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Biomedical subjects

D A Reid

Publications and source records attributed to D A Reid.

At least 19 recordsLinked to original sources
PubMed1990

Early clinical results of long coronary arteriotomy, endarterectomy and reconstruction combined with multiple bypass grafting for severe coronary artery disease.

Within a 2.5-year period between 1985 and 1988, long coronary arteriotomy, endarterectomy and reconstruction (principally left anterior descending artery) and multiple bypass grafting (mean graft rate was 9) were performed in 130 of 329 patients (40%) with severe diffuse coronary artery disease to ensure complete myocardial revascularization. Ninety-two percent of the patients who underwent exercise testing had abnormal (greater than 1 mm ST) depression and/or positive results on scintigraphy. Long coronary arteriotomy (5 to 12 cm), endarterectomy and reconstruction of the left anterior descending artery and its branches, were performed in 121 patients; of the left circumflex artery and its branches in 13 patients; and of the right coronary artery and its branches beyond the crux in 18 patients. Single endarterectomy and reconstruction was performed in 109 patients, double in 20 and triple in 1. The operative mortality was 2.3% and the perioperative infarction was 1.5%. Twenty-four patients (among them 38% who had undergone greater than 1 previous bypass operation) were randomly selected and studied within 20 days after surgery. This group comprised a total of 69 coronary conduits of which 68 (99%) were patent, and a total of 206 coronary anastomoses of which 202 (98%) were patent. Thirty-two of 33 conduits (97%) to endarterectomized and reconstructed arteries were patent. One hundred and twenty-six of 127 patients were followed up for a mean of 20 months; 120 of the 121 patients (99%) were in angina class I by Canadian Cardiovascular Society classification, and 63 of 71 patients (89%) had a normal treadmill exercise stress test.(ABSTRACT TRUNCATED AT 250 WORDS)

Coronary Angiography↗
PubMed1988

Comparative use of cold blood potassium cardioplegia in coronary bypass patients necessitating long (2.5-6 h) versus short (less than 1.5 h) aortic cross-clamp times.

In symptomatic patients with severe diffuse multivessel coronary disease undergoing bypass surgery, complete revascularization with multiple bypass grafts using saphenous vein and internal mammary conduits, and multiple endarterectomies may be necessary. Such complex surgeries may require long aortic cross-clamp times in excess of 2.5 h. To evaluate the myocardial preservation provided by cold potassium blood cardioplegia, two groups of consecutive patients using nearly similar surgical techniques were compared. Group A consisted of 100 patients who received an average of 3.8 grafts per patient and had a mean aortic cross-clamp time of 66 (range 15-90) min. Group B was comprised of 100 patients who received an average of 9.3 grafts per patient and had a mean cross-clamp time of 187 (range 150-351) min. Operative mortality and perioperative myocardial infarction were low (0-2%) and were not significantly different between the groups. In addition, the postoperative creatine kinase-MB isoenzyme levels, use of pharmacologic and/or mechanical (i.e., intra-aortic balloon) support, and follow-up exercise treadmill tests were not significantly different in the two groups. These findings suggest that cold potassium blood cardioplegia is equally protective of the myocardium during surgical revascularization in patients with short aortic cross-clamp times (less than 1.5 h) as in those with severe diffuse multivessel coronary artery disease requiring long cross-clamp times exceeding 2.5 h and up to 6 h.

Blood Transfusion, Autologous↗
PubMed1988

Knowledge of schoolchildren about the acquired immune deficiency syndrome.

Teenage schoolchildren are often sexually active and first experiments with drugs can occur at this age. A questionnaire survey of the knowledge and source of information about the acquired immune deficiency syndrome was carried out on 232 15-year-olds at a school in Fife. The results showed that this younger age group is well-informed about AIDS, particularly methods of transmission of the virus, and that the majority of information was obtained from television (95%) and leaflets (85%).

Acquired Immunodeficiency Syndrome↗
PubMed1987

Multiple (more than eight) bypass grafts in severe diffuse coronary disease: improved exercise tolerance and functional classification in seventy-seven consecutive patients.

During a 43-month period (May 1981 to December 1984), 77 consecutive patients underwent multiple (eight or more) coronary artery bypass procedures using saphenous vein conduits for severe diffuse triple-vessel coronary artery disease. Patients received from 8 to 14 grafts (average 9). All coronary arteries and branches that were at least 1.5 mm in diameter and greater than 50% obstructed were bypassed. The operative mortality rate was 1.3%. Seventy-six of 77 (98.7%) patients are alive at a mean follow-up of 2 years. According to the Canadian Cardiovascular Society Angina Criteria, before surgery 5 patients (6%) were classified class I, 8 (10%) class II, 43 (56%) class III, and 21 (27%) class IV. After surgery all 76 patients were class I. Of 59 patients who had undergone bypass surgery who were followed by exercise testing according to the modified Bruce protocol, 47 exercised to greater than or equal to 85% heart rate. Among these patients, 44 (94%) had a normal exercise test result and only 3 had greater than or equal to 1 mm ST segment depression. Thus, patients with severe diffuse coronary disease can undergo multiple (eight or more) bypass grafting procedures with low mortality rates and improved exercise tolerance and functional classification.

Adult↗
PubMed1986

Sternal dehiscence: pericostal guy wires equals sternal stability.

Our five-year clinical experience with 11 patients treated with pericostal guy wires has uniformly established sternal stability, primary bone healing, and rapid resolution of infection. The stable anterior chest wall helps abolish cardiopulmonary complications (i.e., progressive pulmonary insufficiency, atelectasis, and low cardiac output) commonly associated with sternal dehiscence.

Bone Wires↗
PubMed1985

Improved stress test results after multiple coronary grafting.

Compared with previous reports that have addressed the issue of preoperative and postoperative stress testing in coronary artery bypass grafting, our results show a 30 percent improvement in the conversion rate from abnormal to normal. In a group of patients with severe coronary artery disease, we have been able to obtain normal stress test results postoperatively. Modern surgical techniques, including the use of blood cardioplegia and other methods of myocardial preservation, have allowed for safety in doing adequate grafting. From our population, we identified a select group of patients (approximately 30 percent) who require 6 or more grafts for complete revascularization. Although our follow-up of 30 months is relatively short, we are encouraged by the results so far. We believe that more than 90 percent of patients can be converted to normal postoperative stress test results after adequate coronary artery bypass grafting.

Adult↗
PubMed1984

Digital deformities and dental malocclusion due to finger sucking.

The habit of finger and thumb sucking in infancy usually ceases spontaneously by the age of 5 years. If the habit is not broken, serious deformities of the digit may appear along with significant disturbance of the dental occlusion. If diagnosed early, the habit can be broken and the threatening disturbances of digital growth and dental occlusion will resolve spontaneously. If not, even more complicated surgical and orthodontic measures may be required. Five such cases are reported.

Adolescent↗
PubMed1984

Controlled trial of the Grassi (pH) intraoperative test for completion of proximal gastric vagotomy.

Forty-eight patients undergoing PGV for duodenal ulcer were randomized to Grassi test (24) or no test (24). Operations were performed by surgeons who were Fellows of the Royal College of Surgeons trained in the technique of PGV and every effort was made to complete the vagotomy if the test was positive. Patients were assessed by standard pentagastrin test preoperatively and postoperatively. The two groups were closely matched for age (Grassi 48, non-Grassi 43), sex (Grassi 20 males; non-Grassi, 21 males), preoperative BAO (6.4 +/- 1.2 S.E.M. millimols hydrogen ions per hour and 6.6 +/- 0.9 S.E.M. millimols hydrogen ions per hour) and preoperative PAO (45.5 +/- 2.1 S.E.M. millimols hydrogen ions per hour and 40.5 +/- 2.6 S.E.M. millimols hydrogen ions per hour). Postoperatively, the BAO was 1.2 +/- 0.4 S.E.M. millimols hydrogen ions per hour for the Grassi group and 0.8 +/- 0.2 S.E.M. millimol hydrogen ions per hour. The postoperative PAO (pg) for the Grassi group was 19.1 +/- 0.9 S.E.M. millimols hydrogen ions per hour and for the non-Grassi group, it was 19.5 +/- 1.9 S.E.M. millimols hydrogen ions per hour. The mean reduction in PAO (pg) were 57.0 +/- 4.3 per cent for the Grassi group and 51 +/- 4 per cent for the non-Grassi group, but two patients in the non-Grassi group had a reduction of less than 10 per cent, one of whom has had recurrent symptoms at three months. Eight Grassi and four non-Grassi patients had reductions of greater than 65 per cent. The mean operating was 110.0 +/- 6.8 minutes for the Grassi patients and 87.0 +/- 3.1 for the non-Grassi patients.

Adult↗
PubMed1982

Late follow-up of highly selective vagotomy with excision of the ulcer compared with Billroth I gastrectomy for treatment of benign gastric ulcer.

We present the late results of a prospective randomized trial of highly selective vagotomy with excision of the ulcer (HSV + E) (n = 26 cases) versus standard Billroth I partial gastrectomy (BI) (n = 30). The operations were performed by registrars, senior registrars or consultants. Results of postoperative morbidity, functional outcome and recurrence rates have previously been reported at an average follow-up period of 4 years (1), at which stage neither operation offered a distinct advantage. At an average follow-up period of 8 years, 54 of the original 56 patients have been reassessed, using a standard Visick grading. HSV + E offers a better symptomatic result. There is an increased recurrence rate in both groups with time, 6 following HSV + E and 5 following BI gastrectomy.

Clinical Trials as Topic↗
PubMed1981

Anomalous right subclavian artery arising proximal to a postductal thoracic aortic coarctation.

Approximately 1% of patients with postductal thoracic aortic coarctation have an associated anomalous right subclavian artery. Previous reports indicated that the aberrant right subclavian vessel arose distal to the coarctation site. The case of a patient is presented in whom the anomalous right subclavian artery originated proximal to the postductal coarctation. We believe this to be among the first reports of this entity. The embryological development pathway and clinical implications of this congenital defect complex are discussed.

Abnormalities, Multiple↗