PubMed Health⌕ Search

Biomedical subjects

L B Jacobson

Publications and source records attributed to L B Jacobson.

At least 19 recordsLinked to original sources
PubMed2001

Heart block in patients after bariatric surgery accompanying sleep apnea.

BACKGROUND: Heart block and bradycardia during sleep has been reported in patients with obesity. The occurrence of bradyarrhythmias in patients after undergoing bariatric surgery has not been reported. METHODS: Over a period of 6 months, 3 patients who underwent laparoscopic weight reduction surgery developed prolonged heart block during sleep. Clinical course and follow-up are presented. RESULTS: All 3 patients were diagnosed with sleep apnea. For 2 of these patients this was a new diagnosis. The episodes of heart block coincided with their episodes of sleep apnea. During follow-up of at least 6 months, no patient has had any adverse consequences related to their nocturnal heart block. CONCLUSION: Heart block during sleep is sometimes seen in patients undergoing bariatric surgery. The cause is sleep apnea, which often is worsened in the postoperative state due to narcotic analgesics. These patients require treatment of their sleep apnea, not pacemakers.

Adult↗
PubMed1992

Clinical and epidemiologic studies of Chagas' disease in rural communities of Oaxaca, Mexico, and an eight-year followup: II. Chila.

A seroepidemiologic survey conducted in 1971 in the rural Pacific coastal community of Chila in the Mexican state of Oaxaca showed an unusually high prevalence of antibody against the Chagas' disease agent Trypanosoma cruzi. Further studies were undertaken in 1973 and 1981 to (1) determine the pathologic impact of T. cruzi infection in humans, (2) investigate the natural history of the disease, (3) confirm that serologically positive persons were parasitologically positive, and (4) evaluate whether T. cruzi transmission continued into the next decade. This article reports results derived from those studies.

Adolescent↗
PubMed1980

Isolated aortocoronary bypass operations in patients over 70 years of age.

The early and late morbidity, mortality and beneficial effects of isolated aortocoronary bypass operations in a group of 35 patients 70 years old or older were compared with those factors in patients 50 to 59 years old. The patients in both groups were matched according to the year in which the operation was done and the number of vessels bypassed. Left ventricular function, estimated by the angiographically calculated ejection fraction, was not statistically different in the two groups. Cardiac index, while adequate in both groups, was significantly lower in the older age group. Comparisons were made of "early" events, such as perioperative myocardial infarction, perioperative death and length of post-operative hospital stay; and of "late" events, including myocardial infarction, angina pectoris, congestive heart failure and death, which occurred after patients were discharged from the hospital. The mean length of follow-up of patients was similar in both groups. In comparing early events in the two groups, there was no statistically significant difference in the incidence of perioperative myocardial infarction, perioperative mortality or mean length of postoperative hospital stays. With regard to late events, there was no statistically significant difference in the incidences of myocardial infarction, angina pectoris or mortality.

Age Factors↗
PubMed1975

Vasodilator therapy of idiopathic lactic acidosis.

Afterload reduction with sodium nitroprusside was performed in a patient with idiopathic lactic acidosis in whom sodium bicarbonate therapy had precipitated pulmonary edema. The drug reduced mean pulmonary-artery wedge pressure from 28 to 12 mm Hg, accompanied by a modest rise in left ventricular stroke work index from 33 to 43 g-m per square meter. Concomitantly, there was dramatic resolution of the metabolic acidemia, the arterial pH rising from 7.19 to 7.61, arterial carbon dioxide tension from 13 to 26 mm Hg, and bicarbonate content from 6 to 28 mEq per liter, and the anion gap falling from 32 to 11 mEq per liter. Metabolic improvement occurred despite a fall in cardiac output from 5.5 to 4.8 liters per minute. These findings support the concept that regional vasoconstriction plays a part in idiopathic lactic acidosis, and suggests that vasodilators may be an effective form of therapy for this almost uniformly fatal disorder.

Acidosis↗
PubMed1975

Comparison of 70 degrees tilt, LBNP, and passive standing as measrues of orthostatic tolerance.

The present study was performed to assess the reliability of lower body negative pressure (LBNP) as a test of orthostatic tolerance. The need for this assessment arose from the prior observation in this laboratory that some subjects show wide day-to-day variation in heart rate responses to LBNP. The extent of these variations was so great as to a raise a serious question as to the value of LBNP as a measure of study-induced alterations (e.g. those produced by bedrest or weightlessness) in orthostatic tolerance. Five healthy volunteers were subjected to a series of tests, consisting of 70 degrees tilt, LBNP, and passive standing. on three occasions preceding and three occasions following a 2 week period of bedrest. Study results show that it is possible to subdivide the volunteers into subgroups which show either great or little day-to-day variability in any of the three tests. All three tests reaveled bedrest-induced alterations in orthostatic tolerande quite adequately. Of the three tests studied, LBNP most frequently resulted in the largest test-induced heart rate alterations, followed by quiet standing and, finally 70 degrees tilt

Adaptation, Physiological↗