Biomedical subjects

S Reinhart

Publications and source records attributed to S Reinhart.

6 recordsLinked to original sources

PubMed1990

Syndrome of diminished vasodilator reserve of the coronary microcirculation (microvascular angina or syndrome X): diagnosis by combined atrial pacing and thallium 201 imaging--a case report.

Patients with angina-like chest pain without evidence of epicardial coronary artery disease or coronary arterial vasospasm are becoming increasingly recognized. These are often related to noncardiac causes including esophageal, musculoskeletal, and hyperventilatory or panic states. However, recently a subgroup of such patients are being recognized as having true myocardial ischemia and chest pain on the basis of diminished coronary microvascular vasodilatory reserve (microvascular ischemia or Syndrome X). The authors describe such a patient who was found to have replication of anginal pain associated with a reversible ischemic defect on thallium 201 imaging during atrial pacing, suggesting ischemia in this myocardial segment. Resolution of angina and ST segment electrocardiographic changes of ischemia occurred with cessation of pacing. We believe this is the first report of a patient with this form of myocardial ischemia diagnosed by this method and should be considered in patients with anginal chest pain after significant coronary artery disease and coronary vasospasm have been excluded.

Angina Pectoris↗

PubMed1987

Static exercise with congestive heart failure and the response to vasodilating drugs.

The hemodynamic response to static exercise in 28 patients with congestive heart failure (CHF) was compared with that in 8 control subjects. Static handgrip exercise at 50% of the maximal voluntary contraction was performed to fatigue. In patients with CHF, pulmonary arterial wedge pressure increased from 20 +/- 18 to 31 +/- 10 mm Hg (p less than 0.001) (mean +/- standard deviation) and systemic vascular resistance increased from 1,730 +/- 454 to 2,151 +/- 724 dynes s cm-5 (p less than 0.001). Although cardiac index did not change significantly, stroke volume index and stroke work index decreased from 24 +/- 6 to 20 +/- 6 ml/m2 (p less than 0.001) and 28 +/- 11 to 25 +/- 12 g-m/s2 (p less than 0.05), respectively. In control subjects, pulmonary arterial wedge pressure did not change significantly; cardiac index increased from 3.6 +/- 0.3 to 4.0 +/- 0.4 liters/min/m2 (p less than 0.05) and systemic vascular resistance increased slightly, from 1,011 +/- 186 to 1,106 +/- 180 dynes s cm-5 (p less than 0.05). The effects of arterial dilation with hydralazine on the response to static exercise were assessed in 10 of the patients with CHF. Compared with predrug exercise, cardiac index increased 68% (p less than 0.01), stroke volume index increased 76% (p less than 0.01) and systemic vascular resistance decreased 47% (p less than 0.01) after administration of hydralazine. Thus, static exercise can have adverse effects on cardiac performance in patients with CHF.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1985

An acute hypertensive response after intravenous use of a new pentazocine formulation.

We present the case of a 27-year-old woman with a history of drug abuse. Following her routine intravenous (IV) injection of solubilized pentazocine and tripelennamine tablets ("Ts and Blues"), the patient developed severe hypertension, a finding not characteristic of either drug alone or of the combination. The manufacturers of Talwin (pentazocine) recently have added naloxone to the tablets to discourage IV abuse of this oral preparation. Our patient unknowingly had injected the new pentazocine formulation, and she subsequently developed narcotic withdrawal symptoms. Her hypertension was treated, and she was discharged from the emergency department. We report the case as an "unusual reaction" that may develop in frequent abusers of pentazocine and its combinations.

Adult↗

PubMed1985

The epidemiology of spina bifida in south-western Ohio--1970-1979.

Multiple epidemiological variables of 131 children with spina bifida born during 1970 and 1979 in a seven-county urban/rural region of south-western Ohio were analyzed retrospectively via personal interviews, hospital and clinic records, and birth and stillbirth certificates. The estimated incidence of spina bifida was 0.69/1000. It did not vary over the 10 years, seasonally, or in the urban vs. rural areas. The incidence for whites was three times that for non-whites. Reporting of spina bifida on the birth certificate was found for 52 per cent. Fetal loss in the children's mothers was similar to that for controls. However, there was a high number of therapeutic abortions just prior to the conception of the child with spina bifida. Oral contraceptives were used in the early months of the affected pregnancy more frequently than in controls. Recurrence risk was 3.2 per cent. Almost 12 per cent of the children with spina bifida had other major malformations. Even when the deceased probands were discounted, the malformation rate was higher than in the general population. Siblings of affected children had a less impressive but still increased rate of malformations.

Abnormalities, Multiple↗

PubMed1984

Effect of 30% sodium sulfacetamide on corneal sensitivity.

This study compares the effect of 10 and 30% sodium sulfacetamide on corneal sensitivity. The corneal sensitivity was measured on 11 subjects with a Cochet -Bonnet aesthesiometer without any drug, 10 and 30% sodium sulfacetamide . The results obtained for the mean corneal sensitivities (mean +/- standard error) for the control, 10 and 30% sodium sulfacetamide were 1.07 +/- 0.025, 1.09 +/- 0.023, and 1.36 +/- 0.10 gm/mm2, respectively. We found that there was no statistical difference between the control value and 10% sodium sulfacetamide , but the 30% produced a significant decrease in corneal sensitivity when compared to the control and 10% concentration.

Cornea↗

PubMed1982

Type and timing of permanent pacemaker failure.

Availability of lithium batteries will decrease the incidence of early pacemaker failure. Pacemaker malfunction, exclusive of that due to battery exhaustion, can still occur. Defined as any repeat surgical procedure required after initial implantation, pacemaker system failure occurred in 22 of 115 (19 percent) pacemaker patients. Failure occurred within the first month in 12 with ten being lead-related. Insertion site problems occurred in nine patients. Though most endocardial pacemaker complications occur early, patients continue to be at risk for as long as the units are in place. Despite improvements in the batteries, there continue to be sufficient problems with pacemakers to emphasize the need for selectivity in determining which patients receive permanent units.

Adult↗