Ellen McDevitt

CEREBRAL VASCULAR DISEASES: THEIR SIGNIFICANCE, DIAGNOSIS AND PRESENT TREATMENT, INCLUDING THE SELECTIVE USE OF ANTICOAGULANT SUBSTANCES

Excerpt Cerebral vascular diseases include some of the most serious and widespread of disease processes which still remain among those most neglected. They have been treated too long with a fatalis...

A Long Term Study of Cerebral Vascular Disease.

Excerpt A study of cerebral vascular disease, utilizing the patients on the wards of the Second (Cornell) Medical and Neurological Services and the First (Columbia) Medical Service, has been in pro...

The electrocardiogram in scleroderma: Analysis of 60 cases and review of the literature☆

Abstract Since the paper of Weiss and associates 1 reporting 9 cases of scleroderma heart disease, other authors have described new cases, making mention of the electrocardiographic changes found in such patients. However, most of these reports concern a small number of cases, and the electrocardiograms are not discussed in detail. † †After this paper was prepared, a new report by Windesheim and Parkin appeared. 23 Several electrocardiographic alterations have been described, all of them nonspecific. The purpose of this article is to report our experience with a larger series of patients, correlating the electrocardiograms with the clinical, physiopathologic, and morphologic findings.

Problems of anticoagulant therapy in cerebrovascular disease

FOR the past twenty-seven months, a study of cerebrovascular diseases has been in progress at BeUevue Hospital. A phase of this study has been concerned with the use of anticoagulant drugs in cerebral thromboembolism. McDevitt, Groch, and Wright9 in a preliminary report have briefly discussed this study, including the results of anticoagulant therapy. The present report is concerned with a more detailed analysis of the difficulties and complications which may occur among the population group of a busy city hospital in which admissions are entirely unselected. Materials and methods have been described previously. Patients with cerebrovascular disease admitted to the medical and neurologic wards of the Second Division (Cornell) and to the medical wards of the First Division (Columbia) of Bellevue Hospital constituted the clinical material. The initial evaluation of the patient was carried out by the ward physicians. Every patient included in the study had a carefully performed lumbar puncture. The patient was then seen by the neurologist of the study group and placed in 1 of 2 categories. Group 1: If the diagnosis of cerebral thrombosis was clearly evident and no known contraindication to the use of anticoagulants existed, a previously randomized selector system was used to determine whether the patient should receive anticoagulant therapy. Group 2: If the evidence supported a diagnosis of cerebral embolism or a stroke accompanied myocardial infarction, the patient received anticoagulants on an obligatory basis and thus was removed from the controlled study. While the patient was still on the hospital ward, daily anticoagulant therapy and routine medical care were directly supervised by the ward physicians, in consultation with the study

A clinical trial of premarin in cerebrovascular disease

Abstract A double blind study was carried out in which patients with atherosclerotic cerebrovascular disease and cerebral infarction were randomly selected for treatment with 1.25 mg Premarin or placebo. No prophylactic effect in preventing the recurrence of cerebrovascular accidents or myocardial infarctions could be demonstrated when patients were followed from 6 months to 3 yr. The data from this study suggests that Premarin in this dosage, 1.25 mg, may have a harmful effect as the treated patients in general fared less well than the controls.

Dicumarol, Coumadin, Marcumar and Tromexan Comparative Study of Their Action on the Clot as Registered by the Thrombelastogram

There is considerable interest and some difference of opinion about the relative clinical usefulness of many oral anticoagulant agents. In this study the more commonly used agents are evaluated with respect to their action on the clotting process as measured by thrombelastography. This test does not necessarily provide an evaluation of all aspects of the clinical action of an anticoagulant.

Studies of Vasospasm I. The Use of Glyceryl Trinitrate as a Diagnostic Test of Peripheral Pulses

In the course of a physical examination one is often confronted with the question whether the inability to palpate a pulse in a usual location is the result of arterial spasm, occlusive arterial disease, or an aberrant location of the artery. Evidence is presented that the sublingual administration of glyceryl trinitrate (nitroglycerin) will frequently solve this problem. If the absent or markedly diminished pulse becomes bounding and objective tests confirm this, it can be concluded that the reduced pulsation was due to spasm of the artery under study. This is a simple test readily applied in clinical practice.

VITAMIN STATUS OF THE POPULATION OF THE WEST COAST OF NEWFOUNDLAND WITH EMPHASIS ON VITAMIN C

Excerpt The isolation and synthesis of many of the vitamins have given a tremendous impetus to the study of nutrition throughout the world. Investigations have been conducted in various countries i...