A troubled colleague who asks for help.
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Biomedical subjects
Publications and source records attributed to D J Robson.
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24-hour ambulatory monitoring was performed on 46 healthy men. The ECG analysis system employed a digital filter implemented in software to obtain satisfactory low frequency response. The 46 subjects were aged between 18 and 63. Of the 30 subjects aged 30 and under, 13 had episodes of ST elevation, 3 had episodes of ST elevation and depression and 3 had episodes of ST depression. In the 16 subjects aged over 30, 3 had episodes of ST elevation. During ambulatory electrocardiographic monitoring of healthy men aged 30 and under, ST-segment changes were a common finding.
Aortic blood velocity was measured by a transcutaneous continuous wave Doppler technique in thirty-five patients with proven acute myocardial infarction. Measurements were made on the first and seventh day following admission to hospital. Group I comprised 21 patients who had sustained a first myocardial infarction of moderate size, uncomplicated by hypoperfusion. Group II comprised 14 patients who had had a large rise in cardiac enzymes, a previous myocardial infarction or were clinically hypoperfused. The mean value for peak aortic velocity for Group I on Day 1 was 88 +/- 12.9 cm/s. This was significantly lower than the mean value of 101.8 +/- 23.1 cm/s for a group of 85 normal subjects. By Day 7 the mean value for Group I of 105.1 +/- 19.8 cm/s was not significantly different from normal. For Group II patients on Day 1 the mean value for peak aortic velocity was 67.9 +/- 11.7 cm/s and was significantly lower than that for both Group I and the normal group. By the seventh day the mean value for Group II was 76.5 +/- 17.1 cm/s which was not significantly different from Day 1.
The mitral valve area in mitral stenosis was determined from Doppler velocity recordings and by cross-sectional echocardiography. There was good agreement (r = 0.93) between the two methods in 18 adult patients with mitral stenosis. The results confirm that the non-invasive continuous wave Doppler ultrasound technique is of diagnostic value in the assessment of mitral stenosis.
Two cases are reported in which amiodarone was administered during pregnancy for longer periods than has been reported previously. Limited placental transfer of amiodarone and its desethyl metabolite was observed in both cases. A normal child resulted from each pregnancy despite, in one case, amiodarone therapy throughout the entire pregnancy. However, caution is urged in the use of amiodarone during pregnancy in view of the limited data available.
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The pressure gradient across the mitral valve in mitral stenosis was determined by measurement of the maximum recorded velocity of the mitral jet at end-diastole using non-invasive Doppler ultrasound. The accuracy of the Doppler ultrasound technique was evaluated in 25 adult patients with mitral stenosis. In 10 patients, simultaneous ultrasound recordings and manometric recordings were made during cardiac catheterization. In seventeen patients with pure mitral stenosis, the mitral valve area was calculated from the manometric data using the Gorlin formula and from the ultrasound data. Good correlation was found between the Doppler ultrasound and the manometric method for the determination of both the end-diastolic pressure gradient and the mitral valve area. Results confirm that the non-invasive Doppler ultrasound technique is of diagnostic value in the assessment of mitral stenosis.