PubMed Health⌕ Search

Biomedical subjects

S Spitzer

Publications and source records attributed to S Spitzer.

At least 19 recordsLinked to original sources
PubMed1992

Effects of anger on left ventricular ejection fraction in coronary artery disease.

This study examined the comparative potency of several psychological stressors and exercise in eliciting myocardial ischemia as measured by left ventricular (LV) ejection fraction (EF) changes using radionuclide ventriculography. Twenty-seven subjects underwent both exercise (bicycle) and psychological stressors (mental arithmetic, recall of an incident that elicited anger, giving a short speech defending oneself against a charge of shoplifting) during which EF, blood pressure, heart rate and ST segment were measured. Eighteen subjects had 1-vessel coronary artery disease (CAD), defined by greater than 50% diameter stenosis in 1 artery as assessed by arteriography. Nine subjects served as healthy control subjects. Anger recall reduced EF more than exercise and the other psychological stressors (overall F [3.51] = 2.87, p = .05). Respective changes in EF for the CAD patients were -5% during anger recall, +2% during exercise, 0% during mental arithmetic and 0% during the speech stressor. More patients with CAD had significant reduction in EF (greater than or equal to 7%) during anger (7 of 18) than during exercise (4 of 18). The difference in EF change between patients with CAD and healthy control subjects was significant for both anger (t25 = 2.23, p = 0.04) and exercise (t25 = 2.63, p = 0.01) stressors. In this group of patients with CAD, anger appeared to be a particularly potent psychological stressor.

Anger↗
PubMed1991

Clinical pharmacology education in a division of cardiology.

A working model of how clinical pharmacology education can be interwoven into the matrix of an academic cardiology program that includes didactic teaching, clinical research, and patient care has been presented. Essential to the success of such a program is the commitment and dedication of both its full-time and voluntary faculty. Moreover, a comprehensive plan of organization and allocation of efforts is vital to the success of such a complex undertaking. As we look to the future, the discipline of clinical pharmacology will be increasingly relevant to the practicing cardiologist.

Cardiology↗
PubMed1991

Loss of atrial signal detection with increasing sensitivity settings: a software problem and its practical solution.

A logic error in the software of Cosmos II results in apparent malsensing of atrial signals at high rather than low sensitivity settings. The paradoxical function was found in 54 out of 87 units tested (= 62%) if the atrial sensitivity was increased and in 54 out of 87 units tested (= 62%) if the atrial sensitivity was increased and the ventricular refractory period was lengthened beyond critical limits that could be defined individually. The problem inherent in both unipolar (66%) and bipolar systems (54%) is attributed to a summation of a physiological signal and internal noise, which has to be detected at the atrial level within a specific timing window to disable atrial sensing for the next pacing cycle. The malfunction virtually disappears if the ventricular refractory period does not exceed 210 msec. It is recommended, therefore, that Cosmos II pacemakers be left at their nominal ventricular refractory value (200 msec).

Adult↗
PubMed1991

[Hyper- or isovolemic hemodilution in patients with stage II peripheral arterial occlusive disease].

The influence of hyper- and isovolaemic hemodilution using HES 200/0.5 6% (HES steril, Fresenius AG) on pain-free walking distance in patients with peripheral arterial occlusive disease stage II according to Fontaine was tested in a randomised investigation involving three groups. The increase in pain-free walking distance was significant both in the hypervolaemic and isovolaemic hemodilution group. The increase in both dilution groups did not differ but compared to a control group (infusion of Ringer lactate) it was significantly higher. Considerable changes concerning rheological parameters (decrease in haematocrit and plasma viscosity) were observed after isovolaemic hemodilution.

Adolescent↗
PubMed1991

[Hemorheologic and circulatory effects of hemodilution with medium molecular weight hydroxyethyl starch in two concentrations (HAES 200/0.62 10% and 6%)].

This study was designed to investigate whether the positive effect occurring after infusion of a 10% hydroxyethyl starch solution 200.000/0.62 on cutaneous capillary blood flow could still be increased by using a 6% solution having a lower initial viscosity (HES 6% 200.000/0.62). A single blind study of 10 female volunteers was carried out to study the influence of a hypervolemic hemodilution using 500 ml of a 10% solution hydroxyethyl starch solution at first and that of 6% hydroxyethyl starch solution on macro- and microcirculation, transcutaneous oxygen partial pressure and blood fluidity. After hydroxyethyl starch infusion blood flow in the macro- and microvessels increased significantly. This increase occurred considerably earlier after administration of 6% solution than after infusion of 10% solution. Thus blood flow had already increased after 1 hour and continued to show a tendency of increase over about three hours. 6 hours after end of infusion blood flow had almost dropped to its initial value. The volume effect of the 6% solution immediately after infusion was less pronounced than that after infusion of the 10% solution, but it reached the value of the 10% solution at a later point in time. The course of the haematocrit reflected this process. Average decrease in haematocrit value compared to that following the 10% solution was not as pronounced at hour 3. After 6 hours the decreases were comparable. Similar observations were made of plasma viscosity and platelet aggregation. One hour after infusion plasma viscosity and erythrocyte aggregation had hardly changed but haematocrit had clearly dropped. Thus, blood viscosity at this point in time was essentially lowered.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Haemodilution with medium molecular weight hydroxyethyl starch in patients with peripheral arterial occlusive disease stage IIb.

The basic therapy of peripheral arterial occlusive disease stage IIb, according to Fontaine, is exercise. It should be determined whether a mild hypervolaemic haemodilution with hydroxyethyl starch or Ringer lactate can produce a further increase in walking distance. For this purpose, three groups of 25 patients each were formed. One group exercised three times weekly and the second group, in addition to exercise, underwent a mild hypervolaemic to isovolaemic dilution therapy with HES for a period of 6 weeks. In the final group the haematocrit was reduced to the same extent by venesections and volume substitution using Ringer lactate. The walking distance in the HES group increased from 216 m to 311 m (44%), in the Ringer lactate group from 214 m to 258 m (20%), and in the exercise group from 213 m to 242 m (14%). On comparison of the groups, the increase in pain-free walking distance in the HES group differs significantly (P less than 0.05) from that achieved in the other groups. It was demonstrated that haemodilution with HES in combination with exercise brings about a clinical effect three times that achieved by exercise alone. Venesection with subsequent administration of Ringer lactate and exercise is superior to exercise alone but markedly inferior to the combination therapy with HES.

Adult↗
PubMed1990

Posture, place, and mood effects on ambulatory blood pressure.

Ambulatory blood pressure was studied as a function of posture, place, and mood in 131 subjects classified according to race, gender, and hypertensive status. The effect of posture was significant and explained a substantial proportion of within-subject variability. After controlling for posture, significant place and mood effects were observed when subjects were sitting but not when they were standing. Home vs. work differences in both systolic and diastolic blood pressure were significantly greater in Whites than in Blacks. Similar differences in systolic blood pressure were greater in mild hypertensive than in normotensive subjects. The results of this study underscore the need to control for effects of posture when interpreting ambulatory blood pressure readings.

Adult↗
PubMed1990

[The clinical rheological laboratory].

To quantify the fluidity of blood it is not suitable to measure whole blood viscosity as blood is no Newton's fluid. For this reason, it is necessary to measure characteristic blood flow parameters direct. This study presents methods of measurement for plasma viscosity, haematocrit, thrombocyte aggregation, erythrocyte rigidity, erythrocyte aggregation and leukocyte adhesivity.

Blood Viscosity↗
PubMed1990

[Third replacement of the tricuspid valve in combined aortic-tricuspid defect].

The implantation of valvular prostheses in tricuspid position is problematic due to the slow blood flow in the low-pressure system with the risk of valvular thromboses. Today there are prostheses with supportable low transvalvular gradients; nevertheless, the risk of valvular thromboses is, in spite of anticoagulation, increased by using mechanical prostheses in tricuspid position. We report on a 51-year-old woman in whom a dysfunction of the Starr Edwards ball prosthesis 15 years after its implantation in the tricuspid position was diagnosed. The prosthesis, which was unable to function due to connective tissue proliferation, was replaced by a St. Jude Medical prosthetic valve, which also presented a disturbed function a few days after the implantation. Because of a suspected valve thrombosis the patient was treated with rt-PA-lysis which proved to be ineffective. Thus it was inevitable to implant a third tricuspid valve; this time a bioprosthesis was used.

Aortic Valve↗
PubMed1978

Immunological profile in sarcoidosis patients. The in vitro and in vivo effect of thymic humoral factor.

A study was made of the lymphocytes obtained from 25 patients suffering from sarcoidosis as proved by the Kveim-Siltzbach test and/or organ biopsy. The number of T lymphocytes was determined by the E rosette technique and functional activity by a local xenogeneic graft-versus-host reaction (GVHR) as well as skin tests with PPD, SK-SD, Candida and Trichophyton. In most cases the absolute number of T cells was low and there was an evident impairment of their functional activity. There was also a clear correlation between the severity of impairment of cell-mediated immunity and the clinical stage and activity of the disease. In vitro incubation of the lymphocytes with thymic humoral factor resulted in recovery of the functional activity of the T lymphocytes of 4 of the 7 patients tested, with the previously negative GVHR becoming positive. One of these patients was treated with thymic humoral factor with a resulting restoration of the cell-mediated immune response although there was no evident clinical improvement.

Graft vs Host Reaction↗
PubMed1976

Disodium cromoglycate in the treatment of seasonal and perennial rhinitis.

The efficacy of a 2% solution of disodium cromoglycate was evaluated in 15 patients suffering from seasonal rhinitis and 24 patients suffering from perennial rhinitis. DSCG proved to be highly effective in the seasonal group where pollen was demonstrated to be the cause but gave relief only in some atopic patients of the perennial group.

Adolescent↗