Hypersensitivity pneumonitis: application of a new diagnostic algorithm to a time series of the disease.

Background: The diagnostic criteria for Hypersensitivity pneumonitis (HP) have changed over time. Our aim is to apply a recent diagnostic algorithm to a historical series of patients diagnosed with HP to assess its distribution according to current diagnostic criteria and the diagnostic confidence achieved.

Research Design And Methods: Application to each patient the algorithm criteria.

Effects of cardiac sympathetic innervation on coronary blood flow.

Background: The role of cardiac sympathetic nerves in regulating coronary blood flow is controversial. We sought to determine the degree to which cardiac efferent sympathetic signals modulate coronary blood flow. The heterogeneous sympathetic reinnervation in transplanted hearts provides a model for studying the vasomotor responses to adrenergic stimulation in reinnervated and denervated coronary territories of the same heart.

Acute reversibility of pulmonary hypertension predicts neither long-term hemodynamic response nor outcome in patients awaiting heart transplantation.

For transplant wait-list patients with end-stage congestive heart failure, reversibility of pulmonary hypertension tested with acute administration of vasodilators is a prerequisite to listing for transplantation. We have shown that the magnitude of the initial pulmonary vasodilatory response to nitroprusside predicts neither the extent of the long-term hemodynamic response nor the subsequent need for transplantation versus clinical improvement and removal from transplant consideration.

Clinical status of patients removed from a transplant waiting list rivals that of transplant recipients at significant cost savings.

We retrospectively contrasted the medical outcome of patients removed from the heart transplant consideration list because of clinical improvement with that of transplant recipients. Of 60 patients awaiting transplantation, 18 were removed from the list (group A), and 42 required transplant or died (group B). Group A significantly improved regarding exercise oxygen uptake, ejection fraction, and hemodynamics.

Alterations of iodine-131 MIBG biodistribution in an anephric patient: comparison to normal and impaired renal function.

Iodine-131 metaiodobenzylguanidine (MIBG) is an effective agent for the scintigraphic portrayal of pheochromocytomas of all types. Iodine-131 MIBG is a relatively stable radiopharmaceutical that is primarily excreted in the urine. Therefore, impaired renal function would be expected to alter [131I]MIBG pharmacokinetics which would thus affect blood levels, as well as scintigraphy.