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Biomedical subjects

C A Clyne

Publications and source records attributed to C A Clyne.

At least 19 recordsLinked to original sources
PubMed1999

Comparison of frequencies of atrial fibrillation after coronary artery bypass grafting with and without the use of cardiopulmonary bypass.

This study compared the incidence of postoperative atrial fibrillation in a group of 34 patients undergoing coronary artery bypass graft surgery without the use of cardiopulmonary bypass and cardioplegia with a control group of 747 patients undergoing coronary artery bypass graft surgery using cardiopulmonary bypass and standard cardioplegia. A trend toward a lower incidence of postoperative atrial fibrillation was found in the group that underwent coronary artery bypass graft surgery without the use of cardiopulmonary bypass (n = 0.06).

Adrenergic beta-Antagonists↗
PubMed1997

Inappropriate pauses during bradycardia pacing in a third-generation implantable cardioverter defibrillator.

Many ICD devices have the capability for back up bradycardia pacing. Because of the use of a single sensing algorithm for both bradycardia and tachycardia functions, they may be prone to certain "sensing errors." Following implantation of an ICD in a patient with long QT syndrome, "inappropriate" pauses were noted during bradycardia pacing, which were exactly twice the programmed pacing cycle length. This was due to an automatic increase in the device's sensitivity during pacing, a characteristic of the automatic gain control of this particular ICD. Proper recognition of this ICD's special features, known as "lower threshold crossing," allowed noninvasive rectification of the problem and prevented these pauses.

Aged↗
PubMed1996

Intraoperative heparinisation, blood loss and myocardial infarction during aortic aneurysm surgery: a Joint Vascular Research Group study.

OBJECTIVES: The primary aim of this prospective multi-centre study involving patients undergoing elective abdominal aortic aneurysm (AAA) surgery was to investigate the relationship between intraoperative intravenous heparinisation, blood loss during surgery and thrombotic complications. METHODS: Two hundred and eighty-four patients were randomised to receive intravenous heparin (n = 145) or no heparin (n = 139). Groups were evenly matched for age, sex, weight, aneurysm size, haemoglobin concentration, platelet counts and distal occlusive disease measured by ankle/brachial systolic pressure. RESULTS: There were no statistically significant differences in blood loss (median 1400 ml vs. 1500 ml; z = 0.02, p = 0.98, 95% C.I. = -200 to 200), blood transfused (4.0 units vs. 4.0 units; z = 1.09, p = 0.28, 95% C.I. = -1 to 0) or distal thrombosis between the two groups. However, analysis of the clinical outcome revealed that 5.7% of the non-heparin group but only 1.4% of the heparinised patients suffered a fatal perioperative myocardial infarction (MI); p < 0.05. All MI, including non fatal events, affected 8.5% and 2% respectively (p = 0.02). CONCLUSIONS: Heparin does not increase blood loss or the need for blood transfusion during surgery. Heparin is not necessary to prevent distal thrombosis when the aorta is cross clamped. The results of the study are consistent with the known mechanisms leading to intraoperative MI and strategies for its prevention. Intravenous heparin, given before aortic cross clamping, is an important prophylaxic against perioperative MI in relation to AAA surgery.

Anticoagulants↗
PubMed1993

Duodenal obstruction following reconstruction of abdominal aortic aneurysm.

Two patients developed duodenal obstruction, believed to be due to collagenous adhesions between the duodenum and the Dacron graft itself, following repair of an abdominal aortic aneurysm. The diagnosis was suspected because of a continuous copious bile stained nasogastric aspirate and was confirmed by upper gastrointestinal barium studies. Conservative management for several days with nasogastric aspiration and intravenous hyperalimentation led to resolution of the obstruction. We believe this complication is probably under-reported but will generally resolve with conservative measures.

Aged↗
PubMed1992

Moricizine.

Explore the source record for details and available documents.

Arrhythmias, Cardiac↗
PubMed1991

Systemic and left ventricular responses to exercise stress in asymptomatic patients with valvular aortic stenosis.

Patients with heart disease may have myocardial ischemia or left ventricular (LV) dysfunction without symptoms. The exercise responses of 14 asymptomatic patients with valvular aortic stenosis (AS) were studied using treadmill testing, thallium-201 scintigraphy and radionuclide angiography. Compared with age- and gender-matched control subjects, patients with AS demonstrated reduced exercise tolerance (10.7 +/- 2.5 vs 13.3 +/- 4.2 min; p = 0.06) and maximal oxygen consumption (26.7 +/- 6.3 vs 36.3 +/- 9.5 ml O2/min/kg; p = 0.004) associated with decreased peak systolic blood pressure response to exercise (177 +/- 18 vs 214 +/- 42 mm Hg; p less than 0.004). Ten of 14 patients developed ST-segment depression during exercise, only 3 of whom had reversible thallium defects. Patients with AS tended to have greater LV ejection fractions at rest (65 +/- 11 vs 58 +/- 7; p = 0.08) and significantly decreased early peak filling rates (4.8 +/- 1.3 vs 6.1 +/- 0.6 stroke volume/s; p = 0.003) compared with those of control subjects. During maximal supine exercise, patients with AS had less of an increase in ejection fraction (2 +/- 9 vs 15 +/- 7%; p less than 0.001) associated with a decrease in end-diastolic (-7 +/- 15 vs +5 +/- 16%; p = 0.06) and stroke (-6 +/- 17 vs +30 +/- 13%; p less than 0.001) volumes from baseline measurements.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Chylous ascites following aneurysm surgery.

A case of chylous ascites occurring after elective abdominal aortic aneurysm repair is described. The patient was initially managed conservatively with hyperalimentation and intermittent drainage of the retroperitoneal collection, but, this proved inadequate and a peritoneo-venous shunt was inserted. Although the shunt appeared to work well the patient finally died of septicaemia.

Aged↗
PubMed1991

The surgical value of community hospitals: a closer look.

To assess and compare the safety and efficiency of a surgical unit at a District General Hospital and a Community Hospital for elective cold surgery. A retrospective survey was made using regional computer Hospital Activity Analysis data and monthly audit meeting records of all inpatients having selected elective general surgical operations on one consultant's firm over a period of one year, at Torbay Hospital, Torquay, (DGH) and Newton Abbot Hospital, Newton Abbot (CH). All inpatients and day cases admitted under CACC from April 1, 1987, until March 31, 1988, were studied comparing mortality, morbidity and efficiency for comparable elective surgical procedures. A postal questionnaire to assess patient satisfaction with surgical care at both hospitals was included in the study. 350 patients underwent elective surgical procedures at the DGH and 380 patients underwent similar procedures at the CH. There was no significant increase in mortality and morbidity at the CH, which was preferred by most patients for routine surgical operations. The Community Hospital unit was found to be satisfactory and more efficient for routine elective surgery as determined from the above parameters and the patients themselves.

Consumer Behavior↗
PubMed1990

Antithrombotic therapy in the primary and secondary prevention of coronary-related death and infarction: focus on gender differences.

Much of our understanding of the role of antithrombotic therapy for postmyocardial infarction patients comes from studies which often included few or no women. Despite this shortcoming there are data available which identify gender differences in risk factors, presentation, natural history and treatment results for myocardial infarction. The use of anticoagulants and antiplatelet agents in the prevention and management of myocardial infarction has evolved over 30 years of investigation. The major randomized, controlled and blinded studies of antithrombotics and myocardial infarction are reviewed, with special emphasis on the female population.

Anticoagulants↗
PubMed1989

The prognostic significance of immunoradiometric CK-MB assay (IRMA) diagnosis of myocardial infarction in patients with low total CK and elevated MB isoenzymes.

Patients with suspected myocardial infarction present a diagnostic problem when they have normal total serum creatine kinase (CK) and an elevated myocardial fraction of this enzyme (CK-MB). We studied 40 patients with normal total serum CK and elevated CK-MB (by standard electrophoretic technique), using an immunoradiometric assay (IRMA) for CK-MB. Diagnosis based on IRMA results of serum samples collected prospectively was compared with diagnosis based on application of strict diagnostic criteria with and clinical diagnosis of the responsible physician(s) by chart review. Diagnostic agreement of all three methods and clinical outcome (mean follow-up 6 months after discharge) were analyzed and compared with two control groups: "rule in" group (17 patients) with elevated total CK, CK-MB, and abnormal electrocardiogram (ECG); and "rule out" group (18 patients) with normal total CK, CK-MB, and ECG. All three diagnostic methods (1) clinical discharge diagnosis, (2) chart review diagnosis by application of strict diagnostic criteria, and (3) IRMA diagnosis, agreed completely for both control groups. Follow-up control group outcomes were in concert with expected outcomes for these groups. Diagnostic differences between methods 1 and 2, and 1 and 3 were statistically significant for the study group. Furthermore, only diagnosis based on the IRMA showed a predictive capability for outcome in this study group when compared with the other methods. Follow-up revealed a similar incidence of cardiac events in the study group (56%) and in the "rule in" control group (60%), but not in the "rule out" group (7%).(ABSTRACT TRUNCATED AT 250 WORDS)

Creatine Kinase↗
PubMed1989

Interdependence of the left and right ventricles in health and disease.

Since the publication of Bernheim's report it has been clear that the anatomic and functional integrity of each ventricle is an important determinant of the functional characteristics of the other ventricle. How the ventricles interact in health and disease has been of interest to many investigators. This article reviews and considers the structure and function of each ventricle as an independent subunit and as a unified pumping system in the healthy state and in various disease states.

Animals↗
PubMed1989

Spontaneous iliac artery aneurysm-ureteric fistula.

Isolated iliac artery aneurysms occur ten times less frequently than aortic aneurysms. Symptoms of compression of other pelvic structures may cause their presentation and occasionally they rupture into adjacent organs. We describe only the third case of spontaneous rupture of an isolated iliac aneurysm into a ureter which led to massive haematuria.

Aged↗
PubMed1989

Fever and urticaria in acute giardiasis.

Travelers' diarrhea afflicts some 250 million people yearly. A number of etiologic agents have been identified, including bacteria, viruses, and parasites. Giardia lamblia is one of the pathogens clearly associated with this syndrome. Typical symptoms of giardiasis that include abdominal bloating and cramps are well known, whereas urticaria has rarely been associated with this illness. An American tourist developed acute giardiasis accompanied by urticaria and high fever. No other pathogens were identified, and response to metronidazole therapy was prompt. Giardiasis should be included in the differential diagnosis of acute urticaria and fever in the traveler.

Acute Disease↗