bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of Raynaud's Syndrome with Adrenergic Alpha-Blockade with or without Beta-Blockade
Authors: Cleophas Ton J. M. , van Lier Henk J. J. , Fennis Jan F. M. , van 't Laar Albert 
Published: November 2007

In a double blind placebo-controlled cross-over trial of 24 weeks 31 patients with Raynaud's syndrome were treated with the alpha-blocker phenoxybenzamine (10-20 mg daily) and with the combination of the alpha-blocker phenoxybenzamine (10-20 mg daily) and the beta-blocker sotalol (40-80 mg daily). A favourable effect on recovery of finger temperature after finger cooling was demonstrated after alpha-blockade as com pared to the before treatment situation. This favourable effect was not different when the group received the combined alpha- and beta-blockade. The blood pressure was not influenced by either of the 2 medications. Fluid retention appeared with alpha-blockade and was absent with combined alpha- and beta-blockade. Decrease of heart rate oc curred with alpha- plus beta-blockade and was absent with alpha-blockade alone. Clinical symptoms of Raynaud's syndrome equally were alleviated by the two medica tions. Common, and equally frequent side effects of the two medications were nasal congestion, disturbed ejaculation and potence, dry mouth, exercise-induced and ortho- static dizziness. We conclude that alpha-blockade is beneficial in Raynaud's syndrome and that additional beta-blockade counteracts the alpha-blocker side-effect fluid retention, re duces the heart rate and thus may prevent alpha-blocker induced tachycardia, and that it does not cause hypotension.
Effects of Flunarizine and Pentoxifylline on Walking Distance and Blood Rheology in Claudication
Authors: Perhoniemi Vesa , Salmenkivi Kari , Sundberg Stig , Johnsson Riitta , Gordin Ariel 
Published: November 2007

Thirty-one patients, mean age 60 years (range 45-80 years), with a typical history and objective symptoms of intermittent claudication with a reported maximal walking dis tance less than 500 m, were included in a cross-over study. After a one month's run-in period on placebo, the patients were randomized into two groups: one group started with flunarizine (5 mg t.i.d.) and the other with pentoxifylline (400 mg t.i.d.). The treatment lasted 3 months, whereafter the medications were changed. The trial followed a double-blind design. The median of the maximal walking distance was 255 m after the placebo period, increasing significantly (p<0.01) during both medication periods: by 43% and 18% during flunarizine and pentoxifylline, respectively. No changes were recorded in the ankle systolic blood pressure ratio (ASBP-ratio) after placebo or either medication period. Red cell rigidity (Pmax), which was initially elevated, decreased significantly (p<0.05) during both medication periods, but there were no significant differences between the two drugs. No changes were found in whole blood or plasma viscosity. We conclude that the decrease in red cell rigidity may have contributed to the increased walking distance.
Ineffectiveness of Ca2+-Antagonists Nicardipine and Diltiazem on Experimental Atherosclerosis in Cholesterol-fed Rabbits
Authors: Naito Michitaka , Kuzuya Fumio , Asai Kan-ichi , Shibata Kazuaki , Yoshimine Noboru 
Published: November 2007

There is accumulating evidence that calcium metabolism plays an important role in the pathogenesis of atherosclerosis. The inhibitory effect of nifedipine, a Ca2-antagonist, on experimental atherosclerosis in cholesterol-fed rabbits has been reported, and we examined the anti-atherosclerotic action of nicardipine and diltiazem, similar Ca2+-antagonists, but no inhibitory action was observed. It is necessary to recognize the fact that the sensitivity of rabbits to an antiatherogenic diet shows great individual differences. For the purpose of preventing atherosclerosis due to the abnormality of lipid metabolism the use of Ca2+-antagonist is not warranted at the present stage.
Hand Exercise Effect in Maturation and Blood Flow of Dialysis Arteriovenous Fistulas Ultrasound Study
Authors: Rodriguez Moran Manuel , Almazan Enriquez Arturo , Ramos Boyero Manuel , Rodriguez Rodriguez Jose M. , Gomez Alonso Alberto 
Published: November 2007

With the help of the Doppler Ultrasound we have measured the radial artery blood flow of 20 healthy volunteers and the fistula flow of 40 uraemic patients. The measurements were made at rest and repeated one, three and five minutes after initiation of hand exercise, and one minute after the exercise had finished. Radial artery mean flow increased significantly with the exercise (p < 0.001); radial arteries with greater baseline flow had less flow increase (p < 0.002). However, we were not able to demonstrate any fistula flow increase with the hand exercise. Therefore, we conclude that there is no benefit in advising uraemic patients to squeeze a rubber ball which, otherwise, supposes an unnecessary preoccupation for these patients.
Prevalence of Angiographically Recognizable Atherosclerosis in Non-Dominant Right Coronary Arteries
Authors: Moreyra Abel E. , Sclar Craig , Burns John J. , Kostis John B. 
Published: November 2007

Among 1,000 consecutive patients referred for coronary arteriography be cause of chest pain, 89 patients were found to have a non-dominant right coro nary artery (NDRCA). These patients were compared to 89 consecutive patients with dominant right coronary artery (DRCA) matched for age, sex, smoking and serum cholesterol. There was a lower incidence of obstructive disease in NDRCA (23 of 89 patients, 26%) than in DRCA (55 of 89 patients, 62%), χ2=23.368, p < 0.001. The incidence of coronary disease was also lower in the NDRCA group, 50 of 89 patients (56%), than in the DRCA group, 68 of 89 patients (76%), χ2=8.146, p<0.01. When only patients with coronary artery disease (CAD) were included in the analysis: 23 of 50 (46%) patients with CAD and NDRCA had obstructive disease in the right coronary artery (RCA) while 55 of 68 (80%) patients with DRCA and CAD had obstructive disease in the RCA, χ2=15.646, p < 0.001. The lower incidence of disease in NDRCA persisted even when only the proximal one-third of the DRCA was considered: 41 of 89 (46%) patients with DRCA had proximal lesions compared to the total length of NDRCA, 23 of 89 patients (26%), χ2=7.940, p<0.01. We conclude that (1) obstructive atherosclerotic lesions are less frequent in NDRCA than in comparable populations; (2) the length (extension) of the artery does not appear to explain this fact, since the lesser degree of disease persists even when only the proximal segment of dominant right coronary artery was considered; (3) an intriguing observation is that the incidence of obstructive atherosclerotic lesions was lower in NDRCA than in a matched DRCA popula tion.
Infectious Endocarditis Caused By Actinobacillus Actinomycetemcomitans
Authors: Gould Lawrence , Gopalaswamy C. , Kim B.S. , Patel C. , Freiberg K. 
Published: November 2007

Actinobacillus actinomycetemcomitans is a very uncommon cause of infectious endocarditis. The organism was first described in 1912.1 Thjotta and Sydnes2 reported its isolation in pure culture from a long standing abscess which had developed after tooth extraction. Subsequently this organism was found to be part of the normal flora, and the organism was defined as a slow growing, fastidious gram negative bacillus.3 Carbon dioxide is essential for the growth of A. actinomycetemcomitans. Approximately 50 cases of endocartitis due to A. actinomycetemcomitans have been reported4 since the first case reported in 1964.5 The purpose of this report is to document a case of endocarditis due to A. actinomycetemcomitans and to stress the value of the echocardiogram in the assessment of patients with endocarditis.
Therapy for Late Post Infarction Ventricular Tachycardia
Authors: Somberg John C. , Butler Brenda , Torres Vilma , Tepper David , Keren Gad , Siegel Louis , Jentzer John , Miura Dennis S. 
Published: November 2007

Non-sustained ventricular tachycardia (VT) in the late post myocardial in farction (MI) period (7-21 days) has been reported to be a predictor of sudden death. We suspected that patients with 3 beat VT on Holter monitoring in the late infarction period would demonstrate electrical instability at electrophysio logic studies. Forty-seven patients were identified as having at least 3 beat VT on Holter monitoring. Eighteen patients refused electrophysiologic studies or were not referred by their attending physician. The mean ejection fraction of this group was 43 ± 16%. Eight patients have died, 3 sudden deaths in 13 ± 5 months, a 17% incidence of sudden death. Twenty-nine patients underwent in vasive electrophysiologic studies. Their mean ejection fraction was 37 ±7%, and 28 had inducible, 18 sustained ventricular tachycardia and 10 non-sus tained VT. No complications were noted with electrophysiological testing in the post infarction patients. Using programmed electrical stimulation studies an effective antiarrhythmic agent preventing VT induction (usually experimental) could be found for each patient. After a mean follow-up of 12.5 ± 4 months, the patient without inducible VT is alive and 26 of the 28 "inducible" patients are alive and well. Two patients died, one of stroke and one due to pump failure following a second MI. No sudden deaths were observed in this group. Two patients had breakthrough arrhythmias and were treated by alternative antiar rhythmic therapy that was also effective at the initial electrophysiologic studies. Thus, PES studies post MI are safe and may be an effective way to assess therapy for patients in the early post MI period, indentified at high risk for sudden death.
Alpha and Beta-Blockade and Beta-Stimulation in Raynaud's Syndrome: A Double-Blind, Placebo Controlled, Single Dose Study
Authors: Cleophas Ton J.M. , Fennis Jan F.M. , van 't Laar Albert 
Published: November 2007

We examined in a double blind fashion and placebo controlled the effects of some alpha and beta adrenergic receptor agonists and antagonists on the recov ery of finger skin temperature 12 min after finger cooling (5 min waterbath for both hands) in twelve patients with Raynaud's syndrome. A favourable effect was established on phenoxybenzamine 20 mg as compared to placebo. A signifi cant but rather small effect on orciprenaline 10 mg. The beta-agonists pre nalterol (10 mg) and terbutaline (5 mg) did not influence the recovery of finger skin temperature. The beneficial effect of phenoxybenzamine 20 mg was not influenced by the addition of beta-agonists (prenalterol 10 mg or terbutaline 5 mg) or a beta-blocker (propranolol 40 mg). The beta-agonists terbutaline and orciprenaline caused a fall in diastolic pressure and an increase in heart rate. These effects presumably were con nected with one collaps and three near-collapses. On alpha- and beta-blocker (phenoxybenzamine and propranolol) a decrease in systolic pressure appeared, whereas diastolic pressure did not significantly differ from the placebo value. While physical exercise is considered to exacerbate the hypotensive effect of alpha-blockers, a fall in blood pressure during physical exercise could not be established in our experiments after the addition of propranolol to the alpha- blocker phenoxybenzamine. Our results suggest that an alpha-blocker is a good choice in Raynaud's syndrome, whereas the addition of a beta-blocker may have some advantages.
Thrombocytopenia and Lupus-Like Anticoagulant in a Patient with Peripheral Vascular Disease: Response to Infusion of Prostacyclin
Authors: Fonseca V. , Mikhailidis D.P. , Boag F. , Barradas M.A. , Jeremy J.Y. , Gracey L. , Dandona P. 
Published: November 2007

A 46 year old man with intermittent claudication due to severe peripheral vascular disease had a circulating lupus like anticoagulant (LLAC), thrombocy topenia (79 x 109/1), markedly reduced platelet survival and a normal bone mar row. He was treated with intravenous prostacyclin (PGI 2) infusions which resulted in improvement of the patient's exercise tolerance and normalisation of his platelet count (300 x 109/ 1) and platelet aggregation could then be assessed. The platelets were markedly hyperaggregable and generated supranormal quantities of thromboxane A2. A diagnosis of consumptive thrombocytopenia secondary to peripheral vascular disease and platelet hyperaggregability was made. Despite therapy with aspirin and dipyridamole, gradual and progressive reduction in platelet count followed and his exercise tolerance declined over the next three months. Immunoglobulin prepared from the patient's serum did not inhibit vascular PGI2 synthesis in vitro. To our knowledge this is the first reported case of consumptive thrombocyto penia due to severe peripheral vascular disease and platelet hyperaggregability. PGI2 administration caused a transient resolution of these features which was not sustained by aspirin and dipyridamole.
Superior Vena Caval Obstruction: An Analysis of Seventy-Six Cases, with Comments on the Safety of Venography
Authors: Davies P.F. , Shevland J.E. 
Published: November 2007

Seventy-six cases of superior vena caval obstruction (SVCO) were docu mented in the period 1970-1980. There were 53 males and 23 females, with a mean age of 61.7 years. The underlying causes were: a) Lung cancer 64/76 84.2% b) Metastatic disease 4/76 5.3% c) Lymphoma 4/76 5.3% d) Benign aetiology 2/76 2.6% e) Undiagnosed 2/76 2.6% 97.4% of the cases were due to malignancy. Of 61 patients on whom follow-up is available, only one is alive. Eighty-two percent of this group died within one year following the onset of SVCO. Autop sies were performed on 17 patients. Nine of these (52.9%) showed invasion of the superior vena cava, 6 (35.3%) showed compression without invasion, and 2 (11.8%) showed neither compression nor invasion following Radiotherapy. Venography was performed on all patients with only one minor complication being recorded.
Laboratory Control of Continuous Intravenous Heparin Therapy with Howel Time and Activated Partial Thromboplastin Time A Prospective, Randomized and Blind Study
Authors: Almazan Arturo , Lozano Francisco , Ramos Manuel , Rodriguez-Moran Manuel , Gomez-Alonso Alberto 
Published: November 2007

Although heparin has been used extensively to treat Deep Venous Thrombo sis (DVT) and arterial ischemia (AI), controversy still exists regarding optimal dosage and the need for monitoring. Different authors have employed various test with variable results. Others, however, persist in giving heparin without laboratory control. This study was made in order to compare, in a prospective, randomized and blind manner, two coagulation tests, namely: Howel Time (HT) and Activated Partial Thromboplastin Time (APTT), in controlling the dose of heparin given by continuous intravenous infusion in DVT and AI. Our results show no signifi cant difference in complications and failures of the therapy with either test, although significantly higher doses of heparin were needed to maintain APTT within therapeutic range than those needed to keep HT within a similar range.
A Comparative Study of Conventional vs Rapid Speed of Blood Transfusion in Cases of Chronic Severe Anemia
Authors: Nand Nitya , Gupta M.S. , Bhutani J.C. , Gupta S.P. , Sharma M. 
Published: November 2007

Pulmonary capillary 'wedge' pressure (PCWP) was studied in 20 cases of chronic severe anemia before and after transfusing one unit of blood. They were divided into 2 groups of 10 age and sex matched cases. Blood was transfused at a speed of 2 ml/min in group A and 5 ml/min in group B. Pretransfusion PCWP was normal in all the cases. Following blood transfusion (BT) 'wedge' pressure increased significantly (p < 0.001) in both the groups being 17.2% and 29.2% in group A and B respectively. The difference in the rise of PCWP between the two groups was not statistically significant (p > 0.05). All the cases tolerated BT very well. It is therefore, concluded that transfusion of one unit of blood at a speed of 5 ml/min is nearly as safe as when it is transfused at a rate of 2 ml/min (conven tional speed) so far as the cardiopulmonary haemodynamics are concerned.
The Clinical Spectrum of Tricuspid Regurgitation Detected by Pulsed Doppler Echocardiography
Authors: Missri J. , Agnarsson Uggi , Sverrisson Jon 
Published: November 2007

The clinical diagnosis of tricuspid regurgitation (TR) is often difficult. Two- dimensional pulsed Doppler echocardiography offers a sensitive and specific method for detecting and semi-quantitating tricuspid regurgitation. The clini cal, radiographic, radionuclide, echocardiographic, and when available, the right cardiac catheterization findings were evaluated in 36 patients with a diag nosis of tricuspid regurgitation by pulsed Doppler. Ten healthy subjects served as controls. The underlying cardiac cause was rheumatic heart disease in 7 (20%), ischemic heart disease in 12 (33%), dilated cardiomyopathy in 5 (14%), hypertensive heart disease in 2 (5%), aortic valve stenosis and/or regurgitation in 3 (8%), mitral valve prolapse with mitral regurgitation in 1 (3%), and con genital heart disease in 6 (17%). Seven patients (19%) had a temporary or per manent transvenous right ventricular pacing wire. A systolic murmur was heard in 29 patients (81%) with 16 (46%) having an elevated jugular venous pressure. Tricuspid regurgitation was clinically suspected in only 2 patients (6%). Isolated tricuspid regurgitation was uncommon, seen in 6 patients (17%), and usually secondary to congenital heart disease, ischemic heart disease, with the use of a transvenous pacing wire and following mitral valve replacement. Right cardiac catheterization was performed in 10 patients, of which 7 demon strated elevated right atrial and pulmonary artery pressure. Pulsed Doppler echocardiography offers a practical and accurate method of detecting and evaluating the severity of tricuspid regurgitation. Tricuspid re gurgitation is generally a functional disorder, and frequently occurs in associa tion with left sided valvular heart disease, cardiomyopathy or congenital heart disease.
Carotid Artery Assessment with Continuous Wave Doppler Ultrasound, Comparison of Two Methods with Angiography
Authors: Hutchison Kenneth J. , Potemkowski Antoni P. 
Published: November 2007

A comparison of two non-invasive techniques of evaluation of the internal carotid artery in the neck with the results of angiography was carried out in 31 patients. The techniques were, spectral analysis of the doppler signals obtained from the common, internal and external arteries and, velocity waveform analy sis of the common carotid analogue signal, in both methods a continuous wave doppler ultrasound velocimeter was used. With the spectral analysis technique sensitivity was 80% and specificity was 78% for a diagnosis of internal carotid stenosis of greater than 50% diameter reduction. For a diagnosis of 20% or greater, sensitivity was 82% and specificity 85%. Sensitivity may have been underestimated in this study because the angio graphic technique used in 22 of the 31 patients was the intravenous digital sub traction method. In our hands velocity waveform analysis of the common carotid analogue signal while showing a similar sensitivity to the spectral analysis method had an unacceptably low specificity.
Aortic Connective Tissue in Ageing—A Biochemical Study
Authors: Andreotti Lupo , Bussotti Alessandro , Cammelli Daniele , di Giovine Francesco , Sampognaro Salvatore , Sterrantino Gaetana , Varcasia Giuseppe , Arcangeli Paolo 
Published: November 2007

The biochemical analysis of samples of aortic connective tissue was carried out in 22 subjects from 9 to 84 years old. Aortic samples were taken at necropsy performed after sudden or, more often, traumatic death. The results suggest that aging of the aorta is accompanied by an increase both in collagen content and in total sugar content when expressed as mg/cm2 while the elastin content, when expressed in the same way, does not undergo any variation.
Continuous Measurement of Transcutaneous Oxygen Tension on Stress Test in Claudicants and Normals
Authors: Ohgi Shigetsugu , Ito Katsuaki , Hara Hiroshi , Mori Tohru 
Published: November 2007

Subjective evaluation of hemodynamics by stress tests in claudicants should be made to establish severity of functional ischemia. As an indispensable examination of vascular laboratory, non-invasive, simple methods can only satisfy methodological conditions. The aim of this study was to apply the transcutaneous oxygen tension measurement for a non-invasive, continuous detector of hemodynamic responses in skin circulation by stress tests and to elucidate the clinical usefulness of this technique. Investigated were 20 legs in patients with intermittent claudication and 9 legs in healthy persons as controls. Ten legs with ischemic pain during exercise loading revealed abnormal transcutaneous oxygen tension (tcPO2) curves in comparison with those with in normal legs. Over the continuous tcP02 curve, the minimum tcPO2 at the reverse postural change after exercise loading was the most reliable indicator for evaluating induced ischemia. We conclude that hemodynamic responses on stress tests should be analyzed both during and after exercise loading, and that the continuous tcP02 curve constitutes a useful method for evaluating and following up the claudicants.
Digital Blood Pressure and Flow Measurements in Patients with Primary Raynaud's Phenomenon
Authors: van de Wal Henry J.C.M. , Wijn Pieter F.F. , Hoppenbrouwers Marc W.J.M. , Skotnicki Stefan H. 
Published: November 2007

The value of digital systolic blood pressure (DBP) and flow (DBF) measure ments for a quantitative diagnosis of Primary Raynaud's Phenomenon (PRP) was evaluated by comparing the results obtained in 10 patients and 20 normals. Digital skin temperature (DST), DBP and brachial systolic blood pressure (BBP) and DBF were measured at room temperature, at maximal vasodilatation and during cold provocation. At room temperature DST discriminates between normals and patients with an accuracy of 77%. On maximum vasodilatation no significant differences can be found in DBP and DBF between normals and patients. However, DBF was significantly different between male and females both in normals and in patients. During gradual cooling a decrease in DBF (a closing phenomenon) was observed both in normals and patients. In contrast DBP did not show a substantial pressure drop. Calculating digit to brachial systolic pressure indexes (DBI) a slight significant increase can be found during cold provocation both in normals and in patients. Only the DBI of digit IV during cold provocation showed a significant differ ence between normals and patients which resulted in an accuracy of 83%.
Cardiorespiratory and Metabolic Effects of Buflomedil: Case Reports
Authors: Giovannini Ivo , Boldrini Giuseppe , Chiarla Carlo 
Published: November 2007

An extensive study has been performed of the cardiovascular, respiratory and metabolic effects of buflomedil. The results indicate that the drug, at the administered dose, does not alter the patient physiological stability. An improved perfusion regimen in peripheral tissues and an optimization of cardiac energetics are also directly or indirectly implied in the results.