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ANTHONY D. MERCANDO SEYMOUR FURMAN DEBRA JOHNSTON ROSEMARY FRAME RICHARD BRODMAN SOO G. KIM JOHN D. FISHER 《Pacing and clinical electrophysiology : PACE》1988,11(11):2059-2063
Between May 1982 and May 1988, 37 patients (28 males and 9 females, mean age 57.6, range 16–76 years) of approximately 600 evaluated for sustained ventricular tachycardia and/or fibrillation (VT/VF) were treated with an automatic implantable cardioverter defibrillator (AICD). Twenty-eight of the patients had coronary artery disease, 7 had nonischemic cardiomyopathy, 1 had amyloid hear disease, and 1 had rheumatic heart disease. The mean ejection fraction was 32.2 ± 12.9% (range, 9–64%). Eleven patients have died at a mean of 16.7 months after implantation. The cumulative survival rate was 81% at 1 year, 77% at 2 years. 68% at 3 years, and 53% at 4, 5, and 6 years. Considering only sudden deaths, the survival was 97% at 1 and 2 years, 90% at 3 years, and 80% at 4, 5, and 6 years. Twenty-one of the 37 patients received spontaneous shocks. If the first shock marks the time to death in the absence of an AICD, the cumulative survival rate would have been 56% at 1 year, 42% at 2 years, 29% at 3 years, and 14% at 4, 5, and 6 years. The maximum amount of time to a first appropriate shock was 39.7 months. Thirty-nine devices have been explanted; 28 for battery depletion; 5 for infections; 3 for improper sensing; 2 for electronic failure; and 1 at the time of cardiac transplantation. The average time to failure of the 28 units removed for battery depletion was 19.8 ±6.9 months. We conclude that in this group of patients, short-term survival is increased by AICD implantation, hut long-term survival remains poor. Incidence of sudden death is reduced to 3% at 1 and 2 years, 10% at 3 years, and 20% after 4 years. Other patient selection criteria may be useful in selecting those patients whose survival will be improved by the AICD. 相似文献
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JOHN P. BOURKE LYNNE HOWELL ALAN MURRAY WILLIAM E. HILL J. CAMPBELL COWAN KEVIN BEATT JOAN ERRINCTON STUART JAMESON RONALD G. GOLD 《Pacing and clinical electrophysiology : PACE》1989,12(8):1419-1425
A randomized prospective study was undertaken to compare the electrical performances of three permanent, endocardial, tined pacing leads with different electrode designs--sintered platinum, vitreous carbon, and porous carbon. Ninety-nine patients received one of the leads (S80 31; 423S 32; S100 36). Acute R wave amplitude and ST elevation of the native endocardial electrogram, voltage threshold, impedance, and current flow at four pulse durations (0.25-1.0 msec) were measured. Voltage thresholds were measured noninvasively at each of four pulse durations at 2 days and 1, 3, and 6 months after implantation. No significant differences were found in sensing properties, or current flow at threshold at 0.5 msec pulse duration. The 423S lead had a significantly higher impedance at threshold and both a higher impedance and lower current flow at 5 V. No significant differences in threshold voltages were found between the three leads at any pulse duration, at any of the assessed times after implantation. Six-month thresholds for the S80, 423S, and S100 leads were 1.18 +/- 0.35, 1.17 +/- 0.29, and 1.06 +/- 0.38 V respectively at 0.5 msec pulse duration. Differences between 'high performance' pacing leads need to be of a greater order of magnitude before they can be exploited to give any real clinical advantage to patients. 相似文献
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Identification of Babesia bigemina infected erythrocyte surface antigens containing epitopes conserved among strains 总被引:4,自引:0,他引:4
SANKALE SHOMPOLE TERRY F. McELWAIN DOUGLAS P. JASMER STEPHEN A. HINES JOSEPH KATENDE ANTHONY J. MUSOKE FRED R. RURANGIRWA TRAVIS C. McGUIRE 《Parasite immunology》1994,16(3):119-127
The presence of previously uncharacterized antigens (new antigens) on the surface of intact erythrocytes infected with three strains of Babesia bigemina from Kenya and one each from Puerto Rico, Mexico, St. Croix, and Texcoco-Mexico was demonstrated by indirect immunofluorescent antibody (IFA) reactions. These antigens were not strain specific because antibodies in bovine immune serum to either the Mexico or Kenya isolates reacted with all seven strains tested. Homologous and heterologous immune serum antibodies bound a maximum of 83% and 55%, respectively, of intact erythrocytes infected with the Kenya-Ngong strain but not uninfected erythrocytes. Both sera caused agglutination of only infected erythrocytes. Antibodies eluted from the surface of glutaraldehyde (0.25%) fixed infected erythrocytes had IFA reaction patterns among strains similar to those of immune sera before elation. Eluted antibodies were used to determine if these antigens were protein and encoded by B. bigemina. Eluted antibodies bound seven parasite-encoded proteins of 240, 220, 66, 62, 58, 52 and 38 kDa in an erythrocyte surfacespecific immunoprecipitation reaction of 35-methionine labelled proteins. It was concluded that the surface of B. bigemina infected erythrocytes had parasite-encoded proteins and that these proteins had surface exposed epitopes that were conserved among the seven strains examined which were from two continents. 相似文献
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MICHAEL O. GAYLE C. ANTHONY RYAN SHEMIN NAZARALI 《Acta paediatrica (Oslo, Norway : 1992)》1991,80(4):486-487
ABSTRACT. A child with respiratory distress was found to have been given an antibiotic which was reconstituted with methadone. A delay in standard emergency room management led to a delay in diagnosis and treatment. 相似文献
7.
PHILIPP ROBIN; HARVEY KELLY; FLETCHER GILL; HUGHES ANTHONY; JOLLY KATE 《Occupational medicine (Oxford, England)》1987,37(1):128-129
The worth of influenza immunization for employees in U.K. industryhas been debated for more than a decade. In this study no evidencecould be found of a protective effect for sickness absence patterns.Other evidence is also cited that suggests routine influcnzalimmunization programmes for healthy adults of working age areno longer justilied.
*Requests for reprints should be addressed to: Dr Robin Philipp, Department of Epidemiology and Community Medicine, University of Bristol, Bristol BS8 2PR. 相似文献
8.
ANTHONY HEWSON 《Developmental medicine and child neurology》1994,36(11):941-942
For more than 30 years, The Spastics Society has provided generous support to Mac Keith Press. This has allowed us to pursue our policy of scientific/educational publishing without undue commercial pressures, benefiting our readers world-wide. Now the Spastics Society–one of the largest and most successful charities in the UK–is changing its name to Scope. We asked its Chairman to explain why. 相似文献
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