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Bicuspid aortic valve diagnosed during life
SELECTED
401
ABSTRACTS
treatment was decreased to less than one-tenth of what it formerly had been. The length of stay in bed was reduced from forty days to less than five days, and incapacitating aftereffects did not BELLET. appear in the majority of cases so treated. Manchester, logic 131:
and 200
R. C.: Toxic
Rheumatic Fever Erects of Intensive
in Naval Salicylate
Enlisted Therapy
Personnel. in Acute
III. Cases.
The PhysioJ. A. M. A.
(May lS), 1946.
Following the regimen outlined by Coburn, thirty-five patients with acute rheumatic fever daily intravenous doses of 10 Gm. of sodium salicylate dissolved in 1 liter of saline solution or Ringer’s lactate solution for four to ten days. Nineteen additional patients received oral therapy throughout the course of treatment, which consisted of between 10 and 12 Gm. of acetylsalicylic acid or sodium salicylate daily, usually in conjunction with 8 Cm. of sodium bicarbonate. Under this regimen, toxic reactions of serious proportions occurred, but these were preventable in most instances. Hypoprothrombinemia occurred frequently, reaching a maximum in the first week of sa!icyl.ate administration, but improved spontaneously thereafter even though large doses were continued. No instance of hemorrhage as a result of hypoprothrombinemia was observed. The alkali reserve was depleted unless adequate amounts of alkali were given in conWhen large doses of salicylates were given orally, between 0.8 and 1 junction with salicylatcs. Cm. of sodium bicarbonate was given with each gram of salicylate. For the same reason, intravenous salicylates should be administered in Ringer’s lactate solution instead of saline solution. Severe delirium, “acute salicylism,” is dependent on the rapid rise in blood salicylate levels associated with intravenous therapy and occurs most often in acutely ill patients who have not built up an antecedent tolerance to the drug. It was not observed in this series, following oral therapy. The author found that serum salicylate levels of 25 mg. per 100 C.C. or higher ‘have been Salicylate therapy was continued until the found to suppress rheumatic infection satisfactorily. erythrocyte sedimentation rate had been normal for two weeks. BELLET. received
Bourne,
G.:
Bicuspid
Aortic
Valve
Diagnosed
During
Life.
Brit. M. J. 1: 609 (April 20),
1946. This author discusses criteria upon which he believes a diagnosis of bicuspid aortic valve may be made during life. These are the appearance of Jhe signs and symptoms of subacute bacterial endocarditis and accompanying aortic insufficiency in an individual, usually young, who has previously been carefully examined and in whom there was no evidence of heart disease of any kind. Since bacterial endocarditis rarely develops upon a normal aortic valve, the sudden appearance of aortic regurgitation together with infective symptoms in a previously normal person is extremely suggestive of the presence of a bicuspid valve. The diagnosis was made in life and con!irmed by necropsy in a case presented by the author. BELLET. Lenegre, Right
J.,
and Auricle
Maurice, P.: and Ventricle
38:298 (Nov.-Dec.),
Some Results by the Direct
of kecording Intracavity
Electrical Lead.
Currents Arch.
From
the
d. mal. du coeur.
1945.
The authors report some of their results in e!ectroc&diograms recorded from within the right auricle and ventricle in man. Their technique involved the use of a soft exploring electrode of tin which projects from the end of a No. 13 urctera! catheter. A gold wire in the lumen of the catheter connected the lcad wire to the electrode. The catheter was inserted into an antccubital vein and, under fluoroscopic observation, was passed into the right auricle or ventricle. The indifferent electrode was placed on the left leg. The inera-auricular and intraventricular leads were recorded simultaneously with the three limb leads. Records obtained from within.the right auricle showed rapid auricular waves of co&iderab!e amplitude which were often analogous to those obtained from an esophageal lead. Records ob-
401
ABSTRACTS
treatment was decreased to less than one-tenth of what it formerly had been. The length of stay in bed was reduced from forty days to less than five days, and incapacitating aftereffects did not BELLET. appear in the majority of cases so treated. Manchester, logic 131:
and 200
R. C.: Toxic
Rheumatic Fever Erects of Intensive
in Naval Salicylate
Enlisted Therapy
Personnel. in Acute
III. Cases.
The PhysioJ. A. M. A.
(May lS), 1946.
Following the regimen outlined by Coburn, thirty-five patients with acute rheumatic fever daily intravenous doses of 10 Gm. of sodium salicylate dissolved in 1 liter of saline solution or Ringer’s lactate solution for four to ten days. Nineteen additional patients received oral therapy throughout the course of treatment, which consisted of between 10 and 12 Gm. of acetylsalicylic acid or sodium salicylate daily, usually in conjunction with 8 Cm. of sodium bicarbonate. Under this regimen, toxic reactions of serious proportions occurred, but these were preventable in most instances. Hypoprothrombinemia occurred frequently, reaching a maximum in the first week of sa!icyl.ate administration, but improved spontaneously thereafter even though large doses were continued. No instance of hemorrhage as a result of hypoprothrombinemia was observed. The alkali reserve was depleted unless adequate amounts of alkali were given in conWhen large doses of salicylates were given orally, between 0.8 and 1 junction with salicylatcs. Cm. of sodium bicarbonate was given with each gram of salicylate. For the same reason, intravenous salicylates should be administered in Ringer’s lactate solution instead of saline solution. Severe delirium, “acute salicylism,” is dependent on the rapid rise in blood salicylate levels associated with intravenous therapy and occurs most often in acutely ill patients who have not built up an antecedent tolerance to the drug. It was not observed in this series, following oral therapy. The author found that serum salicylate levels of 25 mg. per 100 C.C. or higher ‘have been Salicylate therapy was continued until the found to suppress rheumatic infection satisfactorily. erythrocyte sedimentation rate had been normal for two weeks. BELLET. received
Bourne,
G.:
Bicuspid
Aortic
Valve
Diagnosed
During
Life.
Brit. M. J. 1: 609 (April 20),
1946. This author discusses criteria upon which he believes a diagnosis of bicuspid aortic valve may be made during life. These are the appearance of Jhe signs and symptoms of subacute bacterial endocarditis and accompanying aortic insufficiency in an individual, usually young, who has previously been carefully examined and in whom there was no evidence of heart disease of any kind. Since bacterial endocarditis rarely develops upon a normal aortic valve, the sudden appearance of aortic regurgitation together with infective symptoms in a previously normal person is extremely suggestive of the presence of a bicuspid valve. The diagnosis was made in life and con!irmed by necropsy in a case presented by the author. BELLET. Lenegre, Right
J.,
and Auricle
Maurice, P.: and Ventricle
38:298 (Nov.-Dec.),
Some Results by the Direct
of kecording Intracavity
Electrical Lead.
Currents Arch.
From
the
d. mal. du coeur.
1945.
The authors report some of their results in e!ectroc&diograms recorded from within the right auricle and ventricle in man. Their technique involved the use of a soft exploring electrode of tin which projects from the end of a No. 13 urctera! catheter. A gold wire in the lumen of the catheter connected the lcad wire to the electrode. The catheter was inserted into an antccubital vein and, under fluoroscopic observation, was passed into the right auricle or ventricle. The indifferent electrode was placed on the left leg. The inera-auricular and intraventricular leads were recorded simultaneously with the three limb leads. Records obtained from within.the right auricle showed rapid auricular waves of co&iderab!e amplitude which were often analogous to those obtained from an esophageal lead. Records ob-