PubMed Health⌕ Search

Biomedical subjects

S Reisner

Publications and source records attributed to S Reisner.

At least 19 recordsLinked to original sources
PubMed2006

Comprehensive multidetector CT assessment of apical hypertrophic cardiomyopathy.

16-slice multidetector CT (MDCT) cardiac findings of a middle-aged man with known apical hypertrophic cardiomyopathy (AHC) and recent atypical chest pain are presented. MDCT enabled comprehensive evaluation of the coronary arteries, diagnosing myocardial bridging of the left anterior descending (LAD) and first diagonal arteries. It also enabled dynamic evaluation of myocardial thickness and left ventricular global and regional function. This case illustrates the full capabilities of MDCT in the evaluation of AHC.

Adult↗
PubMed2001

Electroanatomic mapping of arrhythmogenic right ventricular dysplasia.

OBJECTIVES: We tested the hypothesis that spatial association of low-amplitude intracardiac electrograms can identify the presence, location and extent of dysplastic regions in arrhythmogenic right ventricular dysplasia (ARVD). BACKGROUND: Arrhythmogenic right ventricular dysplasia is a right ventricular (RV) cardiomyopathy characterized pathologically by fibrofatty infiltration and clinically by a spectrum of arrhythmias, sudden cardiac death and RV failure. Diagnosis of ARVD still remains a clinical challenge. METHODS: A three-dimensional electroanatomic mapping technique was used to map the RV of two groups of patients: 1) those with ARVD presenting with typical clinical, electrocardiographic and echocardiographic or magnetic resonance imaging (MRI) findings; and 2) those with structurally normal ventricles. RESULTS: The dysfunctional RV area could be identified only in the first group and was characterized by the presence of discrete areas of abnormally low-amplitude electrograms. Hence, the normal voltage values observed in the control group (unipolar: 11.9 +/- 0.3 mV; bipolar: 4.6 +/- 0.2 mV [mean +/- SEM]) and in the nonaffected zones in the ARVD group (unipolar: 10.4 +/- 0.2 mV; bipolar: 4.6 +/- 0.2 mV) were reduced significantly (p < 0.05) in the dysplastic areas (unipolar: 3.3 +/- 0.1 mV; bipolar: 0.5 +/- 0.1 mV). The pathologic process mainly involved the RV anterolateral free wall, apex and inflow and outflow tracts and ranged from patchy areas to uniform and extensive involvement. Concordance between electroanatomic findings and MRI or echocardiographic findings was noted in all patients. CONCLUSIONS: The pathologic substrate in ARVD can be identified by spatial association of low-amplitude endocardial electrograms, reflecting replaced myocardial tissue. The ability to accurately identify the presence, location and extent of the pathologic substrate may have important diagnostic, prognostic and therapeutic implications.

Adult↗
PubMed2001

Choosing an oestrogen replacement therapy in young adult women with Turner syndrome.

OBJECTIVE: Hormone replacement therapy (HRT) is prescribed to most patients with Turner syndrome (TS) although its use in adult TS patients has not been scientifically evaluated. The present study was performed to compare the short-term effects in adult women with Turner syndrome of low-dose oral conjugated oestrogen (0.625 mg, CE) with relatively high dose ethinyl oestradiol (30 microg, EE2); both combined with an oral progestin. DESIGN AND PATIENTS: After 4 months off HRT, 17 young, otherwise healthy women with TS were enrolled in a random, unblinded, crossover study of the two oestrogenic preparations, each given for 6 months. MEASUREMENTS: We compared parameters of oestrogenic activity that would cover immediate changes in hormone levels, biochemistry, bone turnover, uterine and cardiac variables, which constitute risk factors for later development of diabetes, atherosclerosis, osteoporosis and aortic dissection. RESULTS: Serum FSH returned to normal follicular phase levels only on the EE2 regimen. The hypotrophic endometria normalized with either of the two oestrogen regimens with no excessive hypertrophy. Hyperinsulinaemia was suppressed to normal by both EE2 and CE. PTH and 1,25-dihydroxyvitamin D levels increased on HRT (EE2 > CE), and phosphorus decreased. Alkaline phosphatase, osteocalcin and urinary deoxypyridinoline cross-links (DPD) were high off therapy; the former two suppressed to high-normal levels on the EE2 regimen, but not on CE, and DPD did not normalize with either HRT. Lipid profiles in these young TS patients were normal. Liver enzymes were mildly elevated off therapy and suppressed to normal levels on both regimens, but more so with EE2. CONCLUSIONS: The risk factors embodied in hyperinsulinaemia and enhanced bone turnover which, ultimately, have consequences for TS morbidity, are minimized by HRT. In the short term, neither regimen is effective for bone turnover in adult women with Turner syndrome.

Adolescent↗
PubMed1997

The role of a secondary pediatric ambulatory care service within the community.

OBJECTIVE: To describe the establishment and function of a secondary pediatric ambulatory care service within the community, to assess the utilization of a pediatric community service ("The Center"), and to assess parents' degree of satisfaction with the quality of care in the center. DESIGN: Personal information and information regarding all visits was recorded and analyzed. A structured telephone interview was used to evaluate parents' satisfaction with the quality of care in the center. SETTING: A pediatric community centre managed by board certified pediatricians. The clinic offers primary and secondary care. PARTICIPANTS: A random sampling of parents of children who visited the center (n = 615). RESULTS: The number of children treated in the center increased five-fold within three years. Most visits took place during evening hours and over the weekends. The most common presenting symptoms were fever, respiratory and gastrointestinal complaints, earache, and trauma. Eighty-nine percent of parents were satisfied or very satisfied with the quality of care in the center; 95% were satisfied or very satisfied with the attitudes of physicians and nurses providing treatment. CONCLUSION: The center is widely utilized by parents with a great degree of satisfaction. The availability and extended working hours of the center provided medical care for a large number of children seeking "after hours" medical attention, as well as a backup for the primary care physicians. The center, therefore, provides a model for improved quality of medical care within the community.

Ambulatory Care↗
PubMed1996

Intrapericardial minocycline sclerosis for malignant pericardial effusion.

STUDY OBJECTIVE: To evaluate the effectiveness and safety of minocycline hydrochloride (minocycline) intrapericardially in patients with malignant pericardial effusion. DESIGN: Consecutive patients admitted to the hospital during a 32-month period received intrapericardial minocycline. SETTING: A 900-bed university hospital. PATIENTS: Fourteen consecutive patients with malignant pericardial effusion. INTERVENTION: Following percutaneous insertion of a pericardial drain, minocycline was administered at a dosage of 10 mg/kg every 48 h until fluid drainage stopped or until further therapy was deemed necessary. MEASUREMENTS: Complications associated with therapy, total minocycline requirements, immediate and late failure of therapy, and clinical and echocardiographic follow-up of at least 6 months. RESULTS: Mean amount of minocycline administered was 1.9 +/- 1.0g given in 2.4 divided doses. Total drainage time was 5.4 +/- 2.5 days. Recurrence of malignant pericardial effusion was seen in only 1 of 14 patients. Death occurred in 10 patients due to severe metastatic disease in all. Minocycline instillation was associated with severe chest pain in seven patients, and with ECG changes suggesting pericardial or subepicardial injury in two patients. CONCLUSION: (1) Intrapericardial minocycline instillation is very effective in preventing recurrence of malignant pericardial effusion. (2) Minocycline is irritative to the pericardium and may cause severe chest pain with transient ECG changes, suggesting pericardial or subepicardial injury.

Adult↗
PubMed1994

Intracardiac mass as the initial manifestation of metastatic germ cell tumor.

Cardiac metastases as initial presentation of disseminated germ cell tumors have rarely been reported. The hematogenous route is believed to be the most common pattern of dissemination by germ cell tumour, mainly to the lung, central nervous system and liver. We report a 33-year-old patient with embryonal cell carcinoma who presented with an intraatrial metastatic mass as the initial manifestation of metastatic disease.

Adult↗
PubMed1990

Statistics of the physiologic phase of integrated backscatter from canine myocardium with normal and reduced coronary circulation.

The phase, relative to the arterial pressure, of cyclically varying integrated backscatter from canine myocardium was measured at normal and reduced coronary blood flow levels and was found to become more randomized with decreasing flow. The phase, modeled as a von Mises distribution on a unit circle which is very similar to the normal distribution on the line, is characterized by a mean (mu 0) and a concentration or width parameter (kappa). kappa is used to characterize the degree of randomization. The von Mises distribution provides an excellent fit to measured data (p less than 0.01). Hypothesis tests performed on the data for various coronary flow levels indicate that the phase distribution for normal coronary flow level is significantly different from the distributions at other flow levels (p less than 0.05). The results suggest that the parameter kappa may be used for differentiating normal and ischemic myocardium.

Animals↗
PubMed1990

Diagnostic and prognostic value of oral dipyridamole test using echocardiography.

The diagnostic and prognostic value of the oral dipyridamole test using echocardiography was evaluated in 47 consecutive patients undergoing coronary arteriography. The results of the tests were not communicated to the physicians treating the subjects during a 1-year follow-up. The test had a sensitivity of 54% and a specificity of 100% for predicting severe (greater than or equal to 70% luminal stenosis) coronary artery disease. Neither ST-T segment changes nor chest pain during the test were associated with the presence of severe coronary artery disease. In the subgroup of 34 patients with severe coronary artery disease, the appearance of left ventricular segmental systolic dysfunction or ST-T segment depression (greater than or equal to 1 mm) during the test has a strong predictive value for subsequent cardiac events during a 1-year follow-up.

Administration, Oral↗
PubMed1988

Mononuclear cells from human neonates are partially resistant to the action of 1,25-dihydroxyvitamin D.

1,25-Dihydroxyvitamin D [1,25-(OH)2D] inhibits mitogen-induced proliferation of lymphocytes by a receptor-mediated mechanism. Peripheral blood lymphocytes may serve as a model for detecting hereditary defects in the response of classical target organs to 1,25-(OH)2D. Delayed bone mineralization and deficient intestinal calcium absorption are common in low birth weight formula-fed infants. The defect in calcium absorption exists despite normal or even elevated serum 1,25-(OH)2D levels, suggesting partial end-organ resistance to the hormone. We assessed the response to 1,25-(OH)2D of activated mononuclear cells obtained from cord blood of fullterm and preterm infants and from peripheral blood of adults. We found that the inhibitory effect of 1,25-(OH)2D on mitogen-induced [3H]thymidine incorporation was significantly less [mean, 34 +/- 8% (+/- SE)] in mononuclear cells from neonates (independent of gestational age) compared to mononuclear cells from adults (66 +/- 5%; P less than 0.001). This difference in the inhibitory effect was not due to a smaller number of high affinity receptors for 1,25-(OH)2D in activated cord blood lymphocytes. We conclude that the coupling between the receptors for 1,25-(OH)2D and the biological response in neonates is less efficient than that in adults.

Adult↗
PubMed1986

Treatment of hypertension during pregnancy with hydralazine monotherapy or with combined therapy with hydralazine and pindolol.

Forty-four consecutive patients referred for treatment because of hypertension (greater than 150/90 mmHg) occurring during pregnancy were randomly allocated to one of two treatment groups, hydralazine alone (n = 21) or hydralazine combined with pindolol (n = 23). Satisfactory blood pressure control (diastolic pressure less than 90 mmHg) was achieved in 86% of patients receiving hydralazine alone and 91% of those on combined therapy. Although the treatment did not lower the overall incidence of hypertensive complications it appeared to delay the onset of such complications until successful surgical intervention was possible. Fetal outcome was similar in both groups and there was no perinatal mortality in this high-risk population. Although blood pressure control was similar in both groups of patients, combined therapy with hydralazine and pindolol can be considered to be superior to hydralazine monotherapy, since in patients treated with the combination the incidence and intensity of troublesome side-effects was markedly lower.

Adult↗
PubMed1985

Neonatal outcome of infants delivered at 26-28 weeks of gestation.

The delivery results of 42 infants born to 40 mothers at the gestational age of 26-28 weeks during a period of 5 years were analyzed. The study was evaluated in two periods of time: in the first period out of 15 infants born only 5 (33.3%) survived, while in the second period 21 (77.7%) out of 27 infants survived (p less than 0.01). 38 infants were transferred to a neonatal intensive care unit for premature infants. Only 41% of the infants transferred in the first period survived, as compared to 80.7% of those transferred during the second period (p less than 0.01). There was no significant difference in the mean birth weight at each gestational age between the survivors and those who subsequently died in both periods of the study. In the study groups, cesarean section rate rose from 13.3% in the first period to 44% in the second. Mode of delivery, regardless of the presenting part, did not seem to influence neonatal survival. Obstetrical management, including the performance of operative delivery for fetal indications and active neonatal resuscitation, seems to be reasonable for infants at the gestational age of 26 weeks or more.

Cesarean Section↗