Testing ambulatory monitors

No data exist regarding the efficacy of antiarrhythmic therapy in mitral valve prolapse patients with hemodynamically significant mitral regurgitation. At present, /3-blockers seem preferable when ventricular performance permits. Class I agents should be used with careful follow-up by ambulatory monitoring and/or exercise testing to avoid any proar-rhythmic effects. 

Only a small fraction ofthe studies reported have been conducted outside the laboratory. The main reason for the predominance of laboratory research in psychophysiology may be the problem of bringing various physiological measures to the field. However, the now available multichannel ambulatory monitoring systems (see chap. 5, this volume) will increase the number of physiological systems that can be monitored continuously. Hypotheses that have been developed and for which evidence has been found within experimental studies that include the differential sensitivity of cardiorespiratory and electrodermal variables for determining mental versus emotional strain (Boucsein, 1992,1993) need to be tested in the field as well. 

More definitive diagnostic tests include endoscopy (via endoscope or Pillcam ESO capsule), 24-hour ambulatory pH monitoring, diagnostic proton pump inhibitor (PPI) administration, or esophageal manometry. 

Hour ambulatory pH monitoring A test that quantifies the amount of acid that refluxes into the esophagus over 24 hours under ambulatory (outpatient) conditions. 

After acute PSVT is terminated, long-term preventive treatment is indicated if frequent episodes necessitate therapeutic intervention or if episodes are infrequent but severely symptomatic. Serial testing of antiarrhythmic agents can be evaluated in the ambulatory setting via ambulatory ECG recordings (Holter monitors) or telephonic transmissions of cardiac rhythm (event monitors) or by invasive electrophysiologic techniques in the laboratory. 

The vessels to be dilated must su btend at least a moderate area of viable myocardium In the physician s judgment, there should be evidence of myocardial ischemia such as ECG exercise testing, stress nuclear imaging, stress echocardiography, ambulatory ECG monitoring, or intracoronary physiologic measu rements... 

Caracciolo EA, Chaitman BR, Forman SA, et al. Diabetics with coronary disease have a prevalence of asymptomatic ischemia during exercise treadmill testing and ambulatory ischemia monitoring similar to that of nondiabetic patients An ACIP database study. ACIP Investigators. Asymptomatic Cardiac Ischemia Pilot Investigators. Circulation 1996 93 2097-2105. 

The Bernstein test, another procedure used to measure gastric fluid pH, is less expensive than ambulatory pH monitoring. This procedure requires inserting a nasogastric (NG) tube and administrating... 

The behavioral effects of dermal exposure to maneb were studied in adult male Swiss mice (Mitchell et al. 1989). Five mice per dose group were dermally exposed to either 16, 160, or 1,600 mg/kg maneb in a conditioned taste aversion assay. Aversion to a saccharin solution was tested 24 hours following the dermal application of the compound to a shaved area on the mouse s back, immediately caudal to the skull. Maneb application did not affect taste aversion compared to water controls. Activity was measured for both ambulatory and nonambulatory activity ambulatory was when a subject sequentially disrupted at least two adjacent infrared beams in an activity monitor nonambulatory activity was when a subject sequentially broke the same beam. When given at a dose of 1,600 mg/kg, maneb increased the activity levels of a tested group (5 subjects) by 3-fold over controls. When the mice were tested individually, however, there were no... 

Buse, L., Pawlik, K. (1996). Ambulatory behavioral assessment and in-field performanee testing. In J. Fahrenberg M. Myrtek (Eds.), Ambulatory assessment Computer-assisted psychological and psychophysiological methods in monitoring and field studies (pp. 29-50). Seattle Hogrefe Huber. 

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