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Biomedical subjects

M Jaeger

Publications and source records attributed to M Jaeger.

At least 19 recordsLinked to original sources
PubMed1992

[Complementary information from Doppler echocardiography in the electrocardiogram in the basic assessment of chronic coronary heart disease, especially following a myocardial infarct. Observations from an ambulatory cardiology clinic].

In chronic ischemic heart disease, Doppler echocardiography (DE) at rest permits semiquantitative evaluation of scarring and remodelling processes, global ventricular function and, frequently, regional wall motion state. Late complications are detected, namely infarct expansion, true and false ventricular aneurysm, mitral insufficiency, thrombus formation, and associated valvular and aortic diseases are discovered. We studied 100 patients with known chronic coronary artery disease referred for noninvasive evaluation, including electrocardiogram (ECG) and DE. In all patients, the global left-ventricular function was satisfactorily assessable. In roughly two thirds of the documented infarctions. DE confirmed the ECG diagnosis and permitted a more precise diagnosis in the majority of them in terms of localization and/or dimension of the necrosis. In one third of the patients. DE clarified inconclusive ECG tracings. Thus, the baseline noninvasive investigation with ECG and DE is a potent tool in the management of chronic ischemic heart disease, serving as a guide to further investigation and to treatment adjustments.

Adult↗
PubMed1992

[Is electrocardiographic diagnosis of left ventricular hypertrophy possible in the presence of an anterior hemiblock?].

The electrocardiographic diagnosis of left ventricular hypertrophy is often difficult because it is based on a large number of criteria which, even if taken on their own or as "scoring systems", have a poor sensitivity ranging from 10 to 60%. Some authors have shown that the diagnosis is easier--though at first sight this seems paradoxical--in the presence of altered ventricular depolarization. To verify this statement in the case of left anterior fascicular block, we tested the value of six different indices for the detection of left ventricular hypertrophy. We analyzed 100 patients with left anterior fascicular block and compared the six electrocardiographic indices with the echocardiographic reference method, using the formula of the Penn convention, to establish the left ventricular mass. The best index of the six was that of Gertsch: [S3+ (R+S) maximal precordial] greater than or equal to 30 mm. Its sensitivity was 74%, its specificity 69%, its positive predictive value 79% and its negative predictive value 63%. The other tested indices had a sensitivity of less than 45% with a specificity of more than 80%. Furthermore, Gertsch's index was of equal value in confirming the increased left ventricular mass due either to concentric hypertrophy or to dilated cardiomyopathy. This study therefore confirms that electrocardiographic diagnosis of left ventricular hypertrophy is even easier in the presence of left anterior fascicular block than in absence of altered ventricular depolarization. This result is of practical interest, the incidence of left anterior fascicular block being 1 to 5% in the general population and as high as 30% after the age of 80.

Adult↗
PubMed1992

[Secondary hemochromatosis in polytransfused patients with myelodysplastic syndromes].

In a retrospective analysis we assessed the data of 46 patients with myelodysplastic syndromes (MDS), who had received more than 50 blood transfusions during the course of disease. The number of units given ranged from 50 to 155 (mean 79). 20 patients (RA n = 4, RARS n = 12, RAEB n = 1, RAEB/T n = 2, CMML n = 1), followed up between 8 and 108 months (mean survival time 39.4 months), developed a secondary hemochromatosis. More than 40% of the patients showed signs of heart failure, in some cases accompanied by cardiac arrhythmias. 11 patients also suffered from hepatopathy and 5 developed diabetes mellitus. Secondary hemochromatosis was particularly common in patients with RARS. Refractory congestive heart failure secondary to hemochromatosis was the cause of death in 14 patients, whereas none died from hepatic insufficiency. We conclude that the risk of secondary hemochromatosis should not be neglected in polytransfused patients with MDS. In some cases, particularly those with favorable prognostic features of MDS, it may shorten life expectancy. The availability of a new oral iron chelator (1,2-dimethyl-3-hydroxypyrid-4-one or L1) offers a promising and practicable approach to prevent this complication.

Adult↗
PubMed1991

[Hazards of radiotherapy in the presence of a cardiac pacemaker].

A patient with cardiac pacing operated for cancer of the breast received subsequent radiotherapy, first with a linear accelerator, then with a betatron. The pacemaker was found deprogrammed as a sequel to irradiation although care was taken to keep it outside the irradiation field. After reprogramming the pacemaker changed a second time spontaneously the given parameters indicating permanent damage by the irradiation. In such cases the exchange of the pacemaker is recommended. Precautionary measures ranging from surveillance to possibilities for reprogramming and even reanimation or pacemaker replacement should be assured prior to irradiation of patients with cardiac pacing.

Breast Neoplasms↗
PubMed1990

Transcranial magnetic stimulation: specific and non-specific facilitation of magnetic motor evoked potentials.

Different physiological mechanisms of facilitation of latencies and amplitudes of magnetic motor evoked potentials (MEPs) were evaluated in a cohort of 140 healthy volunteers. The potentials were induced at the vertex and recorded at the abductor pollicis brevis. The aim of the present investigation was to compare physiological mechanisms which presumably facilitate motor pathways at the cortical level with those known to occur during contraction of small hand muscles. When compared with MEPs at rest, the maximum average decrease of latencies (1.5, SD 1.1 ms) as well as the highest increase of peak to peak amplitudes (2.6, SD 2.1 mV) was observed during exertion of a voluntary background force, at the muscle recorded from. Pre-innervation of a neighbouring muscle (abductor digiti minimi) led to a lesser average decrease of latencies by 1.0, SD 1.1 ms and an average increase of amplitudes by only 0.5, SD 1.5 mV. Non-specific manoeuvres, like sticking out the tongue or counting aloud, reduced mean latencies slightly by 0.4 ms, SD 0.8 ms and 0.3 SD 0.85 ms respectively, but increased amplitudes markedly by an average of 1.0, SD 1.6 mV and 0.8, SD 1.4 mV respectively. It is concluded that facilitation of MEPs by non-specific manoeuvres occurs and must be taken into account when evaluating MEPs.

Adolescent↗
PubMed1990

[Sudden death during sport activities. How can the incidence be reduced?].

Sudden death after sporting activities is not a rare occurrence on the basis of the statistics of a country: there appear to be 100 to 1,500 cases each year in France, and possibly even 10 times as many. This event is of cardiovascular origin or linked to the use of stimulants, if accidental causes are left out. Almost all unexpected deaths of medical origin are due to cardiac arrest. In practice, this only rarely involves an apparently healthy organ. Cardiomyopathies (almost 50% of cases occurring before the age of 35) and coronary disease (80% of individuals dying over 35 and 75% of all cases) are among the essential causes. The final mechanism most often (62.4%) is ventricular fibrillation following a ventricular tachycardia. These sudden deaths are sometimes preceded by cardiorespiratory symptoms (angina pectoris, faintness, dyspnea) and by extrasystoles, with the latter showing their potentially malignant nature in some cases. These features must be sought and identified if an attempt is to be made to reduce sudden cardiac deaths in athletes. Detailed and routine sophisticated investigations would have little to offer and are expensive. It would seem more valid to educate general practitioners and athletes themselves, but this should be on a very wide scale, i.e. at national level.

Arrhythmias, Cardiac↗
PubMed1989

Idiopathic epiretinal membranes. Ultrastructural characteristics and clinicopathologic correlation.

Current theories of idiopathic epiretinal membrane (ERM) pathogenesis, based mainly on clinical and autopsy studies, emphasize a glial tissue origin. The clinical and ultrastructural features of 101 cases of idiopathic ERMs removed from the macular area during vitrectomy were studied. The predominant cell type was retinal pigment epithelium (RPE) in 51 cases, fibrous astrocytes in 29 cases, fibrocytes in 14 cases, and myofibroblasts in 7 cases. Features of myofibroblastic differentiation were present in 64 cases. Myofibrocytes were more common in younger patients with shorter duration of symptoms. Fibrous astrocytes were more common in females. The high incidence of RPE cells in this series raises new questions regarding the pathogenesis of idiopathic ERMs.

Adolescent↗
PubMed1989

The predictive relationship between beliefs, attitudes, intentions and secondary school mathematics learning: a theory of reasoned action approach.

This study investigated how attitudes and intentions about learning mathematics might be related to subsequent mathematics learning and achievement using the Ajzen and Fishbein theory of reasoned action. The sample consisted of 142 boys and girls between 12 and 14 years old in a large inner city comprehensive school who were assessed in a follow-up design over a nine-month period. Beliefs about the outcomes of learning, attitudes to learning, perceptions of significant others' prescriptions about learning, intentions to engage in learning behaviours, self and teacher reported learning behaviour and mathematics achievement were assessed at both stages. Regression analysis suggested that while the expectancy-value components of attitude did relate to learning behaviour intentions, perceived prescriptions did not relate to intentions. There was a weak relationship between the two measures of learning behaviour, but with neither measure did intention independently predict future behaviour once prior behaviour was taken into account. The best predictor of subsequent mathematics achievement was prior achievement, though teacher-reported learning behaviour did have an independent relationship with subsequent achievement. The findings are discussed in terms of the assessment of learning behaviours, the relevance of the behaviour intention construct for repeated multiple behaviours and future work on how affective variables might be related to cognitive achievements.

Achievement↗
PubMed1989

[A study of prescriptions for psychotropic drugs at a French psychiatric hospital].

The prescribing habits were studied in a psychiatric hospital which provides services for one district of Paris. The sample consisted of 175 inpatients. A mean of 2.1 psychotropic drugs was prescribed per patient, and more than two-thirds received two psychotropic drugs or more. Almost one-half had a PRN order. Major tranquilizers were frequently used in patients not having a psychotic disorder and were associated to anticholinergic drugs in 55% of the cases. Factors associated with drug prescriptions were diagnosis, age and unit of treatment. Our results are similar to those of previous studies on excessive polypharmacy. The discussion draws attention on the need to obtain data on the rationale for prescribing and the response to treatment. Emphasis is placed on the potential usefulness of studying drug prescriptions for psychiatric practice.

Adolescent↗
PubMed1989

[The risk of sudden death in sports practice--can it be diagnosed and reduced?].

The sudden death of a sportsman in full action is fortunately rather uncommon. Nevertheless, it is all the more frightening, as it befalls unexpectedly someone who is seemingly in full health. Moreover, this type of accident, essentially a cardiac event, strikes more often competitive athletes than leisure sportsmen, who are submitting themselves to more moderate exertions. The mechanism leading to death is in most cases a heart rhythm problem ending in ventricular fibrillation. Its origins are generally a cardiomyopathy or an inborn structural anomaly of the heart in young subjects. In men over 30 years of age, most deaths can be explained by degenerative coronary disorders. It is important to note that 93% of sudden death victims related to exertion in sports are men, even if women form 45% of practising sports people. A large part of the decreased had already a functional disorder, often angina, before the tragic event took place. 38% of this group even took medical advice from a cardiologist. We may thus consider that a fraction of these deaths could be prevented through diagnosis and subsequent treatment. Therefore, sports people should be better informed on the risks they incur in not taking care of themselves. This information has to be distributed on a large scale. With regard to the other cases, we should examine which detection tests are to be discussed and used. They may involve a financial problem, but should nevertheless be considered carefully.

Adult↗