How ECG can cause confusion in pulmonary embolism and how echocardiogram can help.

A case of pulmonary embolism in which the diagnosis was aided by transthorasic echocardiography is described. Echocardiography may be helpful in emergency presentations, as ECG changes can be neither sensitive nor specific for the diagnosis of acute massive pulmonary embolism.

Haemostatic and haemodynamic abnormalities associated with left atrial thrombosis in non-rheumatic atrial fibrillation.

Objective: To evaluate the role of haemostatic and haemodynamic variables in left atrial thrombosis in non-rheumatic atrial fibrillation.

Design: Case-control study.

Subjects: One hundred and nine patients with non-rheumatic atrial fibrillation.

Diastolic dysfunction is not related to changes in glycaemic control over 6 months in type 2 (non-insulin-dependent) diabetes mellitus. A cross-sectional study.

Diastolic dysfunction may be the earliest marker of a diabetes-induced heart muscle disease which leads to the progressive development of cardiac failure. Left ventricular diastolic function was indirectly assessed using pulsed wave Doppler ultrasound mitral-flow velocities in 20 normotensive patients with a new diagnosis of type 2 diabetes mellitus, normal cardiac function and no evidence of coronary artery disease and in 16 age-matched normal subjects. Peak velocities of early (E) and late (A) left ventricular filling were measured.

Comparison of enalapril and atenolol in mild to moderate hypertension.

Purpose: Short-term therapy with angiotensin converting enzyme (ACE) inhibitors for hypertension is effective and well tolerated, and compared with beta blockers, may cause fewer adverse reactions. Furthermore, enalapril has been observed to have a greater effect on systolic blood pressure than beta blockers. We therefore decided to compare the ACE inhibitor enalapril and the beta blocker atenolol as monotherapy in a double-blind study of patients with mild to moderate hypertension.

Circulating adrenaline and noradrenaline concentrations during exercise in patients with exercise induced asthma and normal subjects.

A failure of the usual increase in plasma adrenaline and noradrenaline concentrations during submaximal exercise has been suggested as a contributory cause of exercise induced asthma. Six normal subjects and six asthmatic patients underwent a standard graded maximal exercise test. Measurements of oxygen consumption, minute ventilation, exercise time, blood lactate concentration, and heart rate indicated that the two groups achieved similarly high work loads during exercise.

Evidence for a dual effect by beta-adrenoceptor antagonists on post-exercise airway calibre.

The effect of selectivity of beta-adrenoceptor antagonists on resting and post-exercise airway calibre in normal subjects was studied. Eight normal subjects were given atenolol 50 mg, propranolol 80 mg and placebo orally, in random order, double-blind. Specific airways conductance and flow-volume curves (partial and complete) were recorded before, 2 hours after drug administration and after exercise.

Effect of low dose adrenaline and noradrenaline infusions on airway calibre in asthmatic patients.

Airway, cardiovascular and metabolic responses were measured in six asthmatic patients with stable asthma during separate adrenaline, noradrenaline and control infusions. Four incremental infusion rates (4, 10, 25 and 62.5 ng min-1 kg-1) produced circulating catecholamine concentrations within the physiological range.

Cystic fibrosis--a review of 26 adolescent and adult patients.

Twenty-six patients, mean age 20.5 years (range 11-33 years) at last assessment or death, attended an adult cystic fibrosis clinic between 1975 and 1983. Twenty-one presented in infancy, and 5 later (3-17 years).

Airway responses to low concentrations of adrenaline and noradrenaline in normal subjects.

Airway, cardiovascular and metabolic responses were measured in six normal subjects during separate infusions of adrenaline and noradrenaline. Four incremental infusion rates of the catecholamines (4, 10, 25 and 62.5 ng X kg-1 X min-1) produced circulating levels of adrenaline and noradrenaline within the physiological range.

A double-blind controlled study comparing temazepam with papaveretum as premedication for fibreoptic bronchoscopy.

One hundred patients undergoing routine fibreoptic bronchoscopy were randomly allocated to receive premedication with either intramuscular papaveretum or oral temazepam in a double-blind manner. They all received atropine before and oxygen during the procedure. Patients found the drugs equally acceptable in terms of discomfort, anxiety and the possibility of repeat bronchoscopy, but more had recall of the procedure with papaveretum.

Tiaramide--a new oral drug for the treatment of asthma.

1 TIaramide, an anti-inflammatory drug, inhibits the action of mediators released from mast cells and has direct smooth muscle relaxant properties. It may therefore have a beneficial effect in asthma. 2 A double-blind crossover trial comparing the bronchodilator activity of tiaramide and placebo over 16 days was undertaken in 13 patients with asthma.

Effect of lignocaine, sodium cromoglycate, and ipratropium bromide in exercise-induced asthma.

Eight patients with exercise-induced asthma participated in a single-blind trial comparing the protective effects of inhaled lignocaine (estimated dose 48 mg), sodium cromoglycate (estimated dose 12 mg), and ipratropium bromide (estimated dose 120 μg). Saline was used as control. Effects were assessed from the mean maximal percentage fall in forced expiratory volume in one second (FEV) and maximal mid-expiratory flow rates (MMFR) after they had run on a treadmill for eight minutes.

Dose-response study of sodium cromoglycate in exercise-induced asthma.

Ten patients with exercise-induced asthma participated in a single-blind dose-response study comparing the protective effect of inhaled sodium cromoglycate in increasing concentrations from 2 to 40 mg/ml. Saline was used as a control. Effects were assessed from the mean maximal percentage fall in forced expiratory volume in one second (FEV1) after the patients had run on a treadmill for eight minutes.