To investigate the relationship between the clinical diagnosis of thromboembolic disease and heparin requirements for anticoagulation, we prospectively studied 31 patients suspected to have either deep vein thrombosis or pulmonary embolism. Six had the diagnosis of pulmonary embolism confirmed by a combination of ventilation and perfusion scans with pulmonary angiography, eight had venograms showing deep vein thrombosis, seven had diseases which mimicked pulmonary embolism, and ten had normal venograms. These four diagnostic groups were not significantly different with respect to heparin requirements during the first 24 hours of therapy (mean +/- S.D. = 426 +/- 105, 507 +/- 105, 434 +/-79, and 457 +/- 46 units/kg per 24 hours, respectively). Patients with pulmonary embolism and deep vein thrombosis did not differ significantly with respect to heparin requirements (UNITS/kg per 24 hours) on the second (386 +/- 108 vs. 439 +/- 127), third (415 +/- 136 vs. 464 +/- 130), and fourth (374 +/- 104 vs. 418 +/- 127) days of therapy. Our data suggest that the clinical diagnosis does not affect the dose of heparin necessary to anticoagulate patients with pulmonary embolism and deep vein thrombosis.

Adult↗

PubMedDate not supplied

Pulmonary embolism from amniotic fluid, fat, and air.

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Embolism, Air↗

PubMedDate not supplied

Further studies on the relationship of dietary fluoride to fluoride content of human teeth.

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Adolescent↗

PubMedDate not supplied

Computer-assisted medical direction of respiratory care.

As medical technology and the increased demand for respiratory care make concurrent monitoring of all respiratory care services more difficult, computers are coming to the aid of medical directors and quality assurance committees. The respiratory care staff at LDS Hospital, Salt Lake City, has used computers to enhance patient care and quality assurance.

Hospital Bed Capacity, 500 and over↗

PubMedDate not supplied

Exercise performance of subjects with ankylosing spondylitis and limited chest expansion.

To examine the mechanism of exercise limitation associated with chest wall restriction (CWR), we compared the ramp (1 W/3 s) exercise performance of six untrained subjects with ankylosing spondylitis (AS) and six healthy subjects matched for age and body size. Subjects with AS had CWR (maximum rib cage expansion : 1.4 +/- 0.2 cm; means +/- sem). The maximum oxygen uptake (VO2max) of AS subjects (2.15 +/- 0.2 1-stpd) was less than their predicted VO2max (2.68 +/- 0.13 1-stpd; p less than 0.03) and the measured VO2max of matched healthy subjects (2.78 +/- 0.22 1-stpd; p less than 0.03). Subjects with AS achieved 95 percent of predicted maximum heart rate, and their maximum voluntary ventilation exceeded their maximum exercise ventilation by at least 15 l X min-1 unless parenchymal pulmonary disease was present. We conclude that maximum ramp exercise performance of AS subjects with CWR is decreased. Deconditioning or cardiovascular impairment rather than ventilatory impairment appears responsible for the observed reduction of VO2max.

Adult↗

PubMedDate not supplied

Effects of aminophylline upon the exercise performance of patients with stable chronic airflow obstruction.

To assess the effects of aminophylline upon the exercise performance of patients with chronic airflow obstruction (CAO), we performed ramp exercise tests (1 W/3 s) on six CAO subjects before and after intravenous aminophylline (6 mg X kg-1). The subjects had airflow obstruction (mean FEV1/FVC = 0.53) which did not improve following the inhalation of aerosolized isoetharine. After intravenous aminophylline, maximal oxygen uptake, maximal work rate and exercise duration increased (p less than 0.03) and the subjective dyspnea scores during exercise decreased (p less than 0.05). These changes were not accompanied by increases of FEV1 or peak expiratory flow rate, but maximal inspiratory pressure and peak inspiratory flow rate during exercise increased (p less than 0.05). These observations suggest that aminophylline acutely improves the maximal exercise performance of CAO subjects by mechanisms other than bronchodilation.

Adult↗