Presentation of the Academy Medal to Paul F. Cranefield, M.D., and Brian F. Hoffman, M.D.
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Biomedical subjects
Publications and source records attributed to M I Ferrer.
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Recent increase in our knowledge of the basic features involved in ventricular preexcitation has moved it from being a somewhat rare curiosity for which there was no cure to an important medical condition requiring careful therapeutic planning. This review summarizes a body of information concerning mechanisms, various forms of preexcitation, embryologic features, electrophysiology and special testing maneuvers, treatment, prognosis and aviation plus insurance aspects of the syndrome. A new classification of the locations of the Kent bundles in the Wolff-Parkinson-White form of preexcitation is also offered.
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It is now possible to diagnose early cor pulmonale by utilizing electrocardiographic fluctuations which are the result of moderate pulmonary hypertension and the accompanying effect upon right ventricular function. This holds whether the ECG alterations are produced by chronic obstructive pulmonary disease or by the rarer forms of obliterative lung disease. The late stage of cor pulmonale, in which right ventricular hypertrophy is manifest, should now be rarely encountered in view of our improved understanding of cor pulmonale and more rational therapeutic approaches to the underlying disorders.
In reviewing the present-day status of cor pulmonale, it is clear that considerable progress has been made in almost all instances of the disease. It is clearly a preventable form of heart disease in most cases and it is treatable and curable in its most common form, i. e., in COPD. One must agree with Petty, that today we have effective means of caring for the majority of respiratory cripples. Therapy for lung disease now appears even to have reduced the expected rate of pulmonary function deterioration in some patients. Surely with improved gas exchange and early detection of respiratory insufficiency the outlook for patients with respiratory diseases leading to cor pulmonale is better today than it was 30 years ago.
Septic complications often lead to halting nutritional parenteral therapy. In general, the source of infection lies in the mixture, the connection and/or point of catheter insertion. The objective of this study is to show the need for bacteriological control throughout the parenteral nutrition process in order to assess the efficacy of the methods used, discover the source of infection and establish an in-house quality control. Different methods for bacteriological control of parenteral nutrition mixtures are studied and are compared with the method used at our hospital which is based on routine culture sampling after the mixture is prepared and before it is perfused, on repeating bacteriological control cultures and on performing bacteriological assessments of the catheter. In order to achieve this goal, 28.501 nutritional parenteral samples from 1,782 patients were studied. Only 185 (0.65%) samples were originally positive, and only 59 of them (0.21%) remained positive following a verification culture. Of the 6 culture-verified septic cases, 5 corresponded to Enterobacter cloacae and 1 to Klebsiella pneumoniae.