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Biomedical subjects

P Bach

Publications and source records attributed to P Bach.

27 records · Page 2Linked to original sources
PubMed1986

Ventricular preexcitation following catheter ablation of the His bundle in concealed WPW syndrome.

Catheter ablation of the His bundle is reported in a patient with drug-refractory supraventricular tachycardia meeting standard criteria of concealed WPW syndrome (conduction of the accessory atrioventricular pathway in retrograde direction only). After successful ablation of the His bundle, anterograde conduction along the accessory pathway, to our surprise, became apparent. During twelve months of follow-up, the patient was free of the tachycardia recurrences off antiarrhythmic drugs. While the clinical problem has been solved, the patient may--in case he should develop atrial fibrillation--present with rapid anterograde conduction via the accessory pathway. Based on this experience, better electrophysiologic protocols are needed to evaluate anterograde accessory pathway conduction properties in 'concealed' WPW syndrome, thus permitting one better to decide whether and which site of ablation should be chosen in drug-refractory cases.

Bundle of His↗
PubMed1986

Atrial natriuretic factor in plasma of patients with arterial hypertension, heart failure or cirrhosis of the liver.

Since the discovery of the atrial natriuretic factor (ANF) an endocrine function has been attributed to the mammalian heart. This function may include definition of optimal conditions for efficient performance of the heart, e.g. by reduction of afterload in hypertension or of preload and afterload in heart failure. Plasma ANF levels were measured in various cardiovascular disease states and compared with those of controls and of patients with liver cirrhosis. Plasma ANF levels in hypertensive patients were sevenfold higher than in controls, and in patients with heart failure 40-fold higher than normal values. Small differences were detected between controls and patients with cirrhosis of the liver, in spite of the impaired renal sodium handling seen in cirrhotics. Plasma ANF levels were significantly correlated with haemodynamic parameters and were inversely related to the cardiac index. Treatment with an angiotensin converting enzyme inhibitor led to a significant decrease in plasma ANF levels in parallel with the haemodynamic improvement. Preliminary chromatographic analysis suggested differences in the structure of plasma ANF between normotensive and hypertensive subjects.

Atrial Natriuretic Factor↗
PubMed1984

Lack of effect of haemodialysis on mebendazole kinetics: studies in a patient with echinococcosis and renal failure.

The effect of haemodialysis on mebendazole kinetics has been studied in a patient receiving both mebendazole therapy and haemodialysis. The procedure of haemodialysis did not influence the plasma concentration-time profiles or the mean daily plasma levels. The arterio-venous difference in the dialyser was negligible and no mebendazole could be detected in the dialysate. Protein binding of mebendazole was 90% before dialysis and 88% during dialysis and not significantly different from the binding in patients without renal disease (91.4 +/- 1.9%, n = 22).

Adult↗
PubMed1984

Haemodynamics in acute arthritis of the knee in puppies.

In order to study the haemodynamic changes of the juvenile knee in acute arthritis, an experimental model was developed in puppies by unilateral intra-articular injections of Carragheenin solution into the knee. Tissue blood flow was studied by the tracer microsphere technique in eight dogs and simultaneous intra-articular and intraosseous pressure recordings were performed in seven other dogs. The intra-articular pressure was elevated in all arthritic knees. Hyperaemia was found in the knee-joint capsule and distal femoral metaphysis, whereas juxta-articular epiphyseal blood flow rates were not significantly changed. A decrease of femoral muscle blood flow was encountered. Intraosseous pressure recordings during venous tamponade of the knee-joint capsules suggested a qualitative change of bone vasculature in acute arthritis. The juxta-articular bone blood flow in arthritis appears to be influenced by synovial hyperaemia, synovial effusion pressure, an "inflammatory resistance factor" and the anatomical relationship of the epiphyseal vessels to the knee-joint capsule.

Acute Disease↗
PubMed1981

Gastric emptying after oesophagectomy as assessed by plasma paracetamol concentrations.

Gastric emptying after oesophagogastrectomy may be affected by opposing influences. Truncal vagotomy of the orthotopic stomach, as used by surgeons for peptic ulcer, results in delayed gastric emptying. The emptying of such a denervated stomach is affected by position and posture and may result in gastric "incontinence", particularly if associated with drainage procedures. It is possible that postural effects may outweigh the reduced motility if the vagotomised stomach is transplanted into the chest as after oesophagogastrectomy. Despite the effect that disturbed gastric emptying may have on nutrition and drug absorption there have been few studies concerning patients who have had oesophageal resection or bypass. We report our preliminary experience of an indirect method to estimate gastric emptying after oesophageal resection and bypass, using the absorption profile of paracetamol (acetaminophen). This technique is safe and has been shown to reflect gastric emptying accurately in the innervated stomach. With this technique we have shown that, even in the absence of a concomitant drainage procedure, oesophageal resection, or bypass, using the denervated stomach to restore alimentary continuity does not result in any detectable delay in gastric emptying.

Acetaminophen↗
PubMedDate not supplied

[Waterborne outbreak of gastroenteritis transmitted through the public water supply].

INTRODUCTION: The chlorination of public water supplies has led researchers to largely discard drinking water as a potential source of gastroenteritis outbreaks. The aim of this study was to investigate an outbreak of waterborne disease associated with drinking water from public supplies. METHODS: A historical cohort study was carried out following notification of a gastroenteritis outbreak in Baqueira (Valle de Arán, Spain). We used systematic sampling to select 87 individuals staying at hotels and 67 staying in apartments in the target area. Information was gathered on four factors (consumption of water from the public water supply, sandwiches, water and food in the ski resorts) as well as on symptoms. We assessed residual chlorine in drinking water, analyzed samples of drinking water, and studied stool cultures from 4 patients. The risk associated with each water source and food type was assessed by means of relative risk (RR) and 95% confidence intervals (CI). RESULTS: The overall attack rate was 51.0% (76/149). The main symptoms were diarrhea 87.5%, abdominal pain 80.0%, nausea 50.7%, vomiting 30.3%, and fever 27.0%. The only factor associated with a statistically significant risk of disease was consumption of drinking water (RR = 11.0; 95% CI, 1.6-74.7). No residual chlorine was detected in the drinking water, which was judged acceptable. A problem associated with the location of the chlorinator was observed and corrected. We also recommended an increase in chlorine levels, which was followed by a reduction in the number of cases. The results of stool cultures of the four patients were negative for enterobacteria. CONCLUSIONS: This study highlights the potential importance of waterborne outbreaks of gastroenteritis transmitted through drinking water considered acceptable and suggests the need to improve microbiological research into these outbreaks (viruses and protozoa detection).

Disease Outbreaks↗