PubMed Health⌕ Search

Biomedical subjects

A Domae

Publications and source records attributed to A Domae.

9 recordsLinked to original sources
PubMed1997

Long-term evaluation of combined antihypertensive therapy with lisinopril and a thiazide diuretic in patients with essential hypertension.

For the treatment of hypertension, the combination of an angiotensin-converting enzyme (ACE) inhibitor and a thiazide diuretic is supported by multiple lines of evidence, because these drugs have synergistic action and are expected to cancel out each other's adverse side effects. However, the long-term outcome of this combination antihypertensive therapy is not entirely clear. In the present multicenter open trial, we investigated the long-term efficacy and safety of combined antihypertensive therapy with an ACE inhibitor, lisinopril, and a thiazide diuretic, trichlormethiazide. A total of 466 patients with essential hypertension were treated with lisinopril alone (monotherapy group, n = 360) or with a combination of lisinopril with trichlormethiazide (combination therapy group, n = 106) for 1 year. The average blood pressure was effectively lowered to below 150/90 mmHg in both the monotherapy and the combination therapy groups throughout the study period. The average maintenance dose of lisinopril was lower when combined with thiazide than when given alone (9.8 vs. 11.5 mg/day, p < 0.001). Dry cough was the major side effect of lisinopril; no severe adverse effects were observed. The incidence of cough was not significantly different between the monotherapy group (13.1%) and the combination therapy group (11.3%). The increase in serum potassium observed in the monotherapy group was reversed by the concurrent use of the thiazide diuretic in the combination therapy group. Fasting blood glucose was significantly reduced in the monotherapy group; the reduction observed in the combination therapy group was not significant. Thus, the present results provide useful information as to the effectiveness and safety of combined antihypertensive therapy with lisinopril and a thiazide in comparison with monotherapy with lisinopril.

Adult↗
PubMed1992

Evaluation of five computer programs in the diagnosis of second-degree AV block.

Five electrocardiogram (ECG) analyzing systems were tested with a microcomputer-based ECG signal generator to assess the accuracy of the systems in interpreting Wenckebach periodicity. Although normal sinus rhythm with normal PR intervals and sinus rhythms with first-degree atrioventricular (AV) block were diagnosed by all five systems, second-degree AV block with classic Wenckebach periodicity was routinely misdiagnosed by four of the five systems. No system recognized the atypical Wenckebach periods in a total of 200 trials, misinterpreting the phenomenon as atrial fibrillation, supraventricular rhythm, sinoatrial block, and other rhythm disturbances. In advanced AV block and a variety of ventricular arrhythmias, none of the five systems diagnosed second-degree AV block with Wenckebach periods. Marked unsatisfactory performance with regard to the diagnosis of Wenckebach periodicity indicates the urgent need for accelerated and comprehensive testing of ECG diagnostic equipment. The present generating device was seen as an effective troubleshooter in optimizing the diagnostic competency of computerized ECG systems.

Computer Simulation↗
PubMed1987

Is a higher sampling rate desirable in the computer processing of the pediatric electrocardiogram?

A considerably large number of ECGs of pediatric patients had small notches and slurs on QRS complexes. By sampling these ECGs at higher rates, namely 4 KHz, it was shown that the higher rate data accurately reconstructed the notches and slurs on the QRS complex which were occasionally missed or distorted when the sampling rate was 250 Hz. When using the sampling rate of 250 Hz, it was observed that the reduction of the peak-to-peak amplitude of a QRS complex exceeded 0.1 mV in nearly 30 percent of tested cases, even if the ECG did not contain unwanted noise signals. Moreover, if there is relatively more noise in children's ECGs, one should reduce noise in such data in order to prevent measurement errors in the succeeding steps of the computer program. In such circumstances, the higher sampling rate would be preferable since filtering techniques which are used to reduce noise may considerably affect the estimation of the onset, offset and amplitude of the intrinsic ECG signals if the sampling rate is low. The reduction of the price of computers and their peripheral devices may facilitate the adoption of the higher sampling rate. From these considerations it was concluded that the use of the higher sampling rate might be both practical and an effective measure to enhance the diagnostic performance of the computer ECG systems.

Child↗
PubMed1984

The reproducibility of interpretation of 10 computer ECG systems by means of a microprocessor-based ECG signal generator.

The use of computer ECG systems has become widespread in Japan, and many new models are available. In order to provide a method for comparative evaluation, a microprocessor-based ECG signal generator was built. This generator was used to compare 10 of the computer ECG systems which are currently available in Japan. Since the generator can produce a precisely defined wave form, it is particularly suited for testing the reproducibility of diagnostic interpretation. Several deficiencies of some current ECG analysis systems were noted. Specifically in three systems, there was interference of the interpretation of morphology with the interpretation of rhythm when WPW-like patterns were analyzed. The current evaluation concentrates on the reproducibility of interpretation in the tested systems. As the library of test ECG patterns is expanded in the future, the technique will also become applicable to the evaluation of diagnostic accuracy.

Arrhythmias, Cardiac↗
PubMed1980

Arrhythmia diagnosis by the IBM electrocardiogram analysis program.

A comparative study was made between rhythm diagnosis by computer using the IBM ECG program (Bonner-I), and diagnosis by a physician, 2434 electrocardiograms (ECGs) recorded in Kitasato University Hospital from July to August 1978 were used. Of the 2434 cases the physician made a diagnosis of sinus rhythm in 2185 and of abnormal (other than sinus) rhythm in 249. Among theformer, 32 cases were erroneously classified into abnormal groups by the computer (false positive), and in 30 out of the latter 249 cases, the computer failed to detect abnormalities (false negative). In the remaining 219 cases, 33 of 57 cases of sinus rhythm with VPCs, 19 of 41 sinus rhythm with SVPCs, and 62 of 64 atrial fibrillation were correctly diagnosed by the computer. In 27 out of the 219 cases "undetermined rhythm" was printed out after an unsuccessful dominant rhythm determination by the computer. Cases of artificial pacemaker were not recognized by the computer, but were distributed into 7 classification categories. We were of the opinion that if the computer program had utilized the information on the duration of QRS complexes these cases could have been correctly classified. We repeated ECG sampling and analysis in the cases of complicated arrhythmias, because more valuable information was often supplied by the computer after successive ECG recording. From these results we concluded that the usefulness of the IBM ecg program was confirmed concerning the recognition of sinus rhythm, whereas the detection and identification of complex rhythm disturbances by the computer program was still in need of improvement.

Arrhythmias, Cardiac↗