PubMed Health⌕ Search

Biomedical subjects

H Gattiker

Publications and source records attributed to H Gattiker.

16 recordsLinked to original sources
PubMed1992

Cardiac rehabilitation. Current status and future directions.

Comprehensive cardiac rehabilitation is more than exercise training for patients with coronary artery disease and now includes all aspects of secondary prevention. Exercise training is individually prescribed based on clinical status and therapeutic goals. Smoking cessation and abstinence and the treatment of hypercholesterolemia are integral to the rehabilitation process. Education and counseling are important adjuncts to treatment, especially soon after a coronary event. Vocational rehabilitation can be included simply and effectively in the rehabilitation process. Efficient and cost-effective cardiac rehabilitation is tailored to a patient's medical condition, risk factor evaluation, and vocational status. The future of cardiac rehabilitation will be linked to the success of training nonphysician health professionals to provide preventive services.

Ambulatory Care↗
PubMed1987

[Two-dimensional exercise echocardiography. Comparison with electrocardiography, myocardial scintigraphy with thallium 201 and coronary angiography].

Biapical two-dimensional echocardiograms were obtained immediately before and after a bicycle exercise test in 54 patients referred for coronary angiography. Images of adequate quality were recorded in 47 cases (87%), 39 of whom had significant coronary artery disease. All patients also underwent a stress electrocardiogram. In 22 subjects echocardiography and bicycle stress test in the supine position were combined. 23 patients underwent scintigraphy with thallium-201. The sensitivity of rest and exercise echocardiography for the diagnosis of coronary artery disease was 90% and the specificity 63%, compared to 82% and 75% respectively for the electrocardiogram. The sensitivity for the detection of jeopardized myocardium, defined by angiographic criteria, was 75% for the exercise echocardiogram and 65% for the exercise electrocardiogram in the 28 patients without myocardial infarction. In 19 patients with infarction echocardiography detected jeopardized myocardium with a sensitivity of 73%, compared to 53% for the electrocardiogram. In the subgroup of 23 patients studied by thallium-201 scintigraphy, sensitivity for identification of multivessel disease (8 patients) was comparable for both rest and exercise scintigraphy (6/8) and echocardiography (7/8). The specificities were 88% and 94% respectively. Jeopardized myocardium was detected in this subgroup with a sensitivity of 82% by echocardiography, 76% by thallium scintigraphy and 65% by electrocardiography. In conclusion, this study demonstrates that two-dimensional echocardiography can be combined with exercise electrocardiography in one stress test. This improves the diagnosis of coronary artery disease, detection of jeopardized myocardium and identification of patients with multivessel disease.

Adult↗
PubMed1981

Gel chromatography of heparin.

It is assumed that heparin is a heterogeneous substance. In order to further investigate the purification of heparin, a column chromatographic technique for the fractionation of heparin is described using various diameters of bead form cross-linked dextran gels and an automated apparatus. It was observed that Sephadex G-50 resulted in the separation of three well formed peaks and provided superior resolution compared to all other gels. One of the peaks, representing 51% of the original material, possessed strong anticoagulant activity as measured by the recalcification time, partial thromboplastin time, thrombin time and the anti-Xa test. This peak also possessed strong metachromasia after electrophoresis as well as having a very potent anticoagulant effect in vivo. This technique may have a significant role in the purification of this agent from tissue sources.

Animals↗
PubMed1981

Heparin excretion in intact and hepatectomized rats.

Metabolism and kinetics of 3H-heparin were compared in intact and hepatectomized rats. Rats were divided into three groups: 1) intact rats with biliary fistulas and cystostomies 2) intact rats with only cystostomies and 3) hepatectomized rats with cystostomies. Radioactivity in blood, bile and urine besides anticoagulant activity in blood and urine were examined. In addition, column chromatography of urine was used to isolate possible metabolites. Seventy percent and 80% of the radioactive dose was found in the urine of intact rats at 24 hr and 48 hr. Close to 5% of the radioactivity was found in bile or rats with a biliary fistula after 48 hr. The APTT declined to near normal values at 1 hr whether rats had a biliary fistula or not. In contrast, only 25% of the radioactivity could be exerted into the urine of hepatectomized rats in 24 hr; the APTT did not decline as fast and at 5 hr, it was still 100 seconds. Only one radioactive component could be isolated on chromatography from all urines of these animals and appears to be similar to the original heparin. Thus, the liver has no important role to play in regulating the anticoagulant effects and excretion of heparin.

Animals↗
PubMed1981

Levels of antithrombin III, alpha 2-macroglobulin, and alpha 1-antitrypsin in acute ischemic heart disease.

Since measurements of AT III and other possible coagulation inhibitors might provide an index of hypercoagulability, the goal was to measure over a 3-month period individual changes in blood levels of AT III, alpha 2-microglobulin, and alpha 1-antitrypsin in 51 patients with acute ischemic heart disease who were admitted to a Coronary Care Unit with the following diagnosis: unstable angina (26 patients), acute transmural myocardial infarction (20 patients), or subendocardial myocardial infarction (5 patients). Some patients received prophylactic antithrombotic therapy. AT III was measured by the von Kaulla, Owen, Thrombo-Screen, chromogenic, immunodiffusion, and immunoelectrophoretic methods. Alpha 2-macroglobulin and alpha 1-antitrypsin were measured by immunodiffusion. All inhibitors were measured on three different occasions: (1) on admission to hospital, (1) day of departure from hospital, and (3) at 3 months after hospitalization. Alpha 1-antitrypsin showed a significant increase compared to the control and remained elevated during the 3-month interval. Compared to normal control values, AT III was found to be significantly diminished when measured by one functional method (von Kaulla) in all three blood samples from patients with unstable angina and transmural myocardial infarction and by one immunological method (immunodiffusion) in patients with unstable angina, transmural myocardial infarction, and subendocardial myocardial infarction. Most methods determining functional AT III detected a significant increase 3 months after the acute ischemic episode; this rise was observed more often in patients with myocardial infarction than in those with unstable angina. Stepwise discriminant analysis separated the patients of the three groups. Subcutaneous heparin has no significant effect on AT III levels. Unexplained discrepancies still exist between the results obtained by various functional and immunological methods for determining AT III. It appears, however, that methods measuring functional AT III seem to be more suited than immunological methods to detect changes in AT III levels that might occur during and after an acute episode of ischemic heart disease.

Angina Pectoris↗
PubMed1979

Evolution of cardio-pulmonary involvement in Friedreich's ataxia.

The evolution of 15 patients initially evaluated during Phase One of the Quebec Cooperative Study of Friedreich's ataxia has been studied approximately three years later. It is concluded that the deterioration of cardio-pulmonary function in Friedreich's ataxia is multifactorial. The neuromyopathy (or the underlying metabolic or cellular defect) appears to be the main contributing factor to the deterioration of cardio-pulmonary function, which is exacerbated by the scoliosis and varying severity of the cardiomyopathy.

Adolescent↗
PubMedDate not supplied

Transmitting echocardiograms by telephone.

The feasibility of sending echocardiographic tracings to distant places by means of telephonic facsimile equipment has been investigated, and the quality of the transmitted copies was found to be acceptable. Three models were used for transmission, and although they presently have some technical limitations, use of satellites promises to enhance their capacity. Use of the already available technology will allow remotely located echocardiographers to benefit from the expertise of consultants in this field. Rapid telephonic access to referral centers, especially for difficult cases, will prevent potential interpretation errors and will give the referring physicians another tool for upgrading their interpretative skills. Transmission of echocardiographic tracings could thus become another means of continuing medical education in a constantly evolving field.

Echocardiography↗