Biomedical subjects

D Kosinski

Publications and source records attributed to D Kosinski.

21 records · Page 2Linked to original sources

PubMed1994

The use of serotonin reuptake inhibitors for the treatment of recurrent syncope due to carotid sinus hypersensitivity unresponsive to dual chamber cardiac pacing.

Carotid sinus hypersensitivity can be a cause of recurrent unexplained syncope in the older patient. Dual chamber cardiac pacing may relieve the bradycardia, but may not affect the vasodilatory component of this disorder. We report on two patients with carotid sinus hypersensitivity with a predominant vasodilatory component who experienced recurrent syncope following permanent pacemaker implantation. Both patients were treated with serotonin reuptake inhibitors and after 4-6 weeks of therapy had complete resolution of symptoms. We conclude that serotonin reuptake inhibitors may be useful in the treatment of recurrent syncope due to carotid sinus hypersensitivity resistant to dual chamber cardiac pacing.

1-Naphthylamine↗

PubMedDate not supplied

Antibody coated bacteria in otitis media with effusions.

The significance of bacterial isolates of coagulase negative Staphylococcus epidermidis and Corynebacterium species in middle ear fluids remains controversial. This study was undertaken to evaluate the possible role of these organisms in different effusions. Cultures were obtained from the external cartilaginous ear, bony canal, tympanic membrane, middle ear fluids, tonsils and nasopharynx of 93 patients at the time of myringotomy for otitis media with effusion. Isolates of coagulase negative staphylococci from the middle ear, external ear and posterior aural skin were evaluated in regard to antibiotic sensitivity, biochemical tests and phage typing. Furthermore, in another series of patients in whom these organisms were isolated, specific antibody activity in both middle ear washings and corresponding sera were measured, using the technique of indirect immunofluorescence. The results suggest that the isolates from the middle ear and ear canal are not always identical. There is some evidence that specific IgM and IgG as well as IgA responses to these organisms are present in middle ear washings and not in corresponding serum. These results suggest that coagulase negative Staphylococcus and Corynebacterium species in middle ear effusions may not be contaminants from the external canal and that a local immune response may be produced by these organisms. Whether or not these organisms represent etiologic agents responsible for otitis media with effusion cannot be ascertained from this data. One very interesting point is the presence of IgF coating of organisms in some effusions.

Adolescent↗

PubMedDate not supplied

Recurrent unexplained syncope: the role of head-upright tilt table testing.

Recurrent episodes of sudden unexplained syncope are a common complaint of patients referred to health care professionals for evaluation. Traditional evaluations are both time consuming and expensive and leave many patients without a diagnosis. Although vasovagally mediated episodes of hypotension and bradycardia have been thought to be a common cause of unexplained syncope, this was traditionally a diagnosis of exclusion. Head-upright tilt table testing has recently emerged as a valuable method for confirming the diagnosis of vasovagal syncope and has allowed a better understanding of this phenomena. This article reviews the pathophysiology of vasovagal syncope, the use of head-upright tilt table testing in its diagnosis, and potential therapies used to prevent recurrences.

Hemodynamics↗