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Biomedical subjects

M Halim

Publications and source records attributed to M Halim.

26 records · Page 2Linked to original sources
PubMed1988

Provocation and amplification of the transvalvular pressure gradient in rheumatic tricuspid stenosis.

A low cardiac output and high compliance of the systemic venous system may mask a resting tricuspid diastolic gradient in patients with significant rheumatic tricuspid stenosis. Thirty-three patients (mean age 28 +/- 10 years) with rheumatic tricuspid stenosis evidenced by 2-dimensional echocardiography (doming and restricted motion of all 3 tricuspid valve leaflets) were studied to expose occult and to amplify borderline and basal tricuspid valve gradients. At cardiac catheterization, the right atrium and right ventricular pressures were recorded simultaneously in the basal state, after intravenous infusion of 200, 400, 500, 700 or 1,000 ml of normal saline until a mean right atrial pressure of 12 mm Hg was achieved, and after 0.6 mg of intravenous atropine. Eleven patients (33%) had a mean tricuspid diastolic gradient of greater than 2 mm Hg at rest (group 1). After 483 +/- 240 ml of saline infusion, the mean tricuspid diastolic gradient increased from 5 +/- 2 to 9 +/- 3 mm Hg (p less than 0.001), secondary to a marked rise in right atrial pressure from 8 +/- 3 to 12 +/- 2 mm Hg (p less than 0.001). Concomitantly, there was no increase in right ventricular end-diastolic pressure, although the heart rate increased from 76 +/- 13 to 79 +/- 12 beats/min (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Percutaneous single- and double-balloon aortic valvotomy in adolescents and young adults with congenital aortic stenosis.

Percutaneous balloon aortic valvotomy was attempted in six consecutive adolescents and young adults, (mean age 18 +/- 5 years), with severe congenital aortic valvular stenosis. Peak systolic aortic valve gradient measurement and aortography was performed before and immediately after valvotomy, and a 1-6 months follow-up. The single-balloon technique was used in two patients and the double-balloon technique in four patients. After balloon valvotomy the mean peak systolic aortic valve gradient (PSG) decreased from 122 +/- 53 to 43 +/- 20 mmHg (P less than 0.01). The haemodynamic improvement persisted at follow-up (PSG = 47 +/- 31 mmHg), except in one patient who had previously undergone aortic surgical valvotomy. One balloon valvotomy was unsuccessful, presumably because of the selection of an inappropriately small balloon. Two patients with critical aortic stenosis (PSG greater than 165 mmHg), who exhibited a thick aortic valve on echocardiography with a relatively small aortic root and annulus, had a dramatic reduction in PSG. However, the degree of aortic regurgitation increased significantly in both cases. The theoretical haemodynamic advantage of the double versus the single balloon techniques was confirmed in one patient. We have demonstrated that percutaneous balloon aortic valvotomy using either the single- or double-balloon technique is feasible in young adults with severe congenital aortic stenosis. Further studies are required both to define appropriate patients and the selection of balloon diameter and length.

Adolescent↗
PubMed1987

Hemodynamic evaluation of porcine bioprostheses in the mitral position by Doppler echocardiography.

Twenty-four patients with porcine bioprostheses in the mitral position were studied by Doppler echocardiography followed by cardiac catheterization within 24 hours. Doppler mean diastolic mitral valve gradient was calculated by a 3-point method and mitral valve area was determined by the pressure half-time method. Data from Doppler echocardiography and cardiac catheterization were compared. There was a strong correlation between Doppler echocardiography and catheterization-determined mean diastolic gradient: r = 0.9, standard error of estimate (SEE) = 1.4 mm/Hg (regression equation y = 0.63x + 1.41), p less than 0.001. There was also a strong correlation between Doppler echocardiography and catheterization-determined mitral valve area: r = 0.86, SEE = 0.18 cm2 (regression equation y = 0.64x + 0.52), p less than 0.001. Fourteen patients whose valvular function was considered normal by clinical evaluation had Doppler-calculated mean diastolic gradients of 4.5 to 9.5 mm Hg (mean 6.5 +/- 1.4); the Doppler-determined valve area was 1.15 to 2.0 cm2 (mean 1.54 +/- 0.3). Ten patients had a malfunctioning bioprosthesis, 7 had severe mitral regurgitation and 3 had stenosis. Valvular malfunction in all 10 patients was detected by Doppler echocardiography and confirmed by catheterization and angiocardiography. Nine patients underwent reoperation. Doppler hemodynamic evaluation of porcine bioprostheses in the mitral position provided noninvasive information comparable to that obtained by cardiac catheterization.

Adult↗
PubMed1985

Endomyocardial fibrosis: report of eight cases.

Endomyocardial fibrosis is a disease of unknown origin which has not previously been described in detail from the Middle East. The clinical, echocardiographic, hemodynamic and angiocardiographic findings in eight patients (five men and three women, mean age 38 years) are presented. Two patients had right-sided involvement, two had left-sided involvement and four had biventricular involvement. The presence of a small ventricle with obliteration of the apex and a large atrium is a two-dimensional echocardiographic finding highly suggestive of endomyocardial fibrosis. Hemodynamic characteristics of dip and plateau on ventricular pressure curves were present in six patients. Ventricular angiography was diagnostic in all cases. Endomyocardial biopsy yielded positive findings in three of six patients and is not essential for diagnosis.

Adult↗
PubMed1981

Surgical treatment of mitral regurgitation caused by floppy valves: repair versus replacement.

Between October 1969 and April 1980, 132 patients underwent operation for floppy mitral valve. The 46 patients in group A underwent valve replacement using an inverted, fresh, unstented, antibiotic-sterilized aortic homograft and the 86 patients in group B underwent valve repair. The onset of symptoms was sudden. More than 80% of the patients in both groups were in New York Association functional class III or IV. The dominant lesion in both groups was ruptured chordae to the posterior cusp (72% in group A and 58% in group B). There were five early deaths (11%) and 15 late deaths (32%) in group A and four early deaths (5%) and five late deaths (7%) in group B. The actuarial survival rate at 5 years was 62% in group A and 90% in group B. In group A, five patients (11%) had valve failure, which led to late death in two. Four patients (8%) in group A required reoperation. Two patients in group B developed a loud mitral systolic murmur soon after operation and required reoperation. Two patients in group B had thromboembolism before routine anticoagulation. Sixteen patients (61%) in group A and 56 (76%) in group B were functional class I after operation.

Anticoagulants↗
PubMedDate not supplied

Susceptibility of methicillin-resistant Staphylococcus aureus to minocycline and other antimicrobials.

The incidence of methicillin-resistant Staphylococcus aureus (MRSA) is on the rise, especially in nosocomial and intravenous-drug-abuse-related infections, with a concomitant increase in morbidity, mortality and health care costs. At present the drug of choice, vancomycin, which must be administered intravenously, is expensive and can cause serious side effects in vancomycin-intolerant patients. Recently, minocycline has received much attention as an antibiotic to combat the increasing frequency of MRSA-related infections. We tested 102 recent clinical isolates of MRSA from tertiary-care patients and found none to be resistant to minocycline, with minimum inhibitory concentrations of < 1-2 micrograms/ml. The only other drug that inhibited all the strains was vancomycin, followed by ciprofloxacin (87%), clindamycin (55%) and chloramphenicol (52%). Gentamicin, beta-lactams, tetracycline and trimethoprim-sulfamethoxazole had little or no activity against our isolates of MRSA.

Anti-Bacterial Agents↗
PubMedDate not supplied

In vitro activity of quinupristin/dalfopristin, RP59500, against gram-positive clinical isolates.

Synercid (quinupristin/dalfopristin, RP59500) is a new water-soluble streptogramin which offers some advantages over the commercially available antimicrobials against drug-resistant gram-positive bacteria. Its in vitro activity was compared with ampicillin, augmentin, penicillin, erythromycin, oxacillin and vancomycin against gram-positive bacteria isolated from clinical specimens. Of the 837 gram-positive bacteria tested 834 (99.6%) were inhibited by < 0.6-4.0 mg/l of Synercid. It had excellent activity against both staphylococci and streptococci, including methicillin-resistant staphylococci and vancomycin-resistant enterococci.

Ampicillin↗