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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effects of Ca++ and Mg++ infusion on the cardiovascular system were studied in 96 normotensive subjects and 85 hypertensive patients. The results obtained were as follows: (1) The effects of Ca++ infusion on the systolic time intervals were characterized by the shortening of QS2I, PEPI, and ICT, and increase in ET/PEP. The responses of the systemic hemodynamics were elevation of mean blood pressure and increase in cardiac index and stroke index. The heart rate was not altered. (2) These results support that Ca++ has a positive inotropic action and increases the left ventricular performance. (3) The effects of Mg++ infusion on the systolic time intervals were characterized by the prolongation of QS2I, PEPI, and ECT. The responses of systemic hemodynamics were elevation of mean blood pressure and increase in heart rate. The ET/PEP and cardiac index tended to decrease, but these changes were not significant. (4) From these results it is suggested that Mg++ depress myocardial contractility and has a positive chronotropic action. (5) There were no significant differences in the systolic time intervals and hemodynamic responses to the infusion of Ca++ and Mg++ between normotensives and hypertensives.
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PMID:The effects of infusion of calcium and magnesium ions on the cardiovascular system in man. 65 Sep 6

Coronary and systemic circulations, and contractility and oxygen consumption of the left ventricular myocardium were depressed as arterial enflurane concentration increased in acute experiments with 22 adult mongrel dogs. Uneven transmural blood flow in the left ventricular free wall did not appear and the inner/outer ratio remained near 1.0 until a very deep stage of the anesthesia was attained and as far as diastolic aortic pressure was maintained above 40 mmHg, according to the microsphere injection study. Once diastolic pressure fell below 35--40 mmHg, the ratios started to be reduced significantly. When arterial enflurane content reached 53.0 +/- 2.1 mg/100 ml (mean +/- s.e.), the ratio became 0.84 +/- 0.08 (p less than 0.001), and simultaneously calculated DPTI/TTI ratio also showed a significant redution from the control (0.79 +/- 0.03, p less than 0.001). The I/O and DPTI/TTI ratios, however, did not correlate significantly with each other until very deep enflurane anesthesia was attained. The lower limit of autoregulation of coronary vascular bed was suggested to be near 35--40 mmHg of diastolic aortic pressure during deep enflurane anesthesia in the dog. Among systolic time intervals measured directly during the study, PEP and ICT showed significant negative correlations with Vmax and LV dp/dt max, while LVET neither changed nor correlated significantly with stroke volume or other parameters representing myocardial contractility during the course of enflurane anesthesia.
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PMID:Enflurane-induced hypotension modifies transmural blood flow distribution in the canine left ventricle. 73 52

Systolic time intervals and the a/H ratio were recorded in 20 patients with uncomplicated acute myocardial infarction over a period of five days. The initial high heart rate and systolic blood pressure and the short PEP and ICT indicating a sympathetic overactivity were spontaneously normalized during the first week of infarction. LVET was reduced indicating a fall in stroke volume and the a/H ratio was unchanged at the high levels suggestive of elevated preload or LVEDP. In 10 patients with acute myocardial infarction and recurrent chest pain recordings on noninvasive parameters were made before and 30 min after intravenous injection of practolol. In addition, 7 patients with chest pain, classified as acute myocardial infarction, were given practolol. The average dose of practolol was 17.9 mg ranging from 5 to 30 mg. An almost immediate and pronounced relief of pain was observed in all patients and no signs of impaired left ventricular function appeared. The product of systolic blood pressure and heart rate was decreased by practolol and the PEP and the ICT were prolonged to normal values while no changes were seen in LVET and a/H ratio. On 126 occasions practolol was given in dosages ranging from 5 to 30 mg (mean 8 mg) to 75 patients with acute myocardial infarction and recurrent chest pain. A satisfactory pain relief was seen on 108 occasions. It is suggested that an inappropriate sympathetic overactivity is an important factor in provoking recurrent chest pain in acute myocardial infarction. Administration of the beta-adrenergic blocking agent practolol resulted in pain relief due to reduction of heart work and in severity of myocardial ischemia. The beta-blocking agent was well tolerated in the present study. Continuous beta-blockade during the whole hospital stay to patients with acute myocardial infarction seems to be a very attractive therapy in order to preserve the ischemic myocardium and limit the size of infarction.
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PMID:Effect of cardioselective beta-blockade on heart function and chest pain in acute myocardial infarction. 106 28

The acute effects of ethanol (ETOH) on cardiac function in 32 normal subjects has been studied utilizing systolic time intervals. Seven (group I) 13 (group II), and 12 subjects (group III), reported an average daily consumption of less than 1 oz, 1-2 oz, and more than 2 oz of ETOH, respectively. Progressively higher control values from group I to group III in PEP, PEPI, ICT and PET/LVET were observed (PEP-I vs PEPI-III: P smaller than 0.05; PEP/LVET-I vs PEP/LVET-II and PEP/LVET-III: P smaller than 0.05). There was progressively less change in these variables following acute ETOH (P smaller than 0.02-0.05 in group I; P equals NS in group III, group II intermediate). This indicates some degree of chronic myocardial impairment in group II and especially in group III, which tends to be proportionate to the degree of chronic ETOH exposure. These data are not necessarily disparate with previous reports of little or even a salutary hemodynamic effect of ETOH in normal subjects. Thus, the relative stability of LVET post ETOH, coupled with the observed increase in heart rate, is consistent with previous reports of ETOH-induced rate-dependent increments in cardiac output with unchanging stroke volumes, in spite of the presence of acute myocardial depression. The observations reported herein demonstrate the probable incremental influence of ETOH consumption in a chain of events which may culminate in alcoholic cardiomyopathy.
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PMID:The basis for differences in ethanol-induced myocardial depression in normal subjects. 113 3

The effects of intravenous disopyramide phosphate on myocardial function were evaluated by non-invasive indices of cardiac performance (systolic time intervals, STI) in 15 patients with atherosclerotic heart disease and different degrees of cardiac failure. Disopyramide (1.5 mg/Kg) was given intravenously over a period of 5 min. This drug induced in patients in I-II classes of NYHA a significant decrease of LVETc, while PEP, ICT, and PEP/LVET ratio rose significantly. STI were affected much more markedly in patients in III-IV classes of NYHA. Particularly affected were contractility indices (PEP, ICT, PEP/LVET), which were reduced significantly more in patients in III-IV classes as compares to patient in I-II classes. In contrast, LVETc, which correlates to stroke volume and cardiac output, was similarly worsened by the drug in the 2 groups of patients. Therefore, this study shows that disopyramide has relevant depressant effects on myocardial performance, simultaneously reducing stroke volume and contractility, and that the effect on contractility is more marked in patients with severe left ventricular impairment.
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PMID:Effects of intravenous disopyramide on myocardial function in patients with different degrees of cardiac failure. 737 60

We analyzed Doppler echocardiographic data in 120 subjects with normal sinus rhythm; normals (NL, n = 60, ages 54.1 +/- 15.1) and essential hypertensive patients (HT, n = 60, ages 57.3 +/- 10.2). The IMP was calculated as follows: IMP = (ICT + IRT)/ET, ICT; isovolumic contraction time, IRT; isovolumic relaxation time, ET; ejection time. There were no significant differences in ejection fraction (EF), stroke volume index (SVI), cardiac index (CI), ET and ICT between NL and HT. There were, however, significant differences in deceleration time (DT), E/A ratio, IRT and the IMP between the two groups (199.5 +/- 45.6 msec vs 222.3 +/- 54.3 msec, p < 0.01; 1.4 +/- 0.7 vs 0.9 +/- 0.2, p < 0.01; 113.6 +/- 30.2 msec vs 134.2 +/- 29.6 msec, p < 0.01; 0.6 +/- 0.1 vs 0.8 +/- 0.3, p < 0.05). In HT, there were no differences in EF, SVI, CI, E/A ratio and DT between the NYHA I (Gp I, n = 36) and II (Gp II, n = 24) groups. However, ET of Gp II was significantly shorter than that of Gp I (259.4 +/- 43.5 msec vs 297.8 +/- 33.6 msec, p < 0.01). ICT, IRT and the IMP were significantly increased in Gp II, compared to those of Gp I (64.4 +/- 23.9 msec vs 89.4 +/- 46.2 msec, p < 0.05; 120.3 +/- 21.0 msec vs 155.2 +/- 28.5 msec, p < 0.001; 0.6 +/- 0.2 vs 1.0 +/- 0.4, p < 0.001). There were no differences in heart rate and mean blood pressure between Gp I and Gp II (70.9 +/- 11.4/min vs 66.3 +/- 11.4/min, p > 0.05; 138.4 +/- 21.2 mmHg vs 131.3 +/- 19.9 mmHg, p > 0.05). These data suggest that the IMP may be a useful parameter and an early indicator of left ventricular dysfunction in essential hypertensive patients with normal systolic function.
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PMID:Index of myocardial performance using Doppler-derived parameters in the evaluation of left ventricular function in patients with essential hypertension. 982 94

The Dutch national ICT institute in healthcare (www.nictiz.nl) developed a domain information model for perinatology, to map to the Health Level 7 Reference Information Model (HL7 RIM). This model was constructed with the intention to make it reusable for other domains in order to achieve a national infrastructure based on the HL7 RIM. In two projects, the perinatology model was reused, which lead to some changes to better express the domain. It proves valuable to have a kind of generic domain model, which can be adapted easily to other domains. In these projects, information for hart infarction (cardiology) and stroke (neurology) was modelled. Few domain specific changes where necessary, which could be made following the same methodology. Both the models and the methodology prove to be re-usable.
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PMID:Model once, use multiple times: reusing HL7 domain models from one domain to the other. 1536 Aug 36

This article reports on the project management and Culture Change Programme adopted by the NHS Greater Glasgow Health Board to deliver an electronic patient record (EPR) to support cardiology and stroke clinical services. To achieve its vision for the EPR (;to "really make a difference" to patient care by providing to the right person, the right information, under the right safeguards') the Board recognized that attending to social and organizational issues is at least of equal importance to addressing strictly technical concerns. Consequently, an ICT Culture Change Programme (ICT CCP) was devised and implemented to assist in the management of change, and in particular to facilitate a visionary clinical and cultural environment operating in conjunction with the evolving technical environment. In this article we describe the key components of this approach, outline the benefits we believe have accrued, and describe the steps being taken to build upon lessons learned.
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PMID:Deploying a culture change programme management approach in support of information and communication technology developments in Greater Glasgow NHS Board. 1847 99

Lifestyle is a key determinant in the prevention and management of chronic diseases. If we would exercise regularly, eat healthy, control our weight, sleep enough, manage stress, not smoke and use alcohol only moderately, 90% of type II diabetes, 80% of coronary heart disease, and 70% of stroke could be prevented. Health statistics show that lifestyle related diseases are increasing at an alarming rate. Public health promotion campaigns and healthcare together are not effective enough to stop this "tsunami". The solution that is offered is to empower people to manage their health with the assistance of ICT-enabled services. A lot of R&D and engineering effort is being invested in Personal Health Systems. Although some progress has been made, the market for such systems has not yet emerged. The aim of this critical review is to identify the barriers which are holding back the growth of the market. It looks into the theoretical foundations of behavior change support, the maturity of the technologies for behavior change support, and the business context in which behavior change support systems are used.
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PMID:Rethinking health: ICT-enabled services to empower people to manage their health. 2227 95

Monitoring physical activities during post-stroke rehabilitation in daily life may help physicians to optimize and tailor the training program for patients. The European research project INTERACTION (FP7-ICT-2011-7-287351) evaluated motor capabilities in stroke patients during the recovery treatment period. We developed wearable sensing platform based on the sensor fusion among inertial, knitted piezoresistive sensors and textile EMG electrodes. The device was conceived in modular form and consists of a separate shirt, trousers, glove, and shoe. Thanks to the novel fusion approach it has been possible to develop a model for the shoulder taking into account the scapulo-thoracic joint of the scapular girdle, considerably improving the estimation of the hand position in reaching activities. In order to minimize the sensor set used to monitor gait, a single inertial sensor fused with a textile goniometer proved to reconstruct the orientation of all the body segments of the leg. Finally, the sensing glove, endowed with three textile goniometers and three force sensors showed good capabilities in the reconstruction of grasping activities and evaluating the interaction of the hand with the environment, according to the project specifications. This paper reports on the design and the technical evaluation of the performance of the sensing platform, tested on healthy subjects.
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PMID:Wearable Textile Platform for Assessing Stroke Patient Treatment in Daily Life Conditions. 2704 39


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