Diseases Commons^™

Thrombolytic Therapy For Acute Myocardial Infarction In The Elderly, Bernard Bun-Lap Wong, Wai-Hong Chen

Journal of the Hong Kong College of Cardiology

Acute myocardial infarction (MI) is a leading cause of morbidity and mortality in developed countries. Patients ≥75 years constitute up to 30% of the acute MI population and are associated with a 50% in-hospital mortality. Thrombolytic therapy was shown in a metaanalysis of 9 largest randomized controlled trials to reduce 35-day mortality. However, the benefit was observed mainly among patients < 75 years old. For patients ≥ 75 years, the 35-day mortality was 24.3% in those treated with thrombolytic therapy and 25.3% in the placebo group, a difference not reaching statistical significance.

An Assessment Of Prothrombotic Tendency In Humans Using Functional And Genomic Determinants In The South Eastern Irish Population, Carmel Cullen

Theses

Venous thrombosis occurs in about 1 per 1,000 individuals per year. It is a serious disorder and accounts for a significant number of hospital admissions and deaths annually. Thrombophilia describes the familial or acquired disorders of the haemostatic mechanism that predispose to thrombosis. Inherited thrombophilia can be defined as a genetically determined tendency to venous thromboembolism Mutations in genes that code for proteins involved directly (or indirectly) In blood coagulation have been associated with prothrombotic status. Laboratory investigations for thrombophilia include screening for deficiencies of antithrombin, protein C or protein S and testing for activated protein C resistance. Together these …

Stereospecific Pharmacokinetics And Pharmacodynamics Of Beta-Adrenergic Blockers In Humans, Reza Mehvar, Dion R. Brocks

Pharmacy Faculty Articles and Research

The beta-blockers comprise a group of drugs that are mostly used to treat cardiovascular disorders such as hypertension, cardiac arrhythmia, or ischemic heart disease. Each of these drugs possesses at least one chiral center, and an inherent high degree of enantioselectivity in binding to the b-adrenergic receptor. For beta-blockers with a single chiral center, the (-) enantiomer possesses much greater affinity for binding to the b-adrenergic receptors than antipode. The enantiomers of some of these drugs possess other effects, such as antagonism at alpha-adrenergic receptors or Class III antiarrhythmic activity. However, these effects generally display a lower level of stereoselectivity …

Brachytherapy In The New Millennium Abstracts, Jilin Chen, Runlin Gao, Qiangjun Cai, Yuejin Yang

Journal of the Hong Kong College of Cardiology

In order to examine long-term efficacy of percutaneous transluminal coronary angioplasty (PTCA), coronary stenting and to assess the factors affecting its efficacy, 790 patients who underwent successful PTCA and PTCS+Stent in this Hospital were followed by direct interview or letter.

The Cardiac Correlates Of Attention In The Denervated Heart: A Study Of Infant Heart Transplant Recipients, Stephanie Dianne Griffone

Loma Linda University Electronic Theses, Dissertations & Projects

The cardiac correlate of attention is a deceleration in heart rate, controlled by the parasympathetic division of the autonomic nervous system. This has been extensively studied in infants; the findings indicate that this deceleration is affected by a number of factors, several mediated by the vagus nerve. However, the effects of denervation on this response are not known. Studies with adult heart transplant recipients have shown attenuated acceleration in response to stressful mental tasks. This study investigated the cardiac response to attention in infants who had received a heart transplant, using a habituation paradigm. The hypothesis that they would show …

Differences Between Blacks And Whites With Coronary Heart Disease In Initial Symptoms And In Delay In Seeking Care, Sally B. Richards, Marjorie Funk, Kerry A. Milner

Nursing Faculty Publications

BACKGROUND: Mortality rates for coronary heart disease are higher in blacks than in whites. OBJECTIVES: To examine differences between blacks and whites in the manifestation of symptoms of coronary heart disease and in delay in seeking treatment. METHODS: Patients were directly observed as they came to an emergency department with symptoms suggestive of coronary heart disease. The sample included 40 blacks and 191 whites with a final diagnosis of angina or acute myocardial infarction. RESULTS: After controlling for pertinent demographic and clinical characteristics, logistic regression analysis revealed that blacks were more likely than whites to have shortness of breath (odds …

The Association Of Fluid Intake With Total Natural-Cause Mortality, Coronary Heart Disease And Fatal Stroke, Jacqueline Chung Lun Chan

Loma Linda University Electronic Theses, Dissertations & Projects

Hypohydration may be more widespread than realized since it does not always arouse a sense of thirst. When thirst is felt, it is often ignored, or satisfied before euhydration is achieved. There is growing evidence indicating that hypohydration contributes to acute and chronic illnesses, and to rheological factors associated with coronary heart disease (CHD) and stroke. Therefore the relationship of fluid intake with risk of total natural-cause mortality, CHD and stroke death was examined using data on 34,192 white, non-Hispanic participants in the Adventist Health Study.

Among the 27,342 reporting no CHD, stroke or diabetes at baseline, during six years …

Cardiorespiratory Fitness And Cardiovascular Disease Risk Factors In Postmenopausal Women, Bryan L. Haddock

Loma Linda University Electronic Theses, Dissertations & Projects

In spite of the reductions in cardiovascular disease mortality over the last several years, cardiovascular disease remains the number one cause of death in the U.S. Prior to menopause, women have approximately 2.5-4.5 times lower risk of cardiovascular disease than do men of a similar age. Within about 10 years following menopause, however, the rate in women becomes similar to that seen in men. Increased cardiorespiratory fitness and use of hormone replacement have been suggested as ways to improve the cardiovascular disease (CVD) risk profile. Unfortunately, very little is known about the effect of cardiorespiratory fitness on the CVD risk …

Where Do Elderly Veterans Obtain Care For Acute Myocardial Infarction: Department Of Veterans Affairs Or Medicare?, S M. Wright, J Daley, E S. Fisher, G E. Thibault

Dartmouth Scholarship

To examine Department of Veterans Affairs (VA) and Medicare hospitalizations for elderly veterans with acute myocardial infarction (AMI), their use of cardiac procedures in both systems, and patient mortality. DATA SOURCES: Merging of inpatient discharge abstracts obtained from VA Patient Treatment Files (PTF) and Medicare MedPAR Part A files. A retrospective cohort study of male veterans 65 years or older who were prior users of the VA medical system (veteran-users) and who were initially admitted to a VA or Medicare hospital with a primary diagnosis of AMI at some time from January 1, 1988 through December 31, 1990 (N = …

An Enzyme-Linked Immunosorbent Assay For The Detection Of Cardiac Myoglobin Using Monoclonal Antibodies, Deborah F. Kelly

Chemistry & Biochemistry Theses & Dissertations

The most prevalent life-threatening disease worldwide, secondary to coronary artery thrombosis is Acute Myocardial Infarction (AMI). Increases in three clinical markers have been explored as an early means of AMI detection: Cardiac myoglobin, and the two specific cardiac isoforms of Creatine Kinase, CK-MM and CK-MB. However, myoglobin levels have shown to give a more accurate correlation (R = 0.89) than does Creatine Kinase evaluation. Therefore, we have developed a two-site Enzyme-Linked Immunosorbent Assay (ELISA) using monoclonal antibodies against myoglobin isolated from human heart tissue. This assay is based on specific anti-genantibody interactions and is sensitive at the nanogram level. We …

Association Between Nutrient Intake And Risk Of Coronary Heart Disease In California Seventh-Day Adventists, Peter Pribiš

Loma Linda University Electronic Theses, Dissertations & Projects

Dietary habits are believed to be major determinants of risk of coronary heart disease (CHD). Studies of high and low risk populations have suggested several nutrients to be protective or hazardous against CHD. Most published work since 1984 on diet and CHD in the Adventist Health Study (AHS) population examined either foods or food groups. This study investigated ten nutrients as exposure variables and their relationship to CHD risk. A cohort of 23,616 nonsmoking, non-Hispanic white California Seventh-day Adventists was followed for six years beginning in 1976. Extensive dietary information was collected at baseline, as well as values of traditional …

The Effect Of Cardiac Rehabilitation On Quality Of Life, Anxiety, And Self-Care In Coronary Artery Disease Patients, Susan Susskind Wilkinson

Theses & Dissertations

This study was designed to explore the effect of cardiac rehabilitation program participation on anxiety, quality of life, and self-care among coronary artery disease patients.

Major lifestyle changes are required after a person experiences an acute coronary event. Rehabilitation programs for coronary artery disease patients are designed to assist the patient with these lifestyle changes by altering the survivor's self-care patterns and improve long-term physical and psychological outcomes. By coordinating education, counseling, and exercise programs, the nurse can help individuals move toward a maximal physiological, psychological, social and vocational recovery. This study was designed to explore the effect of cardiac …

Predictors Of Compliance With Diet And Exercise Six Months After Heart Transplantation, Kathleen L. Grady

Dissertations

No abstract provided.

The Report Of The American Heart Association Task Force On Strategies To Increase Federal Research Funding, Michael R. Rosen, Harold C. Strauss, Holly G. Atkinson, Alfred P. Fishman, Charles K. Francis, Arnold M. Katz, August M. Watanabe, Francois M. Abboud, Myron L. Weisfeldt, William F. Friedman, Bernadine P. Healy, Scott D. Ballin, Claudia Louis, Rodman D. Starke, Wallace G. Frasher

Publications and Research

No abstract provided.

Autonomic Nervous System And Cholesterol Transport, Yuan-Line Hung

Loma Linda University Electronic Theses, Dissertations & Projects

The effect of autonomic nervous system on cholesterol transport is of clinical interest because the relationship between lipoprotein metabolism and atherogenesis is expressed in coronary artery disease.

Generally speaking, beta blockers increase serum VLDL level but decrease both HDL and HDL₂ cholesterol levels without affecting the LDL in humans. We are unaware of reports concerning the effects of metoprolol on lipoprotein metabolism nor comparison of the effects of metoprolol and propranolol in the unhandled rat model. In part I we employed the unhandled rats to compared the effects of these 2 drugs administered with the drinking water in order …

Factors Determining Peripheral Vascular Disease Clients' Intent To Adhere To Prescribed Behaviors, Gretchen Grahn Hitchcock

Ellmer School of Nursing Theses & Dissertations

Motivation of clients with Peripheral Vascular Disease (PVD) to adhere to Recommended risk-reducing behaviors (RRB’s) was explored. The sample (n =30) was comprised of clients in a vascular physician group’s practice with a medical diagnosis of PVD. A nonexperimental, descriptive design was utilized to investigate how much variation in adherence to RRB’s by PVD clients could be accounted for by the client’s perceived effectiveness of a RRB and the client’s perceived difficulty in adhering to a RRB. A self-administered three part instrument, a demographic data form, and a self-administered qualitative data form were utilized to collect the data. Regression analysis …

The Synthesis And Evaluation Of 5-Phenyloxazolidines As Potential Cardiovascular Drugs, Tammy C. Wang

Chemistry & Biochemistry Theses & Dissertations

Drugs such as adrenoceptor antagonists and certain centrally acting agents are known to lower blood pressure and thus serve as clinically useful antihypertensive agents. Norepinephrine 4, a natural ∝-adrenoceptor agonist, is the major agent associated with increased blood pressure in the periphery. Based on a careful structure-activity comparison, a series of substituted oxazolidines, 20, 21, 22 and 23, have been designed as possible antihypertensive candidates. Specifically, 22 and 23 have been synthesized to serve as potential norepinephrine antagonists.

Preliminary evaluation of these compounds indicated that they were not antihypertensive in nature. The more active compound, 23, …

Hemoglobin E B-Thalassemia In A Pakistani Family, Aftab Ahmed, Atiya Abbasi, Gerhard Braunitzer, Zafar H. Zaidi

Pharmacy Faculty Articles and Research

Hemoglobin E is a slow moving B chain variant of hemoglobin, first discovered by Itano¹. Characterized by Hunt et al² showed glutamic acid at B 26 to be replaced by lysine. It is a common variant of hemoglobin in the world and reported in high frequency from South-East Asia^3-6. Cases of Hb E, in combination with thalassemia have been reported on the basis of electrophoretic pattern only. In this communication a case of Hb E with B thalassemia is reported on the basis of amino acid sequencing of the abnormal peptide.

Insulin And Glucagon Responses To Dietary Protein In Diabetic And Nondiabetic Men, Monica L. Blomstedt

Loma Linda University Electronic Theses, Dissertations & Projects

Five men with non-insulin-dependent diabetes mellitus and fourteen nondiabetic men, were given test meals with soy protein, casein or additional carbohydrate in place of protein. Blood levels of insulin, glucagon, glucose and lipids were measured at fasting, one-half hour and two hours postprandial. To all meals, the nondiabetic subjects responded with a quick rise of the insulin level which decreased at two hours. In contrast, the diabetics showed a significantly lower insulin response at one-half hour (p < 0.05), but a tendency to higher levels at two hours. The same pattern was observed in the insulin to glucagon ratio. No significant difference between the meals was found in regard to insulin or glucagon responses, suggests that a sustained, although delayed postprandial insulin response, may be a precursor to the higher cholesterol and increased risk for cardiovascular disease among diabetics.

The Relationship Between Meat Consumption And The Biological Determinants Of Cardiovascular Disease Risk, Fred E. Kollwitz

Loma Linda University Electronic Theses, Dissertations & Projects

Fasting blood samples were collected from 26 omnivore and 27 vegetarian men (35-60 years of age), who were not taking any medications and by self-assessment were in good health. The following analyses were done: glucose (Glu), glycohemoglobin (HBA1), total serum cholesterol (chole), high density lipoprotein-cholesterol (HDD, low density lipoprotein (LDL), very low density lipoprotein (VLDL), platelet factor four (PF4), and beta-thromboglobulin (BTG). In addition, the blood pressure (BP) was determined.

The systolic (p<0.001) and diastolic BP (p=0.016) were lower in the vegetarian subjects than in the omnivores. The serum total cholesterol levels were also lower in the vegetarian subjects compared to the omnivores (p<0.05). There was no significant difference in Glu, HBA1, LDL, VLDL, HDL, PF4, and BTG levels between the two groups.

The Relationship Of Vitamins B-6 And B-12 To Plasma Homocysteine Levels In Men At Low- And High-Risk For Coronary Heart Disease, Marlene E. Swift

Loma Linda University Electronic Theses, Dissertations & Projects

There is evidence that homocysteine may be a factor in increasing the risk of coronary heart disease (CHD). To explore this relationship further, we assessed the interrelation of dietary vitamins B-6, B-12 and folate, and plasma pyridoxal-5'-phosphate and vitamin B-12 with plasma free and protein-bound homocysteine levels. Fasting blood and three-day dietary records were obtained from nine men low-risk (LR) and five at high-risk (HR) for CHD. The HR mean systolic blood pressure, total cholesterol (TC), and TC/cholesterol ratios were significantly higher than LR levels. Groups were comparable by age, weight, height, skinfolds, exercise, and smoking history. No significant difference …

Psychosocial And Behavioral Characteristics Of Ischemic Heart Disease Patients: Their Measurement And Relationship To Adherence In An Intensive Nutrition Education Program, Lynn Caldwell

Loma Linda University Electronic Theses, Dissertations & Projects

Nonadherence to therapeutic regimens which necessitate major lifestyle change is recognized as one of the most serious problems in medical practice today. Attempts to prevent and control chronic disease, including the development and progression of cardiovascular disease, are only effective when recommendations to the patient are carried out. Few studies have systematically studied the relationship of psychosocial and behavioral factors to adherence outside the theoretical framework of a specific behavioral model; no study has done so with a carefully measured diet as the outcome variable in a controlled prospective clinical trial with patients suffering from cardiovascular disease.

This study, as …

Oral History Interview: Dr. Pat Tuckwiller, Pat Tuckwiller

0064: Marshall University Oral History Collection

Dr. Pat Tuckwiller was born on April 13, 1905, in Morgantown, West Virginia. He received his medical degree from Rush Medical College in Chicago, Illinois, in 1929 and began practicing internal medicine in Charleston, West Virginia, on April 1, 1932. Dr. Tuckwiller discusses making house calls in Kanawha County, West Virginia, and focuses on the most common illnesses he treated and the medicines and procedures he used. He also discusses the differences in medical practice from the 1930s to the 1980s. In the audio clip provided, Dr. Tuckwiller discusses the issue of venereal disease in West Virginia and focuses on …

The Effect Of Dietary Alpha - Linolenic Acid On Apparent Risk Factors Of Cardiovascular Disease, Kelvin D. Lindbeck

Loma Linda University Electronic Theses, Dissertations & Projects

Eight healthy male lacto-ovo-vegetarian subjects averaging 28.0 ± 3.6 years of age (22 to 53 years) were fed a diet rich in α-linolenic acid (18:3 ω 3) for four weeks. Arterial blood pressure and body weight were recorded each week. Plasma 6-keto-prostaglandin F_1α (6-keto- PGF_1α ), thromboxane B₂ (TXB₂), total cholesterol, triglyceride, and total phospholipid fatty acid composition were analyzed at 0, 2 and 4 weeks.

Systolic blood pressure increased significantly between weeks 0 and 1 (106.5 ± 2.7 mmHg to 114.0 ± 3.7 mmHg; p < 0.003), but decreased to 107.3 t 2.6 mrHg (p < 0.02) at week 2. There was an insignificant increase in both systolic and diastolic blood pressures after four weeks. There was no significant change in either total cholesterol or triglyceride levels during the four weeks.

Plasma 6-keto-PGF_1α levels increased significantly from 60.13 ± …

The Effect Of A Cardiac Education Program On The Knowledge, Stress, And State Anxiety Levels Of First Time Post Myocardial Infarction Patients In A Post Coronary Care Unit, Jeanine L. Johns

Ellmer School of Nursing Theses & Dissertations

The effect of a cardiac education program in terms of changes in knowledge, state anxiety and stress were examined for persons suffering a myocardial infarction for the first time. In addition, the relationship between stress and trait anxiety and changes in knowledge and state anxiety were examined. A sample of 20 patients were selected from two medium sized hospitals in Southeastern Virginia. Statistically significant differences at the .01 level were found between the means of the pretest and posttest scores of the experimental group for knowledge and state anxiety using the t test for dependent groups. The same test showed …

Development Of A Procedure For Analysis Of High Density Lipoprotein Subclasses, Chan Chin

Chemistry & Biochemistry Theses & Dissertations

Human serum high density lipoprotein subclasses, HDL₂ and HDL₃ , were isolated by preparative salt density gradient ultracentrifugation and further analyzed by electrophoresis on a 4 to 15% concentration gradient polyacrylamide gel.

The separation of the major classes of serum lipoproteins was achieved after a single ultracentrifugation for 272,000 g at 15°c in a swinging bucket rotor. High resolution concentration gradient gel electrophoresis was found to be particularly suitable for the separation of lipoproteins. The isolation of HDL by precipitation methods, heparin-manganese and dextran-magnesium have also been evaluated in this study, and were found not to completely separate …

J.T.: A Case Of Mitral Valve Prolapse, F. Matthew Mihelic

Faculty Publications

No abstract provided.

The Cardiovascular Effects Of Human Contact With Coronary Artery Disease Patients In The Coronary Care Unit, Margaret A. Palmour

Loma Linda University Electronic Theses, Dissertations & Projects

Ten coronary artery disease patients were selected using purposive method of sampling and observed for six hours. It was postulated that 1) Human contact with coronary artery disease patients in the coronary intensive care unit would be associated with significant (p = 0.05) changes in the electrocardiogram such as: (a) increased heart rate more than 10 per cent, (b) changed atrio-ventricular conduction more than 10 per cent, (c) changed ST segment one millimeter or more and (d) increased frequency of ectopic beats more than 10 per cent. 2) The degree of stress and cardiac response was related to a number …

The Effect Of Programmed Instruction About Pacemakers Given In The Hospital Setting On The Immediate And Delayed Retention Of Information On Patients With Permanent Cardiac Pacemakers, Ann Ekroth, Eileen Zorn

Loma Linda University Electronic Theses, Dissertations & Projects

A convenience sample of nineteen patients composing group A, hospitalized for initial placement of permanent cardiac pacemakers, was studied. A programmed instructional test was prepared by the investiga- tors for this population. The question under study was, does programmed instruction for pacemaker patients affect immediate and delayed recall of information? Patients were pre-tested, presented with the programmed instruction package and given a post-test immediately upon completion of the package. They were retested later to evaluate retention level. An IQ test was administered at the same time as the pre-test. Statistical analysis using t-tests indicated significant differences between pre-test scores and …

Evaluation Of A Special Teaching Program With Ambulatory Cardiac Patients, Mary L. Mcgregor Minns

Loma Linda University Electronic Theses, Dissertations & Projects

This study was designed to test the hypotheses that ambulatory cardiac patients given a special teaching program would have increased understanding about their medication, make fewer medication errors, and know more about undesirable effects and how to handle them than patients not included in the special teaching program. Forty-one ambulatory cardiac patients were, after a random start, alternately assigned to an experimental or to a control group. All the patients were taking one or more of three different medications before hospitalization, during their hospital stay, and after their discharge. Three medications, digoxin (lanoxin), lasix, and nitroglycerin, were studied. The program …