Biomedical subjects
Publications and source records attributed to D Matthys.
Impairment of sinus rhythm has been reported after the Mustard procedure for complete transposition. We observed two patients who developed severe bradycardia during or after exercise. The first had a 2.8 s sinus pause in the recovery period, the second had a drop in heart rate during exercise. Both eventually had a pacemaker implanted. Exercise testing can be helpful in detecting sick sinus syndrome.
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The blood pressure profile during exercise of children who have undergone surgery for left-to-right intracardiac shunt is not well documented. The aim of this study was to measure the peak blood pressure during dynamic exercise stress testing in children operated on for atrial or ventricular septal defects and to compare the results with those of normal children and children operated on for tetralogy of Fallot. Forty eight cases of atrial septal defect, 53 cases of ventricular septal defect and 33 cases of tetralogy of Fallot aged 5 to 14 years underwent maximal exercise stress testing on a treadmill using a modified Bruce protocol, one to ten years after the surgical repair. The heart rate, blood pressure and electrocardiogram were recorded. The duration of the test was used to judge effort tolerance. In order to compare children of different ages and sizes, the relative values were calculated using the following formula: patient value minus the mean value of the control group of the same age divided by the standard deviation of this group. At rest before exercise, there was no difference between the blood pressure of patients operated on for a left-to-right shunt and of the control group of normal children. However, the maximum systolic blood pressure during exercise was higher in patients who had undergone surgery for a left-to-right shunt than in the controls. The differences were only 0.42 standard deviations in ventricular septal defects and 0.61 standard deviations in atrial septal defects, but they were statistically significant (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
No differences in lymphatic absorption ratio were observed using different osmotic agents (Glucose, Amino acid, glycorol). The differences in UF rate and intraperitoneal volumes during dialysis with these osmotic agents are soley dependent on the interactions between the osmotic agents (nature, strength) and the peritoneal membrane.
A retrospective 10 year analysis of the reasons for admitting patients in a university hospital CAPD or hemodialysis program is performed. More specifically, the influence of age as indicator has been investigated. It appears that since 1983, the CAPD population becomes progressively younger and the hemodialysis population older. This is mainly due to preferential admission in CAPD of young diabetics and because of patients preference. The reasons for dropout and prognosis after transfer to another mode of treatment are discussed.
Long-term follow-up of CAPD patients indicates that these patients are at relatively low risk for developing de novo diabetes mellitus. Transperitoneal glucose absorption and the blood glucose and serum insulin response to the glucose load remain relatively unchanged with time. Alterations in lipid metabolism do occur; there is a tendency for the triglyceride levels to increase after 1 year and to maintain these high values with time. Total HDL cholesterol and its subfractions HDL2 and HDL3 remain unchanged and in the low normal range. Apoprotein A1 levels increase after 1 year and are maintained in the normal range.
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A 5-month-old male infant developed junctional ectopic tachycardia after surgical repair for ventricular septal defect. Management with sotalol and moderate hypothermia was initially successful, but he died from Pseudomonas aeruginosa pneumonia. The safety of treatment with hypothermia is discussed.
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In a multicenter open study, intraperitoneal aztreonam was used together with vancomycin, cloxacillin, or flucloxacillin for initial empiric treatment of peritonitis associated with continuous ambulatory peritoneal dialysis (CAPD). Monotherapy with aztreonam was continued in 34 episodes of gram-negative peritonitis in 28 patients. The microorganisms isolated included Escherichia coli, Acinetobacter species, Pseudomonas species, and Klebsiella species. In three episodes, two organisms were cultured. Microbiologic assessment revealed cure in 27 episodes, cure with relapse in two, cure with superinfection in one, and treatment failure in four (with resistance to aztreonam in three). As assessed by clinical criteria, 27 episodes were cured, five failed to respond, and two responded partially. No adverse reactions to aztreonam were observed. Comparison of these 34 episodes with 35 episodes in historical controls (treated mainly with aminoglycosides and/or trimethoprim-sulfamethoxazole) showed significantly higher rates of cure (84% vs. 51%) and of survival (97% vs. 86%) as well as lower rates of catheter removal (65% vs. 87%) with aztreonam. Thus aztreonam is a safe and efficient agent for the treatment of peritonitis caused by gram-negative organisms in patients undergoing CAPD.