Thesis (Ph. D.)--University of Washington, 1990. / Vita. Includes bibliographical references (leaves [270]-296).

No description available.

Thesis (M. Res. (Med.))--University of Hong Kong, 2006.

Thèse d'exercice : Médecine. Cardiologie et pathologies vasculaires : Université de Nantes : 2005. / Bibliogr. f. 107-120 [244 réf.].

published_or_final_version / Medicine / Master / Master of Philosophy

Thesis (M. Res.(Med.))--University of Hong Kong, 2007.

Thesis (Ph.D.)--Boston University

The endotracheal (ET) route for the administration of selected drugs has been proposed as an effective alternate route of drug administration during emergency situations when an intravenous (IV) line cannot be established. Lidocaine may be beneficial in the treatment of ventricular fibrillation (VF) resulting from acute myocardial infarction, although this hypothesis has not been confirmed in the literature. The efficacy of lidocaine in the treatment of ventricular fibrillation due to acute coronary artery ligation was examined, as well as the use of the endotracheal route as an alternative to IV injection. Rabbits were anesthetized with sodium pentobarbital or halothane, intubated with an endotracheal tube, and animals receiving pentobarbital were mechanically respired. Ventricular fibrillation was produced by occlusion of the left circumflex coronary artery, or by subsequent reperfusion of ischemic myocardium. Endotracheal administration of 2mg/Kg lidocaine (2mg/ml in normal saline) resulted in lower peak plasma lidocaine concentrations initially compared with IV injection, but more sustained levels in the therapeutic range for lidocaine (p<0.05). Administration of lidocaine either IV or ET during ventricular fibrillation resulted in a significant increase (p<0.05) in plasma lidocaine concentrations during the first minute compared with controls. During ventricular fibrillation there was no significant difference between plasma lidocaine levels following IV or ET administration. Administration of lidocaine 2mg/Kg endotracheally (in normal saline) during VF resulted in a significant decrease in the duration of fibrillation compared with untreated and normal saline controls (p <0.001). / Pharmaceutical Sciences, Faculty of / Graduate

La fibrillation auriculaire (FA) est une pathologie très répandue qui affectera au sein de la population occidentale, une personne sur quatre au cours de sa vie. À partir d'extraits d'appendices auriculaires chez des patients, nous avons mesuré les niveaux d'expression de gènes et des protéines de communication intercellulaire des connexines (Cx) 40 et 43 et de marqueurs inflammatoires (TNF-a, 1TL-Ip\ IL-6, IL-8 et le Nf-icb) par PCR en temps réel, par immunobuvardage de type Western et par immunoessai de type sandwich à l'aide d'un système Bio-Plex®. Les résultats quantitatifs ont été confrontés aux données cliniques afin d'identifier des corrélations entre les résultats et certaines conditions pathologiques comme le syndrome métabolique (SM), le diabète de type II (DU) et la FA post-opératoire (FAPO). Notre étude n'a pas démontré de relation entre la FAPO et l'expression des marqueurs inflammatoires et des protéines de communication intercellulaire. Une sous-expression de la Cx40 chez les individus atteints de SM et de DU et une surexpression de IL-1P chez le groupe de DU ont été observées. La FAPO est une pathologie complexe qui émerge d'une combinaison de variables physiologiques mais aussi opératoires souvent imprévisibles.

Atrial fibrillation is a common arrhythmia encountered in the emergency department. In the United States, newly diagnosed cases of atrial fibrillation is projected to be 2.6 million cases in 2030 and the annual prevalence of atrial fibrillation is expected to be 12.1 million in 2030 (Colilla et al., 2013). Patients may present to the emergency department for treatment of atrial fibrillation with a variety of symptoms and therefore makes diagnosing atrial fibrillation based on symptomatology challenging for the clinician. The primary goal of this Doctor of Nursing Practice (DNP) project is to describe symptoms of atrial fibrillation in patients that seek medical treatment in the emergency department. Methods: This descriptive study contains secondary analysis of existing data derived from structured interviews that took place at two academic medical centers. This analysis included 74 patients that presented to the emergency department with symptoms suspected of acute coronary syndrome and were later diagnosed with atrial fibrillation. Descriptive statistics were used to synthesize data, while inferential statistics (bivariate tests) were used to compare symptoms between the age groups. Results: The mean age of subjects was 70 + 13 years, ranging 31 to 92 years. The majority of subjects were men (75.7%) and whites (90.5%). The most common symptoms reported by study subjects included chest discomfort (n = 50; 67.6%), followed by generalized weakness (n = 39; 52.7%) and shortness of breath (n = 39; 52.7%), and palpitations/ funny beating of the heart (n = 36; 48.6%) and unusual fatigue/ tiredness (n = 36; 48.6%). Sweating was the only symptom that was statistically significant in the younger adult group than in the older adult age group. Conclusion: The symptoms identified in this DNP project can be used to aid in identifying patients that present to the emergency with symptomatic atrial fibrillation. Further efforts for the assessment of atrial fibrillation should focus on the dissemination of common although nonspecific symptoms to facilitate the inclusion of atrial fibrillation as part of the differential diagnosis.