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Biomedical subjects

E Michelson

Publications and source records attributed to E Michelson.

At least 19 recordsLinked to original sources
PubMed2003

Clinical features and contemporary management of patients with low and preserved ejection fraction heart failure: baseline characteristics of patients in the Candesartan in Heart failure-Assessment of Reduction in Mortality and morbidity (CHARM) programme.

AIMS: To describe the clinical characteristics and contemporary treatment of a broad spectrum of patients with chronic heart failure (CHF) randomised in the Candesartan in Heart failure-Assessment of Reduction in Mortality and morbidity (CHARM) programme, consisting of three component studies comparing placebo to candesartan. METHODS AND RESULTS: CHARM Alternative, CHARM Added and CHARM Preserved enrolled 2028 low left ventricular ejection fraction (LVEF) ACE inhibitor intolerant patients, 2548 low LVEF ACE inhibitor treated patients and 3025 preserved LVEF patients, respectively. Patients in CHARM Preserved were more often female. The proportion of women in CHARM Preserved was 40% compared to 32% in CHARM Alternative and 21% in CHARM Added. Patients in CHARM Preserved were also more often hypertensive than in the other two trials (64% vs. 50% and 48%, respectively). Symptoms and signs (with the exception of a third heart sound) were similar in all three patient groups. Beta-blockers were used in over half of patients in all three groups. Digoxin and spironolactone were used less frequently and calcium antagonists more frequently in CHARM Preserved. Spironolactone was used most frequently in CHARM Alternative, i.e. in ACE inhibitor intolerant patients. CONCLUSIONS: The CHARM Programme provides the largest and most detailed comparison to date of patients low- and preserved-LVEF CHF. It also describes the causes of ACE-inhibitor intolerance in a large cohort of patients and the other treatment which these patients receive.

Adrenergic beta-Antagonists↗
PubMed1999

Evaluation of the patient with shortness of breath: an evidence based approach.

Shortness of breath is a common presenting complaint of emergency department patients, and may result from a number of different causes. Work-up to determine the etiology in a given patient may be challenging. The authors undertook a literature review limited to causes of dyspnea other than reversible airway disease. The results of this review are discussed herein, as well as recommendations for further research.

Adult↗
PubMed1992

Donor alloreactivity may predict acute graft-versus-host disease in HLA-matched bone marrow transplantation for leukemia in early remission.

The pretransplant alloantigen-dependent responding and stimulating capacity of donors and of recipients was studied retrospectively, in a study of prediction of acute graft-versus-host disease. Donor responding capacity (DRC) and host stimulating capacity (HSC) were defined by mixed lymphocyte culture (MLC) and normalized by help of the pool response. High and low DRC and strong and weak HSC was defined by distribution plots. Kaplan-Meier estimates of the risk of developing Grade II or higher aGvHD showed that first remission patients (N = 125) had a significantly different risk if transplanted with marrow from a donor with high (N = 54) or low (N = 71) DRC (chi 2 = 9.49; d.f. = 1; p less than 0.002). This was not the case for patients transplanted in later remissions. Host SC status had no significant influence on the aGvHD status (chi 2 = 1.75 and 2.40; d.f. = 1; p = 0.19 and 0.12, defined by normal controls A and B respectively). In conclusion, the results indicate that pretransplant donor alloreactivity may predict aGvHD, confirming the results from a Scandinavian study. The results need to be confirmed in prospective studies of alloreactivity as risk factor for aGvHD.

Acute Disease↗
PubMed1989

Nicardipine and hydrochlorothiazide in essential hypertension.

Nicardipine is an investigational dihydropyridine calcium channel blocking agent. One hundred fifty-one patients with hypertension received either 30 mg nicardipine t.i.d. or 25 mg hydrochlorothiazide b.i.d. in a double-blind, randomized, multicenter trial. After 4 weeks of therapy and at the end of the dosing interval, nicardipine reduced arterial pressure by 10/6 mm Hg and 12/6 mm Hg in the supine and standing positions, respectively (all p less than 0.01). In the hydrochlorothiazide group, the reductions were 12/6 mm Hg and 14/6 mm Hg, respectively (all p less than 0.01). The maximum reduction in blood pressure of 16/14 mm Hg supine and 20/15 mm Hg standing occurred within 1 hour after administration of nicardipine. The mean reduction in the hydrochlorothiazide group after 1 hour was 14/11 mm Hg supine and 16/12 mm Hg standing. Neither drug affected autonomic reflexes associated with maximum exercise. Nicardipine increased urinary sodium excretion during the 4-hour period after the first dose. Adverse effects of nicardipine were primarily extensions of its vasodilator effect and included flushing, headache, and edema.

Adult↗
PubMed1985

Interaction of the input atrial excitatory waves and conduction through the atrioventricular node. I. Changes in the cellular electrical activity.

Extrasystoles were applied only at the posterior input, only at the anterior input and jointly at both AVN-inputs in preparations from rabbit right atrium, after 10 basic beats. The effect of the interaction of the input excitatory waves was evaluated by the changes in the cellular electrical activity and in the output H1H2-interval. It has been demonstrated that both the summation effects (shortening of the H1H2-interval) and the inhibition effects (prolongation of the H1H2-interval) are accompanied by substantial changes in the spatial-temporal organization of conduction within the node. The summation of excitatory waves leads to higher velocity of AP increase (most frequently in the N-zone), to changes in the shape of AP as a result of electrotonic influences, to changes in the sequence of activation of cellular group forming different conduction pathways. The inhibition of the excitatory waves is related to the increase in the inhomogeneity of conduction, manifested in the formation of competitive conduction pathways. In addition to the changes in the AP-front, a typical characteristic is the hill-structure reflecting the effect of the excitatory fronts. The formation of conduction pathways under the effect of each of the input excitatory waves probably takes place on the background (spatial and temporal) of the disappearing refractoriness, related to another excitatory wave. The interaction between the input excitatory waves, taking places through the proposed model, could also be present in a normally functioning heart provided the phasic correlations between the moments of activation of the posterior and anterior inputs are optimal for such an interaction.

Action Potentials↗
PubMed1981

Results of polytetrafluoroethylene grafts in the femoropopliteal region: two year evaluation of 146 bypass procedures.

One hundred twenty patients, who underwent femoropopliteal bypass procedures using polytetrafluoroethylene (PTFE) grafts, are reviewed. There were 70 male and 50 female patients ranging in age from 42 to 84 years, the mean age being 64.27 years. A total of 140 procedures were performed for tissue loss or impending tissue loss; only 26 procedures had been done for limiting claudication. Review of the results showed a cumulative patency of 83.86%, t two years. The results for good run off showed a patency of 99.07% at two years, while the cases with poor run off, the patency was 47.0%. There were no early mortalities. Two patients, however, died during the follow-up period. Of the 17 amputations required, eight were defined as major and nine as minor amputations. The series is compared with a series of saphenous vein bypasses and also one using Dacron prosthesis.

Adult↗
PubMed1977

Clinical spectrum of infantile lobar emphysema.

Infantile lobar emphysema in an uncommon disease affecting newborns and infants with varying degrees of respiratory distress, evidence of lobar overaeration, mediastinal shift, and herniation. Congenital malformations of the bronchi and alveoli and extrinsic compression by vessels and cysts account for less than 50% of these cases. All segments of the upper and middle lobe may be involved, but the major overexpansion occurs in the anterior segment. Respiratory distress may be absent, mild, or severe, and the condition may be acutely progressive, acutely reverisble, chronic, or recurrent. This symptom complex is the result of multiple factors requiring investigation prior to definitive operation.

Acute Disease↗
PubMed1977

Primary pulmonary sporotrichosis.

A patient with primary pulmonary sporotrichosis with infiltration and cavitation is reported. Treatment for one year with potassium iodide resulted in marked resolution of the inflammatory lesions but persistent cavitation and fungal infection. Cure followed bisegmental lung resection with no recurrence during eight-year follow-up. Excellent results are reported in 10 patients treated by resection despite less then optimal preoperative iodide therapy. Surgical treatment of primary sporotrichosis with cavitation is indicated and should be unattended by complications or recurrence.

Adult↗