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PubMed1979

Mycosis fungoides: electron beam therapy in England.

Since 1962, total-skin electron-beam therapy has been available in London, England, for the treatment of patients with mycosis fungoides and skin lymphomas. The 6-mev linear accelerator produces a pencil beam of electrons at 7 mev, which are scattered through a brass scatterer and decelerated by either of two carbon decelerators or a copper decelerator to produce a beam of effective energy of 2.5, 3, or 3.5 mev; these beams have an 80% isodose distribution at 5.5, 8, and 11.5 mm, respectively. The patient receives 200 rads to the anterior, posterior, and right and left lateral fields, for a total dose of between 1600 and 2600 ras in ten treatments over 5--7 weeks. Complete clearing of the disease can be predicted in all patients except those with the most advanced tumors. However, the duration of remission after electron-beam therapy is approximately 18 months and we are presently investigating the combination of psoralens and ultraviolet light therapy as maintenance treatment following lower-dose electron-beam therapy.

Humans↗
PubMed2001

Restrictive left ventricular filling pattern as a strong predictor of depressed baroreflex sensitivity in heart failure.

BACKGROUND: The aim of this study was to test the hypothesis that a restrictive left ventricular diastolic filling pattern, as an index of elevated pulmonary wedge pressure, would predict a depressed baroreflex sensitivity (BRS) in patients with chronic heart failure. METHODS: A total of 189 consecutive patients with an ejection fraction < or = 40% at echocardiography, in sinus rhythm and clinically stable for at least 1 month in oral therapy, underwent clinical examination, echo-Doppler study and the phenylephrine test. RESULTS: The correlations between the NYHA functional class, echo-Doppler variables and BRS were weak, although significant (r ranging from -0.15 to 0.40). However, patients with a deceleration time < 140 ms as an expression of restrictive filling, compared to those with a deceleration time > or = 140 ms, had a lower BRS (3 +/- 4 vs 6 +/- 4 ms/mmHg, p < 0.00001), a lower ejection fraction (20 +/- 6 vs 28 +/- 7%, p < 0.00001), greater left ventricular (end-diastolic volume index 137 +/- 43 vs 113 +/- 45 ml/m2, p < 0.00001) and left atrial dimensions (25 +/- 6 vs 20 +/- 5 cm2, p < 0.00001), more severe mitral regurgitation (3 +/- 1 vs 2.3 +/- 1, p < 0.00001) and were in a higher NYHA class (2.3 +/- 0.6 vs 1.8 +/- 0.5, p < 0.00001). Medications at the time of the study were similar in the two groups. At stepwise regression analysis, the deceleration time emerged as the most powerful independent predictor of a depressed BRS (< 3 ms/mmHg), followed by mitral regurgitation, age, and NYHA class (all data p = 0.0001). CONCLUSIONS: In patients with chronic heart failure, the presence of a restrictive left ventricular filling pattern is highly predictive of autonomic derangement as expressed by low values of BRS.

Age Factors↗
PubMed2000

[Differences in hemodynamics of thromboembolic and primary pulmonary hypertension].

It is not clear whether right ventricle to pulmonary artery coupling is modified by the site of vascular obstruction in patients with chronic severe pulmonary hypertension. We compared invasively (Swan Ganz) and non-invasively (echo/ /Doppler) assessed hemodynamics between two groups of patients with severe chronic thromboembolic pulmonary hypertension (CTEPH)--(n = 6; 52 +/- 24 yrs) and pulmonary arterial hypertension (PAH) (n = 5; 42 +/- 9 yrs) who had similar invasively measured right ventricular systolic pressure (CTEPH: 78 +/- 14 mm Hg; PAH: 83 +/- 17 mm Hg; p = NS), mean pulmonary arterial pressure (CTEPH: 51 +/- 10; PAH 56 +/- 11 mm Hg, p = NS) and pulmonary vascular resistance (CTEPH: 15.6 +/- 4.4 l/min; PAH: 19.2 +/- 6.1; p = ns). Patients with CTEPH have significantly shorter acceleration time corrected to ejection time (RVET): (AcT/RVET % = 24 +/- 5% vs 32 +/- 6% in PAH; p = 0.04) as well as AcT corrected by RR distance was highly significantly shorter (8 +/- 2% vs 12 +/- 2%; p = 0.006). AcT in the CTEPH group was shorter than in the PAH (60 +/- 5 vs 75 +/- 15; p = 0.047). The mid-systolic deceleration was significantly more frequent in the CTEPH group than in the PAH group (88% vs 30%; p = 0.005). If the mid-systolic deceleration was present in patients with PAH, the time to mid-systolic deceleration (t-N) had tendency to be longer in CTEPH group (118 +/- 22 ms vs 150 +/- 28 ms in PAH; p = 0.09). Significant differences appeared after correction t-N to RVET (t-N/RVET % = 46 +/- 9% vs 61 +/- 4%; p = 0.027) and to RR interval (t-N/RVET % = 16 +/- 2% vs 24 +/- 1%; p = 0.002). Doppler derived RV index proposed by Tei was slightly higher in CTEPH (0.81 +/- 0.18 vs 0.65 +/- 0.32 in PAH) but not significantly. Taken together our observations indicate that dynamical coupling between RV and pulmonary arteries is more disturbed in CTEPH than in PPH despite similar levels of chronically increased PAP.

Adult↗
PubMedDate not supplied

Pointing movement in short and long-term exposure to hypoxia.

Kinematics variables of pointing movements where assessed in five adult subjects exposed acutely (30 min) and chronically (10 days) to a low O2 mixture (13.5% O2 in N2). Amplitude of displacement did not vary in both experimental conditions but movement duration markedly increased compared to pre and post exposure conditions. While in acute hypoxia the times of acceleration and deceleration are almost equal, in chronic hypoxia deceleration time exceeded of 100 ms the time of acceleration. The time from the peak acceleration to the peak of deceleration ("switch" time) increased in both experimental conditions and was about 50% of the movement duration. This time lengthening at hypoxia may be explained either by alteration of propioceptive loops or by a different strategy elaborated by the CNS to generally slow accurate movements.

Adult↗
PubMed1976

Human tolerance to acceleration after exposure to weightlessness.

The major role in the genesis of varying human tolerance to decelerations that follow weightlessness is evidently played by hypodynamic and hydrostatic factors. Long disuse of compensatory antigravity mechanisms in weightlessness may bring about their deconditioning and reduction of their functional capabilities, and may finally affect general tolerance of crewmembers to decelerations. Laboratory experiments demonstrated changes in the human tolerance to Gx accelerations of varying duration (from 3 to 100 days) and tested the efficacy of different countermeasures. A decrease in the human tolerance to +Gx is on the average -2.0g. It should be noted that an elongation of simulated weightlessness (from 7 to 100 days) caused no further decrease in the +Gx tolerance. Our investigations helped to assess the threshold of human tolerance to accelerations after an exposure to simulated weightlessness and to delineate the value of real risk. The tolerance limit to +Gx accelerations which followed simulated weightlessness of the above duration ranged from 9.5 to 13.0g, averaging 11.6 +/- 1.6g. The information on the tolerance of Soviet and American astronauts to decelerations shown during re-entry in real space flights give support to the laboratory results and predictions.

Acceleration↗
PubMed2002

Prehospital rounds. The quick stop.

The coroner's post-mortem examination revealed a tom aorta. This case illustrates that although a patient may appear stable, a major catastrophic event may nonetheless be taking place. How many times have we responded to MVAs similar to the one described here and seen those involved deny injuries? We carry a higher suspicion of aortic injury after someone has been ejected from a vehicle or involved in a high-speed crash. That's not always the case, however, and understanding how internal organs respond to high-speed impacts is crucial. Damage to the aorta may result after a sudden deceleration injury of any type: a fall, vehicle crash or violence. The most common forms of traumatic aortic injury occur where the aorta is "tethered" in place: at its intersection with the heart and at its distal portion just beneath the left subclavian artery near the ligamenta arteriosum. Approximately 80% of patients with aortic injury die at the scene. The injury may be hidden in the other 20%, but they have the potential to rapidly deteriorate and die. Those who survive typically are at a trauma center and are cared for by providers who have a suspicion of the injury. A high index of suspicion should be maintained on all rapid-deceleration injuries and with patients who experience chest pain, dyspnea, a difference in pressure between the upper and lower extremities, and paralysis. Paralysis can occur when aortic injury cuts off blood supply [table: see text] to the spinal cord. The spinal cord obtains its blood supply from arteries coming directly off the aorta, and a torn aorta can shear off these vessels, leaving the spinal cord to infarct and the patient to lose all distal function. When a victim sustains a sudden-deceleration injury to the chest, signs of aortic injury should be sought. It is imperative to maintain a high index of suspicion throughout patient care and be aware that although a patient may appear to be quite stable, the reality might be otherwise, and rapid transport to a trauma center will be necessary to save their life.

Accidents, Traffic↗
PubMed2002

[Management of abnormal fetal heart rate in the second stage of labor].

OBJECTIVE: We investigated the correlations between abnormal fetal heart rate (FHR) during the second stage of labor and delivery types and intrapartum maternal complications and fetal outcome. METHODS: The data of 232 nulliparas with single vertex in the second stage of labor (111 cases with normal FHR, 121 cases with abnormal FHR) were analyzed retrospectively. RESULTS: The incidence of abnormal FHR in the second stage of labor was 52.2% (121/232). The patterns of abnormal FHR included: 81 (66.9%) cases with moderate and/or severe variable deceleration (VD), 27 (22.3%) cases with scattered late deceleration (LD), only one with continuous LD, 4 (3.3%) cases prolonged deceleration (PD), 2 (1.7%) cases with VD and LD, 3 (2.5%) cases with VD and PD, 4 (3.3%) cases with diminished baseline variability. There were 13 (11.7%) among the cases with normal FHR and 35 (28.9%) among the cases with abnormal FHR underwent assistant delivery operations (forceps or/and vaccum), respectively (P < 0.05). Furthermore 29 of 35 (82.9%) cases underwent assistant operations for vagina delivery due to abnormal FHR, the others underwent assistant operations for vagina delivery due to weak expulsive force or malpositioning of fetal head. There was one case of complicated vaginal laceration in the group with abnormal FHR. There was no difference of newborns with low Apgar score between two groups. CONCLUSIONS: There was a very high incidence of abnormal FHR during the second stage of labor, however, the most cases were response to parasympathetic stimulation due to umbilical cord or fetal head compression by mothers over push and descent of fetal head, or temporal diminishing of uterine placenta blood flow. It suggests that it is unnecessary to interfere immediately, unless truly fetal distress.

Adult↗
PubMed1992

[Status of cerebral and central hemodynamics in patients with ischemic stroke].

Overall 30 patients who suffered ischemic brain stroke were examined for cerebral and central hemodynamics by radiocerebrography (RC) with the aid of the radiopharmaceutical preparation Tx-99 and by radiocardiography (RCG) using 131I. These methods were employed simultaneously with computer-aided tomography, cerebral angiography, rheoencephalography. The control group was made up of 18 patients suffering from peripheral nervous diseases. In 11 patients with a favourable outcome of ischemic brain stroke and the recovery of work fitness, the RC and RCG readings did not practically differ from those in the controls. The remaining 19 patients with disability due to brain stroke demonstrated deceleration of the cerebral blood flow, most pronounced on the side of brain infarction. Asymmetry of the cerebral blood flow and deceleration of blood supply in the main and intracerebral vessels as shown by the RC readings turned out the signs of the hemodynamically significant stenosis of one of the internal carotid arteries, even in lack of the changes on the angiogram. A correlation was established between deterioration of central hemodynamics and deceleration of the cerebral blood flow, as was a possibility of an increase of the blood inflow to the brain after administering drugs that make the RCG readings return to normal.

Adult↗
PubMed2003

[The relationship between intrapartum fetal heart rate disturbances, electrocardiographic changes and umbilical venous troponin-I (T-I)].

OBJECTIVE: To analyse the relationship between intrapartum fetal heart rate disturbances and electrocardiographic changes and umbilical venous troponin-I (T-I), concentrations as well. MATERIAL AND METHODS: 14 fetuses were continuously surveyed by CTG and ECG recordings in the first and second stage of labor, using STAN S-21 analyser. After birth, umbilical venous blood samples were collected for determination of acid-base balance, base excess and troponin-I concentrations. RESULTS: From among monitored fetuses, in 8 cases the CTG and FECG patterns were correct. Vaginally delivered neonates were born in good clinical status, with normal acid-base balance, base excess and T-I < 0.3 ng/ml. In 3 cases abnormal CTG patterns were observed with early decelerations but FECG patterns were correct. Vaginally delivered neonates were born in good clinical status, with normal acid-base balance, base excess and T-I < 0.3 ng/ml. In 2 cases abnormal CTG patterns were observed with variable decelerations but FECG patterns were correct. Vaginally delivered neonates were born in good clinical status, with normal acid-base balance, base excess and T-I < 0.3 ng/ml. In one case abnormal CTG pattern were observed with late decelerations but FECG patterns was correct. The pregnancy was terminated by caesarean section because of fetal distress. The neonate was born in good clinical status with normal acid-base balance and base excess but T-I concentration was increased (1.5 ng/ml).

Acid-Base Equilibrium↗
PubMed2004

Adult growth hormone deficiency. Metabolic alterations and evaluation of different risk groups.

Adult growth hormone deficiency (AGHD) is an heterogeneous clinical entity characterized by increased cardiovascular morbidity and mortality, alterations in body composition, osteoporosis and impaired quality of life. In order to characterize higher risk subpopulations we studied 77 patients with AGHD, 35 with childhood onset (AGHD-CO): CA 18-44 yr.; 13 females and 22 males, and 42 with adult onset (AGHD-AO): CA 25-70 yr.; 22 females and 20 males. IGF-I, lipid profile, glycemia and glycosylated hemoglobin were measured. Cardiological evaluation: blood pressure, electrocardiogram, ergometry and 2D echocardiogram with mitral Doppler, evaluation of diastolic function (A/E waves ratio and deceleration time), systolic function (ejection and shortening fractions) and Cardiac Mass Index (CMI). The Body Mass Index and waist circumference were recorded. Total body composition and bone mineral density were evaluated by densitometry, and the following bone markers were measured: osteocalcin, bone-specific alkaline phosphatase, carboxyterminal propeptide of type I procollagen, Pyridinoline and Deoxipyridinoline. The subset of females with AGHD-AO had higher levels of total cholesterol: 240 mg/dl (156-351) (p < 0.005), LDL: 140 mg/dl (62-262) (p < 0.04) and of total cholesterol/HDL: 4.04 (3.12-12.7) (p < 0.04); while females with AGHD-CO had a decreased CMI: 62 g/m2 (53-107) (p < 0.01), lower A/E waves ratio: 0.56 (0.39-0.72) (p < 0.01) and lower deceleration time: 164 msec. (135-210) (p < 0.01). The subset of males with AGHD-AO had a greater waist circumference: 98 cm (83-128) (p < 0.03) and males with AGHD-CO had a lower shortening fraction: 41% (30-49) (p < 0.006) and lower deceleration time: 153.5 msec. (127-230) (p < 0.03). In both genders, the bone mineral content was lower in patients with AGHD-CO (females p < 0.02, males: p < 0.0008). Our findings confirm the differences in impairment in AGHD patients, which are mainly dependent on gender and the time of onset of the deficiency, and thus demonstrate the heterogeneity of the syndrome.

Adolescent↗
PubMed1992

[Fetal monitoring for anesthesiologists].

Several monitoring methods for the fetus are presented, the knowledge of which is appropriate for anesthesiologists active in the field of obstetrics. A distinction is made between external, indirect methods for monitoring when the amniotic sac is intact and internal, direct methods employed when the sac has ruptured. Particular emphasis is placed on cardiotocography (CTG), which is an obligatory method of routine monitoring during the late period of cervical dilatation and expulsion. It registers the reaction of fetal heart rate to parturition and labor, and represents a good indirect measure of both uteroplacental blood flow and fetal cardiac reserve. Criteria of evaluation for cardiotocograms are presented on the basis of guidelines elaborated by the Standard Committee on Cardiotocography (Chairman: Prof. Dr. H. Rüttgers). These enable the status of the fetus to be evaluated with differentiation. An inevitable sign of fetal well-being is a normal baseline with a rate between 120 and 160 beats/min, normal microfluctuation, and oscillations between 5 and 25/min with absent variable or late decelerations. Warning signs are restricted microfluctuation, elevated baseline, variable decelerations, and clinical passage of meconium. Suspicious signs are a baseline between 100-119 and 161-170 beats/min, respectively, decreased oscillation amplitude, and protracted decelerations over as much as 2 min.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2005

[Pilot study of the noninvasive assessment of endothelial dysfunction by post-occlusion dopplerometry velocity curves analysis in arteria brachialis].

BACKGROUND: A new method of noninvasive assessment of endothelial dysfunction was used in this pilot study. Study has been set on a. brachialis dopplerometry velocity curves analysis. Index of blood stream deceleration between the first and second minute of the postocclusion periode was measured on a. brachialis after transient mechanical occlusion of the forearm--so called Deceleration Index. METHODS AND RESULTS: Eighteen patients with so far untreated hypercholesterolemia were involved in our study. Profile of velocity curves became significantly different after six months of fluvastatin therapy, Deceleration Index increased from 3 % to more than 7 % (p<0.05). That correlated with LDL-CH levels decrease, but also with the significant decrease of biochemical markers of endothelial dysfunction (trombomodulin, von Willebrand factor). CONCLUSIONS: The result is corresponding with previously published studies that have proved endothelial function improvement after statin therapy using another ultrasonographic methods.

Anticholesteremic Agents↗
PubMed2006

Screening of foetal distress by assessment of umbilical cord lactate.

PURPOSE OF INVESTIGATION: Studies on umbilical cord blood for determination of lactate indicate that high levels seem to be correlated to foetal metabolism for anaerobic glycolysis taking place in oxygen-deprived tissues of the foetus. These findings may be of particular-deprived clinical importance when foetal distress or foetal hypoxemia is caused by perinatal events. METHODS: The maternal and foetal heart rates, acid-base values measured and the outcome of 94 pregnancies complicated by intrapartum foetal asphyxia have been reviewed, and the maternal and foetal acid-base and lactate levels during the course of labour and at delivery were studied in patients with evidence of metabolic acidosis. Lactate concentrations were measured during labour and at delivery in blood samples obtained from the foetal presenting part and from the umbilical cord with the use of a rapid electrochemical technique. The foetuses were evaluated by means of the Apgar score, intrapartum cardiotocography, observation of the presence of meconium stained amniotic fluid, and clinical features of distress at birth. RESULTS: Evidence of clinical foetal distress was not related to the severity of the asphyxia. An increased lactate level was found in asphyctic infants and a clear correlation between lactic acidosis and foetal distress was documented. Low Apgar scores were observed in infants with moderate or severe asphyxia at delivery. Scalp lactate correlated significantly with umbilical artery lactate, but not with 1-min or 5-min Apgar scores. The lactate concentration was higher in cases of instrumental delivery compared to spontaneous delivery. No perfect correlation was found between lactate level and neonatal outcome but there were not a significant number of neonates with immediate complications. The rate of forceps delivery in the distress group was significantly higher than that of the healthy foetuses, so spontaneous labour was less frequently associated with foetal distress than instrumental delivery. In the distress group, severe variable decelerations were generally recorded in the second stage of labour. The incidence of neonatal Apgar score < or = 7 in neonates with abnormal baseline foetal heart rate (FHR) was higher than in those with severe variable decelerations, mild variable decelerations, and transient tachycardia. Duration of the active second stage of labour was significantly with the presence of foetal lactate at the time of crowning of the foetal head and the presence of lactate in umbilical arterial and vein blood at delivery. Expulsion time > or = 45 minutes, compared with shorter active second stage, and acidaemia at birth implied larger arterial-venous lactate differences. The presence of foetal lactate at crowning was also significantly associated with the level of umbilical arterial-venous lactate difference. CONCLUSION: Lactate and pH values provide the best parameters to distinguish between asphyctic and normal newborns, with lactate having the most discriminating power. The prospective value of the discrimination functions derived from lactate and pH data is good when the foetuses are allocated into normal parameters but poor when an attempt is made to allocate the foetuses into pathologic ones, with a high false-negative rate. However, the discriminating ability is improved when pathologic foetuses are included into one single abnormal group. These results confirm the potential use of rapid foetal blood lactate measurements for the early diagnosis of intrapartum foetal distress.

Acidosis, Lactic↗
PubMedDate not supplied

Effect of preload and heart rate manipulation on Doppler transmitral flow velocity pattern: search for load--independent parameters.

Pulsed Doppler transmitral flow-velocity provides a non-invasive method for serial evaluation of diastolic function. However confounding influence of loading conditions and heart rate on transmitral flow makes many conclusions suspect. To study the effect of preload, various parameters of Doppler mitral spectrum were studied in 11 patients with stable effort angina, angiographic coronary artery disease and intact global and segmental systolic function, before and after administration of sublingual isosorbide dinitrate (group 1). Following isosorbide dinitrate administration, there was a significant increase in heart rate (p less than 0.001), decrease in left ventricular end-diastolic volume (p less than 0.01), no change in left ventricular ejection fraction and systolic blood pressure. Peak E velocity, E velocity-time integral, E/A velocity time integrals ratio, acceleration and deceleration rates and diastolic filling period were significantly reduced whereas peak A velocity, A velocity time integral, acceleration and deceleration times and atrial filling period were unchanged. In 10 age-matched patients (group 2), atrial pacing performed to achieve similar degree of increase in heart rate as in group 1 (10 +/- 1 vs 12. +/- 4, p = NS), resulted in a decrease in E velocity time integral, E/A velocity time integrals ratio and diastolic filling period (p less than 0.01) without any significant change in any other parameter. Absolute A velocity time integral, acceleration and deceleration times are the only parameters of transmitral diastolic flow-velocity profile which are relatively independent of preload and heart rate provided the change is small.

Administration, Sublingual↗
PubMed1991

Prophylactic amnioinfusion in pregnancies complicated by oligohydramnios: a prospective study.

Prophylactic amnioinfusion was assessed in term and post-dates pregnancies with decreased amniotic fluid volume. Subjects were randomly assigned to one of three groups: amnioinfusion with warmed saline solution, room-temperature saline, or control. Patients receiving prophylactic amnioinfusion had a significant decrease in both the frequency and severity of variable decelerations in the first stage of labor (P = .006) and in the average total number of variable decelerations in the first and second stages of labor (P = .01) compared with controls. There was no observed effect on newborn serum electrolyte levels with amnioinfusion, nor was there any apparent benefit of infusion of warmed saline compared with room-temperature saline. In contrast to premature gestations with oligohydramnios, prophylactic amnioinfusion was not associated with a significant improvement in mean umbilical arterial and venous pH or a significant decrease in cesarean delivery for fetal distress (P = .09). This is perhaps because the term fetus has an enhanced ability to tolerate recurrent episodes of heart rate decelerations without demonstrating the rapid metabolic changes seen in the premature fetus.

Adult↗
PubMed1990

Doppler echocardiography in dilated and restrictive cardiomyopathies.

Dilated cardiomyopathy is characterized by systolic dysfunction and cardiac enlargement of unknown origin. Various Doppler modalities are useful to detect and quantitate atrioventricular regurgitation, which is common and contributes to clinical symptoms. Pulsed Doppler assessment of mitral and tricuspid inflow velocities shows a spectrum of findings indicative of abnormal diastolic function and hemodynamic status. When mitral regurgitation is more than moderate and heart failure is severe, the ratio between early inflow E wave to atrial inflow A wave peak velocities is increased. Mitral deceleration time may be short. When mitral regurgitation is trivial and left atrial pressure is not increased, abnormal relaxation may be detected as a low E:A ratio. Mitral deceleration time and isovolumic relaxation time are prolonged. In restrictive cardiomyopathy, there is an abrupt limitation in early ventricular filling due to abnormal compliance of endocardial or endomyocardial origin. Mitral and tricuspid inflow velocities show normal to increased early peak velocity, rapid deceleration time, low peak atrial velocity, and an increased E:A ratio. Differentiation between restriction and constriction might be possible by the demonstration in pericardial constriction of inspiratory decreases in mitral early inflow peak velocities and in prolongation of isovolumic relaxation time, with reciprocal changes on tricuspid inflow velocity profiles. In constriction, these respiratory variations are caused by the ventricular limitation to accommodate changes in venous return due to the pericardial shell. Doppler abnormalities and two-dimensional echocardiographic assessment of ventricular and atrial size and ejection fraction provide the practicing physician with valuable diagnostic information.

Cardiomyopathy, Dilated↗
PubMed1990

[The rate and time indices of mitral and tricuspid valve movement during the cardiac cycle in congenital heart defects].

Ultrasonic Doppler echotachocardiogram of the mitral and tricuspid valves together with polycardiogram were recorded in 44 patients with interatrial septal defect and in 18 patients with interventricular septal defect. The patients with interatrial septal defect manifested an increase of the velocity of the movement of the mitral valve during its opening, deceleration of the movement velocity in the atrial systole, a tendency towards movement deceleration during the closure, and a rise of the time of the mitral valve during its closure and opening. In interventricular septal defect, there was a tendency towards deceleration of the movement velocity of the mitral valve in the atrial systole. The velocity and time parameters of the movement of the tricuspid valve remained unchanged in patients with congenital defects under study.

Adolescent↗
PubMed1975

Correlation of fetal heart rate-uterine contraction patterns with fetal scalp blood pH.

The significance of fetal heart rate-uterine contraction (FHR-UC) monitoring as a means of predicting the condition of the fetus during labor was studied by correlating 460 fetal pH determinations obtained from 216 patients with the analysis of the 20-minute FHR-UC record preceding the fetal scalp blood sample. Both qualitative and quantitative analyses of the FHR-UC record were performed. The results indicate a less than 10% chance of fetal pH less than or equal to 7.250 with an normal baseline FHR and no periodic changes or with periodic accelerations, early decelerations, and uncomplicated baseline bradycardia or tachycardia. Variable or delayed decelerations with a total surface area (TSA) of 1-100 for the 20-min period were associated with a fetal pH less than or equal to 7.250 in 23 and 34% of cases, respectively. Variable or delayed decelerations with a TSA greater than 100 had a 35 or 47% chance of fetal pH less than or equall to 7.250. It is concluded that FHR-UC monitoring can be used to screen the innocuous from the ominous periodic change but that fetal scalp blood pH must be obtained to identify accurately the true from the false-positive ominous pattern.

Female↗