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Biomedical subjects

S Morrison

Publications and source records attributed to S Morrison.

69 records · Page 4Linked to original sources
PubMed1976

Efficacy of cardioselective beta adrenergic blockade with intravenously administered tolamolol in the treatment of cardiac arrhythmias.

The efficacy of tolamolol, a cardioselective beta adrenergic blocking agent, was evaluated in the treatment of cardiac arrhythmias in 27 patients. Nineteen patients had supraventricular arrhythmias and eight had ventricular arrhythmias. Evaluation was by doulbe-blind randomized trial in 23 patients. Tolamolol was effective in reducing ventricular rate in 17 (85 percent) of 19 patients with supraventricular arrhythmias and resulted in conversion to sinus rhythm in 2 of the 17. The mean ventricular rate in 17 patients decreased from 135 to 102/min 10 minutes after initiation of administration of tolamolol and gradually decreased further to 93/min after 60 minutes. Reduction in ventricular rate was sustained for 2 hours of monitoring undergone by all patients and for 4 and 6 hours monitoring in two subgroups. Among the eight patients with ventricular ectopic beats, tolamolol reduced their frequency in four patients and had no effect in four. Six patients had chronic obstructive pulmonary disease and experienced no adverse clinical effects on respiratory function in association with administration to tolamolol. Untoward effects occurred in 10 patients, including hypotension in 3, 1 of whom required vasopressor therapy. Other side effects were sedation, nausea, dyspnea and warmth in the chest, all of which were mild and transient, requiring no treatment. Cardioselective beta adrenergic blockade with tolamolol was highly effective in controlling ventricular rate in supraventricular arrhythmias and reduced the frequency of ventricular ectopic beats in half of the small group of patients with this arrhythmia. It is particularly applicable in patients with obstructive pulmonary disease in whom cardiac beta adrenergic blockade is indicated. Hypotension is an important potential side effect.

Adrenergic beta-Antagonists↗
PubMed1976

Comparative effects of morphine, meperidine and pentazocine on cardiocirculatory dynamics in patients with acute myocardial infarction.

The cardiocirculatory effects of the commonly used parenteral analgesics, morphine sulfate 15 mg, meperidine hydrochloride 100 mg and pentazocine 60 mg, each administered intravenously, were compared in 12 patients with acute myocardial infarction during cardiac catheterization and by echocardiogram. No untoward hemodynamic effects occurred following the administration of morphine or meperidine. In contrast, pentazocine produced significant (p less than 0.01 to less than 0.05) increases in systemic and pulmonary arterial pressures, left ventricular filling pressure, systemic vascular resistance, and systolic and diastolic dimensions; and decreases in left ventricular ejection fraction and mean velocity of circumferential fiber shortening. These deleterious actions of pentazocine appeared due to peripheral vasoconstriction and negative inotropic properties. Further, pentazocine-induced increases in left ventricular preload and afterload increased myocardial oxygen demands. Since this study demonstrates that pentazocine is hazardous in myocardial infarction, morphine and meperidine are the preferred analgesics in this condition.

Adult↗
PubMed1972

Too many tests?

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Clinical Laboratory Techniques↗
PubMedDate not supplied

When is echocardiography unreliable in patients undergoing catheterization for pediatric cardiovascular disease?

Technologic advances in echocardiography (e.g., better spatial resolution, Doppler, and color flow mapping) have improved our ability to demonstrate anatomy and physiology in previously problematic conditions, precluding catheterization and angiography in some instances. However, diagnostic catheterization remains necessary in other instances. The aims of this study were to determine whether echocardiography alone was sufficient to delineate the anatomic and flow abnormalities in patients subsequently selected to undergo catheterization and, if not, under what circumstances was echocardiography unable to establish the definitive diagnosis. Echocardiograms of 252 infants and children who underwent catheterization during a 14-month interval were analyzed retrospectively to determine whether the echographic assessment was nondiscrepant (group 1) or discrepant (group 2) with the catheterization assessment. Any deviation in the complete accurate assessment constituted a discrepancy; identification of more than one discrepancy in a single patient was possible. Independent variables included patient's age, weight, operative status, use of color flow mapping, echocardiograph operator, and interval between echocardiogram and catheterization. To determine whether the discrepancies were clinically significant, data from patients in group 2 were reviewed independently by three cardiologists to determine whether patient management would have changed given the added data provided by catheterization. Echocardiographic evaluations were discrepant in 155 instances. In 54 of 155 instances (35%), discrepancies were judged to be clinically significant (group 3). Twenty-three of 54 cases (43%) involved extracardiac lesions (i.e., aortic arch, pulmonary arterial, bronchial collateral, and pulmonary venous anomalies), 20 of 54 (37%) involved pressure gradients, 7 of 54 (13%) involved intracardiac lesions, and 4 of 54 (7%) involved coronary arterial lesions.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Pneumopericardium in very low birth weight infants.

The objective of this study was to describe the incidence, neonatal correlates, and outcome of pneumopericardium (PPC) in very low birth weight (VLBW) < or = 1.5 kg infants. Forty-seven VLBW infants with a PPC, born during 1977 to 1989, were compared with a cohort of 1302 ventilated VLBW infants. PPC developed in 2% of 2389 VLBW infants and 3.5% of 1349 ventilated infants. The mean birth weight (1008 +/- 220 gm), and mean gestation (27 +/- 2 weeks) of the PPC cohort was similar to the control cohort. Thirty-two (68%) of the infants with PPC were male, compared with 691 (53%) of the ventilated infants (p < 0.05). Eight (17%) of the infants with PPC survived, compared with 780 (60%) of the control cohort (p < 0.00001). The oxygenation index significantly increased before PPC, and was significantly higher in nonsurvivors than survivors. Four (50%) of the PPC survivors had neurodevelopmental impairment at 20 months, compared with 35% of the control cohort. Pneumopericardium is a rare event with high morbidity and mortality. Clinicians should suspect this diagnosis in VLBW infants with a rising oxygenation index and subsequent acute deterioration.

Female↗