Blood pressure in infants children and adolescents.

In infants the flush and Doppler methods of blood pressure measurement are usually used. The flush method measures mean pressure; the Doppler method, systolic and diastolic pressures. Normal flush values from 1 to 12 months of age do not exceed 100 mm of mercury; Doppler systolic levels do not exceed 113 mm of mercury.

Effects of 5-thio-D-glucose on cellular adenosine triphosphate levels and deoxyribonucleic acid rejoining hy hypoxic and aerobic Chinese hamster cells.

Intracellular adenosine triphosphate (ATP) levels were measured in both hypoxic and aerobic cultures of V79 Chinese hamster cells treated with 5-thio-D-glucose (5-SH-D-Glc). This glucose analog, a known inhibitor of D-glucose transport and metabolism, reduced ATP in cell cultures allowed to become hypoxic by cell metabolism, but not in aerobic cultures treated similarly. Cells depleted of ATP were unable to rejoin x-ray-induced deoxyribonucleic acid (DNA) strand breaks as measured by the alkaline surcrose gradient sedimentation technique.

Primidone in the treatment of the long QT syndrome: QT shortening and ventricular arrhythmia suppression.

We studied a family with the long QT syndrome. The initial case was in a patient who presented with seizures, ventricular fibrillation, and syncope. After a trial of conventional modalities of treatment including left stellate ganglionectomy, primidone (Mysoline) therapy was initiated.

Frequency and complexity of ventricular ectopic beats in the posthospital phase of myocardial infarction.

This study is a descriptive report of the occurrence of ventricular arrhythmias in a large, prospectively designed follow-up study of postcoronary patients. Six-hour Holter recordings were obtained on 954 postinfarction patients prior to hospital discharge and at 4 (n = 837), 8 (n = 762), 12 (n = 713), and 24 (n = 487) months post-discharge. Ventricular ectopic beats (VEB) were quantitated by frequency and patterns at each recording, and antiarrhythmic medication usage was recorded.

Detection, significance and management of VPBs in ambulatory patients.

The detection, clinical significance, and management strategies of VPBs in ambulatory patients have been presented. VPBs can be easily detected by a variety of recording techniques, and the major risk posed by VPBs occurs predominantly in patients with complex VPB patterns and concomitant organic heart disease. Available antiarrhythmic therapy is quite limited, and efficacy, convenience, and tolerance considerations dictate a conservative approach to initiating therapy.

Prediction and prevention of sudden cardiac death.

The most common cause of SCD is coronary heart disease. Epidemiologic and pathologic studies have demonstrated the presence of chronic myocardial damage and extensive multivessel coronary disease as the substrate for SCD in ASHD. Instantaneous coronary death is an electrical event and not the result of acute coronary thrombosis.

Ventricular ectopic beats and their relation to sudden and nonsudden cardiac death after myocardial infarction.

The role of ventricular ectopic beats (VEBs) in identifying patients who die of cardiac cause in the posthospital phase of myocardial infarction was evaluated in 940 patients who survived an acute coronary event. Six-hour Holter ECG recordings were obtained before hospital discharge, and VEBs were classified as complex (bigeminal, multiform, repetitive or R on T), simple (one or more VEBs that did not have complex patterns), or not present. Patients were followed 1-60 months (average 36 months) and cardiac mortality was categorized as sudden (less than or equal to 1 hour) or nonsudden (greater than 1 hour) among 98 witnessed cardiac deaths.

Significance of protein-bound neuraminic acid levels in patients with prostatic and bladder carcinoma.

The role of plasma N-acetyl neuraminic acid (NANA) level in detection and staging prostatic and bladder carcinomas was evaluated. Multiple determinations were obtained in 73 male subjects, including normal controls, patients with prostatic or bladder carcinoma or with benign prostatic hyperplasia. Patients with prostatic or bladder carcinoma had significantly higher NANA levels than normal individuals.

Preatherosclerotic aortic lesions in cystic fibrosis.

Patients with cystic fibrosis have fat malabsorption, providing an experimental model for evaluation of the hypothesis that a low-fat intake may prevent atherosclerosis. We studied the frequency and extent of aortic precursor lesions (fatty streaks, early fibromusculoelastic lesions, late fibromusculoelastic lesions) found at autopsy in this disease as well as in other patients with debilitating disorders but with no apparent impairment of fat absorption. Fatty streaks were less common in the cystic fibrosis group, as were the late fibromusculoelastic lesions.

Atrial pacing from the coronary vein. Ten-year experience in 50 patients with implanted pervenous pacemakers.

During the past ten years, pervenous atrial pacemakers have been implanted in 50 patients (mean age 68 years, 60% males) using an electrode positioned in the coronary vein. The indications for atrial pacing were symptomatic sinus bradycardia (72%), atrial brady-tachy syndrome (20%), and recurrent tachyarrhythmias (8%). Atrial pacemakers have been implanted for a total of 1531 pacing months, average 31 months per patient, median 26 months and range 3-97 months.

Cardiac Death in the first 6 months after myocardial infarction: potential for mortality reduction in the early posthospital period.

In a prospective postmyocardial infarction study of 759 patients aged less than 66 years, 42 posthospital cardiac deaths (42 of 759; 6 percent) occurred during a 6 month follow-up period. The average age of those who died was 53.5 +/- 8.

Clinical significance of ventricular ectopic beats in the early posthospital phase of myocardial infarction.

The clinical significance of ventricular ectopic beats in the posthospital phase of myocardial infarction was studied in 272 patients aged 65 years or less who were followed up for 1 year after the infarction. Ventricular ectopic beats, identified in 6 hour electrocardiographic tape recordings, obtained before hospital discharge (study 1) and 5 months after discharge (study 2) increased in frequency and complexity in the 5 month interval. Ventricular ectopic beats at a rate of 20 or more per hour recorded before discharge were associated with complex ventricular ectopic patterns in the same 6 hour recording and with frequent (20 or more per hour), early cycle and bigeminal patterns in recordings mad 5 months later.

Cardiac disease in the wheezing child.

Cardiac and pulmonary disease are so closely interrelated that it is often difficult to determine in young infants which is the primary offender. As illustrated in these case reports, failure to recognize the true nature of the disease process may lead to unnecessary procedures and delays which can be life-threatening. Statistically, the wheezing infant very likely is suffering from primary pulmonary disease; however, congenital cardiac abnormalities can cause pulmonary symptoms which completely dominate the clinical picture and lead to erroneous diagnoses.