Isolated hypoplasia of right ventricle with atrial septal defect: a rare form of cyanotic heart disease.

Isolated hypoplasia of right ventricle is a rare kind of congenital heart disease that can present with cyanosis in childhood. We evaluated the clinical profile, diagnosis and management strategy of isolated hypoplasia of right ventricle in children. During 1993-1997, six children were diagnosed to have isolated right ventricular hypoplasia in our institution.

Imaging of current density and current pathways in rabbit brain during transcranial electrostimulation.

A magnetic resonance imaging (MRI) method was used for a noninvasive study of current density (CD) and current pathways (CP's) inside the skull during transcranial electrostimulation in rabbits. The transcranial impulse current directions studied were those previously used in transcranial electric treatment either sagittally or bilaterally. MRI data were collected from slices perpendicular to the direction of current application.

Thalamic stimulation and functional magnetic resonance imaging: localization of cortical and subcortical activation with implanted electrodes. Technical note.

The utility of functional magnetic resonance (fMR) imaging in patients with implanted thalamic electrodes has not yet been determined. The aim of this study was to establish the safety of performing fMR imaging in patients with thalamic deep brain stimulators and to determine the value of fMR imaging in detecting cortical and subcortical activity during stimulation. Functional MR imaging was performed in three patients suffering from chronic pain and two patients with essential tremor.

Death in the home: the doctor's responsibility.

The role physicians assume when patients die at home is nebulous and ill defined. Beyond the traditional function of providing comfort and condolence to family members, the physician's duties are directed toward how our society deals with the bureaucratic and legal aspects of death. Statistics are maintained regarding the numbers of deaths in municipalities and states and the causes of death, and those numbers are used by individuals and organizations for a multitude of legal, medical, and political purposes.

Determinants of vancomycin clearance by continuous venovenous hemofiltration and continuous venovenous hemodialysis.

The clearance of vancomycin is significantly reduced in patients with acute, as well as, chronic renal failure. Although multiple-dosage regimen adjustment techniques have been proposed for these patients, there is little quantitative data to guide the individualization of vancomycin therapy in acute renal failure patients who are receiving continuous renal replacement therapy (CRRT). To determine appropriate vancomycin dosing strategies for patients receiving continuous venovenous hemofiltration (CVVH) and continuous venovenous hemodialysis (CVVHD), we performed controlled clearance studies in five stable hemodialysis patients with three hemofilters: an acrylonitrile copolymer 0.

A primer on continuous renal replacement therapy for critically ill patients.

Objectives: To characterize the multiple continuous renal replacement therapy (CRRT) techniques available for the management of critically ill adults, and to review the indications for and complications of use, principles of drug removal during CRRT, drug dosage individualization guidelines, and the influence of CRRT on patient outcomes.

Data Sources: MEDLINE (January 1981-December 1996) was searched for appropriate publications by using terms such as hemofiltration, ultrafiltration, hemodialysis, hemodiafiltration, medications, and pharmacokinetics; selected articles were cross-referenced.

Study Selection: References selected were those considered to enhance the reader's knowledge of the principles of CRRT, and to provide adequate therapies on drug disposition.

Clonazepam: benzodiazepine therapy for the restless legs syndrome.

Clonazepam is one of several agents used for the treatment of the restless legs syndrome of ESRD. The drug's pharmacokinetic profile demonstrates safety in patients with altered kidney function. Future studies may provide an enhanced understanding of the physiological basis of the disorder to lead to improved pharmacological therapy.

Effects of corn processing on the site and extent of digestion in lactating cows.

Three multiparous Holstein cows in midlactation were fitted with ruminal and duodenal cannulas. Cows were used in an experiment with a 3 x 3 Latin square design to study the effect of corn processing on nutrient flow from the rumen to the duodenum and on ruminal fermentation in lactating cows. Cows were fed diets consisting of 40% forage and 60% concentrate.

Multicenter comparative study of the efficacy and safety of sotalol in the prophylactic treatment of patients with paroxysmal supraventricular tachyarrhythmias.

We performed a randomized, double-blind, placebo-controled, parallel-group comparison study of the efficacy and safety of sotalol in the prophylaxis of paroxysmal supraventricular tachyarrhythmias (PSVTs) (including paroxysmal atrial fibrillation and paroxysmal reentrant SVTs). The frequency of PSVT episodes while not receiving drug therapy was monitored during a baseline phase, the length of which depended on the frequency of PSVT events. In the double-blind phase, the duration of which depended on the baseline frequency of episodes of PSVT, patients received placebo, sotalol 80 mg twice daily, or sotalol 160 mg twice daily.

Medication knowledge and compliance among patients receiving long-term dialysis.

The extent to which patients receiving longterm dialysis understood and complied with their drug therapy regimens was studied. Patients undergoing long-term hemodialysis or continuous ambulatory peritoneal dialysis (CAPD) in a university-affiliated outpatient dialysis center were surveyed to determine their knowledge about and compliance with prescribed regimens for antihypertensives, phosphate binders, and calcitriol. They were asked to list their prescribed medications and state the medications' indications, the frequency with which they missed doses, and the actions they took after missing a dose.

Rotating frame RF current density imaging.

RF current density imaging (RF-CDI) is a new MRI technique for imaging the Larmor frequency current density parallel to B0 in electrolytic media. To extend the use of RF-CDI to biological tissue for generating conductivity contrast, the sensitivity must be increased and the data requirements reduced. A rotating frame approach, in which a large B1 field is applied simultaneously as a rotary echo with RF current, is proposed to meet these requirements.

Electromagnetic considerations for RF current density imaging [MRI technique].

Radio frequency current density imaging (RF-CDI) is a recent MRI technique that can image a Larmor frequency current density component parallel to B(0). Because the feasibility of the technique was demonstrated only for homogeneous media, the authors' goal here is to clarify the electromagnetic assumptions and field theory to allow imaging RF currents in heterogeneous media. The complete RF field and current density imaging problem is posed.

Health service costs of coronary angioplasty and coronary artery bypass surgery: the Randomised Intervention Treatment of Angina (RITA) trial.

For some patients with coronary artery disease, percutaneous transluminal coronary angioplasty (PTCA) is an alternative to coronary artery bypass grafting (CABG). We report comparative health service costs of these interventions within the Randomised Intervention Treatment of Angina (RITA) trial. Medications were costed at published UK prices; other resource use was costed with a set of unit costs estimated at two recruiting centres to the RITA trial, one in London and one outside.

Maternal erythropoietin in singleton pregnancies: a randomized trial on the effect of oral hematinic supplementation.

Objective: Our purpose was to study the effect of hematinic supplementation on the maternal erythropoietin response during singleton pregnancy.

Study Design: In a randomized, double-blind trial 97 patients with a first-trimester hemoglobin level > or = 14.0 gm/dl received either iron and folic acid (hematinic group, n = 53) or a placebo (n = 44).

Influence of angiotensin converting enzyme inhibition on exercise performance and clinical symptoms in chronic heart failure: a multicentre, double-blind, placebo-controlled trial.

One hundred and seven patients with chronic heart failure (NYHA class II to IV) stabilized on digitalis and/or diuretics, recruited from 11 centres were randomized into a double-blind, placebo-controlled study to assess the effect of 12 weeks of cilazapril therapy on exercise tolerance and clinical status. Thirty-five patients were randomized to placebo and 72 to cilazapril at a starting dose of 1 mg daily; titration to cilazapril 2.5 mg at week 4 and 5 mg at week 8 (or matching placebo) was carried out in patients who did not improve clinically.