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PubMed2002

Dexamethasone pulse therapy in pemphigus.

Pulse therapy with high-dose glucocorticoids was introduced 20 years ago as a treatment modality for autoimmune disease and transplant rejection. The most popular dermatological indication for pulse therapy is severe pemphigus. We reviewed the sequelae of 14 patients with pemphigus who were treated by pulse therapy. Seven of them reached complete remission, although three of them needed a new pulse course due to disease flare-up. Adverse events were minor and confined to 60% of all patients: temporary facial flushing during pulse administration, sleep disturbances during the first night after pulse administration, and mood changes occurred during the week of pulse therapy. The study showed the possibility of oral instead of an intravenous mute of dexamethasone pulse administration, which makes double-blind placebo-controlled trials ethically feasible. Fifty per cent of the patients reached complete remission. This retrospective study does not allow claims on the steroid-sparing effect.

Anti-Inflammatory Agents↗

PubMed2000

Simultaneous comparison of thoracic bioimpedance and arterial pulse waveform-derived cardiac output with thermodilution measurement.

OBJECTIVE: To compare the accuracy and reliability of thoracic electrical bioimpedance (TEB) and the arterial pulse waveform analysis with simultaneous measurement of thermodilution cardiac output (TD-CO) in critically ill patients. DESIGN: Prospective data collection. SETTING: Emergency department and critical care unit in a 2,000-bed inner-city hospital. PATIENTS: A total of 29 critically ill patients requiring invasive hemodynamic monitoring for clinical management were prospectively studied. INTERVENTIONS: Noninvasive cardiac output was simultaneously measured by a TEB device and by analysis of the arterial pulse waveform derived from the finger artery. Invasive cardiac output was determined by the thermodilution technique. MEASUREMENTS AND MAIN RESULTS: A total of 175 corresponding TD-CO and noninvasive hemodynamic measurements were collected in 30-min intervals. They revealed an overall bias of 0.34 L/min/m2 (95% confidence interval, 0.24-0.44 L/min/m2; p < .001) for the arterial pulse waveform analysis and of 0.61 L/min/m2 (95% confidence interval, 0.50-0.72 L/min/m2; p < .001) for the TEB. In 39.4% (n = 69) of all measurements, the discrepancy between arterial pulse waveform analysis and TD-CO was >0.50 L/min/m2. The discrepancies of the arterial pulse waveform analysis correlated positively with the magnitude of the cardiac index (r2 = 0.29; p < .001). In 56.6% (n = 99) of all measurements, the discrepancy between TEB and TD-CO was >0.50 L/min/m2. The magnitude of the discrepancies of the TEB was significantly correlated with age (r2 = 0.17; p = .02). Measurements were in phase in 93.2% of all arterial pulse waveform analysis and in 84.9% of all TEB readings (p < .001). CONCLUSIONS: The arterial pulse waveform analysis exhibits a greater accuracy and reliability as compared with the TEB with regard to overall bias, number of inaccurate readings, and phase lags. The arterial pulse waveform analysis may be useful for the monitoring of hemodynamic changes. However, both methods fail to be a substitute for the TD-CO because of a substantial percentage of inaccurate readings.

Adult↗

PubMed2003

Pulse-inversion-based fundamental imaging for contrast detection.

Pulse-inversion-based fundamental imaging was experimentally investigated for the enhancement of contrast detection. The pulse-inversion technique involves two firings with inverted waveforms. When the returning echoes from the two firings are summed, the residue signal is limited to even-order harmonics for tissue. However, when the returning echoes are from microbubbles, the fundamental signal is not completely cancelled because the reaction of the bubbles under compression is different from that under rarefaction. Thus, with the application of pulse-inversion technique, the fundamental signal can be used to enhance the contrast-to-tissue ratio. In this paper, B-mode, pulse-inversion-based fundamental images were constructed with various transmit waveforms. Motion artifacts also were studied. The results indicate that the contrast-to-tissue ratio was significantly enhanced compared to that obtained using either conventional, fundamental imaging or second-harmonic imaging. Longer transmit pulses resulted in a better signal-to-noise ratio, but did not noticeably affect the nonlinear response of the bubbles. In addition, the optimal ratio of the magnitude of the positive pulse to that of the negative pulse was unity, in terms of avoiding the uncancelled, third-order response in the fundamental frequency range. It also was found that the pulse-inversion fundamental technique is highly sensitive to tissue motion because the fundamental tissue signal is not cancelled when motion is present.

Artifacts↗

PubMed1999

[Steroid pulse therapy and vital prognosis among pediatric cancer patients with sepsis].

The usefulness of glucocorticosteroid therapy in patients with sepsis has been controversial. We investigated the effect of steroid pulse therapy on the vital prognosis of pediatric patients with sepsis and followed the vital status up to one month after the use of pulse therapy. We reviewed the medical records of 89 pediatric cancer patients with sepsis treated at our hospital between 1988 and 1996. The risks of potential predictors were estimated by calculating crude and adjusted relative risk (RR). The total cumulative death was 33/89 (25%). All patients treated with steroid pulse therapy died (12/12). Patients with either interstitial pneumonia (IP), infection-associated hemophagocytic syndrome (IAHS) and graft-versus-host disease (GVHD) showed a significantly higher cumulative death (57% (12/21) vs 31% (21/68), p = 0.03). Increased risk of cumulative death was suggested for the older age group, inappropriate antimicrobial therapy, and the conditions requiring steroid pulse therapy (IP, IAHS, and GVHD), (crude RR were 1.6, 1.6, and 1.9, respectively). However, when adjusted for pulse therapy, these three factors no longer indicated risk elevation, (adjusted RR = 1.2, 1.2, and 0.3, respectively). On the other hand, steroid pulse therapy per se was independently associated with increased risk of cumulative death (crude RR = 3.6, adjusted RR = 10). Thus, the risk of the conditions requiring steroid pulse therapy (IP, IAHS, and GVHD) firstly observed could be regarded as an apparent association due to steroid pulse therapy.

Child↗

PubMed1986

Is the pulse in atrial fibrillation irregularly irregular?

The belief that there is total irregularity of the pulse in atrial fibrillation has been re-examined. In a computerised analysis of R-R intervals and pulse volumes, 100-500 (mean 237) consecutive cycles were examined in 74 patients with atrial fibrillation, of whom 36 were on digoxin and 38 were not taking any antiarrhythmic treatment. A Doppler ultrasound technique was used to assess pulse volumes, against which R-R intervals were correlated. Although the sequence of consecutive R-R intervals was random in 52 (70%), patients there was a significant correlation between consecutive intervals in 22 (30%), the correlation coefficient being negative in 11 and positive in 11. In 43 (58%) cases the sequence of consecutive pulse volumes was significantly non-random; 34 (46%) showed pulsus alternans, indicated by a negative correlation between consecutive volumes. The proportion of patients with a non-random sequence of R-R intervals or pulse volumes was the same whether or not they were taking digoxin. Thus patients with atrial fibrillation often have patterns of regularity of the pulse, with the ventricular rhythm being non-random in almost one third and the sequence of pulse volumes being non-random in over a half. Contrary to classic teaching, in many patients with atrial fibrillation the pulse is not irregularly irregular.

Adult↗

PubMedDate not supplied

An alternative method of steroid-induced lens opacification in brown norway rat eyes applying systemic pulse administration.

PURPOSE: To confirm whether long-term administration of prednisolone sodium succinate (prednisolone) alone is able to induce cataract in rat eyes. MATERIALS AND METHODS: A 1% solution of prednisolone was administered topically as eye drops to Brown Norway rat eyes, and a systemic pulse administration of 10 mg/kg/day was given via the tail vein. Both administration methods were applied in different combinations. Eighty-three 6-week-old male rats were divided into 8 groups: group 1 = control; group 2 = topical instillation every day; group 3 = single pulse; group 4 = single pulse + eye drops; group 5 = 3 times pulse; group 6 = 3 times pulse + eye drops; group 7 = 3 times pulse per 2 months; group 8 = 3 times pulse per 2 months + eye drops. Observations for changes of lens transparency were made by slitlamp microscopy and documented by an anterior eye segment analysis system (Nidek EAS-1000) from the onset of drug administration to a maximum period of 16 months. RESULTS: Lens opacity in the shallow anterior and posterior lens layers developed from the tenth month following commencement of prednisolone administration. The incidence of anterior and/or posterior cortical cataract at the sixteenth month was 15% in group 2, 12.5% in group 5, 25% in group 6, 17.9% in group 7 and 35.3% in group 8. The lenses of groups 1, 3 and 4 maintained their transparency throughout the observation period. Light scattering intensity in groups 8 and 7 was the highest, followed by groups 6 and 5, then groups 2, 4, 3 and 1. CONCLUSION: Cortical cataract was successfully induced in Brown Norway rat eyes by sustained administration of prednisolone succinate alone applied as systemic pulse.

Animals↗

PubMed2005

Ethanol inhibits pulse pressure-induced vascular smooth muscle cell migration by differentially modulating plasminogen activator inhibitor type 1, matrix metalloproteinase-2 and -9.

We investigated the effect of ethanol on the pulse pressure-induced expression of PAI-1 and MMP-2/9 in human smooth muscle cells (SMC). Human SMC were exposed to static or pulse pressure (25 mL/min; pulse pressure 106/50 mm Hg) conditions for 24 h in the absence or presence of ethanol (0.1-100 mM). SMC migration was then measured by Transwell migration assay. SMC exposed to pulse pressure demonstrated a significant increase in PAI-1 mRNA and protein expression (approximately 4-fold and approximately 3-fold) concomitant with a 3- and 8-fold increase in MMP-2 and MMP-9 protein, respectively. Ethanol dose-dependently inhibited the pulse pressure-induced SMC migration with complete inhibition observed at 20 mM. There was no effect of ethanol on basal PAI-1 or MMP-2/9 in SMC under static conditions. However, ethanol significantly enhanced the pulse pressure-induced PAI-1 mRNA and protein expression (2.2 +/- 0.52 fold and 2.5 +/- 0.27 fold, for 10 mM), respectively. In contrast, ethanol dose-dependently inhibited the pulse pressure-induced increases in MMP-9 protein and pro-MMP-9 activity and to a lesser extent MMP-2 mRNA and protein and pro-MMP-2 activity, with significant inhibition observed at 1 mM. These data provide a molecular mechanism mediating the inhibitory effect of ethanol on pulse-pressure-induced SMC migration and may be relevant to the cardioprotective effects of ethanol in vivo.

Blood Pressure↗

PubMed2001

Pulse pressure changes with six classes of antihypertensive agents in a randomized, controlled trial.

Pulse pressure has been more strongly associated with cardiovascular outcomes, especially myocardial infarction and heart failure, than has systolic, diastolic, or mean arterial pressure in a variety of populations. Little is known, however, of the comparative effects of various classes of antihypertensive agents on pulse pressure. In retrospective analyses of the Veterans Affairs Single-Drug Therapy for Hypertension Study, we compared changes in pulse pressure with 6 classes of antihypertensive agents: 1292 men with diastolic blood pressure of 95 to 109 mm Hg on placebo were randomized to receive hydrochlorothiazide, atenolol, captopril, clonidine, diltiazem, prazosin, or placebo. Drug doses were titrated to achieve a goal diastolic blood pressure of <90 mm Hg during a 4- to 8-week medication titration phase. Pulse pressure change (placebo subtracted) was assessed from baseline to the end of the 3-month titration and 1-year maintenance. Mean baseline systolic, diastolic, and pulse pressures were 152, 99, and 53 mm Hg, respectively. Reductions in pulse pressure during titration were greater (P<0.001) with clonidine (6.7 mm Hg) and hydrochlorothiazide (6.2 mm Hg) than with captopril (2.5 mm Hg), diltiazem (1.6 mm Hg), and atenolol (1.4 mm Hg); reduction with prazosin (3.9 mm Hg) was similar to all but clonidine. After 1 year, pulse pressure was reduced significantly more (P<0.001) with hydrochlorothiazide (8.6 mm Hg) than with captopril and atenolol (4.1 mm Hg with both); clonidine (6.3 mm Hg), diltiazem (5.5 mm Hg), and prazosin (5.0 mm Hg) were intermediate. These data show that classes of antihypertensive agents differ in their ability to reduce pulse pressure. Whether these differences affect rates of cardiovascular events remains to be determined.

Adult↗

PubMed1995

Lung lesions induced by continuous- and pulsed-wave (diagnostic) ultrasound in mice, rabbits, and pigs.

These studies documented the presence or absence of macroscopic and microscopic intraparenchymal hemorrhage in individual lung lobes of mice, rabbits, and pigs exposed to continuous- and pulsed-wave (diagnostic) ultrasound; we described the character of and lesions associated with the hemorrhage and compared differences in the lesions among species and exposure conditions to investigate the pathogenic mechanisms and species differences associated with ultrasound-induced lung hemorrhage. In a series of three sequential interdependent studies, 312 mice, 91 rabbits, and 74 pigs were divided at random into experimental groups and exposed to continuous-wave ultrasound (3 kHz modulated at 120 Hz) of acoustic pressure levels ranging from 0 to 490 kPa for 5, 10, or 20 minutes. In a fourth study, three mice, 43 rabbits, and six pigs were divided at random into experimental groups and exposed to pulsed-wave ultrasound (3- and 6-MHz center frequency) of peak rarefactional acoustic pressure levels ranging from 0 to 5.6 MPa for 5 minutes. Macroscopic lesions induced by continuous- and pulsed-wave ultrasound consisted of dark red to black areas of hemorrhage that extended from visceral pleural surfaces into lung parenchyma. Hemorrhage appeared spatially related to the edges of lung lobes where pleura of dorsal and ventral surfaces met, occurred in specific lung lobes in all three species, and appeared anatomically related to lung that was closest to and in contiguous alignment with the ultrasound transducer and thus the path of the sound beam. Macroscopic lesions were similar in all species under all exposure conditions for both continuous- and pulsed-wave ultrasound; however, hemorrhage was not induced in pig lung exposed to pulsed-wave ultrasound at any peak rarefactional acoustic pressure level. Eighteen mice (145 kPa exposure pressure), 60 rabbits (145-460 kPa exposure pressure), and 58 pigs (145-490 kPa exposure pressure) from study 3 were used for microscopic evaluation of lung exposed to continuous-wave ultrasound; three mice (6 MHz; 2.9 and 5.4 MPa), 39 rabbits (3 and 6 MHz; 2.3-5.4 MPa), and six pigs (3 and 6 MHz; 3.3, 5.4, and 5.6 MPa) from study 4 were used for microscopic evaluation of lung exposed to pulsed-wave ultrasound. Microscopic lesions and the character of hemorrhage induced by continuous-wave ultrasound were different from those induced by pulsed-wave ultrasound. Lesions induced by continuous-wave ultrasound under all exposure conditions were similar in all three species. Lesions induced by pulsed-wave ultrasound under all exposure conditions were similar in all three species.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

PubMed1980

Assessment of the severity of aortic stenosis from the carotid pulse tracing.

The morphology of the externally recorded carotid pulse tracing was studied in 33 patients with valvular aortic stenosis for indices of severity. Comparisons were made with 10 normal controls. In aortic stenosis, initial upstroke time (IUT) of the carotid pulse, and left ventricular ejection time index were significantly higher and the rate of rise of the carotid pulse was slower than in the control group. Severity of stenosis (calculated valve area and mean pressure gradient) could not be predicted, however, from any of these indices. The IUT of the carotid pulse did correlate well with mean velocity of circumferential fiber shortening (mVcf) (r=-0.72). The rate of rise of the carotid pulse had also a correlation with mVcf(r=0.66). However, other commonly used hemodynamic indices (cardiac index, systemic vascular resistance, stroke volume, and ejection fraction) did not have a good correlation with IUT and rate of rise of the carotid pulse. These results suggest that we are able to separate by carotid pulse tracings aortic stenosis from normal subjects, but we cannot say what is the degree of severity of aortic stenosis from analysis of the external carotid pulse recording.

Adolescent↗

PubMed2000

Intraocular pressure and pulse rate measurements by the OBF tonograph--comparison to reference instruments.

The purpose of this study was to evaluate the accuracy of intraocular pressure (IOP) and ocular pulse rate (OPR) measurements obtained by the Ocular Blood Flow (OBF) tonograph (OBF Labs, Wiltshire, UK). Measurements of IOP and OPR by the OBF tonograph were compared to those of reference instruments. For IOP evaluation, measurements were obtained on patients with normal and abnormal pressures using the OBF tonograph and the Goldmann applannation tonometer in random alternate order. For the OPR evaluation, measurements were obtained using the OBF tonograph with simultaneous heart rate monitoring by ECG on patients with normal IOP. The validity of the OBF tonograph measurements was quantified in terms of 95% limits of agreement and their relationships to measurements by reference instruments was determined by linear regression analyses. 102 patients were recruited for IOP measurements. Mean IOP obtained by the Goldmann tonometer was 20.7 mmHg (7-42 mmHg, SD 6.98) whilst mean IOP obtained by the OBF tonograph was 20.1 mmHg (8.1-40.2, SD 6.1). Goldmann IOP and OBF tonograph IOP readings were well correlated (r = 0.945). Analysis of the difference in IOP measurements between two instruments (tonograph minus Goldmann tonometer) showed the mean bias to be 0.26 mmHg (-7.8 to +6.1 mmHg) and the 95% limits of agreement to be -4.35 to +4.87 mmHg. Agreement between two instruments appeared to be dependent on the IOP; at IOP lower than 20.6 mmHg there was an overall tendency for the tonograph IOP to be higher than Goldmann IOP and vice versa when IOP was above 20.6 mmHg. 47 patients were recruited for OPR and ECG measurements. Mean pulse rates were 74.8 beats per min (mean 43-110) by ECG and 73.9 beats per min (43-110) by tonography. Analysis of the difference in pulse rate between instruments (tonograph OPR minus ECG pulse rate) against the average pulse rate showed the mean bias to be -0.8 beats and the 95% limits of agreement to be between -7 to +5 beats. Ocular pulse rate values obtained by the OBF tonograph were very accurate when compared to ECG pulse rate. This indicates that there is unlikely to be a systematic lag in continuous ocular pulse waveform recording. Intraocular pressure measurements by the OBF tonograph correlated very well with Goldmann readings over a wide range of pressures and should be valid in the clinical setting.

Heart Rate↗

PubMed2002

[A study on Cai Xishan's Mai jing (Pulse classic)].

Cai Yuanding, also named Cai Xishan, was a great Confucian scholar in the Southern Song dynasty, and his book, Mai jing (Pulse Classic), was long lost in China. According to Dai Qizong's Mai jue kan wu ji jie (Collected Annotations of Correcting Errors in Pulse Study in Verse) of the Yuan dynasty, Liu Yude's Yi lin xu chuan (Extending Biography of Medicine) of the Ming dynasty etc., the author makes a study on "Pulse Classic", the fourth volume of Zhen mai xu zhi (Notice of Pulse Taking), a book came back from the Cabinet Library of Japan and holds that it was an extract edition of Cai's Pulse Classic. When discussing the pulse, Cai paid attention to the theory of pulse while neglected the pulse conditions and its indications, which was further researched by the author.

Books↗

PubMedDate not supplied

Femoral pulse palpation before and after exercise: a guide to occult iliac stenosis?

Iliac artery stenosis may produce significant haemodynamic impairment in the absence of any visible iliac narrowing on uniplanar arteriography. Such stenoses may be unmasked by the use of biplanar angiography or by direct femoral pressure measurements before and after papaverine. The aim of this study is to determine whether simple femoral pulse palpation is a reliable guide to haemodynamic impairment in the radiologically normal aorto-iliac segment, and in particular whether occult iliac stenosis can be unmasked by noting a reduction in the palpable pulse after exercise. Twenty-nine limbs with normal aorto-iliac segments on uniplanar angiography were examined at rest and after exercise and the femoral pulses were graded clinically. Haemodynamic assessment was performed by direct femoral pressure measurements before and after intra-arterial papaverine injection. Significant haemodynamic impairment was noted in 8 out of 29 limbs. Six of these 8 limbs had normal resting femoral pulses and 4 of the 8 limbs had a diminished pulse after exercise. Four out of the 21 limbs with normal haemodynamic studies had diminished pulses after exercise. Resting femoral pulse palpation is a poor guide to radiologically occult but haemodynamically significant iliac stenosis although pulse palpation after exercise may help to unmask a proportion of such stenoses.

Aorta, Abdominal↗

PubMedDate not supplied

Epidemiology of resting pulse rate of persons ages 25-74--data from NHANES 1971-74.

Data from the first National Health and Nutrition Examination Survey (NHANES) were examined to produce national estimates for pulse rate distributions, confirm previously reported associations with pulse rate, and to perform analyses of associations of pulse rate with dietary, biochemical, hematological, and other variables that might shed light on the nature of the associations of heart rate with hypertension and mortality. Among persons 25-74 years in the NHANES Survey, women had slightly higher resting pulse rates than men. Age had no consistent effects. Pulse rate was slightly higher in whites than in blacks among women and 25-44-year-old men. Resting pulse rate was slightly higher in fall and winter than in spring and summer and in the afternoon and evening than in the morning. Blood pressure and body temperature were significantly positively associated with pulse rate independent of multiple confounders. Heart beats per minute as recorded by electrocardiogram were slightly higher among smokers than nonsmokers after adjustment for multiple confounders. Of a large number of dietary, biochemical, and hematological variables, only total white blood cell count, hemoglobin, and serum uric acid showed consistent, independent associations with resting pulse or heart rate; these findings require confirmation in other populations.

Adolescent↗

PubMed2005

[The arterial pulse: from oblivious to revival?].

It seems reasonable to suppose that there is some relationship between the fanciful descriptions of arterial pulse dating back to ancient times and the more sophisticated data stemming from the technological advances of recent years. The clinical evidence derived from "the flowing blood" has always been associated with diseases of the heart and vessels and indeed of apparently unrelated organs, as well as with emotional states. Centuries before the Christian era, Chinese and Indian doctors seat great store by the study of the pulse which was described in imaginative terms and considered a clue to a person's character and illnesses. This subject was just as important to Greeks and Romans: to mention just one famous name Galeno, who wrote extensively about pulses. Up to the 18th century many European Universities had chairs entitled: "De pulsibus et urines" and from this time onwards sphygmic doctrine gained an ever-growing space in the scientific literature in the attempt to establish diagnostic and prognostic connections (often rather whimsical ones) between different kinds of pulses and so-called "crises of cerebral, thoracic and abdominal organs". Between the mid 18th century and the end of the 19th century the study of pulses was mainly focused on identifying arrhythmias and valvular defects even though we still find descriptions of "alternating" and "paradoxical" pulses accompanied by somewhat ambiguous explanations. From the second half of the 20th century the possibility of measuring the pulse wave velocity and the "augmentation index" has led to remarkable advances in epidemiological studies of cardiovascular diseases. This work would like to draw the readers' attention to the relevance a simple semeiological practice such as the examination of the pulse still has in the clinical approach to a patient even in these modern times.

Cardiology↗

PubMed1991

Determining the pulse for infant CPR: time for a change?

The accepted standard for determining cardiac arrest in infants is the use of palpation of the brachial pulse to detect pulselessness. The investigators have observed that CPR-certified individuals have difficulty locating the brachial pulse in infants. Therefore, the purpose of this study was to determine if a more effective way exists for assessing the pulse in an infant. Of the 102 subjects tested, 84 correctly assessed the apical pulse by placing a naked ear against the chest wall, whereas only 48 correctly palpated the brachial pulse. The study results demonstrated that there was a statistically significant (p less than 0.001) difference between the two methods for assessing pulses in infants. This indicates that the apical pulse method is a faster and more accurate method for locating the pulse in an infant, and should be used during cardiopulmonary resuscitation.

Auscultation↗

PubMed1990

[Asymptomatic blood pressure and pulse rate changes during intravenous urography. Ionic contrast media vs. nonionic contrast media].

In 8,232 examinations of intravenous urography (4,832 examinations with ionic contrast media and 3,400 examinations with nonionic contrast media), systemic blood pressure and pulse rate were continuously monitored by an automatic blood pressure and pulse rate monitoring device before and after injection of contrast media. The intravenous injection of ionic contrast media caused mild to moderate hypotensive reactions (20%-39% decrease of systemic blood pressure) in 7 examinations (0.14%) and severe hypotensive reactions (greater than 40% decrease of systemic blood pressure) in 12 examinations (0.25%). There were no clinical symptoms other than hypotensive reactions in 8 of the 19 examinations (42.1%). On the other hand, the intravenous injection of nonionic contrast media did not cause severe hypotensive reactions but mild hypotensive reactions (20%-29% decrease of systemic blood pressure) in 3 examinations (0.09%). These 3 examinations did not have clinical symptoms other than hypotensive reactions. Of the 19 examinations using ionic contrast media, the hypotensive reactions with significant change of pulse rate (greater than 20%) was associated with increase of pulse rate in 17 examinations and decrease of pulse rate in 2 examinations. On the other hand, the hypotensive reactions had an association with a significant increase (greater than 20%) of the pulse rate in only one of the 3 examinations using nonionic contrast media. The pulse rate was unchanged after injection of contrast media in the remaining 2 examinations although there was mild hypotension. In conclusion, nonionic contrast media caused fewer and less severe changes in blood pressure and pulse rate without obvious clinical symptoms compared with ionic contrast media.

Adolescent↗

PubMed1976

[Studies on the palpable intensity of the radial pulse (author's transl)].

Depending on the pressure of the palpating finger the radial pulse may be found differently "large" in spite of unchanged intravasal pulse pressure. In this paper the amplitude of the extravasal volume pulse is examined related to a continually diminished coupling pressure of a foto-electrical pulse detector. First, the amplitudes increase with the declining external pressure, reach a maximum and then diminish again. This is exactly the same course one gets palpating the radial pulse with the finger. The intravasal pressure amplitudes however show at the same time a different kind of course. These differences between extra- and intravasal pulsation usually can be seen in patients with undistrubed circulation. Having a vasoconstriction in the radial artery the course of the extravasal volume pulse-curve appears different and the sensation of the palpating finger, too. In this case the pulse is palpable evenly small. The differences can be explained by the changes in the pressure-builded elastic tension of the arterial wall and the stronger contraction of the vessels muscles in vasconstriction. Thus, the diagnosis vasoconstriction can be made palpating the radial pulse.

Blood Pressure↗