ness and cavity size have not been studied previously in athletes. In this investigation, RVAW was increased in all participants and RV cavity was increased in most. Whether this increase in RVAW was part of the general hypertrophy which occurs in the heart of if this was related to prolonged elevation of pulmonary artery pressure during in-water training for 2-4 hours per day is not known. Clearly this is not an altitude factor alone since the previous normals were from the same community. We cannot explain why the aortic and aortic cusp separation measurements exceeded the 95th percentile of normal in most swimmers.In summary, the unique finding of this investigation is that children who participate extensively in training programs
The main objective in the use of computer-based systems which dynamically order hospital waiting lists is to produce a more systematic and clinically acceptable pattern of selection from the waiting list than that resulting from traditional manual systems. This has been achieved previously through the evaluation of fairly complex mathematical formulae which require detailed analysis to modify their behaviour pattern, and thus separate the clinician from direct control of the system.This paper describes a waiting list management system which uses a conceptually simple ordering process based on waiting time limits set by the clinician for each planned clinical procedure relevant to the specialty. The clinician receives periodic analyses of the current performance of the process and can easily control the behaviour pattern by changing the limits for any procedure. The system also keeps account of allocated bed and theatre resources.Use of this waiting list management system in a Urology Department has resulted in a significant shift in the composition of the waiting list and in a more equitable pattern of selection from the waiting list;. In addition, the time spent by the clinician in managing the waiting list has been considerably reduced.
Although M-mode echocardiography (MME) is not a reliable method for detecting left atrial thrombi, recent reports suggest that two-dimensional echo (2DE) may be more effective than MME in identifying intracardiac thrombi. In three patients with prosthetic mitral valves who presented with either arterial embolization or prosthetic valvular dysfunction, 2DE demonstrated left atrial masses consistent with thrombi, while MME was either negative (two patients) or suspicious (one patient) for left atrial thrombus. Thrombi were documented by surgical or postmortem examination in all cases. Clear delineation of the atrial cavity and the margins of the masses, visualization on multiple echocardiographic views and comparison of serial examinations were helpful in identifying these masses as thrombi. In addition, the masses visualized had certain patterns of motion which seem unique and may allow characterization of atrial masses as thrombi.
The clinical, echocardiographic, and catheterization findings in a patient with discrete subaortic stenosis, aneurysm of the membranous interventricular septum, and mitral valve prolapse are presented. Echocardiography showed a subaortic membrane, abnormal aortic valve motion, accentuated systolic anterior motion of the membranous interventricular septum, and prolapsing mitral leaflets. Cardiac catheterization confirmed the diagnoses. The possible functional interrelationship of these lesions is discussed.
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