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Biomedical subjects

E L Kinney

Publications and source records attributed to E L Kinney.

69 records · Page 4Linked to original sources
PubMed1981

Underrepresentation of women in new drug trials.

Young women serve less frequently than young men as subjects in premarketing clinical drug trials. Moral, legal, and medical implications of this underrepresentation of women are considered. Risks of medical harm to female patients can increase because medication is withheld. Also, risks of toxicity increase when women receive certain new drugs only in the postmarketing phase. Remedies to increase participation of young, nonpregnant women in clinical trials are discussed.

Clinical Trials as Topic↗
PubMed1980

Thallium-scan myocardial defects and echocardiographic abnormalities in patients with sarcoidosis without clinical cardiac dysfunction. An analysis of 44 patients.

Sarcoidosis of the myocardium, an illness occurring predominantly in young adults, frequently becomes clinically apparent when the disease is far advanced. Since the thallium myocardial perfusion scan (TMPS) is known to be capable of detecting granulomas, it seemed to be promising as a noninvasive means of screening for this complication of sarcoidosis. We, therefore, examined 44 consecutive patients with sarcoidosis, none of whom had clinical evidence of heart disease, utilizing TMPS, echocardiography, electrocardiography, systolic time interval ratios (PEP-LVET) and 24-hour Holter monitoring. TMPS disclosed left ventricular defects in 14 patients (32 per cent) and abnormalities of the right ventricle in an additional four patients. Left ventricular abnormalities on the TMPS were associated with echocardiographic evidence of left ventricular dysfunction (widened mitral E point septal separation) but not with abnormalities on Holter monitoring or electrocardiograms. Systolic time interval ratios were insensitive but highly specific for the presence of abnormalities on the TMPS. We conclude that the TMPS frequently discloses abnormalities in sarcoidosis, which may be a reflection of its sensitivity in this setting.

Adult↗
PubMed1980

Beneficial effect of dexamethasone on the "no reflow" phenomenon in canine myocardium.

The purpose of the present study was to determine if pretreatment with dexamethasone 6 mg.kg-1 would preserve coronary artery blood flow during reperfusion, thus preventing the no reflow phenomenon. Blood flow to small segments of the left ventricle was measured by the use of 15 micrometer tracer microspheres in intact dog hearts. During 2 hours of occlusion of the anterior descending coronary artery by balloon catheter, dexamethasone produced a small increase of the blood flow to perfused myocardium, when compared with untreated animals; this effect was not seen in underperfused segments of the myocardium. In nontreated animals, reperfusion of the underperfused portion of the left ventricle did not lead to a restoration of flow to normal when measured 1 hour later. In fact, the "no reflow" phenomenon resulted in a post reperfusion left ventricular segment which was similar to that measured during coronary arterial occlusion. However in the dexamethasone treated animals there was a decrease in the extent of left ventricular underperfusion from 19 to 6%. It is concluded that dexamethasone protects the border zone of canine myocardium during occlusion, and prevents the no reflow phenomenon in underperfused regions during reperfusion

Animals↗
PubMed1979

Recurrent pulmonary emboli secondary to right atrial thrombus around a permanent pacing catheter: a case report and review of the literature.

This report describes the management of a woman with multiple pulmonary emboli secondary to a large right atrial clot which had formed around her permanent transvenous pacemaker. She continued to have pulmonary emboli despite adequate anticoagulation. Removal of the catheter and pacing required right atriotomy under cover of cardiopulmonary bypass. Additionally, eight English language case reports of symptomatic pericatheter thromboses are reviewed. In these cases, pericatheter clot resulted either in right-sided inlet obstruction or pulmonary emboli. The mortality rate was 75%. Although the cause for our patent's thromboembolic events is uncertain, congestive heart failure was a predisposing factor in 75% of the other reported cases. We suggest that pacemaker patients in congestive heart failure might benefit greatly from chronic anticoagulation.

Aged↗
PubMedDate not supplied

The pharmacokinetics and pharmacology of oral diltiazem in normal volunteers.

Oral diltiazem is being used increasingly in the treatment of Prinzmetal's angina. This study investigated the pharmacokinetics, electrocardiographic effects, and blood pressure responses of normal male volunteers to various single oral doses of diltiazem. Doses selected were 30, 60, 90, and 120 mg. Thirteen subjects received 30 mg. 12 subjects received 60 mg, 10 subjects received 90 mg diltiazem, and four subjects received 120 mg diltiazem AUCs for the 60, 90, and 120 mg doses were 565, 984, and 1258 ng/ml . hr, respectively. The values for t1/2, beta, and tmax were similar after each dosing.

Adult↗
PubMedDate not supplied

Causes of false-negative auscultation of regurgitant lesions: a Doppler echocardiographic study of 294 patients.

Few data are available regarding the prevalence and causes of false-negative auscultation (mis-auscultation) of aortic (AR), mitral (MR), or tricuspid regurgitation (TR), and there are no such data that are relevant when the patient's pretest probability of having regurgitation is unknown. The authors therefore studied 294 patients examined by pulsed Doppler echocardiography. On 755 examinations (2.57 examinations per patient), Doppler velocity patterns typical of AR, MR, or TR were found in 63, 96, and 49 patients, respectively. For all three murmurs, mis-auscultation was the rule, rather than the exception, with sensitivities of auscultation ranging from 0 to 37%, depending (but weakly) on the site of the murmur and the years of training of the observer. Specificity of auscultation was high (85% to 100%). The factors associated with the mis-auscultation of AR were poor image quality in the echocardiograms, absence of cardiomegaly, and less experience of the examiner. The probability of missing MR increased in the presence of coronary artery disease (CAD) or if the examiner had less experience. The likelihood of missing TR by auscultation was increased by CAD, obesity, chronic obstructive pulmonary disease, or the absence of cardiomegaly. This study suggests that there is a high prevalence of "silent" murmurs, and that not hearing a regurgitant murmur does not suffice to rule out the presence of regurgitation.

Aortic Valve Insufficiency↗