test in sick sinus syndrome.

It is generally accepted that a positive response to carotid sinus massage (CSM) or head-up tilt (HUT) in patients affected by syncope suggests a reflex cause of the syncope. To study the role of the autonomic nervous system in causing syncope in the sick sinus syndrome (SSS), CSM and HUT were performed in 35 consecutive patients (20 men, mean age 70 +/- 9 years) with syncope and SSS. Results were compared with those in 35 patients affected by syncope that, despite careful cardiovascular and neurologic examination, were of uncertain origin (21 men; mean age 68 +/- 9 years) and with those of 35 subjects without syncope (20 men; mean age 69 +/- 10). All patients underwent CSM in the supine and standing positions for 10 seconds and HUT to 60 degrees for 60 minutes. In the patients with SSS, the full reproduction of spontaneous symptoms by CSM occurred in 21 (60%) and by HUT, in 19 (54%). At least 1 test was positive in 28 patients (80%): cardioinhibitory or mixed responses in 69%, vasodepressor responses in 11%. The percentages of positive tests in the patients with syncope of uncertain origin were similar to or slightly less than those of patients with SSS (CSM 63%, HUT 26%, overall 74%) with cardioinhibitory or mixed responses in 54% and vasodepressor in 20% (p less than 0.05). In control subjects, syncope was induced by CSM in 1 (3%) and by HUT in 2 (6%); overall positivity was 9%. In conclusion, in most patients affected by syncope and SSS, an abnormal neural reflex probably plays a major role in causing syncope.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

Atrial rupture in a child from cardiac massage by his parent.

A 4-year-old boy presented with a single seizure following a viral syndrome. He had a pericardial effusion on admission, and this increased suddenly on the third day of hospitalization, producing cardiac tamponade. After blood was aspirated from the child's pericardial cavity, the father revealed that he performed cardiac massage on his son following the seizure. A laceration of the right atrium was repaired at operation, and the boy made a good recovery. Cardiopulmonary resuscitation by lay persons is not without hazard, and patients with such a history should be watched carefully for the possibility of damage to intrathoracic structures.

Cardiac Tamponade↗

Defibrillation with a minimally invasive direct cardiac massage device.

OBJECTIVE: This study examined (1) the defibrillation efficacy of using a minimally invasive direct cardiac massage (MID-CM) device as one electrode of the defibrillation electrical circuit and (2) the effect on external defibrillation of defibrillating when the MID-CM device is in place and a pneumothorax is present. METHODS: Part 1: in seven pigs, defibrillation thresholds (DFTs) were determined with a truncated exponential biphasic waveform. DFTs were determined for five electrode configurations: standard transthoracic defibrillation with electrodes on the left and right chest walls (1), with the MID-CM as one of the defibrillation electrodes pressed gently (2) or firmly (3) against the heart with the right chest wall patch as the second electrode, the same as (1) with the MID-CM device in place and the lungs at end-inspiration (4) or at end-expiration (5). Part 2: in six pigs, DFTs were determined with a monophasic damped sinusoidal waveform with external defibrillation electrodes (1) and with the device as one defibrillation electrode and the other electrode on either the anterior (2), lateral (3), or posterior right chest wall (4). RESULTS: Part 1: the DFTs for (2) or (3) were not different (18.7+/-12.4 vs. 17.0+/-8.3 J), but both DFTs were lower than that for (1) (155+/-45 J). The DFT was elevated for (4) (205+/-69 J) compared with (1). For (5) only one animal could be defibrillated with shocks up to 360 J. Part 2: the DFTs for (2), (3) or (4) were not different (19.5+/-11.0, 25.4+/-9.4, 27.4+/-9.0 J), but all three were lower than the DFT for (1) (198+/-70 J). CONCLUSIONS: Using the MID-CM device as one electrode of the defibrillation circuit markedly lowers the DFT compared with that for standard transthoracic defibrillation for both a monophasic and biphasic waveform. Defibrillation with the device in place and the chest opened elevates the DFT for external defibrillation much more during end-expiration than during end-inspiration.

Animals↗

Mass data massage: an automated data processing system used for NHEXAS, Arizona. National Human Exposure Assessment Survey.

Data entry and management are critical components of all large survey projects; data quality objectives must be met and data must be quickly and readily accessible. We developed a comprehensive system for data entry and management utilizing scannable forms with bubble fields and handwriting recognition. This 'Mass Data Massage' (MDM) system had three components: (1) form creation and database definition; (2) programming of data dictionaries for documentation and preliminary logic and range checks; and (3) data entry, management and documentation using the 'Mass Data Cleaning Program' (MDCP). Scannable forms were written in Teleform, where the data field definition, variable names and ranges were defined as the form was created. Completed forms were returned from the field, subjected to final field quality control (QC) checks, and transferred to the data management section. They were batched and coded as necessary. Once a batch of data was scanned and visually verified, the operator called up the menu for the MDCP. The MDCP had 31 program modules with 500-1200 lines of code each. The operator could select and run the appropriate dictionary on each data batch 'correcting' apparent errors in responses. This process was iterative until the data batch passed all dictionary checks. Proposed 'changes' were forwarded to the data coordinator (DC) for acceptance or rejection. After all errors had been resolved, each data batch was subjected to a 10% quality assurance (QA) check. The original data batch and associated file of applied changes were archived. Time expenditure using the scanning approach varied with the number of questions and the types of responses (handwritten or bubble fields). One-page forms took 42-60% of the time needed for hand entry; forms longer than 10 pages took 35-38% of the time. Use of faster machines will further speed the process. The main advantage of the system was the reduction of systematic errors. Scanning alone reduced errors found on 995 NHEXAS Baseline Questionnaires. Overall, the dictionary identified 0.55% errors on the scanned forms. Ten percent QC checks, performed on corrected batches ready for appendage to the master database, revealed an overall error rate of 0.02%. Similar checks on a laboratory form scanned from numeric handwriting detected 0.3% errors following dictionary application and 0.2% errors during the 10% QA check. This system was faster, more accurate, and more cost-effective than hand entry of data. A batch of data that took >1 week to process using the hand entry method was processed within 1 day using MDM. Human coding of specific answers and the final verification were the most time-consuming processes.

Arizona↗

Negotiating risk: how women working in massage parlours preserve their sexual and psychological health.

The small exploratory study was conducted in a heavily populated urban area in the Midlands region of England. Through semistructured interviews with women working in massage parlours, we investigated the health risks inherent in the work and the strategies adopted by the women to overcome these, as well as examining circumstances where theses strategies could be compromised. The effects of working in the sex industry on women's relationships and lives outside also emerged as the research progressed. We found that, in addition to preserving their sexual health, women's main concern was with the separation of home and work.

Adult↗

Cardiac effects of carotid sinus massage in old age.

The effects of carotid sinus massage in aged subjects with a high incidence of arteriosclerosis are described. In 71 men and 315 women tested, a slowing of more than 10 per cent of the heart rate was found in 25 per cent of the men and 19 per cent of the women, which is not of statistical significance in relation to sex. Only men showed a significant increase with age and the women had a significant preponderance of a right-sided response. The technique was found to be safe, although a review of reported side-effects suggests care is advisable and carotid compression must not occur. The findings are discussed in relation to those reported in younger subjects and in carotid sinus syndrome with syncope. The fact that men have an acquired increase in response in old age, which is not seen in women, may be a factor of importance in the explanation of why carotid sinus syncope is almost always seen in men. Carotid sinus sensitivity appears to diminish in old age and some of the ageing factors which might influence the carotid sinus reflex are examined.

Age Factors↗

The effect of carotid sinus massage is independent of posture in patients with heart disease.

The influence of posture on the effect of carotid sinus massage (CSM) in patients with heart disease has not been systematically evaluated. In the present study CSM was performed in 80 patients (mean age 55 +/- 10 (SD) years) suffering from various cardiovascular diseases. Each subject had unilateral right- and left-sided CSM performed in the supine and in the sitting position, while heart rate and systolic blood pressure were monitored. No statistically significant differences in the CSM-induced response in systolic blood pressure or heart rate were found between the two postures. In the supine position the drop in heart rate was significantly greater after right-sided than after left-sided CSM (P less than 0.05). In only one patient (1%) was a significant carotid sinus reflex evoked. The response was cardioinhibitory with asystole for 3700 ms during right-sided, supine CSM. These results imply that posture does not influence the effect of CSM in patients suffering from heart disease.

Aged↗

The cultural and philosophical aspects of pressure, massage, and touch healing as alternative therapies.

Integrative medicine is becoming more popular, not only in developing nations, but also in countries such as the United States. Acupuncture, which is practiced more than any other kind of alternative medicine, is based on the philosophy and culture of old Chinese healing. Pressure, massage, and touch healing depend on stimulation by the fingers rather than needles, although they are based on acupuncture principles. Touch has social, educational, cultural, and humanitarian aspects. Touch therapy has been shown to have excellent effects on children's growth, development, and emotional well-being. In adults, a 15-minute rubdown by fingertips can lead to relaxation and sleep. It is also useful for premature babies. Such therapies were practiced in the Old World, but have been rediscovered in the New World. They represent some aspects of the old, noble art of healing.

Acupressure↗

Establishment and characterization of a human prostatic carcinoma cell strain obtained from exfoliated tumor cells after prostatic massage.

During a control campaign connected to our main program on early diagnosis of prostatic carcinoma through tissue culture of prostatic fluid samples obtained after prostatic massage (M. Bologna et al., Eur. Urol., 14, 474-476, 1988), we isolated and characterized a human prostatic carcinoma cell strain from a 58-year-old patient with a grade III prostatic carcinoma. The epithelial cell strain, named PMU-23, has been passaged in vitro for 31 subculture cycles during a period of approximately 8 months, after which cell proliferation slowed down irreversibly. The isolation of this cell strain constitutes a renewed confirmation of the validity of our method for the early diagnosis of prostatic carcinoma and demonstrates some intermediate features in the progression of prostatic tumors. In addition, the study of limited-lifespan tumor cell strains in culture may extend the knowledge on prostatic cell biology, particularly toward the identification of intermediate steps of tumor progression, for a better approach of tumor therapy and prevention of metastatic spread.

Cell Division↗

Exit block of artificial pacemaker induced by carotid sinus massage.

Failure of the pacemaker is a common complication of pacemaker therapy. Identification of the disorder responsible for the failure to pace is often difficult. An increase in myocardial threshold can result in nonconduction of the artificial impulse, particularly near the end of the life of the battery, when the output of current has started to decline. This report demonstrates such an increase in myocardial resistance which was apparent only upon massage of the carotid sinus.

Aged↗