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Biomedical subjects

J Sala

Publications and source records attributed to J Sala.

At least 73 records · Page 4Linked to original sources
PubMed1991

Risk of thrombosis during coronary angioplasty with low osmolality contrast media.

Studies in vitro have suggested that nonionic low osmolar contrast agents produce an increase in thrombogenicity. To determine the incidence of thrombi related to the use of nonionic low osmolar contrast media during coronary angioplasty, a double-blind randomized study was performed in 100 patients. Medication before angioplasty included oral aspirin (250 mg/day) in all cases. At the beginning of the procedure, aspirin (250 mg) and heparin (10,000 U) were intravenously administered. During the procedure patients were randomly assigned to receive either an ionic low osmolar contrast agent ioxaglate (n = 50), or a nonionic low osmolar contrast media iohexol (n = 50). The presence of thrombus was evaluated on the angiogram and on the guidewire immediately after its retrieval from the patients. Clinical, angiographic and procedural variables were similar in the 2 randomized groups. Angiographic evidence of thrombus was observed in 1 patient (2%) assigned to ioxaglate and in 11 patients (22%) assigned to iohexol (p less than 0.005). One patient (2%) from the ioxaglate group and 6 patients (12%) from the iohexol group showed thrombotic residues on the guidewire (p = not significant). Three patients had acute myocardial infarction, 1 patient (2%) receiving ioxaglate and 2 patients (4%) iohexol (p = not significant). There were no deaths. Thus, compared with an ionic low osmolar contrast media ioxaglate, the nonionic low osmolar contrast agent iohexol increases the incidence of thrombus during coronary angioplasty.

Angioplasty, Balloon, Coronary↗
PubMed1991

[Ten-year survival of a cohort of 736 patients with a first myocardial infarction. Sex-related differences?].

The survival of a cohort of 736 patients (617 men and 119 women) with a first acute myocardial infarction is reported. All patients were admitted and diagnosed at a referral center of six areas of the province of Girona, Spain. The results of a follow-up period of 10 years are analyzed. The overall 10-year survival rate was 55% (57% in men and 43% in women). The survival curves for males and females were significantly different (p = 0.0001). In the acute phase of infarction, the mortality amongst women was higher than amongst men. Women suffered from myocardial infarction at an older age than men. When the study population was stratified by age groups, no statistically significant differences in the survival rates between men and women were observed. We conclude that age is the confounding variable that all other survival-related variables have to be adjusted for. Sex was not found to be a determinant factor for long-term survival after myocardial infarction. The worse hemodynamic condition amongst women prior to the infarction may account for the greater mortality in the acute phase observed in females.

Age Factors↗
PubMed1991

[Stenosis of the common trunk with and without ostium involvement: clinical and angiographic characteristics].

STUDY OBJECTIVE: To evaluate the clinical and angiographic profile of patients with left main coronary artery stenosis with (LM-OS) and without left coronary ostial stenosis (LM-NOS). DESIGN: Retrospective study of patients submitted to coronary angiography. SETTING: Laboratory of Hemodynamics and Interventional Cardiology at Bellvitge Hospital -Barcelona, Spain. PARTICIPANTS: 4663 consecutive patients (pts) with angiographically defined coronary artery disease. 139 pts had left main stenosis greater than or equal to 50%. Twelve pts were excluded because nonatheroesclerotic disease. Twenty two pts (17%), had LM-OS and 105 (83%) LM-NOS. INTERVENTIONS: Pts records were reviewed, to analyse the following clinical and angiographic variables: age, gender, risk factors to coronary artery disease, history of myocardial infarction, anginal class, presence of unstable angina, basal ECG ischemia, percentage and localization of left main stenosis, number and degree of vessels diseased, indexes of left ventricular function and coronary dominance. MAIN RESULTS: 1. Clinical characteristics--In the LM-OS group 18 pts were male and 4 female, while in the LM-NOS the numbers were respectively 90 and 15, p = ns. As for the gender the age showed also a similarity: 58 +/- 8 and 57 +/- 8 years, p = ns. A history of arterial hypertension was present in 73% of pts with LM-OS and 47% with LM-NOS, p greater than 0.05. With respect to the other clinical variables both groups were similar. The incidence of LM-OS was 0.4%. 2. Angiographic characteristics--The severity of left main stenosis was identical in the two groups: 80 +/- 15 in LM-OS and 75 +/- 16% in LM-NOS (p = NS). Four (18%) of the pts with LM-OS had no associated coronary disease versus 7 (7%) of the LM-NOS (p = 0.08). There were 1.3 +/- 1 diseased vessels in the LM-OS group and 2.1 +/- 1 in the LM-NOS (p greater than 0.01). CONCLUSIONS: In the present series, the clinical and hemodynamic profile of patients with left main disease suggest that the following characteristics are more frequently seen in patients with ostial stenosis: 1) history of arterial hypertension; 2) no associated coronary disease; 3) smaller number of diseased vessels; 4) less significant stenosis.

Aged↗
PubMed1991

[Residual myocardial function in dilated myocardiopathy. Response to post-extrasystolic potentiation].

OBJECTIVE: to evaluate the effectiveness of post-extrasystolic potentiation (PESP) to detect latent residual contraction function in patients (pts) with idiopathic dilated cardiomyopathy. DESIGN: retrospective study in pts referred for cardiac catheterization. SETTING: Haemodynamic Laboratory of Cardiology Service, Bellvitge Hospital. Barcelona, Spain. PATIENTS: the criteria for including pts with sinus rhythm were (SR): 1-The appearance of an extra beat R' on the ventriculogram; 2-The location of R' in relation to the preceding sinus beat R1 and the following beat R2 being such that R1-R' less than R'-R2. In patients with atrial fibrillation (AF), the criteria were: 1-An early beat Re had to be identified; 2-R1-Re interval had to be at most half of the Re-R2 interval; 3-The length of the cardiac cycle preceding R, has to be equal to the mean cycle length. All the patients with an increase of the ejection fraction (EF) from R, to R2 less than 12% were included in group A: 12 patients (3 females, 9 males, mean age 51 years, 5 SR, FE 27 +/- 10%). In group B were included patients with an increase of the ejection fraction greater than or equal to 12%; 14 patients (4 females, 10 males, mean age 50 years, 7 SR, FE = 31 +/- 7%). MEASUREMENTS: In each ventriculogram we assessed the performance of left ventricle on R1 and R2 beats by determining: 1-Left ventricular end diastolic (EDV), end systolic (ESV), stroke (SV) volumes; 2-Volumes index (EDVI), (ESVI) (SVI); 3 - Ejection fraction (EF) - Change in ventricular contractility from R1 to R2, delta EF. RESULTS: in the sinus rhythm group the values of R1 and R2 were respectively: EDV: (184 +/- 48 ml/m2; 191 +/- 17 ml/m2; NS); SVI (53 +/- 19 ml/m2; 80 +/- 22 ml/m2; p less than 0.01) FE (29 +/- 7%; 42 +/- 10%; p less than 0.01), delta EF 13 +/- 6%. The change of the ejection fraction from R1 to R2 in pts with SR and AF were respectively: 13 +/- 6% and 11.5 +/- 6.4%; NS. Group A: Deterioration of the functional class and two deaths occurred. Group B: Improvement in functional class in all cases but one. CONCLUSION: our data suggest that augmented ventricular filling and consequent Starling's effect is not a significant contribute for PESP in pts with dilated cardiomyopathy. The analysis of post extrasystolic beat in SR pts and the beat following an early beat with a long diastole in AF, is a valuable method of determining the residual left ventricular function in this group of pts.

Cardiomyopathy, Dilated↗
PubMed1990

[Myocardial ischemia caused by anomaly at the origin of the left coronary artery].

The case of a 68 years old man admitted because of angina "de novo" and submitted to coronariography is reported. The rest ECG showed abnormalities of the ST-T suggesting myocardial ischemia. The coronariography showed: No significant atherosclerotic lesions. The left coronary artery had an anomalous origin; the left descending coronary artery originated from an independent ostium located at the right Valsalva sinus, the circumflex artery had its origin at the same ostium as the right coronary artery.

Aged↗
PubMed1990

[Comparative study of iohexol and iopamidol as cardioangiographic contrast media].

We have done a double-blind randomized study to compare the cardiac effects of 2 nonionic low osmolality contrast agents, iohexol (n = 25) and iopamidol (n = 25), for left ventriculography and coronary arteriography. No statistical differences were detected between both groups in quality of image, clinical (absence of nausea; intense warmth [8% vs 8%, p = NS]) and electrocardiography (repolarization changes [24% vs 12%, p = NS], absence of severe bradycardia and ventricular arrhythmia) effects. Ventriculography induced no change in systolic left ventricular pressure (iohexol: 128.6 +/- 18 vs 127 +/- 19 mmHg, p = NS; iopamidol: 133 +/- 24 vs 131.8 +/- 23 mmHg, p = NS), and a little but significant rise in left ventricular end-diastolic pressure (iohexol: pre = 11.6 +/- 7 vs post = 13.9 +/- 7 mmHg, p less than 0.01; iopamidol: 11.7 +/- 4 vs post = 15.5 +/- 5 mmHg, p less than 0.001). Our results suggest that iohexol and iopamidol are comparable and qualified for angiocardiography.

Angiocardiography↗
PubMed1987

Palliation of advanced pelvic malignant disease with large fraction pelvic radiation and misonidazole: final report of RTOG phase I/II study.

Between October 1979 and June 1982 forty-six patients were entered on a non-randomized Phase I-II protocol for the evaluation of Misonidazole combined with high dose per fraction radiation for the treatment of advanced pelvic malignancies. Pelvic radiation consisted of 1000 cGy in one fraction repeated at 4-week intervals for a total of three treatments. Oral Misonidazole at a dose of 4 gm/m2 was administered 4-6 hr prior to radiation (total dose 12 g/m2). The distribution of histology consisted of 20 gynecologic, 24 bowel, and 2 prostate malignancies. Of the thirty-seven patients completing the three treatments; there were 6 complete responses (14% CR), 10 partial responses (27% PR) 19 minimal or no response (32% NR), and 4 unevaluable. One patient remains NED 5.5 years following radiation. Toxicity directly related to Misonidazole was minimal and consisted primarily of transcient Grade 1, 2 peripheral neuropathy (20% Grade 1, 4% Grade 2) and Grade 2 ototoxicity (4%). Radiation toxicity was significant for late bowel damage. There were 4 (11%) Grade 3 and 7 (19%) Grade 4 gastro-intestinal (GI) toxicities. Kaplan-Meier plot of GI toxicity showed a progressive increase in incidence with time for projected rate of 49% Grade 3, 4 by 12-month. GI toxicity (Grade 3, 4) was also related to tumor response. The complication rate was 80% (4/6) for CR, 30% (3/10) for PR and 26% (5/19) for NR or progression. Because of the GI complication rate, this protocol for palliation of advanced pelvic malignancies has been replaced by a protocol that uses 4 fractions over 2 days (b.i.d.) of 370 cGy per fraction repeated at 3-week intervals for a total of 3 courses.

Combined Modality Therapy↗
PubMed1985

[Effect of tamoxifen on blood calcium and bone structure of normal and ovariectomized rats].

The effect of tamoxifen on calcaemia and framework was studied, both in normal and ovariectomized rats. Tamoxifen caused hypercalcaemia. Only in one of seven animals hypercalcaemia due tamoxifen was accompanied by radiological changes although no structural modification was histologically evident. In ovariectomized rats, tamoxifen dit not produce either hypercalcaemia or radiological changes. These data suggest that the antioestrogenic activity of tamoxifen is involved in the hypercalcaemia it produces.

Animals↗
PubMed1983

Serum malondialdehyde-like material (MDA-LM) in acute myocardial infarction.

Serum malondialdehyde-like material (MDA-LM), as an index of lipid peroxidation, and the serum enzymes CK, CK-MB, LDH, LDH1 and, alpha-HBDH were evaluated in a group of 26 patients with acute myocardial infarction (AMI), seven with angina pectoris (AP), and in a normal control group of 94 subjects. MDA-LM values were within the normal range in AP patients, while in AMI patients a significant increase in serum MDA-LM was observed in the days following the acute event, reaching a maximum 6-8 days later, when 90% of the patients had values higher than the upper normal limit (mean +/- 2SD) of the control group. A significant correlation was found between the integrated concentration-time MDA-LM curve and the integrated serum enzymes activity curves reached during the nine days after the acute event. The "in vivo" relevance of the increased serum MDA-LM in the post-infarct period is unknown at the present, but as lipid peroxides are known to harm cellular structures and to inhibit prostacyclin synthesis, it may be of interest with regard to the long term secondary effects in AMI patients.

Adult↗