Biomedical subjects
Publications and source records attributed to D Moldovan.
An intermittent vanishing of the P wave from a standard electrocardiogram (ECG) while normal atrial activity was recorded on intracavitary leads was observed in a 58 year old man. This intermittent concealed atrial conduction is discussed.
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Pharyngeal viral flora was studied in 0-1-year-old dystrophic children with acute infections of the upper respiratory tract and with interstitial pneumopathy. Influence of the dystrophic factor on the qualitative and quantitative aspects of the viral flora is discussed.
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Performing in two cases three instances of pericardiocentesis, there always occurred sinus node dysfunction. Our explanation is of a mechanical involvement of the sinus node after the complete evacuation of the pericardial fluid.
Sinus node recovery time, used as an objective parameter of the sinus node function estimation, may be left out in the situation in which an atrial parasystolic focus is present. The overdrive suppression induced through rapid atrial pacing is without effect upon the protected parasystolic focus, and its firing will disturb the post-drive pause. This situation is noticed in two instances and demonstrated in one case.
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Using norepinephrine given intravenously in 10 patients with tachyarrhythmias associated with cardiogenic shock, an important sinus bradycardia was always produced, indicating an evident vagal stimulation as underlying mechanism of the termination of arrhythmias.
In order to eliminate the first pass through the liver where the drug is deactivated, 80 mgs verapamil was given in sublingual way in a) 10 patients with supraventricular tachycardias where in 7 instances sinus rhythm was obtained after 15-30 minutes, b) in 18 patients with atrial fibrillation and in 5 with atrial flutter with rapid ventricular rate, where a significant slowing down of ventricular rate was obtained after 20 minutes. The sublingual way of verapamil administration is a simple, effective and safe procedure in the treatment of tachyarrhythmias.
Acute hypoxia induced in dogs by breath stopping produces a significant increase of ventricular epicardial monophasic action potential duration, thus an increase in myocardial refractoriness. This may be an explanation of the effect of breath holding test in terminating reentrant cardiac arrhythmias.
Using an original device, unipolar electrograms in 36 points on the anterior thoracic wall were recorded. The equal intensity contour lines of the amplitudes of electrical events were drawn as precordial maps, by mathematical procedures.
Precordial thump is considered a useful manoeuver in cardiac arrest and ventricular tachycardia. On ecg recordings we have observed that the precordial thump has always been followed by an atrial or ventricular depolarization (premature beats), which is responsible for the cardiac electric activity enhancement and for the interruption of reentrant mechanism in ventricular and supraventricular tachycardias.
A transient pseudoatrial dissociation (Deitz-Marques phenomenon) occurring immediately after right atrial pacing in a 44-year-old woman, and spontaneously together with periods of hiccups in a 50-year-old man are presented. The same phenomenon was produced experimentally in three dogs, after rapid diaphragmatic stimulation. The diaphragmatic origin of fibrillary-like waves on standard ECG is argued because of dependence on respiratory phases and because it does not influence the basic sinus rhythm.
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In fifteen patients with WPW syndrome the standard electrocardiogram, the vector cardiogram and the precordial map were used togther in order to better localize the ventricular pre-excitation. These three noninvasive techniques permit a more precise location of the accessory pathway in WPW syndrome.
Bronchial provocation tests have become a standard procedure to establish the diagnosis of asthma when symptoms are current but spirometry is normal. A simple, reproducible and widely used method for measuring airway responsiveness is continuous aerosol generation and tidal breathing inhalation. This paper presents the method, the apparatus built-up in our lung function office, reproducibility of aerosol production, and expression of results. With our set-up we are able to perform technically well regulated challenge. It has the advantages of relative simplicity in terms of equipment needed, short distance and no obstacles between nebulizer and mouthpiece. Our specially conceived computer programme is easy to handle, allows comparison and recalculation of data. Variations of nebulizers' output needs a carefully individual evaluation before use to allow reproducibility.
The inhalational histamine and metacholine test is a standard procedure to estimate the degree of bronchial reactivity. During the last 10 years the method of continuously generated aerosol inhalation compels recognition. The test consists in the inhalation during 2 minutes, every 5 minutes of a double dosage of drug followed by measurement of MEVS after each step. Thus the dosage response curve is set up. The concentration of the necessary drug dosage for decreasing with 20% of MEVS (PC20 or PD20) are accepted as indices for bronchial reactivity. The method is indicated in cases suspected for atypical bronchial asthma, professional asthma and drug research. The technical and subjective factors interfering the measurements should be taken into account and analysed in order to ensure reproducibility and comparability of the method.