SEARCH · Search PubMed

Results for “Periodical Index”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 127 records · Page 7Linked to original sources

PubMed1984

Effect of prolonged intense endurance training on systolic time intervals in patients with coronary artery disease.

We studied the effect of exercise training (ET) on systolic time intervals (STI) in 13 patients with coronary artery disease (CAD). All patients trained for at least 10 months. They exercised three times/week at 50% to 70% of maximal oxygen uptake (VO2max) for the initial 3 months and at least four times/week for approximately 50 minutes at 70% to 90% of VO2max thereafter. A significant training effect was documented by an increase in VO2max from 26.0 +/- 4.3 to 37.2 +/- 5.8 ml/kg/min (p less than 0.01), a lower heart rate (HR) at rest, and a lower blood pressure and HR during submaximal work. The indices of total electromechanical systole (QS2I) and left ventricular ejection time (LVETI) did not change. However, pre-ejection period index (PEPI) decreased from 137 +/- 9 msec to 129 +/- 9 msec (p less than 0.01). PEP/LVET decreased from 0.373 +/- 0.028 to 0.342 +/- 0.032 (p less than 0.01). Left ventricular end-diastolic dimension and posterior wall thickness, measured echocardiographically, were increased after training. We conclude that exercise training may improve myocardial performance in some patients with CAD.

Adult↗

PubMedDate not supplied

Reporting psychosomatic consultations in the discharge letter: an examination of communication between inpatient and primary care physicians.

The discharge letter is the primary means of communication between the inpatient and the outpatient treatment providers in the German health care system. The inclusion of psychosomatic consultation findings within the discharge letter is a critical step for impacting the psychosocial aspects of patient care following discharge. The present retrospective study measured the extent to which psychosomatic consultations conducted at the University of Heidelberg Medical Hospital were mentioned in the discharge letter during a 2-year index period. Psychosomatic consultations (N=605) were requested by a total of 101 inpatient physicians and conducted by 9 consultants. Of the 528 discharge letters that were reviewed, 67.8% referenced the psychosomatic consultation. Results from a stepwise logistic regression analysis found that a reason for referral due to "presumed psychiatric etiology of unexplained physical complaints" was the strongest predictor of whether the consultation was mentioned in the discharge letter (odds ratio=2.27). In contrast, a referral due to "coping and compliance problems" or the identification of psychosocial problems secondary to a somatic illness significantly decreased the chance of communication. The high rate of communication when physicians are confronted with a complex diagnostic picture involving presumed psychiatric comorbidity underscores the perceived usefulness of the consultation. However, consultants may need to take an active role in facilitating the management of psychosocial aspects of care during the inpatient stay and following discharge in an effort to improve concordance.

Adult↗

PubMed2004

Manic patients receiving ECT in a Brazilian sample.

BACKGROUND: Characterization of manic inpatients receiving electroconvulsive therapy (ECT) has not been done. METHODS: The charts of 425 consecutive admissions of 269 inpatients treated for manic or mixed episodes, between 1996 and 2000, in a Brazilian private psychiatric hospital were reviewed. A logistic model was built to determine the predictors of use of ECT for mania. Median total length of stay (LOS) and LOS deducted from the delay until ECT was started were compared between ECT and non-ECT admissions. The risk of readmission was estimated using Cox's regression. RESULTS: Significant predictors of ECT prescription were: history of previous admission (OR=4.09), psychotic features (OR=1.60), female gender (OR=2.04), married (OR=1.79), and treatment by a psychiatrist who assisted more than 20 manic inpatients in the index period (OR=1.97). Co-morbidity with cardiovascular disease was negatively associated with ECT use (OR=0.49). Median LOS after starting ECT was similar to that of non-ECT admissions (12 vs. 13 days). ECT reduced (HR=0.678) and previous psychiatric admissions increased (HR=2.320) the risk of readmission after a manic episode. LIMITATIONS: Only one hospital was included in this study. CONCLUSIONS: The presence of psychotic features and violent behavior during manic episodes and indicators of chronicity of bipolar illness (history of previous admissions, duration of disease) were predictors of ECT use for the treatment of mania. Suicidality was not associated with the use of ECT for mania. LOS after ECT was started was similar to LOS of non-ECT admissions. The use of ECT for mania reduced the risk of readmission.

Adult↗

PubMed1999

Prevalence and 12-month outcome of threshold and subthreshold mental disorders in primary care.

BACKGROUND: The authors investigated the occurrence and 12-month outcome of mental disorders in primary care setting. METHOD: Out of 1555 primary care patients screened in an index period in 16 primary care clinics, 457 subjects were selected for the second phase interview with the CIDI and 250 subjects completed the assessment. Of these, 116 patients (49 ICD-10 cases and 67 subthreshold cases) completed the 12-month follow-up evaluation. RESULTS: Overall, 12.4% of consecutive primary care attenders had a current ICD-10 disorder and 14.2% had a subthreshold mental disorder. Psychiatric comorbidity was found in 45% of the initial sample. Physicians recognized the presence of a mental disorder at baseline in 84.6% of cases with depression comorbid with anxiety and in 44.8% of subthreshold cases. Subthreshold cases outnumbered by three times threshold cases in terms of remission after one year. However, 18% of subthreshold conditions showed no improvement after 12 months. Recognition of mental disorder by the physician at baseline was not associated with an improvement of psychopathology after 12 months, but was associated with an improvement in occupational disability and self-reported disability among threshold cases. CONCLUSIONS: Mental disorders are frequent in primary care but their outcome is relatively independent from recognition by the physician. Threshold cases have a worse 12-month outcome than subthreshold cases. However, a substantial outcome variability seems to characterize different diagnostic subgroups both in threshold and subthreshold cases.

Adolescent↗

PubMed2002

Inflection point of ascending aortic waveform is a powerful predictor of restenosis after percutaneous transluminal coronary angioplasty.

BACKGROUND: Although it was reported that the pulsatility of ascending aortic pressure is closely related to restenosis after percutaneous transluminal coronary angioplasty (PTCA), it is not known whether the reflection period of ascending aortic pressure can predict restenosis after PTCA. The purpose of this study was to evaluate whether reflection in the arterial system can be used to predict restenosis after PTCA. METHODS: We used the inflection point as the reflection period index and measured the coronary artery diameter, aortic pressure, and inflection time before PTCA. We defined the inflection time as the time interval from the initiation of systolic pressure waveform to the inflection point. We prospectively investigated the effect of inflection time in relation to the subsequent risk of restenosis after PTCA in patients with coronary artery disease. RESULTS: Crude cumulative incidence rates of restenosis were 74.1% for the lowest, 33.3% for the middle, and 26.1% for the highest tertile of inflection point levels. After adjustments for age, gender, smoking habits, hypertension, type 2 diabetes, hypercholesterolemia, old myocardial infarction, vessel location, post-minimal lumen diameter, heart rate, and ejection fraction, the odds ratio of restenosis was 6.99 (95% confidence interval, 1.54 to 31.7) for the lowest tertile of the inflection time level compared with the highest tertile level. CONCLUSIONS: Inflection time is a powerful predictor of restenosis after PTCA.

Adult↗

PubMed1981

Amiloride-induced changes in digoxin dynamics and kinetics: abolition of digoxin-induced inotropism with amiloride.

Digoxin dynamics and kinetics were studied in six healthy subjects with and without amiloride. Amiloride increased mean renal digoxin clearance from 1.3 to 2.4 ml . kg-1 . min-1 (p less than 0.001) due to increased tubular secretion of digoxin, while the glomerular filtration rate was unchanged. This might be caused by an increase in intracellular potassium concentration in the tubular cells provoked by amiloride. In contrast, the extrarenal clearance of digoxin was almost blocked by amiloride; it fell from a mean of 2.1 to 0.2 ml . kg-1 . min-1 (p less than 0.025). Total body clearance tended to fall, but the decrease was not statistically significant. EValuation of myocardial contractility by systolic time intervals revealed a concentration-response relationship between digoxin and changes in preejection period index when digoxin was given alone (rs = 0.750, p less than 0.001). Pretreatment with amiloride abolished this relationship (rs = 0.307, p = NS). Blood pressure and echocardiographically determined left ventricular end-diastolic diameter measurements indicated no changes in the left ventricular post- and preload. It is concluded that amiloride suppressed digoxin-induced inotropism.

Adult↗

PubMed2002

Complexities in ETS-domain transcription factor function and regulation: lessons from the TCF (ternary complex factor) subfamily. The Colworth Medal Lecture.

The ETS-domain transcription factor family can be divided into a series of subfamilies. Elk-1 represents the founding member of the ternary complex factor (TCF) subfamily. By focusing on the TCF subfamily, we can demonstrate the complexities that exist in the function and regulation of ETS-domain transcription factors. This article focuses on Elk-1 in detail and summarizes the functions of other TCFs. The key themes covered include the domain structure of the TCFs, the mechanisms of complex formation with serum response factor, regulation of TCFs by mitogen-activated protein kinase cascades, and transcriptional regulatory properties of the TCFs. Finally, the emerging role of the TCFs in vivo is discussed. A picture is developing indicating that, while these proteins exhibit significant sequence and functional conservation, key differences in their structure and regulation are being identified which may relate to unique functions of these proteins in vivo.

Amino Acid Sequence↗

PubMed2001

Comparison of asthma costs in patients starting fluticasone propionate compared to patients starting montelukast.

An observational study using pharmacy and medical claims was used to determine whether there are differences in asthma care cost between patients that are newly started on montelukast and low-dose fluticasone propionate. Patients were identified who had at least one ICD-9 (493.XX) claim for asthma and were newly prescribed inhaled fluticasone propionate 44 microg (FP) or montelukast 5 or 10 mg (MON). Subjects could not have had a claim for any inhaled corticosteroid or oral leukotriene modifier in 9 months prior to the first prescription claim for either FP or MON. They were subsequently followed for 9 months. Multi-variate regression analysis was used to determine the influence of these single-controller therapies on post-index asthma related costs. Positively skewed cost variables were log-transformed prior to their inclusion into the multi-variate model. Asthma-related costs were adjusted for age, gender, health plan, co-morbidities, pre-index asthma medication use and pre-index asthma care costs. Multivariate regression analysis, adjusting for baseline covariates, indicated that compared to treatment with montelukast, treatment with FP had significantly (P<0.001) lower post-index total asthma related costs. Adjusted least squares mean total asthma care costs for the 9-month post-index period were $US649 for FP 44 microg compared to $US1028 for montelukast.

Acetates↗

PubMed2000

The microfilarial periodicity of Wuchereria bancrofti in north-eastern Brazil.

The periodicity of Wuchereria bancrofti microfilariae (mff) in peripheral blood was analysed in 42 microfilaraemics living in Maceió, in Alagoas state, north-eastern Brazil. Nine blood samples were collected from each subject, over a 24-h period, and two quantitative (60-microliter) thick smears were prepared from each sample. Although all the subjects had detectable microfilaraemias from 23.00 hours to 06.00 hours, no mff could be detected in most (71.4%) of the smears prepared from samples collected at 15.00 hours. Samples collected during the day, at 15.00 hours, contained 170 times fewer mff/microliter than those collected at 01.00 hours, when microfilaraemias were generally most intense. For diagnosis of bancroftian filariasis in Maceió, blood samples should be collected between 22.00 and 03.00 hours, when microfilarial counts will be at least 90% of the peak counts. The circadian variation observed was independent of the subject's gender and microfilarial density. Mathematical analysis, using a simple harmonic-wave model, indicated a periodicity index of 127.6 and that maximum microfilarial densities occurred at 00.51 hours, confirming the nocturnal pattern of microfilaraemia in the study area.

Adolescent↗

PubMedDate not supplied

Alloimmune thrombocytopenia in the fetus: current management theories.

Fetal alloimmune thrombocytopenia (AIT) affects only a small number of fetuses but the consequences may be devastating. Outcomes range from mild thrombocytopenia without signs or symptoms to intracranial hemorrhage (ICH) and fetal or neonatal death. Antenatal screening is available but not used routinely in the United States. The most frequent method of AIT identification is its diagnosis in the neonatal period (index neonate). AIT may be diagnosed antenatally if an ICH is noted on routine obstetric ultrasound. There are accurate predictors of AIT, as well as antenatal therapies, to prevent the occurrence of severe disease and ICH.

Adult↗

PubMed1984

People and dollars: the experience of one hospice.

The Hospice of the North Shore (HONS) provides home hospice care, using local hospitals when inpatient care is essential. The actual cost of 4,779 patient days of care delivered from May 1, 1980 through Dec 31, 1981 was $14.26 per patient day. The median length of service was 31.5 days, with a mean of 66.4 days. Care was provided to 22.3% of all those dying of cancer during 1981 within the service area of the HONS. It is estimated that each patient receiving hospice care avoids 11.05 days of traditional inpatient care, resulting in a saving of $3,167.06 during the index period of this study. If this saving were extrapolated to a national scope, it is conservatively predicted that approximately $266,000,000 could be saved annually. The experience of the HONS strongly supports further development of outpatient, home care hospice organizations.

Adolescent↗

PubMed1982

Effects of prenalterol administered orally in patients with congestive heart failure.

A single-blind study of prenalterol 20-200 mg daily in a slow-release tablet preparation and a placebo was performed in 15 patients with moderate to severe congestive heart failure (NYHA II-IV) to evaluate the haemodynamic and clinical effects of oral prenalterol. Non-invasive parameters in the measurement of cardiac output, stroke volume, pre-ejection period index (PEPI), PEP/LVET ratio, ejection fraction and mean Vcf were significantly improved, indicating beneficial effects of prenalterol on cardiac contractility. Systolic blood pressure, heart rate and rate-pressure product were slightly increased at rest but were considerably lower during exercise. Arrhythmogenecity was not seen in the patients studied. Subjective improvement was noted in the majority of patients as evidenced by a decreased frequency of dyspnoea, fatigue and angina. Unwanted effects, such as palpitations and transmitted arm pulsations, were transient and disappeared with dose adjustment, while the inotropic effect of the medication was maintained. The clinical response appeared to be sustained for up to 2 weeks of treatment, indicating non-development of tachyphylaxis.

Administration, Oral↗

PubMed1984

Influence of atenolol and nifedipine on digoxin-induced inotropism in humans.

Short term effect of digoxin on left ventricular performance was studied in six healthy volunteers before and during atenolol or nifedipine administration. Left ventricular function was evaluated by systolic time intervals and echocardiography. No changes in left ventricular end diastolic or systolic dimensions occurred throughout the study, indicating unchanged ventricular pre- and afterload. Thus, changes in the systolic time intervals must be attributed to changes in cardiac contractility. Changes in the pre-ejection period index (PEPI) obtained from the systolic time intervals were used as a measure of digoxin-induced inotropism. A concentration-response relationship between plasma digoxin level and changes in PEPI was revealed when digoxin was given alone. Atenolol did not influence the digoxin-induced inotropism at a given serum digoxin level. During nifedipine administration no inotropic effect of digoxin could be demonstrated. Thus, it is concluded that nifedipine attenuates digoxin-induced inotropism, while atenolol seems without this effect. These results are in accordance with previous experiments and reflect the different pharmacological sites of action of beta-adrenoceptor antagonists and calcium channel blocking agents. Plasma digoxin concentration, renal digoxin clearance and creatinine clearance did not change during atenolol or nifedipine.

Adult↗

PubMed1982

Effects of low-dose ketamine and thiopentone on cardiac performance and myocardial oxygen balance in high-risk patients.

Induction of anaesthesia may pose a significant hazard to patients with critical cardiovascular status. Ketamine has been advocated as the drug of choice for maintaining cardiovascular performance during induction of anaesthesia in severely ill surgical patients. The purpose of this study was to compare the relative changes in the haemodynamic effects of ketamine and thiopentone during the first 30 min of anaesthesia induction measured by thoracic impedance cardiography. Twelve adult high-risk surgical patients, ASA class III-V, were induced with thiopentone and fentanyl or with infusion of ketamine. Cardiac output decreased to 69% in the thiopentone group (P less than 0.05), but was hardly affected in the ketamine group. The pre-ejection period to left ventricular time (PEPI) and the pre-ejection period index ratio increased significantly after thiopentone (P less than 0.05), while ketamine caused only minimal changes in left ventricular performance. The diastolic pressure time index to systolic pressure time index ration decreased significantly in both groups.

Adult↗

PubMed1985

Systolic time intervals in adolescents with insulin-dependent diabetes mellitus.

Systolic time intervals were used to evaluate left ventricular performance in 20 diabetic adolescents with a mean age of 15.2 +/- 2.2 years (range 9-17 years) and were compared with an age- and sex-matched control group. Pre-ejection period index (PEPI), left ventricular ejection time index (LVETI), total electromechanical systole index (QS2I) and the PEP to LVET ratio were calculated at rest and following sustained isometric handgrip (SIHG). None of the diabetics had demonstrable microangiopathy or autonomic neuropathy. There was no significant difference in resting or post-exercise heart rate, PEPI, LVETI or PEP/LVET ratio between the two groups. QS2I was significantly prolonged (p less than 0.05) at rest in the diabetics, but was not significantly different following SIHG. These results indicate that cardiac contractility is not detectably abnormal in young diabetics, compared to their adult counterparts who may develop impaired myocardial performance.

Adolescent↗

PubMed1994

Spatial and temporal inhomogeneity of adenosine's effect on atrial refractoriness in humans: using atrial fibrillation to probe atrial refractoriness.

INTRODUCTION: Adenosine is an antiarrhythmic agent widely used for the diagnosis and treatment of supraventricular tachyarrhythmias. Bolus administration of adenosine has been associated with transient atrial fibrillation, but the underlying mechanisms have not yet been delineated, due in part to the technical limitations resulting from adenosine's short half-life. In this study, the rapid, repetitive activation of atrial tissue during atrial fibrillation was exploited to yield a nearly continuous estimate of atrial refractoriness, enabling a description of adenosine's action on atrial refractoriness in humans. METHODS AND RESULTS: Simultaneous right and left atrial, narrow-spaced, bipolar electrograms were recorded in 15 patients before, during, and after bolus administration of 12 mg of adenosine during atrial fibrillation. By estimating the local cycle length of excitation from the atrial activation frequency, a refractory period index (RPI) of local tissue was obtained. Adenosine dramatically increased the activation frequency from 6.4 +/- 0.7 to 12.2 +/- 12.2 Hz in the right atrium and from 6.1 +/- 0.6 to 8.7 +/- 1.2 Hz in the left atrium, corresponding to a decrease in the RPI from 156 to 82 msec (P < 0.0001) and from 163 to 116 msec (P < 0.0001), respectively. The magnitude of adenosine's effect was greater (47% vs 29% shortening) (P < 0.001) and the duration of adenosine's effect longer (28 vs 19 sec) (P < 0.05) in the right compared to the left atrium. CONCLUSION: Adenosine, at doses routinely used clinically, produces a transient, but spatially and temporally inhomogeneous, shortening of atrial refractoriness, which may explain the increased propensity toward atrial fibrillation associated with its use.

Adenosine↗

PubMed1995

Coercive measures in psychiatric care. Reports and reactions of patients and other people involved.

In ongoing studies of the quality of the mental health services in two Swedish counties, two thirds of the committed versus about one third of the voluntarily admitted patients reported coercive measures during the index period of care. Committed patients reported an equal degree of coercive treatment and restraint, whereas restraint dominated among the voluntarily admitted. The majority of the patients described the coercive measures as implemented by fait accompli; force was reported in 23% of the examples given by the committed patients but never by the voluntarily admitted. The committed patients justified 19% and the voluntarily admitted 38% of the coercive measures reported; the committed patients justified coercive treatment and restraint to about the same extent; the voluntarily admitted patients justified 65% of the examples of restraint but only 20% of the examples of coercive treatment. There was a 70% concordance between the reports of the committed patients and psychiatric personnel as to the occurrence of coercion, but the head nurses tended to state that treatment had been implemented by persuasion in cases where the patients stated that implementation was by coercion.

Adolescent↗

PubMed1979

Mechanisms of prolongation of pre-ejection period in patients with left ventricular disease.

In order to determine the mechanism underlying prolongation of the pre-ejection period in patients with left ventricular disease, 11 patients with congestive cardiomyopathy and 29 with coronary artery disease, 10 of whom were taking beta-adrenergic blocking drugs, were studied non-invasively. Recordings of carotid pulse, and apex, phono-, and echocardiogram were obtained. In the absence of treatment with beta-blocking drugs, prolongation of pre-ejection period correlated closely with incoordinate left ventricular wall movement during isovolumic contraction assessed from simultaneous apex and echocardiograms. There was no correlation between pre-ejection period index (PEPI) and end-diastolic dimension and PEPI correlated poorly with fractional shortening and peak Vcf. A PEPI of greater than 140 ms was associated with incoordinate contraction in all but one case, and of less than 140 ms with normal contraction in all. Therapeutic doses of beta-blocking drugs caused prolongation of PEPI to a greater extent than would have been predicted from wall movement during isovolumic contraction. Incoordinate left ventricular contraction and a negative inotropic effect both therefore prolong PEPI, but by different mechanisms, whose effects can be separated in individual patients using non-invasive methods based on echocardiography.

Adrenergic beta-Antagonists↗