Edward D. Freis May 13, 1912 February 1, 2005 was an United States American physician and researcher, who received the Albert Lasker Award for his studies of the treatment of hypertension . Biography Born in Chicago, Illinois to Lithuania n immigrant parents, he had his eyes set on becoming an actor. After a few shows, however, he realized that acting was not for him, and he decided to be a doctor. Freis attended the University of Arizona and the Columbia University medical school. After graduation he joined the United States Army Air Corps , working in the medical corps during World War II . When the war ended, he met Doctor Chester Keefer , who had done penicillin trials. Freis decided that he wanted to become a researcher. He went to work for the United States Department of Veterans Affairs United States Veterans Affairs Administration in Washington, DC , specializing in the study of hypertenstion. At the time, it was felt by the medical community that high blood pressure was a good thing, because it improved circulation. But Freis s studies, first published in the New England Journal of Medicine in 1954 then later expanded in the 1960s, showed that hypertension actually increased the likelihood of stroke and myocardial infarction heart attack . He was awarded the Lasker Award for his studies, cited for an exemplary demonstration of the potential of preventive medicine. In 1957, Freis was appointed professor of medicine at Georgetown University Medical Center. He was president of the Washington Heart Association and received an award of meritorious accomplishment from the American Heart Association . In later years, he moved on to the study of hemodynamics , the study of circulation. Publications The High Blood Pressure Book , with Gina Kolata, 1979 External links http oculus.nlm.nih.gov cgi f findaid findaid idx?c nlmfindaid id navbarbrowselink cginame findaid idx cc nlmfindaid view reslist subview standard didno freis550 Edward D. Freis Papers 1926 2004 Nationa ... more details
Orphan date February 2009 refimprove date March 2009 Burantashi literally penis get up is a native Hausa people Hausa Fulani powder derived from the bark of the African tree Pausinystalia yohimbe . Burantashi is used as a food additive to barbecued meat suya in Nigeria , especially the Northern parts. The extracts contain the alkaloid yohimbine , an Alpha 2 adrenergic receptor alpha sub 2 sub receptor antagonist antagonist that has been used widely with variable success in erectile dysfunction , but the whole bark of the tree was not studied until recently. In one recent study, pure Burantashi powder obtained from a local suya vendor in Lagos, Nigeria was extracted aqueously and studied on the renal circulation of Sprague Dawley rat s. ref name Ajayi Ajayi AA, Newaz M, Hercule H, Saleh M, Bode CO, Oyekan AO. Endothelin like action of Pausinystalia yohimbe aqueous extract on vascular and renal regional hemodynamics in Sprague Dawley rats. Methods. Find. Expt. Clin. Pharmacol . 2003, 25 10 817 22. ref In the in vivo study, the extract code named CCD X , caused a rise in mean arterial pressure MAP , and a rise in renal medullary blood flow MBF . This systemic vasoconstrictor and renal medullary dilator action was attenuated separately by the endothelin A receptor blocker BMS 182874, ET B blocker BQ788, but blocked by their combination ref name Ajayi . Further, the nitric oxide inhibitor NO , L Nomega nitro Arginine Methyl Ester L NAME 10 mg kg totally inhibited the rise in medullary blood flow due to CCD X. In vitro studies in isolated perfused kidneys IPK and in pressurised microvessels PMV confirmed the in vivo effect to cause vasoconstriction , which was inhibited by endothelin A and B antagonists. The pressor dose response characteristic of CCD X on PMV was similar to that of endothelin 1 with EC sub 50 sub close to 100ng. It was concluded from these studies that, the aqueous extract exhibited a vasoconstrictor effect possibly alpha sub 2 sub mediated like yohimbin ... more details
Early goal directed therapy was introduced by Emanuel Rivers Emanuel P. Rivers, MD , MPH in the New England Journal of Medicine in 2001 and is a technique used in critical care medicine involving intensive monitoring and aggressive management of perioperative hemodynamics in patients with a high risk of morbidity and mortality. ref Gordon A, Russell J, Crit Care. 2005 9 6 647 648. Published online 2005 November 23. doi 10.1186 cc3951. ref In cardiac surgery, GDT has proved effective when commenced after surgery. The combination of goal directed therapy and Point of Care Testing has demonstrated a marked decrease in mortality for patients undergoing congenital heart surgery. ref Rossi AF, Khan DM, Hannan R, Boliver J, Zaidenweber M, Burke R, Intensive Care Med. 2005 Jan 31 1 98 104. Epub 2004 Dec 1 ref Furthermore, a reduction in morbidity and mortality has been associated with GDT techniques when used in conjunction with an electronic medical record . ref Rossi AF, Khan D, Clin Biochem. 2004 Jun 37 6 456 61. ref Early goal directed therapy is a more specific form of therapy used for the treatment of severe sepsis and septic shock . This approach involves adjustments of cardiac preload, afterload, and contractility to balance oxygen delivery with an increased oxygen demand before surgery. ref Rivers, 2001 http scalpel.stanford.edu articles Goal 20directed 20therapy.pdf ref Elements In the event of hypotension and or lactate greater than 4 mmol L, then deliver an initial minimum of 20 ml kg of crystalloid solution crystalloid or colloid equivalent . Apply vasopressors for hypotension not responding to initial fluid resuscitation to maintain mean arterial pressure MAP 65 mm Hg. In the event of persistent hypotension despite fluid resuscitation septic shock and or lactate 4 mmol L 36 mg dl Achieve central venous pressure CVP of 8 mm Hg Achieve central venous oxygen saturation ScvO2 of 70 References reflist treatment stub Intensive care medicine Category I ... more details
File Adolf Loewy Gasuhr.png thumb Adolf Loewy during a walk experiment. Adolf Loewy German spelling Adolf L wy June 29, 1862 December 26, 1937 was a German physiologist who was a native of Berlin . He studied medicine in Vienna and Berlin , where in 1885 he received his medical doctorate. Later he was an assistant to Nathan Zuntz 1847 1920 at the Landwirtschaftlichen Hochschule Agricultural University in Berlin. In 1900 he became an assistant professor, and in 1921 was a professor and in charge of the Schweizerisches Institut f r Hochgebirgsphysiologie und Tuberkuloseforschung Swiss Institute for Altitude Physiology and Tuberculosis at Davos . In 1925 he became a member of the German Academy of Sciences Leopoldina . Loewy did extensive research in the field of altitude physiology. This included studies performed at the J dischen Krankenhaus Jewish Hospital at Berlin, and at Capanna Regina Margherita, a research station at the top of Monte Rosa , Italy. Here he worked with Dr. Zuntz, and other renowned scientists that included Angelo Mosso 1846 1910 and Arnold Durig 1872 1961 . With Austrian physiologist Hermann von Schr tter 1870 1928 he performed pioneer research in pulmonary hemodynamics . In 1905, through the use of an endobronchial valve endobronchial catheter , they were the first to achieve airway separation on a human subject. Selected written works Untersuchungen ber die Respiration und Zirkulation bei nderung des Druckes und des Sauerstoffs der Luft Studies on the respiration and circulation regarding Air Pressure and Oxygen , Berlin, 1895 Untersuchungen ber Blutcirculation beim Menschen , Studies on Blood Circulation in Humans , 1905 197 311 with Hermann von Schr tter Lehrbuch der Physiologie des Menschen . Textbook of Human Physiology Leipzig, 1909 with Nathan Zuntz ber den Stoffverbrauch bei der landwirtschaftlichen Arbeit , Concerning Energy Consumption in Agricultural Work , Wiener Med. Wschr. 27 1925 1585 1590 with Hermann von Schr tter ber den E ... more details
Infobox Disease Name Hemopericardium Image Caption DiseasesDB ICD10 ICD10 I 23 0 i 20 , ICD10 I 31 2 i 30 , ICD10 S 26 0 s 20 ICD9 ICD9 423.0 , ICD9 860.2 ICDO OMIM MedlinePlus eMedicineSubj eMedicineTopic MeshID Hemopericardium refers to blood in the pericardial sac of the heart . It is clinically similar to a pericardial effusion , and, depending on the volume and rapidity with which it develops, may cause cardiac tamponade . ref name urlForensic Pathology cite web url http library.med.utah.edu WebPath FORHTML FOR034.html title Forensic Pathology work accessdate ref The condition can be caused by full thickness necrosis death of the myocardium heart muscle after myocardial infarction, as well as trauma, ref name pmid10882282 cite journal author Krejci CS, Blackmore CC, Nathens A title Hemopericardium an emergent finding in a case of blunt cardiac injury journal AJR Am J Roentgenol volume 175 issue 1 pages 250 year 2000 month July pmid 10882282 doi url http www.ajronline.org cgi pmidlookup?view long&pmid 10882282 ref and in patients receiving anticoagulants. ref name pmid17355673 cite journal author Katis PG title Atraumatic hemopericardium in a patient receiving warfarin therapy for a pulmonary embolus journal CJEM volume 7 issue 3 pages 168 70 year 2005 month May pmid 17355673 doi url http caep.ca template.asp?id 472F89B37E8746A79053B22F89AB7C8D format dead link date July 2010 ref ref name pmid17711963 cite journal author Hong YC, Chen YG, Hsiao CT, Kuan JT, Chiu TF, Chen JC title Cardiac tamponade secondary to haemopericardium in a patient on warfarin journal Emerg Med J volume 24 issue 9 pages 679 80 year 2007 month September pmid 17711963 pmc 2464639 doi 10.1136 emj.2007.049643 url http emj.bmj.com cgi pmidlookup?view long&pmid 17711963 ref Other causes include ruptured aneurysm of sinus of Valsalva and other aneurysm s of the aortic arch . ref Gray s Anatomy, 1902 ed. ref References reflist Heart diseases Chest trauma Hemodynamics Category Chest trauma Catego ... more details
Pulsatile blood flow in the body is a response to periodic variations in velocity. These pulsating characteristics have been shown to be a result of two pumps. As the primary pump, the heart causes the blood flow and velocity to oscillate from zero to very high rates as the valves at the entrances and exits to the ventricles intermittently close and open with each beat of the heart. The second pump is a result of the respiratory and skeletal systems, which exert their greatest action on venous flow. ref cite book last Trainor first Freida S. title Peripheral Vascular Surgery Hemodynamics of Arterial Pulsatile Blood Flow year 1973 publisher Appleton Century Crofts location New York pages 1 ref Specifically pulsation that result from the release of blood from the left ventricle show that they exhibit non linear, transient pulsations in pressure and flow. These create complex pulse patterns which are further propagated through the rest of the network. This results in variations in the applied shear stress to the layer of enodthelial cells which separate blood flow from the vessel wall. Depending upon the amount of force, the ECs will release chemicals that either induce dilation or constriction of the smooth muscle surrounding the vessel. It is nearly impossible to mathematically model such a flow using the standard Navier Stokes equations . Rather than give an equation that can model the flow, which has proven to be near impossible the Womersley number is used. This dimensionless number has been developed to give a measure of the frequency and magnitude of pulsations rather than a model of the actual flow. Center math alpha R left frac omega nu right 1 2 R left frac omega rho mu right 1 2 , math As you can see, the equation can take on two forms by substituting mu rho for nu . It can also be shown that Wormesley number is primarily influenced by the size of the vessel which can be shown in the table below. Since the density of blood and blood viscosity remain fairly c ... more details
In biomechanics , the Moens Korteweg equation models the relationship between wave speed or pulse wave velocity PWV and the incremental elastic modulus of the arterial wall or its distensibility . The equation was derived independently by Adriaan Isebree Moens ref Cite thesis publisher S.C. Van Doesburgh location Leiden, The Netherlands last Moens first Adr. Isebree title Over de voortplantingssnelheid van den pols language Dutch trans title On the speed of propagation of the pulse year 1877 degree Ph.D. ref ref cite book last Moens first A. Isebree title Die Pulskurve publisher E.J. Brill location Leiden, The Netherlands language German trans title The Pulse Curve year 1878 oclc 14862092 url http www.archive.org details diepulscurve00iseb ref and Diederik Korteweg . ref cite journal last Korteweg first D.J. title Uber die Fortpflanzungsgeschwindigkeit des Schalles in Elastischen Rohren journal Ann. Phys. Chem. NS year 1878 pages 52 537 volume 5 ref It is derived from Newton s laws of motion Newton s second law of motion , using some simplifying assumptions, ref name Milnor1982 cite book last Milnor first William R. title Hemodynamics publisher Williams & Wilkins location Baltimore year 1982 isbn 0 683 06050 3 ref and reads math PWV sqrt dfrac E text inc cdot h 2r rho math The Moens Korteweg equation states that PWV is proportional to the square root of the incremental elastic modulus, E sub inc sub , of the vessel wall given constant ratio of wall thickness, h , to vessel radius, r , and blood density, , assuming that that the artery wall is isotropic and experiences isovolumetric change with pulse pressure. ref cite journal last1 Gosling first1 R.G. last2 Budge first2 M.M. title Terminology for Describing the Elastic Behavior of Arteries journal Hypertension year 2003 volume 41 pages 1180 1182 doi 10.1161 01.HYP.0000072271.36866.2A issue 6 ref References reflist Further reading cite book last1 McDonald first1 Donald A. first2 Wilmer W. last3 O Rourke first3 Micha ... more details
altitude exposure on cerebral hemodynamics in normal subjects journal STROKE volume 36 issue 3 year ... system Hemodynamics DEFAULTSORT Cerebral Edema Category Cerebrum Category Body water ar ... more details
monitoring hemodynamics, through the use of 4 dual sensors placed on the neck and chest. Both ... references Category Hemodynamics Category Cardiology ... more details
Cardiovascular physiology is the study of the circulatory system . More specifically, it addresses the physiology of the heart cardio and blood vessel s vascular . These subjects are sometimes addressed separately, under the names cardiac physiology and circulatory physiology . ref http www.lib.mcg.edu edu eshuphysio program section3 3outline.htm Overview at Medical College of Georgia ref Although the different aspects of cardiovascular physiology are closely interrelated, the subject is still usually divided into several subtopics. Heart See Heart Physiology for more details Cardiac output heart rate stroke volume . Can also be calculated with Fick principle . Stroke volume end diastolic volume end systolic volume Ejection fraction stroke volume end diastolic volume Cardiac Output is mathematically to Systole Inotropic , chronotropic , and dromotropic states Cardiac input heart rate suction volume Can be calculated by inverting terms in Fick principle Suction volume end systolic volume end diastolic volume Injection fraction suction volume end systolic volume Cardiac input is mathematically to Diastole Electrical conduction system of the heart Electrocardiogram Cardiac marker Cardiac action potential Frank Starling law of the heart Wiggers diagram Pressure volume diagram Regulation of blood pressure Baroreceptor Baroreflex Renin angiotensin system Renin Angiotensin Juxtaglomerular apparatus Aortic body and carotid body Autoregulation Cerebral Autoregulation Hemodynamics Under most circumstances, the body attempts to maintain a steady mean arterial pressure . When there is a major and immediate decrease such as that due to hemorrhage or Orthostatic hypotension standing up , the body can increase the following Heart rate Total peripheral resistance primarily due to Vasoconstrictor vasoconstriction of arteries Inotrope Inotropic state In turn, this can have a significant impact upon several other variables Stroke volume Cardiac output Pressure Pulse pressure Systole m ... more details
Infobox Disease Name Aneurysmal bone cyst Image Aneurysmal Bone Cyst.jpg Caption The ABC is located on the left, on the fifth metatarsal. Notice that the bone appears to be missing on the x ray. DiseasesDB ICD10 ICD10 M 85 5 m 80 ICD9 ICD9 733.22 ICDO OMIM 606179 MedlinePlus eMedicineSubj radio eMedicineTopic 26 eMedicine mult eMedicine2 article 1254784 MeshID D017824 Aneurysmal bone cyst is a benign osteolytic bone neoplasm characterized by blood filled spaces separated by fibrous septa. The term aneurysmal is mainly derived from its macroscopic appearance. Causes Aneurysmal bone cyst has been widely regarded a reactive process of uncertain etiology since its initial description by Jaffe and Lichtenstein in 1942. Many hypotheses have been proposed to explain the etiology and pathogenesis of aneurysmal bone cyst, and until very recently the most commonly accepted idea was that aneurysmal bone cyst was the consequence of an increased venous pressure and resultant dilation and rupture of the local vascular network. However, studies by Panoutsakopoulus et al. and Oliveira et al. uncovered the clonal neoplastic nature of aneurysmal bone cyst. The lesion may arise de novo or may arise secondarily within a pre existing bone tumor, this is because of the abnormal bones changes in hemodynamics . An aneurysmal bone cyst can arise from a pre existing chondroblastoma , a chondromyxoid fibroma , an osteoblastoma , a Giant cell tumor of bone giant cell tumor , or fibrous dysplasia . A giant cell tumor is the most common cause, occurring in 19 to 39 of cases. Less frequently, it results from some malignant tumors, such as osteosarcoma , chondrosarcoma , and hemangioendothelioma . It can be associated with a TRE17 USP6 translocation. ref name pmid20418905 cite journal author Ye Y, Pringle LM, Lau AW, et al. title TRE17 USP6 oncogene translocated in aneurysmal bone cyst induces matrix metalloproteinase production via activation of NF kappaB journal Oncogene volume 29 issue 25 pages ... more details
Transcutaneous pacing also called external pacing is a temporary means of pacing a patient s heart during a medical emergency. It is accomplished by delivering pulses of electric current through the patient s chest, which stimulates the heart to contract. The most common indication medicine indication for transcutaneous pacing is an abnormally slow heart rate . By convention, a heart rate of less than 60 beats per minute in the adult patient is called bradycardia . Not all instances of bradycardia require medical treatment. Normal heart rate varies substantially between individuals, and many athletes in particular have a relatively slow resting heart rate. In addition, the heart rate is known to naturally slow with age. It is only when bradycardia presents with signs and symptoms of Shock circulatory shock that it requires emergency medicine emergency treatment with transcutaneous pacing. Some common causes of hemodynamics hemodynamically significant bradycardia include acute myocardial infarction , sick sinus syndrome sinus node dysfunction and complete heart block . Transcutaneous pacing is no longer indicated for the treatment of asystole cardiac arrest associated with a flat line on the electrocardiogram ECG , with the possible exception of witnessed asystole as in the case of bifascicular block that progresses to third degree heart block complete heart block without an escape rhythm . During transcutaneous pacing, pads are placed on the patient s chest, either in the anterior lateral position or the anterior posterior position. The anterior posterior position is preferred as it minimizes transthoracic electrical impedance by sandwiching the heart between the two pads. The pads are then attached to a monitor defibrillator, a heart rate is selected, and current measured in milliamps is increased until electrical capture characterized by a wide QRS complex with tall, broad T wave on the electrocardiogram ECG is obtained, with a corresponding pulse. Pacing artifact ... more details
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