ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1978.tb04900.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

Summary:The clinical value of exercise testing in the detection of severe coronary artery disease remains undefined. This question was examined in 289 men and 45 women. The diagnosis of coronary artery disease could be reliably made without exercise testing in patients with angina pectoris which markedly restricted walking or which was accompanied by pathological Q waves on the ECG. Such patients usually had coronary artery disease involving two or three major vessels.Exercise testing was an aid to diagnosis in patients with a normal standard ECG and chest pain suspicious of myocardial ischaemia, either mild angina or atypical. When exercise testing resulted in both angina and ST segment depression in men, coronary artery disease was present in 38 of 41 (93%) of cases. On the other hand, three vessel disease was found in only six of 100 (6%) of men whose exercise test did not evoke anginaandST segment change. A normal exercise test in a woman with suspicious chest pain and a normal ECG was associated with normal coronary arteries in 14 of 15 (93%) of cases. It may be concluded that exercise testing is of most diagnostic value in the assessment of patients with a normal standard ECG and a differential diagnosis of mild angina pectoris and atypical chest pain.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1978.tb04901.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

Summary:HV intervals were measured in 42 of 119 patients in the acute phase of myocardial infarction associated with bundle branch block (BBB). The mean HV intervals of patients with right, left and incomplete bilateral BBB were similar. The hospital and subsequent mortality of patients with prolonged HV intervals did not differ significantly from that of patients with normal HV intervals. The HV interval appeared to remain stable over the following months in most patients in whom it was re‐measured. We conclude that the HV interval cannot be used to select patients who might benefit from prophylactic long term pacin

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1978.tb04902.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1978.tb04903.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

Summary:Five hundred and eighty‐eight patients with mitral valve disease were studied.The incidence of systemic emboli was found to be higher in patients with pure mitral stenosis (16‐6%) and mixed mitral stenosis and incompetence (19‐4%) than in patients with mitral incompetence (3‐1%).The patients with mitral stenosis who had episodes of systemic emboli tended to be older than 40 years, with moderate or severe valve lesions, atrial fibrillation and moderate or gross enlargement of the left atrial appendage or left atrium.The following factors were found to be unrelated to systemic embolism–associated aortic valve disease, sex, smoking habit, history of rheumatism, parity, haemoglobin, blood urea, pulmonary hypertension, duration of antifailure treatment, presence of heart failure, and cardiothora

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1978.tb04904.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

Summary:The electrophysiological effects of an intravenous dose of disopyramide phosphate (2 mg per kg body weight) were studied in 17 patients. Studies were performed with the patients fasting, unpremedicated, and off all medication for three days. Blood samples for estimation of serum levels of disopyramide were collected in 15 of these patients. The effects of intravenous disopyramide were maximal at five minutes, less marked at 20 minutes, and largely gone by 30 minutes after administration of the drug. Sinus cycle length and corrected sinus node recovery time were shortened significantly. No index of atrioventricular nodal function was significantly changed. Both atrial and ventricular effective refractory periods were significantly prolonged. Further impairment of intraventricular conduction occurred in six patients with bundle branch block on electrocardiogram or prolonged HV interval. In one of two patients with Wolff‐Parkinson‐ White syndrome, the bypass effective refractory period was prolonged.These electrophysiological changes are similar to quinidine and quinidine like drugs. It is recommended that disopyramide should be used cautiously in patients with evidence of His Purkinje system disease since it may lead to higher degrees of intraventricular bl

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1978.tb04905.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

Summary:Thein vitroantimicrobial activities of gentamicin and amikacin against WOO bacteria/ isolates from clinical material were compared. The minimum inhibitory concentrations were determined by an agar dilution technique. Both of these aminoglycoside antibiotics had a similar spectrum of activity, being highly active against most species of aerobic Gram negative bacilli. Gentamicin was more active than amikacin against most species of enterobacteria, Haemophilus influenzaeandStaphylococcus aureusbut amikacin was more active against a proportion ofKlebsiellaandProvidenciaisolates. For most isolates, the differences in activity between gentamicin and amikacin were small, however, amikacin achieves higher serum levels. Most resistant isolates in this survey did not influence patient mortality.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1978.tb04906.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

Summary:The adequate care of a patient entails consideration of his social and psychological problems in addition to the relevant medical data. To facilitate this integrated approach, a Social Work Indices Checklist (SWIC) is described, and its use in practice is illustrated. A narrative report is generated from a possible 3095 items of information recorded in SWIC.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1978.tb04907.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

Summary:There is controversy both in regard to the severity of small bowel mucosal damage attributable to giardiasis and to the causal relationship of these changes to the associated diarrhoea. In this series of 17 consecutive patients with giardiasis, small bowel histology and diarrhoea were independently assessed and compared. Disaccharidase assays were performed in 16 of these patients and a repeat biopsy obtained in seven cases. On histological examination the villous architecture varied from normal to sub‐total villous atrophy. When these changes were compared with the severity of diarrhoea, a direct correlation was obtained, the more severe symptoms being associated with the more severe villous changes. Repeat biopsy after treatment demonstrated improvement in the histology which correlated with improvement in diarrhoea. Lactase activity was low in all patients with moderate or severe diarrhoea as well as in some patients with mild diarrhoea, two of whom had normal histology. This series demonstrates the occurrence of a spectrum of mucosal changes in giardiasis and supports the concept that these changes mediate the diarrhoea associated with this gut parasit

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1978.tb04908.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

Summary:The effect of Mucaine and Aludrox on basal and food stimulated immunoreactive gastrin has been assessed in normal control subjects and patients with duodenal or gastric ulcer. No differences in gastrin responses were observed either in the basal period or after the protein meal with the two antacids. As previously described, release of gastrin was greatest in gastric ulcer patients but in contrast to previous results, normal subjects seemed to show a greater response than duodenal ulcer patients but this was not statistically significant. Thus the combination of a local anaesthetic oxethazaine with aluminium hydroxide gel does not lead to diminished gastrin re/ease and is not the prime mechanism of action of this agent.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1978.tb04909.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY