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Biomedical subjects

L Rives

Publications and source records attributed to L Rives.

3 recordsLinked to original sources

A comparison of patient charges associated with percutaneous transluminal coronary angioplasty and coronary artery bypass grafting.

Appropriate interventional treatment for coronary artery disease is an important component in controlling health care expenditures. We conducted a retrospective study to compare the patient charges associated with percutaneous transluminal coronary angioplasty (PTCA) or coronary artery bypass grafting (CABG). All patients underwent treatment for left anterior descending coronary artery stenosis over a 3 year 9 month time period from March 1987 to December 1990 and were followed for 7-58 months (median 43 months) after treatment. The two groups were constructed in such a way that they were balanced for common vessels diseased, number of vessels diseased, sex, age, and ejection fraction (EF). The study included 26 PTCA patients between the ages of 33 and 86 years, 18 males and eight females, with a mean EF of 58 per cent, and 26 CABG patients from 39 to 80 years of age, 18 males and 8 females, with a mean EF of 61 per cent. Charges were categorized as to hospital, professional, cardiac medication, follow-up, and total costs. While CABG was initially more expensive, nine of the PTCA patients (38%) required further interventional treatment (3 PTCA, 5 CABG, 1 PTCA and CABG), whereas none of the CABG patients required further intervention (P < .001). This short-term follow-up demonstrated, that although initially less expensive, repeat interventional charges are significantly higher in PTCA patients. With the escalating costs of health care, the appropriate initial interventional therapy for coronary artery disease must be carefully selected to reduce long-term health care expenses.

Adult↗

Methanol intoxication. Case report.

A 46-year-old male presented to the emergency room seven hours after consuming a large container of sterno. He could not see and complained of abdominal and back pain. He was tachypneic, tachycardic, hypertensive and hypothermic. Laboratory results were significant for a severe metabolic acidosis, a serum osmolality of 465 and serum methanol level of 493 mg/dl. Aggressive treatment included ethanol drip, bicarbonate and hemodialysis. He survived and regained his eyesight in spite of this degree of elevation of the serum methanol level. The literature does not reveal a similar report.

Acidosis↗

Dietary obesity and weight cycling in rats: a model of stress-induced hypertension?

The present study was designed to reproduce the mild hypertension seen in dietary obese weight-cycled rats [P. Ernsberger and D. O. Nelson. Am. J. Physiol. 254 (Regulatory Integrative Comp. Physiol. 23): R47-R55, 1988] and determine whether this mild hypertension was associated with changes in sodium excretion and pressor responsiveness to angiotensin II (ANG II). Male Sprague-Dawley rats were fed pelleted chow (Pellet group) or chow plus sweetened condensed milk (Milk group) or were exposed to four cycles of a 4-day fast alternated with 2 wk of refeeding of pelleted chow and sweetened condensed milk (Cycled group). Blood pressure and heart rate were measured by tail cuff at the onset and last day of each fast and after 3 days of refeeding. During fasting, urine sodium excretion was measured. Mean arterial pressure and heart rate responses to intravenous administration of ANG II (40, 80, and 120 ng/kg), metoprolol (1 mg/kg), and methyl scopolamine (2 mg/kg) were obtained from the femoral artery in awake unrestrained rats. Weight cycling did not lead to mild hypertension or increased bradycardic response to sympathetic blockade with metoprolol. ANG II-elicited pressor responses were similar for Pellet, Milk, and Cycled groups. Sodium excretion did not change with fasting. Mild hypertension developed when obese weight-cycled rats were housed together in groups and not when housed individually. Our preliminary data are consistent with the notion that stress associated with group housing may be a factor in the mild hypertension of obese weight-cycled rats.

Animals↗