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Biomedical subjects

E R Giuliani

Publications and source records attributed to E R Giuliani.

115 records · Page 7Linked to original sources
PubMedDate not supplied

Cerebral ischemic events in patients with mitral valve prolapse.

All patients 20 years old or older referred for echocardiographic examination and found to have mitral valve prolapse during the period January 1975 through December 1979 were included in the study. Of the 1,138 patients, two-thirds were women and one-third were men. Their average age was 48.4 years. Forty patients (3.5%) had histories of prior focal cerebrovascular ischemic events. In 26 of the 40 patients, no responsible mechanism other than mitra valve prolapse was identified, and in 4, the ischemic event occurred during an episode of bacterial endocarditis, a known complication of mitral valve prolapse. In 10 of the 26 patients, there was clinical information to suggest an embolic mechanism for the ischemic. A conservative estimate of the prevalence rate for cerebral infarction in this group of patients is four times greater than the rate expected in a normal population. This difference is likely due to the contribution of mitral valve prolapse in the pathogenesis of cerebral infarction.

Adult↗
PubMedDate not supplied

Myocardial infarction after general anesthesia.

During 1967 and 1968, a total of 32,877 patients had general anesthesia at the Mayo Clinic; 422 had previous myocardial infarction. Of these 6.6% experienced another infarction during the first postoperative week. There was no relationship between incidence of postoperative reinfarction and type or duration of anesthesia. However, operations on the thorax and upper abdomen were followed by three times as many reinfarctions as operations at other sites. Patients who were operated on within three months of infarction had a 37% reinfarction rate. This rate decreased to 16% in patients at three to six months after infarction, and remained at 4% to 5% when infarction had occurred more than six months previously. A significantly higher number of myocardial infarctions occurred during the third postoperative day.

Adult↗
PubMedDate not supplied

Randomized phase II trial of rubidazone and adriamycin in women with advanced breast cancer.

Thirty-eight females with advanced breast cancer who had failed prior chemotherapy were entered in a randomized study of rubidazone (150 mg/m2 iv over 1 hour) versus Adriamycin (60 mg/m2 iv over 5 minutes), both given every 4 weeks. The two treatment groups each contained 19 patients and were similar with respect to age, menopausal status, dominant disease status, Eastern Cooperative Oncology Group performance score, and prior hormonal therapy and chemotherapy exposure. No regressions (complete or partial) were observed with rubidazone, but four (21%) patients achieved regressions (one complete and three partial) with Adriamycin. Considering all cycles, hematologic toxicity included leukopenia (wbc count nadir of less than 4000/mm3) in 88% of patients receiving rubidazone and in 89% of those receiving Adriamycin. Three of eight patients treated with Adriamycin after rubidazone failure achieved a regression. Rubidazone appears to be of little value in the treatment of patients with advanced breast cancer who have failed prior chemotherapy.

Adult↗
PubMedDate not supplied

Short-term therapy for streptococcal infective endocarditis. Combined intramuscular administration of penicillin and streptomycin.

In a prospective study, 91 patients with penicillin-sensitive infective endocarditis (IE) were treated for two weeks with intramuscular (IM) penicillin G procaine, 1.2 million units every six hours, plus streptomycin sulfate, 500 mg IM every 12 hours. Viridans streptococci were isolated from 70 patients (77%); 21 patients (23%) had Streptococcus bovis infections. Eighteen patients (20%) had had symptoms of IE for three months or longer. Follow-up ranged from two months to 6.6 years. There were no relapses; mild vestibular toxic reactions occurred in two patients (2%). Two patients (2%) died--one of sudden-onset severe heart failure and one of cardiac arrest after aortic valve replacement. Twenty-six patients (19%) required cardiac valve replacement after completion of antimicrobial therapy. This therapy seems as efficacious as four weeks of parenteral antimicrobial therapy and is more cost-effective.

Adolescent↗