Prognostic significance of electrocardiographic findings in angina at rest. Therapeutic implications.

Ninety-five patients with angina at rest were observed in the coronary care unit. Eighty-one per cent presented concomitantly or had previously presented some other manifestations of coronary artery disease. These patients were divided into two subgroups. In subgroup 1 (40 patients), episodes of non-exertional angina were associated with a pattern of hyperacute subepicardial injury and, frequently, with ventricular arrhythmias. In subgroup 2 (55 patients), the episodes of angina at rest were attended by horizontal ST depression, isolated T wave inversion, or trivial ST-T changes. Coronary angiographic findings were similar in both subgroups. Symptoms regressed in only 9% of patients in subgroup 1 while they were receiving beta-receptor antagonists, whereas amiodarone alone or amiodarone with nifedipine was successful in 58%. Of these patients, 25% developed a myocardial infarction shortly after admission. In subgroup 2 patients, beta-blockers were successful in 61%. Amiodarone isolated or associated with nifedipine was successful in 55% of the patients in whom it was tried. Only 5% of patients in this subgroup developed a myocardial infarction during their hospital stay. It is concluded that: (1) observation of the electrocardiogram during spontaneous angina in patients with known atherosclerotic coronary heart disease may be of prognostic significance and may influence therapeutic decision. (2) Amiodarone by virtue of its anginal and antiarrhythmic properties may be particularly useful in the treatment of non-exertional angina

Ion Temperature-Measurements in a Tokamak by Collective Thomson Scattering

Collective Thomson scattering, using a high-power pulsed D2O laser at 385-mu-m and a heterodyne receiver system, has provided local ion temperature (T(i)) measurements of the plasma in the tokamak chauffage Alfven (TCA) tokamak. Recent improvements in the noise-equivalent power of the Schottky barrier diode mixers permitted us to achieve a typical precision of +/- 12% for a single shot measurement at densities above 10(20) m-3. Even at densities of standard TCA discharges (5 x 10(19) m-3) the uncertainty is better than +/- 25%. For the interpretation of the measured spectra and the evaluation of T(i) the local value of the electron temperature (T(e)) is an important parameter. Therefore, T(e) was measured simultaneously by incoherent Thomson scattering at 0.694-mu-m during a series of shots. The density was obtained from a far-infrared interferometer. An independent measurement of T(i) on TCA can be obtained from a neutral particle analyzer. Comparison of the results from the two methods showed good agreement. The precision of a T(i) measurement depends strongly on the plasma density. Since an uncertainty of +/- 25% at standard densities may still not be regarded as satisfactory, further investigations using a numerical simulation code have been carried out to find ways of improvement

Optimisation du traitement médicamenteux des patients atteints de BPCO en état stable. Position de la Société de pneumologie de langue française. Actualisation 2021

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