Acral erythema induced by chemotherapy with cisplatin.
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Antineoplastic Agents↗
Biomedical subjects
D Vakalis
Publications and source records attributed to D Vakalis.
Computer-aided prescription--a prototype system.
This study intends to satisfy two purposes: To prove the necessity of an electronical prescription aid and to propose a structure that can be interpreted into software which will be able to cover that need. The complicated market reality and the disadvantages of the written pharmaceutical directories make the existence of an electronical aid absolutely necessary. The structure of a prescription system should be based upon the drastic substance with its consequences (adverse effects, relative and absolute contraindications, pharmakokinetics and interactions). Every drastic substance will lead to the connection of pharmacology with the market reality and its own consequences (product identification through text and image, trade name, pharmaceutical company, strength, package information). The whole structure constitutes a completed relation--database system that is capable of answering any simple question or query that concerns the field of prescribing. The final production of such an aid is believed to help in a very high degree prescribing in a more precise and correct way, saving financial means for the patient and the health insurance as well as saving the doctor's time.
Computer Communication Networks↗
Acoustic quantification: new diastolic indices of left ventricular function in hypertension correlation with Doppler echocardiography.
A study of left ventricular diastolic function in early hypertension was performed by the new method of acoustic quantification and Doppler echocardiography. A total of 23 untreated patients, five males and 18 females (mean age 53.52 +/- 9.10 years) with mild or moderate hypertension (160 +/- 13/98 +/- 10 mmHg) and 12 normal, age- and heart-rate-matched, control subjects were studied. All subjects showed normal left ventricular systolic function and wall thickness on two-dimensional echocardiography. The following indices were obtained. (1) Acoustic quantification (AQ): the time rate of area change in early diastole (dA/dt)E, in late diastole (dA/dt)A and their ratio (dA/dt)E/(dA/dt)A. (2) Doppler echocardiography: the early peak E, the late peak A flow velocities, their ratio E/A and deceleration E-F slope in early diastole. Measurements of left ventricular diastolic function by acoustic quantification showed, in the patient group, that the time rate of area change in early diastole (dA/dt)E was significantly lower (64.7 +/- 11.0 cm2/second versus 74.3 +/- 5.9 cm2/second; P < 0.01), the rate of area change in late diastole (dA/dt)A was not significantly higher (43.3 +/- 9.2 cm2/second versus 38.4 +/- 6.0 cm2/second; P > 0.05), and the ratio between the above indices (dA/dt)E/(dA/dt)A was significantly lower (1.55 +/- 0.42 versus 1.95 +/- 0.20; P < 0.01), compared with normal values. Doppler diastolic indices were all significantly abnormal in patients, in comparison with the values of the control group. Reduced left ventricular diastolic function was found in nine of 23 patients (39.1%) by the AQ method and eleven of 23 patients (47.8%) by Doppler echocardiography. Acoustic quantification was in agreement with Doppler echocardiography in identifying left ventricular diastolic dsyfunction in nine of 11 hypertensive patients with reduced Doppler diastolic values (82% sensitivity, 100% specificity). The correlation between the two methods showed that the time rate of area change in early diastole (dA/dt)E correlated well with the early peak E flow velocity (r = 0.59), the ratio between the time rates in early and late diastole (dA/dt)E/(dA/dt)A also correlated well with the Doppler E/A ratio (r = 0.89), while a poor correlation was found between the time rate of area change in late diastole (dA/dt)A and peak A flow velocity (r = 0.26). Thus abnormal diastolic filling of the left ventricle can be seen in the early stages of hypertension, even in the presence of normal systolic function and wall thickness, while acoustic quantification could be considered as a useful noninvasive modality for the early identification of left ventricular diastolic abnormalities.
Algorithms↗
Pericardial effusion concomitant with specific heart muscle disease in systemic sarcoidosis.
Eighty-one consecutive patients, 32 males and 49 females, with biopsy-proven systemic sarcoidosis, none of whom had clinical evidence of heart disease, underwent M-mode and two-dimensional echocardiography, ECG and chest X-ray in order to investigate the frequency of sarcoid pericardial effusion. Mild or moderate size pericardial accumulations were found by echocardiography in 17 patients (21%), four males and 13 females (mean age 49.7 +/- 9.2 years). Pericardial effusion could not be correlated with clinical symptoms or physical signs, chest X-ray and ECG findings. All 17 patients with pericardial effusion were also studied by technetium-99m pyrophosphate radionuclide myocardial imaging, targeting to reveal the coincident presence of specific heart muscle disease or 'infiltrative cardiomyopathy'. The results showed abnormal scans in 13 of 14 patients with technically satisfactory scans, indicating the coincidence of sarcoid myocardial involvement in 92% of the patients with pericardial effusion, representing 16% of the total population studied. Thus, pericardial effusion in sarcoidosis should not be considered a rare condition, while concomitant presence of positive technetium-99m pyrophosphate radionuclide myocardial imaging could suggest that sarcoid pericardial effusion is often accompanied by specific heart muscle disease. This observation has not been well established previously in the literature.
Cardiomyopathies↗