Electrocardiographic Changes in Spontaneous Left Pneumothorax

ABSTRACT. Keller N, Szaff M, Sykulski R (Department of Internal Medicine, Sundby Hospital, Copenhagen, Denmark). Electrocardiographic changes in spontaneous left pneumothorax. Acta Med Scand 1987; 221:499–501. A 25-year-old man was admitted with severe chest pain and an electrocardiogram suggestive of anterior myocardial infarction. Echocardiogram was normal, but chest X-ray showed left-sided pneumothorax. The electrocardiogram showed increasing R-wave amplitude in the days after correction of pneumothorax. Taken in the supine position the electrocardiogram can be misleading in case of pneumothorax or mediastinal emphysema, but the electrocardiogram should be normal if taken in the erect position.     

Effects of aging on event-related brain potentials and reaction times in an auditory oddball task

Auditory event-related potentials (ERPs) were recorded from 71 healthy individuals between 18 and 82 years of age during performance of a disjunctive reaction time task in an auditory oddball paradigm. The effects of aging on reaction times and on the latencies, amplitudes, and distributions of each of the main ERP components were examined. No significant slowing of the reaction times of the elderly subjects was observed in relation to the younger ones. The peak latencies of both the N1 and P2 components elicited by standard tones were slightly but significantly slowed with age. In the ERPs of target tones, the later, endogenous components (N2, P3, and SW) showed linear increases in latency as a function of age; the later the component, the longer the age-related delay. In general, aging was associated with less negativity (both N2 and SW) and more positivity (P3) over the anterior scalp, together with a smaller P3 and a more pronounced N2 over posterior scalp areas. Most of the effects observed in target ERPs were also evident in the difference waves derived from subtraction of the standard from the target ERPs, although the slope of the age-related latency increase of N2 was shallower and that of the P3 was steeper in the difference ERPs. These findings are discussed in relation to previous accounts of ERP changes with aging.     

Primary Immunodeficiency Diseases in Latin America: The Second Report of the LAGID Registry

This is the second report on the continuing efforts of LAGID to increase the recognition and registration of patients with primary immunodeficiency diseases in 12 Latin American countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Honduras, Mexico, Panama, Paraguay, Peru, Uruguay, and Venezuela. This report reveals that from a total of 3321 patients registered, the most common form of primary immunodeficiency disease was predominantly antibody deficiency (53.2%) with IgA deficiency reported as the most frequent phenotype. This category was followed by 22.6% other well-defined ID syndromes, 9.5% combined T- and B-cell inmunodeficiency, 8.6% phagocytic disorders, 3.3% diseases of immune dysregulation, and 2.8% complement deficiencies. All countries that participated in the first publication in 1998 reported an increase in registered primary immunodeficiency cases, ranging between 10 and 80%. A comparison of the estimated minimal incidence of X-linked agammaglobulinemia, chronic granulomatous disease, and severe combined immunodeficiency between the first report and the present one shows an increase in the reporting of these diseases in all countries. In this report, the estimated minimal incidence of chronic granulomatous disease was between 0.72 and 1.26 cases per 100,000 births in Argentina, Chile, Costa Rica, and Uruguay and the incidence of severe combined immunodeficiency was 1.28 and 3.79 per 100,000 births in Chile and Costa Rica, respectively. However, these diseases are underreported in other participating countries. In addition to a better diagnosis of primary immunodeficiency diseases, more work on improving the registration of patients by each participating country and by countries that have not yet joined LAGID is still needed. Latin American Group for Primary Immunodeficiency Diseases     

Antiarrhythmic Effects of VVI Pacing at Physiologic Rates: A Crossover Controlled Evaluation

Ventricular pacing can prevent bradycardia-dependent ventricular ectopic activity (VEA) and is helpful in some cases of drug-refractory venfricuiar tachycardia (VT). This study is a prospective evaluation of VVI pacing for the control of VEA not related to underlying bradycardia, drug side-effects, or prolonged QT interval syndromes. Twenty-nine patients undergoing serial electrophysioiogic-pharmacoiogic testing for VT control were studied. Eighteen of these patients (12 men; meon age = 60.1) both completed ihe protocol and had sufficient VEA for analysis. Coronary disease was present in 13 patients, cardiomyopathy in two patients, and one patient each had myocarditis, mitral valve prolapse, and no structural heart disease. Ambulatory (Holter) monitor recordings during VVI pacing were compared with control recordings made in the absence of pacing, VVI pacing rates were 10–15 bpm above the mean daily heart rate (mean = 92 bpm; range = 63–110). Hours from paced recordings were paired with hours from control (prior to analysis) according to time of day to reduce the effects of spontaneous variability in VEA frequency. Overall, VVI pacing reduced ventricular premature complexes (VPGs) 26% from 331 to 245/hour (p < 0.001). During pacing, couplets (pairs, successive VPGs) were reduced from 6.95 to 1.03/hour (p < 0.000001) and VT (≥3 successive VPCs) from 0.89 to 0.045 episodes/hour (p < 0.003). Of 13 patients with couplets, 11 had ≥50% reduction and five had ≥90% reduction. Baseline VT was eliminated in four out of nine patients during pacing. Pacing did not increase VEA significantly in any patient. In this group of patients, reduction of VEA by VVI pacing was significant and was comparable to pharmacologic interventions. Higher forms of VEA fcouplets and VT) appeared to respond better than single VPCs. Further studies may define patients with VEA who can benefit from pacing     

VIOLENCE AND ALCOHOLISM IN THE FAMILY: HOW ARE THE CHILDREN AFFECTED?

We made an evaluation of how children and adolescents are affectedif they live in a family environment where violence associatedwith alcoholism is a feature. Interviews with 20 families andthe use of psychological tests on their children were performedin this study. The study has demonstrated the existence of psychopathologicaldisturbances in those families' children, whose immaturity andinsecurity were expressed by aggressive behaviour or by depressivemanifestations. It also became evident that there was a transgenerationalalcoholism-violence frequency.     

Analysis of Rabbit Vascular Responses to DBI,an Ingol Derivative Isolated from Euphorbia canariensis

We have analysed the effects of 7,12-O-diacetyl-8-O-benzoil-2,3-diepiingol (DBI), an ingol derivative isolated from E. canariensis, on isometric tension developed by isolated rabbit basilar and carotid arteries. Concentration-response curves to DBI (10^?8 - 3 × 10^?5 m) were obtained cumulatively in both arteries at resting tension and active tone (KC1, 50 mm). At resting tension, DBI induced a concentration-dependent contraction, which was not inhibited in Ca²⁺-free medium. H7 (1-(5-isoquinoline sulphonyl)-2-methylpiperazine dichloride) (10^?4 m) inhibited the DBI-induced contraction both in basilar and in carotid arteries. Calmidazolium (10^?4 m) inhibited the maximum contraction of the carotid artery to DBI, and completely abolished the response in the basilar artery. In pre-contracted basilar arteries DBI induced a concentration-dependent relaxation that was not modified by incubation with N^G-nitro-l-arginine (l-NOARG; 10^?5 m) or indomethacin (10^?5 m). In the carotid artery with active tone DBI induced further contractions, which were not significantly modified by l-NOARG (10^?5 m) and were potentiated by indomethacin (10^?5 m). These results suggest that DBI contracts rabbit basilar and carotid arteries by a mechanism that is independent of extracellular Ca²⁺ and involves the participation both of protein kinase C and of calmodulin. DBI relaxes basilar but not carotid arteries by a mechanism independent of the liberation of nitric oxide and prostacyclin. In the carotid artery prostacyclin but not nitric oxide partially counteracts the contractile action of DBI.     

Monitoring health in the war-affected areas of the former Yugoslavia, 1992-1993

In October 1992 the World Health Organization (WHO) set up ahealth monitoring programme in the former Yugoslavia to obtaininformation on communicable disease upon which to base decisionsabout medical aid requirements. This paper covers the firstyear of the programme (October 1992–October 1993) anddetails the steps taken to set it up. Information was soughtfrom personal contacts, ‘ad hoc’ sources (UnitedNations agencies and non-governmental organizations) and thehealth authorities of the regions of former Yugoslavia. An attemptwas made to establish a sentinel monitoring system to provideroutine data to allow health predictions to be made. A bulletinwas produced to disseminate surveillance results and healthadvice. The system obtained sufficient data (mostly from ‘adhoc’ sources) for WHO to take informed decisions aboutmedical aid but the sentinel system was not established successfully.     

Effect of lamotrigine on EEG paroxysmal abnormalities and background activity: a computerized analysis

1 Little information is available about the action of lamotrigine (LTG) on EEG paroxysmal abnormalities and background activity. On the contrary, several clinical trials have shown the therapeutic efficacy of the drug in preventing partial and generalized seizures.
2 We performed computerized EEG monitoring in 21 patients suffering from focal and generalized epilepsy before and 4 months after addition of LTG. The anticonvulsant modified the EEG ictal events by reducing their frequency and duration. A statistically significant decrease of the interictal spikes was observed. The decrease involved mainly the spreading component of the interictal events leading to a better spatial definition of the epileptic focus.
3 In the presence of LTG, generalized tonic-clonic attacks were completely controlled, whereas partial seizures were decreased.
4 The EEG background activity was not modified by the addition of the drug.
5 Our findings suggest a specific role for LTG in the generation and propagation processes of epileptiform activity without interfering with the EEG background activity.