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The Belgian law legalizing euthanasia under strict conditions came into effect September 22, 2002. Any physician performing euthanasia has to complete a registration document and to send it within four days to a federal commission whose mission is to verify that the legal conditions were fulfilled. From September 22, 2002 to December 31, 2013, 8.767 documents have been registered and analyzed by this commission. They are described in six reports referred to Parliament. The present paper analyzes the work of this commission and answers the criticisms concerning its quality and its efficiency. The allegations that clandestine euthanasia's escaping any control are performed are also discussed. In conclusion, it appears that the legal obligations concerning the practice of euthanasia in Belgium are fully effective., SCOPUS: ar.j, info:eu-repo/semantics/published

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The first report of the federal commission of control and evaluation of euthanasia, transmitted to Parliament on September 17, 2004, gives interesting data concerning the practice of euthanasia in Belgium under the conditions specified by the law of May 28, 2002. The present paper analyses and comments upon this report., SCOPUS: re.j, info:eu-repo/semantics/published

The Belgian law relative to euthanasia prescribes that a physician performing an euthanasia has to complete a registration document and to send it within 4 days to the federal commission for control and evaluation of euthanasia. The 259 first documents are described in the report of the commission referred to Parliament on September 17, 2004. The present paper analyses this report and compares its most important data with those published in the Netherlands: apart from the total number of euthanasia's, much smaller in Belgium, and apart from aspects which are specifically related to the Belgian law, the statistical data are very similar in both countries. The difference in the number of registration documents written in French and in Flemish is analyzed and discussed. A first evaluation of the application of the law in a supportive and palliative care unit is reported., Comparative Study, English Abstract, Evaluation Studies, Journal Article, SCOPUS: ar.j, info:eu-repo/semantics/published

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The electrophysiologic effects of xamoterol were studied in ten patients with electrophysiologic evidence of sinus node dysfunction. A significant shortening of mean sinus cycle length, maximal corrected sinus-node recovery time, and the mean of the three longest corrected sinus-node recovery times was observed after intravenous administration of 0.1 mg/kg of xamoterol. The atrioventricular (AV) conduction time and the effective and functional refractory periods of the AV node were shortened as the effective refractory period of the atrium. These effects suggest that xamoterol could be tried safely for the treatment of patients with moderate symptoms due to sinus-node disease. © 1990 Kluwer Academic Publishers., SCOPUS: ar.j, info:eu-repo/semantics/published

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False tendons are well recognized structures of the left ventricle. They are fibromuscular strings joining 2 ventricular walls or 2 papillary muscles, distinct from the chordae tendineae, which join papillary muscles to mitral valve leaflets. These structures can be identified using 2-dimensional echocardiography.1 The reported frequency of false tendons in children has varied2,3; that in adults is about 5%.4 False tendons have been suggested as a cause of precordial musical murmur.5 To our knowledge, no causative association with any heart disease has been shown.4,6 We describe a patient with echocardiographic evidence of a chordal structure corresponding to a false tendon associated with a left ventricular (LV) aneurysm. We have encountered 4 other patients with similar abnormalities. © 1985., SCOPUS: ar.j, info:eu-repo/semantics/published

Fifty-five consecutive adult patients with mitral stenosis (MS) were investigated by Doppler echocardiography, to assess the severity of MS. The measurement of mitral valve area (MVA) by cross-sectional echocardiography (CSE) was considered as the reference method, because catheterization data are often inadequate when combined lesions are present. Doppler MVA was calculated from apical mitral flow using the pressure half-time method. Adequate Doppler recordings (52 on 55) were easier to obtain than adequate CSE images. The correlation between both methods was excellent (r = 0.90, SEE: 0.42 cm2) despite systematic underestimation of MVA by Doppler versus CSE. From our data, the following regression equation could be drawn, providing MVA from Doppler measurements: MVA = 250 (pressure half-time)-1 +0.15, where the area is in cm2 and half-time in ms. Both severe and mild MS were identified by Doppler with enough accuracy for clinical use. Reproducibility, inter and intraobserver variability were better for Doppler than for CSE. We conclude that Doppler seems particularly suitable for noninvasive quantification of MS and for patient follow-up., SCOPUS: ar.j, info:eu-repo/semantics/published

Although Doppler echocardiography allows recording of regurgitant turbulent flow patterns in normal persons, sparse information is available concerning the incidence, characteristics and mechanism of these flow patterns. Therefore, pulsed Doppler echocardiograms were recorded in 25 normal persons to detect regurgitation. A regurgitant turbulent flow pattern was recorded at the pulmonic valve in 23 subjects (92%), covered up to 81% of the diastole and could never be recorded in early diastole. An early to midsystolic regurgitant flow pattern was recorded at the mitral valve in 10 subjects (40%) and covered up to 60% of systole. A similar regurgitant flow was recorded at the tricuspid valve in 11 subjects (44%) and was holosystolic in 1 subject. An early diastolic regurgitant flow with low maximal velocities and rapid decrease in velocities was recorded at the aortic valve in 8 subjects (33%) and covered up to 26% of the diastole. In no person could those flows be recorded farther than 1 cm proximal to the valve closure. Whatever the still-debated mechanisms of those regurgitant flow patterns in normal subjects, one should be aware of their existence and characteristics when assessing valvular function by Doppler. © 1986., SCOPUS: ar.j, info:eu-repo/semantics/published

The authors describe a very simple operated system by which single breath CO diffusing capacity can be measured in anesthetized dogs. All controls and the automatic system are operated pneumatically. Cams forming an integral part of the pistons of the inspiratory and expiratory syringes activate push buttons which control the valves, enabling dead spaces to be flushed, a specific volume of air to be injected into the dog's lungs, and expiratory samples to be taken. Their results, due account being taken of the dogs' weight, are in the upper range of normal values published in earlier studies; the reproducibility of the method is good., SCOPUS: ar.j, info:eu-repo/semantics/published

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In order to assess the value of pulsed Doppler echocardiography in detection of valvular regurgitation, 63 patients were evaluated for aortic and/or mitral regurgitation using pulsed Doppler echocardiography and selective cineangiography. The Doppler study was considered as positive when a turbulent flow was detected below the aortic valve for aortic insufficiency and behind the mitral valve for mitral insufficiency on a graphic display (time interval histogram) when technically adequate and/or on an audiosignal. These results were compared with standard angiographie evaluation of the regurgitation: echocardiography had 94% sensitivity and the specificity rate was very high (87.5%) even for mild regurgitation. Thus, Doppler technique is highly specific and sensitive in detection of aortic and mitral regurgitation when both audiosignal and time-interval histogram are simultaneously performed., SCOPUS: ar.j, info:eu-repo/semantics/published

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In a group of 50 patients we investigated the daily reproducibility of the resting heart rate (RHR), the maximal corrected sinus node recovery time (CSNRTM), the pacing rate at which the CSNRTM occurred (OP), and the sinoatrinl conduction time (SACT) during basal slate. The study population was divided into two groups according to the presence or absence (as evidenced during the initial electrophysiologic study) of sinus node disease: group I included 35 patients with normal sinus node function, and group II included 15 patients with sick sinus syndrome. The electrophysiologic study was repeated approximately al the same hour and under similar conditions after an interval of at least two days (mean: 3.2 days for group I and 4.7 days for group II). The results showed good reproducibility with the exception of RHR in group I which slightly but significantly decreased in the second electrophysiohgic study. The daily variations of the sinus node parameters appeared to be of similar levels in the two groups except for the CSNRTM; this parameter showed wide variations in single values in both groups, more marked in group II than in group I. Furthermore, if the CSNRTM and/or SACT were normal, it was likely that they would remain normal whatever the electrophysiologic status of the patient. Inversely, the change of status from abnormal to normal CSNRTM or SACT was not uncommon in patients with electrophysiologic signs of sinus node disease., SCOPUS: ar.j, FLWNA, info:eu-repo/semantics/published

We evaluated the hemodynamic effects of combined administration of metoprolol and tocainide in nine patients with uncomplicated acute myocardial infarction. After 24 h of treatment with oral metoprolol (50 mg q.8 h), intravenous tocainide was given (750 mg over 15 min), followed by oral administration of both drugs (50 mg metoprolol q.8 h; 800 mg tocainide, then 400 mg q.8 h). Hemodynamic variables were measured before and after 25 h of oral metoprolol treatment, immediately after intravenous tocainide (at 15 and 30 min), and then during continued oral treatment with both drugs (at 2 h 15 min and 25 h 45 min). Following injection of tocainide, cardiac index changed significantly (2.7-2.3 L/min.m2; p<0.01), but the increases in pulmonary wedge pressure (9-13 mm Hg) and total systemic resistance (15.9-18.1 IU) were not significant. During the continued oral treatment with both metoprolol and tocainide no significant hemodynamic interaction was observed. We conclude that the injection of tocainide can slightly and transiently depress left ventricular function in patients treated with metoprolol., SCOPUS: ar.j, info:eu-repo/semantics/published

We report a case of mitral valve aneurysm formation and perforation, secondary to Streptococcus sanguis endocarditis of the aortic valve. Aneurysm formation was documented by cross-sectional echocardiography and its perforation was established by Doppler colour flow mapping, and subsequently confirmed at surgery., SCOPUS: ar.j, info:eu-repo/semantics/published

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A double-blind randomised, parallel, placebo-controlled study was performed in patients with congestive heart failure, at 13 centres in 10 countries, to assess the efficacy and safety of lisinopril, a new antiotensin-converting enzyme inhibitor. After a 2-week run-in period, 130 patients receiving digoxin and/or diuretics were randomised to 12 weeks of treatment with lisinopril 5 mg daily (87 patients) or with placebo (43 patients), with an option to increase lisinopril dosage to 10 or 20 mg. Patients treated with lisinopril improved significantly more than placebo-treated patients (p < 0.05) for all clinical parameters except oedema and paroxysmal nocturnal dyspnoea. Left ventricular ejection fraction rose by 8% in lisinopril patients compared to 2% in the placebo group, while the cardiothoracic ratio and echocardiographic end systolic diameter fell in the lisinopril group (p < 0.01) but not in the placebo group. Exercise duration was greater in the lisinopril group at all timepoints, and the increase in exercise duration at 12 weeks was greater by more than 2 min in the lisinopril group as compared to the placebo group (p < 0.01). Changes in clinical and noninvasive parameters such as the New York Heart Association status, were well correlated with changes in exercise duration. Four patients in the lisinopril group and three in the placebo group died in this study, and there were 31 adverse clinical experiences in the 87 lisinopril-treated patients compared to 13 in the 43 placebo-treated patients. We conclude that lisinopril in doses of 2.5-20 mg/ day is well tolerated and effective in patients with heart failure who are receiving digitalis and diuretics. © 1987 Raven Press, New York., SCOPUS: ar.j, info:eu-repo/semantics/published

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The authors compared two methods of measurements of the elastic lung properties in normal subjects and in pathology. For pulmonary volumes greater than the functional residual capacity, there is no difference between the elastic recoil measured by the quasi static method and that obtained by the true static method, both in normal and pathologic subjects. For lung volumes under FRC, the quasi static method underestimates the elastic recoil., SCOPUS: NotDefined.j, info:eu-repo/semantics/published

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The mechanical and the diffusing lung properties have been measured in 19 cases of diffuse fibrosing alveolitis of unknown etiology (proved by histology in 17 cases). The characteristic findings are: a striking reduction in lung diffusing capacity for CO in all the cases; a marked reduction of the static and dynamic compliance, in correlation with the reduction of vital capacity; an increase in total lung capacity in correlation with the decrease of the helium dilution method; an increase of the elastic recoil when it is considered at various percentages of the predicted lung volume, but in some cases a normal shape of the volume pressure curve if the measured lung volume is taken into account; a reduction of the maximum expiratory flows suggesting bronchiolar stenosis; alterations of lung diffusing capacity (DL) more marked than those of lung compliance suggesting that DL is a more sensitive test., SCOPUS: ar.j, info:eu-repo/semantics/published

Electrophysiologic studies of sinus node function were performed in 61 patients without organic heart disease and with a wide range of ages. All had normal extrinsic and intrinsic electrophysiologic parameters of sinus node function. The electrophysiologic study of the sinus node function was performed four times: at basal state, under sympathetic blockade, under parasympathetic blockade, and after autonomic blockade. All the electrophysiologic variables of the intrinsic sinus node function lengthen progressively with age, showing an aging of the intrinsic sinus node throughout life. Furthermore, the respective effects of the two components of the autonomic nervous system differ significantly according to age: vagal tone predominates in young people and decreases with increasing age; sympathetic activity increases with increasing age and becomes most prominent in the elderly. The normal sinus node function represents an equilibrated system. In parallel with aging of the intrinsic properties of the sinus node, vagal tone decreases and sympathetic activity increases in such a way that the basal properties remain stable throughout life., SCOPUS: NotDefined.j, info:eu-repo/semantics/published

In 44 patients undergoing operation for mitral disease, the pulmonary volumes, the pulmonary mechanics and the alveolocapillary transfer of CO were examined prior to the operation and 3 times postoperatively: in the 3rd or 4th wk, between the 3rd and 5th mth and between the 10th and 14th mth. During the immediate postoperative period an episode of considerable aggravation of functional impairment was observed which was not due exclusively to the surgical trauma of the chest wall but also to specific affection of the alveolocapillary membrane. One year postoperatively, the preoperative functional alterations were found to have only partially returned. In particular, the transfer of CO and the resistance of the respiratory tract remained abnormal even in cases running a favorable clinical course. The possible causes of these phenomena are discussed. (11 references)., SCOPUS: NotDefined.j, info:eu-repo/semantics/published

The bioavailability of propranolol administered at the same dosage as an oral tablet (Inderal) or a sustained-release capsule (Inderal Retard) was determined by its physiological effects on the heart rate recorded in 10 subjects over 96 hours., SCOPUS: NotDefined.j, info:eu-repo/semantics/published

The elastic properties of the lung (elastic recoil and static compliance) were studied in 22 young subjects by a quasistatic method. There is a significant relationship between pulmonary compliance and the height of the subjects, but the static expiratory pressures are independent of the height or the pulmonary volumes. Static inspiratory pressures have also been studied. The variations of pulmonary elasticity with age and sex are discussed., SCOPUS: ar.j, info:eu-repo/semantics/published

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