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Biomedical subjects

B M Kennelly

Publications and source records attributed to B M Kennelly.

At least 19 recordsLinked to original sources
PubMed2000

Floating gallbladder: a questionable prelude to torsion: a case report.

A 55-year-old woman had recurrent bouts of low substernal and epigastric pain radiating into the interscapular region. A hepatobiliary scan initially showed what was believed to be a dilated common bile duct and nonvisualization of the gallbladder. A delayed image obtained after having the patient move about revealed the presence of a filled gallbladder and normal common bile duct. The combination of recurrent pain with this scintigraphic picture may be representative of a floating gallbladder or an incomplete torsion with spontaneous detorsion. This case is presented to describe the scintigraphic appearance of a mobile gallbladder that may be prone to volvulus and to emphasize the importance of obtaining decubitus or oblique views at the end of a hepatobiliary study in selected cases of unusual findings.

Common Bile Duct↗
PubMed1982

Aetiology and risk factors in young patients with recent acute myocardial infarction.

One hundred and forty-five young patients (aged 18-40 years) with acute myocardial infarction are reported. In 14 of these infarction was due to unusual cause of which infective endocarditis was the most common. One hundred of the patients underwent review of risk factors 2-4 months after infarction: 29% had a previous history of angina, 11% were hypertensive, 85% were smokers during the year before infarction and 5% were ex-smokers, while 31% had a family history of ischaemic heart disease among first-degree relatives and 27% were obese. Seventy-two per cent had serum cholesterol values of greater than 5,7 mmol/l, 63% had fasting serum triglyceride values of greater than 1,7 mmol/l and 29% were hyperuricaemic. Only 2% had none of the following major risk factors: serum cholesterol greater than 6,5 mmol/l, serum triglycerides greater than 1,7 mmol/l, a history of cigarette smoking, a history of hypertension or blood pressure greater than 160/95 mmHg. We conclude that there should be a high index of suspicion for unusual causes of acute myocardial infarction in patients in this age group and that one or more of the major risk factors are an almost invariable finding in patients with infarction of atheromatous origin.

Adolescent↗
PubMed1982

The relationship between angiographic findings and risk factors in young men with myocardial infarction.

Coronary angiography was performed and risk factors were evaluated 2-4 months after myocardial infarction in 50 men aged 40 years or less. There was a high incidence of heavy cigarette smoking, obesity and hyperlipidaemia among these young men. Single-vessel disease (greater than or equal to 70% coronary obstruction) was found in 52%, double-vessel disease in 22% and triple-vessel disease in 20%, the right coronary artery being more frequently involved (greater than or equal to 70% obstructed) or totally occluded than the left anterior descending or left circumflex coronary arteries, in that order. One of the 2 patients with a normal coronary arteriogram had left ventricular angiographic evidence of previous infarction. There was no apparent difference in the distribution of coronary artery disease in this group of young men from the reported distribution found in older subjects. Neither was there any significant correlation of any single major coronary risk factor or combination thereof with the extent or severity of coronary artery obstruction.

Adult↗
PubMed1981

Ventricular tachyarrhythmias induced by disopyramide and other similar anti-arrhythmic drugs.

Two patients with atrial arrhythmias are described who developed ventricular tachyarrhythmias shortly after starting disopyramide therapy. One patient had manifested ventricular tachycardia while on quinidine therapy earlier and the other patient, who died, had survived ventricular tachycardia and fibrillation complicating both quinidine and lidoflazine therapy 5 years earlier. We advise against the use of lidoflazine in patients with previously documented 'quinidine syncope' and caution that ventricular tachyarrhythmias appearing for the first time with the administration of disopyramide should be considered to be drug-induced until proved otherwise.

Aged↗
PubMed1981

Surface recording of His-Purkinje activity on an every-beat basis without digital averaging.

Efforts to record evidence of electrical activity from the body surface originating in the His bundle or bundle branches have been reported since 1973. Almost exclusively, these techniques have required digital averaging of 50-100 sequential cardiac cycles. For immediate diagnostic, therapeutic and prognostic application, recording on an every-beat basis is highly desirable. This is especially important in instances of changing atrioventricular conduction, arrhythmias or less-than-constant RR intervals. Our object has been to develop a system for more nearly optimal noise reduction, to avoid the disadvantages of serial signal averaging, and to be able to record His-Purkinje activity in man on an every-beat basis. Using multiple parallel inputs wih linear amplification, additional logarithmic amplification, some bandpass filtering, and a logic circuit that ultimately examines and accepts or rejects a deflection as "true" signal, we can record, in most instances, on a beat-by-beat basis, this very valuable component of the cardiac electrical cycle.

Adult↗
PubMed1981

Plasma pancreatic polypeptide and gastrin in the assessment of autonomic activity in acute myocardial infarction.

Measurements of plasma pancreatic polypeptide and gastrin are reported for the first time in patients with acute myocardial infarction and compared with clinical signs of vagal or sympathetic overactivity. Pancreatic polypeptide concentrations were assessed as an index of vagal activity, but elevated values of pancreatic polypeptide found in 7 of the 13 patients on admission did not correlate with clinical evidence of vagal overactivity. The mean pancreatic polypeptide concentrations were not higher in patients with clinical vagal overactivity than in patients with clinical sympathetic overactivity during the 12 h after the onset of symptoms of acute myocardial infarction. Mean gastrin levels were significantly higher on admission and at 4, 5, 6 and 8 h after the onset of infarction in the patients with clinical features of sympathetic overactivity than in the patients with clinical vagal overactivity. Thus plasma gastrin warrants further assessment as an index of sympathetic overactivity in acute myocardial infarction.

Adrenergic beta-Antagonists↗
PubMed1980

A computerized report form for the Cardiac Intensive Care Unit (Cardiac Computer Report - B.M. Kennelly).

A report form is described which has been designed to cover the likely diagnoses of patients admitted to a cardiac intensive care unit. The information entered can readily be stored for computer retrieval and includes biographical and clinical data, information pertaining to medications, procedures, complications, arrhythmias, and electrocardiographic and serum enzyme values, with special reference to patients with acute myocardial infarction. The data is entered by the medical, nursing and secretarial staff prior to encoding and computer storage. The report from which has evolved from its prototype 7 years ago, is described in the hope that it may be a basis for modification to the needs of other cardiac intensive care units presently without a data retrieval system.

Computers↗
PubMed1980

ECG recognition of extent of acute myocardial infarction in ventricular extrasystoles.

A patient has an ECG on admission to the hospital that demonstrated acute transmural inferior and anterolateral infarction. Charges of additional transmural anteroseptal infarction were evident in ventricular extrasystoles but not in conducted sinus beats. The patient died five days after admission, and autopsy confirmed the presence of fresh anteroseptal infarction, in addition to inferolateral and right ventricular infarction.

Cardiac Complexes, Premature↗
PubMed1979

The heart in diabetes mellitus. Part I. Biochemical basis for myocardial dysfunction.

The heart in acutely diabetic animals is subject to multiple inhibitions of glucose metabolism caused by enhanced metabolism of free fatty acids (FFA) and ketone bodies. Such metabolic changes may impair the reaction of the diabetic heart to oxygen lack. In chronically diabetic hearts the increased deposition of triglycerides in the heart and the formation of glycoproteins may underlie the newly recognized clinical entity of diabetic cardiomyopathy.

Alcoholism↗
PubMed1979

Does cimetidine alter the cardiac response to exercise and propranolol?

The recent discovery of histamine (H) receptors in the heart raises the possibility that the H2-antagonist drug, cimetidine, used in the therapy of peptic ulcer, might have cardiac side-effects and might impair the cardiac response to exercise. In 10 normal subjects, cimetidine did not alter the normal heart rate and blood pressure response to treadmill exercise, nor was the effect of beta-blockade by propranolol exaggerated. Thus it appears that the use of propranolol is not necessarily a contraindication to cimetidine therapy, or vice versa. However, further trials on patients with ischaemic heart disease are required to exclude any additive effects of cimetidine and propranolol on the diseased heart.

Adult↗
PubMed1979

Permanent pacemaker implantation in the absence of a right superior vena cava. A case report.

In a patient with syncope and sinus bradycardia the left superior vena cava drained into the right atrium via the coronary sinus. He underwent permanent transvenous pacemaker implantation via the tortuous left superior vena-caval route, and has continued to show normal pacing over an 18-month follow-up period. The problem of pre-operative recognition and the optimum means of permanent and temporary pacing in this condition are discussed.

Aged↗
PubMed1979

Failure to recognize a His bundle potential in complete atrioventricular block.

This report concerns a patient with complete heart block, in whom electrophysiological studies showed at times an escape rhythm with narrow QRS complexes preceded by His potentials with normal HV intervals (35--40 msec) and at other times an escape rhythm of similar rate, having wide QRS complexes of left bundle branch block configuration with no preceding His bundle activity. Complexes intermediate in width and configuration and preceded by His potentials with an HV interval inversely proportional to QRS width were also recorded. These observations are explained by a site of block proximal to the His bundle and competition between two pacemaker foci having similar discharge rates, one situated in the junctional region below the site of block and the other more distally in the right bundle branch or right ventricle. It is proposed that the combination of a proximal site of block and a distally situated dominant pacemaker may be a common reason for failure to record a His potential in patients with complete heart block.

Adult↗
PubMed1978

Electrophysiological studies in four patients with atrial flutter with 1:1 atrioventricular conduction.

Electrophysiological studies of atrioventricular conduction during rapid atrial overdrive pacing and during programmed premature atrial stimulation are reported in four patients with an unusually rapid 1:1 ventricular response to atrial flutter (ventricular rates 240 to 310 per minute). Second-degree AV block development during atrial overdrive pacing at rates well below those during spontaneous atrial flutter. Although none of the four patients showed evidence of pre-excitation on the standard 12-lead electrocardiogram, evidence suggesting a partial AV nodal bypass was demonstrated at electrophysiological study in one case. It is postulated that the profile of the atrial wavefront presented to the normal AV node by atrial flutter differs from that during high right atrial pacing and may account for the lower ventricular rates achieved during high right atrial overdrive pacing than during spontaneous atrial flutter in the remaining three cases.

Adult↗