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Diagnosis-Related Groups↗

Workload of a new district AIDS counselling unit, April 1987 to March 1988.

The Hampstead district AIDS counselling unit in London was opened in January 1987. It is staffed by a clinical psychologist, a social worker, and an administrator. From April 1987 to March 1988, 141 new patients and their relatives were referred from a range of clinical departments and 544 counselling sessions were provided. In addition, 666 staff consultations were organised to help colleagues manage some of the psychosocial problems of patients. An increase in demand during 1988-89 and a need for additional resources are anticipated. A strong case is seen for training other members of health care teams so that they may counsel patients with AIDS without referring them to the unit.

Acquired Immunodeficiency Syndrome↗

Comparative experimental study of myocardial energy metabolism during ventricular workload induced by chronic stenoses of ascendent aorta and pulmonary artery.

In this paper, an attempt was made to describe the alterations of the myocardial energy metabolism following moderate stenoses of aorta or pulmonary artery. Biochemical investigations regarding the main high energy phosphates and a large series of dehydrogenases in the myocardium of the overloaded ventricles have revealed the following facts: (1) the myocardial CP-CPK system appears to be more labile than the myocardial AMP-ATP system in response to a ventricular overload; (2) the changes in the amounts of myocardial high energy phosphates seem to be more important in the right chronic cardiac overload than in the left one; (3) before the overloaded ventricle becomes insufficient, the myocardial dehydrogenase system elicits no alteration, suggesting that the oxidative phosphorylation is not affected; (4) there is a closer relationship between the coronary flow and pressure and the myocardial energy metabolism than that existing between this metabolism and the tension of the myocardial fibres following a persistent increase in the systemic arterial resistance.

Adenosine Triphosphatases↗

A polygraphic study of systolic time intervals and their correlations with heart rate and workload during supine ergometry in one hundred normal subjects.

The present study was designed to investigate systolic time intervals (STI) in 100 normal subjects undergoing continuous-maximal supine cycle ergometry and to search for possible linear correlations between STI (dependent variables) and heart rate, diastolic blood pressure, systolic blood pressure, age, sex, weight, and height (independent variables), by stepwise regression analysis. The only significant correlation discovered in the study was between the contractility index (isometric contraction time-ICT) and the total work produced by each participant. Exercise tolerance was limited primarily by shortening of the ICT interval, all subjects discontinuing the test when ICT reached 13.7 +/- 7 ms.

Adult↗

Interaction between body size and cardiac workload: influence on left ventricular mass during body growth and adulthood.

The development of the left ventricle parallels body growth. During infancy, the relation between body size and left ventricular (LV) mass is very close. With advancing age, variability of LV mass in relation to body size markedly increases. To test the hypothesis that the age-related increase in variability of LV mass is due to the progressive impact of hemodynamic stimuli on LV growth, quantitative M-mode echocardiograms were obtained in 766 normal-weight, normotensive individuals over a range of ages from 1 day to 85 years (330 female subjects, 373 subjects younger than 18 years). LV mass was linearly related to height2.7 (r2=.69). Prediction of values of LV mass by body size was more accurate at birth and progressively less precise with increasing age. Stroke work (stroke volume times systolic pressure) was closely related to LV mass (r2=.74). The explained variance of LV mass increased from 69% in the univariate regression with height2.7 to 82% in a multivariate model including height2.7, stroke work, and gender. In children and adolescents (younger than 18 years), height2.7 was the main determinant of LV mass, whereas during adulthood stroke work and gender were more important predictors of LV mass than height2.7. Thus (1) the influence of body growth on development of LV mass decreases after early infancy because of both the variability of hemodynamic load and the increasing effect of gender; (2) after adolescence, during adulthood, in normotensive, normal-weight individuals, the impact of hemodynamic load and male gender on LV mass is greater than the one of body size; and (3) an appreciable proportion of variability of LV mass remains unexplained with the studied models. This might be due to genotypic variations and/or measurement error.

Adult↗